A reflective piece inspired by themes commonly explored in therapy with later-diagnosed Autistic women. Details have been altered to protect privacy.
A client recently sat across from me in session and said something that visibly startled her the moment the words left her mouth.
“I think asking my husband to leave may have been about control.”
She immediately began explaining herself, almost as though she needed to soften what she had just admitted. For months, she had understood the separation as an act of self-preservation and boundary-setting after years of emotional loneliness, disconnection, avoidance and relational pain. She believed she was finally surrendering and accepting that she could not force another person to change.
And part of that was true.
The separation was an attempt to protect herself from continued emotional harm; reflecting the exhaustion, grief and recognition that something in the relationship was no longer sustainable. As she spoke, it became clear that the boundary itself was emotionally more layered than she had initially understood. Boundaries formed inside attachment pain are often complex. They can emerge from genuine self-protection while still carrying longing, hope and unfinished attachment underneath them.
As she continued talking, a deeper realization began taking shape. She was recognizing that the separation had also contained an unspoken hope that something relationally might finally shift; that perhaps distance, loss or disruption might succeed where years of direct conversations had not.
That realization felt deeply unsettling because it complicated the story she had been telling herself about surrender, letting go and acceptance. Up until that moment, she believed she was finally surrendering and releasing attachment to outcome. But now she was confronting the possibility that another part of her had remained quietly attached to the hope that the relationship itself might still change.
Holding both truths at once “I needed this boundary” and “part of me still hoped it would change something” created enormous internal tension.
She began recognizing that this, too, was a form of trying to influence outcome; the hope that something might finally create emotional responsiveness within the relationship. In many ways, part of her nervous system was still trying to create relief from the chronic uncertainty, emotional disconnection and unresolved pain she had been carrying for years. The separation was both a boundary and, underneath it, an attempt to shift the emotional reality of the relationship itself.
What struck me most was the profound discomfort she felt while confronting it. She did not experience herself as controlling. She experienced herself as deeply caring, emotionally invested and desperate for connection. Realizing that part of her had been trying to create emotional movement through the separation challenged the way she understood her own intentions. It forced her to sit with the uncomfortable reality that boundaries and hoped-for outcomes can coexist together, especially after years of emotional deprivation, disconnection and relational uncertainty.
I suspect many later-diagnosed Autistic women will recognize themselves in this immediately.
Particularly those of us who have spent years trying to create connection, clarity, emotional reciprocity and relational closeness inside relationships that often felt emotionally uncertain, inconsistent or unreachable. For many Autistic women, especially those of us with long histories of adaptation, attachment wounds, emotional deprivation or chronic relational instability, the drive toward repair, clarity, emotional engagement and resolution can become deeply intertwined with safety itself. The realization is often far more nuanced and painful than simply recognizing “control.” It is the dawning awareness that part of us may still believe connection can be secured through enough insight, effort, repair, patience or emotional responsiveness from the other.
Emerging research suggests that Autistic individuals may experience higher rates of insecure attachment patterns, particularly when growing up in environments where our needs, communication styles, sensory experiences and emotional realities were chronically misunderstood, invalidated and unsupported. For many later-diagnosed Autistic women, attachment strategies often develop alongside years of masking, hyper-attunement, emotional monitoring, relational uncertainty and adaptation.
As a result, Autistic women may recognize themselves in anxious, avoidant or fearful-avoidant attachment dynamics while simultaneously sensing that traditional attachment language does not fully capture the complexity of their experience.
It is important to recognize that attachment is not fixed or static. Attachment patterns are fluid, relational and often shaped by the dynamics that emerge between people. Many individuals move between anxious, avoidant, fearful and secure patterns across different relationships and different periods of life. Attachment is not something we “are.” It develops and expresses itself within the context of our relationships with others.
Because of this, attachment patterns are also capable of changing over time. Human beings can learn new experiences of safety, trust, emotional regulation and secure connection through healing relationships, self-awareness, therapeutic work and consistent experiences of genuine emotional attunement.
In many ways, this was part of what my client was beginning to move toward. Beneath the grief, uncertainty and relational pain, she was beginning to recognize how much of her life had been organized around trying to regulate safety externally by staying intensely focused on the relationship itself; monitoring, repairing, managing emotions, seeking reassurance, over-functioning and remaining emotionally attached to outcome. Much of her internal world had learned that stability depended on accurately reading the relationship, preventing rupture, restoring connection quickly, reducing ambiguity or finding some way to shift the emotional reality between them.
For Autistic women, this outward orientation begins very early. Survival often depends on learning to read others carefully; monitoring moods, tracking relational shifts, anticipating needs, avoiding rupture and adapting continuously to external expectations and emotional environments. Over time, attention becomes organized outwardly toward maintaining connection, reducing conflict and creating stability within relationships, often at the expense of remaining internally connected to oneself.
This is most likely part of what makes surrender feel so unfamiliar and frightening at first. Because the shift is less about the relationship itself and more about no longer organizing one’s entire emotional world around it. It is about slowly turning attention back inward; toward one’s own emotional reality, needs, limits, uncertainty and sense of self.
For my client, her love, hope, grief and longing for connection had not disappeared. But she was beginning to tolerate the reality that another person’s emotional engagement, insight, healing or willingness to repair ultimately existed outside of her control. The surrender she was moving toward involved learning that her emotional stability, sense of self and capacity for grounding could not depend entirely on another person’s responses, reassurance or emotional availability. Instead, the deeper shift involved learning how to stay connected to herself within the relationship itself. It meant remaining rooted in her own emotional reality, needs, boundaries, and sense of self, even while uncertainty still existed around her.
Perhaps this is what true surrender becomes for many of us; a gradual return inward toward self-trust, grounding and the ability to remain emotionally present with ourselves rather than organizing our entire sense of safety around another person’s responses, reassurance and presence.
In many ways, this brings the entire “control” realization full circle. Because what initially appeared to my client as “control” was, underneath it all, an attempt to create safety, certainty, connection and emotional stability in the only ways she had learned how. And healing was beginning to look less like controlling the relationship and more like learning how to stay connected to herself regardless of what the relationship ultimately became.
What can sometimes appear externally as “anxiety,” “avoidance,” or “control” may also reflect sensory overwhelm, trauma, uncertainty intolerance, alexithymia, autistic hypervigilance, burnout and deeply learned strategies for creating predictability and emotional safety inside relationships that have often felt emotionally inconsistent or unsafe.
When most people think of control, they often imagine something rigid, domineering, manipulative or intentionally coercive. But in Autistic women, control can look very different; it can look responsible, insightful, helpful, relational and emotionally intelligent. It may appear as hyper-awareness, emotional labour, conflict resolution, anticipating needs or constantly trying to maintain stability within environments that feel unpredictable.
From the outside, these behaviours can look like exceptional relational awareness, and sometimes they are. But they can also reflect deeply learned ways of navigating uncertainty, maintaining connection and trying to feel emotionally anchored within relationships that have often felt inconsistent or difficult to predict.
This remains one of the least discussed aspects of autism in women, particularly later-diagnosed women. Many of us spend years organizing ourselves around predictability, clarity, emotional monitoring and relational management because uncertainty itself can feel profoundly destabilizing internally; not just uncomfortable, but unsafe.
We can become extraordinarily skilled at reading others while simultaneously losing connection with ourselves. And for many Autistic women, that disconnection from self is not always immediately visible or easy to articulate internally either.
Many later-diagnosed Autistic women describe experiences like:
“I don’t fully have words for this yet.”
“I can feel something shifting internally but I can’t explain it.”
“It feels like I know something before I fully understand it.”
This experience of sensing something deeply before being able to fully organize language around it is incredibly common in Autistic women, particularly those of us who struggle with alexithymia or difficulty identifying and translating internal emotional states in real time.
Many of us experience an almost internal split at times; one part of us tracking relational patterns, emotional distance or disconnection with remarkable clarity while another part feels unexpectedly calm, detached or less desperate to force immediate resolution.
“It almost feels like a knowing without fully knowing.”
Sometimes the body understands before the mind can fully organize language around what it is sensing. Sometimes there is embodied knowing long before cognitive clarity arrives. One part of the mind may be tracking patterns with extraordinary precision while another part struggles to fully identify or articulate what is happening emotionally in real time. And perhaps this is part of what many of us begin recognizing over time; how profoundly disconnected from ourselves we may become while trying to maintain connection to everyone else.
So much of our attention can become organized around:
What the other person needed.
What needed resolving.
What might restore connection.
What would reduce tension.
What might finally create steadiness within the relationship again.
While very little attention gets directed inward:
Toward our own needs.
Our own internal experience.
Our own uncertainty.
Our own emotional reality.
And perhaps this is one of the most painful realities many Autistic women eventually confront: survival often required becoming extraordinarily attuned to everyone else while simultaneously losing connection with ourselves.
The painful truth is that no amount of emotional labour can fully eliminate uncertainty from relationships. No amount of insight can guarantee reciprocity. No amount of over-functioning can force emotional engagement. No amount of monitoring can fully prevent rupture, grief, distance or disappointment. Eventually, we exhaust ourselves trying.
But something else often begins emerging underneath that exhaustion; the possibility of remaining connected to ourselves even while uncertainty still exists.
And maybe that is what surrender actually is. Allowing reality to unfold without abandoning ourselves in the process. Releasing the belief that clarity, repair, reassurance or emotional resolution can fully protect us from grief, uncertainty or loss. Learning instead how to remain grounded within ourselves even when outcomes remain unresolved. For many of us, that may be one of the hardest and most transformative forms of healing we will ever encounter.
Further Reading
Giannotti, M. et al. (2020). Alexithymia, Not Autism Spectrum Disorder, Predicts Perceived Attachment. Frontiers in Psychology.
Moore, H. L. et al. (2022). The Mediating Effects of Alexithymia, Intolerance of Uncertainty, and Anxiety on the Relationship Between Sensory Processing Differences and Restricted and Repetitive Behaviours in Autistic Adults.
Lin, Y. et al. (2024). Intolerance of Uncertainty and Anxiety in Autistic Individuals.