Unlike most people in their twenties, I spend more time in the waiting room for one of my therapies than I do in the club. And yes, that’s therapies, plural.
When I was first assessed for Autism at the age of seven, it was still seen as a “boys’ disorder,” and people were more curious about its origins—and how to prevent it—than actually making life easier for the Autistic people that already existed. I was only formally diagnosed as an adult, as the issue of those assigned female at birth being underdiagnosed only came to light recently. Honestly, though? Autism itself is a relatively recent concept; the first diagnosed Autistic individual, Donald Triplett, only died in 2023. The first officially recognized Autistic person ever, and he lived well into my lifetime.
I digress—because we’ve spent most of the past eight decades of Autism research on what to do about Autism, nobody warned me that I would be in not one, not two, but three different types of therapy, with almost a decade on antidepressants and an arthritis scare at the age of nineteen.
Yes, really, it’s all connected.
Newer understandings of Autism recognize it not just as a difference of the brain, but a full-body disorder, with common comorbidities including joint hypermobility, GI issues, allergies, and general chronic pain, alongside an increased prominence of other neurodevelopmental and mental health disorders. I have a few of these, and because there was nobody to help me parse what was normal and what wasn’t, I once saw my whole constellation of disabilities as a big, nebulous blob of things that hurt, things that frightened me, and things that kept other things out of reach.
My disabilities limit me, and always have. When I was younger, I dreaded these limitations being acknowledged, but was also resigned to their presence. At times, I got defensive when people tried to push me past them—whatever these problems were, they were mine, and I was fine living with them… so long as I kept to a strict, insular routine, and avoided any sensory or anxiety triggers. So long as I didn’t try to get too close to other people, in case I got overwhelmed and embarrassed myself. So long as I practiced restraint even with the things I loved, like playing my beloved flute, which I could only do for so long before my fingers would ache, and then tingle like TV static, and then go numb.
For a long time, I figured that was going to be my life forever, that the best I could hope for was maintenance that prevented me from actively getting worse—that I could stop the walls from closing in further, but that I had to be grateful for what little room I still had.
My therapies changed that, all three of them,* and in a world where disabled people often feel like I did, like the options are to stay the same or get worse, I want to advocate for an alternative.
Talk therapy at eleven
Talk therapy came first, when I was eleven. My first therapist was Doctor Frank, and above everything else, I remember how patient he was with me, then a tiny, timid thing that preferred books to people, and how he looked more than a little bit like Santa Claus. He told me about his own disabilities, and how they weren’t just something to tolerate at the best of times and loathe at the worst, but part of who he was. Severely dyslexic, he’d memorize the layouts of entire pages so the individual letters wouldn’t swim about, and that became an easy, natural part of his workflow. He retired only a couple years after taking me on, but before we parted ways, he told me to trust myself and see myself as worthy. One of my biggest regrets is not doing so sooner.
That, though, wasn’t Doctor Frank’s fault. My Autistic traits were still medically unacknowledged, so he was stuck treating me as a bog-standard anxious tween—and as he and a litany of other counsellors would learn, I didn’t always find relief where my peers would. My emotions and anxieties were volatile and unpredictable, even to me, and I was never quite sure why my brain worked how it did.
Physio, and a mystery in my hands
Physiotherapy was a similar story—I started when I was eighteen, when my regular aching and numbness turned out to be very irregular indeed. I went to the closest rehab office I could find, and while nobody ever really named what was wrong with me, they reduced the pain and inflammation in my hands, and that was good enough, wasn’t it? Occasionally, they mused in some vague direction of a diagnosis, but even under the same roof, the therapists would contradict each other: maybe it was carpal tunnel syndrome, maybe something with my tendons, maybe even early-onset arthritis.
But hey, the treatments worked, so who cared?
Why I finally tried occupational therapy
For a few years, that was enough. When I finally got my Autism diagnosis, it wasn’t anything life-changing—more just a confirmation of what everyone in my life had already suspected. I’d become somewhat more extroverted and found a small circle of friends who shared some of my interests, and while my limitations remained, we worked around them—my aversions to cooking and sensory overwhelm had us regularly meeting at each other’s houses, ordering takeout, and watching movies. On occasion, I’d go to a concert or a local nightclub, but I’d have to spend days in recovery afterwards—despite my sobriety, I’d always end up with something of a sensory hangover. I fell in love, but my partner was even more introverted than I was, so my homebody tendencies were never much of a problem.
The real issues remained, though: emotional dysregulation, executive dysfunction, chronic pain. I felt like a dead weight in the kitchen and other domestic environments, and my clumsiness made me a household hazard. But what was there to do, really? I was disabled. I still figured I’d be lucky if things didn’t get even worse.
Until, almost as an afterthought, the doctor who diagnosed me with Autism mentioned occupational therapy: a treatment that focused on equipping patients with the necessary skills for everyday life. I’d scored abysmally in general day-to-day functioning at my assessment, so she’d figured I’d benefit.
I could, at least hypothetically, learn to cook for my girlfriend without freezing up at the stove. I could write letters for my friends without my hands cramping up. I could improve my coordination skills. I could maybe have a better understanding of my inner world, and generally better regulate my senses and emotions.
Just the idea gave me hope: I wasn’t stuck preventing myself from getting worse—I could get better. And I was deeply fortunate to have people who, when I told them about this therapy, thought that I was smart and capable and could set my mind to doing more. Most of them are neurodivergent themselves, so they knew exactly what I was up against—and I promised to share my findings, if anything came of it. I was hopeful, though, that I’d finally confront a lifetime of internalized ableism, a lifetime of being stuck in that tiny room, and make it flinch first, blowing the walls open. I loved myself enough to try, thanks to the people in my life and the things I wanted to do for them.
Of course, it’s easy to say all that. Doing it is something else entirely.
What occupational therapy changed
And so we arrive at occupational therapy. I specifically went to a “neurodivergent-affirming” practice, one with a vested interest in not just strategies for where I struggled, but explanations for why.
My therapist was a massive nerd about neuroanatomy, or how the brain is built. Autism, being a neurodevelopmental disorder, comes with a range of differences compared to the brains of allistic people: some things are more active, or more connected, or just wired differently. And being able to come to my therapist with a problem—executive dysfunction, emotional regulation, or clumsiness—and not just get a band-aid solution, but an explanation as to why the issue was there, was the game-changer I had lacked all my life. For the first time ever, I had a qualified professional who could explain my brain to me, and how to work with its differences instead of against them, because they weren’t going away. I could make educated decisions on where to push myself and where to step back, and come up with tangible strategies for issues I faced.
I went to therapy because I loved myself and my support system, and I came out loving my Autistic bodymind, too, finally having its differences named and accommodated. I learned about differences in interoception and proprioception, and how my joint pain was likely a result of hypermobility, which was disproportionately prevalent in Autistic folks. I learned about all the subtle ways I would still mask myself as neurotypical, and how to stop, because it was deeply draining—and why should I have to pretend to be something I’m not, anyway?
Bringing it back to counselling and physio
That new perspective has followed me to the other therapies, too. Having a solid sense of how my brain worked emboldened me to try new things, and I went back to my other forms of therapy able to better advocate for myself.
Counselling looks something like an ongoing seminar, with my wellbeing and growth as the subject. I go into every session having written down what I want to discuss, and I take notes on how to respond and which coping tools I have in my arsenal. I’ve got pages upon pages of strategies and exercises that help me self-regulate and pull through when I need it. In the past, all of that knowledge used to fly out the window when I spiralled, but now, it lives on paper, tailored for my unique needs.
Physiotherapy, meanwhile, has completely changed since I was able to name my hypermobility and have it acknowledged. I know why my joints ache the way they do, and can actually carry a conversation with the specialists who treat me, instead of passively nodding and letting them try anything. I can also finally reach out to other people with similar problems, and take their advice. Today, my workspace is customized to minimize joint pain and uncomfortable positions, and I have a solid roster of braces, splints, and compression gear.
Of course, I still come up against walls in all of my treatments—they always say “knowing is half the battle” like it’s empowering, but there still remains the whole other half of the battle. And there are some things I’ll probably never do, regardless of any treatment. Disabilities, after all, are disabling. But in recent years, I’ve had the capacity to try and see just how far I can push my limits, and isn’t that a gift in itself? I think so.
Therapy today
My therapy today is mostly maintenance; my occupational therapy program has ended, and I mostly go to counselling and physio when I have emotional or physical flare-ups, respectively. I notice with pride—and my wallet with relief—that I’m not attending either as much as I used to. I help my girlfriend with dinner, and knock nothing over when we load the dishwasher. I can write a whole extra page more than I used to in one sitting, and if I have to wear compression gloves or a brace to do so, what of it? The words are there.
I spend less time frustrated with all that I am. I never really got “better” in the sense of some miracle cure, but I got better at knowing and loving every part of me, and found more accessible ways to move through the world. So what if I’m the youngest person in the therapist’s waiting room? It just means I have so many more years of learning and growth ahead.
*Technically four if you count pharmacotherapy, but that story’s just one sentence: I’ve spent five years taking a pill that makes my brain a smidge quieter. La-dee-da.