Why Neurodivergent Bodies Often Need a Different Approach to Touch: A player’s handbook for understanding sensory profiles and nervous system patterns

Every person arrives at a massage appointment with their own sensory profile and nervous system patterns, which shape their experiences. For neurodivergent adults, especially autistic and ADHD individuals, touch isn’t simple. It can feel grounding, overwhelming, confusing, or contradictory, depending on the day, mood, environment, or even the part of the body being worked on.

In my experience, when I receive a massage, I typically need firm, deep pressure on my shoulders and calves, where I carry a lot of my stress. Conversely, my mid and low back, which are chronically tight and in pain, require a gentler touch because my muscles there tend to guard against deeper pressure, no matter how much I try to relax them. Sometimes these general rules don’t apply, so I have to check in with my body to see what it needs before a session. If needed, I ask my therapist to change up our normal approach to our sessions, and sometimes I even need to request an adjustment mid-session, which is why building trust and having someone attuned to your needs matters.

This is why ND-affirming massage isn’t just a stylistic choice. It’s a necessary shift in bodywork, honoring the mechanics of neurodivergent bodies to create sessions that feel safe, predictable, and restorative.

With that foundation, let’s dive into what understanding and supporting those differences actually means for hands-on care.

Understanding Sensory Profiles: Your Character’s Sensory Stats

Neurodivergent sensory systems tend to fall into three broad categories:

• Hyper-sensitivity: High Passive Perception

Unexpected touch can feel sharp, sudden, and too intense, like an ice knife spell detonating point‑blank before you’ve even had a chance to roll initiative. Light pressure may be as uncomfortable as delivering a nat 1 charisma check to a council of stone‑faced dwarves who already disliked you. And sudden changes in temperature, texture, or pace can trigger overwhelm faster than catching the exact moment your GM leans back, steeples their fingers, and smiles that slow, delighted smile that means they’ve been waiting all session for you to fail that insight check and spring whatever nonsense they’ve cooked up.

• Hypo-sensitivity: Low Passive Perception

Some nervous systems run like a half‑asleep barbarian on watch duty—light touch barely registers, slipping past unnoticed the way a twig snaps, and they assume it was “probably nothing.” Deep pressure, though, lands with the clarity of a full‑body shove that finally gets their attention. It cuts through the static, anchors the body back into itself, and reminds every muscle where it’s supposed to be. Which is honestly a relief, because the barbarian is now realizing the “boulder” they were leaning on just growled, the campfire has started scooting closer like it wants to be part of the conversation, and that stray dog that keeps trailing the party seems to have far too many teeth...roll initiative.

• Mixed Profile Sensitivity: Average Passive Perception, But Constantly Rolling Checks

In a mixed sensory profile, some areas of the body act like an over‑alert ranger who reacts to the slightest shift in the air, while others behave more like a distracted rogue who needs to be bribed with something more substantial before they bother paying attention. Sensitivity can shift depending on stress, burnout, hormones, or how many spell slots (spoons) you’ve already burned through just getting through the day. You might find that touch feels soothing in one spot, overwhelming in another, or suddenly it changes its entire attitude because your body decided to reshuffle its priorities like a party arguing over marching order.

Each profile offers distinct sensory intelligence. These different sensory builds deserve a massage approach that adapts rather than forces a standard template.

Why Neurodivergent Nervous Systems Respond Differently to Touch

Touch interacts with the nervous system in ways that are especially significant for ND adventurers:

• Masking and chronic tension:

Years of holding your body in “acceptable” positions can create armor‑like patterns of tension.

• Hypervigilance:

Unpredictable touch can quickly activate a fight‑or‑flight response faster than you can roll initiative.

• Interoception differences:

Many ND adults struggle to interpret internal signals — pain, pressure, temperature, or even emotional cues.

• Burnout and sensory fatigue:

When your nervous system is already taxed, even gentle touch can feel like too much input.

• Touch history:

Past negative experiences with healthcare, bodywork, or physical boundaries can shape how safe touch feels now.

(Pincus & Beller, 2025)

That’s why ND-affirming massage goes beyond technique, providing a sensory and emotional environment that supports the nervous system’s health and encourages relaxation. It’s about creating a sensory and emotional space where your nervous system can relax, feel supported, and find a sense of calm. An ND-affirming therapist plays a crucial role in this process by actively checking in with you throughout the session to ensure your comfort, explaining each step before it occurs, and inviting your feedback. They focus on building rapport to foster open communication and trust, so you feel safe expressing your needs and preferences during the session.

When looking for an ND-affirming therapist, look for someone who prioritizes consent and comfort. Consider asking questions like, ‘How do you incorporate feedback during a session?’ or ‘What steps do you take to ensure a supportive environment for neurodivergent clients?’ Green flags include responses that emphasize active listening and flexibility. Conversely, be cautious of therapists who dismiss your concerns or seem unwilling to adapt their techniques.

Common Touch Challenges ND Adventurers Face

These patterns show up again and again in my work with many neurodivergent clients — and naming them can help us feel less alone.

• The Paralyzed Problem:

Chronic bracing, clenched jaws, tight shoulders, and rigid posture from years of masking or anticipating judgment.

• The Stunned Status:

Unpredictable touch, sudden pressure changes, or unclear intentions can instantly spike overwhelm.

• The Failed Insight Roll:

Not knowing whether something hurts, feels good, or feels “weird.”

Not knowing how to describe sensations.

Not knowing how to ask for adjustments.

• The Burnout Debuff:

During burnout, sensory thresholds shift dramatically. What felt good last week may feel impossible today.

• The Failed Medicine check:

Many ND adults have been dismissed, talked over, or touched without consent in medical or wellness settings. This history matters, and it affects how safe touch feels now.

These challenges aren’t flaws. They highlight that being neurodivergent means navigating a world designed for different sensory systems, which brings unique experiences and requires different supports. Remember, your needs are valid and deserving of respect, and embracing them is an important step towards self-acceptance and empowerment.

(Vallet, 2026)

How Sensory Needs Change Across the Campaign

One of the most essential truths about ND sensory life is this:

Your sensory profile is not static. It shifts — sometimes daily, sometimes hourly, sometimes in just moments.

Here are a few reasons why:

• Stress and overstimulation

A day full of social interaction, noise, or unpredictability can lower your tolerance for touch.

• Hyperfocus posture

Hours spent in a single position can create tension patterns that change how your body receives

pressure.

• Emotional load

Grief, excitement, anxiety, or transitions can all alter sensory thresholds.

• Hormonal cycles

Many ND folks notice sensory changes tied to menstrual cycles, sleep cycles, or medication

shifts. (Stewart et al.,2018)

• Burnout or recovery

During burnout, any touch could feel overwhelming.

During recovery, deep pressure may feel grounding and stabilizing.

This variability is normal and part of your character build; your care should change as you do. Before your session, take a moment to prepare. Consider journaling about your current sensory needs, or bring comfort items like a favorite piece of clothing, a fidget toy, or a plushie. These steps can help you feel more grounded and in control. To make preparation easier, you could try creating a checklist or a reminder note that includes key tasks such as selecting comfort items, noting any changes in sensory needs, and setting goals for the session. Advocate for changes during sessions and communicate your preferences to create a more comfortable, beneficial experience.

After a massage, simple grounding practices—like deep breathing, holding a comfort object, or taking a quiet moment before re‑entering your day can help your system integrate the work and ease the transition back into the world.

Quick Recap: How ND-Affirming Massage Supports Your Build

Here’s a condensed reference guide that ties everything together:

Think of these practices as essential support tools that help neurodivergent nervous systems feel safer and more empowered during care. These practices build on the foundations from the first article—predictability, consent, and sensory‑aware care—and translate them into hands‑on support for your build. Think of this as a quick‑reference guide for how ND‑affirming massage helps your nervous system stay regulated and in control:

● Uses deep pressure and a slow, rhythmic pace to support proprioception.

● Honors your sensory customization to prevent overwhelm.

● Builds trust with a consent‑based structure.

● Facilitates flexible communication to keep you in control.

Together, these approaches help your neurodivergent nervous system feel safer, more grounded, and more empowered throughout care. If you’ve already read the first blog, this section acts like the practical follow‑up—where the core principles become something you can actually feel in your body. And if you haven’t read it yet, it offers a deeper look at why these strategies matter and how they support your sensory needs. (For a deeper look, check out my first blog post here)

A Call To Adventure

When your massage adapts to your sensory profile, you get care that truly fits you. ND‑affirming massage meets you where you are, not where society or the therapist thinks you ought to be. If you’re curious about exploring how sensory-aware massage can support your unique nervous system, you’re welcome to begin that journey here through an individualized consultation session tailored to your specific needs. Whenever you’re ready, you can set up camp here and rest.

I’ll take the first watch.

Book your consultation session today

References

Pincus, J. D. & Beller, K. (2025). Emotional well-being in neurodivergent populations. Frontiers

in Psychology. https://doi.org/10.3389/fpsyg.2025.1606232

Steward, R., Crane, L., Roy, E., Remington, A., & Pellicano, E. (2018). “Life is much more

difficult to manage during periods”: Autistic experiences of menstruation. Journal of Autism and Developmental Disorders, 48(10), 3583–3596. doi.org/10.1007/s10803-018-3664-0

Vallet, M. (2026). Creating Safe Space for Your Neurodiverse Clients. Massage Therapy

Journal.

https://www.amtamassage.org/publications/massage-therapy-journal/safe-space-neurodiverse-clients/