Introduction/Advice Request

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Hi all,

I found this forum a couple of weeks ago now, and I've been lurking for a bit, so I thought it was about time to make the obligatory introduction post

My name is Jason (42yo, he/him), I've been diagnosed with ADHD, and I also strongly believe that I'm Autistic (although I don't yet have a diagnosis). I've started to believe that getting an Autism assessment might be a good idea for me, and was hoping in part to get a bit of advice and perspective from other neurodivergent individuals over what to do.

The main problem I have is a very strong aversion to talking with strangers on the phone. This problem is unique among my family and peer group, and while some friends and family are willing to make this accommodation when communicating with me, many others are not. This in fact led to me losing my job, as the job changed to include frequent and numerous phone calls, and the company was unwilling to accommodate me as they felt it would be unfair to my coworkers.

The general consensus among my family and my therapist is that this is some type of phobia that I've been reinforcing through avoidance, and my therapist has been getting me to work through exposure therapy. I did what he said for a while, although I didn't feel like it was at all getting easier, and the other suggestions he was giving mostly involved getting out and getting new experiences, which didn't feel like it was going to help. Ultimately, in our most recent session, I mentioned my belief that I was Autistic (not for the first time), and he immediately challenged my belief by saying that he didn't think I was Autistic because I could make eye contact (big cliche, I know), and because I would have been identified as a child.

I'm sure many of you can understand the feeling of hearing something like that from a therapist, so I won't go into too much detail here, and I'll just say that I had a rough couple of days after that session. Once I was feeling more up to it, I remembered that there was a book I came across while researching Autism, "The Autistic Survival Guide to Therapy" by Dr. Steph Jones, and decided to get the audiobook version and listen to it on my morning walk. I listened to it over a few days, and it not only reaffirmed my belief that my therapist was using invalid stereotypes; but it also supported my feeling that exposure therapy, and getting out and doing more things, weren't right for me.

And that's kinda where I'm at right now. I feel like I need an official diagnosis just to get people to take an accommodation which I feel I need seriously, but they are expensive, are only available where I live by paying with private insurance or paying out-of-pocket, and I simply cannot afford one on my own. I feel like I might be able to get the money from certain family members, but given how others have reacted when I've tried to talk about this I'm a bit hesitant to reach out and broach the subject. I feel like I've been caught in a bit of limbo for a week now, overthinking and overanalyzing what to do, and I don't really have anyone to go to for advice on this. And after an incredible number of rewrites, I've finally decided to post this and reach out.

So, that's my situation, and any advice you can give would be greatly appreciated. I never really know how to end a post, so I'm just going to leave it here before I overthink my way into not posting

Cheers,
Jason

Welcome to Wrong Planet!

I don't have much advice since I was diagnosed as a child (unlike a lot of my generation and practically all of yours). The only thought I have is that your therapist is clearly an idiot and you'd probably be best off finding a different one, but I'm sure others will have better advice. Good luck.

Hi Jason,
Welcome to WP.
You're not alone in hating the phone and for me it's not just with strangers.
That therapist doesn't seem to get the idea of a spectrum.
I am quite capable of making eye contact, at least for a few seconds, although it's rather discomforting and I have to defocus to maintain it. I had a psychiatrist offer to confirm my self diagnosis (last year) but there didn't seem much point at my age.
The only advice I'll offer is this.
Stuff 'em... You do you.

Welcome to WP! I hope you decide it is a good place for you.

Are you Autistic? We can't tell you that, of course. I recommend this online quiz: AQ. It might reinforce your suspicion, or suggest that you should research other possible explanations.

Hi Jerrian, Welcome to Wrong Planet.

You wrote, My name is Jason (42yo, he/him), I've been diagnosed with ADHD, and I also strongly believe that I'm Autistic (although I don't yet have a diagnosis). I've started to believe that getting an Autism assessment might be a good idea for me, and was hoping in part to get a bit of advice and perspective from other neurodivergent individuals over what to do.

Many children are diagnosed during their school youth because they have problems that are very visible. But once a person reaches adulthood, they are set adrift. There are many online test available that can provide an unofficial diagnosis. Many of these test are free.

You then went on to describe one of your current problems. The main problem I have is a very strong aversion to talking with strangers on the phone.

That is an interesting problem. It leads me to ask a question. Does this problem occur with both Talking on the Telephone and also Talking when you can see the individual you are communicating with on a Cell Phone? Modern technology allows you to see an image of the person you are communicating with. Does this help?

I did a quick search on the internet in Wikipedia and came up with this article:

Telephone phobia (telephonophobia, telephobia, phone phobia) is reluctance or fear of making or taking phone calls, literally, "fear of telephones". It is considered to be a type of social phobia or social anxiety.[1] It may be compared to glossophobia, in that both arise from having to engage with an audience, and the associated fear of being criticized, judged or made a fool of.

Sufferers may have no problem communicating face to face, but have difficulty doing so over the telephone.

As is common with other fears and phobias, there is a wide spectrum of severity of the fear of phone conversations and corresponding difficulties. In 1993, it was reported that about 2.5 million people in Great Britain had telephone phobia. A 2019 survey of UK office workers found that 40% of baby boomers and 70% of millennials experience anxious thoughts when the phone rings.

This youtube discussion may explain the problem.



He refers to it as Social Anxiety Disorder.

Hi!

I'm in no position to give advice, as I'm also trying to figure out the best ways to treat my anxiety-related issues and disentangle them from possible autistic traits. But here are some thoughts to consider:
- Do you think this phone aversion is caused by anxiety alone? Or is it that you don't know when or how to talk etc., and this in turn causes anxiety? In the second case exposure therapy likely isn't the best choice. But I know it's not always easy to say what's what.
- Generally, exposure therapies are considered very effective, but, as with all treatments, they don't work for everyone. It might be related to autism (I've read CBTs in general are much less effective for autistic people), but it might be for other reasons. I attended exposure therapy for my OCD. This therapy is seen as one of the most effective treatments in psychology, with about 75% participants having significant improvements. But there is the remaining 25% for which it isn't as effective, and apparently I'm in this 25%. Why? Maybe because I just wasn't able to expose systematically enough, maybe something related to autism, maybe something completely different.
- Do you believe your therapist has enough experience to provide exposure therapy (preferably, is he a certified CBT therapist)? It shouldn't look like he just says "yo, expose yourself" - it should be gradual (starting from exposures which don't cause too much anxiety) and systematic. And, what's most important, do you want this kind of therapy? If not, a therapist shouldn't force it on you.
- Do you trust your therapist in matters other than autism? Just a general truism - if you don't trust him and don't see positive effects of a therapy, it's better to find another therapist. And from what you've written, it seems like he lacks basic knowledge, at least in the topic of autism.
- Do you think you would benefit more from a diagnosis itself or from a therapy with someone who has experience with autism? Maybe there are some therapists specializing in this area (or maybe even autistic therapists) and maybe it would be better to spend money on a good therapy instead of a diagnosis? What do you need more - a possible explanation and validation of your problems, which you can get from a diagnosis, or the ways to cope with specific problems, which you can get from therapy?

But in general I don't know anything. Would be nice to be able to scan one's brain and see what's what Good luck, I hope you'll find out what's best for you!

Thanks for all of your responses so far

I'm going to do my best to go back and answer all of your questions when I have the mental bandwidth.

In terms of online Autism tests, I should have mentioned, I've done a few in the past, and they've always indicated likely Autism. I don't specifically remember doing the AQ previously (although it looks familiar), but doing it just now I got 36 (significant Autistic traits).

As you noted, an AQ score of 36 indicates significant Autistic traits.

Specifically, the AQ score I received was accompanied by two details:
▫ Your score is out of a possible 50
▫ Scores in the 33–50 range indicate significant Autistic traits (Autism)

It sounds to me like you are unofficially on the Autism Spectrum.
To be any surer I guess you'd need a formal Adult Autism Assessment by a licensed psychologist who works with Autism and agrees to assess you.

By the way, after AQ said I had significant Autistic traits I was convinced it wasn't my imagination so I got an Adult Autism Assessment. It was kind of fun!

If you get an Assessment it would almost certainly be from a licensed psychologist. I imagine that in addition to the assessment they would offer and/or recommend whatever other services they thought might help you.
▫ But I don't think they can force you to accept the other services
▫ And, after doing your assessment, they would have the benefit of knowing you are Autistic.

Whatever you decide, I hope you continue visiting WP. (And, if you are willing, tell us how things go. It might be useful information for anyone else who finds themself in a similar situation.)

welcome

I had trouble for years with phone and "real time/in person" conversations and never had a clue that my troubles were neurological in nature. It seems I have only 35th percentile auditory processing, so I miss most of what is said in real time. I read and write for best and most reliable interactions, I may hear perfectly everything that is said, but once I hear it, what my brain does to those words is 65 percent lost due to my inability to process what I hear. Could be that "real time" interactions may be a struggle because your processing , like mine, may not be capable of keeping up with conversations on the phone or "in person". I have always had trouble with lectures, videos, group gatherings/ meetings/ presentations.

If I write down what I hear, I can read and process it, so I take lots of notes and always appreciate charts, graphs, brochures and information sheets in printed form. I was stunned when I found out about my poor visual and hearing processing but it explained why I had always struggled, constantly being told I was not paying attention, not listening, etc. Nope, it was my neurology all along. What a relief.

It has not made life any easier, except that I have stopped trying to force myself to participate in "real time" things, from gatherings, lectures, concerts, presentations, movies, plays, and so much more. It has stopped a lot of the misery and confusion in my life.

Reading and writing are the main ways I interact with my world for best understanding. Forums like this are perfect for me. Even texting or messaging and especially face time using cameras and real time conversation over the internet are too demanding. At least I know why I have struggled all these years and I can forgive myself for failure to perform as expected.

I find it interesting that, back in the days of landline only, not answering the phone was unthinkable, yet I had far less reluctance to engage.