Dynamic Interpersonal Therapy for Autistic Adults: A Neuro-Affirming Approach
Dynamic Interpersonal Therapy, or DIT, is a structured, time-limited psychodynamic approach that focuses on understanding patterns of relating and emotional experience. Whilst it has traditionally been used in mainstream mental health settings, when thoughtfully adapted for autistic individuals, DIT offers something particularly valuable: a framework for fostering self-understanding and relational wellbeing that respects and affirms autistic identity rather than attempting to change it.
Understanding the relational landscape
Autistic people often face challenges in relationships, but these difficulties don't stem from deficits or an inability to connect. Instead, they arise from fundamental differences in communication styles, sensory processing, and the way social expectations have been shaped by neuronormative standards. The monotropism theory helps us understand this better. It explains that autistic cognition tends towards deep, focused interests, which naturally influences attention and emotional regulation. When interpersonal difficulties occur, they're typically the result of mismatched expectations between different neurotypes rather than any lack of capacity for meaningful connection.
This is where DIT's emphasis on exploring relational patterns and emotional meaning becomes particularly relevant. The approach creates space to explore and validate these differences rather than attempting to correct them, which aligns well with contemporary understanding of neurodivergence.
Moving towards neuro-affirmation
DIT practitioners working with autistic clients are encouraged to move away from deficit-based models towards frameworks that genuinely value difference. This requires reflection on how to engage with autistic clients authentically, considering necessary adaptations to the therapeutic stance and addressing the real harm caused by years of invalidation.
Two concepts are particularly important here: epistemic injustice and epistemic mistrust. Epistemic injustice occurs when someone is denied the opportunity to share knowledge and derive meaning from their own experiences. Epistemic mistrust develops when someone can no longer trust others as a source of knowledge because their experiences have been repeatedly invalidated and pathologised. For autistic individuals, these aren't abstract concepts but lived realities that have shaped their relationships with themselves and others.
DIT can address these issues directly by allowing for the adjustment of techniques to support mentalisation of relational patterns, foster psychological resilience, reduce alienation and autistic burnout, and crucially, increase joy in relating to others.
The importance of trauma-informed practice
A trauma-informed perspective is essential when working with autistic clients using DIT. Many autistic individuals carry trauma from chronic invalidation, the exhausting pressure to mask their authentic selves, and environments that have consistently failed to accommodate their needs. DIT can help by creating a safe, predictable therapeutic space where autonomy and authenticity are prioritised above conformity.
This involves practical adaptations to the therapeutic frame. Flexibility in communication methods and session timings, acknowledging and supporting sensory sensitivities, and validating the client's need for structure all become part of the work. These adjustments aren't special accommodations but necessary elements of ethical practice that help prevent re-traumatisation and promote genuine empowerment.
Addressing the double empathy problem
DIT also offers a way to work with the double empathy problem, a theory that suggests when people with different experiences of the world interact, they may struggle to understand and empathise with each other. This is crucial because it reframes communication difficulties as a mutual challenge rather than as a problem localised within the autistic person.
By exploring relational patterns collaboratively, DIT helps autistic clients articulate their experiences and develop strategies for navigating relationships without resorting to masking or compliance-based behaviours. These coping strategies might have felt necessary at one time, but they often lead to autistic burnout, identity confusion, and significant mental health difficulties over time.
Creating space for authentic relating
What makes DIT particularly valuable for autistic adults is its capacity to honour difference whilst supporting genuine connection. It doesn't ask autistic individuals to become more neurotypical in their relating, but instead creates space to understand patterns, make sense of past experiences, and develop ways of connecting that feel authentic and sustainable.
For autistic adults seeking therapy in Southeast London, finding an approach that truly affirms neurodivergence whilst offering meaningful support can make all the difference. DIT represents one pathway towards therapy that respects who you are whilst supporting the relationships and sense of self you want to develop.
If you're interested in exploring Dynamic Interpersonal Therapy with our DIT therapist, Funmi, you can get in touch with Heathwell to arrange an initial consultation. We're located in Blackheath Village and work with clients across Southeast London, Greenwich, Lewisham and online.
