Occupational Therapy for an Adult: Me!?!?

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So, for the past 7 months, my psychologist has been urging me to see an Occupational Therapist, because for someone who's so supposedly "high-functioning", I have sensory integration, processing, and motor function problems one would expect in the most autistic of autists. She actually found an OT willing to work with an adult, and I met with this person a while back. She seemed nice enough.

My problems are myriad and pervasive. I have a lot of difficulty understanding speech, but have developed coping mechanisms for that(mostly running probabilities for what that person is most likely to have said). I have hypersensitivity to touch, sound, sights, and smells. I get lost even in familiar places, I stumble into walls, and have very little sense of depth perception and distance, which makes stairs a nightmare and driving a car nearly impossible. I have fairly significant prosopagnosia, and cannot tell people apart more than half the time, if that. Facial expression are divided into "smiling" and "not-smiling" for me. To give an idea of how clumsy I am, I didn't really walk until I was almost three years old, and had to CRAWL up and down stairs into my TEENS.

The other side of this: I'm a full time student with a 3.9 GPA. I'm gainfully employed and have been for more than five years. I have a group of friends (several on the spectrum) and a fiancee I love very much. The mitigating factors:
-I'm an incredibly determined person with clearly defined goals.
-My IQ is estimated to be somewhere between 138 and 167 and I'm willing to apply it to social and cognitive issues.
-i'm nearly 30 years old and have had time to "work on myself".

My resistance to Occupational Therapy is something i've been wondering about, and in my recent appointment with Psychologist, I finally broke down and cried.

I'm so. tired. of being. MEDICALIZED.

I'm sick to death of being poked and prodded, and given medication I don't need. I've had seriously dehumanizing and traumatic experiences with doctors that span my whole life. Even the decision to go back into therapy a year ago was fraught with pain and indecision, and connected to receiving services (only for my foreign-language class, and needed audio typed out!) at my college. I will freely admit to being almost mortally afraid. Functioning at this level is incredibly difficult, but the rewards are great. I feel good about myself for the first time in a long, long time. I'm PROUD of myself! I don't want some doctor telling me all about the things I can't do, will never be able to do, and how limited I am. I REJECT IT.

My question is this: Am I being unreasonable? Is my fear causing me to reject something that could potentially be helpful? I've pretty much told my therapist i need even more time to think about it.

I can relate to that kind of fear, and it sucks that you have to deal with it. I have also had horrible experiences with doctors and other helping professionals--I can't say that my experiences were anything like yours, but they scarred me.....

The last time I had an injury that actually hurt enough to make me wonder if I'd broken a bone, I didn't go to the doctor for days. When I finally realized the pain wasn't getting better, one of my friends had to take me to get medical attention. We sat on the grass near the parking lot of a community clinic for hours as I hyperventilated and my friend tried to remind me that I was safe....that they would just take some x-rays, give me a cast if necessary, and then let me go. There was a time in my life when I just wouldn't have gone to see a doctor at all--not for anything....if someone had tried to force me anywhere near a doctor's office I would have reacted by hysterically screaming (stating my refusal) and running away or hiding.



Good on you for giving yourself time.

I don't think you're being unreasonable--I think your fear and your hesitance are totally understandable (you have reasons for how you feel).

However, I do think that your fear might be preventing you from pursuing something that could be helpful. If you can, I do think it might be worth it to give occupational therapy a chance at some point--or maybe to find out more about what the OT you met actually does, if you don't feel you have a good idea of it already (i.e. the kinds of therapy she uses for different issues, her philosophy). Of course, it's up to you to decide if it would indeed be worth it, but I'll tell you what my opinion is based on:

OT's are all about what people can do. My OT tells me far more about what I can do than what I can't, and when she explains what I can't do or seem to have difficulty with, she does so with the intention of helping me devise coping strategies or explaining how a therapy activity will help me overcome current difficulties/limitations. (Or to normalize my experience....e.g. "Lots of people on the spectrum...") She jokes about being extremely demanding because she doesn't easily accept the idea that I truly can't do something.....I think that most OT's would be like this, from what I've read.

Having said that, though, my OT has never pushed me to do anything I find too overwhelming or unpleasant. For example: the Wilbarger brushing protocol (she had me try it once and when I reacted very badly she reassured me that I didn't have to brush my skin...and furthermore said that I shouldn't brush my skin if I found it horrible--she explained that the goal is to help people feel better, so to overwhelm them is counterproductive); and auditory integration therapy--I freak out over certain frequencies and couldn't stand listening to the music with the bone conduction piece on.

I have global sensory processing dysfunction: my vestibular system is extremely sensitive, I have dyspraxia, hypersensitivity to sound, light, touch and smell, and don't register proprioceptive input very well.....currently, working on my vestibular processing is a huge focus in my OT sessions, and it has improved with therapy. I've also learned some good strategies for calming down when I get into overload states (they involve working on proprioception), and for managing my hypersensitivities.

Just because I find OT to be helpful doesn't mean everyone will, but I think that quite a lot of people with sensory issues do find OT makes a difference for them--I just can't tell their stories. Have you read "Too Loud, Too Bright, Too Fast, Too Tight"? I can't remember the author's name, but it's filled with information about sensory sensitivities, some personal anecdotes, and strategies/activities a person can use on their own.

Once bitten twice shy, I can relate to your understandable fears of the mainstream medical fraternity.

Your too smart for OT, even a 'nice' therapist

Google it yourself and start doing the exercises. You are more than capable of educating yourself!

Therapist----the rapist

I would be prepared to resign yourself to these shortcomings, if no improvement seems likely. And be happy with all your marvellous talents!

Good for you!

PS: Dont waste your time with bad meds

My mom is an OT and there's no limit on the intelligence of her patients--assuming that because you're good at school and IQ tests that an OT can't teach you anything isn't really on target, because the things an OT can teach aren't really the ones they teach you in school.

I get that you're tired of being pathologized, but honestly, if you need to learn something, then isn't it generally easier to have a teacher? That's what an OT would be for you--a teacher.

One of the ways to do what you want to do with your life is to go about gathering up the skills that will be useful to you. You say that you have problems that are holding you back; why do you have to "work on yourself" without any help?

Sure, if the OT doesn't treat you with respect or patronizes you, dump them and find another. If it doesn't teach you anything useful, sure, then don't do it. But don't write it off as something you couldn't possibly benefit from. You already know that being disabled is not a reason to sit back and assume you're incompetent; well, neither is going to occupational therapy.

We grow up with the world telling us that Disability=Incompetence, that it's impossible to be both disabled and talented, that it's impossible to be delayed in one thing and really good at something else. We have the world tell us that if you're disabled you've got to be either a tragedy or an inspirational story, rather than an ordinary person going about your business in the world. The more you're aware of that crap and the more you toss it in the trash where it belongs, the better you'll be able to see yourself and your abilities clearly.

Well said. I sometimes feel like I'm walking a tightrope between being overestimated and underestimated. I think of myself as an extraordinary person going about her business in the world.

That being said, the cost of these session with OT would be threefold: First, she explained that I'd need a referral/prescription for OT from my "regular doctor", who seriously leaves a lot to be desired(but is better than the last guy who screamed in my face and cussed at me when I told him I was autistic). I'm worried about having to justify myself to a virtual stranger. WAY too much of that in my life.

Then, I have to worry about the literal financial cost. I don't receive services. I'm set up just like any NT: Part-Time Job, Grants through college that I earned through the sweat of my own damn brow, and middling quality health insurance. I'm worried that between my therapy and my insomnia, I'm going to run out my yearly outpatient limit. I've thought about contacting the state Vocational Rehabilitation Services, but I get the impression I'm both "not disabled enough" and "too disabled".

Thirdly, I'm a little bit like a bipolar who won't take medication...I'm worried that if I reduce my sensory sensitivity, I'll lose a lot of things I enjoy. There are a lot of times that I get a LOT of joy out of very subtle things. Which for me, are very intense. Like the feeling of water on my skin, or the smell of my fiancee from across the room.

TL;DR:

It would cost a lot of money, and I'm not sure I WANT to lose my sensitivity or change my perspective on the world that much. More hemming and hawing necessary.

I hate that sort of thing--seems exceedingly stupid to require a referral from a GP....particularly when most doctors seem to know little to nothing about sensory stuff anyways.



Definitely a huge consideration.



Very understandable.

I wish you luck (or something other than "luck" that's still positive...given that "luck" doesn't seem to have much to do with decision making) with mulling it all over

I'm glad to have some validation on my reasons for being hesitant.

I think I'll let the back of my mind chew on this for a while. Sometimes if I let my "subconscious/intuitive" brain gnaw at something for a week, or a month, or a year, it'll spew back an answer. Most decisions contingent on emotion require this method, for me.