Therapist questioning diagnosis

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i am now 55 years old. I have been on and off in counseling since the early 2000s with different therapists, mainly for depression, anxiety. The most serious episode was triggered by a divorce. Over the last 5-8 years I have suspected myself to be on the autism spectrum through self observation, self reflection and analysis. I started reading and learning about autism.

One psychologist flat told me “no, you have no signs of Autism or Aspergers” another you don’t have it, you have just some ‘traits’. The last one I saw did the most comprehensive exam with extensive testing (IQ, verbal, math, empathy, etc...) and concluded I have autism with a need for adaptation, there are verbal challenges, reading and math challenges, anxiety, obsession, ADD and depression in my spectrum. He made recommendations for adaptations (calculators, text to speech programs, more time for assignments, learn active listening, etc...). I thought it was an accurate and reasonable assessment, some things surprised me, but it made sense.

I decided to find a local (the diagnostician is a four hour drive one way) psychologist to help me with some of my issues, especially as it relates to my marriage. I gave him my written report and test results (61 pages). He glances it over and almost immediately questions my diagnosis. “this is kind of scattered, so many different things”. “maybe it is more OCD”. This was at our first intake session. He questioned the diagnosis and at one point said “you have embraced this diagnosis”, I said “yes, it is not a spontaneous thing, this is the result of many years, and it based upon testing, my life history, and an expert opinion. Without a laboratory, blood or urine test some will always question Autism or Aspergers diagnosis. The only other tests I could do would be neuroimaging to analyze my amygdala and hippocampus and brain function, but even those are not equivocal. I cannot deny my history (I was always a loner, I obsess in my special interests (even though they sometimes fluctuate a little), I love structured activities and environments). The overall picture is highly suggestive of ASD.

My suspicion is because there is no “treatment” for ASD, some psychotherapists may push more towards a “treatable condition” or something they are more familiar with. I told him ASD is basically the umbrella that holds the other symptoms or Co-morbidities together. I doubt that OCD is the root cause of all my symptoms.

It is frustrating to work with new therapists. I really don’t mind too much what he calls it as long as the counseling and therapy help, but it irritates me to get constantly re-assessed and of course I have had doubts, but in the end my symptoms need to,be addressed, there is nothing that can be done to “cure autism”.

I would argue having autistic traits means you are on the spectrum (by the definition of spectrum). Some of those traits can be very mild, but others (I.e. social fear) strong, almost debilitating. As someone on this forum said, mild autism may just mean it looks mild to others, but it can still feel severe to me and cause severe symptoms for me. if those symptoms become so severe, that they interfere with my quality of life I need help.

thoughts? Opinions?

I'd have been tempted to ask a few questions of that last shrink to see if he knew much about ASD. If he could show that he understood the subject well, the next thing would have been for him to present his evidence that I didn't have the condition. Then I'd consider the evidence, if he produced any. If not, he's got no business being my therapist.

I agree it's possible that he doesn't want to deal with you as an Aspie because he doesn't know how, so quite likely he's just twisting the truth into something he does think he can deal with. If I were you I'd bear that possibility strongly in mind if you deal with him again. If he's genuine, he'll be able to make it clear that he is, he'll be able to answer tough questions about how he knows what he's saying is correct, and his answers will make sense. If he can't, I'd look elsewhere for help.

A lot of therapists and other professionals do not know anything about autism. It sounds to me like you want to look for another therapist if possible. Perhaps when you are looking you could ask at the initial phone call if the therapist deals with autistic individuals.

The problem is he listed that he does see autistic patients...
I will ask more questions at the next session and go from there...

I had a Jo blow psychiatrist try to tell me that I didn't have autism, that "it was just OCD and Social anxiety" though I got her to admit she wasn't qualified to assess me for autism and thus she was not qualified to say that I don't have autism given that she did no assessment whatsoever. Her argument was that I could maintain some eye contact and articulate myself well, both relying on myths about autism. She also told me that no one in the $550 million mental health hospital was qualified to assess adults with autism and refused to refer me to anyone who did. Turns out there was a clinic just 1 floor below and down the hall that does just that, but being incompetent as she was, she had no clue about the services offered in the hospital she presumably works at daily.

I had another psychiatrist previously who said I had ASD but wasn't qualified to assess me as well another GP who agreed but I got fed up being given the run around when it came to a formal assessment. I found a psychologist off of psychologytoday's website and did a formal autism assessment where they found I had Aspergers(I don't know why he used the DSM-IV but he did. I used that diagnosis to participate at an autism research study in the same hospital as that last useless psychiatrist and had a much more thorough autism assessment than the one used to diagnose me with Aspergers(because that is all I could afford since it was out of pocket), this time I saw a neuropsychiatrist who administered the ADOS and WASI II test among others for hours and hours for which they diagnosed me with ASD level 2 using the DSM-V. I had the ADOS and the other testing done for free during my 2nd assessment since it was part of an autism research study.

With two autism assessments back to back stating I have ASD, I don't have to deal with doctors questioning my diagnosis anymore. I give more weight to someone who deals with autism for a living and who actually performed formal testing rather than just an ordinary doctor or psychiatrist who doesn't know what they are talking about.

Thank you all for the responses...
It is so discouraging to repeatedly hear this on the forum how therapists evidently repeatedly question the diagnosis based upon myths (you can make eye contact, you understand metaphors, you have a job, you can talk).

I look at my ability to obsess about things not always as a negative. It gives me the ability to do things and find solutions to problems others may not find.
My goal is to minimize my depression episodes and to channel my strengths to improve my marriage. I have problems with empathy not sympathy. Communication is difficult at times due to ADD, avoidance of eye contact etc... I have a tendency to cover up mistakes with small lies (I think it is the perfectionism that gets me there). If I admit mistakes it increases depression. It sucks to realize one’s own mistakes...
None of the things I deal with are ASD specific, and I am not out to “cure” my ASD, I want to level things out a little and minimize my struggle.

Any specific suggestions on how to evaluate the therapist? I am having some thoughts for questions I should ask:

- what is your experience with ASD?
- do you see adults with ASD?
- do you Diagnose ASD? If yes, how?
- how do you differentiate between high and low functioning?
- ASD has as a spectrum disorder many possible Co-morbidities? Do you think depression/OCD/ADHD in ASD individuals may require different therapy than in a NT individual?

Thoughts? comments?

I've had two therapists question my diagnosis because I could tell them how I feel... BUT what I told them came after a week of thinking deeply about what we were going to talk about. Luckily this didn't make me spiral too much because the first one actually backed down and researched more about autism in girls which is now only recently being given extra attention and took back what she said, helping me to get my diagnosis after coming around and the second one barely knew me. Plus I also have NES and when I turned up to my group for it they were mostly autistic and those who weren't many parents suspected they were.

How about studying a few Aspie relationship books and seeing if any of the advice offered can be used to help your situation?