top of page

Leila Pirnia

Dually Licensed Psychotherapist | Autism, AuDHD & Relationship Specialist

Leila Pirnia Headshot 2026.png

At A Glance

  • Dually licensed psychotherapist in California (LMFT and LPCC) specializing in autism, ADHD, AuDHD, giftedness/twice-exceptionality, executive functioning, anxiety, OCD, and relationships
     

  • Works especially well with highly analytical, high-achieving, and late-identified autistic or AuDHD adults trying to better understand themselves and how they relate to others
     

  • Particular expertise in relationships, emotional regulation, executive functioning, rejection sensitivity, masking, burnout, and the impact of neurodivergence on work and family life
     

  • Founder and Clinical Director of the Center for Twice Exceptional Counseling
     

  • Integrates Internal Family Systems (IFS), psychodynamic and attachment-oriented therapy, CBT, ACT, DBT-informed work, family systems, and practical executive-function interventions
     

  • Former technology and business executive, with a Bachelor of Science from MIT and Master’s in Clinical Psychology from Pepperdine University
     

  • Trilingual in English, Farsi (Persian), and Spanish

You May Understand Autism Better Than You Understand Yourself

Many autistic men come to therapy after spending years trying to figure out why certain parts of life seem harder than they “should” be. You may be successful at work and still struggle to initiate ordinary tasks at home. You may understand complicated systems easily but have trouble knowing what someone close to you is feeling, or even exactly what you are feeling yourself.
 

You may want connection but find relationships exhausting or confusing. You might replay conversations afterward, trying to determine what went wrong. Or perhaps people have repeatedly told you that you seem distant, defensive, rigid, overly logical, insensitive, or difficult to read when none of those descriptions match what you experience internally.
 

Some of my clients have known they were autistic for years. Others have only recently been diagnosed or have begun wondering whether autism or AuDHD might explain patterns that have followed them throughout their lives. Either way, I'm interested in more than the label.
 

I want to understand how your particular mind works, what has helped you succeed, where things repeatedly break down, and what you want your life to look like from here.

Knowing Yourself

Therapy That Doesn't Ask You to Become More Neurotypical

I don't see autism as something we need to “treat” out of you. At the same time, being neurodiversity-affirming doesn't mean pretending that everything is easy or that there aren't things you may genuinely want to change.
 

You may want to communicate more clearly with your partner or become less overwhelmed when plans change. Maybe you want to understand emotions sooner rather than after you've already shut down or follow through more reliably on things that matter to you, and recover from conflict without disappearing for two days.

Building friendships, dating, and advocating for yourself at work could be on your agenda. And generally stop organizing your entire life around avoiding situations that feel uncomfortable. Those are worthwhile goals.
 

The question isn't, “How can we make you act more neurotypical?” It's, “What would make your life work better for you?”

Relationships Are Often Where the Differences Become Most Visible

Relationships are one of my primary areas of specialization. Many autistic men tell me they care deeply about their partner but feel bewildered by the amount of conflict in the relationship.
 

You may hear that your partner doesn't feel emotionally connected to you even though you love them enormously. You may think you've answered a question clearly only to discover that your response felt dismissive. When conflict becomes intense, you may need distance in order to think, while your partner experiences that distance as abandonment.
 

Or you may feel as though you're constantly being corrected, criticized, or told that you're doing relationships incorrectly. Eventually both people can become defensive.

Because I work extensively with neurodiverse couples as well as autistic individuals, I'm particularly interested in helping clients understand what happens between people rather than simply teaching social rules.
 

We can look at a specific interaction and ask: What did you experience? What did your partner experience? Where did the meaning diverge? What happened inside you when the conversation became emotionally charged? And what might help the two of you communicate across that difference next time?
 

The goal isn't to teach you to perform empathy correctly, instead it's to help you become better able to understand and communicate what is actually happening inside you while also making more room for someone else's experience.

Late Diagnosis and the Question of “Who Am I, Then?”

Learning that you're autistic or AuDHD as an adult can make many pieces of your life suddenly make sense. It can also raise new questions.
 

How much of what you've called anxiety, introversion, perfectionism, laziness, sensitivity, stubbornness, or social awkwardness was actually neurodivergence? How much energy have you spent learning to appear comfortable when you weren't?

Which parts of the person you've become are genuinely you, and which developed because you learned that certain parts of you weren't well received?
 

For some people, diagnosis brings enormous relief. For others it comes with grief, anger, uncertainty, or a desire to reinterpret large parts of their history. Therapy can give us somewhere to do that without requiring you to immediately turn autism into either a tragedy or a superpower. It's simply an important part of understanding you.

When Being Capable Doesn't Mean Everything Is Easy

I particularly enjoy working with gifted, twice-exceptional, and high-achieving adults. One of the confusing things about neurodivergence is how uneven ability can be. You might manage a team, write sophisticated software, practice medicine, teach at a university, or build a company, and still struggle enormously with paperwork, transitions, time management, household tasks, emotional conversations, or getting started on something you've been avoiding.
 

Other people may look at your accomplishments and conclude that you could do these things if you tried harder. You may have concluded the same thing. I find it more useful to understand what actually changes your capacity: interest, structure, urgency, sensory environment, anxiety, perfectionism, working memory, emotional state, predictability, or the nature of the demand itself.
 

Once we understand the mechanism, we can stop turning every difficulty into a character judgment and start figuring out what might actually help.

Masking, Burnout and Living at the Edge of Capacity

Many autistic adults become extraordinarily skilled at compensating. You may have learned to prepare for conversations in advance, observe other people closely, suppress sensory discomfort, imitate social behavior, work harder to compensate for executive-function problems, or simply push through exhaustion because that is what life seemed to require. “White knuckling” your way through life.
 

Those strategies may have helped you build a successful life. They can also become very expensive. Sometimes what looks like depression, withdrawal, loss of motivation, irritability, or “not functioning like I used to” is occurring in the context of a life that has required more compensation than you can sustainably provide.
 

When that happens, I'm interested in both sides of the equation: what can you build capacity for, and what no longer makes sense to demand of yourself in the same way?

How I Work

My style is engaged, curious, practical, and fairly direct. You don't have to come to therapy already knowing how you feel or knowing what you want to talk about. In fact, if questions like “How does that make you feel?” mostly make your mind go blank, that's useful information too.
 

We can work more concretely. Tell me what happened. What did you notice in your body? What thoughts were going through your mind? When did you first want the conversation to stop? What did you think the other person wanted from you? What happened next? Sometimes we work from the outside in. The emotional understanding comes later.
 

I also don't believe insight and practical problem-solving are opposites. We may explore an old protective pattern through Internal Family Systems or psychodynamic work in one session and design a concrete executive-function system in another.

The question is always: What does this particular problem need?

Work, Achievement and Executive Functioning

Before becoming a psychotherapist, I spent many years in technology and business leadership, including roles as president, CFO, COO, and founder. That background is useful in my work with engineers, physicians, executives, founders, academics, attorneys, and other professionals.
 

I understand workplaces built around performance, ambiguity, politics, deadlines, competition, and increasingly complex interpersonal demands. I also understand how someone can be highly competent professionally while devoting an enormous amount of invisible energy to appearing as though everything comes naturally.
 

Our work might involve executive functioning, perfectionism, difficult colleagues, burnout, leadership, career transitions, communication, imposter feelings, or simply figuring out how to structure your work around the brain you actually have.

You Don't Need to Have Everything Figured Out Before You Start

You don't need a formal autism diagnosis to work with me. You also don't need to arrive with a neat list of therapy goals. You might know only that you're unhappy, your relationship isn't working, you're exhausted, you feel stuck, or you've begun seeing yourself differently since learning more about autism or ADHD.


That's enough to start with. We can figure out the rest together.

Clinical Background

For the past several years, I have worked closely with Dr. Harry Motro and the New Path Therapy Centers, one of the earliest practices devoted specifically to neurodiverse couples, receiving ongoing specialized training and consultation while treating autistic, ADHD, AuDHD, and otherwise neurodivergent adults and couples.
 

This work has included ongoing clinical training and consultation focused on the ways neurodivergence affects relationships, communication, emotional processing, executive functioning, intimacy, conflict, attachment, and family life.
 

My approach has been shaped by years of working directly with neurodiverse couples and individuals whose difficulties often do not fit neatly into traditional relationship or psychotherapy models. I have particular experience helping clients understand the difference between a neurological difference that may need accommodation, a skill that can be developed, and a relational pattern or accumulated injury that needs to be addressed more directly.
 

I am also Founder and Clinical Director of the Center for Twice Exceptional Counseling, where I work with gifted and twice-exceptional people whose high cognitive abilities coexist with ADHD, autism, anxiety, executive-function challenges, emotional regulation difficulties, or other areas of neurodivergence. This work has given me particular appreciation for the unevenness that often accompanies neurodivergence, and the fact that someone can be exceptionally capable in one area while genuinely struggling in another.
 

I integrate this neurodiversity-focused training with a psychodynamic and depth-oriented foundation, Internal Family Systems (IFS), attachment and family-systems approaches, CBT, ACT, DBT-informed work, and practical executive-function interventions.
 

Earlier in my clinical training, I worked in community mental health and as a school-based mental health therapist with children and adolescents, and I served as a Graduate Research Associate at Pepperdine University.
 

I live in Los Angeles with my husband and two children. You can learn more about my background, clinical work, and areas of research and interest at Pirnia Therapy

Other Areas
of Focus

  • High Achievers

  • Tech Executives, Corporate Executives

  • Midlife and Life Transitions

  • First Generation, Immigrants and Children of Immigrants

  • Trilingual: Farsi (Persian), Spanish, and English

Clients
 

  • Individuals

  • Couples

  • Families

  • Teens

Modalities
 

  • Psychodynamic/depth-oriented psychology

  • EFT (emotion focused therapy for couples)

  • IFS (internal family systems)

  • CBT (cognitive behavioral therapy) including ACT and DBT

  • Family Systems Dynamics

  • Solution focused therapy

Education & Licensing
 

  • Bachelor of Science, Massachusetts Institute of Technology (MIT)

  • Master of Arts in Clinical Psychology, Pepperdine University

  • Dually Licensed Psychotherapist in California

  • Licensed Marriage and Family Therapist (LMFT #150408)

  • Licensed Professional Clinical Counselor (LPCC #19451)

  • Member of Psi Chi, the International Honor Society in Psychology; member of the California Association of Marriage and Family Therapists (CAMFT)

bottom of page