Autistic Again

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Brief history: in 2009 I was diagnosed by a psychiatrist specializing in childhood autism as autistic. I was 39 at the time. She returned to teaching so I was referred to another psychiatrist, an English man nearing retirement. After a couple of sessions he declared that I wasn't autistic. It became apparent that his experience with autism, especially women on the spectrum, was limited. So we confined ourselves to discussions about my depression and anxiety.

Yesterday I saw him. I have been in rough shape lately (see the Haven) and I guess I wasn't putting my usual effort into passing. Well after 40 minutes he reversed his opinion and declared that my autism had come back and that the previous psychiatrist was right after all. But I am not to despair... he's told me to work on socializing by putting myself in as many social situations as possible. He says this will reduce my anxiety and I'll go back to being a "recovered autistic."

Has anyone else had to deal with such nonsense?

I think your psychiatrist is incompetent, and you should get someone else.

I have one more meeting with him before he retires. Not sure who, if anyone, I will be seeing then. There are not enough psychiatrists for the number of patients needing help.
He really is fairly useless. But you kinda have to work with what you get here. His training for ASD seems to date from the early '70s.

Not everyone in the medical profession has a good handle on what autism is about.

When I told my doc a few years ago (who had been my doc since I was 13 - I'm in late 40's) that I thought I might have Asperger's he referred me to the clinical psychologist at the medical centre. The psychologist screened me fully but did tell me afterwards that it was fairly obvious early on in my sessions with her that I was on the spectrum.

She (the psychologist) told me a funny story later on. She had run into into my doctor in the hallway who remarked to her "It didn't look to me like <eggheadjr> had Asperger's". She told me she laughed and replied to my doctor saying "clearly, you weren't looking very closely".

So there you go...

I agree with Ettina, your psychiatrist is incompetent. But this anecdote here by eggheadjr is brilliant. In fact, if it's alright with you, eggheadjr, I may use this in my future academic discussions about autistic passing (I will cite your username as the author).

Being able to appear normal IS wellness, in psychological terms. Your psychiatrist is not considering that autistic people require time to recover from faking being neurotypical. This is probably true for most people who pass as something, but it seems to be much worse for autistic people. The closest equivalent would be to imagine a person who has to pretend that they speak another language, are another race, are native to a different culture, and are from a different socioeconomic class. This would be enormously stressful. No one could do it all the time.

I would try to find a therapist who specializes in adults on the spectrum. If you can't find anyone like that, I would try to find someone with experience treating minority classes- women, people of color, immigrants, and so forth. You can just call the front desk and ask the secretary if any of the doctors or counselors specialize in treating minorities.

"Recovered autistic" - my ....Well trained autistic - I reckon, that´s what he meant.
He accepts your autism and advice you to train social situations - and once your anxiety has gone(been managed), he will say, that one of your comorbidities is under control - so you must have recovered.
No, he doesn´t understand.

Please do - certainly alright with me.

If, at age 45 years, you haven't already learned to mask and socialize well enough for your clinician [sarcasm, of course, you have learned well], then there is no hope of improving your skills [again, sarcasm]. Besides, you don't need to meet the arbitrary threshold for a clinician who apparently misunderstands the spectrum's nuances.

However, I would stick with him if you gain something from attending him. At this point, it seems that you are "back on the autism wagon," so, if I were you [I amn't, so this doesn't matter], simply find a way to accommodate each other if things other than autism are improving in your opinion.

Yes...He doesn't get it. He seemed genuinely concerned about the reappearance of this vile disorder. Lol. I expected this would be my last session with him. But he wants to see me again before he retires. He seemed particularly concerned that I wasn't able to suppress my negative self-talk, in order to avoid a meltdown. I tried to tell him that it was more physical than intellectual. But he was almost angry - he even raised his voice.

I wonder what else he will diagnose you with. Or what his notes look like. Maybe he will diagnose you with hysteria and prescribe you some quaaludes. Tell you to do some calisthenics.

Ah yes, another example of someone who doesn't know that they don't know. I am having a chuckle at the youngsters who think that someone's having a credential guarantees that their competence.

And, that guy's advice is not only stupid, but dangerous. Plenty of ASD folk push themselves to ruin without advice like that.

I keep telling everyone, consider a psychiatrist's age and what that tells you about when he got his training. Someone nearing retirement may be very good at older entities like unipolar depression or anxiety disorders. But anyone nearing retirement got their professional training BEFORE the big surge in Asperger's conversations in the 1990s. It might still be possible that such a person has a special interest in the topic and therefore has educated himself; but that would be unusual.

He seemed almost angry that I had a meltdown. He seemed to think it was my fault for not controlling my thinking. When I mentioned that I felt better after he was surprised.


No such luck. He seems almost afraid of autism.

Not sure what changed his mind. We did talk about making smalltalk. That people saying "how are you, I have been thinking about you" haven't actually been doing so. They just want to make you feel cared about. I pointed out that the person's not having actually been thinking about me makes their words insincere and empty. I asked him why this would make him feel good. He was perplexed by my thinking.

"it appears you are allergic to peanuts. I recommend you eat as many peanuts as possible, and you'll soon be back to not being allergic to peanuts."

"You appear to have a fear of heights. I recommend taking up skydiving."

"you appear to be epileptic. You should take a job as a night-club DJ."


Social skills can be practiced and improved, sure, but is the concept of a gradual approach just unknown to this guy?

Oh, that makes sense. Back then, they didn't really have HFA, but they did have a category for 'residual autism' - meaning someone who used to meet autistic criteria, had mostly 'recovered', but still had some autistic tendencies. That's probably what he's talking about here.

I wouldn't excuse him being outdated due to his age, though. One of the responsibilities of being a trained professional is to keep up-to-date on new discoveries and changing understanding of the field. It really bugs me when professionals refuse to learn anything more after they graduate, because they get less and less qualified as they get older. It's kind of like not renewing your driver's license.

But it's a moot point now for him, I suppose. I hope he has a happy retirement.

Androbot, I can follow your experience quite well.
He might bee good enough, but still rely on an old model of ASD - as did mine. I saw a psychologist instead.
To be fair: The psychiatrist actually called the psychologist for an explanation to his statement and verified it himself officially, which is a great step to take for an old chief psychiatrist.

Find someone younger with a more up-to-date education. Good luck.