You need routine and suffocate in it, on the same day. Autism and ADHD pull in different directions, and strategies that work for one side usually get in the way of the other. We hold both in view at once, rather than taking them in turn.
This is for you if
Do not start with me if
You are in crisis right now
If you are having thoughts of harming yourself, do not start with me. Call 999, or Samaritans on 116 123, free and around the clock in the United Kingdom. The place here stays open afterwards.
Substance use is running your life
When alcohol or drugs come first, work on how you function does not take hold. It is not a judgement, it is a question of order: specialist support for that part first.
You are looking for a formal assessment
I do not diagnose and I do not prescribe. I work with people who have a diagnosis, people who are waiting, and people who decided they do not want one. If you do want the assessment, I will tell you the options in the United Kingdom and in Romania, including the fact that being assessed for both in one place is still hard to find.
You want a system that works once and for all
That is the great temptation with AuDHD and I cannot sell it to you. There is no system that permanently reconciles a need for predictability with a need for novelty. What can be built is something else: recognising which side of the swing you are on today, and having something ready for each.
What this looks like day to day
You set up a schedule and the first two days go beautifully, because it is new. On the third you are bored, on the fourth you abandon it, on the fifth you tell yourself off for having no discipline. It is not a lack of discipline. The very routine that settles one part of you drains the interest out of the other.
You want to go out and you want nobody to leave the house. You want something new and you want exactly what there was yesterday. It is not indecision and it is not a whim: two systems are asking for different things at the same time, and whichever you pick, the other one objects.
You were told, correctly, that routine reduces anxiety. You built it, you got calmer, and then you got bored out of your mind and blew it up within a week. This is usually where the conclusion arrives that you are the case that cannot be fixed. You are not. The advice was only for half of you.
What we do together
We do not pick one half of you to please the other.
The most exhausting part of AuDHD is neither the autism nor the ADHD. It is the arbitration, the constant effort of reconciling two needs that do not want the same thing. It is also why you have tried a great deal and come away feeling that nothing works for you: every piece of advice was right for one side and wrong for the other.
So we do not build a system, we build two gears. We learn to recognise which one you are in, because it feels different in the body before you know it in your head, and we prepare in advance what you need in each. Structure when you are losing the thread, novelty when you are suffocating, and above all permission to move between them without it counting as a failure.
Alongside that, what comes from both: energy, leaking in two directions at once; the mask, doubled, because you learned to seem both calmer and more attentive than you are; and the shame collected in the years when the explanation was missing.
What I draw on: Internal Family Systems, which fits particularly well here, because the parts arguing with each other are not a figure of speech. Schema Therapy, for what you came to believe about yourself before you had the words. Polyvagal work, for the overload threshold. And your pace rather than mine. I do not work with "endure it until it passes" techniques, which do harm in overload.
The psychometric questionnaires
The questionnaires: before the first session, or shortly after it.
I set you up with an account in the client area and send you a small pack: three short questionnaires about how you are doing generally, about mood and about anxiety. Nothing long, nothing about the profile yet.
Then, usually within the first two sessions, the part that concerns us. With AuDHD we look at both sides rather than one: ADHD traits, autistic traits, how much you mask, the way your attention runs deep on a single channel, and where the energy goes. Precisely because the strategies contradict each other, it helps to see both sides in numbers.
You fill them in on your phone or your computer, at your own pace, stopping halfway and coming back tomorrow. You can change the font and turn off the automatic jump to the next question. If the list feels too long, say so and we shorten it; it is not a race.
It is not an exam, it does not hand down a verdict, and it does not replace an assessment. With AuDHD it has one extra use: it shows in black and white why advice that ought to work does not work for you, and that takes away a lot of the blame you put on yourself. You see the results too.
The first few months
The opening conversation, 30 minutes, free
On Google Meet, with the camera however you want it. You tell me what brought you and ask me what you want. No obligation, no preparation. If it turns out by the end that I am not the right person, you found that out in half an hour and without paying, which is also a good outcome.
The small pack of questionnaires
In your account, before the first session or straight after, whichever suits you. Three short questionnaires, so we have a starting point in numbers and not only in impressions. If you have nothing for them that day, they stay there and you do them when you can.
The first session
You tell me what brought you, at your own pace. You do not have to arrive with your profile explained; in fact, if you are tired of explaining yourself, you can set the explaining aside for a while. I do not open with a list of questions, and if you cannot find the word for something, we wait for it to come.
The first four or five sessions
We draw the conflict: where each side asks for something different, what you have tried, what held and what collapsed and why. Not as a list of failures, but as a map: almost every time it turns out that what collapsed had been built for one side only. Seeing that whole map is, for many people, the first quiet moment in years.
The second and third months
We build the two gears and work on what hurts: the doubled mask, the exhaustion, the relationships where you are sometimes too much and sometimes too little, and the shame of being "complicated". The strategies start from whatever has ever worked for you, even once, rather than from what ought to work.
How we know it is working
Two short questions at the end of sessions, and every few months we redo one of the opening questionnaires. Not for the sake of numbers, but so we do not go by how it feels: with AuDHD it is easy to mistake a good week for a real change. If it is not working, we say so and change it.
How long it takes
I cannot promise you a number. Some people need a few months, others more than a year, and we stop every so often to look together at where we have got to. What I can promise is that we will not treat your oscillation as a lack of willpower.
Questions people ask me
Not for how we work. A great many people hold one diagnosis and recognise themselves in the other profile without any paperwork, and that is to be expected: until 2013 you could not even be given both. We work with how you function, not with what the documents say.
Usually because they were built for one side only. A rigid routine calms the autistic side and starves the ADHD side of novelty; constant stimulation feeds the ADHD and overloads you sensorially. You did not fail, the advice was half of one.
I do not prescribe and I do not make medication recommendations; that is between you and your doctor. What I see in people is that medication changes what reaches you, so it sometimes brings forward sensory or emotional things you did not catch before. That is worth discussing rather than ignoring.
Yes, but not the set-in-stone routine you have already tried. The structure that holds with AuDHD is a skeleton, not a timetable: a few fixed points that keep your day standing, and empty space between them where you choose on the spot. The fixed points are rest for the autistic side; the space between them is air for the other. Neuro-affirmative literature says the same: structure helps because it gives you something to lean on, not because it disciplines you, and it does not have to be rigid to do that.
Because for one part of you a crisis lifts your arousal to the point where you can move, and without it you stay below the threshold. It is described in the adult ADHD literature: some people end up manufacturing an emergency in order to work. It works, and that is exactly why it is hard to give up. The price is that with AuDHD the emergency takes you straight into sensory overload, so you pay twice for the same thing. What we work on here is arousal that does not cost that much, not more willpower.
It is common, and it is not a contradiction. You can genuinely enjoy seeing someone and still pay for it, because the pleasure and the sensory cost do not cancel each other out. People who live this describe it exactly that way: they were fine, they enjoyed it, and then came days when they could not leave their room. What changes in therapy is not the pleasure but the reckoning beforehand: what it costs, what you put after it, and what you stop putting on the same day.
No. If one blocks you, we drop it. And if the pack feels too long, we shorten it.
They sit in your account in the client area, the two of us see them, and you can reread them whenever you like. They do not reach your GP or your employer unless you ask in writing. The details are on the privacy page.
No. You can look elsewhere, you can pace, you can hold something in your hands, you can turn the camera off. Sessions are online only, on Google Meet, 50 minutes.
A standard session is £80 for 50 minutes. Reduced rate of £50 for Romania and Eastern Europe. The opening conversation is free, 30 minutes.
One small step
You do not have to write to me today. You can start smaller.
What clients say
“From our very first conversations, I could see that he is a truly passionate person, extremely aware of all the complexities and diagnostic implications associated with neurodivergent conditions.”
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