Neurodivergence is not a licence to normalise distress: better coping is not better wellbeing

Every time I post about autism care

someone comes into the comments with the same warning.

“Autistic and ADHD nervous systems are structured differently. It sounds like you’re saying the right intervention will heal them to be neurotypical. We should understand neurotype, not try to fix it, because it can’t be healed.”

I get why people say this. For decades, autistic people were treated as broken. Families were pushed to chase “normal”. Professionals were trained to focus on behaviour, not lived experience. Many of us were forced into compliance (ABA) in the name of help. So yes, I have zero interest in “fixing” autism or ADHD into neurotypical.

Here is what I am challenging.

The real danger is when distress becomes the baseline.

The most harmful idea still floating around in autism care is not “neurodivergence is different”. The harmful idea is this: distress is just part of autism, so we should accept it as normal.

That framing does something sneaky. It turns a body under strain into an identity label. It shuts down clinical curiosity. It stops the most important question we should be asking any child or adult in care:

Do you actually feel safe in your body?

Instead, the question becomes: can you still function?

And that is where harm creeps in. We start praising coping, endurance and compliance as if they are the same as wellbeing. We call survival “doing fine”. We call masking “skills”. We celebrate someone who looks calm, even if they feel flooded inside.

I have seen this fatalism up close, even from well-meaning professionals.

I have sat in intervision and heard therapists tell me I should “accept” that autistic people will always need a certain level of support, and that long, never-ending trajectories are simply part of the deal. As if the only realistic goal is better coping inside a permanently overloaded body.

That is not acceptance. That is resignation dressed up as kindness.

And it is harmful because it removes the possibility of change before we have even looked at what might be driving the distress in the first place. When a profession starts treating chronic overload as an identity feature, it stops being care and becomes management.

There is also a trap that looks like good support.

A lot of coaching today runs on one main idea: if we can explain a meltdown, we can prevent the next one.

So we analyse. We map the timeline. We list triggers. Noise. Changes in routine. Social demands. Too many transitions. We tell the story back: “This is why it happened.”

Sometimes that helps. Not because the body suddenly feels safer, but because the mind gets a storyline. The person stops feeling random. Parents feel less helpless. Professionals feel like progress is happening.

But you can explain a meltdown perfectly and still miss what keeps producing the overload.

This is where I keep coming back to one line.

Stop treating the smoke. Start treating the fire.

Smoke is what you can see. Meltdowns. Shutdowns. Agitation. Avoidance. Rigidity. Exhaustion. “Challenging behaviour”. Emotional storms. Social withdrawal. The constant need for control. Sensory seeking. Sudden aggression. Collapse after school.

All of that is real. It deserves care.

But smoke is not the fire.

The fire is the biology driving those states. A sensory system under strain. A body that does not register safety. A nervous system that keeps dropping into defence because the world and the body cannot be mapped reliably. Weak interoception. Impaired touch processing. An overload threshold that gets reached fast and recovers slowly.

When care focuses mainly on symptoms, it can look effective while leaving the cause untouched.

You can reduce visible meltdowns by lowering demands, tightening routines, increasing avoidance, teaching scripts, rewarding compliance, training “calm” behaviour. You can create someone who looks regulated.

You can also create someone who has simply become better at hiding the smoke.

Why it feels kind and still causes harm

Most autism and ADHD support is not cruel. It is often warm and well-intentioned.

It feels kind because it offers quick relief. It validates difference. It explains distress. It gives carers something to do. Sometimes it reduces chaos.

But kindness is not the same as accuracy.

The harm starts when the whole model rests on one hidden assumption: the body will stay more or less as it is, so the best we can do is help the person manage it.

That is how symptom-led care turns into a lifelong management plan for a state that might be treatable.

It centres what we can observe, so behaviour becomes the target. It rewards performance, so “looking fine” becomes the goal. It replaces physiology with insight, so understanding gets mistaken for safety. And it normalises chronic overload under the banner of acceptance.

Then the most dangerous thing happens.

The person learns to survive in an unsafe body while everyone calls it progress.

What changes when the sensory system is impaired

Here is the deeper problem. A lot of autism and ADHD care is built around outcomes, not biology.

We measure meltdowns, shutdowns, school attendance, “tolerance”, social behaviour, emotional control. We treat what shows up on the surface.

But biology does not care what looks good from the outside. If the sensory system is under strain, the body keeps producing defensive states, no matter how well someone can explain them or mask them.

That is why symptom improvement can create a false sense of success. The presentation changes. The person looks calmer. Yet the physiology stays unsafe.

The kind of care I am arguing for starts with a different question.

What is driving this state in the body?

When sensory feedback is unreliable

Because sensory impairment changes the whole feedback system.

When the sensory system is underdeveloped or impaired, you do not feel your body in a clean, reliable way. Signals arrive late, distorted or too intense. You often notice the problem only once you are already past threshold.

So you compensate.

You outsource your internal feedback to the outside world. You rely on other people to interpret you. You rely on post-event analysis to make sense of what happened. You become hyper-focused on “what might set me off” instead of anchored in “what is happening in me”.

That creates a vicious circle. The less you can sense internally, the more you depend on external explanations. The more you depend on those explanations, the more you override the weak signals you do have. The more you override them, the quieter they get. Then the body escalates, because escalation becomes the only way it can be heard.

Felt safety and the unseen trauma of “fine”

This is also why sensory impairment and feeling unsafe are so closely linked.

Felt safety is not a concept. It is not insight. It is not a good explanation.

Felt safety is the body’s signal that says: “I can settle.”

If the sensory system cannot map the body and the world accurately, that signal stays shaky. Someone can understand every trigger and still have no inner anchor.

And yes, the body can feel unsafe in a safe environment.

Nothing “bad” has to be happening. The room can be calm. People can be kind. Demands can be reasonable. Yet the body stays on alert because sensory input gets registered as threat, or because internal sensations are confusing, intense, or unreadable.

That is not mindset. That is physiology.

It also creates trauma that is hard to spot, because it is built from ordinary moments. Not one dramatic event, but thousands of small ones. Forcing yourself through overwhelm. Being told you are fine because you look fine. Learning to override your body because you cannot read it anyway.

One tiny moment at a time, life becomes something you survive instead of inhabit.

I learnt to gaslight myself

I am not saying this from theory. I am saying it from experience.

The more coaching and support I received, the more I could explain myself. I could identify the “why”. That helped, because at least the story made sense.

But I was also learning to gaslight myself.

When your sensory feedback is unreliable, you start looking for certainty outside yourself. You look for your truth in other people’s interpretations. You learn to override what you feel, because what you feel is delayed, confusing or arrives too late.

You become good at functioning. You become good at looking regulated. And you can still be flooded inside.

Regulated vs trained

That is why I do not accept a model of care that ends at explanation, coping and performance.

If the body remains unsafe, the person is not regulated. The person is trained.

This is also why the “different operating system” narrative becomes dangerous when it is used as a full stop.

Yes, neurotype is different. Yes, we should understand it.

But if “different” becomes the reason to stop investigating distress, we quietly normalise suffering.

This is where language matters.

Do not confuse neurodivergence, which is an identity umbrella, with autism and ADHD, which are diagnostic categories. Identity language can be empowering. It can also become a shield that blocks care.

When “this is just their neurotype” becomes the end of the conversation, untreated distress gets normalised. The system stays under strain. The person adapts to suffering. Everyone calls it acceptance.

Identity should never be used to normalise untreated distress.

Biology-led care asks a different set of questions.

It does not aim to erase neurodivergence. It aims to reduce unnecessary suffering.

It is not about making someone “more normal”. It is about making the body safer, so the person can live as themselves with less masking and more real capacity.

It asks things like:

What sensory input is this system struggling to process?
What sensations feel like threat?
What signals are missing or delayed?
Where is the strain coming from: touch, sound, movement, temperature, internal sensations, digestion, pain, pressure?
What are the early body signals, even if they are subtle: nausea, dizziness, tremor, twitching, sudden fatigue, headache, temperature swings?
What happens when sensory load decreases?
What helps recovery happen without collapse?
What starts improving when felt safety returns: sleep, digestion, muscle tone, pain, motor control, mood, social capacity, flexibility, learning?
Are we rewarding calm presentation or tracking real settling?
Are we building a life around avoidance and endurance, or restoring capacity?

These questions do not replace accommodation and acceptance. They make accommodation meaningful.

Because you can accommodate someone and still keep them in survival mode, if you never address the sensory strain underneath.

So this is my position.

Not against neurodivergence.

Against the normalisation of distress. Against reducing autism care to trigger-hunting and “regulation” while ignoring the bodily overload that keeps producing overwhelm.

Because reducing suffering does not erase neurodivergence.
It reduces suffering so the person can live as themselves, with less masking and more real capacity.

Autism and ADHD do not need curing. Untreated distress does.

If you are a professional, the next question is obvious.

What do we do on Monday morning?

Here is a practical starting framework. It is not a rigid protocol. Adapt it to your scope and setting. The point is simple: move from explanation and symptom management towards biology-led tracking. Ask whether the body is becoming safer, not just whether the person is performing better.

-Stop guessing. Measure whether your therapy is working.

Most therapists work hard. Effort is not the issue. The issue is that many trajectories run for months or years without a clear, shared definition of progress. Everyone is busy. Everyone is trying. Yet nobody can name what should be changing, how soon and how to tell the difference between real improvement and better masking.

That is why I created a free guide: Therapist’s progress checklist.

It shows the kind of measurable improvements you should be seeing within a realistic time frame. It helps you ask one honest question early, not after two years: is this approach reducing overload and building felt safety, or are we only improving presentation and coping?

-Screen the sensory nervous system, not just behaviour.

Do not assume you can “see” sensory impairment. Many clients look composed while their body is not safe. Use a structured tool you already have. In OT that might be standardised sensory measures. If you do not have that, use a clear checklist. Anything is better than pure intuition.

In my work, the SSRC / Sensory Snapshot is one option. It helps you document patterns and track change over time instead of relying on impressions.

-Include interoception on purpose.

If you are not checking interoception, you can miss a core part of the puzzle. Someone can explain triggers perfectly and still lack early warning signals. If internal feedback arrives too late, insight will not prevent overload. It only gives better narration afterwards.

So assess it deliberately. Use a questionnaire or structured prompts. Track whether interoceptive clarity changes over time, not just “insight”.

-Track felt safety, not just functioning.

Do not only track meltdown frequency or strategy use. Also track body-based signs like recovery speed, sleep, digestion, appetite, pain, headaches, muscle tension, temperature swings, internal escalation signals (nausea, tremor, twitching, dizziness, sudden fatigue), and the client’s own report: “Can I relax?”

Behaviour can improve while the body stays unsafe. Your tracking needs to catch that.

-Treat patterns, not episodes.

Trigger-hunting keeps you stuck in one-off events, you will be forever fire-fighting. Biology-led care looks for repeating patterns. Ask if overload links to touch, sound, movement, temperature, digestion or internal sensations. Notice under-responsiveness, over-responsiveness or switching. Watch for “fine all day, collapse later”. Notice whether “good days” are paid for with shutdown.

-Rule out obvious medical contributors.

When someone is chronically overloaded, basic medical questions matter: sleep disorders, pain, GI issues, nutritional deficiencies, medication effects, seizures, migraine, orthostatic intolerance. You do not need to become a physician. Just stop calling physiology “behaviour” or “anxiety” when the body is clearly sounding an alarm.

-Choose interventions that reduce load and increase felt safety.

Skills and strategies have their place. But the main goal is not to teach someone to tolerate an unsafe baseline. The main goal is to make the body safer.

Ask one blunt question: does this reduce sensory strain and increase felt safety or does it mainly improve outward functioning?

If outward functioning improves but felt safety does not, you may be training endurance.

-Use a feedback loop: measure → intervene → re-measure.

Pick one toolset and stick to a rhythm. Baseline. Intervention. Re-check at a fixed interval (ideally every 3-6 months). Adjust based on what you see.

This keeps you honest. It protects clients from vague, endless trajectories. And it moves care from ideology to physiology.