An autistic therapist's honest view on how counselling can help autistic adults.

One of the first questions I get from autistic professional women experiencing burnout or depression is: "Can you fix this for me? Can you make me feel like myself again?"

I wish I could say "yes". I wish I could promise that therapy will lift the heavy fog, restart your motivation, help you enjoy things, give you back that sense of direction you've lost.

But I'd be lying.

Therapy can't fix things for you. Only you can. Sometimes. Other times it's about managing the best you can in the circumstances.

"What?! Why are you charging so much then?"

Because therapists are trained to support you with gaining insight and arriving at conclusions about how you wish to resolve issues or...learn to live with them.

The crushing weight of depression, the complete inability to start even simple tasks, feeling of acute aloneness. What you want the most is for the pain to go away as quickly as possible. Doesn't matter how, just to be rid of it.

I understand that urgency. I've been there myself. Here are my thoughts on how counselling can help autistic adults.

Why therapy isn't like taking paracetamol and what it actually is

Therapy is not like swallowing a pill and waiting for the pain to go away all by itself. Having said this, the initial sessions, where you are truly heard, can offer great relief effortlessly simply because you get to share a burden you may have been carrying for a long time.

However, longer term it's more like going to the gym.

In my experience, successful therapy requires determination, insight, action, patience and perseverance. And yes, acceptance too.

Sometimes it doesn't work. Even with the best intentions and effort from both the therapist and yourself. There are no guarantees.

But it often does work. And do you know what the best part is?

Once you take control of your own wellbeing and no longer depend on something or someone else fixing things for you, managing adversity becomes far less crushing.

When you're stuck in burnout-depression cycles and can't see a way forward

I worked with a kind, gentle psychologist recently and they said to me: "Well, Lii, you have wedged yourself into such a tight corner that there's nothing we can change in this situation. All I can offer you is some emotional relief."

I appreciated that truth even though of course I would much rather hear about a miracle solution.

Sometimes this is what therapy looks like for autistic professional women in their 40s, 50s, and 60s experiencing recurrent burnout and depression.

I have found in my clinical practice that it is often external, circumstantial factors, like chronically stressful work environments, that negatively affect your wellbeing. The question often is about what power you may have to change the situation.

When situational change is genuinely possible

Therapy helps you identify what's within your control and supports you in taking action. Perhaps it's reducing demands, renegotiating work boundaries or addressing relationship patterns.

When situational change isn't currently possible

Therapy offers emotional relief, helps you develop coping strategies and supports you in accepting circumstances while preserving your integrity and autonomy.

Both are valuable, honest and require you to commit.

How counselling can help autistic adults: therapy for when you can't start things and nothing feels worth doing

For many autistic professional women experiencing burnout-depression cycles, the struggle isn't just about feeling sad or exhausted. It could also involve:

• Apathy

Nothing feels worth doing anymore, even things you used to love

• Paralysis

You know what needs to be done but can't make yourself start

• Lost meaning

Life hasn't turned out the way you imagined and you're not sure what you're working towards anymore

• Physical hurdle

Starting even simple tasks feels like there's a literal barrier in the way

Therapy doesn't magically remove these issues but it can help you:

• Understand the burnout-depression cycle

Why this keeps happening, what triggers it, how masking at work contributes

• Identify achievable steps

When everything feels impossible, breaking things down to the smallest possible action

• Process grief about how life has turned out

The career that didn't develop as you had hoped, the relationship that hasn't materialised, the burden of motherhood (or the pain of its absence), the version of yourself you thought you'd be by now

• Distinguish between what's changeable and what needs acceptance

This is perhaps the hardest part and having a therapist to navigate this with you makes it bearable

• Find meaning in small moments

When the big picture feels bleak, therapy can help you identify what still matters even if it's different from what you expected

In my role as a counsellor I help clients by facilitating the process of positive change. But the lead actor is always the client.

Struggling with burnout-depression cycles and lost your sense of purpose?

As an autistic therapist, who also works as a data analyst at a management consultancy, I understand professional demands and the exhaustion that comes with masking. I specialise in supporting autistic professional women navigating burnout, depression and the search for meaning.

Book a free 15-minute call to explore whether therapy might help your specific situation.

Here is how counselling helps you, or, more truthfully, here’s how you help yourself

Once a month I am at the synagogue on Erev Shabbat. A Hillel quote on laminated paper catches my eye every time: "If I am not for myself, who will be for me? And if I am only for myself, what am I? And if not now, when?". This is a succinct description of what I have observed in counselling.

In my role as a therapist I help clients by facilitating the process but it's almost always about encouraging your autonomy. The process is different in every case, however it is likely to include the following points:

• At first you may find that you simply need to talk, let it all flow out, raw, uncensored. With an attentive counsellor you will feel heard and encouraged to be your genuine self

• Then you may find yourself exploring the individual elements of what is bothering you. The counsellor will help you examine the role of each component and the meaning of the issue as a whole

• Having given yourself the permission and the time to process your concerns, you may be ready to look at what kind of change is within your power. Your therapist will be by your side to help consider your existing strengths and what new skills may be useful

• Gradually you will find the way forward which is unique and genuinely yours. At this point your thoughts might become directed outwards. By coming to peace with yourself, you might feel compelled to offer greater acceptance to others. This may well be the time for you and the counsellor to reflect on whether you have achieved what you had hoped for from therapy
  

Even though there aren’t shortcuts in counselling, the good news is that you are in charge. Remember, “If I am not for myself, who will be for me?”.

It’s an invitation, take it. Start being there for you. Today.

Frequently asked questions about therapy for autistic professional women

Q: I've tried therapy before and it didn't help. Why would this be different?

A: Many autistic women have had therapy that focused on "fixing" autism-related traits or ignored the professional burnout context entirely. Autism-affirming therapy acknowledges your neurotype as valid and explores the mismatch between your needs and your environment. It also recognises that sometimes therapy's role is emotional support while you navigate unchangeable circumstances, not forcing change that isn't possible.

Q: I can barely get out of bed most days. How am I supposed to do "work" in therapy?

A: When you're in deep burnout or depression, therapy work looks different. It might mean sitting in silence while I hold space for you. It might mean talking about why nothing feels worth doing. It might mean acknowledging that this week, just showing up to the session is the work. I won't push you to sort yourself out when you're depleted. That's not how healing happens. We would likely be focusing on physiological needs, kind and compassionate inner voice and looking after yourself holistically.

Q: Will therapy give me back my motivation and sense of purpose?

A: I wish I could promise this! What therapy can do is help you understand why you lost those things, process the grief of life not turning out as you imagined and explore whether there's meaning to be found in different places than you expected. Sometimes motivation returns. Sometimes you discover you don't need motivation in the same way you thought you did. Both are valid outcomes.

Q: I'm successful professionally but my personal life is empty. Can therapy help with that?

A: Yes, this is common for autistic professional women who've invested heavily in career success while relationships and personal fulfillment have been harder to navigate. Therapy can help you explore what you actually want (not what you "should" want), why forming close connections has been difficult and whether your current lifestyle is sustainable or needs renegotiation.

Q: How many sessions does it take to feel better?

A: There's no set timeline. Some clients feel relief after a few sessions just from being heard and understood. And that is enough for them. Others work with me for months or years navigating complex burnout, depression and life transitions. The gym metaphor applies here too. You wouldn't expect to get fit after one session. Meaningful change takes time, patience and consistent effort.

Working with an autistic therapist who understands professional burnout and depression

As an autistic professional working in tech alongside running my therapy practice, I navigate both demanding career expectations and the reality of burnout-depression cycles. I specialise in supporting autistic professional women, particularly those in their 40s, 50s and 60s, who are experiencing:

• Recurrent burnout-depression cycles that keep returning despite your best efforts

• Lost sense of purpose and direction

• Grief about how life has turned out differently than you imagined

• Professional success but personal emptiness

My approach is honest, therapy won't fix everything. Sometimes it helps you make meaningful changes. Sometimes it helps you make peace with what can't be changed.

/*In-person sessions in Gerrards Cross, Buckinghamshire, and online across the UK and Republic of Ireland.*/

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The door to my counselling room