My shrink says that I "might" be on the spectrum,

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I tried to get a firm diagnosis of AS from my shrink. At least, I wanted his opinion one way or another. No surprise, he avoided the issue as he usually does with such questions.

When I brought the issue up, he asked me to talk about why I thought I had AS. I talked for a half hour about my social problems, the various symptoms of AS that I have. His final conclusion: different people have different social abilities. My difficulties could come from different sources. I might be on the spectrum.

He's actually pretty good, and has helped me with a lot with my depression. He just evades the issue when I ask for a firm diagnosis. I think that he doesn't like labels. Sigh.

That's really frustrating when having diagnostic labels has an institutional impact: ADA protection, possible accommodations in education. It can also have a negative impact with regards to insurance (although this should be illegal soon? The reform is so toothless it's hard to say).

But withholding a diagnosis out of a desire to avoid labels strikes me as profoundly disingenuous and potentially harmful to patients. I can see avoiding some for the aforementioned negative outcomes (if I were a psych I would be extremely wary of diagnosing anyone with a personality disorder, for example), but I think that such avoidance should come with a lot of discussion with the person primarily affected - the patient, who is also a paying customer.

It sounds like his justification is also very slippery. I am not sure if it will help, but I liked the advice I got in my thread about my therapist: Go through a book like Tony Attwood's complete guide, highlight the stuff that you identify with, and write something up for him to read with references.

In Australia, we have the Autism Association which you can self refer to for assessment. I wonder if that is an option where you live. In my experience with psychologists they tend to work more on how to deal with certain issues rather than actually "diagnosis". I also found it very frustrating. I have felt for years that there is something "unusual" about my husband. The psychologist has pretty much given up. Saying to me that he is extremely rigid in his ways of thinking and appears to have no motivation to change these. When she tries to discuss relevant issues with him, he has a way of reverting all topics back to his favourite subjects. I also think that some psychologists are specialised in areas of autism and others are not. The psychologist you are seeing may not have had a lot of experience with aspergers and therefore does not feel qualified to make that "diagnosis". I would look to get a referral to another psychologist who specialises in this area.

forgive me if I'm wrong, but don't you need to see a psychiatrist, rather than a psychologist, to get a diagnosis? It could just be that he isn't qualified to give you the diagnosis or the tests or whatever. Maybe talk to him about getting a clinical diagnosis, with someone he could recommend. If not, look into places nearby. My mom had to search for ages to find someone qualified to test my brother for dyslexia, so it could just be there is a shortage of people who know how to work with aspies in your area. I was lucky and found a great psychiatrist close by with a recommendation from a family friend.

Clinical psychologists can diagnose, and are generally much better educated on mental health than psychiatrists. Psychologists typically cannot prescribe medication, although there's a movement in the states so they can get the education and qualifications to prescribe medications.

Thanks for the feedback. In truth, I got pretty much what I expected from the session, though I was hoping for a bit more. At least I got some assurance that I'm not totally wrong. My problems could stem from some ASD.

The label won't have much effect on me, though I really would like the assurance that I'm exploring something useful. I was also hoping to get some sort of referral to some Aspie specific support groups. ADA is not an issue, because I can function well enough in the workplace; it is my personal life that is a disaster. Education is not an issue. I'm already over-educated, and unlikely to seek more.



This makes sense. I think that for my next session (in three weeks), I will have a specific list of symptoms, and will be be prepared with exactly what I am looking for.



There is something similar in the United States. I've been exploring their resources too. My experience mirrors yours. My shrink tend to work on certain issues and doesn't really diagnose unless it is absolutely necessary. I think that getting a referral to an expert on AS would be a good thing. I was hoping to get one during this session, but my therapist sidetracked me into exploring the reasons why I thought I had AS.



My shrink is a psychiatrist. I was just using "shrink" in a generic term, because he does do therapy with me. He also prescribes drugs. I think that may be part of the problem, because he tends to focus on disorders that can be treated by medication, and AS is not treatable by medication. I think that I really need a psychologist who specializes in developmental disorders.

Again, thank you all for your feedback. I think that I will make one more attempt, and I will try to be more specific about what I want, and push harder for a recommendation to a specialist. It may be time to move on. I am reluctant to do so, because I have had a good working relationship with my shrink, but I am beginning to think that I have reached the limits of what he is capable of doing.

Well, at least he sounds open to the idea of you having AS instead of shutting you down right away.

I'm sure the more you discuss things with him, or even bring in some testimony from others, the more he will; understand.

A shrink can just diagnose you without any kind of testing?

My old shrink (who I'd been seeing for years ahead of time) told me he was almost certain I was AS. I didn't bring it up to him, he just told me that out of nowhere. But he told me he couldn't diagnose me and referred me to someone who could. I never saw that reference because I was moving shortly thereafter, I still wish I could have done that.

I hope so. I've gotten some good suggestions and I have some ideas of my own, so maybe things will work out.

It's different in every country.
In Australia only a psychiatrist can diagnose autism and other such disorders.
I have to road trip every time I see my psychiatrist. I call him my ADHD doctor.

The "testing" procedure for autistic spectrum disorders just requires observation and interviews. There are no real diagnostic tests. So, in principle, any shrink with sufficient training can diagnose you. I knew that my shrink did not specialize in the subject, so I wasn't expecting a formal diagnosis. I was just hoping for something a little more definite, something along the lines of what you got.

Also, there is no standardized protocol for assessments. I.e. Some professionals may require neuropsych testing (WAIS), or interviews of relatives, and others may not.