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David Smith David Smith

When Neurodivergence and Trauma Meet - and why the distinction may matter less than you think

I've spent thirty-nine years in therapy. Through all of it, I got better and better at one thing: understanding, in exquisite detail, exactly why I felt so messed up. What I couldn't do — for most of those thirty-nine years — was change any of it.

I was diagnosed as autistic at 56. I also have complex PTSD. And once both pieces were on the table, I started to understand something I now consider one of the most important questions in my clinical work: when neurodivergence and trauma grow up together in the same nervous system, trying to separate them is often the wrong problem to solve.

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David Smith David Smith

What Happens When I Speak: An Autistic Therapist on Unmasking, Silence, and the Cost of Being Seen

What Happens When I Speak

I made a video on a Wednesday morning before my first session. Not the polished kind — the raw kind. I talked about what I'm watching happen in my community as Medicaid cuts ripple through Oregon. I talked about getting bullied for speaking up. I talked about the exhaustion of being a person like me in a world like this one.

Then I shared it with the people I love most. And mostly got silence.

If you're autistic, you know what that silence does. Your nervous system — already hypervigilant, already scanning for rejection — registers it as data. You got it wrong again. Too much. Wrong topic. Put it away.

I've spent most of my life learning to be quiet. Not quiet as a spiritual practice. Quiet as armor. And here's what nobody tells you about that kind of silence: it doesn't protect you. It just means you're invisible and in pain, instead of visible and in pain.

This is a piece about unmasking, rejection sensitivity, and what it actually costs to use your voice when you've been told — in a thousand ways, over a lifetime — that who you truly are is either too much or not enough.

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