Diagnosis without therapy

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A while back I started a thread called "Therapy without diagnosis" because instead of being given a proper AS diagnosis (I already had an unofficial one) I was offered therapy instead. Well, the therapist I was sent to saw me a few times and diagnosed me with AS and said that she didn't know what to do with me in the way of therapy because I just am the way I am so she didn't know what there was to therapise because AS isn't curable. So we are not going to do therapy, which suits me because I didn't want therapy in the first place. So now I have a diagnosis without therapy instead of therapy without a diagnosis. When she gave me the diagnosis she said there wasn't much point in giving me the diagnosis either because I already had one and would probably call the new one into question, too.

I assume that anyone reading this thread is interested in the relation of diagnosis to therapy for people on the spectrum. I really don't see how therapy can help at all beyond helping someone to see that they do in fact have the problems and limitations that they do have and not to hate themselves for it. For example, one thing that has helped me in learning that I (probably) have AS is that I don't hate myself anymore when I fail abysmally in social situations as I always do. Just knowing that there is (probably) a neurological explanation for why I feel so out of place in such situations and fail to respond empathically to the people there is a big help because I don't come away wanting to hang myself or throw myself off a tall building as used to be the case. So a diagnosis is itself a kind of therapy.

Therapy isn't about "curing" autism, but about addressing deficits that you may wish to work on, assuming that you have things about yourself you wish to work on. Any sort of life coach, not limited to behavioral and cognitive psychologists, can offer "therapies" for areas in your life in which you would like to grow. I have found plenty of books, articles, websites, and conversations with individuals which have proved immensely valuable towards my own self-improvement.

If all you're looking for is a reason why you act the way you do, but do not wish to improve yourself, then it sounds like you have your answer. I'm confused, though. Why do you keep couching your diagnosis with "probably have"? You've been unofficially diagnosed by one professional, and you said the therapist has now diagnosed you. What's left to be probable about it? Why do you keep holding on to some probability that you are not on the spectrum?

If you go in distrusting the doctors competence to correctly assess, then that's not going to change, even if you do get the diagnosis you think is right. You can't get certainty from people whose competence you're dubious about. That part I understand.

What I don't understand is what use a diagnosis could possibly be in such a situation, if you don't want to access any help.

I'm not sure why. I think it has to do with my obsessional nature. In the same way, when I was a child I worried about an undiscovered misdeed I had committed 8 months before, worrying endlessly for about 2 months, all day every day, because there was a remote possibility that my parents might one day find out. In the end I confessed it to them completely unnecessarily, just to get rid of the tiny 1% chance of them finding out, because the doubt was torturing me. At work years later I had to make photocopies and if the paper round the edges was only one tiny fraction not straight I would copy it again and again until it was, wasting masses of paper , although the copies were only for classroom use. In the past I bought second copies of several books because there was a small blemish on one of the pages in them. My mother thought it totally weird that I had some of the books twice. "Why?" she wanted to know and looked at me as if I was mentally unbalanced. It's the same with this diagnosis thing. I am afraid that they could all be wrong and me too and that my syndrome (not the obsessionality but the whole thing) is something else, although there isn't really anything else it could be when I think about it.

As regards not wishing to improve myself, I'm 58 years old and am not too sure what improving myself would look like. Or rather, I'm not too sure where I would start. The therapist herself said she didn't know what to do with me. I have my way of functioning and am not too sure how I could change it now. But you are probably right in thinking that self-improvement is a good idea. What I'd really like to do would be to understand the past better and come to terms with it properly, but for that I'm in the wrong kind of therapy. She does behaviour therapy rather than depth psychology.

Last edited by Halligeninseln on 14 May 2012, 10:57 am, edited 2 times in total.

See my answer in the previous post. It is simply a matter of getting objective confirmation that the reason I am the way I am is that I am on the autism spectrum. I know how I have always been and that the way I have always been is unusual and problematic (for myself mostly as I've tended to be isolated most of the time), but I am only gradually coming to be sure that being on the autism spectrum is what it is called and not something else. As regards getting help, I don't think that at my age I need help in the same way I needed it when I was young. Trying to change could even "rock the boat" as it were, because my life is more or less stable within its limits.

However, if the therapist is willing to do something other than behaviour therapy or would refer me to more of a "coming to terms with the past" type of therapy I'd like to do it.

Isn't OCD fun?

It's very rare that a diagnosis for something is going to be purely objective. Autism is subjectively diagnosed, and there's really no changing that any time soon. You can make a choice to accept that this is as good as the diagnosis gets, or you can fall prey to that obsessive need to want something more definitive. I don't think it's worth trying to continue to confirm your diagnosis more than what you already have, especially if you're already seeing a difference in how your mind is accepting things and making sense of things. You're right, just being able to put an encompassing name to your symptoms seems to work as a first-step "therapy" pretty well in the grand scheme of things.

Thanks for your helpful comments. I appreciate them .