Therapy as a Site for Ableism & Healing
Therapy isn't automatically free from ableism: it takes intention to create spaces where disabled and chronically ill clients don't have to justify their experiences. This post explores what disability-affirming therapy can look like, inviting mental health professionals to question assumptions about independence, productivity, and healing while centring access, interdependence, and clients' lived realities.
Therapy should be one of the few places where people don’t have to prove their pain.
And yet - ableism often slips quietly into the room. Sometimes through us.
“But have you tried a morning routine?”
“You’ve got to push yourself a little.”
“What’s stopping you from being more consistent?”
“Let’s work on becoming more independent.”
For clients living with chronic illness, neurodivergence, or a dynamic disability - this can feel like being asked to deny their body’s wisdom, mask their truth, or chase a version of functioning that was never designed for them. We don’t do this to harm. Many of us were trained in systems that prize autonomy, linear progress, and “overcoming.” But these frameworks often exclude disabled experiences and quietly pathologize access needs, rest, and interdependence.
What might a more disability-affirming practice look like?
Holding space for crip time: progress that moves in spirals, pauses, or plateaus.
Respecting energy and pain cycles instead of trying to “fix” them.
Validating non-compliance as a boundary, not resistance.
Seeing assistive devices, medication, or support systems as tools of agency not signs of failure.
Asking “What does access look like for you?” at the start of your work together.
If you’re a therapist, try sitting with this
Where might I be unconsciously centering “functionality” or “independence” as therapeutic goals?
How do I respond when a client says, “I couldn’t do it this week”?
What emotions come up in me when a client expresses deep fatigue, resignation, or despair that doesn’t shift?
How do I hold space for non-linear, non-normative healing?
For individuals living with non-visible disabilities, the lack of external “evidence” can lead to disbelief, judgment, or accusations of exaggerating or faking symptoms.
Many are told they “don’t look disabled” or are questioned when they ask for accommodations. This skepticism not only adds emotional labor to an already challenging experience but also reinforces internalized shame and isolation.
When society equates disability with visibility, it creates a narrow and exclusionary definition that marginalizes a vast group of people.
As mental health professionals, we hold space for the grief, frustration, and exhaustion that comes with being misunderstood, disbelieved, or expected to perform in neurotypical, able-bodied ways. But we also witness the fierce resilience, advocacy, creativity, and care that neurodivergent and disabled people bring into the world.