To read to my psychiatrist at our next session

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I wanted to follow up on our conversation in our last session. I think what we missed was that it takes time for me to process novel things that are said to me. You said I have "obsessive tendencies", but one reason why I do exercise them is because I need time and repetition to process novel information. Last session, I had a familiar uncomfortable feeling as our conversation went through its many twists and turns and you mentioned new things requiring consideration that I wasn't able to effectively engage what you were saying.

You said for example that I do not trust myself; to me, this was so out of the blue I had no idea how to respond to it, so I assumed you were correct. When I thought about it afterwards, however, I realized that didn't tell the whole story. I do trust myself to do what is right and to effectively engage in problems, but lately I have come to learn more and more about myself, including where I am weak. I trust that my solutions to these problems, that of "obsessively" going over past conversations in my head over and over again, would help me better understand them, which has greatly benefited me in the past. Sure, being "obsessive" may have no adaptive value for "normal" people, but I'm not like them. I'm different, and it takes me longer to process conversations. Because I find these conversations important to understand, I am going to "obsess" over them plain and simple. "Obsessing" over stuff is how I understand anything in any real depth at all. I ask that you not try to stop me from using this tool.

So, yes, I "obsessed" over our conversation, many aspects of which I was unprepared for. This time, however, I am prepared, thanks to "obsessing".

This letter is for our next session in a month. I just had a session today, and reflecting upon it makes me feel much worse than I did before going into the session.

Wow!! That is a great explanation! Do you mind if I use that to explain it to other people?

And, please do not feel bad. You learned more about yourself and found out that one of your "problems" is actually a useful tool to overcome your real problems.

_________________
31st of July, 2013
Diagnosed: Autism Spectrum Disorder, Auditory-Verbal Processing Speed Disorder, and Visual-Motor Processing Speed Disorder.

Weak Emerging Social Communicator (The Social Thinking-­Social Communication Profile by Michelle Garcia Winner, Pamela Crooke and Stephanie Madrigal)

"I am silently correcting your grammar."

That's interesting. Is going over something in your head automatically an obsession? I have OCD, and I don't call it an obsession until I start to worry about it or it affects me negatively in some other way. Especially when I can't stop dwelling on unpleasantness when I choose.

What concerns you most about your session with the psychiatrist?

Good for you, and I hope that leads to improvement. "Question-battering" and/or being blindsided derail many many people on the spectrum, and there is a dire and urgent need to educate clinicians about their assumptions that the approach they take to working with NTs fits (or should fit) us too. You could perhaps suggest a flashcard signal you could make when/if the derailing continues. (You hold up a red card to signal that you are not ready to process some other issue and want to stay on track, and the clinician acknowledges it and returns to the issue you are processing) or some workable variation of that. It's often too hard to explain verbally without derailing the whole session and being flooded with upset when this happens.

I always associated "obsessions" as being persistent, unintentional & unavoidable. Nothing wrong with purposely spending time considering past events/conversations. On the other hand, if it's something that's going to steal your attention anyway and you manage to mine useful insight from it, that's cool too.

You did a great job on that letter. I hope your psychiatrist gets what you're getting at.

this is pretty remarkable as I just "prepared" a speech for the psychotherapist I was about to see yesterday. My feelings are almost identical to yours. Only last week did I realise that my (near) photographic memory (well videographic memory) is my brain struggling to process and code the auditory input that is coming in. This explains why I still have speech fragments from 30 years ago floating around in my brain, often looping at some times.

You say I don't trust myself, but that isn't true. I often trust myself to be right and I do want I feel is right and I'm confident in, like the matter we discussed at our last session. If contradicted, however, I will try to consider what the person says, but I must keep in mind the possibility that we simply misunderstand each other and that if we did understand each other we would see eye-to-eye on the matter. Because of this, I will try to get clarification as to whether such misunderstanding occurred but it isn't easy, and it's like picking my way through a fog. So I may seem to "obsess", but as I discussed previously, it's because I am trying to get a handle on the conversation. Remember, as you yourself have diagnosed me along with many previous clinicians, I am on the autism spectrum and therefore pragmatics and semantics, the actual use and understanding of meaning in a language, is always going to be a challenge.

There are times where I have admitted I was wrong, but that is after I am done picking my way through the fog and have verified that my interlocutor and I are on the same page. I ask that, in light of my disability, you bear with me through this process. This is not an accommodation I receive from most people, but I do hope to get it from my mental health professional.

If I'm trying to talk about things with certain strong emotions attached, my speech rate goes way down. My speech can also go offline completely.

I might be misinterpreting what you wrote, but if someone said it's because I don't trust myself, they'd be way off. It's more like, somewhere in my brain, I need a 60-amp wire, and I've got a 15-amp one, and it overheats easily and the circuit breakers start flipping...

I didn't understand this issue for a long time; what I'd usually do was to redirect the conversation to "the weather" or something and go into autopilot. (I didn't really have that ability until sometime after 20?) My priority was always to "look normal", not to communicate authentically, if it came to a choice; lots of fear involved I guess due to years of early bad experiences. I've had decades to learn strategies now; it doesn't mean that all the underlying wiring is different, but maybe I have more ways to compensate.

These speech issues left me often feeling very unconnected even after therapy sessions. My focus was on "being normal" for that person so "I" wasn't really connecting, sharing. ...so I'm really glad I started noticing... a NT lady commenting that I spoke very slowly about an emotional issue was the first I even started realizing this, less than a year ago.

I would have periods in therapy where I couldn't talk, but I didn't know about the autism then; there are other things to "blame" that on in therapy I guess. Not sure exactly what those therapists thought was going one. (No one considered autism at all.) However I didn't improve after years with that problem, and it's pretty general with strong emotions for me. I also take forever to identify my emotions at times.

You could try writing in a journal specifically for a therapist? Things you would like them to read.

Do you think this therapist really understands your issues though? Have they read about issues like your autism? Also, are they defensive? Do you mostly feel safe there? Don't blame yourself if not, please find a better therapist!

My sense is that you are trying to be honest; a good therapist should really appreciate that, and appreciate the difficulty -- ASC folks apparently often don't have all the "hardwired" socialization brain parts so we have to learn and use slower brain circuits, and we need to doublecheck our accuracy. You are totally being honest.

Nicely put, Beneficii. That last post clarified a lot.

I'm kinda mad I keep having to deal with this. I'm mad he seemed to forget I was autistic at first and remembered it more and more as we went on but staying stubborn.

He's normally good, and in fact we spoke of this matter previously, 3 months ago, where he mistook my tendency to go into a lot of detail and to try to work and work to understand, that he mistook that for anxious obsessiveness. I wasn't prepared to re-explain that this time. Now I must suffer through waiting for our next visit and reminding myself to keep this in mind. Maybe for every session I should carry a card explaining this, which I will invariably read at the beginning of each session.

If he complains, I'll tell him he's already forgotten once, to MY detriment and I don't want it happening again.

I wonder if there is anything that Tony Attwood has written about this clinical miscommunication? If there is and if it is relevant, maybe you could print that out and give it to him. (He could probably learn a lot from TA generally)

Well written, Beneficii. Try to relax between now and the next meeting, knowing you already have a plan for the session.

Take care. Bea