5.4. Therapy Approaches, Cognitive Models, and Ethical Misalignment

Conventional therapy models such as Applied Behavior Analysis (ABA) and Cognitive Behavioral Therapy (CBT) are often misaligned with monotropic cognition at a structural level.

ABA, in particular, prioritizes compliance through conditioning, often at the expense of internal narrative coherence. It teaches individuals to suppress natural cognitive expressions in favor of externally rewarded behaviors, reinforcing masking, self-abandonment, and trauma. While some practitioners attempt to make ABA more ethical by emphasizing positive reinforcement or consent, the underlying premise—that behavior must be reshaped to conform to external norms—remains incompatible with the Monotropic Expansion model. Such practices interfere with the anchoring process and override internal logic with imposed expectations, severing the link between cognition and authentic expression.

CBT, while less coercive, still risks harm when applied without adaptation. It assumes that thoughts are available for reframing through direct, conscious processing, but monotropic individuals may not be able to access or reorganize those thoughts without first revisiting the anchoring context in which they were formed. Attempts to “reframe” without understanding how those thoughts were built may lead to deeper entrenchment or invalidation.

Effective therapy for monotropic individuals requires a narrative-sensitive approach—one that respects inertia, builds trust through anchoring, and works with the individual’s cognitive rhythm rather than against it. Pacing, contextual scaffolding, and relational anchoring must all be prioritized. This isn’t simply about comfort; it’s about cognitive integrity.