Ableism and Neurodivergence


Ableism is the belief that some people’s bodies are more fit than others and are therefore superior. It is the foundation of racism, sexism, allism, homophobia, and transphobia. Ableism as it applies to neurodivergence is the belief that people must act according to some arbitrary social rules in order to have social value and that people who don’t, regardless of whether they try to do good things for others, or regardless of how kind they are to others, have less value than people who are able to fit into these social standards.

People think, “if only you tried harder, if only you tried to heal, that you would be able to fit in and then you would be worth something in my eyes.” Neurodivergence doesn’t work that way. Many aspects of neurodivergence do not change much as a result of therapy or healing trauma. In fact, some aspects of behavior, that are more natural to neurodivergent folks may be seen as authentic and beneficial for them to accept rather than to try to change. And indeed even for those things that we may try to change, the best way to do that is through acceptance first, before change. 

Many people are harmed by the people they love the most because of ableism. People will say many things in response if you call them out. They may attack the person who says these things out loud and suggest that they are being combative or defensive or even sinister or that they are hiding behind neurodivergence or that they don’t really want to heal.  Many people who are neurodivergent, whether they are formally diagnosed or not, will  internalize these things about themselves. Many of these things people might have changed if they could and even sought to change in the past.  Therapists may even inadvertently contribute to this kind of trauma if they don’t understand neurodivergence. 




My name is YanLin.  As a neurodivergent person, I have dedicated the past 20 years of my adult life towards understanding mental health, trauma, relationships and oppression. I have worked through much of the trauma that needed to be healed. I recognized these things in others before myself. And it is mainly as an advocate for others that I wish to speak up so that others do not have to suffer in these ways. 

How to Navigate Therapy When You Fear Loss of Autonomy 

By YanLin Tso


As both a therapist and a neurodivergent person who has sought therapy, I recognize  an unusually strong desire for autonomy and a fear of losing my autonomy in therapeutic settings. I write this article as a continuation of my previous blog article on PDA. I  also want to affirm that having a sense of autonomy is a legitimate need that anyone in therapy needs to feel they have at all times.  If a therapist is unable to affirm your right for autonomy then you can and probably should make the choice to go to a different therapist.

On the other hand, it is possible that the fear of loss of autonomy comes from a tendency to fawn to authority figures.  


In the framework of Internal Family Systems, we may have a fawning part as a  coping mechanism that likely arose in reaction to a parent or caregiver who wasn’t able to affirm your autonomy.


Fawning is hard to control as it is part of a trauma response.  It is not fully voluntary.  




Fawning tends to look like being overly agreeable or easy in someone’s presence, and at times even idolizing the person.  It can become apparent when we realize that over time or when we are outside of the situation we feel really differently about the person or interaction.   It suggests that there is a need for resources for self-regulation at the beginning or potentially throughout sessions.  It may be important for clients to take a really active role, potentially more than usual in steering the therapy.  The danger in fawning is that it can hinder progress in therapy and leave you vulnerable to potential abuse.

The difficulty is that there are moments when we might need to allow the therapist to take the lead in certain ways.  However, it is important for you to realize that it is okay and often necessary for you to have boundaries around when and how that happens.  You can ask your therapist to ask for consent prior to initiating specific work, for example.

It may be important to express your fears about loss of autonomy specifically to your therapist.  And a therapist can help make room for all of your parts to be in the room, even the parts that feel things that might be inconvenient to the therapy itself. 

“Pathological Demand Avoidance” from the perspective of an Neurodivergent Person


YanLin Tso, LCSW


Pathological Demand Avoidance (PDA) has been described either as a type of neurodivergence within itself or associated with other types of neurodivergence (abbreviated here as ND), such as autism and ADHD. What is PDA? It is defined in Wikipedia and elsewhere as a greater than usual refusal to comply with requests and expectations.  In children, it can be associated with Oppositional Defiant Disorder.  I agree with other professionals that it would be beneficial to rename it as the “pathological” descriptor isn’t necessarily accurate or helpful.  I suggest referring to it as simply Demand Avoidance.

Woman holds up hands as a refusal or boundary.

What does Demand Avoidance look like?  Sometimes it manifests as refusal for what someone externally might deem as a “reasonable request.”   Other times it manifests as something that someone avoids doing because they believe it is something they “should” do in order to get what they want. 

What PDA is not.  It is not general defiance towards authority figures, it is not resistance to treatment, it is not laziness, it is not a fixed character trait that cannot be changed and it is not necessarily animosity towards a caretaker (unless a caregiver is doing something that makes it reasonable for a person under their care to be defiant).  It is not necessarily pathological either. 




Could PDA be a way of coping with ableism?

Many ND people, whether diagnosed or not, have had the experience of having someone expect them to be able to do things that they cannot do, or they are expected to be able to do things in the same way that neurotypical people do.  But people who are neurodivergent by definition, may think or experience the world differently.  Thus they may have their own ways of doing things that work best for them.  It is this misunderstanding that can lead people to believe that they are just being difficult, lazy, irresponsible or that they are somehow inferior because they cannot or will not do what is being asked of them. ND people tend to internalize this type of feedback, believing that they are inferior in some way, thus it can be a trauma that is the result of internalized ableism. 

Demand Avoidance can be positive,  as a means of self advocacy.  If one is trying to work with someone who displays Demand Avoidance, it is possible that they are not able to do what you are asking them to do in the way you are asking.  It is possible that they are having a reasonable response to someone who is trying to take away their autonomy or a similar projection based on past experiences.  It is also possible that this behavior is a barrier that gets in the way of their goals and it is treatable.



Reality Redefined.

For the latter situation, I suggest an Internal Family Systems (IFS)  approach. If you aren’t familiar with this framework, see Richard Schwart’s book, called, “No bad parts.”  In the context of IFS, we can view Demand Avoidance as a part, specifically as a protector that helps the individual avoid the feelings that they have historically experienced as a result of not meeting the expectations of others. Perhaps they experienced feelings of shame, inadequacy, or guilt.  In the IFS framework, we can view the part as having the positive intention of helping someone to not have to feel these difficult feelings.  Likewise, neurodivergent people often internalize the authoritative part that says what we “should” be doing and have a demand avoiding part that responds to that part.  In treating Demand Avoidance, in the IFS framework, we would help the client to flesh out the parts and understand the needs of the parts. 

Perhaps the therapist and the Self would try to help the part(s) that are being protected. Then we might find boundaries or an appropriate role for the protector part so that it does not need to be exiled and it operates in a way that is beneficial to the whole Self.  


YanLin Tso, Licensed Clinical Social Worker and Autistic Person