Prolonged Exposure Therapy for Neurodivergent Women in Portland & Washington State
Finding Your Way Through Trauma as a Late-Diagnosed Autistic Woman
If you're reading this, you might be one of the many autistic women who've spent decades masking your way through life, only to discover that the trauma you've been carrying hits differently when you understand your neurotype. Maybe you've recently connected the dots about your autism after your child's diagnosis, or perhaps perimenopause has brought everything to the surface in ways you weren't expecting. Either way, you're here because you know that healing from trauma as a neurodivergent person requires something more nuanced than the standard approach.
I get it. As a neurodivergent mom myself, I understand how exhausting it can be to navigate trauma recovery while also processing what it means to be autistic in a world that wasn't built for us. That's why my approach to Prolonged Exposure Therapy isn't just evidence-based—it's neurodivergent-affirming at its core.
What Is Prolonged Exposure Therapy?
Prolonged Exposure (PE) Therapy is one of the most extensively researched and effective treatments for Post-Traumatic Stress Disorder (PTSD) and trauma-related difficulties. But here's what I want you to know: while PE has incredible research backing it, the way I implement it with my neurodivergent clients looks different than what you might find elsewhere.
At its foundation, PE helps you process traumatic memories and experiences by gradually approaching—rather than avoiding—the thoughts, feelings, and situations that have been triggering your trauma responses. For my autistic and ADHD clients, this means we're not just addressing the trauma itself; we're also considering how sensory sensitivities, communication differences, and executive function challenges shape your experience of both trauma and healing.
The therapy typically involves two main components that we'll adapt to your specific needs:
Imaginal Exposure: This involves revisiting and processing traumatic memories in a safe, controlled environment. For neurodivergent folks, I pay special attention to how we structure these sessions, recognizing that your processing style might be more visual, require more breaks, or need different grounding techniques than neurotypical approaches suggest.
In Vivo Exposure: This involves gradually approaching real-world situations that you've been avoiding since your trauma. As someone who understands the intersection of autism and trauma, I recognize that what looks like trauma-related avoidance might sometimes be sensory overwhelm or social exhaustion. We'll tease these apart together and create exposures that actually make sense for your neurodivergent brain.
Why Trauma Therapy Needs to Be Different for Autistic Women
Here's something that doesn't get talked about enough: trauma looks different when you're autistic. Maybe you've been through traditional therapy before and felt like something was missing. Perhaps therapists mistook your autistic traits for trauma symptoms, or worse, treated your neurotype as something to be fixed rather than understood.
The reality is that many of us late-diagnosed autistic women have complex trauma histories. We've spent years, even decades, forcing ourselves into neurotypical molds, pushing through sensory overwhelm, and managing intense social demands without understanding why everything felt so hard. That constant state of masking and overwhelm can be traumatic in itself, and it often compounds other traumatic experiences we've had.
When I work with autistic women using PE, I'm holding space for all of this complexity. I understand that your trauma might include:
Years of being misunderstood or pathologized for your autistic traits
Exhaustion from constant masking and code-switching
Experiences of being taken advantage of due to different social processing
Medical trauma from being dismissed or misdiagnosed
The particular vulnerabilities that come with being a high-masking autistic person in relationships and workplaces
How I Adapt Prolonged Exposure for Neurodivergent Minds
My approach to PE recognizes that your autistic brain isn't broken—it just processes things differently. This means we might:
Honor Your Processing Style: Some of my clients need to write things out, others need visual aids, and some process best through movement. We'll find what works for your brain, not force you into a neurotypical framework.
Respect Sensory Needs: I understand that fluorescent lights, certain textures, or unexpected sounds aren't just uncomfortable—they can be genuinely dysregulating. Our sessions will account for your sensory needs, including how sensory issues might intersect with trauma triggers.
Work With Your Communication Style: Direct communication? Need time to process before responding? Prefer written communication between sessions? I'm here for all of it. There's no "right" way to communicate in my practice.
Account for Executive Function: Trauma work is exhausting for anyone, but when you add in the executive function challenges that often come with ADHD or autism, it can feel impossible. We'll build in supports and structures that actually work with your brain's way of organizing and processing information.
Recognize Stimming and Regulation: Your stims aren't something to hide or suppress during our work together. In fact, they might be exactly what helps you stay regulated during challenging exposures.
What the Process Actually Looks Like
When you begin PE therapy with me, we start with a comprehensive understanding of not just your trauma, but your whole self—including your neurotype, your masking patterns, your sensory profile, and your unique strengths. This isn't about fitting you into a predetermined treatment protocol; it's about adapting evidence-based treatment to work with your neurodivergent brain.
Our initial sessions focus on psychoeducation that's actually relevant to you. This means talking about how trauma and autism intersect, understanding your particular triggers and responses, and developing coping strategies that don't require you to mask or suppress your autistic traits.
As we move into the exposure work itself, we go at your pace. I've found that many of my autistic clients need more preparation time, clearer structure, and more explicit communication about what to expect. That's not a limitation—it's just different, and I plan for it.
During imaginal exposures, we might use techniques that work specifically well for autistic minds. This could include using special interests as grounding tools, incorporating movement or tactile elements, or structuring narratives in ways that align with how your brain naturally organizes information.
For in vivo exposures, we carefully distinguish between trauma-related avoidance and autistic needs. Avoiding the grocery store might be about trauma, sensory overwhelm, social anxiety, or all three. We'll figure out what's what and create exposures that address the trauma without demanding that you suppress your autistic needs.
The Integration of Identity and Healing
What I love about working with late-diagnosed autistic women is that trauma recovery often happens alongside identity integration. As you process your traumatic experiences, you're also understanding yourself through this new lens of neurodivergence. You might realize that some of what you thought was trauma response is actually your authentic autistic self. Or you might discover that trauma has been masking some of your autistic traits.
This parallel process of trauma healing and identity development is something I hold space for in our work. It's not uncommon for my clients to experience grief about late diagnosis, anger about years of misunderstanding, and relief about finally having context for their experiences. All of these feelings are valid and important parts of your healing journey.
Moving Forward Without Masking
The goal of our work together isn't just to reduce trauma symptoms—though that's certainly important. It's also about helping you build a life where you don't have to mask your way through every interaction. As we process your trauma, we're also working toward:
Understanding and advocating for your sensory needs
Building relationships that accept your authentic self
Creating routines and structures that work with your brain
Developing sustainable ways of being in the world that don't require constant masking
Integrating your understanding of your neurotype with your healing from trauma
Is This Approach Right for You?
If you're a late-diagnosed or self-identified autistic woman who's ready to address trauma in a way that honors your neurotype, we might be a good fit. My clients typically aren't in crisis—they're in a phase of integration and growth. They've often done therapy before, but they're looking for something more specialized, more understanding of the intersection between neurodivergence and trauma.
Many of my clients are professionals, parents, or both, trying to balance the demands of life with their need for authentic self-expression and healing. They're tired of approaches that treat their autism as a problem to be solved rather than a fundamental part of who they are.
If you're curious about whether Prolonged Exposure therapy could work for you, I invite you to reach out. We can start with a free 15-minute consultation where we'll talk about your specific situation and needs. From there, if we decide to move forward, we'll schedule an intake session where we'll dive deeper into your history and establish clear goals for our work together.
Taking the Next Step
Healing from trauma as a neurodivergent person requires a specialized approach—one that sees your autism not as a barrier to treatment but as an important context for understanding your experiences. My practice combines the robust evidence base of Prolonged Exposure therapy with a deep understanding of neurodivergent experiences, particularly for late-diagnosed women navigating identity, trauma, and authenticity.
If you're ready to explore trauma healing that actually makes sense for your neurodivergent brain, I'm here. Reach out to schedule your free consultation, and let's talk about how PE therapy can support your journey toward healing and authentic self-expression.