Leaving the label at the door: working with neurodivergent clients in psychedelic preparation and integration

Why sensory profiles, interoception and pacing may matter more than diagnosis

I specialise in working with neurodivergent people, but I do not assume that a diagnosis tells me how to work with an individual.

There is a phrase often used in relation to autism: if you have met one autistic person, you have met one autistic person. For me, this is an important starting point. A diagnostic label may provide useful information, but it cannot tell me how somebody experiences their body, whether they are highly sensitive to sound or barely register it, whether they think predominantly in images or experience aphantasia, how they communicate when distressed, or what they have learnt to do to survive environments that overwhelm them.

This becomes particularly important when preparing someone for a psychedelic experience.

My own approach is interdisciplinary and integrative. I draw from Cognitive Hypnotherapy, Applied EMDR (Eye Movement Desensitization and Reprocessing) and the InCorr (Interoceptive Core Reconsolidation) Method, alongside my training as an  NLP (Neuro-Linguistic Programming) Master Practitioner. I do not regard any one of these as the way to work with a client. Different people need different approaches. My job is to understand the particular person and nervous system in front of me and adapt a methodology accordingly.

That principle becomes even more important in psychedelic preparation and integration, where sensations, emotions and perceptions that are manageable in ordinary consciousness may become greatly intensified.

1. Leave the label at the door

Neurodivergence is enormously heterogeneous. Sensory processing differences are common in autism, but they do not all travel in the same direction. One person may be hypersensitive to sound, light or touch; another may be hyposensitive and seek greater sensory input. The same person may be hypersensitive in one sensory domain and under-responsive in another.

Internal experience varies widely too. Some clients can visualise in extraordinary detail, while others experience aphantasia, a variation in mental imagery where a person has little or no ability to voluntarily create pictures in their mind’s eye. King et al. (2024), for example, found lower average visual imagery vividness among autistic participants, alongside a higher proportion reaching the cut-off for aphantasia. This does not mean autistic people generally have poor visual imagery. Rather, it highlights the diversity of internal experiences within a diagnostic label and the importance of not assuming that everyone processes information in the same way.

This matters therapeutically. Asking a highly visual client to notice an image accompanying a bodily sensation may be helpful. Repeatedly asking somebody with aphantasia to “picture or imagine” a safe place may leave them wondering what they are doing wrong. The intervention has failed to fit the person, not the other way around.

Where sensory differences appear particularly significant, I use a detailed sensory screener. I want to understand the person’s sensory world before we begin trying to change anything within it.

This becomes particularly important when that person is considering a psychedelic experience. We already know that set and setting can largely influence psychedelic experiences (Golden et al., 2022). For a neurodivergent client, I would argue that their sensory profile forms part of both.

2. When adaptation becomes disconnection

Many neurodivergent people become extraordinarily good at functioning. They may mask. They may fawn. They may override sensory distress, learn what response is expected and produce it, or appear calm while internally overwhelmed.

Research into autistic camouflaging has documented the considerable effort that can be involved in suppressing or disguising autistic characteristics in order to navigate social environments. Participants in Hull et al.’s (2017) study described masking and compensatory strategies alongside the consequences of these repeated behaviours including exhaustion, anxiety and effects on their sense of self.

In my clinical work, I also see a pattern I describe as functional freeze.

I use this term to describe clients who continue to work, care for others, socialise and fulfil responsibilities while remaining profoundly disconnected from aspects of their emotional and bodily experience. This is a clinical description rather than a diagnostic category. From the outside, they are functioning. From the inside, something has gone very quiet.

This matters because much of my trauma work involves helping clients approach what, within the InCorr framework, we describe as the core wound: the underlying embodied pain around which protective responses have developed.

For some clients, however, getting anywhere near this is difficult because the protection has worked extremely well.

If somebody learnt very early that expressing fear, anger, need or vulnerability was unsafe, disconnecting from those signals may have been highly adaptive. Asking them simply to “feel into the body” does not necessarily bypass that protection. Nor should it.

3. Interoception: learning to hear the body

Interoception broadly refers to our perception of signals arising from within the body. In practice, this might include recognising heartbeat, tension, temperature, hunger, breath, nausea, pressure or other internal sensations.

It is tempting to say that autistic people have poorer interoception. The evidence does not justify such a simple conclusion. A recent systematic review and meta-analysis found considerable variation between studies, with autistic participants showing reduced, increased or similar interoceptive abilities depending upon what was measured and how it was assessed (Klein et al., 2025). That finding makes sense to me clinically.

Some neurodivergent clients I meet are extraordinarily attuned to internal sensation. Others initially struggle to tell me anything about what is happening inside their body. Rather than assuming, I explore.

Where is the sensation? Does it have a shape? A temperature? Pressure or movement? If it had a colour, what would it be? Is there an image, sound, word or impulse associated with it?

The aim is not for me to decide what a sensation means. It is to help the client develop a language for their own experience. This is also where pacing becomes critical.

One client I worked with had spent much of her life emotionally isolated following significant childhood neglect. At the beginning of our work, she found it extremely difficult to identify bodily signals at all. Over several weeks this began to change.

But accessing the body was not immediately relieving. It was overwhelming, as the disconnection had served her a protective purpose.

We therefore spent many months working slowly, titrating and pendulating between difficult sensations and experiences of greater safety rather than trying to force our way through the protection. Over time, she became increasingly able to recognise her bodily responses without immediately becoming overwhelmed by them.

Only much later did psychedelic work enter the picture. We prepared carefully for her first ceremony and integrated what emerged afterwards. She has subsequently undertaken further psychedelic experiences, each prepared for and integrated within our work together.

I cannot say that psychedelic ceremonies caused the changes I have witnessed in her life. There are too many interacting factors for that claim. What I can say is that by the time she entered those experiences, her body was no longer entirely unfamiliar territory.

For me, that distinction matters.

4. Preparation may need to start much earlier than we think

Psychedelic preparation is sometimes understood as preparing somebody for what the medicine may do: discussing possible effects, intentions, surrender, challenging experiences and practical aspects of the setting. For some clients, I think preparation needs to begin earlier.

If somebody has spent decades avoiding, overriding or simply not recognising the somatic experience associated with trauma, what happens if that material suddenly becomes extraordinarily vivid?

Within my own approach, I want a client to become acquainted with their embodied distress before entering a psychedelic space where possible. Where do they experience fear? What happens in their chest, stomach, throat or limbs? What tells them they are moving towards overwhelm? What helps them return?

I am not suggesting deliberately opening trauma before a psychedelic experience. Quite the opposite.

I have learnt how destabilising it can be when protective mechanisms soften too quickly. When somebody encounters previously inaccessible bodily material without sufficient capacity to remain alongside it, the experience can be profoundly dysregulating.

Preparation, therefore, is not about getting someone to their deepest wound before the ceremony.

It is about helping them recognise the road signs.

5. Control, protection and the pressure to surrender

Another pattern I have become interested in clinically is control.

Some of my neurodivergent clients have developed powerful strategies for creating predictability: researching extensively, planning, monitoring health, focusing intensely on particular subjects or needing to understand exactly what is going to happen.

These strategies should not automatically be pathologised. Control can create safety where life has previously felt chaotic.

Yet psychedelic culture often carries a different message: surrender.

Let go. Trust the medicine. Stop resisting.

I think the relationship between these two positions deserves more attention.

One client I worked with had ADHD alongside suspected autism and significant developmental trauma. Control and intense focus had become central organising strategies in his life. We had prepared extensively, and he had developed an ability to recognise his core wounding somatically.

His psychedelic experience was nevertheless extremely intense. During the ceremony, an additional hands-on energetic intervention was introduced. He became profoundly overwhelmed and dysregulated, experiencing an acute and frightening disruption to his usual sense of safety, reality and self. The months that followed required considerable support as he tried to understand and integrate what had happened.

One case cannot establish causation. I cannot know which elements of the experience contributed to his response.

But it changed my practice.

I now think preparation should include not simply what psychedelic are you taking? But what might happen around you while you are taking it?

Will there be touch? Breathwork? Energy work? Live music? Sound healing? Incense? Chanting? Changes in lighting? Will people move around the room? Can someone decline an intervention? What happens if they cannot speak?

Guidance developed for psilocybin-assisted therapy increasingly emphasises that preferences around touch should be established beforehand, with boundaries discussed while the participant is in an ordinary state of consciousness (Back et al., 2024).

My own clinical learning has taken this one step further. Where possible, if an additional embodied modality may be introduced during a psychedelic experience, I would prefer a client to have encountered it sober first. That gives them an opportunity to notice their response, discuss boundaries and decide whether it feels right for them.

Novelty may be unavoidable in psychedelic states. We do not need to add unnecessary novelty to the container.

6. A psychedelic experience is not necessarily integration

There is another question I have become increasingly interested in.

Within psychedelic communities, I have encountered people who repeatedly attend ceremonies and genuinely believe they are continually processing their difficulties. They may well be. But I have also begun to wonder whether repeated peak experiences can sometimes become another way of moving around difficult material rather than through it.

The concept of spiritual bypassing is useful here, provided it does not become another label we impose on people. Psychedelic harm-reduction literature has raised the possibility that people may seek further psychedelic experiences when previous experiences have not produced the hoped-for changes, and that spiritual practices or altered states can sometimes become ways of avoiding unresolved psychological distress (Gorman et al., 2021).

I therefore try not to assume that another ceremony necessarily means another layer of healing.

Instead, I am interested in what happens between the ceremonies.

Can the person remain present with something they previously avoided? Are their relationships changing? Can they tolerate vulnerability differently? Can they recognise their protective responses? Has insight begun to become embodied in ordinary life?

For some people, the need to retain control may also remain active throughout psychedelic work. This is a clinical observation rather than something I would claim research has established specifically in neurodivergent populations.

But it raises an important possibility: repeated access to altered states is not necessarily the same thing as deeper processing.

Integration may be less about how profound an experience felt and more about what becomes possible afterwards.

7. What if the veil is already thinner?

There is one further question I am increasingly curious about, and I want to present it explicitly as a question rather than a conclusion.

Could some neurodivergent people enter psychedelic experiences from a different sensory or perceptual starting point?

I sometimes think of this as an already “thinner veil.”

By this I do not mean that autistic or ADHD people are inherently more spiritual, psychic or closer to another reality. Nor am I suggesting that neurodivergence itself is a psychedelic state.

I mean something more modest.

If an individual’s ordinary sensory world is already unusually intense, if attention operates differently, if bodily signals are amplified or difficult to filter, or if perception and imagery differ substantially from those of the person sitting beside them, might the transition into a psychedelic state also be experienced differently?

At present, we do not know enough.

Research specifically examining autistic people’s psychedelic experiences remains limited. Stroud et al. (2025) surveyed 233 autistic adults about their most impactful psychedelic experience. Many attributed positive changes in psychological distress, social anxiety and engagement to the experience. Yet 20% also reported undesirable effects, including increased anxiety, and some described the experience as one of the most negatively impactful of their lives.

The study was retrospective and self-selecting, so it cannot tell us that psychedelics caused either the positive or negative changes reported.

But that combination should make us curious rather than certain.

The question is not whether psychedelics are “good” or “bad” for neurodivergent people. It is what individual differences might alter the experience, and how we prepare accordingly.

8. Curiosity before protocol

Neurodivergent-informed psychedelic practice is not another protocol.

For me, it means becoming more curious about the particular person sitting in front of us.

How do they experience sound and touch? What happens when they become frightened? Do they speak more, speak less, freeze, fawn, intellectualise, move or become silent? Can they visualise? How do they experience their body? How do we know when they are overwhelmed if they have spent a lifetime becoming very good at looking fine?

And what do they need to know beforehand in order to feel safe enough to relinquish some control?

Perhaps most importantly: are we listening to their experience, or interpreting it through our own preferred model?

Psychedelic work asks us to tolerate uncertainty. So does good neurodivergent-informed practice.

A diagnosis can give us useful information. Research can identify patterns. Therapeutic models can give us maps.

But none of them are bespoke for that person.

Perhaps the most useful thing we can do is leave the label at the door, remain curious about the nervous system that has actually walked into the room, and prepare that person for the experience they may have rather than the experience our protocol assumes they should.

References

Back, A. L., Myers, S., Guy, J., Perez, J., Lazar Thorn, L., McGregor, B. A., et al. (2024). Evolving guidelines for the use of touch during a clinical trial of group psilocybin-assisted therapy. Psychedelic Medicine, 2(4). https://doi.org/10.1089/psymed.2023.0069

Golden, T. L., Magsamen, S., Sandu, C. C., Lin, S., Roebuck, G. M., Shi, K. M., & Barrett, F. S. (2022). Effects of setting on psychedelic experiences, therapies, and outcomes: A rapid scoping review of the literature. Current Topics in Behavioral Neurosciences, 56, 35–70. https://doi.org/10.1007/7854_2021_298

Gorman, I., Nielson, E. M., Molinar, A., Cassidy, K., & Sabbagh, J. (2021). Psychedelic harm reduction and integration: A transtheoretical model for clinical practice. Frontiers in Psychology, 12, 645246. https://doi.org/10.3389/fpsyg.2021.645246

Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M.-C., & Mandy, W. (2017). “Putting on my best normal”: Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534. https://doi.org/10.1007/s10803-017-3166-5

King, R., Buxton, H., & Tyndall, I. (2024). Aphantasia and autism: An investigation of mental imagery vividness. Consciousness and Cognition, 125, 103749. https://doi.org/10.1016/j.concog.2024.103749

Klein, M., Witthöft, M., & Jungmann, S. M. (2025). Interoception in individuals with autism spectrum disorder: A systematic literature review and meta-analysis. Frontiers in Psychiatry, 16, 1573263. https://doi.org/10.3389/fpsyt.2025.1573263

Stroud, J., Rice, C., Orsini, A., Schlosser, M., Lee, J., Mandy, W., & Kamboj, S. K. (2025). Perceived changes in mental health and social engagement attributed to a single psychedelic experience in autistic adults: Results from an online survey. Psychopharmacology, 242(2), 373–387. https://doi.org/10.1007/s00213-024-06685-8