Understanding the overlap between autism and trauma
For many years, the relationship between autism and trauma has been overlooked. Increasingly, however, research is showing that autistic people are more likely to experience traumatic events than non-autistic people, and they may also experience a wider range of life events as traumatic. This growing understanding is changing the way psychologists think about assessment and therapy, helping to ensure that autistic people receive care that is both evidence-based and neuroaffirmative.
Trauma is not defined solely by what happens to someone. Instead, it is about how an event is experienced. An event becomes traumatic when it feels frightening, out of your control, or overwhelms your ability to cope. While experiences such as abuse, assault, and serious accidents can be traumatic for anyone, autistic people may also find experiences such as sensory overload, or sudden changes in their routine or care environment to be deeply distressing. Research suggests that autistic people are more likely to experience these kinds of adverse events throughout their lives, placing them at greater risk of developing trauma-related difficulties.
Trauma can affect many aspects of daily life. People may find themselves reliving distressing memories, feeling constantly on edge, avoiding reminders of difficult experiences or struggling with anxiety, low mood or emotional overwhelm. Sometimes these reactions are recognised as post-traumatic stress disorder (PTSD), while in other cases people experience significant traumatic stress without meeting the full criteria for PTSD. Either way, these experiences deserve understanding and support.
One of the challenges is that trauma can look different in autistic people. Some behaviours that might be interpreted simply as characteristics of autism may actually reflect traumatic stress, while some trauma symptoms may be expressed differently because of differences in communication, emotional awareness or sensory processing. This means that psychologists need to understand both autism and trauma in order to build a complete picture of a person's experiences.
If you decide to see a psychologist, you should expect them to take time to understand you as an individual, rather than making assumptions based on your autism diagnosis. A good assessment is collaborative, and your psychologist should want to understand your strengths, communication preferences, sensory needs, life experiences and the ways that difficult events may have affected you. Therapy should never feel like you are being asked to fit into one way of working. Instead, the therapy should be adapted to meet your needs.
Many autistic people worry that they will be expected to talk about emotions in ways that feel difficult or unnatural. An experienced psychologist will understand that identifying and describing emotions can be challenging for some autistic people, particularly if they experience something called ‘alexithymia’. Rather than expecting immediate understanding, they may use scales, emotion cards, body maps or creative materials to help build emotional awareness over time. They should also avoid using vague or metaphorical language without checking that it makes sense to you. Research has shown that using concrete explanations and allowing additional processing time are important adaptations for autistic people.
You should also expect your psychologist to ask about your sensory preferences. The therapy room itself can influence how safe and comfortable you feel. Lighting, background noise, seating, temperature and opportunities for movement or sensory regulation may all be discussed. Small adjustments can make it much easier to focus on therapy rather than managing an uncomfortable environment. Therapy should also be flexible enough to accommodate your preferred communication style, whether that involves speaking, writing, drawing or using other forms of communication if talking becomes difficult.
Another important feature of autism-informed therapy is predictability. Psychological therapy often involves discussing painful memories, which can naturally feel anxiety-provoking. Knowing what will happen during each session, understanding why particular exercises are being used and having a clear plan can help reduce unnecessary uncertainty. Many autistic people also appreciate having written summaries, or visual information that they can revisit between sessions.
During trauma therapy, psychologists also recognise that distress may be expressed in different ways. Some autistic people stim more, become quieter, need additional pauses or communicate differently when discussing difficult memories. These responses are not necessarily signs that therapy isn’t going well. Instead, your psychologist should use a collaborative approach to understand what these behaviours mean for you personally, allowing therapy to proceed safely, while respecting your individual ways of coping.
Perhaps the most important message is that being autistic should not be seen as a barrier to psychological therapy. Every autistic person is different, and there is no single "right" way to experience trauma or engage in psychological treatment. Good therapy is collaborative, flexible and respectful of neurodivergence. It recognises that understanding trauma is an essential part of helping autistic people feel safe, understood and supported on their journey towards recovery.
If you are autistic and think past experiences may still be affecting your wellbeing, you do not have to face them alone. Seeking support from a psychologist with knowledge of both autism and trauma can be an important first step towards making sense of those experiences and moving forward with greater confidence and self-understanding.
