The hidden trauma of being misunderstood as an autistic person

Have you ever walked away from a conversation wondering what you said wrong or feeling totally misunderstood, pondering how you could have explained your thoughts and motivations better? These are common questions for many autistic people who share the unfortunate experience of spending years feeling and being misunderstood, questioned or dismissed.

When you have experienced hundreds of repetitions of this over time, it’s easy to understand why so many autistic people might end up doubting their instincts, masking and ignoring their own boundaries. The lesson they are taught again and again is this: your beliefs, your perceptions and your feelings are simply wrong.

But research suggests there may be more behind these experiences of being misunderstood. Research has found that differences in autistic people’s communication styles, facial expressions, use of eye contact and body language can impact how other (presumably non-autistic) people perceive or interpret them (Lim, 2021).

Another study found that out of 1,200 autistic adults, 24.6% overall received at least one psychiatric diagnosis they felt was a misdiagnosis before their autism was recognised. For autistic women alone, this figure rose to 31.7%. Many of those participating in this study described years of struggles to gain an autism diagnosis as their symptoms and experiences were frequently misunderstood as anxiety and depression (Kentrou, 2024).

When misunderstanding leads to self-doubt

Many autistic and other late-diagnosed neurodivergent people talk about the pain of being told that they’re too sensitive, lazy, dramatic or difficult. Another common experience is minimisation of their distress to the extent that they doubt their own instincts and reactions to boundary violations.

Repeatedly hearing such deeply negative interpretations of their reactions, behaviour and traits can leave autistic people struggling to reconcile the version of themselves others see with the person they know themselves to be inside.

The cost of not being believed

When considering the repeated invalidation experienced over many years, it becomes easier to understand why some autistic people may experience:

• chronic self-doubt
• perfectionism
• people-pleasing
• masking
• anxiety
• burnout
• difficulty asking for help
• constantly justifying themselves
• having a harsh inner critic.

After years of hearing that you're overreacting or imagining things, it's hardly surprising that some autistic people might begin questioning their own reality.

How therapy can help

The chronic low-level trauma of constantly feeling the need to explain and defend your actions, beliefs or needs is particularly painful, and over time this can lead to exhaustion and burnout as well as genuine crises around identity and belonging.

But with help from a therapist who understands autism and the impact of these common negative experiences, autistic people can have the opportunity to:

• Understand the origins of their self-doubt.
• Separate their identity from other people's misunderstandings.
• Develop pride in being themselves.
• Process the grief of years spent feeling unseen.
• Develop greater trust in themselves, their intuition and boundaries.
• Let go of shame.
• Understand the impact of masking and chronic stress.
• Learn advocacy skills and let go of guilt around boundaries.
• Build relationships where they feel understood and accepted.

It’s understandable if you have doubted yourself if you've experienced years of feeling misunderstood or having your concerns dismissed. Therapy can't and won’t change the past, and grieving past losses and misunderstandings can be deeply painful. But therapy can help you understand how those experiences have shaped you, process them, and develop more self-compassion and advocacy skills to protect yourself in the future.

References 

Kentrou, V., Livingston, L.A., Grove, R., Hoekstra, R.A. and Sander Begeer (2024). Perceived misdiagnosis of psychiatric conditions in autistic adults. EClinicalMedicine, 71(4), pp.102586–102586. doi:10.1016/j.eclinm.2024.102586.

Lim, A., Young, R.L. and Brewer, N. (2021). Autistic adults may be erroneously perceived as deceptive and lacking credibility. Journal of Autism and Developmental Disorders, 52(2). doi:10.1007/s10803-021-04963-4.