by Sarah Swenson, Licensed Clinical Mental Health Counselor in Seattle, WA

Don’t Give Up on Couples Counseling! Find a Therapist Who Understands Neurodiversity Instead  

In my work with neurodiverse couples around the world, the most common and the saddest comments I hear relate to their previous attempts to seek counseling. Instead of providing support and insight into their experience, counseling seemed at best ineffective or at worst (and not infrequently) downright harmful. Naturally, these negative encounters create a strong disinclination toward further attempts to seek help. If this describes your views of couples counseling, and if you fear it would be hopeless for you and your partner, please mull over these comments and consider giving it another try. 

Understanding Neurodiversity 

First, let’s make sure we’re talking about the same thing when we speak of neurodiversity. It’s a term that has only been around since a graduate student coined it in her master’s thesis in 1997 to describe individuals who felt they didn’t fit comfortably into the larger social patterns of expectations. She included those with ADHD, dyslexia, and autism under this umbrella.  

Her efforts were based in her concept that these are variations, not deficits, in the normal spectrum of human brain development. When I say neurodiverse couple, therefore, I am specifically referring to a couple in which one partner is what we call neurotypical (that describes roughly 97% of the global human population) and the other is neurodivergent with the traits of autism, whether diagnosed or undiagnosed. I often see ADHD accompanying autism as well, since it is frequently a diagnosis given to individuals whose autism was not diagnosed at the time of evaluation. 

Treating Neurodiverse Couples 

Remember that autism is a result of differences in the structure of the brain, when compared to what we call the neurotypical brain, and these differences affect an individual’s perception of the world as well as their responses to it and, therefore, social interactions. The key word is differences. These differences need to be identified, accommodated, and supported within the counseling framework in order for both partners to feel heard and understood by themselves, by their partners, and by their therapists. 

Faulty Assumptions Lead to Frustrating Sessions 

Besides the normal range of relationship complications faced by all couples, neurodiverse couples experience unique challenges that set them apart from the neurotypical couples that licensed therapists are trained to treat. Traditional couples therapy modalities are generally emotion-focused and insight-based, often embedded in a cognitive-behavioral frame, and they can offer profound help to struggling neurotypical couples. However, these treatment modalities present two great challenges for an autistic individual. For various reasons, the autistic partner is likely to shut down completely in the counseling environment, where presumptions are based in the neurotypical experience and where departures from those expectations are misconstrued to be resistance, reluctance, or manipulation.  

This likelihood needs to be identified and embraced with compassion toward both partners, but what often happens instead is that the autistic partner is pushed in ways that don’t make sense to them, while the neurotypical partner may feel slightly vindicated in the moment but ultimately frustrated when they sense that “there is no follow-through by my partner after counseling sessions,” as it is often described to me. 

Ignorance Leads to Misunderstanding 

A key point is this: graduate counseling education and post-graduate internships across the country lack deep emphasis and training in the concept of neurodiversity as it applies to couples. The best and most competent therapists, therefore, often miss signs of autism and proceed as if a couple were neurotypical and difficult or intransigent.  

Seeking Help, Finding Frustration 

Sometimes, therapists do consider autism, and suggest to a couple that they work with a neurodiversity specialist or consider pursuing an evaluation to rule out autism or to diagnose it. This suggestion can be met with resistance by an undiagnosed autistic partner, who feels blindsided and labeled abruptly. The couple leaves in tatters and often never returns to a counseling room because the therapist did not adequately explain their reasons for making the suggestion nor describe the benefits to the individual and to the couple seeking an evaluation. 

The more common reason couples leave counseling and don’t return is that they feel they are getting nowhere. The therapist’s ideas may sound good, but the couple senses they don’t address the root of their challenges, which they often struggle to express in a way that the therapist understands. They leave in great frustration, and often aggravation, especially if one partner inadvertently feels blamed for the other’s distress or feels identified as responsible for the dysfunction in their relationship. An autistic partner, for example, is often primed by life experience to feel blame where there is no intention to blame. This fact also needs to be understood and normalized for a couple, both to help them understand where they’ve been and preventively for the future. 

Getting What Neurodiverse Couples Experience 

Getting Neurotypical Partners 

In my years of work with neurodiverse couples, I have heard absolute horror stories. Not a small number of women, for example, have been misdiagnosed with Borderline Personality Disorder by therapists who interpreted their frustration inaccurately. I often hear about vague mentions of dependent personality or co-dependency on the part of the neurotypical partner whose legitimate struggles are misinterpreted. It is often suggested to the neurotypical partner that they stop viewing themselves as a victim in the relationship when they try to describe their inability to communicate clearly to their partner, no matter how they try. 

Getting Autistic Partners 

The autistic partner, on the other hand, is seen as aloof, disinterested, even intentionally cruel. A common misconception, and one that makes me seethe inside, is that autistic persons lack empathy. Pushing an autistic partner to express their thoughts or feelings in session can intensify the baseline anxiety already present in most autistic individuals. The experience is overwhelmingly unpleasant. 

Getting the Neurodiverse Couple’s Sexual Relationship 

A couple’s challenges in their sexual relationship are also frequently misunderstood. If the suggested antidotes to their problems don’t make sense to the autistic partner for reasons that make perfectly good sense to someone who understands autism, there is no follow-through. Use of porn, affairs, flirtation, alcohol use, struggles related to holding a job, and legal problems are all misattributed, and therefore suggested solutions by a well-meaning therapist most often do not align with the root issues. 

Finding Couples Therapy That Can Help 

The miracle is that so many couples do take a deep breath and are still willing to give counseling another chance.  

If you believe that either you or your partner might be autistic, and you are struggling to feel understood and supported by your therapist, please don’t give up. Instead, seek a specialist who understands the neurodiverse relationship and the implications for both partners. It truly is possible to feel embraced in a therapeutic relationship. 

The therapist directory here at GoodTherapy.org is a good place to start. You can search by location and clinical specialty. Many therapists work online now; thus, your choices regarding therapists are not so location-dependent. 

Find someone who can help you both understand what neurodiversity is and what it means, who can work as an interpreter between you and your partner, so that you understand yourself and your partner in ways that help you develop successful communication strategies. In this way, you can identify and explore the differences between you in good faith, with hope and compassion, and, in doing so, develop deeper connection and intimacy.  

Isn’t that why you sought therapy in the first place? 

Although most autism literature focuses on children, autism is a lifelong spectrum condition that affects about 1% of adults. People who are diagnosed with autism in adulthood may have a range of reactions. Some may feel confused about their identity, while others might feel peace of mind now that they have an explanation for their unique cognition. No single reaction is “right,” and many people bounce from one emotion to another following a diagnosis.

Autistic adults who did not receive supportive services in childhood may have struggled in school or with relationships. While finding support can be difficult, a wide range of organizations offer help to autistic adults. Many organizations focus on helping autistic adults see their diagnosis as a unique way of thinking—not a disease or syndrome.

Barriers to Official Diagnosis

A generation or two ago, many people had their autism go unnoticed, especially if their symptoms were relatively mild. Even as recently as 2000, just 1 in 150 children were diagnosed with autism, compared to 1 in 59 in 2014. This apparent increase in the autism rate is likely due to better early diagnosis and detection. The shift toward greater awareness of autism means that people who did not get diagnosed in childhood may pursue diagnosis as adults.

Even as early diagnosis becomes more prevalent, some groups are less likely to be diagnosed as children:

• Adults may miss autism symptoms in girls, particularly since most media coverage of autism focuses on boys. A 2017 study found that autistic girls may have better social skills than their male peers, masking symptoms of the condition. This can delay diagnosis, sometimes into adulthood.
• Racism may lead to underdiagnosis of autism in children of color, especially black children. Children of color are diagnosed later than their white peers, and black children are more likely to be misdiagnosed, leading to inadequate or inappropriate treatment regimens.
• Poverty and classism can reduce access to appropriate health care. Children who attend underserved public schools may not have the resources that wealthier children possess. Additionally, without quality doctors or adequate insurance coverage, parents may delay seeking treatment for unusual symptoms in their children. Even in adulthood, financial woes may deter a person from seeking mental health care or make it difficult to find a competent clinician.

Self-Diagnosis

As autism awareness spreads, some people self-diagnose with autism spectrum conditions. This practice is controversial. Supporters of self-diagnosis point to the many barriers to official diagnosis, emphasizing that even when a person can afford treatment, they may not receive an accurate or timely diagnosis. Some other arguments in favor of self-diagnosis include:

• Neurodivergence as identity. Many adult autistics view autism as a type of neurodivergence, not a disease. They see autism as something that brings both benefits and challenges, and they embrace autism as an identity. Many disability activists herald the right of a neurodivergent person to self-identify as such.
• Potential for improved accuracy. An autistic person knows their own symptoms better than anyone else. Armed with sufficient research and a sound understanding of autism, a person may be able to accurately diagnose themselves. In fact, they may do so faster than a professional.
• Stress of diagnosis. Getting a diagnosis often requires many long and involved tests. It also requires numerous interactions with medical professionals, receptionists, insurance representatives, and other people involved in managed care. These interactions can be highly stressful, especially to some people with autism.

Conversely, the arguments against self-diagnosis include:

• Potential reliance on autism stereotypes. Stereotypes about people with autism are pervasive and often paint an inaccurate portrait of the diagnosis. While some autistic people struggle with social interactions and cues, others do not. Autism is a continuum of symptoms, and people who rely on media portrayals or popular articles as their primary source of information may get the diagnosis wrong.
• Fear of appropriation. Some autistic self-advocates feel that people who self-diagnose are co-opting another person’s identity and lived experiences. There is a concern that some self-diagnosed individuals might present themselves as representatives of the autistic community without understanding its history.
• Lack of access to support. Some forms of support may require an official diagnosis. A person seeking accommodations at work, for example, may need a letter from a doctor.

Members of the same community who share similar values often have significant disagreements about the value of self-diagnosis.

Reacting to the Diagnosis

People diagnosed with autism should know that the diagnosis does not change anything about who they are. It merely gives them a label to apply to their symptoms and experiences.

There is no “normal” or “right” reaction to an autism diagnosis. Indeed, many people cycle through a wide range of reactions. Some quickly join self-advocacy communities and become disability rights activists. Others feel embarrassed or ashamed. Some are angry that they did not get a diagnosis earlier. Still others feel comforted because they finally have a label that describes the challenges they have experienced.

Newly diagnosed autistics may find that processing the diagnosis with friends, family, or a therapist helps them manage their emotions.

Finding Autism Services for Adults

Autistic adults often struggle to find services, since many advocacy organizations and public health agencies focus on children. The right doctor or therapist may be able to offer a referral to local organizations. The Autistic Self Advocacy Network offers a rich variety of resources, including tips on advocating for oneself and talking about autism with others. The Asperger/Autism Network has compiled a list of resources specifically for adults.

Autistic adults should know that discrimination against people with autism is a form of disability discrimination. The Americans With Disabilities Act prohibits employers from making hiring or firing decisions based on disability status. It also requires that, in most cases, employers offer “reasonable” accommodations to people with disabilities, including those with autism. In some cases, a lawyer may be a valuable resource who can help with identifying specific rights and accommodations to which a person may be entitled.

Therapy can help autistic adults in many ways. Therapists who specialize in autism can connect autistic people to additional services, offer coping strategies, and educate adults about life on the spectrum. A therapist can also help autistic adults talk to others about their diagnosis and manage relationship challenges. In addition, therapy can help a person cope with the social or economic barriers that may have delayed their diagnosis.

You can find a compassionate autism therapist here.

References:

1. Dababnah, S., Shaia, W., Campion, K., & Nichols, H. (2018). “We had to keep pushing”: caregivers’ perspectives on autism screening and referral practices of black children in primary care. Intellectual and Developmental Disabilities, 56(5), 321-336. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30273522
2. Data and statistics on autism spectrum disorder. (2019). Retrieved from https://www.cdc.gov/ncbddd/autism/data.html
3. Murphy, C., Wilson, C., Robertson, D., Ecker, C., Daly, E., & Hammond, N. et al. (2016). Autism spectrum disorder in adults: diagnosis, management, and health services development. Neuropsychiatric Disease and Treatment, Volume 12, 1669-1686. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940003/
4. Sarrett, J. (2016). Biocertification and neurodiversity: The role and implications of self-diagnosis in autistic communities. Neuroethics, 9(1), 23-36. Retrieved from https://link.springer.com/article/10.1007/s12152-016-9247-x
5. The Americans with Disabilities Act of 1990 (ADA). Retrieved 8 January 2020, from https://www.carautismroadmap.org/the-americans-with-disabilities-act-of-1990-ada/

Loneliness can be one of the most painful experiences in a relationship—especially when the relationship is neurodiverse. If you love your partner but still feel unseen, unheard, or emotionally distant, you are not alone. Many couples face this challenge, and understanding its roots can be the first step toward healing.

While loneliness can occur in any partnership, the dynamics in neurodiverse relationships bring unique emotional and communication challenges that deserve special attention.

Understanding Loneliness in Neurodiverse Partnerships

Many people experience occasional loneliness in relationships, but the loneliness in a neurodiverse partnership often has unique characteristics. Friends may reassure you by saying “that’s life” or “marriage is hard,” but these responses can dismiss what makes your situation different.

A person in this situation may feel guilty or wonder if they are making too much of the problem. They might try to convince themselves that things are fine—until the longing for emotional connection grows too strong to ignore.

How Autism Can Impact Emotional Connection

For some in neurodiverse relationships, deep loneliness becomes a constant presence, not just an occasional feeling. It may wax and wane, but it’s always there—woven into daily life, much like a wedding ring on your hand.

Autistic and neurotypical partners can both feel lonely, but for different reasons. A neurotypical partner may crave affective empathy—emotional attunement and validation—while an autistic partner may respond with cognitive empathy, offering solutions rather than emotional comfort. Neither is wrong, but the mismatch can create feelings of being unseen or unsupported.

Over time, these differences can lead to frustration, hurt, or even withdrawal from the relationship. In some cases, both partners feel equally isolated. 

Common Causes of Loneliness for Both Partners

• Communication gaps: Different ways of interpreting emotions and intentions

• Mismatched needs: One partner seeks emotional reassurance while the other prioritizes practical solutions

• Chronic stress or fatigue: Emotional distance can worsen when mental and physical resources are low (fatigue)

• Self-blame: Both partners may feel they are failing the other

• Depression and low self-worth: Persistent loneliness can lead to depression and negative self-talk

Strategies for Bridging the Understanding Gap

One of the most effective tools for working with neurodiverse couples is psychoeducation (learn more). This involves exploring both the autistic and neurotypical experiences—not to label one as “better” but to understand similarities and differences.

From there, couples can:

• Learn each partner’s communication style and needs

• Make the implicit explicit—clearly stating expectations and emotional experiences

• Develop strategies for expressing affection and empathy in ways the other partner understands

• Practice nonverbal communication (read more)

• Build trust through small, consistent actions

When to Seek Professional Support

If loneliness is leading to ongoing resentment, emotional withdrawal, or repeated conflict, it may be time to seek outside help. A therapist experienced in neurodiverse relationships can help partners:

• Translate and interpret each other’s communication styles

• Rebuild emotional connection

• Develop realistic expectations for the relationship’s dynamics

You can find a qualified therapist who understands both autism and relationship challenges.

Questions to Ask Your Therapist

• How do you help couples navigate neurodiverse relationship challenges?

• What strategies can increase emotional connection when communication styles differ?

• How can we each better understand and meet the other’s needs?

The Path Forward

Every relationship faces challenges, but in a neurodiverse partnership, understanding and acceptance are the keys to a deeper connection. A neurodiverse relationship will never be entirely neurotypical or autistic—it will always be uniquely yours. By learning to navigate your differences, you can deepen your connection and create a partnership that honors both individuals.

You don’t have to navigate this alone—working with a therapist experienced in neurodiverse relationships can help you and your partner build mutual understanding and emotional closeness. Find a qualified therapist on GoodTherapy today and take the next step toward a stronger, more connected partnership.

During an autistic person’s life, there may be times when they seem to lose skills or show more obvious signs of autism. For example, a toddler who had a vocabulary of a dozen words may stop talking altogether. A social teenager may find it harder to make appropriate eye contact or take turns in conversation, despite having learned these skills as a child.

This phenomenon is called autistic burnout (or autistic regression, depending on the source). Autistic burnout can be very distressing for the autistic individual and their family, especially if they don’t know what is happening. However, it is important to note that autistic burnout is not necessarily an omen of permanent regression or skill loss. Recovery is possible.

What Is Autistic Burnout?

Autistic burnout can happen at any age, but it usually occurs at major transition points in life, such as toddlerhood, puberty, or young adulthood. Any period in which a person experiences lots of changes or stress can prompt an episode of burnout.

Very young children with burnout often lose language skills. Some children may forget a chunk of their vocabulary but still retain a few words. Others may stop making sound entirely and resort to physical gestures to communicate. Autistic children may also quit early social behaviors such as responding to their own name or looking at caregivers’ faces.

Older autistic people are able to communicate their experiences with burnout in a way toddlers can’t. Adults have reported symptoms such as:

• Increased sensitivity to sensory stimuli, such as fluorescent lights or scratchy clothing. The person may need to stim more often to compensate.
• Emotional and physical exhaustion. This can keep people from engaging in self-care tasks such as meal preparation.
• Difficulty making decisions, switching between tasks, and other executive functioning skills.
• Speech issues: these can range from forgetting words to being unable to speak at all.
• Reduced social skills. As an individual’s cognitive resources are stretched thin, they may display more stereotypical autistic body language or speech patterns.
• General memory issues.

There are no diagnostic criteria for how many skills need to be lost in order to qualify as autistic burnout. The severity and duration of symptoms can vary widely between individuals. One individual can even have varying levels of burnout at different points in life.

Why Does Autistic Burnout Happen?

Like other types of overwhelm, autistic burnout occurs when life’s challenges exceed a person’s resources. Perhaps a person is undergoing a stressful life transition or they may have been pushing themselves too hard for too long. Regardless, the coping mechanisms they had been using are no longer enough. Certain skills and abilities “shut down” temporarily as the brain recovers. The brain may take a while to remember these skills as the person adapts to their new situation.

Research into autistic burnout is still a relatively new field, so science has not found a definite answer as to why autistic brains react this way. One theory is that autistic people tend to have high levels of neuroplasticity. In other words, autistic brains may find it very easy to create new connections between nerve cells. Neuroplasticity may contribute to some autistic people’s exceptional problem-solving abilities. However, the brain may sometimes redirect its resources away from certain skills as it develops new solutions to problems, taking those abilities temporarily “offline”.

It is important to note that autistic burnout is not a conscious behavior. An autistic individual is not ignoring social norms or neglecting work simply because they are tired. They cannot “willpower” their way back to their old level of functioning. In fact, autistic burnout is often caused by people working too hard to appear “normal”.

Masking

Although public understanding of autism has improved in the last few decades, the autistic community still experiences severe stigma. Much of modern media persists in depicting autistic people as “emotionless”, “self-absorbed”, and other stereotypes. Furthermore, autistic children are at higher risk of being victims of filicide, or murder by their parents. Yet when these crimes come to light, news outlets may depict the murders as “caregivers forced into a desperate situation” and their victims as “burdens” (assuming the victims are discussed at all).

Many autistic people are taught from a young age that they must “mask” their autism in order to be accepted in society.Many autistic people are taught from a young age that they must “mask” their autism in order to be accepted in society. For example, parents may insist that a child must hug their relatives in order to show affection, even if the pressure from hugs is painful to them. If the child resists, they might be accused of being “stubborn” or “selfish.” The parents and relatives may refuse to try alternative greetings such as high-fives. The child then learns their own needs are less important than others’ social preferences.

Masking often takes an exceptional amount of cognitive and emotional energy. Some autistic people consciously monitor their body language and tone of voice as they talk. Others become hypervigilant for signs that they have accidentally upset someone. For some autistic people, even being in a bright, loud, or crowded place can be draining.

Some people become so good at masking that their autism diagnosis is rescinded, and they lose necessary support. Others are not diagnosed at all and do not learn about their autism until they burn out. As people age, their stamina may wane, reducing their ability to mask for long stretches of time and making burnout more likely.

Myth of Sudden Autistic Regression

Autistic burnout is sometimes called autistic regression, especially when referring to infants and toddlers. An estimated 30% of autistic toddlers will experience regression, likely because their brains are developing so rapidly and are thus under a lot of strain. Some people have mistakenly blamed vaccines for causing regression in toddlers. However, regression often begins in the first year of life, before the child is given vaccines.

Multiple studies show children often exhibit signs of autistic burnout long before the parents first notice them. For example, an infant might show signs of social regression, such as a lack of eye contact. The parents might not notice these signs because they are intermittent or subtle. Often the parents don’t realize there is cause for concern until the child shows difficulties with language. The symptoms of burnout may seem sudden to parents, but they are actually part of a gradual progression.

Toddlers who experience autistic burnout are more likely to have a co-occurring intellectual disability. However, people who experience burnout in early childhood can also grow up to have average or even exceptional IQs. Just because a child has had a disruption in their development does not mean they have lost these skills forever.

Recovering from Autistic Burnout

There is limited research on recovery from autistic burnout. An autistic person’s abilities will often come back, but some skills may take longer to return than others. Some skills may not return to the level they were at before.

A person’s prognosis depends on a lot of factors. For example, a teenager who experiences burnout due to a temporary stressor may have briefer, milder symptoms than a middle-aged person who has forced themself to mask for over 30 years. People who push themselves to the point of burnout year after year are likely to have more severe skill loss than those who have a one-time episode and get immediate support.

If you are a caregiver of an autistic child, it is highly recommended that you visit a child psychologist. Early therapeutic interventions can improve a child’s long-term abilities to communicate and cope with stress. A mental health professional can also help you create a home environment that matches your child’s sensory needs. You may also wish to see a family therapist to discuss any concerns you may have about the future.

If you are an adult experiencing autistic burnout, you may benefit from individual therapy. A therapist can help you advocate for your needs with coworkers, friends, and family members. A therapist can also teach you meditation and other coping skills for stress. If you have clinical anxiety or depression (many autistic people do), therapy can treat those diagnoses.

While recovering from autistic burnout, it is important to be patient with yourself. It can be frustrating to lose access to skills, but remember that this is not your fault. During this time, it may help to schedule breaks throughout the day to relax. If you have a special interest or stim that calms you down, feel free to use those as much as you need to. Don’t be afraid to ask friends and family for help as you are recovering.

References:

1. ASAN anti-filicide toolkit [PDF]. (2019). Autistic Self-Advocacy Network. Retrieved from http://autisticadvocacy.org/wp-content/uploads/2015/01/ASAN-Anti-Filicide-Toolkit-Complete.pdf
2. Backer, N. (2015). Developmental regression in autism spectrum disorder. Sudanese Journal of Paediatrics, 15(1), 21-26. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949854
3. Barton, J. (2019). Autistic burnout or regression: Individuals on the autism spectrum [PDF]. Retrieved from https://www.scsha.net/assets/handouts/Austic%20burnout_SCSLHA_2019.pdf
4. Dobbs, D. (2017, August 2). Rethinking regression in autism. Spectrum. Retrieved from https://www.spectrumnews.org/features/deep-dive/rethinking-regression-autism
5. Kim, C. (2013, December 19). Autistic regression and fluid adaptation. Retrieved from https://musingsofanaspie.com/2013/12/19/autistic-regression-and-fluid-adaptation
6. Roberts, W., & Harford, M. (2002). Immunization and children at risk for autism. Paediatrics Child Health, 7(9), 623-632. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796520
7. Ruggieri, V. L., & Arberas, C. L. (2018). Autistic regression: Clinical and aetiological aspects. Revista de Neurologia, 66(1), 17-23. Retrieved from https://europepmc.org/abstract/med/29516448

Self-stimulatory behavior, better known as stimming, is a type of sensation-seeking that can ease feelings of anxiety, frustration, and boredom. Some people find stimming pleasurable and fun. Although stimming is commonly associated with autism, almost everyone stims from time to time. Stimming is especially prevalent among children.

Subtle forms of stimming, such as hair-twisting, or fidgeting may go unnoticed. More dramatic forms of stimming, such as face-slapping, may be alarming to witness. Forms of stimming that cause physical damage may qualify as self-injurious behavior (SIB).

What Is Stimming?

Stimming refers to a wide range of repetitive sensation-seeking behaviors. Some examples include:

• Verbal stimming, such as repeating a phrase or humming seemingly at random.
• Head-banging and face-slapping.
• Nail-biting and thumb-sucking.
• Repeatedly covering and then uncovering the ears, eyes, nose, or mouth.
• Repetitive movements such as twirling or pacing.
• Banging on objects.
• Staring at stimulating objects.
• Turning lights or radios on and off.
• Scratching or rubbing skin.
• Twisting hair.
• Chewing on objects.
• Tapping feet, fingers, or other body parts.

Stimming exists on a continuum. Most people stim at least some of the time. For example, chewing on a pencil while in deep concentration is a form of stimming. Stimming does not necessarily mean a person has autism, ADHD, or another neurological difference. Yet frequent or extreme stimming such as head-banging more commonly occurs with neurological and developmental differences.

Why Do People Stim?

Stimming helps people cope with emotions such as frustration and boredom. It may also help them concentrate, especially on challenging or boring tasks. Over time, stimming can become a habit. A person might come to associate biting their nails or chewing their hair with deep concentration, making it more difficult to concentrate without these stimming behaviors.

Autistic people often feel overwhelmed by sensory input such as flickering lights or loud noises. Stimming can help them recover a sense of control, calming them and making sensory distraction easier to manage. Stimming is often a sign that an autistic person is overwhelmed and struggling to cope with their emotions.

Stimming can also be pleasurable, especially when people associate stimming with relaxation or concentration.

Do Allistic People Stim?

Many forms of fidgeting, such as twisting hair or tapping fingers, are also a type of stimming. These forms of stimming are so common that they often go unnoticed.

Toddlers and preschoolers may also stim to cope with overwhelming emotions and having little control over their own lives. Some parents worry this stimming behavior is an early warning sign of autism, but when stimming is the only symptom, autism is unlikely. According to United Cerebral Palsy, about 20% of neurotypical toddlers bang their heads.

Neurotypical people stim for the same reasons that autistic people do—to cope with boredom, alleviate feelings of sensory overload, manage frustration and anxiety, and because stimming can become a pleasurable habit. Fidget spinners, a recent toy fad, are a stimming tool popular among both neurotypical and neurodivergent children.

Why Punishment for Stimming Behaviors Can Be Harmful

In generations past, some experts recommended punishing stimming behavior—either with aversive correctives (such as slaps, spanks, or shocks) or by taking away or withholding rewards.

The autistic self-advocacy community strongly opposes any type of punishment for stimming. Many adult autistics say punishment caused lasting harm to their self-esteem, undermined their sense of bodily autonomy, and left them with feelings of trauma. Just as adults are permitted to touch their faces or twirl their hair, autistic advocates emphasize that children should be able to stim—especially when doing so is not harmful.

Instead of punishing stimming, it’s important to examine and address the underlying cause.Stimming happens for a reason. Punishing the symptom does not address the underlying cause. Instead, it penalizes a person for their attempts to manage their own emotions. This can make emotions such as anger and anxiety feel more out of control. It also erodes trust between a caregiver and child. Over time, punishing stimming may even make the issue worse by triggering anxiety and fear.

Instead of punishing stimming, it’s important to examine and address the underlying cause. For example, an autistic child might need a quiet space to do homework, or they might find certain fabrics irritating. A toddler might need help coping with the stress of waiting for a meal. A person feeling overwhelming anxiety might need support to develop new anxiety management strategies.

When stimming is not physically harmful, there is rarely a reason to stop it. Often stimming is merely embarrassing to the caregiver and not something that puts a person in real danger. When a person engages in aggressive or violent stimming behavior, redirecting their attention may help.

How Therapy Can Help Manage Stimming Behaviors

Therapy can help families and individuals manage stimming behaviors, especially when those stimming behaviors seem dangerous or interfere with daily life.

Family therapy can help families to:

• Address and manage overwhelming sensory environments.
• Develop strategies for managing the emotions and sensations that trigger stimming.
• Address conflicts between caregivers about how best to manage stimming.
• Determine whether a person is stimming because of an underlying neurological or mental health issue.
• Help caregivers differentiate age-typical stimming from stimming that may signal a problem.

Individual therapy can help children and adults who engage in stimming find healthy outlets for their emotions. A therapist may:

• Help a person manage harmful stimming behavior such as head-banging.
• Offer different strategies, such as meditation, for managing anxiety.
• Help a person talk to loved ones about stress and frustration.
• Offer alternative stimming options that may be less disruptive or harmful.
• Help an autistic person better control their sensory environment by identifying and addressing triggers for stimming.
• Support a person in advocating for their needs, including disability accommodations, at work or school.

A compassionate therapist can help with stimming and the emotions that trigger it. Find a counselor today!

References:

1. Bennie, M. (2016, February 22). Stimming: The good and bad side of anxious behaviors. Retrieved from https://autismawarenesscentre.com/stimming-the-good-and-bad-of-anxious-behaviours
2. Living with children: Head-banging [PDF]. (n.d.). United Cerebral Palsy. Retrieved from http://ucphuntsville.org/wp-content/uploads/2015/06/Head-Banging.pdf
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