When the Therapist and the Client Are Wired the Same Way

What I’ve had to reckon with as an autistic therapist around doing Brainspotting with autistic clients

I’ve been sitting with a question since I first started studying the modality, one I’ve been reluctant to ask out loud because it implicates me directly. Does being autistic make it harder to do Brainspotting with autistic clients? For the non-initiated, Brainspotting is a trauma-focused therapy developed by David Grand that uses fixed eye positions to access and process unresolved trauma stored in the subcortical brain. The premise is that where you look affects how you feel, and that holding a specific gaze point while attending to internal experience allows the brain to process material that talk-based therapy can't easily reach.

Anyway, to the question.. the honest answer is: it depends, and the specificity of what it depends on has been more useful to me than either the reassuring “of course not” or the clinical “possibly yes.”

Here’s what I’ve had to think through.

What Brainspotting is actually asking of my nervous system

Brainspotting is built on dual attunement. The therapist tracks the client’s neurobiological processing and the relational field simultaneously, largely through continuous implicit reading of nonverbal cues. Micro-expressions, breathing shifts, eye movement changes, body tension. David Grand’s model assumes this tracking runs somewhat automatically in the background while the therapist holds the therapeutic frame.

For me, that assumption needs examination. I can read clients. I’ve developed explicit skills for tracking nonverbal cues in my clinical work and in my career as an engineering manager. But explicit processing is cognitively expensive in a way that implicit processing isn’t, and sustained over a 50-minute Brainspotting session, that difference in load is real. I notice it. Naming that honestly feels more useful than pretending I’m doing something I’m not.

The interoception problem, doubled

Brainspotting is also a body-based modality. It relies on clients locating and staying with internal somatic experience, and on me helping them do so. This is where things get genuinely complicated.

Research on interoception in autism consistently shows that autistic individuals experience internal body signals differently, though not uniformly. Some show reduced interoceptive accuracy, others heightened but differently organized awareness. Alexithymia, the difficulty identifying and naming emotions from internal bodily sensations, is present in an estimated 40 to 65% of autistic people, compared to roughly 10% of the general population. A 2026 paper in the International Journal of Developmental Disabilities argues that many difficulties attributed to autism are better understood as consequences of challenges in processing internal physiological signals, with interoceptive differences playing a central mechanistic role.

When I’m guiding an autistic client through body-based emotional processing, there are potentially two people in the room navigating the same territory with differently calibrated internal maps, neither of which matches the neurotypical framework Brainspotting was designed around. I can work with that. But I have to work with it explicitly, which is different from it happening automatically.

A challenge to the theoretical framework itself

This is also where I’ve found a recent paper genuinely clarifying. Kotler, Mannino, Fox, and Friston, writing in Frontiers in Systems Neuroscience in 2026, argue directly against the idea that the body stores trauma. Drawing on predictive coding and the Free Energy Principle, they propose that what endures after trauma is not a memory inscribed in tissue but a collapse of neurological flexibility, a loss of metastability, the brain’s capacity to move fluidly between network states.

On this model, trauma is a disorder of prediction, not storage. The brain locks into narrow threat-expectation patterns, overweighting danger priors, producing the hypervigilance and avoidance that characterize PTSD. Healing is not releasing what is stored in the body but restoring the brain’s capacity for adaptive variability.

This reframe matters for how I work with autistic clients specifically. Brainspotting’s theoretical language leans on somatic storage metaphors. For clients who already have altered interoceptive access, framing healing as locating and releasing bodily stored trauma may not map onto their actual experience. A predictive coding framework, with its emphasis on recalibrating threat predictions and restoring cognitive flexibility, is both neurologically more accurate and, in my experience, more accessible to how many autistic clients actually think about their own minds.

What I do bring to this work

I want to be clear that I’m not arguing against doing this work. I’m arguing for being honest about what I’m actually doing in the room.

The advantages are real. I’m significantly less likely to misread autistic expression. Flat affect as disconnection, literal responses as resistance, reduced eye contact as shame: these are common failure modes in neurotypical-therapist and autistic-client pairings. My baseline error rate on these specific misreadings is lower, not because I’m trying harder, but because they don’t read as errors to me in the first place.

I also bring an explicit, systematic approach to clinical work. Brainspotting has clear procedural structure: identify activation, find the brainspot, process, close. The protocol is clear and implementing it straightforward. The direct presence I naturally offer, less performatively warm than some therapeutic styles, is often exactly what autistic clients find most comfortable. They’ve told me so.

The question I keep coming back to

Underneath the specific question about Brainspotting is a broader one since I started learning more about it: is this the right modality for this client, or is it the modality I know?

For autistic clients, the evidence base for ACT and CPT is stronger than for Brainspotting, and their theoretical frameworks fit autistic cognitive styles more naturally. ACT in particular, with its emphasis on noticing thoughts as thoughts rather than verdicts, on choosing action based on values rather than waiting for emotional states to shift, relies less on continuous interoceptive tracking and continuous nonverbal attunement. It also maps cleanly onto the predictive coding framework: ACT is, in many ways, a clinical technology for recalibrating how the brain weights its own predictions.

I still plan to use Brainspotting with the right clients. I’ve seen it work. But I hold it more carefully with autistic clients now, and I’m more deliberate about which protocol elements I emphasize and which I translate into explicitly cognitive language rather than somatic.

What I’ve learned from asking this question honestly

The diagnostic category doesn’t determine the answer. My specific experience in the room does. How I personally navigate interoception, what I notice about my own cognitive load across different session types, what my autistic clients actually report about working with me: those are the data points that matter.

Asking whether my neurology makes this harder was uncomfortable. It felt like it might be an argument against my own competence. What I found instead was a more precise map of where my strengths are real, where I’m working harder than I let on, and where the modality itself may need to bend to fit the client rather than the other way around.

That kind of specificity, uncomfortable as it is to arrive at, is what good clinical practice actually requires.