By Amy Peters, 2025

Many neurodivergent clients arrive in therapy with a complex mix of lifelong traits and trauma responses and it’s not always clear where one ends and the other begins. As counsellors, we may struggle to untangle what we’re seeing. Is their hypervigilance a result of trauma, or the culmination of years of masking? Is emotional withdrawal a shutdown response, or a need for sensory solitude? In reality, it may be both.

This article builds on my previous writing on the Neurodivergence Trauma Cycle by offering a deeper exploration of how therapists can understand, hold, and work with this ambiguity in clinical practice, without pathologising neurodivergent traits or bypassing trauma. It’s designed to support affirming, trauma-informed approaches with autistic, ADHD, and otherwise neurodivergent clients, and to contribute to ongoing professional dialogue and research.

Trauma and Neurodivergence

The intersection between trauma and neurodivergence presents a significant yet often misunderstood dimension of psychological health. While Autism, ADHD, and other forms of neurodivergence have traditionally been approached through a deficit-based or pathologising lens, emerging affirming frameworks highlight the need to reconceptualise these experiences via a socially conscious and compassionate paradigm.

Neurodivergent individuals frequently encounter high rates of trauma, including abuse, victimisation, and systemic marginalisation (Kerns et al., 2015; Petty et al., 2021). These experiences are further compounded by the chronic stress of navigating a predominantly neurotypical society. The lived experience of neurodivergence in such a context can, in and of itself, constitute a form of trauma, particularly when misunderstood or invalidated by peers, educators, professionals, and even therapists.

For professionals working therapeutically, this presents additional challenges . Without a clear framework, there’s a risk of misattributing trauma-related behaviours to neurodivergence, or vice versa. Traits such as emotional dysregulation or hypervigilance might be interpreted through a purely diagnostic lens, missing the context of lived experience and systemic harm. Therapists may inadvertently pathologise adaptive responses, reinforce internalised shame, or attempt to “treat” traits that are not inherently problematic. This can lead to ruptures in the therapeutic relationship, missed opportunities for healing, and ultimately, further harm.

The Neurodivergence Trauma Cycle

To conceptualise this lived experience, I developed the Neurodivergence Trauma Cycle, which maps the compounding effects of living as a neurodivergent person in a world not set up for us. The cycle begins with repeated negative experiences and miscommunications, which create internalised shame and self-blame. In an attempt to mitigate these experiences, individuals often adopt masking behaviours, consciously or unconsciously suppressing their natural traits to avoid judgment or rejection.

This masking leads to hypervigilance, a heightened state of awareness and social monitoring, often accompanied by an overactive nervous system. The result is an intensification of stress, anxiety, and ultimately, burnout. Importantly, this trauma cycle is self-perpetuating and often remains unrecognised, especially in late-identified or undiagnosed neurodivergent individuals (Peters, 2024).

The Need for Neurodivergent-Affirming Therapy

Mainstream therapeutic models often fail to account for this cycle. Worse, they can inadvertently reinforce it by imposing neuronormative expectations or misinterpreting neurodivergent communication styles and sensory needs. I advocate for an affirming therapeutic stance that recognises neurodivergent experiences as valid, not pathological. My DIVERSE model outlines the seven key principles that can help professionals work towards neurodivergent affirming practice – including the need to challenge our biases, understand intersectionality and internalised ableism, and to shift the therapeutic focus from “fixing” to supporting.

My forthcoming book, Neurodivergent Affirming Therapy: Rethinking Approaches for Autistic and ADHD Clients (2026), expands upon this and offers a comprehensive guide for therapists working with neurodivergent clients. Alongside client reflections, case studies and my own personal insights, it introduces several practitioner tools, including the SCENE Approach and the DIVERSE Model, while addressing key topics such as masking, communication differences, burnout, and rejection sensitivity.  Notably, each chapter also includes a section specifically for neurodivergent therapists, recognising their dual lived and professional experience.

Implications for Practice

An affirming approach doesn’t require therapists to draw a definitive line between trait and trauma. Instead, it asks them to remain curious, collaborative, and attuned, supporting the client in exploring how both neurodivergence and trauma shape their experience, without assigning blame or reducing complexity. When we prioritise safety, autonomy and compassion in the therapy room, a client can feel free to explore their mask, their neurodivergent traits and their trauma background. 

In addition to needing robust knowledge of neurodivergent traits from a nonpathological viewpoint, therapists must approach neurodivergent clients with an understanding of the social and relational nature of trauma in this population. The goal is not to interrogate the source of each trait, but to offer safety, validation, and co-created support.  Repeated misattunement or misunderstanding in therapy can reinforce masking and compound harm. 

In practice, this means creating space for clients to be themselves without judgment, without pressure to explain, and without fear of being misread. It involves holding neurodivergent traits with curiosity and compassion, rather than as symptoms to be corrected. Therapists must resist the pull to pathologise difference, especially when it may be an expression of adaptation, not disorder.

Working with trauma in neurodivergent clients requires an attuned, relational stance. Rather than searching for neat distinctions between what is a “trait” and what is “trauma,” we attend to what is showing up in the room: the responses, the unmet needs. We approach masking as a survival strategy, not resistance. We notice when the client moves into shutdown, and we respond with care, not correction.

Ultimately, we support neurodivergent clients as we would any client: by offering the safety they need to feel, to reprocess, and to rest. When trauma is met and gently processed, what remains is the person’s neurodivergence. And when, as therapists, we can help the client understand their own unique neurodivergent identity (as well as the wider context of ableism and stigma), they can start accommodating themselves and working towards acceptance. 

Tools like the Neurodivergence Trauma Cycle can serve as therapeutic maps, helping bring awareness to the systemic, pervasive messages and experiences that can create trauma for neurodivergent people. This validating approach helps both client and therapist work towards supporting neurodivergent traits to be integrated and accommodated, rather than ousted or pathologised.

References

• Peters, A. (2024). Neurodivergent Trauma Cycle. Newglade Counselling. Retrieved from https://newgladecounselling.co.uk/blog/
• Kerns, C. M., et al. (2015). “Posttraumatic stress disorder in youth with autism spectrum disorders.” Journal of Child Psychology and Psychiatry, 56(9), 1016–1025.
• Petty, J., et al. (2021). “Neurodivergence and trauma: A call for integrated care.” Clinical Psychology Review, 87, 102042.

Amy is the founder and lead counsellor at Newglade. Newglade provides a range of specialist neurodivergent services including in person and online counselling, parent support, professional training and therapist support/supervision. Please contact us for more information.