Bridging the gap between the autistic individual, the therapist, and the theoretical perspective: an intersubjective analysis

Aim/Purpose
Research on autistic experience has often been misrepresented from a pathological deficit medical model focusing on fixing rather than understanding autistic experience relationally, with more focus on children than adults. Neurodivergent advocates report a culture of imposing power dynamics on autistic individuals resulting in exacerbated mental health difficulties (Adams, 2016), which is particularly relevant in today’s strive for social justice. Despite chronic misrepresentation, there is little research exploring underlying relational dynamics between autistic individuals as both client and therapist.

Therefore, this research explored how adult autistic individuals experience relationship as clients and therapists, ranging from family attachment, relating to self-discovery pre-and-post diagnosis, to experiencing therapeutic encounters.

Design/Methodology
Semi-structured interviews across gender, age, and culture, representing three cohorts of autistic clients, therapists, and autistic therapists were analysed qualitatively. A constructivist grounded theory adaptation using an intersubjective analysis was further developed (Doyle, 2017) to analyse the intersubjective space between researcher and 12 participants.

Results/Findings
Several categories evolved around relational dynamics between divergent individuals, leading to a core category termed neurotransception. Neurotransception is an umbrella term which conceptualises how divergent individuals receive each other at an embodied neurobiological level seeking safety
(Porges, 2004). When divergent intersubjectivities from different neurotypes meet, imposed power dynamics from conscious/unconscious levels may evolve based on the non-autistic other’s intrasubjective misinterpretations to reconfigure their prediction error in predictive coding theory (Friston, 2010). This may manifest as an attempt to fix rather than relate to an autistic individual, resulting in exacerbated experiences of masking, shaming, as well as trauma and attachment based reactive responses.

Limitations
Future research could explore focus groups to explore variations between autistic and non-autistic individuals’ experiences as well as gender differences.

Conclusions/Implications
These findings suggest underlying relational dynamics occurring throughout the autistic individual’s lifespan, which may have impacted their mental health experiences that have been misrepresented as part of autistic experience. This has implications for researching misrepresented individuals, exploring a longer conversation around diagnosis at a relational level, and developing more relational therapeutic approaches to neutralise neurotransception.