Part 2 – Exploring Autism & Neurodiversity
13 Oct – written by Katrin Kemmerzehl – Blog
If you’ve read Part 1 Exploring Autism – A different way of experiencing the world, you know that autistic individuals often experience the world differently. In this post, we will find out what the common experiences are that lead autistic adults to seek therapy, including burnout, masking, anxiety, and challenges related to identity, relationships, and late diagnosis.
We will also discuss how counselling can provide a supportive environment for individuals to process these challenges, gain self-understanding, and develop a more authentic and sustainable way of living.
What is autism?
Autism is a lifelong neurodevelopmental condition that influences how an individual communicates, interacts with others, and perceives the world around them. It is part of the broader concept of neurodiversity, which recognises that diverse ways of thinking and processing information are natural and valuable for society (Dekker, 2020).
Key challenges associated with autism include difficulties in communication, social interactions, and flexible thinking. Sensory sensitivities are also common. Signs of autism usually appear by age two, but those with higher functioning may not be diagnosed until adulthood.
How many people are diagnosed with autism in the UK?
In the UK, approximately 1 in 100 people are autistic (National Autistic Society, 2013), with a genetic basis for the condition. While autism is more frequently diagnosed in males, females are often underdiagnosed. Older parental age may increase the likelihood of having an autistic child (Shelton, Tancredi, & Hertz-Picciotto, 2010).
Current estimates suggest that around 1–2% of people in the UK are autistic, with many adults likely remaining undiagnosed (UCL, 2023; NHS, 2025).
Levels of Autism
Autism is often described in levels, reflecting the support a person might need:
- Level 1 – Requiring Support: Individuals at this level may face challenges in social communication and adaptability. Although they often manage daily life with some assistance and may seem ‘high-functioning’ to others, they may still experience significant internal struggles, such as stress, anxiety, or difficulty coping with changes in routines.
- Level 2 – Requires substantial support: Individuals at this level experience greater challenges in social interaction, communication, and adaptation to changes. They may need ongoing support in home, work, or school environments.
- Level 3 – Requiring very substantial support: Individuals at this level may experience significant challenges in communication and daily functioning, and they require intensive assistance for independent living.
It is important to remember that these levels describe support needs, not intelligence or potential. Many people with autism have exceptional abilities, particularly in areas involving focus, memory, or creativity.
The Diagnostic Process in the UK
Receiving a diagnosis can be a crucial step in gaining self-understanding and accessing support. In the UK, the diagnostic process typically involves the following:
- 1. Referral: This can be from a GP, health professional, or in some cases, through self-referral.
- 2. Assessment: A multidisciplinary team, often including a psychologist, psychiatrist, and speech and language therapist, conducts the assessment.
- 3. Evaluation: This may involve structured interviews, observations, and questionnaires to assess social communication, behaviour, and developmental history.
- 4. Feedback: Outcomes are discussed, including recommendations for support, therapy, and strategies.
A diagnosis can be beneficial for several reasons. It provides clarity and helps people understand their personal experiences. It validates that challenges are not personal failures but rather part of a neurodevelopmental difference.
Additionally, a diagnosis enables access to tailored support in education, employment, and healthcare. It also offers guidance for families, educators, and employers on how to effectively support the individual.
Common Challenges Faced by Autistic People
People with autism may face a variety of challenges that impact their daily lives, mental health, and relationships. Many of these challenges arise from the interplay between their neurodevelopmental differences and societal expectations. Common experiences include:
Social Communication Difficulties: Understanding social cues, interpreting indirect language, or engaging in small talk can be confusing or exhausting. For example, one person might find it stressful to interpret casual comments, leading to misunderstandings in friendships or at work.
Sensory Sensitivities: Everyday environments, like bright lights, loud noises, or certain textures,can be overwhelming, causing stress or the desire to avoid such situations.
Rigidity and Dependence on Routines: Small changes in routine can trigger anxiety. For instance, someone trying to quit smoking might struggle not because of the nicotine but because it disrupts a long-standing routine that provides comfort. Therapy can help introduce new routines gradually and safely.
Mental Health Struggles: Anxiety, depression, OCD, burnout and low self-esteem are common among individuals with autism, often stemming from years of trying to ‘fit in’ or mask their natural behaviours. Many report feeling not ok or flawed simply for being themselves.
Autistic individuals face much higher rates of suicidal thoughts and behaviours than the general population. Studies show that 19% to 66% report suicidal ideation, and 1.8% to 36% have attempted suicide.
Factors contributing to this increased risk include social isolation, co-occurring mental health conditions, delayed diagnosis, and inadequate support (Cassidy et al., 2022).
Black-and-White Thinking: Some people view situations as entirely positive or negative.
For instance, one person may feel disheartened by aspects of their university degree, leading them to conclude they would ‘never do a degree again,’ despite it being a lifelong aspiration.
Relationship Difficulties: Misunderstandings, literal interpretations, or intense focus on personal routines and interests can strain partnerships. Therapy can help individuals reflect on communication patterns and develop healthier interaction and communication strategies.
Intense or Narrow Interests: While these can fuel passion and skill development, an intense focus on specific topics may interfere with work, social connections, or relationships.
Obsessive or Repetitive Behaviours: While routines and rituals can provide comfort, they may become limiting if they disrupt other aspects of life.
What Issues Bring Autistic People to Therapy
People seek therapy for various reasons influenced by their experiences and how autism affects their daily lives. Common themes include:
Emotional Regulation and Mental Health Support
Many autistic individuals experience anxiety, depression, or low self-esteem. Therapy can explore the sources of these feelings, including the impact of lifelong masking or negative messages from others.
Black-and-White Thinking, Decision-Making and Relationship Challenges
Individuals with autism may struggle with extreme thoughts or sudden decisions that feel definitive.
For example: Minor conflicts with a friend or partner can feel catastrophic, causing some individuals to leave and withdraw abruptly, viewing the situation as final. However, they often later realise that the conflict was not as serious as it initially appeared, which then requires repair.
Through counselling, clients can learn to pause, reflect, and approach situations differently, allowing them to preserve relationships without sacrificing their authenticity.
Therapy provides a space to recognise these difficulties and develop more balanced perspectives. It can assist you in identifying patterns in friendships, family dynamics, or romantic relationships, and in establishing healthier boundaries.
Coping with Routine Changes and Transitions
Life changes, such as starting new jobs, moving to new homes, or making lifestyle adjustments, can often feel overwhelming.
Therapy can support a gradual adaptation to these changes and help you establish new routines while ensuring you still feel comfortable. Counseling can provide guidance on incorporating routines and interests into your life in a balanced way.
Managing Intense Interests
Counselling can guide in navigating a person’s passions and interests with other life demands and integrating social connections around shared interests.
Obsessive Behaviours and Rigid Patterns
Counselling provides strategies to reduce stress, increase flexibility, and explore alternatives to repetitive coping mechanisms.
Benefits of Counselling for People with Autism
Counselling provides a supportive and non-judgmental environment to explore your experiences, gain self-awareness, and develop strategies for living well.
Benefits of Counseling
- Self-understanding and Acceptance: Acknowledging autistic traits as valid and valuable, rather than seeing them as flaws.
- Mental Health Support: Addressing anxiety, depression, OCD, suicidal thoughts and low self-esteem that may arise from social pressures or the need to mask one’s true self.
- Relationship Skills: Improving communication, setting boundaries, and learning how to seek supportive and respectful connections.
- Coping Strategies: Developing practical tools for managing routines, sensory sensitivities, and emotional regulation.
- Flexible Thinking: Learning to recognise rigid or extreme thought patterns and gradually adopting more balanced perspectives.
Therapy can empower individuals to reclaim confidence, foster authentic relationships, and create a life that aligns with their values and needs.
Taking the Next Step
If you are autistic, neurodivergent or suspect that you may be, counselling can provide a safe space to explore your experiences, embrace your strengths, and develop strategies to manage challenges.
Whether you need support for relationships, routines, life transitions and changes or personal growth, a compassionate therapist can help you navigate your unique journey and create a life that feels authentic and fulfilling. You don’t have to face these challenges alone.
Reaching out for therapy is a positive step toward understanding, self-acceptance, and thriving in a way that works for you. You’re very welcome to get in touch.
References
- University College London (2023). Number of autistic people in England may be twice as high as previously thought. UCL News.
- UK Parliament (2025). Autism: Written question HL9024
- Shelton, J. F., Tancredi, D. J., & Hertz-Picciotto, I. (2010). Neurodevelopmental disorders and prenatal residential proximity to agricultural pesticides: The CHARGE study. Environmental Health Perspectives, 118(10), 1462–1468.
- American Psychiatric Association. (2023). Diagnostic and statistical manual of mental disorders (5th ed., text revision). Arlington, VA.
- Boyd, B. A., McDonough, S. G., & Bodfish, J. W. (2012). Evidence-based behavioral interventions for repetitive behaviors in autism. J Autism Dev Disord, 42(6), 1236–1248.
- Cassidy, S., Bradley, L., Bowen, E., Wigham, S., & Rodgers, J. (2022). Autism and autistic traits in those who died by suicide in England. The British Journal of Psychiatry, 221(6), 683–691.
- Dekker, M. (2020). From exclusion to acceptance: Independent living on the autistic spectrum.
- In S. K. Kapp (Ed.), Autistic community and the neurodiversity movement: Stories from the frontline (pp. 41–49). Springer Singapore.
- Foden, T. (2011). Social skills interventions: Getting to the core of autism. Kennedy Krieger Institute.
- Howlin, P., & Moss, P. (2012). Adults with autism spectrum disorders. Canadian Journal of Psychiatry, 57(5), 275–283.
- Myers, D. A. (2018). Myers’ psychology for AP (3rd ed.). Worth.
- National Autistic Society. (2013). Autistic women and girls.
- Rosenblatt, M. (2008). I exist: The message from adults with autism. London: The National Autistic Society.
- Shelton, J. F., Tancredi, D. J., & Hertz-Picciotto, I. (2010). Independent and dependent contributions of advanced maternal and paternal ages to autism risk. Autism Research, 3, 30–39.
- South, M., Costa, A., & McMorris, C. (2021). Death by suicide among people with autism: Beyond zebrafish. Journal of the American Medical Association, 4(1).
Katrin Kemmerzehl
I am a qualified psychotherapeutic counsellor in Newcastle upon Tyne.
Please get in touch if you’re interested in arranging a consultation.