As an autistic person, I have lost count of how many times I have been told to reframe my thoughts, or challenge my beliefs about the world. I am treated as if the problem lies exclusively in how I perceive reality, rather than in the genuine experiences of existing within a world that fundamentally isn’t designed for autistic people. Cognitive behavioural therapy (CBT) assumes that psychological distress arises from unhelpful thoughts and behaviours that can be corrected through intervention. But what happens when distress isn’t irrational? What if anxiety isn’t a cognitive distortion but a fully rational response to being misunderstood, excluded and forced to navigate an inaccessible world?
Often, when an autistic person is overwhelmed by noise, light or sensory input, it is labelled as catastrophising. When we struggle in hostile or rigid educational or workplace environments, the focus shifts to our supposed lack of resilience rather than to the conditions. CBT, as it is commonly practised, detaches distress from its social and structural context — from inaccessible spaces, school systems that prioritise conformity over curiosity, workplaces averse to difference, welfare systems that dehumanise and scrutinise, and pervasive discrimination. By framing these experiences as cognitive distortions or individual pathology, CBT therapy risks erasing the reality of oppression, creating an unquestioned rational authority and casting the autistic person as someone who must learn to interpret the world correctly.
You cannot think your way out of ableism, because ableism is not a mindset problem. No amount of reframing can make an inaccessible building accessible or transform a hostile environment into a supportive one. Thought work alone cannot dismantle systemic discrimination or redesign social norms that privilege neurotypical behaviour. When therapy focuses solely on changing the individual’s thoughts without addressing the oppressive contexts that produced distress, it asks marginalised people to adapt to systems that refuse to change. It reinforces the very inequalities that are the problem in the first place.
In this way, CBT becomes a diversion, re-directing our attention inwards and away from the collective forces that create distress in the first place. It keeps us isolated, internalising the idea that the problem lies within us, not the system. It ultimately serves the aim to keep us coping just enough to remain functional, productive and compliant within structures that were never designed for us.
Instead of ‘how can autistic people cope better?’ we might ask how society can stop producing environments that harm us, and how we can build systems of care that honour difference instead of erasing it. What would support look like if it centred access, interdependence and community rather than compliance and correction?
We need mental health care rooted not in the policing of thought and behaviour but in solidarity and understanding, where autistic experiences are validated, where autistic people can exist without discrimination and rest without shame. Peer support, community care and access are essential. The goal should not be to make autistic people more resilient to injustice; it should be to make injustice unacceptable in our society.