Trauma, Autism and the Meaning We Make After Harm

A recent study by Prosser and colleagues explored post-traumatic stress symptoms in autistic and non-autistic adults. The findings are clinically important because they suggest that autistic people may not simply experience “more trauma”; but trauma may affect autistic people differently because of the kinds of events they are exposed to, the degree of direct exposure, and the meanings that develop after those experiences.

In this study, autistic and non-autistic adults reported a similar overall number of traumatic events. However, autistic participants reported more events that had happened to them directly. Consistent with previous studies, autistic adults also reported higher PTSD symptom severity and more negative post-trauma self-talk, as well as feelings of fear, shame and alienation.

As we know, PTSD symptoms are not only shaped by the traumatic event itself. After trauma, people may develop different beliefs based on their interpretation of what happened, such as “I am unsafe,” “I am disconnected from others,” “it was my fault,” or “there is something wrong with me.” For some clients, recognising autism may reduce years of misinterpretation: “I was difficult,” “I overreacted,” or “I failed socially” may begin to shift toward “my nervous system and communication style were not understood or supported.”

Including neurodivergence in case formulation and treatment planning helps guide more targeted interventions. EMDR and other trauma-focused therapies are still essential, but clinicians may need to pay closer attention to shame, fear, alienation, sensory triggers, social threat and the client’s lived experience of being autistic in a largely allistic world.

Self-compassion work can be a particularly helpful adjunct. Many trauma survivors struggle with shame and self-judgement, but this may be especially pronounced for autistic clients who have experienced repeated criticism, bullying, exclusion or pressure to mask. Compassion-focused interventions can help clients relate differently to the parts of themselves they have learned to hide, blame or reject.

For me, the key takeaway from this publication is that trauma treatment should not only ask, “What happened?” It should also ask, “What did this come to mean about you, other people, and your place in the world?” For autistic clients, those meanings may be shaped not only by the traumatic event itself, but by a long history of being misunderstood, stigmatised or left unsupported.

Reference:

Prosser, R., Rumball, F., King, D., & Steel, C. (2025). Post-traumatic stress disorder in autistic and non-autistic adults: The impact of appraisals on reactions to traumatic events. Autism, 30(3), 605–625. https://doi.org/10.1177/13623613251403405