I’ve been thinking a lot about the Autism spectrum lately. Mostly, this is because it is in my family and friends and learning about it has been personally important. But equally, it is because I’m seeing it more in my clients, and it has become an essential consideration in therapy. Sadly, this mostly absent from our education and curriculum though!
ADHD has become increasingly prevalent and well understood in recent years, but there is still so much we don’t understand. And now, there is another new term: AuDHD. This refers to people who experience aspects of both Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD).
While these conditions have traditionally been discussed separately, they frequently overlap. Traditionally, some people – including myself – have felt that ADHD has always fit somewhere, somehow in the Autism spectrum. With this new term, we have a more direct bridge. Hopefully understanding how they interact can help us make better sense of ourselves and, importantly, change how we approach therapy.
ADHD, Autism, and AuDHD: What’s the Difference?
ADHD is generally associated with differences in attention, impulse control, activity levels, and executive functioning. People with ADHD may struggle with organization, time management, or following through on tasks, while also experiencing creativity, curiosity, and an ability to become deeply absorbed in things that interest them.
Autism, meanwhile, is associated with differences in social communication, sensory processing, and patterns of interests or behaviour. Autistic people may experience the social world differently, have particular sensory needs, or find comfort in predictability and routine. But similar to ADHD, there is often a penchant for hyper-focus in niche interests. Autism is a spectrum, meaning that these characteristics can present in many different ways. It can be confusing because Autism can look like incredibly high capacity in some things, like verbal skills, but it can also manifest as incredible deficits in verbal skills.
AuDHD describes the experience of having both. Someone might crave routine but struggle to maintain it, desire social connection but find social situations exhausting, or seek novelty while also becoming overwhelmed by unexpected changes. The interaction between these tendencies can sometimes feel contradictory, making self-understanding particularly challenging. It also seems that people with AuDHD can often go under the radar, since they may be sub-clinical in their traits – meaning neither their ADHD qualities nor their ASD qualities are strong enough that they will warrant a diagnosis. Or, one aspect can be stronger than the other.
It’s worth emphasizing that these are broad descriptions, not diagnostic checklists. Everyone’s experience is different, and ADHD and autism can each present in ways that aren’t immediately obvious to others. In fact, they are almost never similar, person to person.
How Should We Adapt Our Approach to Therapy?
One of the most important things we can do as therapists is reconsider the assumption that everyone should be able to engage with therapy in the same way. That should true for us, without even needing to address ASD. Therapists, as they mature, absolutely need to learn to adapt to the particular mind they are meeting.
Traditional therapy can sometimes place considerable demands on attention, memory, emotional awareness, and social communication. A client may be expected to sit still, maintain a conversation, identify feelings in real time, complete homework between sessions, or explain experiences that they themselves don’t yet fully understand. In my experience this is hard for most people, but for some neurodivergent clients, these expectations can become barriers rather than supports.
A more neurodivergent-affirming approach begins, of course, with openness and curiosity. What may seem like resistance or lack of motivation, or even dissociation, could in fact be indications of qualities of a person on the spectrum, such as challenges in interoception, inability to plan and execute new patterns, and simple differences in how emotions are felt or expressed. These are things that we ought to be finding out and listening for in a client when we start to work with them. Remember that many of our clients that we see may themselves have no idea that they are ADHD or ASD – that is often a big part of why they are coming to therapy!
This might mean allowing more movement, using written prompts, providing structure and clear expectations, slowing down when a client becomes overwhelmed, or making space for sensory needs. It can also mean recognizing the exhaustion that sometimes comes from masking—the effort involved in concealing natural behaviours or consciously imitating expected social behaviour in order to fit in.
Above all, we want to help clients understand themselves without treating their differences as defects. The goal is never to make someone function more like a neurotypical person. It’s to help them live with greater ease, self-understanding, and freedom to be themselves. And, if they come to therapy and say that they want function more a non-autistic person – then I would suggest that a big part of the work is on self-acceptance. It always is.
Working with ADHD and AuDHD Through IFS
Internal Family Systems (IFS) offers a particularly interesting perspective on this work. IFS understands the mind as a system of parts, each with its own feelings, beliefs, and motivations. Rather than viewing difficult behaviours as problems to eliminate, we become curious about the protective roles they serve.
Consider someone who struggles to complete tasks. We might discover a part that avoids starting because it anticipates failure, another that criticizes the person for procrastinating, and yet another that seeks immediate stimulation when the work becomes difficult. Instead of fighting these parts, we explore what each is trying to accomplish and what it fears might happen if it stopped doing its job. And, most importantly, we meet these parts from Self – from a caring and compassionate space, rather than a place of pressure or demand.
For someone with ADHD, this can be revolutionary. We are no longer trying to force a square peg into a round hole. We are not colluding with their own masking parts to try to get them to be something they are not. This can be a truly helpful way to explore the emotional consequences of years of struggling with expectations, feeling misunderstood, or being criticized for things that seem to come easily to others.
For autistic and AuDHD clients, we may encounter parts that work hard to manage social interactions, suppress natural responses, or maintain a sense of predictability in an overwhelming world. We might also find parts that are exhausted from trying to meet expectations that don’t accommodate their needs.
However, there is an important distinction to maintain: neurodivergence itself is not a part that needs to be healed. While we don’t fully understand Autism (and I’ll be writing a more exploratory blog post about that soon) for the sake of therapy we ought to consider that there may be “hardwired” differences in the brain of autistic people, which means that this will simply be qualities of their Self. What is Self and what is non-Self – well that is a big part of therapy for any person, whether they are Autistic or not.
We may also need to adapt the way we practice IFS. Some clients find it difficult to sustain attention during lengthy internal dialogues, identify subtle emotions, or access a clear internal sense of a part. Others may benefit from more concrete language, visual representations, or discussing their parts with the therapist before attempting to experience them directly. We should be willing to slow down, externalize the process, and follow the client’s own way of making sense of their experience rather than rigidly following a prescribed sequence.
Ultimately, the goal is the same as in any IFS work: to develop a more compassionate relationship with ourselves, understand the intentions behind our protective patterns, and help our parts feel less burdened. If the client is doing this work with an agenda to change themselves – that’s a part! Name it. Meet it. See it clearly.
Understanding Before Changing
Perhaps the most valuable shift we can make is moving from the question “How do we fix or change this behaviour?” to “What is happening here, how can we understand it, and what does the system need for balance and harmony?”
For neurodivergent clients, that distinction can be profound. We can all feel the difference between being met with pressure, and being met with loving acceptance. But for many, if not most of us, we are used to meeting even our own selves and parts with some kind of pressure. Therapy – for Autistics and non-Autistics alike – is always a path of acceptance much more than a path of change.
Many of us have spent years trying to correct themselves, to conform and adjust often without understanding why certain things feel so difficult. Therapy can offer something different: a space where they don’t have to justify their experience or pretend to be someone else. If we can meet them in that space, then we can model that for their whole system. IFS is perfectly suited for this.
Whether we’re working with ADHD, autism, AuDHD, or simply the many ways human minds differ, our job is not to change people into unnatural versions of themselves. It’s to help people understand themselves, work with their own nature rather than against it, and discover the healing power of acceptance, the great healing power of being exactly our truest Self.
