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The Neurodiverse Sex Therapy Program
An introduction to sex therapy, and a companion to it, for couples where one or both partners are autistic, ADHD or AuDHD. Each module walks you through what tends to happen in one session, and then gives the two of you something to do after it. Nothing sexual happens in a session: it is all talk. Anything you try at home happens only if you both agree to it, at the pace of whichever of you needs it slower. Nothing here needs an account, and nothing you write leaves your own device.
14 of 24 modules are published and readable now. Any others are listed by name so you can see the whole shape of the program before you start it.
How to read it
A framework, not a script. Each module describes one way a session can go. Every therapist at our center is an experienced clinician with their own way of working, and yours will shape each session to the two of you: changing the order, spending longer on some steps, skipping others, or trying something different. Use the modules to know roughly what to expect, not as a checklist your sessions have to follow.
Parts One to Four run in order and each assumes the ones before it: starting the conversation, how your two brains shape sex, asking, answering and planning, and touch, one step at a time. Part Five does not: it is a shelf of the things that most often bring couples to sex therapy (low desire, one of you wanting it more, erections and performance anxiety, pain, porn and secrecy, body image, perimenopause and menopause), and you take the ones that are about your life. Where the body may be part of it, we ask you to see a doctor as well. Part Six is about making it yours. You do not have to be in therapy to use any of it.
Part One - Starting the Conversation
1A — Your First Sex Therapy Session
What to expect, and what never happens, when you first talk about sex. Read Your First Sex Therapy Session
1B — Talking About Talking About Sex (not written yet)
1C — What Sex Is For, for Each of You (not written yet)
Part Two - How Your Brains Shape Sex
2A — How Neurodivergence Shapes Sex (not written yet)
2B — Your Sensory Map (not written yet)
2C — Energy, Masking, and the Onramp (not written yet)
2D — When “No” Lands Hard (not written yet)
2E — Orientation, Identity, and Desire (not written yet)
Part Three - Asking, Answering, and Planning
3A — Saying It Plainly
Plain words you agree on, so nobody has to guess. Read Saying It Plainly
3B — Yes, No, Maybe
Find what you both want, with nobody talked into anything. Read Yes, No, Maybe
3C — The Daily Check-In
Six numbers a day, so neither of you has to guess. Read The Daily Check-In
3D — Asking and Answering
Make it easy to ask, and safe to give any answer. Read Asking and Answering
3E — Scheduling Intimacy
Keep a time for each other, with no promise attached. Read Scheduling Intimacy
Part Four - Touch, Step by Step
4A — Sensate Focus, One Step at a Time
Find your way back to touch, with nothing to prove. Read Sensate Focus, One Step at a Time
4B — Brakes and Accelerators
Ease what switches desire off before adding anything new. Read Brakes and Accelerators
4C — Aftercare and Repair
Make the minutes after feel as safe as the rest. Read Aftercare and Repair
Part Five - When Something Is Wrong
5A — Low Desire
Find what is lowering desire, without blaming either of you. Read Low Desire
5B — When One of You Wants It More
Plan for the desire you each have, not the one you expected. Read When One of You Wants It More
5C — Erections and Performance Anxiety
Step out of the worry loop around sex, together. Read Erections and Performance Anxiety
5D — Pain During Sex
Stop pushing through pain, and find help together. Read Pain During Sex
5E — Porn and Secrecy
Talk about porn without shame, blame or hiding. Read Porn and Secrecy
5F — Body Image (not written yet)
5G — Perimenopause and Menopause (not written yet)
Part Six - Making It Yours
6A — Designing Your Own Relationship (not written yet)
Working with us
The Neurodiverse Couples Counseling Center works with couples where one or both partners are autistic, ADHD or AuDHD, including on sex, desire and touch. Everything described in these modules is part of how we work, shaped by your therapist to the two of you. Therapy for clients in California, coaching worldwide, all by telehealth. A first conversation costs nothing. Talk with our team.
Acknowledgments
The Neurodiverse Sex Therapy Program was compiled by, and written under the direction of, Harry Motro, LMFT, founder and clinical director of the Neurodiverse Couples Counseling Center. It represents the input of the whole clinical team. Every session it describes is one the center’s therapists run, in the way they run it, and the program exists because they were willing to say, in detail, what they actually do in the room.
The clinical team. Our deepest thanks go to the therapists of the center. Their sessions are what these modules describe. Their worksheets, refined over thousands of hours with neurodiverse couples, are what the modules draw on: the Yes / No / Maybe Inventory, the Sensory Map, the Daily Check-In Tracker, the Scheduled Intimacy Agreement, Brakes and Accelerators, the Aftercare Plan, the Designer Relationship worksheet, and many others. Where a module says “we,” it means them. Meet the team.
The couples. And to the couples. Everything here that is true was learned from people who sat in the room, tried it, told us when it did not work, and came back the next week. Nobody’s story is in these pages. Everybody’s is.
The research. Each module lists its sources, with what each one can and cannot support, at the foot of its page. Across the program, the work we lean on, and are grateful for:
- Laura Pecora, Gary Mesibov and Mark Stokes on what the research shows about sexuality in autism
- Sarah Garfinkel and colleagues on how autistic people sense what is happening inside their own bodies
- Damian Milton on the double empathy problem
- Laura Hull and colleagues on social camouflaging
- Gray, Kirby and Holmes on autistic adults' own accounts of the senses, sexuality and relationships
- Helen Fisher, Arthur Aron and Lucy Brown on the brain systems behind desire, romantic love and attachment
- Sue Johnson on the conversations that keep couples close
- Dinah Murray, Mike Lesser and Wenn Lawson on monotropism
- Ari Tuckman on how ADHD shows up in a couple's sex life
- van Asselt, Reekers and Roke on rejection sensitivity in autistic adults
- Teresa Tavassoli and colleagues on sensory over-responsivity in autistic adults
- MacLennan, O'Brien and Tavassoli on the sensory experiences of autistic adults, in their own words
- Kathleen Hupfeld, Tessa Abagis and Priti Shah on hyperfocus in adult ADHD
- Steven Kapp and colleagues on autistic adults' views of stimming
- Beheshti, Chavanon and Christiansen on emotion dysregulation in adult ADHD
- Jeroen Dewinter, Hanneke De Graaf and Sander Begeer on sexual orientation and gender identity in autistic adults
- Varun Warrier and colleagues on autism among transgender and gender-diverse people
- Bush, Williams and Mendes on asexuality among autistic women
- Catherine Crompton and colleagues on information transfer between autistic and non-autistic people
- Emma Kinnaird, Catherine Stewart and Kate Tchanturia on alexithymia in autism
- Michael Robinson and Gerald Clore on how people report what they feel
- Ottenstein, Hasselhorn and Lischetzke on how checking in daily makes feelings clearer
- Paul Schrodt, Paul Witt and Jenna Shimkowski on the demand/withdraw pattern
- Ye In Hwang and colleagues on anxiety and uncertainty in autistic adults
- Rosemary Basson on responsive desire
- William Masters and Virginia Johnson on sensate focus
- Linda Weiner and Constance Avery-Clark on sensate focus in practice
- Erick Janssen and John Bancroft on the dual control model of sexual response
- Emily Nagoski on brakes and accelerators
- Roy Lewicki, Beth Polin and Robert Lount on what makes an apology work
- Marita McCabe and colleagues on how sexual difficulties are defined
- Jan Shifren and colleagues on how common sexual problems and distress are
- William Masters and Virginia Johnson on the human sexual response
- Raymond Rosen and colleagues on erections and general health
- Ronald Pyke on sexual performance anxiety
- Paris, Lodestone, Houser and Lewis on autistic shutdowns
- Elke Reissing and colleagues on how pain with penetration is now understood
- Moniek ter Kuile and colleagues on therapist-aided treatment for vaginismus
- Al Cooper on sexuality and the internet
- de Alarcón and colleagues on what is and is not known about online porn
- Shane Kraus, Valerie Voon and Marc Potenza on compulsive sexual behavior
- Yasisca Pujols, Cindy Meston and Brooke Seal on body image and sexual satisfaction
- Alexandra Leedham and colleagues on autism diagnosed in middle and late adulthood
- Ginny Russell and colleagues on the autistic advantage
- Dora Raymaker and colleagues on autistic burnout
- Yuthika Girme, Nickola Overall and Simpson Faingataa on what shared time together does for a relationship
We have tried to say what each study shows and no more. Where the program goes past the evidence, the module says so.