The Problem Underneath the Problem
We all know that when a client explains their challenge, there's often something else underneath that's the real issue. We see the tip of the ice berg and there is so much more going on under the surface.
In my work with neurodivergent clients, one of those things is often consent.
No one has ever come to me and said, "I'm having a problem with ND consent." Yet with a little careful exploration, it regularly turns out to be the root of the challenge.
I'm not talking about the major violations that can happen in sexual relationships, although that may be part of the picture too. More often it's the small, everyday violations of choice that add up until a client is confused and unhappy, and their therapist or coach isn't quite sure why.
What everyday consent challenges look like
The "yes" that wasn't. A client agrees to homework, a new technique, or a change of session time, then quietly can't do it, and feels they've failed.
- Guessing the answer. "How does that feel?" lands on someone who can't yet tell, and yet doesn't want to mention that, so they offer the answer that seems expected.
- Saying yes to keep the peace. A family gathering, a noisy restaurant, a partner's plans. Each one is small, and they rapidly accumulate into exhaustion and resentment.
- Borrowed goals. In coaching, a client pursues a target that belongs to their employer, their family, or their idea of what "normal" should look like.
- Accepting the label. A client takes on a framing like "codependent", because the professional offered it, while feeling it never quite fits.
- The room's defaults. Lighting, seating, eye contact, a hug at the end. No one asked, and saying so feels impossible.
Often the client isn't being difficult. They're showing us a pattern of going along that has been keeping them safe for years.
Our research found 67% of ND people feel they lose themselves in relationships, so these small situations where consent is overridden may be more common than you realise with neurodivergent people, with the impact becoming significant and disabling over a lifetime.
Three surprising things therapists can do
1. Offer options, not questions. Open questions need fast access to an internal signal. A short menu ("We could talk, draw, or walk. Or something else?") gives a client something to react to, which is much easier than generating an answer from scratch.
2. Make "no" easy. Invite tiny refusals early, on purpose. Window open or closed? Lights on or off? Then visibly welcome the answer. Practising "no" on low-stakes things builds a track record that it's safe when the stakes rise. Make your space a safe "no" place.
3. Make "not yet" a real answer. Let clients revisit any decision between sessions, in writing if they prefer, and come back to it with you next time. For many ND people, real consent arrives after the moment, not in it, or can change depending on a multitude of factors. Show you understand and make space for uncertainty.
An invitation
You don't have to overhaul your practice. Start by noticing one small choice you usually make for your clients, and hand it back.
Still time to take part
Coaches, therapists and helping professionals can still take part in our research into supporting neurodivergent clients here until the 2nd October 2026: www.untangleroots.org/research
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