Therapy needs neurodivergent minds.

Neurodivergence, empathy, and the politics of therapy

Too many neurodivergent people enter therapy only to find themselves re-enacting the very dynamics that brought them there. Being misunderstood. Pathologised. Encouraged: ever so gently, back toward “normal.”

It isn’t always intentional. Often it’s structural.

Psychotherapy was built on neurotypical blueprints: ideas of communication, regulation, attachment, and progress shaped through a narrow cultural and neurological lens. And, if we’re honest, a slightly misogynistic and male-centric one too.

The early models of the mind were written mostly by men, for men, about men (and I wrote about it some time ago as well!) imagining objectivity as neutrality and detachment as strength. Emotional regulation was defined through the capacity to contain, rather than express. Dependence was pathologised, intuition dismissed, sensitivity labelled hysterical.

Even our language of “good therapy”: eye contact, emotional expression, relational tolerance, flexibility, assumes a shared sensory and cognitive world. It rewards those who communicate in familiar ways, and quietly corrects those who don’t.

For those who don’t inhabit that world, the message is quiet but persistent: You are the exception, not the example.

The limits of translation

The Double Empathy Theory (Damian Milton, 2012) shifted the conversation. It proposed that communication breakdowns between autistic and non-autistic people are not due to autistic “deficits,” but to mismatched experiences of reality. Empathy doesn’t fail because one person lacks it, it fails because both are reading the world through different sensory grammars.

When therapy happens across those differences without awareness, the client ends up doing the translation work. Masking. Interpreting. Editing their inner world into something legible for the therapist’s comfort.

The room becomes another site of labour.

Does your therapist need to be neurodivergent?

This question surfaces often, and it’s worth slowing down with it.

No, a therapist doesn’t have to share your trauma, diagnosis, or story to hold you well. If that were the rule, therapy would collapse into self-mirroring.

But neurodivergence is not just a life event. It’s a way of processing the world: a rhythm, a nervous system, a sensory architecture, a mode of attention and meaning-making. It shapes how safety feels, how regulation happens, how language lands.

A neurodivergent therapist doesn’t automatically offer safety, but they may carry a different fluency. A shared shorthand. A natural awareness of when “flat affect” is actually calm, or when silence is processing rather than avoidance.

Sameness is not really what matters here (no two neurodivergent experiences are the same anyway!). It’s about not having to translate every part of yourself before the real work can begin.

Lived experience and epistemic justice

When we talk about lived experience, we’re not talking about identity politics for its own sake. We’re talking about epistemic justice: whose knowledge counts.

Miranda Fricker (2007) defined epistemic injustice as what happens when someone’s voice or way of knowing is dismissed because of who they are. In therapy, that injustice can look like a client’s bodily knowing being reframed as dysregulation. Their intensity described as pathology. Their avoidance mistaken for resistance.

To be neurodivergent-informed is not simply to “work with ND clients.” It is to interrogate the foundations of our field. To ask who was assumed in the early research, in the models of transference, in the definitions of emotional maturity.

The answer, almost always, is not us.

What this asks of the profession

For training institutions, this means more than adding a token lecture on neurodiversity. It means re-examining what we call attunement, progress, and repair. It means teaching future therapists to listen beyond their own nervous systems, to meet difference without interpreting it through pathology.

For supervisors and practitioners, it asks humility: to notice when we are interpreting discomfort as failure, or speed as avoidance, simply because it sits outside our own pattern.

And for neurodivergent therapists: many of whom have been taught to mask even in professional life, it asks courage to practise in a way that honours our rhythms. To let our sensitivity, our pattern-thinking, our nonlinear empathy be part of the work rather than something to hide.

Recognition as safety

Therapy doesn’t need to be comfortable to be good. But for many neurodivergent clients, safety begins in recognition, the moment the therapist stops translating difference into disorder.

Because healing doesn’t happen when someone finally teaches you to act normal. It happens when someone meets you as you are and says, nothing about you needs fixing to be understood.