Differentiating Autism and Trauma: A Clinical and Human Imperative

Many people exploring their neurodivergence wonder: Am I autistic, or have I experienced trauma? The confusion is understandable. At first glance, some traits appear similar — hypersensitivity, dissociation, routines, social mistrust… But these surface-level similarities mask fundamentally different mechanisms. And it is precisely these underlying mechanisms that are crucial to understand.

This article aims to clarify those distinctions using research from neuroscience, cognitive psychology and psychopathology — helping to avoid diagnostic dead ends and supporting people in better understanding themselves.

1. Sensory Hypersensitivity: Structural or Contextual?

Hypersensitivity is often cited as a shared feature. Yet it manifests in very different ways depending on whether it’s rooted in neurodevelopmental factors or trauma.

• In autism, hypersensitivity is transversal: it can affect all sensory channels (auditory, visual, tactile, proprioceptive, etc.) and is typically present from early childhood. It is structural, linked to increased neural connectivity (Tavassoli et al., 2014) and inefficient sensory modulation by the thalamus.

• In trauma, hypersensitivity is contextual. It tends to be triggered by specific sensory cues linked to the traumatic event (e.g. a voice, sound, smell). It stems from implicit traumatic memory (Jaffe et al., 2019), involving structures such as the amygdala and hippocampus.

  
  

2. Dissociation and Disconnection: Defensive Mechanism or Overload Response?

• In autism, dissociation is not central but shutdowns can occur during episodes of cognitive or sensory overload. It’s a slow-building phenomenon, reflecting the exhaustion of regulation capacities. The autistic brain doesn’t switch off emotions — it becomes overwhelmed and unable to express them (Kinnaird et al., 2019).

• In trauma, dissociation is a core mechanism. It often emerges during traumatic episodes or flashbacks, and is described as a parasympathetic "collapse". People may feel as if they are "outside of themselves", detached from their body — a state of depersonalisation or derealisation (Van der Kolk, 2014).

  
  

3. Social Mistrust: Interpretive Ambiguity or Perceived Danger?

• In autism, mistrust is rooted in structural difficulty reading social intentions. It is not about rejecting relationships, but struggling with the readability of social cues and intentions. This often leads to avoidance, not out of fear, but out of confusion or fatigue (Livingston et al., 2019).

• In trauma, mistrust is acquired, often targeted at specific types of people (authority figures, caregivers, etc.). It is directly linked to past abuse or violence, and can develop into a form of hypervigilance, even if the ability to understand social codes remains intact (Herman, 1992).

4. Control and Routines: Internal Logic or Safety Strategy?

• In autism, routines are soothing. They help regulate anxiety through neurological stabilisation and predictability. These are not compulsions, but internal frameworks that offer structure and reduce cognitive effort (South et al., 2007).

• In trauma, control-oriented behaviours often serve to prevent perceived danger. The routines may resemble those seen in autism, but their function is defensive — an attempt to avoid a repeat of past harm (Cloitre et al., 2011).

5. Social Codes: Learned With Effort or Emotionally Disengaged?

• In autism, social rules are rarely intuitive. Many autistic individuals consciously learn these codes through analysis or mimicry, often with considerable effort. Their application can be cognitively taxing, especially in cases of camouflaging (Livingston et al., 2019).

• In trauma, social codes are typically intact, but may be avoided or withdrawn from due to fatigue or mistrust. It’s not a cognitive limitation but rather a temporary emotional disengagement (Cloitre et al., 2006).

  
  

6. Summary: Structure vs Injury

Autism (ASD)	Trauma
Neurodevelopmental condition	Acquired condition due to a life event
Difficulties present from early development	Onset linked to a specific “before” and “after”
Chronic cognitive fatigue	Emotional reactivity to trauma memories
No distress outside of overload triggers	Persistent distress even without triggers
Social rules learned with effort	Social skills intact but emotional engagement disrupted

What if You Have Both?

That’s not only possible — it’s fairly common. Autism can be a vulnerability factor for traumatic experiences, and trauma can overlay autistic traits.

From a diagnostic perspective, a trained clinician will be able to distinguish between the two and provide a robust diagnosis. But on a therapeutic level, yes, having both can affect how you proceed.

The key is to address whichever aspect causes the most immediate suffering. That might mean starting with trauma work (e.g. EMDR), or focusing on structuring and support around autism-related needs. But not both at once — doing so may cause emotional and cognitive overload.

Autism and trauma can overlap — but they must not be confused. Disentangling them allows for more accurate diagnoses and more targeted therapeutic support. Above all, it’s a step toward honouring the specific reality of each person’s experience, without forcing a single narrative onto vastly different internal worlds.