Adult diagnosis: do doctors really know what they are doing?

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I'm pretty sure this is not actually the case.
You can see this on his website now:

http://www.tonyattwood.com.au/index.php/about-aspergers

This does not say anything about the worth of the individual with aspergers. It is not a reason to feel worthless.

No, diagnosis has always been impairment-based, not identity-based, but some people seem to desire that it be identity-based when they would not be diagnosed or are not referred for assessment otherwise.

I think that some think others haven't suffered as much as they have and become defensive -- those who haven't suffered as much much be fakes, they think. Others are probably lost in the desire for black-and-white truth.

For the former, there are 2 obvious problems: not everyone talks about their bad times even if they've lasted for decades, and the human brain naturally makes all sorts of half-assed assumptions to fill gaps in incomplete information. I.e. someone here once thought I was a college physics professor because I talked about physics more than much else (I think it was that, anyway). I have a BA in physics, been on $486 SSDI for the last 10 years, and never had a salaried/professional job. And, forget relationships, friends or the like, but I don't talk about that stuff.

Also, I hate to say it, but life experience in world matters. Many things I thought when I was in high school I know to be false, now. And, it may actually be cool to seem to have depression or bipolar in high school, but the reality is that most adults find it very important that they aren't diagnosed with anything that's in a book with the words "mental disorders" in it's title. And, if a neighbor or coworker is, they're probably not going to like it (and will gossip or maybe even call child protective services or some other loathsome thing). Maybe it's cool in Silicon Valley or at the 'skunkworks,' but for the rest of adult world it isn't.

If a diagnosis is "identity-based," it's an erroneous diagnosis.

I find that a ridiculous concept, frankly.

The psych report includes many references to social impairments including: “long history of social discomfort”, “lack of social awareness”, “weak social skills”, “lack of social or emotional reciprocity”, “impaired social perception”, “non-automatic social perception”, “family history of social ineptitude”, etc.

Yet, from my perspective, the social stuff is not currently my biggest problem. Rather, my biggest issues are with obsessive worry and dysphoria.

I suppose, when I was younger, I used to lament about my inability to be “normal” socially. But, I have since accepted who/what I am (just like I have accepted that I will never be good at athletics). Which is why I wrote (earlier in thread), that I would never say my impairments in social interaction cause me problems.

With that being said, I can imagine a situation when the social stuff could, again, become the bigger issue. Oh wonderful. Something new to worry about.

As much I as like Attwood he is covering his ass on that one. Impairment is a wholly negative term. Attwood usually starts off by saying 'Congratulations,you have Asperger’s syndrome" and often emphasizes the positive elements and deemphasizes the negative. He nearly 100% of the time uses the term "Aspie" which is an identity based term.

Getting back to impairment while basing a diagnosis wholly on negatives should not decide a persons worth IRL it is pushes some people to feel that way or more strongly that way.

My dad (def asp), who got alzheimer, as was said. We(children) would have wanted exams, because he was exposed to toxics during all his life, and we too, for that matter, well his neurologist couldn't be bothered.

In my experience, yes.

Presumably by those who desire little or no social interaction. Such people do exist.
However those who desire social interaction can find that their quality of life is hugely impacted (in a negative way).

The short answer is no. Not really.
I work in health care and I have an autism diagnosis and I have learned 3 truths
1. There is no such thing as a normal person
2. Having/ not having a diagnosis of something doesn't mean the thing isn't there and doesn't change the symptoms.
3. Doctors are also just people. Sometimes they make mistakes. Sometimes they just wing it. Sometimes it all works out.
You know more about your autism than any professional who is paid to know. Sod other people and their thoughts.

Until told about it, I knew nothing about my autism.

"Yeah, I'm fine at socializing, I just don't want to do it." (I didn't want to do it, but that's beside the point.)

I know more about Asperger's than any professional. NTs can't understand it and they think it's an illness that can be cured. Therefore, doctors recommend talk therapy for improving social skills, unaware that it's ineffective.

I agree, we are all winging it some of the time, including professionals who are asked to make decisions from limited info and with an incomplete and ever changing diagnostic toolkit.

Re Impairement based diagnosis = all well and good........ except:
today I`m fine, yesterday I was not........ oh what a shame... today was the day I went to be assessed, never mind eh..
I`ll just go home and shut up, stop complaining, just keep struggling on for the next 30 years with no inkling as to why some things are so difficult for me.

Re labeling ... in spite of certain inferences here, these difficulties are not a game I play for fun, I don`t want a label because I think it is cool..... what kind of idiot would want that!

As mentioned, a diagnostic label for me would give me an opportunity to explore and develop myself on my life`s journey rather than be sitting in the dark thinking that 40+ years of failed social interactions means I am simply a messed up human. We should be careful not to disparage this approach
I have tried so hard for so long to change and I don`t seem to be able to do it.... so this is where a label comes in as a positive explanation/anchor/frame of reference and could at least help me have some peace of mind and start on the road to `acceptance`......

Perhaps the real acceptance for people like me is to not actually expect a clear and helpful answer at all as there isn`t one...................... just do my own thing and label myself in any way that is useful to my self development.

Generally, disability is based on your best, as it's expected you'll fluctuate.

No.

Think about it.

Disability is based on your not being able to do things on average--on what is typical for you.

It's not about your edge case performances, but your typical performance. Your worst and best days don't count unless they are similar to most of your days.
Just because you once or occasionally got through a conversation, this doesn't mean you can engage on conversation with normal social reciprocity. Just because you once were at a loss for words doesn't mean you are nonverbal.

Sorta. Your behavior will always average out and be taken into account, but:

Your highest point must meet whatever is defined as disability for that condition (autism in this case). If your highest point exceeds that, then it's shown that you're actually capable of something above the disability and you probably don't have that disability.

If I were to say, some days I can reciprocate social and emotional verbal and nonverbal cues in a passable manner, but some days I can't, you wouldn't say I have autism. I'm going to have to fail at that to whatever extent is defined for autism (a failure at it means I can't do these things in a passable manner ever).

Hence, your highest point decides these things.