I had spent those decades building a career as a psychotherapist. I had trained rigorously, supervised carefully, and sat with hundreds of clients in their most difficult moments. I had, by most measures, managed my life extremely well. And yet there was always something — a persistent hum of effort that other people did not seem to need to make, a quality of exhaustion that did not respond to ordinary rest, a sense that I was performing fluency in a language I had never quite been taught natively.

When I received my autism diagnosis, I did not fall apart. I did not grieve, at least not immediately. What I felt — and I have since heard this described by nearly every late-diagnosed autistic adult I have worked with — was recognition. A deep, almost physical settling. That is me. That has always been me.

The diagnosis did not change who I was. It changed the story I had been telling about who I was — and that, it turned out, changed everything.

I want to write about compassion, because that is what the diagnosis gave me most unexpectedly. Not compassion as a soft or sentimental thing, but compassion as a clinical and cognitive reorientation — a fundamental shift in how I understood my own history.

Before my diagnosis, I had a story about myself that most high-achieving, high-masking autistic women will recognise. It was a story organised around effort and inadequacy. Why did social situations cost me so much more energy than they seemed to cost everyone else? Why did I need so much time alone to recover from ordinary days? Why, despite succeeding at almost everything I attempted, did I always feel one step behind — as though I were running a race that everyone else had been given different instructions for?

The implicit answer to all of those questions, the one I had absorbed without quite noticing, was: because something is wrong with you. You are oversensitive. You are not trying hard enough. You are too much, or not enough, depending on the day.

A diagnosis does not erase that story overnight. But it does offer a different one. The exhaustion was not weakness — it was the predictable consequence of a nervous system that processes the world with greater intensity, navigating an environment not designed with that nervous system in mind. The social effort was not social failure — it was the entirely logical result of having learned a set of social rules as an intellectual exercise rather than absorbing them intuitively. The need for solitude and recovery was not selfishness — it was essential maintenance.

Compassion, I have come to believe, is not possible without accuracy. You cannot be genuinely compassionate towards a version of yourself you do not actually understand.

This is what I now carry into my clinical work, and what I believe is most missing from how neurodivergent adults — particularly women who receive their diagnoses in midlife — are supported after assessment. The diagnosis itself is important. The understanding that follows is transformative. But neither is sufficient without the space to revisit your own history with new eyes: to look back at the child who struggled, the teenager who never quite fitted, the adult who succeeded brilliantly and exhaustedly, and extend to each of them the compassion that was withheld.

I have sat with many clients since my own diagnosis who describe some version of this same process. The tears that come not from grief but from recognition. The letters they write, sometimes, to their younger selves. The quiet and occasionally startling reframing of relationships, careers, and choices that had previously seemed like failures and reveal themselves, in this new light, as acts of extraordinary resilience.

Late autism diagnosis is, in the end, a narrative event as much as a clinical one. It reorganises the past. It changes what was possible to know about yourself, and what you were therefore able to offer yourself at the time. It creates the conditions — perhaps for the first time — for a relationship with your own experience that is grounded in understanding rather than judgement.

I received my diagnosis at 52. I am a better therapist for it, a more honest writer because of it, and a considerably kinder person to myself than I was before. That is not a small thing. That is, in fact, the whole thing.

AUTHOR BIO

Dr Olena Edwards-Skadowska PhD MA PGDip MBACP Accredited FMBPsS is the Founder and Clinical Director of London Trusted Therapy, a multi-disciplinary private practice at 115A Harley Street, London W1G 6AL. She is a psychotherapist with over twenty years of clinical experience specialising in neurodiversity, late autism and ADHD diagnosis, trauma, and couples therapy. She received her own autism diagnosis at 52 and draws on lived experience throughout her clinical and public-facing work. She is the author of Anxie the Hedgehog (2024), a children's book on anxiety, and is working on a second book on late autism diagnosis in women. londontrustedtherapy.com