# Rethinking CBT: An Autistic Perspective on Therapy Challenges
Written on
Understanding the Limitations of CBT
For years, I've grappled with articulating my thoughts on Cognitive Behavioral Therapy (CBT) in relation to autism and neurodiversity. It’s a complex issue, and the struggle is real. Any therapeutic approach that relies solely on cognitive strategies, even if it incorporates some behavioral elements, is fundamentally flawed. Why? Because the foundational techniques of CBT require abilities that not everyone possesses.
How can CBT, which is primarily designed for neurotypical individuals, possibly be effective for those on the autism spectrum? Most of the research is conducted on a narrow demographic—typically white university students seeking quick compensation for participation. This raises a significant concern: only a minuscule percentage of these subjects, about 3%, are autistic. And those who are often have the academic prowess and cognitive skills necessary to be admitted to university—at least, that’s the assumption.
This discrepancy leads to a critical observation: the brains being studied are neurologically distinct from ours. Attempting to "correct" our neurological differences is not only misguided, but it also ignores the unique cognitive processes that characterize neurodivergent individuals.
Consequences of Behavioral Techniques
The behavioral aspect of CBT often resembles animal training. If an individual is subjected to enough aversive stimuli, they may avoid certain situations, but at a significant cost to their mental well-being. It’s a superficial victory for the therapist or educator who can then mark "success," while the individual continues to suffer internally, silently battling their struggles.
This aversion conditioning is rooted in fear and pain, mechanisms that are effective across many species, including humans. The reality is that fear works, especially on young minds still learning to navigate their worlds.
Examining the Cognitive Component
When discussing the cognitive side of CBT, it’s essential to recognize that executive functioning—essentially decision-making and processing internal states—is often a challenge for autistic individuals. The therapy asks us to track our thoughts for cognitive distortions and replace them with more accurate ones. This involves navigating countless decisions and social cues every second, a process that remains elusive for many of us despite assurances from professionals.
The experience of masking—concealing one's true self to fit societal expectations—compounds this issue. We know that masking is ineffective and detrimental. Fear and pain are not viable strategies for thriving; many of us are already facing the consequences of these approaches.
Recognizing Diverse Cognitive Profiles
Neurodivergent individuals possess varied cognitive profiles. Autistic individuals, those with ADHD, dyslexia, and dyspraxia, all think differently, and even within these categories, there is considerable diversity. For example, an autistic person with ADHD will approach life differently than an autistic person with dyslexia.
To genuinely understand these differences, we need longitudinal studies that examine representative populations before endorsing any therapeutic techniques. This is crucial for practitioners, coaches, and therapists alike.
In conclusion, we must challenge established practices like Applied Behavior Analysis (ABA) and CBT. This is not just a rant; it’s a call to action for more inclusive and effective therapeutic methods that acknowledge and respect our unique cognitive styles.
As I prepare to formalize these thoughts into an article and a podcast, I invite you to support initiatives that advocate for the neurodivergent community.
Support AutisticAF.me here: Paypal · Ko-Fi · Facebook Pay "Johnny Knapp"