Over the past decade, therapy has started embracing somatic (body-based) practices. We are moving past the old idea that the body stores trauma like a filing cabinet; instead, as neuroscientist Lisa Feldman Barrett’s work implies, the brain is constantly running an internal budget of its resources, predicting and keeping the score, while the body serves as the ultimate scorecard (Barrett, 2017). Yet, an interesting pushback has emerged in the neurodivergent-affirming community. Some practitioners and advocates have expressed deep skepticism about bringing the body into therapy.
The underlying message out there is often that asking an autistic or ADHD client, "Where do you feel that in your body?" is an exercise in futility. There is a pervasive assumption that neurodivergent people have a fixed, inherent inability to feel our bodies or interpret their messaging. But this may be a relic of stereotype, and I want to break this down and separate clinical myths from our actual, lived realities (Neff, 2023).
Like many other traits, interoception—our internal sense of what is happening inside our bodies—is simply one more area where we neurodivergent folks display a "spiky profile." Our internal wiring is wildly diverse, not a monolith of deficit. For example, we might rarely feel hunger or the need to use the restroom until our blood sugar is actively crashing or the situation becomes an absolute emergency—especially when absorbed in a special interest or attentional tunnel.
Autism, AuDHD, and ADHD are all characterized by a narrow window of tolerance. Those of us who have ADHD or are AuDHD often experience a tendency toward quickly shifting, intense emotional waves that can roll in like a sudden summer storm. Our ability to interpret these internal states is further complicated by processing that requires more time and effort due to the sheer, unedited volume of incoming sensory data. For some of us, identifying a distinct emotion in real-time feels entirely out of reach. Others might need days to process a single event, undergoing a full-on existential excavation to find the right words (not at all speaking from personal experience). Meanwhile, still others possess complete and instantaneous emotional granularity.
Untangling the Landscape of Alexithymia
To understand this spiky reality, we have to talk about alexithymia—a term that translates to "no words for feelings." It is characterized by difficulty identifying, describing, and distinguishing between emotional states and their accompanying physical sensations. It is important to note that alexithymia is not a core feature of autism itself, nor does it mean an absence of emotion; rather, it is a processing gap between a physical sensation and a cognitive label.
The statistics clarify exactly why this gets so misunderstood:
The General Population: Large-scale studies establish that significant alexithymia affects roughly 5% to 10% of typical, neurotypical individuals (Salminen et al., 1999).
The Autistic Population: In a definitive systematic review and meta-analysis published in European Psychiatry, researchers found a prevalence of 49.9% in autistic populations compared to just 4.9% in neurotypical controls (Kinnaird et al., 2019).
This means that while half, and potentially more, of our community navigates profound emotional-somatic blindness, an entire half do not. Blanketly banning the body from the therapy room ignores the massive population of neurodivergent people who experience their inner world with acute, sometimes overwhelming physical intensity.
The Original Somatic Therapists
I look at this landscape through a slightly different lens: I think us neurodivergent folks were actually some of the first somatic therapists.
Hear me out. Many neurodivergent people stim starting from a very young age. While many of us learn to mask these impulses under social pressure, they don't disappear—they simply turn inward. They mutate into repeating the same line of a song or a phrase over and over in our heads, pacing back and forth (because it appears more socially acceptable), swaying subtly, or manifesting as body-focused repetitive behaviors like skin picking or hair pulling.
Stims are not "purposeless behaviors" to be trained out of us. They are brilliant, innate biological mechanisms designed to soothe a dysregulated nervous system by introducing highly predictable, rhythmic sensory input to the brain. They serve as somatic release valves and protective neural balms, providing the precise rhythmic input needed to help organize and settle the whole body. Our bodies hold immense wisdom regarding how to manage our allostatic load (the cumulative wear and tear of chronic stress on the body). When these organic behaviors are extinguished by parents or driven underground by social rejection, a massive part of affirming therapy is helping you find and build them back in ways that feel genuine and liberating to you.
Exteroceptive Overload and the Mental Toll of Masking
Why do our internal signals get so faint in the first place? The neurodivergent nervous system is often characterized by exceptionally high exteroception—an intense awareness of the noises, smells, textures, and lights around us—which inherently crowds out our internal cues. As Dutch researcher Peter Vermeulen outlines in his groundbreaking work Autism and the Predictive Brain, a brain that is burning the vast majority of its finite, internal resources on processing overwhelming external input simply lacks the leftover computational bandwidth to map and process internal, interoceptive cues (Vermeulen, 2022). (LOL, for a full infodump on Vermeulen, please see me for therapy. That book changed my life.)
Furthermore, social masking severely deepens this mind-body disconnect. A landmark study by Dr. Matthew Lerner at Drexel University offers direct neural evidence of the biological cost of passing: heavy masking forces the brain to hyper-process external social inputs while drastically suppressing internal emotional reactivity (Lerner et al., 2025).
When you spend decades devoting your precious neural energy to fawning, tracking safety, and managing the comfort of everyone else in the room, your own internal cues are driven deeply underground. Chronic masking systematically trains the brain to ignore the body, eventually culminating in functional dissociation, exhaustion, and severe burnout.
A Nuanced Pathway Forward
Bringing the body into a neurodivergent-affirming therapy space isn't about forcing you to stare inward and decipher an invisible heartbeat. It is about co-creating a space where you can safely rebalance an uneven equation.
Because our wiring is spiky, the entryway to this work must look wildly different for everyone:
Somatic Tracking: For those with high interoceptive awareness, physical sensations offer an incredible, direct line of inquiry to process emotional material.
Nervous System Mapping: For those operating with high alexithymia, looking at the body through a structural lens can provide a wealth of data without forcing you to invent emotional words that aren't there yet. It is worth noting that while Polyvagal Theory—the standard clinical framework for this—is rightfully being scrutinized by modern neuroscience for its oversimplified evolutionary biology, attuning to your actual nervous system states still offers immense practical utility. Whether we call it a dorsal collapse or simply a survival-driven energy crash, learning to map your unique activation states gives us a roadmap for support.
Cognitive Trailheads: For those where the body feels like a dangerous or entirely silent landscape, starting with parts work, unblending, and tracking thoughts is the safest, most affirming place to begin.
We carry beautiful, intricate architectures that demand a highly nuanced approach. We cannot simply abandon the physical self because standard, neurotypical mindfulness scripts fail our community. Instead of asking a static, frustrating question to a client sitting perfectly still, we integrate purposeful movement, deep pressure, proprioceptive input, and organizing visuals to help bridge that mind-body gap – and only when that is an invitation to the client’s system. Therapy shouldn’t ask you to conform to a neurotypical standard. It should be the place where you finally get to stop performing, honor your true capacity, and welcome your body back home.
