When two truths miss each other by a millimetre
A different lens
Most people think misattunement means getting it wrong. It doesn’t. It means seeing clearly — but through a different lens.
In therapy, that difference can feel small but carry enormous weight. What looks like “resistance,” “avoidance,” or “lack of insight” from one perspective might, from another, be regulation, overload, or precision.
We call that therapeutic misattunement — when two nervous systems are speaking honestly but in different dialects.
At a glance
- Therapeutic misattunement happens when both people are right — but speaking in different nervous system languages.
- Neurotypical and neurodivergent communication follow different rhythms; neither is wrong, just differently tuned.
- In therapy, mismatched frameworks can mistake self-regulation for avoidance or resistance.
- True attunement means accuracy, not agreement — learning each other’s syntax, not forcing sameness.
- Therapy works best when it makes space for translation, not correction.
Different frames, different rules
Neurotypical frameworks are built on inference. Tone, gesture, timing, and subtext are the grammar of connection. Words are only half the message — the rest lives between the lines.
Neurodivergent communication, by contrast, often prioritises accuracy. The words are the message. Precision matters more than performance. There’s usually less interest in managing how something lands and more in keeping it true.
Put those two systems in a room together and translation issues are inevitable. A neurotypical therapist might hear a flat tone as detachment, while the neurodivergent client hears their own words as clear and calm. A pause might be labelled resistance when it’s actually processing time. A tangent might be seen as avoidance when it’s associative logic doing its job.
Neither is wrong. They’re simply tuned to different frequencies.
Misattunement isn’t wrong. It’s two nervous systems being honest in different languages.
It can get even more complex, too. There may be other factors at play — dual diagnosis, culture, or situational context. For example, I’m a gay, HIV-positive, autistic ADHDer who’s grown up with trauma. My lens is completely different to many others.
Shortcodes and shortcuts
Labels like autism or ADHD give the illusion of understanding. They’re useful for access, funding, and scaffolding — but in the therapy room they can become lazy shortcuts.
One-size rules rarely survive contact with real people.
A combined presentation, for instance — autistic and ADHD, or ADHD and dyspraxic — can create contradictory needs. ADHD strategies that favour movement and stimulation may clash with autistic needs for stillness and predictability. Dyspraxia might slow expression just as ADHD speeds thought. The result: what looks inconsistent is actually the brain self-balancing between multiple sets of rules.
Therapists relying on diagnostic templates can miss that. They might reach for an “ADHD toolkit” or “autism-friendly approach” without realising they’re treating a system that runs both codes at once — and occasionally, neither.
The “cheeky” misunderstanding
I’m often told my directness reads as cheeky, blunt, or even bitchy. It isn’t. It’s simply how my filter works. I speak plainly because that’s how my brain arranges meaning.
Likewise, when someone makes a joke and I respond evenly — “I know” — they sometimes think I’ve missed the humour. I haven’t. I just don’t need to perform the expected laugh to prove comprehension.
This is what misattunement looks like up close. Both people are present, both accurate, but they’re playing to different social scripts. One values tone; the other, truth. Each assumes the other shares their cues — and when that assumption fails, it’s misread as personality rather than processing difference.
In therapy, this can lead to rupture: the client feels judged, the therapist feels disconnected, and both leave thinking the other “doesn’t get it.”
Why frameworks falter
Traditional therapy models were built by and for neurotypical communication. They assume linear progress, emotional inference, and consistent self-presentation. But neurodivergent experience often moves in spirals, fragments, or bursts. Progress might look like chaos before it stabilises. Emotional congruence might arrive through logic, not tears.
When therapy insists on fitting experience into a neurotypical rhythm, it unintentionally pathologises difference.
That’s not cruelty — it’s architecture.
The real harm happens when professionals treat misattunement as resistance instead of a signal to slow down and listen differently.
Regulation that looks different
One of the most persistent points of misattunement sits around regulation.
Many neurotypical frameworks treat calm as something visible — slower breathing, softer tone, a drop in energy.
But for a lot of neurodivergent people, regulation is cognitive. I calm by exploring, by mapping what happened until the logic holds still.
From the outside, that can look like over-analysis or even a spiral. From the inside, it’s steadying.
When therapists mistake intellectual exploration for dysregulation, they interrupt the very process that brings balance.
What genuine attunement looks like
Attunement isn’t agreement; it’s accuracy. It’s being willing to meet someone in their syntax, not just your own.
In practice, that might mean:
- Allowing tangents to unfold and trusting they’ll circle back.
- Checking meaning instead of assuming it: “When you said that, did you mean…?”
- Holding silence without forcing eye contact.
- Using concrete language when abstraction creates static.
- Accepting flat tone as information, not attitude.
These are small shifts, but they change everything. They say, I don’t need you to sound like me to believe you.
Mutual translation
Good therapy isn’t about the therapist being fluent in neurodivergent experience — that’s impossible. It’s about being fluent in not knowing. It’s about curiosity without intrusion, structure without rigidity, and the humility to realise that two true experiences can coexist even when they clash.
When both sides accept that translation takes energy, grace replaces judgement. The neurotypical framework stops trying to “fix communication,” and the neurodivergent client stops bracing for misunderstanding. That’s when therapy starts working.
Attunement isn’t agreement; it’s accuracy. It’s knowing when to listen in someone else’s rhythm, not your own.
Another way of looking at attunement is empathy; but i do feel lived experience in the areas does bring greater attunement.
The duet, not the echo
Attunement isn’t about perfect harmony. It’s about hearing the rhythm beneath the noise — the part that keeps time even when the melody changes. Neurodiversity doesn’t need to be simplified to fit therapy. Therapy needs to expand its ear.
Difference doesn’t break connection; it defines it. Misattunement isn’t failure — it’s the space where both people learn how wide humanity really is.
