Many neurodivergent adults arrive at therapy already carrying fatigue that has been years in the making. Not just tired from daily life, but tired from translating themselves, adjusting their needs, and being told to try again in spaces that were never built with them in mind. Often, they come in hoping therapy might help, while quietly bracing for disappointment.

For people with ADHD, autism, or AuDHD, therapy often has not failed because they lacked insight, effort, or motivation. It has failed because it asked them to adapt to systems that did not recognise their nervous systems, communication styles, or the conditions shaping their lives.

“Neurodivergent adults often experience therapy differently because many models were developed without attention to sensory systems, executive functioning differences, or the long-term impact of masking. When these factors are overlooked, therapy can feel misaligned rather than supportive.” - Ana Mena

If you are an ADHD, autistic, or AuDHD adult and this sounds familiar…

You Might Notice	Therapy Often Felt Like
You left sessions feeling more depleted than supported	Another place where you had to explain or justify yourself
Strategies worked briefly, then stopped	Evidence that you were inconsistent or doing something wrong
You were encouraged to build better habits	No one asked what your body or mind could actually sustain
You learned coping tools but remained burnt out	More expectations layered onto exhaustion
You felt misunderstood or mislabelled	An explanation that never quite fit your experience

If you recognise yourself here, you are not alone.

When therapy assumes a “typical” nervous system in ADHD and autistic adults

Many therapy models were built around ideas of consistency, linear progress, and verbal self-reflection. These expectations often go unnamed, yet they shape how sessions unfold and how success is measured.

Therapy may rely on sustained attention, quick emotional processing, or homework that assumes stable executive function. Progress is sometimes equated with visible calm, behavioural consistency, or the ability to apply strategies week after week.

For neurodivergent adults, this can feel quietly punishing. Attention shifts. Energy fluctuates. Capacity is shaped by sensory input, safety, stress, and environment.

When therapy does not account for this, clients may leave believing they are failing treatment, rather than recognising that the structure itself was misaligned.

Being asked to adapt instead of being understood

Many neurodivergent clients learn early that care is conditional. They are often expected to meet therapy where it is, rather than being met where they are.

This can show up as pressure to maintain eye contact, sit still, communicate emotions in narrow ways, or complete exercises that feel unreachable during burnout.

It can also appear through quieter messages, that stimming should be minimised, that sensitivity should be reduced, or that discomfort is something to push through.

Over time, therapy can become another place where masking is required. Clients may become skilled at sounding reflective, regulated, or cooperative, while feeling increasingly disconnected from themselves.

When behavior is separated from context

Many neurodivergent adults have spent years hearing the same instructions repeated in different forms. Manage your time better. Try harder. Be more disciplined. These messages often show up in therapy too, especially when the focus stays on habits or skills without curiosity about the conditions shaping them.

Executive dysfunction is not a character flaw. Burnout is not a sign of weakness. Sensory overload is not an overreaction. When these experiences are placed back into the realities people are living inside of work demands, relational expectations, economic pressure, and long-term stress they begin to make sense.

When context is left out, responsibility quietly shifts onto the individual. People start to carry blame for struggles that were never solely theirs to hold. Shame settles in. Motivation thins out. Trust, both in the therapeutic process and in oneself, becomes harder to sustain.

When experiences are misread or renamed

Autistic shutdown is often mistaken for depression. ADHD burnout may be framed as avoidance or lack of effort. Emotional intensity can be treated as instability rather than a nervous system under strain.

Without attunement to neurodivergence, therapy can lead to misdiagnosis or guidance that does not fit. Clients may be encouraged toward goals that feel unsafe, unsustainable, or disconnected from their lived reality.

For those who receive a late diagnosis or come to self-identify later in life, earlier therapy experiences can suddenly make painful sense. What once felt like personal failure may reveal itself as misrecognition.

Why coping skills alone often fall short

Many neurodivergent adults are not lacking coping skills. They have been coping for a long time.

They have learned how to endure environments that demanded constant adaptation, self-monitoring, and restraint. Therapy that focuses only on regulation tools or productivity strategies can miss the deeper work that is needed.

This work often involves unlearning internalised blame, recognising the cost of long-term masking, and rebuilding trust with one’s body and limits. Without this foundation, even helpful tools can feel like additional demands placed on an already overloaded system.

What neurodivergent-affirming therapy shifts

Neurodivergent-affirming therapy begins with listening rather than correction. It treats ADHD, autism, and AuDHD as meaningful ways of experiencing the world, shaped by history, environment, and relationship.

Pacing is flexible. Communication adapts to the client. Capacity is understood as variable, not something to overcome. Sensory needs are taken seriously. Progress is defined together, rather than imposed.

Context remains central. Therapy pays attention to how identity, access, culture, and systemic pressure shape distress. The work is not about fitting better into harmful conditions, but about finding ways to live that feel more inhabitable and less extractive.

Rebuilding trust after difficult care

If therapy has not worked before, it makes sense to be cautious. Many neurodivergent adults arrive guarded, unsure whether it is safe to hope for something different.

Affirming therapy does not rush this. It does not require proof, performance, or optimism. There is room to name disappointment, harm, and fatigue. There is room to move slowly.

Over time, therapy can shift from fixing to understanding, from managing symptoms to restoring relationship with self.

When therapy begins to feel different

For many neurodivergent adults, therapy starts to change when they no longer have to translate themselves. When stimming is not questioned. When rest is respected. When burnout is recognised as a signal rather than a flaw.

Feeling understood does not erase difficulty, but it often opens space for gentler forms of change.

Finding support that fits

Not every therapist is trained to work affirmingly with neurodivergent clients, and it is reasonable to ask questions before committing. Therapy should feel collaborative, not evaluative. Support should adapt to your nervous system, not ask you to override it.

At Phoenix Rising Centers, we offer neurodivergent-affirming therapy for ADHD, autistic, and AuDHD adults across Rhode Island, Massachusetts, Colorado, and Georgia. Our clinicians work with consent, pacing, and real-life capacity in mind.

If therapy has not worked for you before, it does not mean therapy cannot work. It may mean you have not yet been met in the ways you needed.

If You’re Considering Support

If parts of this resonated, it may be a sign that you are seeking care that works differently. Support can begin with a conversation, not a commitment. You can take time to ask questions, share concerns, or simply name what has not worked before.

At Phoenix Rising Centers, we offer neurodivergent-affirming therapy for ADHD, autistic, and AuDHD adults across Rhode Island, Massachusetts, Colorado, and Georgia. Our consultations are a space to explore fit, pacing, and what feels possible right now.

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