As an HR business consultant and integrative psychotherapist, who specialises in supporting individuals on the autism spectrum (AS), and as a mum, I’ve discovered ways to raise awareness and increase understanding so that I can pass on my knowledge to AS individuals and business professionals. This article aims to support both therapists and employers in negotiating their relationships with AS clients and employees.

My best qualification is probably that of life experience – having raised my daughter who has an autistic spectrum condition (ASC), I’ve experienced first-hand the trials and tribulations she has endured in trying to challenge discrimination and strive for a sense of equality in the world of work.

As a witness to her life, on occasions it has felt agonising and distressing. I’ve had to grow inner strength and cultivate resilience. I’m gifted with deep compassion for those in a similar position. It hasn’t been easy; some say that working with AS individuals can be like working with hearts of glass1 because those on the AS commonly display low self-awareness or hyper-awareness, reduced self-esteem, difficulty connecting with others, and depression. Fortunately counselling and emotional support are not only possible but absolutely essential for identifying strategies to ease emotional worries, convey acceptance, reduce stress and encourage relaxation.

The challenges for employees with ASC at work

Within the workplace approximately four males and one female in every 1,000 are likely to have an ASC.2 Neurodiversity in the workplace could be considered a good thing, but just 15 per cent of adults with ASC actually secure full-time work.3

Communicating to be understood among your neurotypical family and peers can be painstakingly hard work and often frustrating and exhausting, but in regard to the workplace, tasks such as overcoming the difficulties of writing an application form for employment can feel positively mind-numbing. In my daughter’s experience, her challenge was facing the formidable obstacle of the interview. Autistic applicants may struggle to sell themselves4 and some have described the experience of interview as a method of torture and afterwards have been left feeling positively puzzled.

It’s not untypical for an interview to proceed as follows:

Question: ‘Can you tell me about your job?’
Answer: ‘Yes’.
Question: ‘How did you find your last job?’
Answer: ‘I saw it posted in the Job Centre’.
Question: ‘What can you bring to the job?’
Answer: ‘My briefcase, work boots and a packed lunch’.
Question: ‘Where do you see yourself in five years’ time?’
Answer: ‘Probably still in London’.
Question: ‘What have you got that other candidates haven’t?’
Answer: ‘How do I know that when I don’t know the other candidates?’
Question: ‘What are your hobbies?’
Answer: ‘Why do you want to know?’5

Having secured a job, an AS employee is then classically confronted with meeting their colleagues and becoming acquainted with their workplace surroundings. This can be a recipe for disaster, as the workplace these days is usually open plan, which presents distraction, unpredictability and uncertainty. This, along with the expectation to wear appropriate conforming attire and to kowtow in a socially acceptable manner, is added to the assumed staples of having emotional intelligence, flexibility and adaptability.

How can employers help employees with ASC?

Autism spectrum conditions are among those that represent a particular challenge to employers wanting to embrace diversity and the skills that an autistic employee could bring to the workplace.6 Employers delivering occupational health, case management and vocational rehabilitation and who make reasonable adjustments, which are fair and robust, through assessing, facilitating and planning for an individual’s needs, can moderate the impact of stress at work and alleviate potential performance and attendance issues.

Not everyone with an ASC is gifted, but a large proportion will have high IQs and a talent for computer science. A German software company, SAP AG, has employed hundreds of people with autism as software testers, programmers and data assurance specialists.

In minimising disruption for the AS employee, it can help if their employer is aware of the types of issues that can surface. By way of social norms, for example, how far away should you be before greeting a colleague or a boss when they are walking towards you? My daughter suggests that the topic of socialisation is a complex question, with many variables. Some people with AS don’t recognise faces (especially if they have met you before), so for them, familiarity is not specific enough. Do you say ‘hello’ because you have said ‘hello’ before, or should there be another reason to greet the person? Does it make a difference if it is your superior and would it appear rude to walk past without an acknowledgement?

Sometimes there is not the mental space for this 10 times a day and it can frequently feel like Groundhog Day. For an AS employee, socialising takes energy, such as copying the actions or wording of others to pretend to socially interact, and putting on a persona. It’s not usually on their schedule to be congenial, to acknowledge or interact with someone who they are not friends with, even if they do understand the concept of being friendly or professional.

Stress and overwhelm at work

An AS meltdown will occur when the individual feels overwhelmed and is often due to sensory overload, or practical or specific characteristics. How tasks are presented, or the way they are explained or given without notice, or a change to tasks, can cause a disruption in routine. Temperature, lighting, body odour, strong perfume, the length of time spent on a specific task, sitting without a window or intense sunlight shining in through the window, can cause a meltdown. It can come from something trivial but become big very quickly. The feel of particular workwear or wearing a specific uniform or a certain style of shoe, can cause immense distress.

When a meltdown occurs, the AS employee will feel they want to hide and not be judged for their behaviour. They don’t wish to be looked at or have to deal with anyone or be asked questions by their colleagues, being unsure of what answer would be required anyway. Usually feelings of panic, of wanting to run, and angry feelings, are stirred. If there is nowhere to go, it can be hard to sit quietly at their workstation and regain a sense of composure. They cannot hang out in the toilet indefinitely.

Offering additional training, mentoring and supervision, flexitime, reduction of idle time, a temporary redeployment, or providing employee counselling after an acute episodic meltdown, can help handle unsettled behaviour.

AS people often have a need to control their environment and do not like people touching or borrowing their desk or office equipment. It helps if they have their own desk and control of their own light. It helps to have a lunch break at a certain time and a certain space for eating their lunch, away from their desk. Ideally this should not be in the canteen, as eating while keeping up with topics of conversation or watching a co-worker eat lunch while they are talking can be an excruciating experience.

Time management can be problematic if the AS employee has a hyper-focus on a topic of special interest. Time can pass quickly; they can go into too much detail, unable to find ways to reduce their work, resulting in potential stress in meeting deadlines. For AS people this can become too much, as they have a need to be literal and specific, even when it’s inappropriate. They can forget to have lunch and can be prone to taking on more work than other colleagues, who may feel inadequate.

Simple tasks like being asked to select and buy a cake for their colleague’s leaving party can be a challenge. In fear of having their boss think they are ‘nuts’ because they are unable to just buy a cake, their thoughts can race: how much money to spend? What shape of cake? How big? What flavour? Who would like it? Is there a sell-by date? It can be that AS employees characteristically are unable to have the same comprehension of a situation or expectation that a neurotypical person will have, due to their lack of self-awareness and an inability to see how their reactions may impact on others. The idea of choice, of having an ability to choose how to behave or respond, is not for AS individuals. I am not saying that AS people cannot be held responsible for the consequences of their actions – everyone has to be accountable, surely. However, to call something a choice is confusing unless it is a choice and if we are aware that it is a choice.

How therapy and therapists can help

As an AS therapist, I find it helpful to support my client by raising their awareness and separating out what is their own and what is another’s perspective. Knowing the person we are seeing, and monitoring our reactions alongside them, is normal work for us as psychotherapists. When working therapeutically with neurotypical employees who have displayed a mood of depression and apathy, it is encouraging to see a change in their dynamism. They will usually become more spontaneous and vibrant, influencing the subtle nature of their relationships, even on an energetic basis, at work and home.

However, what happens when the change produces behaviour that we do not resonate with agreeably? For the AS employee going through a similar process and coming out of depression, their behaviour may appear to become more eccentric or peculiar, the more relaxed they become. The reason for this is that the new behaviour is rarely censored and personal awareness or regulation monitoring is not usually engaged with. This can create its own set of problems as it tends to produce a mixed reaction from work colleagues and superiors.

As a therapist, my role is to understand and where possible, increase relational depth with the person I sit alongside, whether or not they fit my usual way of connecting and relating. Expressing my understanding in a way that makes sense to my clients, because it is consistent with their experience of themselves, helps us both to understand the AS perception. In my experience, the most common AS issues presented in therapy are:

  • processing information
  • impulsivity
  • difficulties in predicting the consequences of an action
  • understanding the concept of time
  • executive functioning
  • literal understanding

Remaining fully conscious and observing my own reactions or countertransference feels important, as those with AS frequently experience others as needing them to be different. When I am taken aback by a comment or behaviour, when I feel that my own reaction is a need for someone to act differently or be different, I want to observe and explore this more deeply. I recognise I must wait to consider and understand my client’s perspective first.

I assume that for most folk it’s a good thing to be positive, self-assured and confident and as a therapist observing my client working through their process, and becoming more so, I want to encourage this. However, the challenge is that AS individuals are often experienced by others as arrogant or even obnoxious, and labelled so. Arrogance is a feeling of superiority or an offensive exposition of superiority, but a high number of those with an ASC are generally unaware that they can sound superior to others. They may talk away, offering data to back up their thoughts and opinions, using a directly lofty and patronising tone as they explain something. Combined with their lack of awareness, as I listen, I notice that my client can appear superior and critical. For me, it’s the pedantic tone or apparent lecturing which contributes to this impression. Generally, AS people do not recognise others’ impressions or reactions and largely don’t take them into account.

Should this situation occur in therapy, I try to be aware of recognising and monitoring my own internal responses to my client. In my understanding it appears to be more effective if I observe our communication, waiting until I can objectively see the client’s interest and enthusiasm in sharing what he or she knows. This, together with my awareness of the reasons someone listening could easily feel put down or offended, is something that I can then explore and convey through relating back both perspectives, without judgment. Then we can usually comfortably discuss our feelings openly in a non-threatening and impartial way.

It’s much easier to deal with the misunderstandings that occur for AS people if we are first clear about what they did or did not intend. Then they can learn that their behaviour may mean something to someone else, and accept this more easily if the focus is not judgmental. The impetus to hurt or show an absence of care may be attributed to the comments or actions of someone with an ASC. The experience is then judged to be inappropriate, or erroneous in a rudimentary way. It’s not always easy to separate intention from the consequence of a comment or behaviour but through time and experience I have less powerful affective emotional responses and try not to be as reactive; witnessing myself waiting and observing until I understand my reaction before I respond.

The process of having empathy and self-compassion for what has happened, as well as offering a considered response, can involve much effort, attentiveness and understanding. As AS clients are so cerebral and I am so person-centred, on occasions I have to work extremely hard!

Closing thoughts

Remarkable effort is required for ASC individuals to gain and retain work, as well as remain fully conscious of their behaviour and hold the ability to account for every cognitive and social communication issue. So it’s not a surprise that many AS employees avidly avoid coffee break intervals, lunch canteens, social outings, after-work drinks and collective meetings of any kind.

When settled and accepted in a job they enjoy, AS employees can bring so many worthy qualities to business and contribute value to their colleagues. These qualities can range from being very focused, to having considerable skills in specific areas, attention to detail, a methodical approach, strong research skills, excellent record-keeping and not forgetting good long-term memory.

AS individuals can and do have decent and successful lives and hold the potential to achieve great careers when they can firmly plant their feet under a desk of their choice. Further, it’s perhaps more about the individual finding the right type of vocation to suit them. For my daughter, thankfully, her more recent work experiences have been progressively positive. I’m pleased to write that, after her initial workplace hardships, she now appears settled living and working as an artist in London.

Valerie Sutherland is an integrative psychotherapist and business consultant (HR employment law/employee relations) with 23 years’ experience of living with autism, working with individuals on the autism spectrum in business and working with AS clients in psychotherapy. She lives in Aberdeen-shire, Scotland.


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