she/her
Lacey Cottingham
MSW, LCSW
Neurodivergent-affirming therapy for complex trauma, dissociation, and the things you've been told you should just try harder to overcome.
🟠 Limited Availability
Adults
Individual Therapy
Lacey Cottingham, MSW, LCSW, is a trauma and neurodivergent-affirming therapist in Durham, NC, specializing in complex trauma, autism, ADHD, dissociation, DID, overwhelm, and chronic patterns that can make everyday life and relationships harder to navigate. She also provides adult ADHD and autism assessments.
Meet with Lacey
Free 15-minute phone consultation · Eastern Time
In-person in Durham NC – Southpark
Statewide telehealth in Florida, North Carolina, South Carolina, Vermont
$200 per session - Limited sliding scale fees available
Therapy for When "Try Harder" Has Never Been the Answer
Maybe people have called you lazy, too sensitive, dramatic, or told you that you’re simply not trying hard enough. Maybe you’ve started saying those things to yourself too, even though you know how much energy it takes just to get through tasks, relationships, sensory overload, unexpected changes, and everything happening inside your own head.
You might shut down when you’re overwhelmed, lose track of time, dissociate, struggle to find words when your nervous system is overloaded, or go from calm to completely overwhelmed when something unexpected changes. Communication can feel exhausting when you’re constantly trying to figure out what a boss, professor, partner, friend, or family member expects from you.
Lacey works with autistic and ADHD adults, plural systems, people with DID and other dissociative disorders, and people carrying complex or long-term trauma. Her work starts from a simple belief: pain isn’t a competition. You don’t need to prove that what you’ve experienced was “bad enough” before you deserve to be taken seriously.
I help people with
Approaches I use
My Approach to Therapy
Lacey’s approach is trauma-informed, neurodivergent-affirming, collaborative, and paced around what your nervous system is actually ready for. Therapy isn’t about pushing you into difficult material before you feel safe enough to go there.
Many clients begin by building grounding, regulation, and coping skills from a body-based perspective. From there, Lacey may draw from Ego State Therapy, Internal Family Systems (IFS), Brainspotting, Somatic Therapy, and other trauma-informed approaches depending on what makes sense for you.
Her work recognizes that chronic trauma can come from many places: unmet childhood needs, long-term invalidation, ableism, marginalization, unsafe relationships, repeated microaggressions, and years of being misunderstood because your brain or nervous system works differently.
Lacey is also experienced in working with dissociation, DID, and plural systems. Therapy can move at a pace that respects your internal experience rather than treating it as something strange, dramatic, or inconvenient.
You remain in control of the process. The goal is not to make you tolerate more distress. It’s to help you feel safer in your body, understand your patterns with less shame, communicate your needs more clearly, and build a life that works better for you.
"Everyone keeps telling me I'm too sensitive, lazy, or not trying hard enough, but they don't see how much energy it takes just to get through the day. I'm tired of feeling like my brain and body are fighting me all the time."
You might be thinking
A Little About Lacey
Lacey has been practicing as a clinical social worker since 2018. She earned both her Bachelor of Social Work and Master of Social Work from North Carolina State University.
Her clinical work has developed a strong focus on complex and chronic trauma, autism, ADHD, dissociation, DID, plural systems, and the ways ableism and other social pressures can shape a person’s relationship with themselves. She is also available to help adults explore whether ADHD or autism may help explain experiences they’ve spent years trying to understand.
Lacey is a member of Ego State Therapy North America and continues to deepen her work with trauma, dissociation, and approaches that respect the different parts and experiences within a person.
Outside of therapy, Lacey enjoys proofreading science-fiction and fantasy, crocheting with alpaca yarn, long-play and Let’s Play communities on Twitch and YouTube, and video games. She grew up with Sonic, Mario, Animal Crossing, and Ratchet & Clank and now tends to gravitate toward indie games.
Professional Credentials & Training
- Licensed Clinical Social Worker (LCSW), North Carolina License #C014689: North Carolina Social Work Certification and Licensure Board
- Ego State Level 1 Trained, issued August 2022: Ego State Therapy North America
Articles by Lacey
Our Commitment to Training Future Therapists
Meet the Origins internship program: how supervised graduate students help, what sessions cost on a pay-what-you-can scale, and how to book.
Ego State Therapy
Ego State Therapy sees you as a team of parts rather than one fixed self. Learn how it works, who it helps, and how it differs…
Motivation and Elephants
When you can’t start or finish things, it isn’t always laziness. Meet five “elephants” that stall motivation, and how to work with them.
Finding a Therapist
Choosing a therapist is personal. Get practical questions to ask, places to look, and ways to tell whether someone is the right fit for you.
The Dangers of “See that wasn’t so hard!”
Why “see, that wasn’t so hard” can backfire for autistic and ADHD people, and what to say instead when someone gets through something difficult.
2 Things Right, 1 Thing to Improve
Struggling with a routine? Try the “2 things right, 1 thing to improve” exercise to borrow what already works in your day and apply it where…
