Advice? Going to therapist.

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So I'm pretty sure I'm autistic. This comes after weeks of research and reflection, months of background curiosity, and decades of vague awareness that it's somewhat correlated with the parts of society that I inhabit (computer people, geeks, and other misfits). I've made an appointment with my old therapist--I saw him for several years but we focused on something at best tangential. And I guess... I dunno, I guess I'm curious if anyone has any advice for the first time introducing talk about undiagnosed autism into an established adult therapy relationship? I'm old enough that I don't know if it'll be worthwhile to seek a formal diagnosis, but maybe I'm wrong there. Regardless, I do think I want some professional help identifying coping mechanisms and blind spots. But I guess I'm also a bit anxious that he might dismiss my concerns out of hand on the grounds that he didn't notice anything while I was seeing him before? Or maybe that anxiety is a bit misplaced, I'm not sure. Anyway, does anyone have any parallel experience with this as an adult? I feel a bit lost for what to expect and what to try or to avoid, so if anyone has any experiences they can share, I'd love to hear them.

I just recently got diagnosed (at 31) and its had its positives and negatives. I don't think everyone needs a diagnosis, but you might want one for your own peace of mind.

In any case though, whether you seek to make it official or not, a good therapist can help you with those week spots, blind spots, etc. Even if you don't have autism, anyone can have issues with social interactions, depression, anxiety.

Also, any competent, mental health professional wouldn't dismiss something like that, or be dismissive in general. If an issue is causing a client/patient anxiety, then its an important thing to discuss and explore.

While its true, most support services out there are geared toward children, there are some...and having an official diagnosis, does allow you to potentially seek accommodations in regards to employment/workplace issues and in school.

Going to therapy is a social skill like any other. Think "empathy": in order to properly interact with a therapist, you must think like a therapist. However, because they studied psychology, being in therapy feels like playing chess with Gary Kasparov or wrestling with Mike Tyson. Another caveat is that a therapist will almost universally grill you about your feelings. They'll accuse you of lying if you say something that goes against their training or personal beliefs, and they'll accuse you of withholding if you say "I don't know".

Do some pre-work; get ahead of the game. First, study this article: https://en.wikipedia.org/wiki/Contrasti ... f_emotions. Memorize both simple (happy, sad, angry) and complex (elated, listless, irritated) emotions, so you have both types of answers ready for the therapist. Second, think of situations you plan to discuss with your therapist, and "assign" a feeling term to it, because the therapist will ask you about it. Lastly, don't feel guilty about walking out of the session and never returning, or threatening to do so. Don't forget: underneath the sympathy, therapy is still a business. The therapist doesn't want to lose you as an income source.

If you're not sure what to talk about with your therapist, prepare some "throw-away problems": lighthearted issues that you can easily deal with on your own, but can use to keep the therapist busy, so they don't spend too much time pushing your emotional buttons. Something like getting irritated with icy roads in the winter. If you don't have a throw-away problem, fake one. I faked test anxiety with my therapist, back when I was a teenager. At your age, fake fearing mistakes at work or something.

Also don't forget that some therapists like to groom new clients into becoming a long-term client. They'll dredge up deep-seated emotions in you, in order to retraumatize you and make you feel worse, so that you'll keep coming back to feel better again. (Or even just for a cheap thrill of making a vulnerable person cry.) Then, they'll pass the buck onto you, saying that it's your job to make yourself feel better. Or more insidiously, they'll say they'll help you feel better "in the long run", only the "long run" will never come. Run away, don't walk away, if you ever find yourself crying yourself to sleep after a session.

Final tip: pick someone younger than you. You being older will have a mildly intimidating effect on the therapist. He/she knows: he/she may have the book learning, but you have the life experience. Not only that, you can throw that in their face if need be.

seems a bit cynical and adversarial. perhaps even paranoid?

Tip;
Ignore aspie1

Nope! My therapists did all those things.

I have a better tip: ignore Arganger.
You have NO IDEA how lucky you are not to have been a kid/teen during the dark ages of therapy. Which might still be around.

So did a lot of mine as a kid.

To the OP: Please don't let anyone else's negative experience with therapy put you off it. While it certainly can be negative for some people, it can also be a very useful, beneficial experience.

Yep, mine have been very helpful.

Both of you, do tell. How were your therapists helpful? What did they say and do?

My therapists just took my parents' side in everything, parroted my statements back at me, made fun of me, asked me dumb rhetorical questions, and gaslighted me into doubting myself. I started drinking at age 12 because of them.

In case it makes a difference, this is a therapist I saw for several years and have a positive working relationship with. I've found him very helpful with some other issues. I just don't know what to expect from him specifically with regard to talk about autism.

Aspie1,

I've had similar experiences to yours as a child, by parent-apointed therapists, who were essentailly working for my parents. and I also experienced a lack of confidentiality and trust because of that. (My therapist told my parents things I'd said in confidence etc.). So I do know the kind of adversarial relationship that can happen.

As an adult though, Its been a different experience. My therapist is someone I am employing for my own benefit, I can disagree, I can leave, I can change therapists at my own will at any time. That's makes a difference. A big one.

The dynamic is different. Things I say in confidence are kept that way, if I have an issue I don't want to discuss, I don't have to. I can work on issues I want to work on, and I have a second opinion (not necessarily a better one, but one other than my own) that may show me an aspect of a problem that I had yet to consider. I can look at therapy much as I would go for tutoring in a subject I wish to learn about. I am paying someone with more knowledge than I to teach me something I want to know. When I have learned what I wish to learn I can move on.

I hope that makes sense. My own experince now is not what I would have expected based on childhood history.

And I, like you, started drinking at school (6th grade) and hiding in the library just to avoid the hell that was my existence then.

I was lucky in a sense that I knew what was going on. So I never told my therapist anything my parents didn't already know. She tried to push me for a true answer, but I knew better, and only gave her "good" answers. Like, when she asked me if I plan to have sex in high school, I said: "No way! That's irresponsible! I want to graduate and get married first." (When the real answer was: "Hell, yeah! I just have to find a girl willing to [F-word] me.") I did admit to her that I wanted to find a girlfriend, but I vehemently denied all interest in sex.

That's the thing: my own therapist was a blithering idiot. She didn't have any knowledge I couldn't get from a basic textbook, a chat room (it was 1997), or even a TV show. Heck, I think therapists aren't supposed to give advice in the first place. One time, I tried talking to her about a social situation I saw on "Boy Meets World", to see if I could apply what I saw in real life. She just turned the question back onto me: "What do you think?" "Gee, if I knew, I wouldn't be asking!" I figured she said that because she didn't watch that show, but still, she didn't need to know the characters to know if their interaction is something I can apply or not.

It sounds like that was definitely not a good experience and not helpful. That happens. It takes time to find a therapist who is a good fit and will do something other than reflective listening. I've had a therapist who simply parroted back what I'd just said (and I could guess exactly how she would respond after a while), but it those cases you just move on to another. Its really not much different than finding a barber/hairstylist. In my state, anyone can call themselves a counselor without any accreditation, so yes, you do have to be careful...but my over all point is that it can be beneficial...and it has been for me...recently.

Last edited by DanielW on 10 Mar 2019, 4:28 pm, edited 1 time in total.

Do you feel you have a good connection with this therapist? Since you said he was an old one, I imagine you felt safe enough and like you got along well enough to return to him. Think back to how he handled you and things when you saw him before. Was he ever dismissive to anything you felt or thought back then? If he wasn't there is no reason he will be now.

He may ask you why you think you're autistic or even seem to pose a challenge to the idea but that's typically done because the therapist wants to hear out your reasoning and get a feel for your state of mind about it. Really just be candid about your feelings and what you have experienced. Even if he were to not be in the camp of "You are Autistic" he can still help you with developing coping mechanisms as that's something that even NT's will need help with. His job is to try to help you function and think in a healthy manner regardless if you are ND or NT. Being ND would create some more specific areas of you needing to work on and could change his approach but the goals are always the same.

What is your therapist's specialty? My therapist's is actually drug and alcohol counseling, which is funny because I have neither problem there, but we get along and I feel she gets me pretty well. Because her specialty is not Autism though it wasn't a forefront things for her to be thinking about when talking with me. So we ended up looking at the various criteria together and with doing that, discussion, remembering things my mother had said when I first started seeing her, and from what she had already viewed in me she felt comfortable with saying that I did indeed have Aspergers. So with you bringing it up to your therapist he might do some of his own review work and find that it creates some illumination on what he'd seen in you before, but because it may not be his specialty it may have not 'dawn on him' at the time...or maybe it did and he had some suspicions already. You can't read their minds and what their thinking, so I wouldn't worry about it. A therapist is there to help you figure you out, not the other way around.

If things don't go very favorably, don't get discouraged. It might take some time of 'settling in'. We can get defensive and want to automatically rebuke anything that doesn't flow with how we are thinking. If you feel he isn't understanding what you're trying to say, try to think of another way to explain it. Communication with other people isn't always so easy and that can follow suit with therapists sometimes. Don't give up right away.

If he does end up being dismissive, isn't being helpful for you, or after trying a bit things just don't seem to be working it would probably be best to end it with him and try someone else. It's not an all or nothing thing, if it doesn't work out you can go else where until you find something that works better for you.

Lots of things; my PTSD symptoms are almost gone thanks to her noticing them and working through them with me, my meltdown length is cut in half and they aren't daily anymore, a lot of my general fear has been reduced, she helps me and my mom work things out when we argue (And is on my side most of the time) when due to my many co morbids I need a different type of doctor she gives me suggestions (She suggested the doctor that brought up EDS and reevaluated me, and my current OT for example) She runs some autism groups and introduced me to my current friends through that, and more.