For a long time, I was the picture of a “good therapist.” Productive. Efficient. Great with clients. My performance reviews glowed, and supervisors held me up as an example. I navigated high caseloads, endless paperwork, and constant crises like clockwork. On paper, I was thriving.
But here’s the thing: I wasn’t.
I’m autistic, though I didn’t know it until later in life. Looking back, it’s obvious. My ability to tune into emotions, track patterns, and hold space for complexity wasn’t just a skill set—it was how I moved through the world. But so was my need for predictability, recovery time, and environments that didn’t treat sensory overload like a personality quirk to “get over.” None of those needs were recognized.
Instead, my ability to mask was taken as proof that I was fine. Because I could push through the sensory assault of fluorescent lights, back-to-back sessions, and relentless emotional labor, no one thought to ask how I was doing. And honestly, I didn’t know how to ask either. I bought into the idea that being a “good therapist” meant running myself into the ground. Wasn’t everyone tired?
Turns out, no. Not like this.
I wasn’t just tired; I was unraveling. Slowly at first—missing details in documentation, feeling the weight of every session settle in my chest like concrete. Then all at once—autistic burnout hit me like a freight train, dragging my CPTSD back into full force. I found myself struggling to stay focused in sessions, physically ill after a full day of work, and overwhelmed by the hum of lights and noise I could no longer block out.
By the time I landed at the Houston Area Women’s Center, a workplace that was actually more disability-friendly—one that might have been sustainable for me—it was too late. Years of agency jobs had already burned me out like a Roman candle. I arrived with nothing left to give. The damage was done.
The Houston Area Women’s Center was a workplace where I finally saw the potential for disability-friendly practices, and I believe I could have thrived there if I’d had the chance. But the years of unrelenting systemic pressures had drained me. I had spent too long in settings that equated productivity with resilience, leaving me—and many others—without the support we needed.
Leaving wasn’t just a loss—it felt like a betrayal. I had spent years advocating for autistic clients and colleagues. I trained peers about neurodivergence, helping them see clients (and sometimes themselves) more clearly. I spoke up in meetings about accommodations, not just for clients but for staff. I pushed for change in systems that didn’t make room for people like me.
But while I was busy advocating for others, no one noticed I was burning out. Supervisors waved off my exhaustion and slipping work as if resilience were infinite. To be clear, this wasn’t just their failure—supervisors were as overwhelmed by the system as I was. They weren’t trained to see burnout as systemic, or to recognize the needs of neurodivergent staff. Accommodations weren’t just absent—they were unthinkable. By the time I understood what I needed, it was too late.
What’s particularly tragic is how little it would have taken to keep me going: quiet spaces to decompress, realistic caseloads, and supervisors trained to recognize that burnout isn’t a personal failure but a sign the system itself is unsustainable. These aren’t revolutionary ideas—they’re basic human considerations.
Now, in private practice, I work primarily with autistic and neurodivergent adults. I love it. For the first time, I can show up as myself—unmasked, honest, and present. But I can’t help mourning the chance to have done this work in agency life, where advocacy felt more urgent.
I know I’m not alone. Many neurodivergent professionals are burning out quietly in a field that prides itself on empathy while treating its providers like machines. And while these issues disproportionately harm neurodivergent therapists, they reflect broader systemic failures. Caseloads that stretch staff beyond their limits, a lack of training on how to support overwhelmed employees, and the prioritization of productivity over people hurt everyone.
Yes, agency work is hard on everyone. Yes, resources are stretched thin. But that’s precisely why reform is so necessary. Addressing burnout isn’t just about helping individuals—it’s about creating systems that actually function for the people within them.
The mental health field didn’t just fail me; it failed the clients I could have served, the colleagues I might have mentored, and itself. Losing neurodivergent therapists isn’t inevitable—it’s a choice the system makes when it refuses to change.
Burnout among neurodivergent professionals isn’t about individual resilience. It’s about systemic rigidity. Until we start valuing advocacy, accommodations, and the humanity of our providers, we’ll keep losing the voices we need most. And that’s a loss none of us can afford.
Culture, which includes our intellectual culture and all our worthless intellectual discussion, cannot find answers to our problems because culture itself is a record of our confusion, because it is the very expression of our confusion in cultural and linguistic forms. So no thought and no expert can ever answer our problems. Only the free, uninfluenced awareness can answer our problems because to the brain this thing is the eye of God. It shows what is as it is, and educates the brain directly without the intervention of word, culture or thought. Unless and until you discover this all your works are in vein. Indeed your whole life is in vein, so discover it now, and to discover this you must see it, not believe or agree with what I’m saying. See what the intellect and intellectual discussion actually is – the past, socially conditioned representations of past memories of perceptions which are lost behind the representation, when the eyes and the brain have direct contact with what is when they are free of the thought, the culture and the word. All true knowledge and understanding is born of perception, for if it hasn’t been seen, how can it ever be known? The solution is that YOU must become the expert in all that is, which is simultaneously yourself and the world, because you are consciousness, and this thing we call the self and the world are mere happenings inside of you. How can any expert ever teach you about what you are, which is to say your life, your consciousness, your world – all that ever is? Do you see? Reality, or life, cannot be approached through any specialization and cannot be grasped by the word, by the socially conditioned linguistic representation of the general sensuous patterns of life which are seen directly before they are butchered by thought and word.
The eye and the brain and the consciousness are truly divine instruments when they are clean. It is the word and the thought and the society which is unclean, and obscuring this divine instrument, inevitably it obscures, darkens, the clear perception of what actually is. I may sound like a broken record but your eye, brain and awareness is liberation from thought, word and society, and if you look at it with your eyes rather then with words it is so manifestly obvious, and an Earth shattering insight all at the same time. Discovering this truth is also discovering why all experts and authorities destroy, and all these experts and authorities are themselves confused human beings that through their confusion are destroying you. Perhaps if we all discover and become this all our words would unavoidably and unknowingly work towards only the liberation of the true from the false through the destruction of the false – the destruction of all experts, all authorities, all culture. Life is not culture. Life is life! And when life knows it is life it’s culture is life, is living culture. You will know what living culture is if you are fortunate enough to know precious moments of peace and affection with your family, or if you have a good sex life. Forms of existence are involved – conditioned forms of existence – but they are at the same time life. All culture should be like this (and if it is we will understand what makes for cultural beauty which exists today only in our historical memory, which in America is largely digested via the highly ideologically selective screen of cable documentaries and old Western movies). “What we resist persists.” It has to, because we are all things, including what we resist.
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I won’t venture into your word world. It’s a psychopathic world. Words are the only psychopath in the world. When you see a psychopath know that words won. Nobody is a word. All names are murders and lies.
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I love you, the truth. You taught me that the only thing separating me from another is mere thought, words. You showed me in the clear sunlight light of day that they are the truth, the fact, the actual, the sun-wrapped actual the son of which is an infinity of actuals each of which is producing an infinity of actuals. It takes place in the Mother. The Mother, The Father, and The Son are One. And they are each of us. Understand this or go to hell in a handbasket full of Creme Cafe’s and McDonald Waitress and Isolated Old Lady Dying In Distress and Next Life It Will Be You. And you and you and you. Because you are all that, the beginning and the end, the father, the mother, and the daughterson. You are all that, and no man in a flat cap can ever take from that.
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neurobollox – not a single person has anything EVER identified in their neurology/brain during an assessment – you could see ten psychiatrists and get multiple different labels- its unscientific, invalid nonsense.
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I agree and the diagnosis avoids the basic problem; unrealistic case loads put on workers by a profit driven healthcare system.
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I saw three different doctors, within about three days, and had three different psych labels, according to my medical records. So you are absolutely right, Topher, about the scientific fraud of the DSM “diagnoses” / “disorders.”
The DSM is “unscientific, invalid nonsense.” But it’s used by the incompetent and unethical doctors to cover up their easily recognizable malpractice, and psychological misdiagnosis with the DSM disorders is how the unethical pastors cover up their, and others’, child abuse crimes … at least according to the totality of my family’s medical records.
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Being American ought to be in the DSM. And given that people as idiotic, dangerous and vampiric as Donald Trump and Elon Musk are in charge of all of your futures and that of all your children, it is clear that neither psychiatry nor antipsychotics are ever going to help you. Indeed psychiatry and antipsychotics only makes the jobs of these vampires that bit easier, and the pharmaceutical executives and psychiatrists, who are also vampires, that much richer. Just think how through stealth and slight they steel your life and take it as their profit, whether psychiatrist or politician. Now evil vampires have stolen your beloved nation, which is you, your life and that of all your loved ones, and are instrumentalizing and plundering it all as one big meat stack. So much easier to plunder a twitching meat stack then it is free and natural, and therefore healthy and intelligent, human beings. For so long as you continue to give psychiatry and psychopharmacology any credit whatsoever, or concede to them any role, you may as well as a country extract your own life and blood, and that of your children, and pump it straight into their veins. These oxygen hungry blue blood cells come spilling back at you from the vampires, spilling back to you demanding more. And when you enrich it the blood innervates the destructive activity of these vampires and delivers oxygen rich blood to their brains, powering it’s evolution so that they become worse and worse, i.e.. more effective vampires. Over time these veins widen and thicken and strengthen like tree roots which are sunk deeply into each of you. These roots are ever growing and spreading, but they have exhausted the supply of living organisms. So there is only one possible direction to this process: to increase the extraction from each one of you. And you consider conforming to this society the ‘safe’ option. Tell that to the millions of lonely, isolated, poor old pensioners, or those million destroyed and forgotten US veterans, some of which are committing suicide every single day. Psychiatrists have never solved that one, and pretending they can ensures the perpetual conveyor belt of customer victims, ensuring an never ending supply of ruined meat stacks. So conforming to this society IS like committing suicide a little every day. “Every little helps” says black eyed coffin man with black police badge. He wants to make enormous BBQs out of all of you. And you invented the BBQ to roast meat stacks for yourselves. Now the meat stacks are coming for you.
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The concept of “Autism,” along with the 296 other quasi-diagnoses listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, lacks a scientific basis (Council For Evidence Based Psychiatry, 2024, http://www.cepuk.org, Breggin, 1991; Whitaker, 2010; Woolfolk, 2001; Szasz, 1987). It is important to recognise that everyone is neurodivergent.
Furthermore, “psychotherapy operates within the same authoritarian and patient-humiliating framework that has become entrenched in psychiatric practices” (Masson, J, 2012). It is a victim-blaming, capitalistic scheme that fails to deliver effective results (Smail, D, 1984).
If you consider yourself an expert on unicorns, I encourage you to conduct thorough research.
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I prefer to drop the nuerodiverse bit and just say we are all different. No need to mention nuerones
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I think what the author is describing is the warped values of profit driven companies employing therapists. Autism is a redundant concept here. Nose to the grindstone is inherent to private Healthcare and everyone suffers. To separate out people with perticular identities, whether those be diagnostic catagories such as autism or something else such as gender, race or sexuality doesn’t ameliorate the basic problem, capitalism sucks. Burnout occurs in all professions, especially the caring professions such as therapy, social work and nursing. It can only be addressed by an organised workforce demanding better conditions of employment.
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I think the article neatly illustrates how MH diagnosis act to distract from the social causes of distress.
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I totally agree with you John. Capitalism can make anyone exhausted.
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Yes, better conditions of employment are a big deal in the helping professions.
But so are employees who are healed and emotionally well and can set good workplace boundaries.
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Quite simply I will say, “been there, done that” and did not want the proverbial t-shirt.
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I was an RN. Probably not a good field for a neurodivergent person. The burden of responsibility was beyond what I could handle. Before that I was a caregiver. I, too, worked myself to a pulp and burned out really severely. Some of it had to do with poor workplace boundaries, working night shifts, and an irregular work schedule. My biological clock was shot to hell.
I did a good job at masking my pain for a long time.
I don’t know about all these autism diagnoses. I feel like there’s so many people with that diagnosis nowadays, but are that many people really autistic? I wonder if I’m autistic. I have OCD.
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Thank you so much for writing this blog. It lets me know I’m not the only one who finds life in this brutally rigid, coldly systemic, and productivity-driven, world too much to take. I now know why I can’t stand people who relentlessly preach “resilience”.
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I’m so glad you found a way to make things work for you and thank you for your advocacy. Us neurospicy folks can be such canaries in coal mines, more humanizing workplaces humanize as all.
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“My ability to tune into emotions, track patterns, and hold space for complexity wasn’t just a skill set—it was how I moved through the world. But so was my need for predictability, recovery time, and environments that didn’t treat sensory overload like a personality quirk to ‘get over'”.
“… overwhelmed by the hum of lights and noise I could no longer block out.”
If this is the story of my life, does this mean I too am autistic?
Could someone please tell me the difference between highly functioning autism and an HSP (highly sensitive person)?
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