A neurodivergent client brings their authentic expression, truth, or self-disclosure into the room, perhaps a way of communicating or relating that doesn’t fit neurotypical norms. When faced with a kind, empathic counsellor who is creating initial safety, they decide to try unmasking a little. But when the therapist is unaware of their own hidden biases, they may unconsciously interpret the client’s expression through a neuronormative lens. Miscommunication or misattunement begins, and a small crack forms in the relationship.

The Compounding Effect

Even subtle misattunements can have a compounding effect when they echo past experiences of being misunderstood or pathologised. The client senses this familiar response to their authentic self and begins to feel unsafe. They might start trying to justify or explain themselves or start suppressing/masking more.

When the therapist then tries to use traditional techniques without adaptation (trauma work, regulation tools, cognitive reframing ) they may not land as intended. Instead of feeling heard, the client may feel further dismissed or misunderstood as their needs go unnoticed. The rupture deepens.

Old trauma patterns can surface: fawning, freezing, or shutting down. The client’s nervous system interprets the interaction as unsafe, and the therapist, noticing the shift, may feel stuck or confused. I find it common in my supervision work that therapists can feel like they’ve become stuck, unsure what else they can use or what other tack to take.

If the reason for this stuckness isn’t named and repaired, the client’s hypervigilant parts pick it up instantly. Shame and rejection follow, reinforcing a painful internal belief: “I am too much,” “I’m the problem,” or “Therapy doesn’t work for me.”

The Spiral of Harm

As these moments repeat, even in small ways, the client’s truth can begin to feel minimised or pathologised. Each invalidation, whether intentional or not, deepens the wound.

Eventually, some clients retreat altogether. They stop seeking therapy, convinced it isn’t for them. What began as a moment of misattunement becomes part of a larger pattern of systemic harm, especially when it compounds the minority stress already experienced by neurodivergent people navigating spaces not set up for them.

Moving Toward Repair and Reflection

For therapists, the invitation is to strive for reflection. To stay curious when something feels off and to ask what you might be missing rather than assuming what’s being shown is resistance or avoidance. Increasing knowledge of neurodivergent traits and reflecting on the traditional therapeutic models is a good start. From here we can transform our practice – not with more tools – but with more internal work, uncovering internalised ableism for example.

If you’re the neurodivergent client in this scenario, know that you’re not alone. This doesn’t mean that you can’t do therapy – this is not a personal failing. If it’s available to you it can be incredibly valuable to meet a few counsellors first to check they feel safe for you before committing to sessions. I also find it can be transformative to have either a therapist who is neurodivergent themselves or a truly neurodivergent affirming therapist. My article on therapy and neurodivergence may be a good place to start.   

An Invitation to Reflect

If this spiral feels familiar as a therapist I invite you to notice how these patterns show up in your work. Remember this is systemic and requires specific training and deep reflection.

In my book, Neurodivergent Affirming Therapy (2026), I explore these dynamics in more depth, weaving together lived experience, therapeutic insight, and practical tools. My hope is that it invites both therapists and clients into deeper reflection about what safety, attunement, and authenticity can look like in therapy, for everyone.