Not a Deficit: Living the DSM from the Inside

How autistic attunement, hyper-empathy, and the circuit breaker of self-preservation reveal what the DSM cannot name.

A personal reckoning with the DSM’s cold language, autistic attunement, and the cost of clarity. Not a deficit—but a circuit wired for truth, and a breaker that flips only when the space becomes unliveable.

Introduction

When I first read the DSM-5-TR definition of Autism Spectrum Disorder—particularly the Level 2 support description—I felt a strange kind of dislocation. There it was, my entire relational life, summarised in the cold cadence of clinical detachment: persistent deficits in social communication and social interaction across multiple contexts… marked impairments even with supports in place… reduced or abnormal responses to social overtures. It wasn’t that the words were wrong, exactly. It was that they were so insufficient—so devoid of texture, of context, of humanity. They rendered the complexity of my existence into a sterile set of problems. Deficits. Abnormalities. Limited initiations. As though what I’ve been navigating isn’t a lifelong, nuanced system of pattern recognition, exhaustion, and guarded hope, but a failure to behave as expected.

For me—as an autistic person, a gestalt language processor, hyper-empathic and alexithymic, with a nervous system shaped by sensory integration differences—social interaction isn’t simply challenging. It is volatile, electric, absorbing, and often overwhelming. I live with verbal and auditory processing differences—what is sometimes pathologised under the umbrella of “Specific Learning Disabilities,” but in my world, forms part of a complex gestalt reality. My brain doesn’t process words in neat, linear sequences. Meaning arrives in waves, fragments, tones, whole emotional constellations. I’m always listening—not just to what’s being said, but how it’s being said, what’s not said, the tremor under the syllables. I tune in with such intensity because I have to. Missing even one piece can mean misinterpreting the whole. That heightened tracking—born of necessity—intertwines with my hyper-empathy. When what I hear doesn’t match the incoming emotions, the dissonance hits immediately. The message might be friendly, but the energy isn’t. The smile might hold, but the current falters. And when it does—when the subtle discontinuity reveals itself—the system begins to short. I don’t choose to withdraw. The circuit simply can’t hold. I fall quiet. The connection dissolves. The breaker flips to protect me from further disorientation, not because I’ve misunderstood, but because I’ve understood too much—too quickly, too completely—for the space to remain safe.

Level 2, they say, means I require support. And I do. But the kind of support I need rarely matches the standard interventions. It isn’t about reminders, visual schedules, or social stories—not really. It’s about regulation. Containment. A stable, attuned environment that recognises I am not malfunctioning—I am navigating the world with a radically sensitive and differently wired system. Even after years of scripting, rehearsing, and translating between what I perceive and what others expect, there are days when simply entering a space can begin to overload me. Not because I don’t want to engage, but because the cumulative strain of tracking tone, decoding shifting expressions, compensating for missed or misfired language cues—it builds, fast. The effort doesn’t lessen with familiarity; in fact, it often intensifies. Every new interaction requires my system to re-map and recalibrate, and if the signals are inconsistent, or the emotional undercurrent contradicts the words, my body will know before I do. The circuit can’t hold. And in that moment, the breaker trips. Not out of avoidance, not out of refusal—but as a form of self-preservation. A final act of nervous system integrity. Because when others, often unconsciously, offer only the shape of connection—absent its depth or safety—my system will not allow me to remain. And that’s not a flaw. It’s how I’ve survived.

Ghost Diagnosis: Growing Up Without a Name

I grew up in the United States in the 1970s, before the idea of autism—let alone autistic femmes, or language processing profiles like mine—had any real foothold. There were no diagnostic frameworks that fit someone like me. I wasn’t seen as neurodivergent; I was just “odd,” “overly sensitive,” “too intense.” I was praised for being clever but quietly reprimanded for being difficult to manage. The adults around me didn’t know what to make of the meltdowns I barely held in, the way I’d go mute in certain settings, the absolute overwhelm that seemed to come from nowhere. I was a child trying to hold a system together—one that overloaded constantly—without ever being told it was a system. No one could see the circuitry beneath the surface. And I had no words to explain it. Even if I had, it wouldn’t have mattered. This was still the era of children should be seen and not heard, and my attempts to describe the chaos inside me were often dismissed as exaggeration or attention-seeking.

There were signs, even then. I spoke in scripts, echolalic phrases, lines lifted from books or television that made more sense to me than anything improvised. I processed the world in meaning-laden wholes rather than in neat, piece-by-piece sentences. Sensory input often came in as a flood: too loud, too bright, too fast. Social interaction—particularly among children—was chaos. Wild, shifting, unfiltered. Children lied constantly, often for no reason at all. They excluded and performed and bullied in ways that were socially legible to others but absolutely mystifying to me. I wanted to connect—deeply, genuinely—but the landscape was impossibly unstable. One moment someone was a friend, the next they were leading a chorus of laughter at my expense. I couldn’t keep up. The social current surged and stalled, shorted and sparked, and I was left standing in the middle of it—raw and overloaded, unable to name what was happening.

That absence of language, of recognition, came at a cost. I internalised the disconnects as failure. I thought I was wrong, broken, fundamentally unlikeable. No one told me that the world was a poor fit for my neurology. No one explained that I was wired to read coherence and seek resonance in a world that often rewarded exactly the opposite. And so I learned to mask, to script, to camouflage the misfirings. I began to treat my difference as something shameful, something to be hidden. But the breaker kept tripping, even then. I could never hold the mask for long. The system would overload, shut down, and no one ever understood why.

Lived vs Labelled: The Diagnostic Language Understood from Within

Deficits in Social-Emotional Reciprocity

This phrase—“deficits in social-emotional reciprocity”—sits cold and clinical on the page. It suggests indifference, disinterest, an inability to participate. But the truth is, I feel far too much. Reciprocity is not foreign to me. It’s sacred. It’s something I yearn for so deeply that I often mistake the first hint of it for something more solid than it is. I don’t fail to respond emotionally—I over-respond. I invest. I attune. I bring my whole self to each moment of connection, often without reserve, because when it feels real, I want to believe in it completely.

The problem is not that I can’t give. It’s that the return signal often doesn’t arrive—or if it does, it’s brief, inconsistent, or contingent. And each time that happens, the cost is cumulative. There’s an exhaustion that sets in from years of trying to meet others where they are, only to find that they were never really there with me. The current flows both ways—until it doesn’t. And when it stops, I feel it. Not metaphorically. Viscerally. It’s like an internal click, a sudden absence of charge. Something drops out of the moment, and the connection becomes untenable.

In those moments, I don’t feel unaware or confused. I feel abandoned. Not dramatically—just unmistakably. The signal that was once mutual has become a performance, or an obligation, or worse, a toleration. And even if the interaction continues on the surface, I’m already gone. The breaker trips. The lights are on, but I’m not receiving. Each time it shorted out, I used to think it was my fault. That I was too much. Too intense. Too sensitive. Now I understand that it wasn’t a lack of reciprocity on my part. It was an over-extension into spaces that couldn’t hold what I offered.

Deficits in Nonverbal Communicative Behaviours Used for Social Interaction

There’s something quietly brutal about this phrase: “markedly odd nonverbal communication.” It assumes a standard baseline, a neutral norm, and casts any divergence as defect. But for someone like me, nonverbal communication is less about gestures and facial expressions, and more about energy. About presence. About the invisible signals that hum between people when language falters. My body doesn’t always express itself in typical ways—but it reads other bodies with terrifying precision.

I feel the small things. A flicker of hesitation. A too-still gaze. A micro-pause where a smile should live. I read these not because I’ve studied them, but because they land in my system like static. Unsettling, unmistakable. The patterns light up before I even know what they mean. I’ve always known when someone is masking, even if I couldn’t name it. I’ve felt the social scripts being read at me, rather than shared with me. And when that realisation lands—when the mask flickers before it settles—the circuit begins to fail. That’s when the breaker flips. I don’t shut down as a choice. My system can no longer sustain the lie.

What’s seen as “odd” in me—my sudden silences, my gaze that darts or holds too long, my stillness when others are animated—is simply the natural response of a system that has gone into conservation mode. It isn’t disengagement. It’s the moment before collapse. I’ve learned, slowly, that these responses are not faults. They’re signals. They tell me that what I’m reading and what I’m receiving no longer match—and that I cannot afford to keep giving more than the moment will hold.

Deficits in Developing, Maintaining, and Understanding Relationships

I have always wanted closeness. Deep, rooted connection. The kind that allows for stillness, complexity, and contradiction. But maintaining relationships—particularly under social norms that favour speed, casualness, and subtle negotiation—has often felt like trying to hold water in cupped hands. I try, and try, and try again. And still it spills through.

For me, connection isn’t light or optional. It is full-body, full-self. When I am in it, I am in it. And when something shifts—even slightly—I feel it instantly. What others might call a minor misunderstanding or emotional nuance arrives in my body like a tidal change. The flow changes direction, and suddenly I’m no longer able to stay present. The current, once fluid, turns sharp or still. The breaker doesn’t snap—it gently gives way. And the relationship, however meaningful it once was, becomes inaccessible. Not by choice, but by physiology.

This isn’t a failure to understand relationships. It’s an understanding that runs too deep. I sense the loss before it is spoken. I register the emotional withdrawal before it is named. And because of that, I find myself retreating not from people, but from the impossibility of staying connected when the voltage between us no longer matches. I don’t pull away. The current just stops moving. And I know, in that instant, that it cannot return to what it was. The circuit has broken—not catastrophically, but conclusively.

Level 2 “Support Needs”: The Misread Circuitry

Support needs, as they’re described in the diagnostic manuals, are often framed in terms of what can be externally observed: how often someone initiates, how much prompting they require, how “odd” their social behaviour appears. But for someone like me, most of my support needs are invisible—buried beneath learned competence, scripting, and decades of effortful adaptation. On the surface, I can appear articulate, responsive, functional. But that surface belies the sheer volume of emotional labour involved in sustaining it. Every interaction is a finely balanced negotiation between masking and authenticity, between sensory input and cognitive translation, between the internal pulse of overwhelm and the external expectation to remain steady.

People assume I’m managing well—until I’m not. Until the system tips. Until the accumulated dissonance reaches critical mass and the breaker flips, leaving me wordless, flooded, shut down. The phrase “high-functioning” has always been a misreading. I’m not functioning highly—I’m functioning expensively. The cost of holding everything together is paid in delayed crashes, in lost recovery time, in long hours of silence after short conversations. The reality of Level 2 support needs in my life isn’t about visible meltdowns or constant assistance. It’s about what it takes not to have them. It’s the scripts I rehearse before meetings. The time I need to recover from a casual chat. The daily calculus of which spaces I can safely enter and which ones will overload my system beyond repair.

And then there’s the quiet ache of being required in spaces that never quite welcome me. I’m not there because I’m wanted—I’m there because I’m needed. Because I hold a specific and increasingly rare credential. Because I meet a quota, tick a box, fulfil a compliance requirement. I’m valued for my usefulness, my insights, my steadiness under pressure—but that’s not the same as being chosen. The invitation is conditional. I am the infrastructure, not the community. The one who notices the gaps, who patches the cracks, who prevents the collapse—but rarely the one who is truly seen. It’s a lonely kind of indispensability: present, but peripheral. Depended on, but not held.

Rewiring: HRT, Clarity, and the Cost of Sensitivity

Hormone replacement therapy has been, for me, a kind of rewiring—a slow, intricate remapping of both nervous system and self. It didn’t just change the way I inhabit my body. It altered the circuitry through which I feel. Emotions now arrive differently: without delay, without detour, without the familiar fog. What was once distant or muted now hits in full—bright, immediate, undeniable. Where once I had to guess what I felt and from where that feeling came, now it surges through me, often faster than I can process. That clarity, whilst necessary, has come at a cost.

This article, for example, has taken me nearly three days to complete. Not because I didn’t know what I wanted to say, but because the act of saying it—of naming things this clearly—has been almost unbearable. Each section surfaced more than thoughts; it brought waves of trembling, anticipatory anxiety, tears I couldn’t explain. It’s difficult to write about circuits from inside the one that’s currently overloaded. And it’s harder still to be in a world that recoils from emotionality—especially when it comes from someone like me. There is no social script for an “overly sensitive” woman who stands six feet seven. There is no acceptable shape for this kind of bigness—of feeling, of presence, of grief.

And now, with the rewiring, the short circuits are no longer soft or ignorable. They used to feel vague, like background static—moments I could dismiss or override with effort. What some describe as the “double empathy problem”—the friction between neurotypes—felt like something I could manage with enough patience, enough scripting, enough quiet. But not anymore. Now I feel the break the moment it happens. There’s no lag. Just a quiet click—and then the light is gone. That shift in energy, that sudden impossibility of continuing—I feel it as quickly as a physical boundary. The mask slips, the tone flattens, the warmth vanishes—and my system knows. Before I can speak it, before I can make sense of it, the connection is already over. The breaker has tripped. And I am, again, alone.

This isn’t a failure of resilience. It’s a function of clarity. Transition hasn’t just brought me closer to myself—it’s removed the last buffer between me and what others can’t sustain. I no longer have the luxury of misreading the room. And whilst that makes everything harder, it also means, for the first time, that I’m not gaslighting myself into staying where I’m not truly met.

After the Breaker Trips

I asked for this.
To feel more.
To come home to a body
that didn’t require translation.

And I got it.
Clarity, like breath.
Like finally standing inside my own voice
without flinching.

But with that clarity came the cost:
no more delay,
no more soft static
to cushion the truth.

Now I feel the shift
the second it happens.
A blink too long,
a tone too flat,
a smile that doesn’t reach.

And I know.
They’re not with me anymore.
Maybe they never were.

I used to think it was abandonment—
that I had said the wrong thing,
been too much,
asked too deeply.

But now I see it:
they were managing me.
Masking for me.
Braving me
until they couldn’t.

I was tolerated.
Not seen.
Not joined.
Just… endured.

And when the need passed,
so did the warmth.
The light blinked out—
not suddenly,
just unmistakably.

This is what attunement does.
It makes disconnection
undeniable.

And still—
I wouldn’t go back.
Wouldn’t trade this painful knowing
for the false comfort
of misreading the room.

Because even if it leaves me lonelier,
I am no longer gaslighting myself
into being held
where I was never wanted.

I know now
when the circuit breaks.
And I honour the breaker
for flipping
before I am burned.

Final thoughts …

I’ve come to understand the DSM not as a neutral document, but as a kind of ledger—one that records, in clinical shorthand, all the ways systems have failed to support lives like mine. It catalogues the effects of growing up misunderstood, unsupported, and forced to make sense of a world that misreads difference as defect. The criteria speak of deficits, of abnormality, of supports required—but what they don’t say is that these are often the scars left by being too sensitive in a world that rewards insensitivity. That the autistic person described is not broken, but wired in ways that are exquisitely, sometimes unbearably, responsive to relational harm.

As a GLP with hyper-empathy, alexithymia, and sensory integration differences, I am not less-than. I am a system built to register complexity. The circuit breaker isn’t a malfunction—it’s a survival mechanism. It’s what protects me from dissolving into the dissonance of unreality, from being hollowed out by one-sided connections, from internalising every social failure as a personal one. It’s what has allowed me to keep going. Quietly. Carefully. It’s the reason I’m still here.

I’ve learned how I’m wired. I’ve learned what trips the breaker. I’ve learned the cost of ignoring those signals—of staying too long in rooms that cannot hold me, of softening myself into someone palatable rather than true. What I need now are spaces that don’t push me to overload just to belong. That don’t ask me to tolerate being tolerated. That don’t confuse my presence for compliance, or my quiet for assent.

And I’m not sure those spaces exist here anymore. The political trajectory in the United States—the resurrected eugenic narratives, the chilling pragmatism of RFK Jr.’s rhetoric, the instrumentalisation of autistic bodies in service of pseudoscientific fear—tells me exactly what kind of belonging is being offered. It isn’t real. It isn’t safe. And I’ve spent too long learning how to read the energy beneath the invitation to pretend I can’t feel it now.

So perhaps it’s time to build that space elsewhere. A place where I don’t have to prove my humanity, translate my grief, or survive the silence after the current drops. A place where the breaker doesn’t have to trip so often. A place that doesn’t just accept how I’m wired—but honours it.