ableism Archives - Essy Knopf

I’m not a “professional victim”—I’m a truth-teller in an ableist world

Reading time: 4 minutes

Ever been called a “professional victim” for asking for basic dignity? Accused of having a “victim mentality” just because you pointed out how hard it is to function in a world that wasn’t built for your brain?

As a therapist who’s both autistic and ADHD. I talk about structural ableism a lot. Because I see it every day: in my clients, in my own history, in the systems we’re all trying to survive inside. I talk about burnout, masking, trauma, and the emotional toll of being misunderstood not because I want pity, but because naming the truth matters.

And yet, every time I name that truth, I get all kinds of backlash from online commenters.

Why Naming Needs Is Seen As Threatening

When you advocate for accommodations as a neurodivergents, you’re not asking for “extra.” You’re asking for the baseline things neurotypicals often take for granted: clear communication, environments that don’t trigger sensory overload, time to recover from burnout, compassion for executive dysfunction.

But we live in a culture steeped in structural ableism. It teaches everyone that asking for help is failure. That needing support means you’re not trying hard enough. That suffering is noble, and ease is indulgent.

So when you show up and say, “I need something different,” people think: “You think you deserve special treatment?” Because your truth forces them to confront their own stories, stories built around the myth that resilience means silence.

The Myth of the Self-Sufficient Human

Let’s get real: the idea that strength = independence is a fantasy. It’s a fantasy baked into capitalism, toxic individualism, and neuronormativity. This belief system is a cornerstone of structural ableism, which defines “normal” around neurotypical standards, and then punishes anyone who can’t meet them.

If you’ve ever been told, “Just try harder,” or “We all struggle,” or “Stop making excuses,” you’ve experienced this firsthand. These are cultural scripts meant to shut down dissent. They reinforce the idea that struggle is personal failure, not a signal that the system itself is broken.

But the truth is, many of us are already trying harder. We’re masking, people-pleasing, forcing ourselves through burnout and panic attacks and executive dysfunction just to meet the bare minimum. And we’re still being told we’re not doing enough.

That’s not a motivation problem. That’s structural ableism at work.

Survival Isn’t Strength. It’s What We Were Forced Into.

I moved out at 17. I worked, studied, moved countries, burned out again and again—and I never asked for help. Not because I didn’t need it, but because I believed needing help made me weak.

That belief didn’t come from nowhere. It came from being socialized in a world that shames neurodivergent needs. From hearing, “You’re too sensitive,” or “You think the rules don’t apply to you,” or “That’s just life.”

I internalized all of it.

But here’s the truth: survival isn’t a virtue. It’s a trauma response. Real strength is knowing you have needs and choosing to honor them anyway. It’s saying: “I refuse to perform a false version of ‘okay’ just so others won’t feel uncomfortable.”

Why They Call Us “Victims”

The label “professional victim” doesn’t come from critical thinking, but fear. From people who were never allowed to have needs, and so resent those who name theirs out loud.

Structural ableism teaches all of us to disconnect from our needs. To normalize pain. To see vulnerability as weakness. So when someone dares to speak up and say, “This isn’t working for me,” the world panics.

They mock. They gaslight. They blame. Because it’s easier to believe someone else is exaggerating than to admit that you, too, might be hurting…and that you deserved better, and didn’t get it.

This is why so many people lash out when we advocate for change. They see support as favoritism. They confuse advocacy with accusation. They call us “entitled” when all we’re doing is asking for parity.

Structural Ableism Is Real—And It’s Everywhere

Structural ableism isn’t just interpersonal ignorance. It’s built into institutions: schools that reward compliance over curiosity, workplaces that confuse burnout with dedication, healthcare systems that treat ADHD and autism as personal problems rather than systemic failures to accommodate.

It shows up when people can’t get diagnosed because they’ve masked too well. When they’re denied medication because their symptoms don’t match a textbook. When they’re mocked or excluded for being “weird” instead of recognized as navigating a hostile environment.

It also shows up as microaggressions, like being told you’re “overreacting” to sensory overwhelm, or having your direct communication style interpreted as rudeness.

Naming these realities isn’t playing the victim. It’s truth-telling.

Compassion Isn’t Coddling

When I say we need accommodations, I’m not asking the world to bend over backward. I’m asking it to stop breaking us. I’m asking for a culture that values sustainability over stoicism. That replaces “push through” with “pause and listen.”

I’m not lowering the bar. I’m redefining success.

Because if success requires burnout, masking, or erasing who we are to survive, we don’t want it. We deserve something better.

Final Thoughts

If you’ve ever been made to feel like your needs are “too much”, please hear this: your needs are human. And honoring them is not weakness. It’s wisdom.

We are not professional victims. We are people who are tired of being invisible. People with vision. People with fire in our bellies and hope in our hearts that this world can change. And that we can help change it.

Have you ever been shamed for advocating for your needs? Told you were too sensitive, dramatic, or weak? I’d love to hear how you responded—and what kept you going.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Autism/ADHD

I get called AI because I’m autistic and don’t mask ‘well’ enough

Essy Knopf Leave a comment

Reading time: 4 minutes

It’s happened more than once. I post a video or share a thought, and the comments roll in—not about the content, but about me.

“Is this AI?” “Something about this feels off.” “This is uncanny valley.”

The people making these comments appear to be serious. They’re genuinely doubting my existence, asking if my words, voice, and expressions are computer-generated.

And I get why it happens. In a digital world flooded with algorithmically smoothed voices and cloned personalities, suspicion comes easily. But these reactions are ultimately about how I show up as an autistic person whose neurodivergent presentation doesn’t match social expectations.

What they’re really saying is: “You don’t express yourself the way I expect humans to.” And that taps directly into one of the most harmful stereotypes about autistic people—that we’re robotic, emotionless, or unnatural.

When Neurodivergent Presentation Challenges the Script

In those moments, it becomes clear that there seems to be a standard template for what a real person looks like—and I don’t fit it.

My face might not move the “right” way. My voice might sound too steady, or too intense. My tone might be too neutral for the topic, or too focused to feel casual. Whatever the case, my delivery doesn’t fit their invisible checklist for “authenticity.”

This kind of scrutiny doesn’t come out of nowhere. It’s trained into people. They’re taught to equate humanity with expressiveness, warmth, eye contact, facial variation, vocal modulation. When someone shows up differently—especially online, where presence is already flattened—it sets off an alarm.

But what they’re reading as uncanny is often just a natural neurodivergent presentation. That feeling of “off-ness” often happens when masking is dropped, or isn’t “successful” enough to meet neurotypical norms.

Why We Engage in Neurodivergent Masking

Masking is when autistics and ADHDers attempt to reflect back whatever makes others feel comfortable. For a lot of us, that reflection becomes second nature. We adjust our volume, rehearse our expressions, and carefully monitor our body language, always anticipating how we’ll be read.

Over the years, I’ve fine-tuned everything from my posture to my pauses. I’ve taken classes and coaching. All of this because I wanted to be heard and seen without being dismissed or discarded.

Masking becomes survival. But the longer you wear it, the more invisible your real self becomes, even to you. And when you finally take it off, you’re often met with silence, discomfort, or suspicion.

When Even Safe Spaces Feel Conditional

There’s a lot of talk about how the internet offers freedom for neurodivergent expression. In some ways, it does. But even online, there’s pressure to show up in a way that looks emotionally fluent, relatable, and effortless.

I’ve found that if I don’t smile enough, it’s unsettling. If I do smile at the wrong time, it’s “creepy.” If I speak clearly, it’s “too perfect.” There’s no winning when people are looking for confirmation that you’re not quite human.

Even in spaces that claim to center neurodivergent voices, these same standards can sneak in. Authenticity becomes a brand, and difference still gets trimmed down for comfort. Masking is still expected, just dressed up in more inclusive language.

It’s not enough to be honest. You also have to be emotionally legible to others. And if your presentation doesn’t pass the vibe check, people check out.

The Emotional Labor of Being Misread

There’s a weight that builds up when your natural way of being keeps getting flagged as a problem. Even when you try to shrug it off, it sticks. A comment here, a correction there. None of them seem major on their own, but over time, they chip away at your sense of ease.

You start pre-screening everything before you say it. You think about how your face might be read. You tighten your gestures. You modulate your tone.

This kind of perfectionism is a form of risk management. A defense against a pattern many of us have come to expect: if we don’t smooth out our differences through constant masking we get punished for them.

The Five S’s: How Bias Plays Out

The Five Ableist S’s is a term I’ve coined to describe five core behaviors through which ableism often expresses itself, especially toward neurodivergent people. These behaviors might seem subtle or even well-intentioned on the surface, but they carry lasting impact.

Here’s how they tend to show up in online interactions, particularly when someone like me shows up in a visibly neurodivergent way:

Silencing happens when people dismiss my voice outright. They write off my content before engaging, assuming that my communication style means I have nothing worth listening to.
Shunning shows up as people making vague comments about something feeling “weird” or me looking like AI, then disappearing, or encouraging others not to engage with my content.
Stigmatizing appears again in comparisons to AI. The implication is that something about me is inherently unnatural or even threatening.
Shaming often comes in the form of unsolicited advice: “Maybe try to alternate your tone more.” “Why are you smiling when talking about something serious?” These comments frame neurotypical standards as the only valid ones.
Subjugating is the demand to conform. People telling me I’d be more successful if I changed how I talk, move, or express emotion. The message is: “You’d be more acceptable if you were less you.”

These judgments aren’t always conscious. But they’re learned, and they reinforce a system where only certain kinds of communication are seen as legitimate.

Letting Go of the Mask

After years of shaping myself to fit others’ comfort zones, I reached a point where I had to ask: what’s left of me when I’m done editing?

I still care about being clear. I still want my work to resonate. But I’ve stopped trying to sanitize myself into someone I’m not. Because no matter how many adjustments I make, someone will still find a reason to say I’m too strange.

That realization was freeing. I could stop contorting. I could speak plainly, even if that made some people uncomfortable. I could pause without performing. I could express emotion without translating it into someone else’s dialect.

The people who get it? They stay. And the ones who don’t? Maybe they were never really listening to begin with.

Final Thoughts

If you’ve ever felt like your neurodivergent presentation made people question your legitimacy, I want you to know that you’re not alone.

The world might read your communication style as unusual. It might treat your unmasked presence like an error to be corrected. But that doesn’t mean you’re broken. It just means the framework was never built to include you.

We don’t need more polish. We need more space to be human in all the ways that word can look and sound and feel.

How has the pressure to change your neurodivergent presentation (or the way you express yourself) shaped how you communicate—just to be seen, heard, or taken seriously?

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Autism/ADHD Identity

How compliance culture silences neurodivergent voices

Essy Knopf Leave a comment

Reading time: 4 minutes

Have you ever noticed how quickly people shift when you stop playing by the rules?

Not legal rules, but the subtle, invisible ones. The ones that tell you how to sit, speak, smile, react. The ones that reward you for blending in and quietly penalize you for standing out.

You say what you mean, and someone winces. You stim or flinch, and someone stares. You don’t match the mood or tone, and suddenly, you’re “off.”

This shift isn’t in your head. It’s a product of compliance culture—a web of social expectations designed to keep everyone in line. For neurodivergent people, that line is especially narrow. And stepping outside it, even for a second, can cost you.

What Compliance Culture Really Looks Like

Compliance culture is more than just rules about behavior. It’s an entire atmosphere; a quiet, persistent demand to be easy. Easy to understand. Easy to manage. Easy to forget.

It shows up when a teacher calls you “disruptive” for asking too many questions. When your manager raises an eyebrow because you skipped the team lunch to recover from a loud meeting.

When friends joke that you’re “a bit much” after you share something that genuinely excites you.

Over time, these signals accumulate into something heavy and hard to name.

That weight is compliance culture exerting pressure on your identity.

How Neurodivergent People Respond to Compliance Culture

Autistics and ADHDers often exist in contrast to what’s expected. We move, think, and respond in ways that don’t always fit neatly into the social flow. And for that, we’re often asked to do something subtle but insidious: self-edit.

Edit your pace of speaking. Edit your irregular gait. Edit your emotions so they don’t take up too much room.

You’re told—explicitly or not—that your presence is only welcome if it’s polished, predictable, and pleasant. Not intense. Not inconsistent. Not real.

And when you can’t meet those expectations, the consequences are often the withdrawal of warmth, of patience, of connection.

The Trouble With “Spiky” Abilities

Many neurodivergent people have what’s known as a spiky profile. Our abilities aren’t flat or predictable. They spike in some areas—deep knowledge, creative insight, emotional depth—and dip in others, like short-term memory, sensory processing, or small talk.

This mismatch confuses people. You might explain a complex system effortlessly, then forget to return a text. You might be calm in a crisis but unravel when the lights are too bright or the music’s too loud.

Compliance culture doesn’t allow for this kind of unevenness. It prefers consistency over complexity. When we can’t maintain a steady, expected performance, we’re met with frustration, not curiosity.

Instead of, “What do you need?” We hear, “Why can’t you just…?”

Burnout Disguised as Functioning

Masking—shaping yourself to appear more “acceptable”—is often rewarded. People praise you for being so “high functioning,” for how “well you manage.” But they don’t see the energy it takes.

They don’t see the days where basic tasks feel like running uphill through an active mudslide. They don’t see the sensory overload, or the panic when a routine is thrown off or your brain short-circuits from too much noise.

They only see the moment you stop coping, and then they act surprised. As if the warning signs weren’t visible all along. As if you suddenly became someone else.

That’s the trap of compliance culture: perform until you break, and then be blamed for breaking.

Compliance Culture Is Systemic

This pressure doesn’t exist in a vacuum. It’s embedded into institutions.

In school, it’s the child who finishes worksheets quietly who gets labeled “gifted,” even if they’re quietly falling apart inside.

At work, it’s the employee who doesn’t ask for accommodations who gets seen as a “team player.”

In healthcare, it’s the patient who doesn’t push back who gets called “compliant”, a term that says so much about who the system is designed to serve.

This happens because neurotypicals get to determine which behaviors are seen as “normal,” and which are flagged as disruptions. That’s structural ableism.

What Gets Lost When We Comply

Every time you contort yourself to meet an unspoken expectation as a neurodivergent, something gets chipped away.

That impulse you stifle. That laugh you mute. That question you don’t ask. It adds up.

And over time, it becomes harder to tell the difference between who you are and who you’ve had to become just to be allowed in the room.

That’s what makes compliance culture so dangerous.

Pushing Back: What Resistance Can Look Like

Undoing the impact of compliance culture doesn’t mean becoming reckless or confrontational. It means practicing something quieter, but far more radical: honesty.

It might look like letting yourself stim in public without apology. Turning off your camera on Zoom when your sensory load is too high. Correcting someone when they misinterpret your silence as disinterest. Saying “I need a minute” instead of pretending you’re okay.

It’s about reclaiming your right to show up as yourself, and not the polished version others find more comfortable.

And yes, that might make some people uncomfortable. But discomfort isn’t danger. Discomfort is how people grow.

Final Thoughts

Compliance culture tells us that our differences are obstacles to connection. That to be accepted, we must be less us. But what if that’s a lie?

What if our difference isn’t the problem, but the key?

If you’ve ever felt like your existence depended on being manageable, I want you to know this: you don’t have to perform your way into belonging. You deserve to take up space as you are.

Not because you’ve masked well enough. Not because you’ve earned it through labor. But because you’re human, and that should be enough.

What’s one expectation you’ve stopped following in order to honor your neurodivergent self?

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Autism/ADHD

“Why can’t you?”: Breaking free from internalized ableism as an autistic or ADHDer

Essy Knopf Leave a comment

Reading time: 3 minutes

Have you ever asked yourself, “Why can’t I just be normal?”

If you’re autistic or an ADHDer, chances are you’ve heard this question—whether from others or inside your own head—far too often. Each time, it chips away at your sense of self, your right to exist as you are.

Let’s talk about that voice. Let’s talk about internalized ableism.

Where It Begins: The “Why Can’t You” Script

Many of us remember exactly when it started—early school days, perhaps, when a teacher asked why we couldn’t sit still, or a classmate mocked how we played or spoke. These moments don’t just sting in the moment; they shape the stories we tell ourselves for years to come.

The world asked, “Why can’t you…?” And we began to wonder, “Is something wrong with me?”

TIC: The Tyrannical Inner Critic

Eventually, the outer criticisms become internalized. A voice forms—harsh, relentless, always on alert for any mistake. This voice, which author Pete Walker calls the tyrannical inner critic (TIC), becomes a survival strategy.

“If I beat myself up first,” it says, “it won’t hurt as much when others do.”

But here’s the truth: self-criticism doesn’t protect you. It only deepens the wound. TIC isn’t your inner wisdom—it’s internalized trauma.

You’re Using the Wrong Yardstick

Society measures us using neurotypical (NT) expectations: how we socialize, focus, learn, behave. But this yardstick wasn’t built for us. It ignores the rich inner lives, creative passions, and unique ways of thinking that define many autistics and ADHDers.

No wonder we feel “less than.” We’re being held to a standard we were never designed to meet.

Masking: Surviving, Not Thriving

To protect ourselves, we often mask—camouflaging our traits to appear more “acceptable.” But masking is exhausting. It can leave us burnt out, disconnected, and unsure where the mask ends and we begin.

And when the mask slips, we risk rejection—not just in the form of bullying, but the colder pain of ostracism.

The Invisible Pain of Being Ignored

For many, the silence hurts more than the insults. Being ignored, left out, or dismissed triggers deep feelings of unworthiness. Research shows that even brief ostracism lights up the same pain centers in the brain as physical injury.

This can feed a cycle of rejection sensitive dysphoria (RSD)—where even small slights feel catastrophic. It’s not a weakness. It’s a trauma response.

Perfectionism and the Shame Spiral

To avoid criticism, we may strive for perfection—at work, in relationships, even in therapy. We do all the “right” things and still wonder, “Why can’t I just get better?”

But healing isn’t linear. Especially when we’ve spent a lifetime absorbing messages that we’re broken.

Start Here: Reframe the Question

Instead of asking “Why can’t I?”, try this: “What barriers have I faced that made this harder for me?” “What does my neurotype need that hasn’t been supported?” “Why should I have to mask, bend, and twist myself to fit a world that refuses to bend even a little?”

These are truth-telling questions. They shift the blame away from you—and back where it belongs: on a system that wasn’t built for ND minds.

Unmasking, Boundary-Setting, and Self-Compassion

Healing involves risk. Unmasking, setting boundaries, asking for accommodations—it’s vulnerable work. But it’s also freeing.

You’re allowed to stim. To need quiet. To ask for help. You’re allowed to say “no“.

Each small act of self-acceptance is a rebellion against internalized ableism.

And That Guilt?

Guilt for needing support? For being “different”? That’s not yours to carry.

Would you call a ramp user “a burden” for not climbing stairs? No? Then your sensory aids, executive functioning supports, and communication needs aren’t a burden either.

You Are Not Broken

Next time that voice whispers, “Why can’t you…?”—pause. Take a breath. And say:

“Because the world wasn’t built for me. Because I’ve had to survive in spaces that ignored my needs. Because I’ve masked and hustled and overcompensated just to get by. And above all, because I am not broken.”

Final Thoughts

You are not alone in this. Many of us are on this journey—peeling back layers of shame, questioning old narratives, and learning to stand in our truth.

So I invite you to ask yourself today: Where did “Why can’t you?” show up in your life? What belief did it plant in you? And what can you do—today—to start unlearning it?

Maybe it’s writing that belief down and crossing it out. Maybe it’s advocating for one small need. Maybe it’s letting yourself rest, unpunished.

Every step is a step toward liberation.

What’s one “Why can’t you…?” message you’ve internalized—and how are you beginning to rewrite it?

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Autism/ADHD

Everyday ableism: The subtle judgments that harm autistics and ADHDers

Essy Knopf Leave a comment

Reading time: 3 minutes

Have you ever been called “too sensitive,” “lazy,” or “distracted” for reacting to things others barely notice? If so, you might already know what everyday ableism feels like.

As an autistic and ADHD therapist, I want to shed light on how these everyday interactions—often unintentional—can deeply impact neurodivergent (ND) folks. From casual comments to institutional policies, ableism often shows up as subtle, socially accepted bias. And when left unchecked, it chips away at our confidence, connection, and even our sense of worth.

Let’s explore how ableism operates in quiet but powerful ways—and how we can begin to shift the narrative.

What Is Everyday Ableism?

Everyday ableism refers to the daily attitudes, expectations, and social norms that favor neurotypical (NT) ways of thinking and behaving. It’s often rooted in neuronormativity—the assumption that there’s a single “right” way for a brain to work—and it places the burden of change on ND folks to conform, not on society to accommodate.

Here are some common forms of hidden bias:

Neuroentitlement: “If I can do it, so can you.”
Neurosuperiority: “Your way of thinking is wrong or weird.”
Neuronegativity: Framing ND traits as flaws rather than differences.
Neuroprivilege: The unearned advantages of aligning with NT norms.
Neuroconformity: Pressuring NDs to hide their natural behaviors to be accepted.

These ideas seep into our language, our schools, our workplaces—and they shape how people respond to things like fidgeting, direct communication, or time blindness.

Real-World Examples of Everyday Ableism

To illustrate just how subtle this can be, here are some ND experiences that often get misunderstood:

A student who skips small talk and jumps into deep conversation is seen as rude.
A colleague who wears noise-canceling headphones is labeled “unfriendly.”
An ADHDer who loses track of time is called unreliable—when they’re actually hyper-focused.
An autistic person who gives honest feedback is considered “too blunt.”
A child who stims (rocks, chews, flaps) is told to “act normal” rather than supported.

In each case, the ND behavior serves a purpose—whether it’s emotional regulation, communication, or focus. The problem isn’t the trait. It’s the interpretation.

Why Misunderstandings Happen

Humans naturally use mental shortcuts to make sense of others’ behavior. This often leads to something called correspondence bias—where we assume someone’s actions reflect their personality, not their context.

So, when someone fidgets, we assume they’re distracted. When they speak bluntly, we assume they’re rude. We rarely stop to ask, “What might this behavior mean for them?”

This is where the double empathy problem comes in: while ND folks may struggle to understand NT cues, NTs often struggle to understand ND cues. Yet only NDs are expected to change.

The Cumulative Impact of Ableism

Over time, these misunderstandings and microaggressions build up. ND people are punished for being themselves—socially, academically, professionally. Many begin to internalize these criticisms and believe: “I’m lazy. I’m too much. I’ll never be good enough.”

This is called internalized ableism, and it’s a quiet killer of self-worth.

What Can We Do Differently?

To dismantle everyday ableism, we need to shift both mindset and environment.

Normalize Neurodivergence

Start from the belief that autism and ADHD are natural, valid ways of existing—not flaws to be corrected. Validate differences, rather than minimizing or pathologizing them.

Embrace Universal Design

Instead of reactive accommodations, build systems that proactively support a range of needs. Think: flexible deadlines, quiet workspaces, clear communication formats.

Check Your Assumptions

Before labeling someone’s behavior, pause. Ask: “Is there another way to interpret this?”

Amplify ND Voices

Whether online or offline, center the lived experiences of ND folks. Let them define their identities, set their boundaries, and lead the conversation.

Educate Without Exhausting Yourself

If you’re ND, you don’t have to be everyone’s teacher. Sometimes a quick explanation or casual comment can open minds. Other times, silence is self-care.

You Deserve Understanding—Not Judgment

Being neurodivergent is not a flaw. It’s a way of experiencing the world that brings creativity, honesty, depth, and insight.

Let’s work to create a world where NDs don’t have to justify their needs—or hide who they are to belong.

Have you experienced everyday ableism? What’s helped you navigate it?

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Autism/ADHD

Why neuroaffirming therapy is essential for autistic and ADHDers

Essy Knopf Leave a comment

Reading time: 4 minutes

If you’ve ever explained your autistic or ADHD-related challenges to a therapist, only to have them dismiss or misunderstand you, you’re not alone. Many neurodivergent (ND) individuals experience therapy that is based on neurotypical (NT) standards, failing to recognize their unique experiences and needs. This disconnect can be disheartening and even harmful, reinforcing feelings of alienation, self-doubt, and shame.

This is where neuroaffirming therapy (NAT) comes in. Unlike traditional therapeutic approaches that may view neurodivergence as a disorder to be fixed, NAT respects autism and ADHD as natural variations of human cognition. It focuses on validation, self-acceptance, and working with clients’ strengths rather than against their neurology.

NAT promotes an approach that acknowledges both the challenges and strengths of being ND, ensuring that therapy is tailored to the individual rather than forcing conformity to NT norms.

What is Neuroaffirming Therapy?

NAY is an attachment-based, trauma-informed, and strengths-focused approach that centers the lived experiences of autistic and ADHD clients. It acknowledges that many mental health struggles among NDs stem not from their neurotype itself, but from a world structured around NT expectations.

The stress of trying to navigate an environment that is not designed for them can lead to anxiety, depression, burnout, and masking—all of which NAT seeks to address with compassion and understanding.

Instead of forcing NDs to conform, NAT helps clients navigate the world while honoring their authentic selves. It challenges ableism, prioritizes self-compassion, and fosters empowerment. This approach helps clients build self-esteem, set boundaries, and advocate for accommodations that allow them to thrive.

How Neuroaffirming Therapy Differs from Traditional Therapy

Many traditional therapies operate within a deficit-based model, which assumes that NDs need to be “fixed” or trained to behave in NTs ways. This can result in harmful practices such as:

Masking Encouragement – Encouraging NDs to suppress stimming, force eye contact, or change their communication style to fit neurotypical expectations.
Pathologization of Traits – Viewing hyperfocus, sensory sensitivity, or direct communication as problematic rather than inherent ND traits.
Invalidation of Experiences – Dismissing the impact of ableism and minority stress, attributing distress solely to the ND rather than their environment.
Overemphasis on Social Norms – Prioritizing NT communication and behavior rather than helping NDs express themselves in ways that feel natural and comfortable.

NAT takes the opposite approach, recognizing that neurodivergence is a natural and valid way of being. Instead of trying to change the client, it seeks to support their unique needs and challenges by addressing external barriers, internalized ableism, and self-perception.

Core Principles of Neuroaffirming Therapy

Every ND is Unique

The saying “If you’ve met one autistic person, you’ve met one autistic person” holds true. Autism and ADHD manifest differently in everyone, meaning that therapy must be personalized to the individual’s needs, strengths, and intersectional identities (e.g., gender, race, sexuality, disability status).

Neurodivergence is Dynamic

Traits associated with autism and ADHD can fluctuate over time due to environmental factors, trauma, personal growth, and changing life circumstances. NAT recognizes that neurodivergence is not static but shaped by both genetics and lived experiences.

Pathology Often Co-Occurs

NAT does not pathologize neurodivergence itself, but it does acknowledge that conditions such as anxiety, depression, trauma, executive dysfunction, sensory processing disorder, and sleep disorders often co-occur and require compassionate, informed support.

Ableism is Pervasive and Harmful

Society is structured around NT norms, leading to systemic barriers that disadvantage NDs. NAT actively works to dismantle these barriers by advocating for accommodations, self-advocacy, community support, and radical acceptance.

Ableist Standards Are Internalized

Many NDs experience self-doubt and shame due to lifelong messaging that they are “wrong” or “deficient.” NAT helps clients unlearn internalized ableism, recognize their inherent worth, and embrace neurodivergence as part of their identity.

Ableism Creates Minority Stress

Living in a world that stigmatizes neurodivergence leads to chronic stress, burnout, and trauma. NAT provides a space where NDs can process these experiences without judgment and develop resilience through self-advocacy, community connection, and personal empowerment.

Complex PTSD is Common

Many NDs develop complex post-traumatic stress disorder (C-PTSD) due to chronic social rejection, bullying, masking, gaslighting, and misunderstandings. NAT helps clients recognize and heal from these traumas while rebuilding self-trust, emotional regulation skills, and coping mechanisms.

Rigidity is a Natural Response

NDs often develop rigid routines, preferences, and coping mechanisms as a way to navigate an unpredictable and often overwhelming world. Rather than labeling rigidity as a problem, NAT explores its origins and helps clients develop flexible, self-supportive strategies without forcing NT expectations.

Challenges Are Biopsychosocial

NAT acknowledges that difficulties faced by autistics and ADHDers arise from a combination of biological, psychological, social, and environmental factors—not just their neurotype. A comprehensive approach is necessary for effective support, which includes changing the environment, advocating for accommodations, building self-awareness, and challenging societal norms.

Why Neuroaffirming Therapy Matters

Traditional therapy often forces NDs to fit into NT frameworks, leading to further distress. NAT, however, takes an empowering, strengths-based approach that validates clients’ experiences and identities.

Therapists practicing NAT help clients understand that they are not broken or deficient—they are simply navigating a world not built for them. With the right support, they can learn to self-advocate, set boundaries, and cultivate a life that aligns with their authentic selves.

If you’re looking for a therapist, consider seeking out someone trained in NAT. And if you’re a therapist working with ND clients, integrating NAT principles can make a world of difference in your clients’ lives.

Want to Learn More?

Check out my book, The Neuroaffirming Therapy Handbook, or browse my blog for more insights into neurodiversity and mental health. If this post resonated with you, share it with others who might benefit!

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Autism/ADHD

Living in an ableist dystopia: The daily struggles of being neurodivergent

Essy Knopf Leave a comment

Reading time: 3 minutes

Have you ever wondered why dystopian fiction resonates so deeply? Why so many neurodivergent (ND) folks find themselves drawn to these stories of oppression, survival, and rebellion? Perhaps it’s because, for many of us, dystopia isn’t fiction—it’s a daily reality.

As an autistic and ADHD therapist, I’ve seen firsthand how ableism structures our world in a way that excludes, punishes, and marginalizes NDs. The struggle to exist in a system designed for neurotypicals (NTs) often forces us to mask, suppress, and overcompensate, leading to exhaustion, anxiety, and internalized shame.

But before diving into these parallels, let me share a short fictional excerpt that reflects the lived experiences of many NDs.

A Dystopian Reflection

Imagine a future where a pandemic has erased humanity’s capacity for empathy. Society becomes a place where deception and manipulation are survival skills, and those who remain kind are outcasts. One individual struggles to navigate a world that sees their honesty as foolishness and their empathy as weakness.

At home, their parents criticize them for failing to conform. At school, they’re ostracized. Attempts to challenge injustice result in punishment. Seeking refuge in books and video games, they create their own worlds to escape the cruelty of the one they live in.

Sound familiar?

For many autistics and ADHDers, this isn’t just a story—it’s life. We grow up painfully aware that we are different but unable to explain why. Our deep empathy, sense of justice, and unique way of experiencing the world often make us targets rather than allies. And when we speak up, we’re told we’re too rigid, too emotional, or too much.

Ableism as the Silent Oppressor

Ableism—the belief that NT functioning is superior—permeates every aspect of society. Schools, workplaces, and social spaces are structured to accommodate NT needs while dismissing those of NDs.

Most office spaces are sensory nightmares. Open-plan environments are overwhelming, social interactions are forced, and expectations around communication favor NT norms. Employers often expect ND employees to “just deal with it” rather than making reasonable accommodations.

Schools demand that ADHDer children sit still, remain silent, and suppress their natural learning styles. Autistic students are punished for stimming or struggling with social interactions. Instead of adapting the environment to meet diverse needs, institutions enforce compliance, leading many ND students to associate learning with trauma.

Because NDs behaviors are often viewed as problematic, many of us learn to mask. We camouflage our traits to fit in, suppressing stims, forcing eye contact, and mimicking NT speech patterns. But masking comes at a high cost—leading to burnout, identity erosion, and mental health struggles.

The Double Standard of Accommodation

Consider this: When an ND requests an accommodation—like adjusting the room temperature or asking for a seat change—it’s considered reasonable. But when an ND asks for a quiet workspace, flexible deadlines, or sensory-friendly environments, it’s often met with resistance.

Even something as simple as requesting a classroom change due to a noisy air conditioning unit can feel like an undue burden. This reluctance to provide accommodations reinforces the idea that our needs are “too much.”

Breaking the Silence: The Power of Self-Advocacy Amid Ableism

Many NDs internalize shame, believing they are burdensome for needing accommodations. But advocating for ourselves isn’t just about personal survival—it benefits everyone.

When we challenge ableist structures, we create ripple effects that help others. Speaking up about sensory issues in a classroom, for example, can lead to changes that improve the learning environment for all students, ND or not.

Here’s how we can start dismantling this dystopia:

Reject the shame: Recognize that needing accommodations is not a failure, but a right.
Speak up: Whether at school, work, or in medical settings, advocate for what you need.
Find community: Connect with others who understand your struggles. Shared experiences build resilience.
Educate others: The more people understand neurodivergence, the harder it becomes to justify exclusion.

Final Thoughts

In dystopian stories, oppression is often met with rebellion. The rise of the neurodiversity movement is our rebellion—an effort to dismantle ableism and demand a society that values ND people for who we are, rather than who we’re forced to pretend to be.

Little by little, we are chipping away at this dystopia, advocating for change, and refusing to be silent. And one day, when these rigid structures crumble, we will build in their place a world where all minds are valued equally.

What has been your experience navigating an ableist world? Share in the comments!

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Autism/ADHD

We need ADHD medication parity NOW

Essy Knopf Leave a comment

Reading time: 2 minutes

Accessing ADHD medication isn’t just about filling a prescription—it’s a constant battle. Unlike many other mental health challenges where medications are more readily available, ADHD medication is burdened with extra hoops to jump through. These barriers disproportionately affect those who rely on stimulant medications, leaving many without the treatment they need to function.

The process is exhausting: prior authorizations, frequent refill requirements, and the stigma surrounding stimulant medications all contribute to the problem. Add to that the ongoing stimulant shortage, and what should be a simple, routine healthcare matter becomes a frustrating and even disabling ordeal.

ADHD Medication Shortages: A Crisis with No End in Sight

For several years now, the U.S. has been experiencing a shortage of medication like Adderall and Ritalin. The reasons are complex, involving manufacturing limits, increased demand, and regulatory constraints. But the outcome is simple: ADHDers are left scrambling to find their prescribed medication, often having to switch to alternatives that may not work as well or even going without entirely.

Imagine needing medication daily to function, only to be told month after month that your pharmacy is out. For many, this can lead to worsened executive dysfunction and a severe drop in quality of life.

Insurance and Prescription Barriers

Even when ADHD medication is available, insurance restrictions can create additional roadblocks. Many ADHDers must navigate:

Prior authorizations, where doctors have to prove the necessity of ADHD medication before insurance covers it.
Quantity limits, requiring multiple pharmacy visits for a single prescription.
Frequent reassessments, even for adults who have had a stable diagnosis for years.

These barriers assume that ADHD medication is inherently more dangerous or prone to abuse than other mental health treatments, reinforcing stigma and making care unnecessarily difficult.

The Call for ADHD Medication Parity

Other mental health conditions do not face these same restrictions. If someone with anxiety, depression, or bipolar disorder can access their medication without excessive red tape, why should ADHDers be treated differently?

Parity means equal treatment. It means that ADHD medication should be covered and dispensed as easily as any other psychiatric medication. It means that stimulant shortages should be taken seriously as a public health issue, not dismissed as a minor inconvenience.

Essy Knopf ADHD medication access challenges

What Can We Do?

The fight for ADHD medication parity starts with awareness and advocacy. Here’s how we can push for change:

Call on policymakers to enforce parity laws and remove unnecessary restrictions on ADHD medication.
Raise awareness about the impact of ADHD medication shortages and advocate for improved pharmaceutical regulations.
Support ADHD advocacy organizations that work to improve healthcare access for neurodivergents.

Final Thoughts

If you’ve struggled to access ADHD medication, you’re not alone. It’s time for healthcare systems to recognize ADHD as a legitimate medical challenge deserving of equal treatment. Let’s demand ADHD medication parity—because no one should have to fight this hard for basic care.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Autism/ADHD Identity

A psychologist compared my autism to a fatal condition

Essy Knopf Leave a comment

Reading time: 3 minutes

When I decided to pursue an autism diagnosis, I was hoping for clarity, self-understanding, and maybe even a bit of support. What I wasn’t expecting was to have my neurodivergence compared to a fatal, degenerative disease.

The psychologist I spoke with didn’t offer validation or encouragement. Instead, he presented a hypothetical scenario involving Huntington’s disease, a terminal neurological condition. “Would you even want to know?” he asked, as if discovering I was autistic would be akin to receiving a death sentence.

My stomach sank. I wasn’t calling for a philosophical debate—I was trying to book an appointment for my autism diagnosis.

The Harm of Medical Ableism

Experiences like mine are, unfortunately, not uncommon. Many autistics face skepticism, dismissal, and outright ableism from medical professionals when seeking an autism diagnosis, especially later in life. This can take the form of:

Gatekeeping autism diagnoses by making the process unnecessarily difficult or discouraging individuals from seeking answers.
Invalidating autistic experiences by questioning the legitimacy of self-identification or framing autism as an inherently negative condition.
Perpetuating harmful stereotypes that paint autism as a tragedy rather than a natural variation of neurodivergence.

The psychologist’s comparison to Huntington’s disease wasn’t just offensive—it was wildly inaccurate. Autism is not a degenerative illness. It is not a death sentence. It is a different way of experiencing and interacting with the world. Yet, the way some medical professionals handle autism diagnoses can make it feel like a burden rather than an empowering revelation.

Why an Autism Diagnosis Matters

For many, receiving an autism diagnosis is not about seeking a label—it’s about gaining access to understanding, accommodations, and community. Knowing I was autistic allowed me to:

Identify my sensory sensitivities and social communication differences as valid, rather than as personal failings.
Advocate for my own needs in work and social settings.
Connect with other autistics who shared similar experiences.

Not knowing, on the other hand, often leads to years of struggling with unidentified challenges, self-doubt, and unnecessary hardship. An autism diagnosis can be a transformative moment, allowing individuals to understand their experiences in a new light.

The Importance of Perseverance

After my frustrating encounter, I didn’t give up. I kept calling around until I found a professional who was willing to listen. Eventually, I got my autism diagnosis—and it was life-changing. It validated what I had known deep down but had struggled to articulate.

If you are seeking an autism diagnosis and face similar roadblocks, don’t let one dismissive professional deter you. Your experiences are real, and your struggles deserve recognition. Keep pushing forward. The right support exists—you just have to find it.

The Need for Change

That said, medical professionals must do better. They need to:

Approach autism diagnoses with compassion and respect.
Recognize that autistics are the best experts on their own experiences.
Dispel outdated, harmful misconceptions about autism.

Autistics shouldn’t have to fight for their autism diagnoses, nor should they be made to feel like their existence is a tragedy. Neurodivergence is a part of human diversity, and it’s time the medical field treated it as such.

Final Thoughts

An autism diagnosis is not a label—it is a tool for empowerment. It helps autistic people navigate the world with greater understanding and access to the support they need. By fostering a more inclusive and neuroaffirming approach, medical professionals can ensure that autistics are met with dignity, respect, and the care they deserve.

If you have been met with resistance or ignorance in your pursuit of an autism diagnosis, know that your experience is valid. Your struggles are real, and you are not alone. Keep advocating for yourself, seek out supportive professionals, and remember—your neurodivergence is not a flaw. It is a part of who you are, and you deserve to be seen and heard.

Have you faced challenges in getting an autism diagnosis? Share your story in the comments.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Autism/ADHD Identity Wellbeing

Why I hate going outside as an autistic ADHDer

Essy Knopf Leave a comment

Reading time: 2 minutes

For many autistics and ADHDers, stepping outside isn’t a simple task—it’s an exercise in endurance. From unpredictable noises to overwhelming crowds, the world outside can be exhausting and even painful. Here’s why sensory overwhelm makes going out so difficult, and how it impacts daily life.

The Unseen Battle of Going Outside

For neurotypicals, stepping outside might seem effortless. For me, it’s a calculated risk. The moment I leave my house, I brace myself for a wave of sensory overwhelm—the bright, flickering lights, honking cars, and the endless chatter of people.

It’s not just annoying. It’s exhausting.

Every sound, smell, and visual detail seems to crash into my brain at once, with no filter. My ADHD means I struggle to tune out irrelevant stimuli, and my autism makes everything feel too much, too fast, too loud. The result? I burn out before I even reach my destination.

The Chaos of Public Spaces

Public spaces are an unpredictable sensory minefield. One moment, I’m fine. The next, a sudden noise—an ambulance siren, a child screaming, or harsh sunlight—sends my nervous system into overdrive.

Shops, train stations, and crowded streets all come with their own brand of overstimulation. The sheer number of people moving unpredictably about can be stressinducing.

I’m constantly on edge, trying to manage the discomfort while also masking—pretending I’m “fine” so I don’t stand out. But masking takes energy, and before long, I’m mentally and physically drained.

The Exhaustion of Social Expectations

Going outside also means navigating unspoken social rules. Eye contact, small talk, dodging people on sidewalks—it’s all an exhausting mental game. Unlike neurotypicals, who instinctively follow these social norms, I have to consciously process every interaction.

If I miscalculate—speak too bluntly, react too slowly, or misread a situation—I risk being judged. The stress of trying to “act normal” adds another layer of exhaustion on top of the sensory overwhelm.

Why Staying Inside Feels Safer

At home, I control my environment. I can keep the lighting soft, the noise minimal, and avoid unpredictable social interactions. There’s no pressure to mask, no overwhelming sensory input, and no need to constantly adjust to a world that wasn’t built for me.

But the downside? Isolation. Avoiding the outside world means missing out on experiences, friendships, and opportunities. It’s a constant tug-of-war between self-preservation and the desire to engage with life.

Finding Ways to Cope

While I can’t change the world, I can adapt. Here are a few ways I manage:

Noise-canceling headphones – Blocking out overwhelming sounds helps me focus and stay calm.
Sunglasses or tinted lenses – Bright lights are a major trigger, so I reduce the strain however I can.
Planned outings – Knowing exactly where I’m going, when, and for how long helps me prepare mentally.
Sensory-friendly breaks – Finding quiet spaces to recharge mid-trip prevents burnout.

Final Thoughts

Going outside as an autistic/ADHDer isn’t a simple task—it’s a sensory endurance test. From chaotic public spaces to social expectations, every outing requires energy that I don’t always have.

If you relate to this struggle, know you’re not alone. It’s okay to set boundaries, to take breaks, and to advocate for environments that support neurodivergent needs. When feeling dysregulated, consider trying some of these self-care techniques.

Do you experience sensory overwhelm when going outside? How do you cope? Let’s talk in the comments!

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.