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​​How to bring up autism to a therapist

 Image of a therapist and a client, representing how to bring up autism to a therapist.

It’s remarkable how many people have suspicions that they might be autistic, but they don’t know how (or don’t feel comfortable) to bring up autism with their therapist. They may be nervous that they won’t be taken seriously or they may be  scared they will be dismissed or misunderstood.

If you don’t feel safe, comfortable, or welcome to share your thoughts, concerns, or ideas with your therapist, those feelings are worth looking into. 

Ideally, a therapist helps you feel affirmed and supported in all the things you’d like to explore with them, including autism. However, the unfortunate reality is that for many late-identified autistic adults, especially those who have treatment histories, it’s likely that this apprehension comes from a pattern of being dismissed or invalidated by professionals in the past. 

Many of us have cycled through therapists or medical providers who didn’t make us feel safe or affirmed to show up as who we are, making us more guarded over time. We may not share the things we want or need to share because we’re protecting ourselves from that familiar feeling of being misunderstood or having our ideas rejected. 

If you’re wondering how to bring up autism to a therapist, the following guidance and suggestions may be useful preparation.

Check their expertise
It may be a good idea to first get a read on their expertise. Ask the therapist what they know about autism, what they know about neurodiversity, if they have ever worked with an autistic adult, and if so, in what capacity. If it becomes clear that their experience is limited or they only have a basic understanding, this could be an indicator that they are not well-equipped to explore the topic further with you, provide sufficient psychoeducation, or adequately support you in the neurodivergent exploration process. 

Check their views
Experience working with autistic people doesn’t necessarily mean that a therapist is neurodiversity-affirming. There are a few ways you can figure out if your therapist is actually affirming or if they strictly subscribe to a more medical, pathologizing model. The first tip is to notice whether they use identity-first or person-first language. Using person-first language (i.e. by saying a person with autism) may indicate that they aren’t aware or respectful of the preferences of a majority of the autism community who prefer identity-first language (i.e “autistic person”). Another hint is if they use the terms high or low functioning to describe autistic people, they are probably not familiar with neurodiversity-affirming language or practice. Ask them what they think about the term “high-masking.” If they can’t give you a clear and affirming answer about how autism can go unidentified in people who are high-masking, that might mean that if you bring up autism to your therapist, they may not understand, respect or recognize your own lived experience as a late-identified adult.

Tell them how you feel
If you’re wondering how to bring up autism to your therapist, that could mean you’re unsure about how they’ll react or what they might say. It’s perfectly acceptable to tell them that you’d like to bring something up, but you’re feeling nervous, unsure, hesitant (insert how you feel here). Expressing your hesitance or uncertainty around  a specific topic with them can help to build trust in the therapeutic relationship. Maybe you say something like, “I want to talk to you about a certain topic, but I’m worried that I might be judged or dismissed. I’d like to just neutrally explore it with you.” It’s okay to share any reservations or concerns you have with your therapist. This may set the tone for a productive and valuable conversation. 

Write down your experiences
If you have been researching and learning about autism and have found yourself relating with specific traits or characteristics, feel free to write them down if you think it would be helpful. Some people choose to put together a binder or document of all their experiences related to autism so all the details are in one place. You can always refer to your notes to help you express or explain yourself fully when you talk to your therapist about autism. This can be a way to ensure you don’t forget to mention something important to you.

Share your truth
You can bring up autism to your therapist in whatever way feels right to you. Share your truth. Share as much or as little as you would like. There is no one answer about how to bring up autism to your therapist, and you can do so at any point in your process. You can even bring up autism to a brand new therapist before you begin therapy, so it’s clear from the beginning that you’re looking for autism-affirming support.  

This also doesn’t have to be a conversation that happens during just one session. You can keep bringing it up whenever you want. Remember that this is your therapy. You decide what you would like to talk about, explore, or work on. 

Ask for support
If it becomes clear that your therapist isn’t giving you the support you are looking for, or if autism is outside of their scope, you can ask them to provide referrals for providers who do specialize in adult autism. 

Talk to the experts
At NeuroSpark, you don’t have to worry that your concerns or experiences will be dismissed or invalidated by your therapist. We specialize in late identified autism in adults, and our therapists welcome you to share and explore your autistic identity and experiences without judgment or invalidation. Both therapy and coaching are appropriate venues to engage in conversations about your autistic identity and experiences, and if you would like to explore the possibility of diagnosis, you can also decide to pursue an autism assessment with us. All ways of discovery are valid.