What Is Cognitive Processing Therapy? A Guide for Neurodivergent Women

Oct 30

If you're here, you're probably trying to figure out what Cognitive Processing Therapy is all about and whether it might actually help. Maybe you've recently realized you're autistic, or you've been living with ADHD your whole life without the language to describe it. Either way, you're dealing with some heavy stuff, and you're wondering if CPT could be a tool for healing. Let me break down what this therapy actually looks like, how it works, and why it can be particularly powerful for neurodivergent women who've spent years masking and adapting.

Key Takeaways

Cognitive Processing Therapy (CPT) is a structured approach to healing from trauma by examining how difficult experiences have shaped your thoughts and beliefs about yourself and the world
CPT helps identify and work through "stuck points" – those persistent thoughts that keep trauma's impact alive in your daily life
For neurodivergent individuals, CPT can be adapted to honor different processing styles, sensory needs, and lived experiences, ensuring validation alongside exploration
The therapy often involves writing exercises to examine thoughts and beliefs, which can be especially accessible for people who process better through writing than speaking
My approach to CPT aims to help you reclaim energy that's been spent on trauma responses and masking, fostering stronger self-acceptance and authentic identity development

Understanding Cognitive Processing Therapy

Cognitive Processing Therapy, or CPT, is designed to help people work through the aftermath of traumatic experiences. But here's what makes it different: it's not just about retelling what happened to you over and over. Instead, CPT looks at how those experiences have fundamentally changed the way you think about yourself, other people, and the world around you.

I use a structured approach, which honestly can be really helpful when you're feeling overwhelmed or lost in the fog of trauma. Having a clear framework gives you something solid to hold onto during the healing process.

What Makes CPT Different

What sets CPT apart is its focus on identifying and changing those "stuck points" – the thoughts that keep you feeling trapped by past experiences. It's not about forcing you to forget what happened or minimizing your experiences. Instead, it's about examining the beliefs that formed because of trauma and figuring out which ones are serving you and which ones are keeping you stuck.

For many neurodivergent women I work with – especially those who have spent decades masking and adapting to neurotypical expectations – some of these "stuck points" might actually feel like accurate observations about living in a world that doesn't always accommodate neurodivergent needs. My approach involves sorting through what needs to be challenged and what needs to be validated, fully acknowledging the reality of your experiences.

The Core Principles of CPT

At its heart, CPT is built on a few key ideas:

Identifying "Stuck Points": These are the thoughts or beliefs that keep you from moving forward after trauma. They often involve core themes like safety, trust, power, control, self-worth, and intimacy.
Examining and Reshaping Beliefs: Once identified, these stuck points are carefully examined. I help you look at the evidence for and against these beliefs, and together we develop more balanced and helpful ways of thinking.
Understanding Trauma's Impact: CPT includes education about how trauma affects the brain and body, which can be incredibly validating. It helps normalize your reactions and symptoms in a way that makes sense.

CPT for Neurodivergent Women

When I use CPT with neurodivergent women, I adapt the approach to fit how your brain naturally works. Traditional therapy doesn't always account for sensory sensitivities, different processing speeds, or the unique challenges of masking and late diagnosis. CPT, when applied thoughtfully, can be powerful precisely because it respects that some "stuck points" might actually be valid responses to genuinely difficult environments.

The goal is to help you heal from trauma while fully embracing your neurodivergent identity, not trying to make you fit into a neurotypical mold. This is about healing that honors who you actually are.

The Structure of CPT Sessions

One of the things I appreciate about Cognitive Processing Therapy is that it's not just random talking. There's a clear path forward, which can be incredibly comforting when you're trying to heal from difficult experiences.

CPT typically follows a protocol of around 12 sessions, though the pace is completely flexible. I adjust it based on what you need and what's happening in your life. It's never about rushing through things – it's about making sure the process actually works for you.

Here's generally how CPT unfolds in my practice:

Psychoeducation and Trauma Awareness: I start by making sure we're on the same page about what trauma is and how it affects your brain and body. Understanding the "why" behind certain reactions can be deeply validating, especially if you've spent years feeling confused or like something's fundamentally wrong with you. This builds a shared language for our work together.
Exploring How Trauma Shaped Your Beliefs: Next, we look at how traumatic experiences have shaped the way you see yourself, others, and the world. This isn't about reliving every painful detail, but more about examining how your beliefs might have gotten stuck. For many neurodivergent women, this part sheds light on how trauma and neurodivergence have become tangled together over the years.
Cognitive Restructuring: The core of CPT involves identifying and working through those "stuck points" – the unhelpful thoughts that keep distress alive. I use structured exercises, often involving writing, to examine these thoughts and develop more balanced perspectives. This systematic approach tends to appeal to the analytical side of many neurodivergent brains, providing a logical framework for processing trauma.

This structured approach means you're never left wondering what comes next. It provides a clear framework for understanding and working through trauma's impact.

CPT Through a Neurodivergent Lens

When I talk about Cognitive Processing Therapy with neurodivergent clients, I'm always conscious that some of those "stuck points" might actually be pretty accurate observations about living in a world that wasn't built for neurodivergent people. So when we work together, I'm not challenging every single thought. Instead, we're figuring out what needs to be processed as trauma and what needs to be validated as your lived reality.

Identifying and Working Through Stuck Points

Traditional CPT focuses on identifying beliefs that have been distorted by trauma. For example, a belief like "I am worthless" might stem from a traumatic event. In a neurodivergent context, however, a thought like "My sensory needs are too much for others" might feel like a "stuck point," but it could also be a realistic assessment of trying to navigate environments that aren't accommodating.

My work involves sorting through this complexity. I'll look at:

Beliefs directly tied to traumatic events: These are the core CPT targets, like "I am no longer safe" or "I am fundamentally flawed" due to abuse, neglect, or other trauma.
Beliefs that are accurate reflections of ableism: These are thoughts that, while painful, accurately describe the challenges of being neurodivergent in a neurotypical world. For instance, realizing that advocating for accommodations at work is exhausting and often met with resistance.
The intersection of trauma and neurodivergence: How has trauma impacted your neurodivergent traits, and how have your neurodivergent traits influenced how you experienced and processed trauma?

The goal isn't to erase accurate observations about the world, but to differentiate them from trauma-based distortions.

Validating Your Lived Reality

This is huge. So much of the trauma experienced by neurodivergent individuals comes from constant invalidation. Think about being told you're "too sensitive," "overthinking," or "making things up" when you're just experiencing the world differently. My approach to CPT acknowledges this reality.

I don't just challenge the thought "I'm a burden" – I also validate the experience of feeling like a burden when your needs have been consistently ignored or dismissed. This means:

Acknowledging the effort of masking: The sheer energy it takes to perform neurotypicality is real and often traumatic in itself.
Recognizing sensory overload as genuine: It's not an overreaction to be overwhelmed by lights, sounds, or textures that others might not notice.
Validating the pain of misunderstanding: Years of being misunderstood by family, friends, or colleagues create deep wounds that deserve acknowledgment.

Integrating Your Neurodivergent Experience

CPT is about making sense of the past to live better in the present. For neurodivergent individuals, this means integrating trauma healing with an understanding of your neurotype. It's not about becoming "less autistic" or "more neurotypical." It's about:

Understanding how trauma impacts your specific neurology: How does trauma affect your executive functions, sensory processing, or social interactions?
Using your neurodivergent strengths in healing: Your analytical skills, attention to detail, or unique perspectives can be powerful tools in processing trauma.
Developing coping strategies that work with your brain, not against it: This might mean different communication styles, sensory accommodations, or ways of organizing information that align with your natural way of thinking.

Adapting CPT for Sensory Needs

When I work with clients on CPT, I'm always mindful that healing isn't one-size-fits-all. Especially for neurodivergent folks, sensory experiences shape how you interact with the world and how you process difficult material. So adapting CPT to fit your unique sensory profile is essential.

This means making sure both the therapy space and the process itself feel safe and manageable for your nervous system. It's not just about the thoughts we're unpacking, but also about the environment we're doing it in.

Here's how I adjust things:

Calibrating Session Intensity: If CPT involves revisiting upsetting memories or situations, I'm mindful of sensory overload. This might mean keeping sessions shorter, incorporating more breaks, or adjusting the pacing based on your needs.
Utilizing Sensory Tools for Regulation: Sometimes during difficult parts of therapy, having something to ground you is incredibly helpful. I'll work with you to figure out what helps. This could be a specific fidget toy, listening to particular music or nature sounds, or focusing on a calming visual or scent. The goal is to have tools ready to help you stay regulated.
Respecting Processing Differences: Neurodivergent brains often process information differently. This can affect how quickly you respond or how you communicate. I make sure there's enough time for you to think and respond without feeling rushed. Written summaries or visual aids can also be really useful to help solidify what we're discussing.

Since I provide online therapy sessions, you also have the advantage of being in your own comfortable environment, which can make managing sensory needs much easier.

The Role of Writing in CPT

When I work with clients on Cognitive Processing Therapy, writing comes up a lot. And for good reason – it's not just about jotting down notes; it's a really active part of the healing process. For many neurodivergent individuals, writing can actually be a more accessible way to process things than talking alone. It gives you space to think, organize your thoughts, and really dig into what's going on without the pressure of immediate verbal responses.

Writing as an Accessible Modality

Sometimes when you're trying to explain something complex, especially something tied to trauma, the words just don't come out right in the moment. Or maybe you get overwhelmed and shut down. Writing bypasses some of those immediate barriers. It allows you to:

Organize your thoughts: You can write, erase, rewrite, and structure your experiences in a way that makes sense to you. This is especially helpful when your brain naturally gravitates toward order and logic.
Process at your own pace: There's no rush. You can take as long as you need to find the right words or to sit with difficult feelings that come up as you write.
Create a tangible record: Having your thoughts and experiences written down can be deeply validating. It's proof of what you've been through and the work you're doing.

Examining Thoughts and Stuck Points

CPT is all about identifying and changing those "stuck points" – the beliefs and thoughts that keep you trapped in trauma's aftermath. Writing is a primary tool for this work. You'll write about specific traumatic events, but more importantly, you'll write about the thoughts and beliefs that came up because of those events.

For example, if a trauma made you believe you're fundamentally flawed, you'll write about that belief. Then we look at it together, examining where it came from and whether it's still serving you. It's like being a detective for your own mind, and writing is your magnifying glass.

Structured Exercises for Pattern Recognition

CPT uses specific, structured exercises designed to help you see patterns in your thinking. These exercises are typically written and might involve:

Identifying trauma's impact: Writing about how a specific event changed your beliefs about yourself, others, or the world.
Challenging stuck points: Writing out the evidence for and against a particular negative belief that stemmed from trauma.
Developing new balanced thoughts: Crafting more realistic and helpful ways of thinking based on the evidence you've gathered.

These exercises tap into the natural pattern-recognition strengths that many neurodivergent people have, making the process feel more logical and less like guesswork.

Beginning Your CPT Journey

Starting therapy can feel like a big step, and for many neurodivergent individuals, finding the right fit is even more important. It's totally understandable to feel hesitant, especially if past therapy experiences haven't been the most helpful. The good news is, there are ways to approach this that feel more aligned with who you are.

The Importance of a Consultation

Before diving into full sessions, I offer a free 15-minute consultation. Think of it as a low-pressure conversation to see if my approach feels right for you. It's your chance to ask questions about how I work, especially regarding neurodivergent needs, and to get a feel for my style. This initial conversation is key to making sure you feel comfortable and understood from the start.

A Neurodivergent-Affirming Intake Process

Once you decide to move forward, the intake session is where the real work of understanding begins. My intake process looks at your history and current challenges through a lens that respects your unique brain. I want to know about:

Your personal history, including any late diagnoses or self-discoveries about being autistic or having ADHD
How trauma has impacted your life and beliefs
Your specific needs and how you best process information
What you hope to achieve through therapy

This isn't about fitting you into a box – it's about understanding your world as you experience it. Many of the women I work with are discovering their neurodivergence after having a child diagnosed, or they're navigating perimenopause and finally understanding why things feel so hard. I get it, and I want to understand your specific journey.

Setting Sustainable Goals

Setting goals in therapy should feel empowering, not overwhelming. For neurodivergent individuals, this often means goals that are clear and specific, achievable through manageable steps, and flexible enough to adjust as life happens.

It's about creating a path forward that feels sustainable for your nervous system and your life, ensuring that therapy supports your wellbeing rather than adding to your stress.

Integrating CPT with Your Authentic Self

When you're working through trauma using Cognitive Processing Therapy, it's not about trying to become someone you're not. It's really about peeling back the layers of what you've had to do to survive and finding your real self underneath. For neurodivergent folks, this often means untangling trauma from the experiences of just trying to exist in a world that wasn't built for you.

The goal is healing that lets you embrace your neurodivergent identity, not erase it.

Think about it: years of masking, trying to fit in, and constantly adapting can feel traumatic in itself. CPT helps you sort through this, but it needs to be done in a way that honors your unique brain. It's about making sure the therapy fits you, not the other way around.

Here's how CPT can help you connect with your authentic self:

Understanding the "Why": We look at how trauma and your neurodivergent traits have become intertwined. Sometimes what feels like a trauma response is actually just your natural way of being, amplified by difficult experiences. CPT helps you tell the difference.
Moving Beyond Performance: Therapy with me doesn't require you to perform neurotypical behaviors. You don't have to force eye contact or pretend to process things in a certain way. The focus is on your internal experience and healing, not external presentation.
Reclaiming Energy: All that energy spent on masking and managing trauma responses can be redirected. Imagine having more energy for your interests, your relationships, and just being you.
Building a Life That Fits: Instead of trying to contort yourself into a mold, CPT can support you in building a life that works with your neurodivergent brain. This means finding ways to manage challenges and advocate for your needs without feeling like you're constantly apologizing for existing.

The Goals of CPT

So what's the point of all this CPT work? The main idea is to help you get unstuck from the heavy stuff that trauma leaves behind. It's about freeing up your energy so you can actually live your life, not just survive it.

Here are some of the main things I aim for:

Reclaiming Energy for Self-Expression: Think about all the energy you've spent managing trauma responses, worrying, or just trying to get through the day. CPT helps you take that energy back. Instead of being stuck in old patterns, you can use that energy for things you actually care about – your hobbies, your relationships, your creative projects.
Facilitating Identity Development: For many neurodivergent folks, especially those who discovered their neurotype later in life, trauma can really mess with how you see yourself. You might have internalized a lot of negative messages from living in a world that wasn't built for you. CPT helps you sort through that, understanding how trauma has shaped your beliefs about yourself and then building a stronger, more authentic sense of who you are, separate from the trauma and the masking.
Finding Self-Acceptance and Relief: Ultimately, the goal is to find some peace. This means accepting yourself, quirks and all, and feeling relief from the constant burden of trauma. It's about moving from a place of feeling fundamentally "wrong" to a place of understanding and self-compassion. You deserve to feel okay in your own skin, and CPT is one path to get there.

CPT and Complex Trauma

When we talk about trauma, it's easy to think of big, single events. But for many neurodivergent women, especially those who discover their neurotype later in life, trauma is often more like a slow burn. It's the cumulative effect of years spent trying to fit into a world that doesn't quite make sense, leading to what's called complex trauma.

Trauma from Masking and Misunderstanding

Living as a neurodivergent person in a neurotypical society often means a lot of masking. You learn to hide your natural behaviors, communication styles, and sensory needs to be accepted or just to get by. This constant performance is exhausting and can lead to a deep sense of not being seen or understood.

The trauma here isn't from one incident, but from the ongoing experience of being misunderstood, invalidated, or feeling like you're fundamentally "wrong." CPT can help untangle these deeply ingrained beliefs that developed from these experiences.

Layered Trauma from Societal Expectations

Beyond masking, there's trauma that comes from societal expectations. Think about the pressure to communicate in certain ways, to socialize in specific settings, or to achieve milestones on a neurotypical timeline. When your natural way of being doesn't align with these expectations, it can feel like a constant battle. This can lead to trauma related to feeling inadequate or like a failure, experiencing social isolation or rejection, and internalizing the idea that your needs are too much for others.

CPT helps identify these societal messages and how they've impacted your self-perception and beliefs about the world.

Healing from Feeling Fundamentally Wrong

Perhaps the most profound impact of complex trauma for neurodivergent individuals is the pervasive feeling of being fundamentally flawed. Years of being told, directly or indirectly, that your way of thinking, feeling, or interacting is incorrect can lead to deep-seated shame and self-doubt.

CPT offers a structured way to challenge these beliefs. It's about systematically examining the thoughts that arose from traumatic experiences and understanding how they've shaped your view of yourself, ultimately working toward a place of self-acceptance and relief.

Understanding Prolonged Exposure Therapy

In addition to CPT, I also offer Prolonged Exposure therapy, which is another evidence-based approach for processing trauma. Prolonged Exposure, or PE, helps you process traumatic memories by gradually facing the things you've been avoiding. It's not about forcing yourself into overwhelming situations, but rather a careful, step-by-step process.

The idea is that by confronting triggers in a safe therapeutic space, they lose their power over you. This can be a powerful way to break free from the cycle of fear and avoidance that trauma creates. It's about reclaiming your life from the grip of past events.

Adapting PE for Neurodivergent Minds

If you're neurodivergent, the standard PE approach needs thoughtful adaptation. Your brain works differently, and that's not a problem – it just means I need to make sure the therapy fits you. This means I might adjust the pace, use different grounding techniques, or change how I structure the exposure exercises.

For example, some people benefit from shorter sessions with more breaks, while others need more visual aids or sensory tools to feel secure. The goal is to make the work manageable and effective for your unique nervous system. It's about finding what helps you process without getting completely overwhelmed.

Honoring Your Processing Style and Sensory Needs

This is where things get really personalized. I pay close attention to your specific needs, including:

Sensory Sensitivities: If certain sounds, lights, or textures are a problem, we work around them. Therapy shouldn't add to your sensory load.
Processing Differences: Some people need more time to think before they speak, or they might process information better visually or through writing. I honor that.
Regulation Strategies: We identify what helps you stay calm and regulated, and incorporate those strategies into sessions. This might involve stimming, using fidget tools, or taking mindful breaks.

The aim is to create a healing environment that respects your neurodivergent experience, making the process of working through trauma feel safer and more achievable.

Moving Forward with CPT

That's the overview of Cognitive Processing Therapy and how I approach it with neurodivergent women. It's a structured way to work through the impact that trauma leaves behind. Remember, it's not about forgetting what happened, but about changing how those memories and experiences affect you now.

It takes work, for sure, but the goal is to help you move forward with less weight on your shoulders. If you're considering CPT, know that finding a therapist who understands your unique needs as a neurodivergent person is crucial to the process.

Since I provide online therapy sessions to clients throughout Oregon and Washington State, you can access this support from wherever feels most comfortable for you. If you're curious about whether CPT might be right for you, I encourage you to reach out. We can start with a free 15-minute consultation to talk about your needs and see if my approach feels like a good fit. Contact me to discuss pricing, scheduling, and how we might work together.

Frequently Asked Questions

What exactly is Cognitive Processing Therapy?

CPT is a type of therapy that helps people work through the aftermath of traumatic experiences. It focuses on changing the thought patterns that get stuck in your head after something difficult happens. It's like untangling a knot of thoughts to help you feel better and move forward with your life.

How is CPT different from other types of therapy?

Unlike some therapies where you might just talk about feelings without structure, CPT gives you specific steps and tools. It helps you look closely at the thoughts that are bothering you and figure out if they're accurate or if they're distortions created by trauma. It's very structured and goal-oriented, which many neurodivergent people find helpful.

Can CPT help if my trauma is from everyday life, not just one big event?

Absolutely. CPT can help with different kinds of trauma, including what we call complex trauma. This includes things like ongoing invalidation, difficult family dynamics, bullying, or the cumulative stress of constantly masking your neurodivergent traits. It's about how these experiences affected your thoughts and beliefs about yourself and the world.

What does "stuck points" mean in CPT?

Stuck points are the thoughts or beliefs that keep you feeling trapped in trauma's aftermath. For example, you might think "It was my fault," or "I'm not safe anywhere," or "My needs are too much for others." CPT helps you examine these stuck points and develop more balanced, helpful ways of thinking about yourself and your experiences.

How do you adapt CPT specifically for neurodivergent women?

I adapt CPT to fit how your brain naturally works. This means honoring sensory needs, processing differences, and the unique challenges of masking and late diagnosis. I acknowledge that some "stuck points" might actually be accurate observations about living in a neurotypical world, so we sort through what needs to be challenged versus what needs to be validated. The goal is healing that embraces your neurodivergent identity, not erasing it.

Is writing required in CPT?

Writing is a significant part of CPT, and many neurodivergent people find it really helpful. You'll often write about your experiences and the thoughts that come with them. This can be easier than verbalizing everything in the moment because it gives you time to organize your thoughts and process at your own pace. If writing is particularly challenging for you, we can discuss modifications.

What can I expect in my first session?

After your free 15-minute consultation, we'll schedule a full intake session. This is where I'll learn about your history, including your neurodivergent journey, how trauma has impacted your life, and what you're hoping to achieve. It's a collaborative conversation focused on understanding your world as you experience it, not fitting you into a predetermined box.

How long does CPT usually take?

CPT typically lasts around 12 sessions, but the pace is completely flexible and adjusted to your needs. Some people move through it more quickly, while others need more time. The goal is effective healing, not rushing through a predetermined timeline. I work with you to find a pace that feels sustainable for your nervous system and your life.

Erica Aten