journal · June 22, 2025

Autism, Trauma, and Diagnostic Bias

I've been noticing something as I write about Chris. I go through all of these memories, of times where people in my life sat with me and heard me talk about the situation with him as I was living it. They wanted to understand our complex relationship, but because they're my friend first, they naturally side with me. They tell me Chris is a sociopath or a narcissist. People tell me my dad is a sociopath or a narcissist.

They tell me these things almost to validate my anger, with the implicit understanding that being either of these things is bad, whereas the person I am is good. The intent is to offer an empathy to me, but it always, even today, makes me feel anger at the person making the judgments instead--because it flattens my character, simplifies me into a victim, even when no one is outright saying it.

But that's not where my anger ends.

My anger lives in the blurry ambiguity of how we as a society diagnose these conditions and the fact that there are so many overlaps between autism, narcisissm, and sociopathy and really, if you want to be REALLY honest about it, the key differences are left in the interpretive bias of the clinical psychiatrist making the diagnosis and their own subjective opinions, which may or may not include personal vendettas against the very type of people they are diagnosing.

So here's my hot take.

Autism.

Narcissism. Sociopathy. Borderline Personality Disorder. Obsessive Compulsive Disorder. PTSD. These are all trauma profiles of autism. That's it.

But Aimee, not all narcissists are autistic. How do you know though? If autism is so misunderstood, so underdiagnosed, how can you possibly be able to say that not all narcissists are autistic?

But Aimee, not all PTSD patients are autistic. Then why do some people NOT get PTSD from their trauma? What is the triggering factor that determines whether something will develop PTSD as the consequence of a traumatic event? If EMDR is the "gold standard" for treating PTSD and the process of that boils down to bilateral processing, utilizing both sides of the brain, isn't it just common sense that autistic people, who are genetically predisposed to difficulty activating their prefrontal cortext, the very part of the brain responsible for processing trauma, the most probable candidates for developing PTSD?

But these secondary conditions, defined as "personality disorders" are DSM-directed. And if trauma is the underlying cause, isn't it in the best interest of the people who deliver the hardest trauma to neurodiverse people to ensure that the masses stay undereducated and as far away from the truth as possible in understanding that all of these so-called disorders, which are designed to stigmatize their behaviors and make them look repulsive in society's eyes?

Because when I look at a sociopath, I don't see a harmful person. I see a person that is a lot like me who has been outcast to the point that they conduct harmful BEHAVIORS because it is the only way they WILL be seen. I see that little girl in me at 6 years old, waking up in the middle of the night, dissociating, cutting the cat's ear--because if no one around me could feel the pain that I felt... I was going to make them SEE the pain that I felt. But I was 6 and I later found other, different maladaptive coping behaviors instead. So I never got an antisocial personality disorder diagnosis. I was never deemed a sociopath.

When I look at a narcissist, I don't see a charismatic lothario. I see a person who lacks social intuition enough that they have resorted to going by social playbooks and understanding that the only way they will survive in this world is if they follow scripts and treat social hiearchies like games to be won, because they're terrified of what happens when they show the world who they really are, since the world seems to hate unmasked autistic people. I see myself, every time I have overprojected my confidence, and more recently, every time I have felt reality so strongly and decided that the truth was more important than what people around me were capable of hearing... this is the difference between being authentic/real and being offensive. And people group that latter half into narcissism. But most people who get diagnosed narcissist are men. And I'm not a man, so no one will ever diagnose me with NPD.

These behaviors, people do need to be held accountable for them. But they are not inherently bad people. They are people who, like me, deserve compassion too. This is just how trauma expresses itself when it collides with certain autistic traits—not that all trauma in autistic people leads to these outcomes, or that only autistic people end up with them.

People who work in mental healthcare, they're not bad people either. But they've been trained using this faulty half-assed framework and almost no one in this space is willing to challenge the framework because to do so is to completely distort the public eye of how we look at genetically acquired neurodiversity and the placement of personality disorders and trauma in that space. Because these diagnoses exist to redirect blame back at the person receiving the diagnosis. No one says "how do I find the human underneath the narcissism?" They ask, "When will this evil little narcissist stop behaving the way he does?" But he won't. Because he'll continue to suffer without radical upheaval of systems designed to encourage his trauma: toxic masculinity, societal structures that prioritize fear-mongering as a way of controlling entire populations of people, sometimes religion as a buffer.