“You don't look autistic" - coming out as an autistic therapist

An autistic counsellor? And a person-centred counsellor at that?

The stereotype says that autistic people lack empathy, theory of mind and the capacity for self-reflection, so how can that be? Well, it may just be that, like so many stereotypes, it contains a grain of truth and no more. 

Autism is a particular “brain-wiring”; a particular way of processing both internal and external experiences. So, we will have certain things in common and certain things not; lack of empathy is not one of those things we have in common, but it is understandable that it may seem so to non-autistic (neurotypical) people.

The truth is that the difficulty goes both ways. This is summed up in Damian Milton’s “double empathy” theory. It points out that empathy is a bidirectional phenomenon: it goes both ways. The autistic and the neurotypical understand and experience the world in radically different ways, neither one better or worse than the other; it is inevitable that they will have difficulty understanding and feeling for one another.

I realised I was autistic about seven years ago when I met a group of autistic women. There were none of the usual communication difficulties.

These were people who instantly knew what I meant; none of the endless explaining that otherwise seemed necessary with all but my closest friends. I was at home - I understood not just my present but also my past.

I saw no reason to want a diagnosis, any more than I need medical confirmation that I have blue eyes, or that I am female, white, empathic, creative and logical. At that time it didn’t occur to me that there might be another reason, a reason not for me but for others. 

Like most intelligent autists, I have learned to “speak neurotypical” fluently and empathising with neurotypical clients is second nature. However, it remains second nature, a fact which I can forget until I meet an autistic client - and experience the "first nature" of empathising with a person who works on the the same "operating system" as I do.

If I still notice the difference after a very long time on this neurotypical planet, it would be surprising if a neurotypical person did not struggle to understand and empathise with the autistic minority.

It’s like the early days of personal computers when Apple and Microsoft were so different they could barely communicate with each other. Both operating systems were fine, with weaknesses and strengths. In the techno-world, we are no longer in a situation in which a Mac user receives a Windows file has to either convert it to the Mac format or say "Sorry, I can’t open it." But in the neuro-world we still are.

Until very recently – and, indeed, mostly still – autism and autistic people have been studied and described by neurotypicals. The distinction boils down to this: neurotypicals see and describe our “behaviours”; we (insofar as we have a voice) feel and describe our experiences. 

You see a tantrum resulting from being difficult, picky or disobedient. We experience a meltdown resulting from sensory, demand or cognitive over-stimulus. You think you see a panic attack and you talk to us. But we are experiencing a shutdown and the more you talk the worse we’ll get because it is not caused by the fight-flight-freeze response but by sensory and cognitive overload.

You see a difficulty or a disability that needs to be treated or cured. We experience a society that is bent on denying our natural difference and making us be other than we genuinely are.

You see mind-blindness. We experience frustration that you cannot understand us even when we either explain with minute precision or demonstrate that we are overwhelmed. Frustration that you expect us to read your mind, know your unwritten rules, speak your language when it is not our language. We get it wrong all the time – as one does when one is learning a language. You see mind-blindness, but who is mind-blind? Us? You? Both and neither. We are both simply experiencing the problem of double empathy. 

However – because they are in the majority – neurotypicals typically expect autists to understand them and conform to their ways of being (that is the aim of almost all “therapy” for autistic children, with greater or lesser degrees of coercion and even abuse), but it doesn’t generally occur to them to do the same for autists.

As a counsellor at a university student counselling service, I had of course worked with autistic students. Sometimes I thought “It might be helpful to this person if they knew that I was also autistic”. 

I am a survivor of spiritual abuse, and I have always been open about that in my practice because spiritual abuse is not widely known about or understood. A survivor looking for a therapist will likely be searching for someone who does understand, and that’s likely to be another survivor. So why, given that the same could apply to an autistic or possibly-autistic client, did I hesitate to “come out” as an autistic therapist?

First, there is a huge body of work on autism, and a bewildering number of experts. I knew, academically, little about autism. I hadn’t read all the research, all the publications. While there’s not a lot written on spiritual abuse, and I have read most of the significant work in my journey to understanding my own experience. I should surely, therefore, either do the same with autism or else remain – so to speak – incognita.

Then I realised that in the field of spiritual abuse, almost every book, article, conference, is written, hosted, attended, by survivors. By people who knew from inside what they were talking about. Not by experts who observed the behaviour of survivors and drew their own conclusions as to what the experience of being spiritually abused and surviving was all about.

The opposite is the case in the field of autism. Almost all books, articles, conferences, and courses in that field are written, hosted and attended by people who are not autistic but neurotypicals. They are “expert” either through study or through having an autistic family member; observing the behaviour of autists and drawing their own conclusions as to what the experience of being autistic is all about.

I could no longer claim not to be an expert. I am not an expert through study or through observing a family member, but through lived experience in my own being. My own autistic being. 

Also, I wondered would happen to my practice if I outed myself as autistic. How would a client, searching in a counselling directory for help, feel about contacting an autistic therapist? Would those stereotypes mean that my practice might vanish? I didn’t know, but I did know that I had a responsibility towards my fellow autists. 

And then my first autistic private client arrived. The experience was extraordinary. Since very early in our therapeutic relationship I have been completely open with them about my own autism.

They have found it really helpful to be talking with someone who understands what is normal autistic experience and behaviour and can distinguish between (as they put it) “the Aspergers, which is fine and simply how I’m made, and the anxiety, the OCD, the eating disorder... which are not fine and which are adversely affecting my life.” 

It was that experience that made me decide to get a diagnosis, thus giving myself the option of becoming an “officially autistic” therapist.

Then, as lockdown began, I was offered funding for brief therapy with self-referred autistic women. It became crystal-clear that an autistic-autistic therapeutic relationship had quite a different quality from an autistic-neurotypical one. The same quality, I imagine, that a neurotypical-neurotypical one has; but so much more precious because it's so much rarer. No longer second nature but first nature.

I have now added my autism to my entry here and my Facebook page. I have noticed no drop in contact from neurotypical clients. But what I have noticed is an increase in people who contact me because I am autistic - just as people contact me because I am a survivor of spiritual abuse.

We autists need to be “out” and living our own authentic lives. And the neurotypical world needs our different perspective, our different way of being. So let me encourage any autistic therapists who might be reading this to come out, and both sides to listen to each other. Vive la différence!