Therapy for autistic adults

You get through the day by running a translation layer — reading faces, timing replies, monitoring your volume, working out what was meant rather than what was said. By the evening there is nothing left, and people who saw you managing fine at work have no idea what it cost.

The environment is doing damage nobody else seems to notice: strip lighting, open-plan noise, a shirt seam, an unannounced change of plan. Anxiety builds through the day and either comes out as shutdown or arrives, weeks later, as burnout.

Some people come to me with a formal diagnosis, some are on a waiting list, and some have simply worked it out about themselves and are certain. All three are welcome. What we are treating is not autism — it is the anxiety, exhaustion and low mood that come from living in a world built for a different nervous system.

Late-identified autistic adults often arrive carrying a stack of earlier explanations that never fitted: too sensitive, difficult, lazy, rude, anxious, arrogant. A lot of the early work is simply re-reading your own history with the right frame, and noticing how much of what you thought was failure was in fact load.

The first session covers what you find helpful and what you find hard — sensory needs, communication preferences, how much structure you want, and what you would like written down. If direct questions are easier than open ones, say so and that is how we will work.

Length varies with what we are working on: anxiety work often runs 12–16 weekly sessions of 50 minutes, and burnout recovery can take longer and move more slowly on purpose. Online is the default, camera optional; in-person sessions are available at Sanctuary Therapy Centre in Prestwich and Hebden Bridge.

I am a CBT and EMDR therapist, not a diagnostic service — I do not carry out autism assessments, and I can point you towards where those happen. If you already have a diagnostic report, you are welcome to share it, and equally welcome not to.

Do I need a formal diagnosis to see you? No. Plenty of the people I work with are self-identified or waiting for an assessment, and the therapy does not depend on the paperwork.

Are you trying to treat my autism? No. Autism is not something I treat or want to change. What we work on is the anxiety, burnout, low mood or trauma that sit alongside it.

Standard CBT has not worked for me before. That is a common experience, and it is usually about delivery rather than the model — too much inference, too fast, too much emphasis on naming feelings in the moment. Tell me what went wrong last time and we will build around it.

Can I keep my camera off? Yes. Camera off, breaks, notes in advance, written summaries afterwards — say what helps and we will use it.

I think I am in autistic burnout. Can therapy help with that? Yes, though the shape of the work is different — recovery needs reduced load before it needs new skills, so we start with what can be taken off you rather than what can be added.

What if I mask in therapy without meaning to? It is very likely, at least at first — masking is not usually a conscious decision. We name it early and make it safe not to: no requirement to look interested, to smile, to fill a silence, or to produce the emotion that seems expected. If you notice you have been performing for several sessions, say so and we will change how we are working. A therapy you have to mask through cannot do much for the exhaustion masking causes.

Can sessions be in Spanish? Yes — I offer therapy in English and Spanish.