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.