I think I figured out why therapy hasn't worked for me...

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In general, I have a hard time when people ask me what I call "summary questions"- anything from How are you? to What do you do? (i.e. Who are you?) I imagine some people automatically know the answers to these questions. For me, however, I feel like I have to be a field reporter and go out, survey all the inhabitants, clean the data, calculate variances and means, and, finally, write the report. Someone asks me how my ___ is going and I'm like, I can't believe this person is asking me to take on such a multitudinous project - I mean with no warning, no time to execute, and who is this person anyway?!. I mean the deadline in conversation is always like, right now, and who do they think they are, my boss?

Therapy is often experienced by me as just an onslaught of this type of pressure. By the time I'm halfway through answering one of the therapist's questions, they're usually asking another one. And I spend the entire session consumed by an ever-growing stack of work assigned by this overlord under the tight deadline of 45 minutes. At the end, they act like that must have been very helpful. And I'm left panting, like, Could you please have paid me?

Does anyone relate to this?


I have been brainstorming a list of things which were present when I have enjoyed speaking with somebody about my issues:

1- There was a project. Like I was meeting with someone about an injury or as part of my meditation studies. Progress was made through working through a whole modality's path structure, and the conversations were only one part of that.

2- Non-verbal processing and communication. The person used direct observation to experience how I was progressing and there was time for quiet processing. They didn't constantly depend on asking me questions to know how I was or for the process to occur.

3. Independence. I did most of the work on my own where it was mostly not verbalized. I didn't have to share everything with them. I was in control.

4. Longer sessions. Because it takes a lot of work for me to transition in and out of social situations, I find it really helpful to meet for 1.5-2 hours if I'm going to meet with someone. It's very hard to get into and back out of something in the 45 minutes typically allotted for therapy.

5. Less frequent meetings. Every week?

6. Flexible start & end times. Executive functioning, trouble transitioning, bad with multi-tasking and central coherence. It's just much easier if it's okay to start and end a little bit late. People I've loved working with have almost always proved their worth early on by being late themselves. And by never being abrupt with ends. I can have a real meltdown trying to integrate and transition under pressure.

7. They tell me enough about themselves that I can think they're my kind of people.


Any ideas about how this list could be met working with a psychotherapist...?

I know they have insurance constraints, but I can't be the only one who needs accommodations. Are there laws about accommodations for healthcare specialists as there are for jobs and schools? Are AS-aware therapists any better?

I can totally relate. Every therapist I've been to was unhelpful at best and traumatizing at worst. What I didn't know is that therapy requires EXTENSIVE social skills, more than most aspies can deliver. You have to think on the fly, figure out what your therapist wants to hear, phrase it in a socially skilled way, all in a matter of seconds. To complicate the matters, he/she may act in erratic ways to see how you react, or even to psych you out to make it easier to manipulate you.

Unfortunately, there are no accommodations for aspie patients in therapy. But I did start a thread "Powerful therapy hacks 'they' don't want you to know about"; you might find it useful. It teaches aspies how to navigate therapy successfully, and even intimidate their therapist if needed.
Link: https://wrongplanet.net/forums/viewtopic.php?t=383445

I have trouble answering those kinds of questions too. In my case it has more to do with not being sure of what I should say. Do I say the truth or the socially acceptable answer? Should I be brief of elaborate? Do they actually care or is it just a greeting? I usually settle on the shortest answer and try to remember to ask the question back at them. Largely these kinds of things are spoken as a means of social protocol and often don't require you to think that hard about it. Meaning you really don't need to take it on as a project and collect all the stats, I don't think anyone actually expects that of you.

When a therapist starts off with those questions they are trying to 'get the ball rolling'. Also to find out what you need to talk about as well as start a re pour with you. I have never really felt like that with any of the psychologists/therapists I have had over the years. So my number one thought is that you may not be seeing someone that is very compatible with you or that has a therapy structure that fits you very well.


In therapy you are the project. Do you have a goal with going to therapy? When you go to a session do you ever have something about yourself or maybe even something that happened recently that you want to tackle?


Most do, do this to some degree but they have some reason to have you voice it. Often times there is a need to speak feelings in order to make them more real. Some people can think things about how they are, but will show nothing in their body language. When they speak it or speak around it, emotion can seep out thus giving a clearer picture. Therapists aren't psychic, they may have ideas and hunches but can only confirm by asking. Would writing things instead of speaking be of any help? Do you talk on your own - give information without them asking you questions? (If not this might be why you get asked so much). There are therapists that use art therapy, do you think that would be an acceptable nonverbal way to communicate?


The more information you can give a therapist the easier it is for them to give you advice and the like. BUT you are not obligated to tell them every little thing. I will hold back information from my therapist sometimes. Unless they are very clinical, therapists do believe that your therapy is just that, yours. They may try to get you to open up about something but if you draw the line that it's not something you are ready or wanting to get into then you do not have to. They should respect this, and allow you to use your time with them how you feel it would most benefit you. In addition there is no reason that you can not continue the therapy even after you leave their office.


Its not odd for some therapists to run over time but to schedule 2 hours is unlikely. (Maybe an hour and a half) Part of it has to do with insurances, as they often have guidelines that require the mental health professional to do things a certain way or they won't appropriately paid. Insurance often pays piss to start with. Other factors are their burnout and trying to schedule in a certain quota of clients, while also giving themselves time to 'clear' themselves (or do notes)between clients. I don't suppose it wouldn't hurt asking about it though.


How often are you going now? Why have you been attending at that frequency? How often do you feel you need to be going?


This would make it very hard for them to do scheduling. There are those that try to end their sessions 'on good notes' and not have that sort of abruptness; so you should be able to find that. Therapists are trying to help people but they are also trying to earn a living, when there is an appointment and you're not there that's lost time & money. A clinic might be more flexible but for a private practitioner your best bet would be to always schedule in as their very last client. But they still might not be willing to take you as a client with that kind of stipulation for a busy mental health professional.


This is going to depends on the particular therapists. Some don't like to 'get too friendly' with their clients and others are okay with that. Some also may use their own experiences as a means to talk about different things. You would just have to look around and try some different people.


As noted on them, some of your list can be met upon finding the 'right' therapist, but others would be tricky. As far as I know there are no laws obligating a mental health care professional to adhere to your accommodations. It mostly lies on what the individual practitioner is willing to do for you. A clinic situation might be different, but I have no information on such. An Autism savvy one might be more receptive than someone who isn't, but again I have no idea. I've never talked to one lol

I don't think I can help you. But I will give you my perceptions. Whenever I give a presentation (and I will compare a therapist session to giving a presentation) I go in prepared.

I would first figure out what questions the therapist will ask me.
Then I will figure out how I will respond. (I generally respond honestly - no holds barred)
Then I will write it all down.
Then I will type it out and make two copies one for me and one for the therapist.

When I meet the therapist, I will cordially greet them and then after I sat down I would hand them one of the copies.
They may be a little shocked so I will give them several minutes to read the material and not speak or interrupt.

Then they will begin asking follow on questions or try to give words of wisdom.

These I will jot down on my copy, so I can think about it later, when my mind is at rest.

Any serious questions, I will table for later and after I thought about it, I would create my response in writing and forward to them.

They are not supposed to tell you more about themselves because excessive self disclosure

The reason talk therapy doesn't work, is because it's not science; it's basically a religion. It only "works" because the mainstream masses believe that it works. Some religions, like Catholicism, are very ritualistic: the divine Liturgy, the Eucharist, confessionals, giving up pleasures for Lent, etc. Others are very devotion-driven, like Islam, with praying to Allah five times a day. Others, like Evangelism, are all about blind faith: you MUST believe in the King James Bible, and nothing else will do, and you have to keep recruiting new believers.

Consider Catholicism and its transubstantiation concept. It means that host wafers and red wine transform into the actual body and blood of Christ. Do they ACTUALLY transform? Well... Unless you BELIEVE that they transform, as you would as a Catholic, you're basically eating a plain-tasting wafer and sipping booze in front of a church altar. And even a non-Catholic wouldn't say this verbatim in a Catholic church, at least out of respect for people who do believe.

Therapy is the same way. Nobody ACTUALLY benefits from answering rhetorical questions about feelings; they do nothing but make a therapist look like a blithering idiot. I mean, really, WHO WOULDN'T KNOW that being yelled at makes a patient feel sad?! And any therapist dumb enough not to know it in the first place should be stocking shelves at Walmart, not treating vulnerable patients. But because the mainstream masses BELIEVE that rhetorical questions about feelings are helpful, they go along with the practice, despite the naive silliness of it. Also, people are afraid to admit that these questions don't help, lest they be ostracized, so they claim fervently to feel better from such therapy, even when they cry themselves to sleep at night.

This doesn't imply that transubstantiation is silly; I'm using it as an analogy to point out that beliefs don't always follow laws of science.