In this short video, I explain what I do first when an autistic or ADHD adult comes to me in crisis, and why we lower the demands before we look for causes.
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Acute online neurodiverse psychotherapy helps autistic, ADHD and AuDHD adults whose lives have tipped into crisis right now: burnout, repeated shutdowns or meltdowns, a sudden loss, or a situation you can no longer hold together. We meet by video, soon, usually within days, in 1-hour sessions with 50 minutes of therapy, in English, from a space that feels safe to you.
At first, the aim is simple: reduce the load and steady your nervous system, so you can think again before making big decisions. This is the crisis branch of my online neurodiverse psychotherapy, within my wider online psychotherapy. I do not diagnose, and I am not an emergency service.
If you need me soon, you can book the first open session, request a free 30-minute call, check my client policy or write to me if speaking is hard today.
Acute online neurodiverse psychotherapy is for autistic, ADHD and AuDHD adults, or those who suspect it, who are in crisis this week. Your capacity has collapsed, your days have stopped working and the usual strategies no longer help. You need support soon, from someone who understands neurodivergence, to get through the next days and decide what comes next.
Acute work is built for the first days and weeks of a crisis. If one of these lines describes you more precisely, the linked page will fit better.
You can also send me an email
These reviews describe clients’ experiences of working with me. They come from my wider practice and do not all relate to online sessions. Each person’s experience is their own, and a review does not promise a particular outcome.
“Since my first client in 2004, I have seen neurodivergent people in crisis try to think their way out of collapse. I believe that is the wrong order. A nervous system in burnout cannot problem-solve. It needs the load taken off first. Beneath the panic I often hear one voice asking ‘Will anyone stay with me if I cannot function at all?’ and another saying ‘Do not ask me anything, I need everyone to go away.’ Sometimes the same person says both in one breath: ‘Do not leave, but do not come near.’ That is not contradiction or drama. It is overload. My first job is to help you lower the demands until your mind has room to come back.”
Mark Colclough, MA, psychotherapist and EFT couples therapist
I am Mark Colclough, MA. I have practised since 2004 and offer online psychotherapy and couples therapy in English.
My training brings together your emotions, your thoughts and your relationships. My deep passion is the moment when what happens between you finally makes sense, to each of you and to each other. I have lived and worked in nine countries, so I know something of life across languages, cultures and borders.
Read about my background, or explore online psychotherapy and online couples therapy.
I meet regularly with experienced psychotherapists to reflect on my work, question my understanding and develop my skills. Supervision is part of the professional care I bring to individual and couples work, including online sessions.
My focus is thoughtful practice, integrity and responsibility.
You are welcome to ask about the kind of support you need.
Tell me where you are based and your time zone. We can then consider whether online sessions together are suitable.
Ingeborg is 29 and works as a nurse in Bergen. After months of night shifts and a hospital reorganisation, she had a meltdown in the staff room and has been on sick leave for a week. Some days she cannot speak. She sits in a dark room with headphones on, and her partner, frightened, keeps asking what she needs. She does not know, and the questions make it worse.
In our first video session, I would not ask Ingeborg to explain the crisis. We would agree on 3 things for the coming days: what can be dropped, how she can signal that she cannot talk, and one small anchor each day. Making sense of the burnout comes once she has a little capacity back.
I have presented this clinical example as a compound of 22 years of clinical practice.
Your capacity has run out and your strategies have stopped working, and you need help now, not in a month.
There is no right moment and no right reason. If your life as a neurodivergent adult has suddenly become unmanageable, that is enough. You do not need a diagnosis, a clear explanation or the words to describe it. In 22 years of practice, working with many autistic and ADHD adults, I recognise when overload has become a crisis that needs fast, focused attention.
In a crisis, the first task is not to understand everything. It is to stop the damage, lower the load and help you get through the coming days. The 6 questions below can help you see whether this is where you are.
If so, take it seriously. Washing, eating, opening post, answering the phone or getting dressed may have become too much, almost overnight. You may sleep far too much or not at all, and every small demand feels like a wall.
I help you work out what can be dropped, delegated or simplified this week, so your energy goes only on what is truly necessary. That tells us quickly whether you are in burnout that needs rest and structure, or something that needs other help as well. If this is you, book a session with me as soon as possible.
Yes, both are true in a crisis, because each protects something. Wanting help protects you from being abandoned when you are at your most vulnerable. Wanting to be left alone protects you from more noise, questions and demands that your system cannot process right now.
I do not treat either wish as wrong. I help you find forms of support that do not add to the overload, such as someone sitting quietly nearby, written messages instead of calls, or one trusted person handling contact with others. You decide what you can take in.
In a crisis, it is common to fear that your partner, employer or friends will lose patience. Every unanswered message or worried look can feel like proof that you are too much. You may apologise constantly, try to explain yourself or push to get back to normal far too fast.
Your need for reassurance right now is legitimate, and I will not shame it. I help you calm the alarm enough to see what is actually happening in your relationships, and we work out simple ways to tell people what you need so they do not have to guess.
Many people in neurodivergent crisis describe this. You ask your partner or a friend for help, then cannot bear their questions, their tone or their nearness, and you shut down or snap. Afterwards you feel guilty and even more alone.
I help you slow this cycle down, so we can see what tips support into overload. It is often a sensory or social trigger. I have compassion for that reaction, and I also help you agree simple signals with the people around you, so care can reach you without overwhelming you.
When everything is too much, going dark can feel like survival. You may switch your phone off, stay in bed, cancel everything and stop replying to anyone. It brings some relief, but people worry, and you can become isolated just when you need support.
My view is that rest and quiet are essential in burnout, and I will not push you to be more social. I help you keep one or 2 small lines of contact open, in forms you can manage, so withdrawal protects you without cutting you off completely.
A collapse can shake your whole sense of self. You may wonder whether you were ever really coping, whether you have lost abilities for good, or whether everything you believed about yourself was a mask. These questions are frightening, but they do not mean you are broken.
I help you separate what belongs to the crisis from what belongs to you. I will challenge the harshest conclusions you draw while you are depleted, but I will not tell you who you are. Bigger questions about identity can wait until you have more capacity, and then we can explore them properly.
If this is where you are, book the first open session or request a call. I will tell you honestly how soon we can start.
You can also send me an email
Tell me briefly what kind of support you are looking for.
Include your country and time zone so we can discuss whether online work together is possible and find a suitable time.
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In a neurodivergent crisis, the order matters: lower the load first, then steady your system, then understand what happened and decide what comes next.
I will help you get through the immediate crisis, understand what pushed you past your limits and make the changes needed so it is less likely to happen again. Understanding comes after stabilising, not before.
In 22 years of practice I have found that people in crisis need a therapist who takes the lead. I offer clear structure, practical guidance and direct opinions, and I challenge thoughts that keep you pushing when you need to stop. These 6 questions show what we work towards.
Related reading: Why does ADHD keep pulling us into the same fight?.
In our first session, I help you identify the most urgent pressures and what can be put on hold. We agree a short plan for the coming days: what to drop, who handles which contact, and how you will rest and eat.
I tell you clearly what I think needs to happen first and what can wait. Small, concrete agreements often bring the pressure down faster than long explanations. When you are ready, book a session with me and we make that plan together.
By learning its early signs, even in crisis. There is often a sequence: sounds get sharper, your speech slows, your body tenses, then you shut down or explode. Catching the early stage gives you a moment to leave, rest or use a sensory tool.
In our sessions I help you map your own sequence and its triggers. Mapping it is only the start. We decide on one or 2 concrete actions for each stage, and you try them between sessions until they become usable on the hardest days.
Regulation in a crisis does not mean forcing calm or pretending you are fine. It means keeping the load low enough that your system can recover. You will need rest, food, darkness or quiet, and fewer decisions than usual.
I give you clear, practical guidance for the days between sessions: how to handle a sleepless night, what to say when someone asks how you are, and how to signal that you need space. I will ask you to follow the plan we agree, even when part of you wants to push on.
Clear communication in a crisis starts with knowing a few basic needs: quiet, food, time, no questions. When you are overloaded, even saying that may be hard, so it helps to prepare simple words or written cards in advance.
Together we create short scripts or messages for your partner, family or employer, such as “I am in burnout and cannot talk today, I will write tomorrow.” I challenge you when you go silent and leave people guessing, and also when you try to explain far more than you have the capacity for.
By separating what truly has to be decided now from what can wait. In a crisis, it is tempting to resign, end a relationship or move just to make the pressure stop. Many of those decisions look different a few weeks later.
I help you notice when overload is driving the choice, and we agree to postpone big decisions until you have more capacity. Where something cannot wait, such as a conversation with your employer, I help you prepare it calmly. The decision always remains yours.
When the acute phase has passed, we look at what caused the crisis and what needs to change so it is less likely to return. That might mean different work arrangements, more recovery time, clearer limits or support you did not have before.
Some people continue with online neurodiverse psychotherapy for longer-term work, some take a break and some finish. I help you choose deliberately, so the end of the crisis becomes a starting point for a life that fits you better.
You can also send me an email
You do not need to explain what is happening, or even know. You only need to reach out.
In the first sessions, I hear what has happened, check that you are safe and agree a short plan for the next days. I also tell you honestly whether acute work is the right format, or whether you need medical or emergency help first.
When the crisis has eased, many people move on to structured individual work in my online psychotherapy. If the crisis lives mostly in your relationship and your partner is willing, online couples therapy offers long-term relational development and healing. If you know you will need several sessions close together, a therapy bundle gives you savings and a plan you do not have to rethink in the middle of a crisis.
We meet by video for one hour. I ask what has happened, what feels most urgent and what you can and cannot manage right now. You can type in the chat, keep your camera off or send me notes before we meet.
By the end of the hour, you will have my first view of the situation and a simple plan for the next days. Unsure whether crisis work is what you need? A free 30-minute call lets us check together.
Individual work is right when the crisis is mainly in you: your capacity, your nervous system, your sense of self and your ability to function. We can talk about your partner, family and work without anyone else joining.
In individual sessions I give you direction, continuity and clear structure, which matters when everything else feels chaotic. Once you are steadier, online psychotherapy describes how my structured individual work continues.
Couples therapy fits better when the relationship itself is at the centre of the crisis and needs ongoing attention. If you and your partner keep ending up in the same painful cycle, if trust has been damaged, or if your differences have become unbearable for both of you, working together usually helps more.
In couples sessions I help you both see the cycle between you, take responsibility for your part and find ways of relating that respect both your nervous systems. Online couples therapy is long-term relational development and healing, and online neurodiverse couples therapy works directly with neurodivergent differences.
At the start, sessions are usually closer together than in ordinary therapy, so the crisis does not run away from you between meetings. How close depends on how severe things are, how much you can take in and what support you have around you.
In the first week or 2, I may suggest 2 sessions a week, or 2 sessions back-to-back on one day if a single hour is too short to settle. As things calm down, we space the sessions out and I tell you honestly when we can safely meet less often.
A crisis usually needs several sessions in a short time. A bundle means you do not have to decide, book and pay again after every session, which takes away admin when you have no capacity for it.
A bundle gives you a clear plan and a lower price per session. Look at therapy discounts and bundles, or at the bundle cards a little further down.
The acute phase is over when you can manage basic daily tasks again, shutdowns or meltdowns have become less frequent and you can think about the future rather than only get through the day.
I review this with you openly and do not keep you in acute work longer than needed. We then decide together whether to continue with longer-term work, pause or finish. Coming back if a new crisis arrives is a sensible use of support, not a failure.
Not sure acute work is the right place to start? Here is how it compares with the options neurodivergent adults in difficulty most often consider.
| Option | Choose it when | Pace |
|---|---|---|
| Acute online neurodiverse psychotherapy (this page) | You are in burnout, shutdown or crisis and need help this week. | Video sessions close together at first |
| Online neurodiverse psychotherapy | There is no acute crisis, but life takes too much out of you. | Weekly 1-hour video sessions |
| Acute online autism psychotherapy | You know you are autistic and are in autistic burnout. | Video sessions within days |
| Back-to-back online neurodiverse psychotherapy | You want a planned, concentrated block rather than crisis help. | Several sessions over a few days |
Acute online neurodiverse psychotherapy is short-term, structured individual therapy by video, in English, for autistic, ADHD and AuDHD adults in crisis. It focuses first on lowering the load and steadying your nervous system, then on understanding what happened and what needs to change.
I offer it with quick access, usually within days, and adapt the format to how you communicate. If there is no immediate crisis, online neurodiverse psychotherapy is the broader place to start.
Regular neurodiverse psychotherapy works on long-standing patterns at a steady, weekly pace. Acute work starts faster, meets closer together and puts stabilisation before understanding. Once the crisis has passed, many people move on to regular work.
My professional judgement is that trying to explore your history while you are in collapse usually adds to the overload. Steadying comes first.
Yes, often I can. I cannot promise how quickly you will recover, and I do not diagnose. What acute work can do is help you lower the demands, protect your recovery and avoid choices that make it worse.
In my clinical experience, people recover more fully when they stop trying to push through and accept a period of genuinely reduced demands. We plan that reduction concretely, with work, family and daily life.
Yes. You can type in the chat, keep your camera off, send me notes in advance or say very little. Many people in shutdown find that someone calm on the other side of the screen helps, even without many words.
I adapt to your capacity on the day, and we can keep the session shorter in content if that is all you can take in. The aim is to support you, not to make you perform.
No. I will help you see clearly and decide when you have more capacity, but the decision is yours. In a crisis, my main concern is that you do not make permanent choices out of overload.
I help you notice when panic or exhaustion is driving you and agree what can wait. When it is time to decide, I help you think it through step by step.
We spend the hour on what is most urgent, what you can still manage and what can be dropped, and you leave with a short plan for the next days. You can stay quiet, type or keep your camera off. If you are in immediate danger or thinking of ending your life, contact the emergency services where you live first, because I am not an emergency service.
Once you are safe, acute work can help with what led you there. Book a session, or contact me to arrange the next step.
It varies with the severity and the support around you. Some people steady things in a handful of sessions, others need close support over several weeks.
In 22 years of practice I have found that frequent reviews matter more than a fixed number. After each session we decide together what is needed next, and as you recover we space the sessions out.
Yes. In a neurodivergent crisis, video can be easier than travelling to an office, because you stay in your own safe space with your own light, sound and comfort items.
You need a private room, headphones if possible, a stable connection and a laptop, tablet or phone. If speaking is hard, have something to type on. The calendar shows times in your own time zone, and if no time is soon enough, write to me.
Acute neurodiverse work is individual psychotherapy, booked as 1-hour online sessions with 50 minutes of therapy. There is no separate crisis rate, and today’s fee in US dollars is on my prices page.
Because a crisis usually needs several sessions close together, a therapy bundle saves you 10 per cent on each session and gives you a plan. The options are on therapy discounts and bundles.
Book the first open session directly, or request a free 30-minute call if you want to speak first. Open slots appear in your own local time, wherever you are.
Room is held back for acute cases like yours, usually a time within days. If none of the available times are soon enough, or speaking is too hard, write to me with a few lines about what has happened, and I will reply with the earliest time I can offer.
You can also send me an email
I want therapy to help you understand your experience and make choices you can use in everyday life. We pay attention to feelings, needs and the responses that happen before you have time to think.
Our online room should offer enough trust and honesty to explore what is difficult. I bring attention and professional judgement. You bring your experience, questions and the right to say when something does not fit.
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