Unpacking CBT: A Supportive Tool on the Autistic Journey: Part 1 of 3.

In a previous post, we explored the often-hidden world of camouflaging and masking in autistic girls and women, shedding light on the energy and effort involved in navigating a world not always built with neurodivergent minds in mind. We heard how many autistic individuals, particularly those identified later in life, have developed sophisticated strategies to 'fit in,' often at a significant personal cost.

Today, we want to introduce a therapeutic approach that many autistic people have found genuinely supportive in understanding themselves and developing strategies to navigate life's complexities: Cognitive Behavioural Therapy, or CBT. Unpacking CBT.

It's crucial to say from the outset that the autistic community is wonderfully diverse. Every autistic person has their own unique strengths, challenges, and lived experiences. There's no single 'right' way to be autistic, and similarly, no single therapy works for everyone. However, for many, CBT offers a practical framework that resonates with their way of processing information and can provide concrete tools for managing specific difficulties.

So, What Exactly is CBT?: At its heart, CBT is a talking therapy that helps you understand the connection between your thoughts, feelings, and behaviours. It's based on the idea that our thoughts about a situation affect how we feel and behave in response to it.

Think of it like this:

• Situation: You are invited to a social gathering.

• Thought: "I won't know anyone, I'll say the wrong thing, and everyone will think I'm awkward."

• Feeling: Anxiety, dread, fear.

• Behaviour: Declining the invitation, withdrawing, masking heavily if you go.

CBT helps individuals identify these automatic thoughts, evaluate if they are realistic or helpful, and then work on changing unhelpful thinking patterns and behaviours to feel better. It's often quite structured and goal-oriented, which many autistic people find helpful.

For autistic people navigating a predominantly neurotypical world, this framework can be particularly relevant. The social rules are often implicit and confusing, sensory input can be overwhelming, and unexpected changes can be highly distressing. These situations can lead to challenging thoughts and intense feelings, impacting how one feels able to interact with the world.

How Can CBT Offer Support? CBT has been found to be a valuable tool for autistic individuals in addressing a range of common experiences. While it doesn't aim to 'cure' autism (because autism isn't a disease to be cured!), it can significantly improve well-being and coping.

Some key areas where CBT can provide support include:

1. Managing Anxiety: As we touched upon in our masking post, anxiety is a frequent companion for many autistic people. This can stem from social pressures, sensory sensitivities, or the effort of masking. CBT helps to identify the specific triggers for anxiety, challenge the anxious thoughts ("What's the actual evidence that I will say the wrong thing?"), and develop practical coping strategies like relaxation techniques or gradual exposure to feared situations in a controlled way.

2. Navigating Social Situations: Rather than providing rigid scripts (which can feel like another form of masking), CBT can help autistic individuals understand social situations better, manage the anxiety they provoke, and develop more flexible and authentic ways of interacting that feel comfortable for them. This might involve exploring social scenarios, understanding different perspectives, and practicing interactions in a safe therapeutic space.

3. Understanding and Expressing Emotions: Identifying and understanding emotions can sometimes be challenging. CBT can provide tools for recognising physical signs of different emotions, labelling feelings, and finding helpful ways to express them. This can reduce frustration and improve communication.

4. Developing Coping Strategies for Change and Uncertainty: Autistic people often thrive on routine and predictability. Unexpected changes can be highly unsettling. CBT can help build resilience by identifying anxious thoughts about change and developing strategies to manage the associated feelings, such as creating new routines or focusing on what can be controlled.

A Brief Example: Imagine an autistic person who finds unexpected changes to their schedule very distressing.

• Situation: A planned meeting at work is suddenly moved to a different time.

• Automatic Thought: "Everything is ruined! I can't cope with this. This is a disaster."

• Feeling: Intense anxiety, panic, possibly anger.

• Behaviour: Feeling overwhelmed, unable to focus on other tasks, potentially shutting down or reacting strongly.

Using CBT, they might work with a therapist to:

1. Identify the thought: "Everything is ruined! I can't cope."

2. Challenge the thought: "Is it really a disaster? What specifically feels overwhelming? What evidence is there that I can't cope with any change?" They might explore past instances where they did manage unexpected changes.

3. Develop a more balanced thought: "Okay, the meeting time changed, which is unsettling. But the meeting is still happening, and I can adjust my schedule. I have managed changes before."

4. Implement coping strategies: Practice deep breathing to manage the panic, break down the task of rescheduling their day into smaller steps, or use a visual schedule to map out the new plan.

This isn't about making them love unexpected change, but about giving them tools to navigate it without becoming completely overwhelmed.

Finding the Right Support: It's vital to stress that the effectiveness of CBT for autistic individuals often depends on the therapist's understanding and experience of autism. A neurodiversity-affirmative approach is key – one that respects and values autistic identity and doesn't aim to 'normalize' the individual. The therapy needs to be adapted to the individual's communication style, sensory needs, and way of processing information. When seeking CBT, look for a therapist who explicitly states experience in working with autistic clients.

This post has offered a general overview of how CBT can be a supportive tool for autistic individuals. In the coming weeks, we will delve deeper, focusing specifically on how CBT can empower autistic girls and women.

Our next post will explore how this therapeutic approach can specifically help with navigating social interactions and, importantly, support the journey towards unmasking and embracing one's authentic self.

We hope this introduction has been helpful. CBT is not a magic bullet, but for many, it provides a valuable roadmap and toolkit for navigating the world with greater confidence and reduced anxiety. Stay tuned for our next post