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Jackie Schuld Art Therapy Blog

Therapy is all About the Internal Work… or Might it Not be For Autistics?

Therapy is all about the internal work. That’s what the textbooks teach. That’s what therapists practice. That’s what we humans like to say to each other.

It makes sense why this focus on the internal work is so lauded. We cannot change others. We can only change ourselves.

Many times it is our own internal beliefs that hold us back. Thinking we’re not good enough to ask for a raise or try that new business idea.

An abstract watercolor of yellows and brown by autistic art therapist Jackie Schuld
"External Pressures" Watercolor by Jackie Schuld

Other times, it’s our lack of trust in our intuition that harms us. Our guts give us some insight, but we listen to others instead of ourselves.

We need to have powerful connections with ourselves. Therapy can certainly help do that.

But internal work isn’t everything, especially when it comes to autistics.

I’m an autistic therapist who specializes in late-identified autism. I work with clients daily who want their lives to feel better. Many times that means examining their external world.

An autistic can refine their beliefs to perfection, but if their daily schedules are overloaded, they’re still going to feel exhausted at the end of the day. No amount of gratitude lists or cognitive reframing is going to shift their energy. What they really need is a day with less meetings. A day with more breaks. A day with more opportunities for downtime. A day that allows space to move slowly and deliberately. A day that allows time for self interests and other things that bring joy.

I understand I’m talking about a great amount of privilege here. Most of us don’t have that kind of flexibility. We have demands and we need money to survive. So in therapy we look at what is needed and how to slowly get there. We look at how to manage the demands of the short-term and make shifts for the long-term.

Another therapeutic example is socializing. “Internal work” would say to teach an autistic all of the social skills they need. However, all of the social skills in the world aren’t going to change grating social norms, overstimulating environments, and how uncomfortable crowds and groups feel.

Instead, we can look at external changes, like finding autistic friends or groups that don’t adhere to harmful social norms (like hiding the truth to be “nice” or not saying what they actually mean). We can also limit our exposure to overstimulating environments, and suggest alternatives like meeting in a park or a quiet restaurant. We can also know that a group or crowd will impact our energy no matter what, and plan for downtime afterward.

These external shifts make MASSIVE differences. It also shifts the blame away from us. Instead of saying “YOU are the problem, YOU need to change,” we say, “Hey, how about we make some of these external problems so life is more enjoyable for you?”

Yes, every human can benefit from doing some internal work, but it’s not the only work that matters.


Thank you for reading. If you’d like to read more, sign up for my FUNletter. If you would like to explore your autistic identity with an autistic therapist, you can learn more about my therapy services here.


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