Help! What not to do, in a diagnostic interview

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Or, "How NOT to Freak Your Interviewer All the Hell Out", heh.

Okay.
I have Asperger's Syndrome, self-diagnosed, at this point. There's really no questioning it, as far as I'm concerned. See, in all my life I have NEVER truly "related" to anyone or anything. Never found my niche, never met other people "like me," in any but the most superficial of ways. Got along pretty well, but never "fit in" anywhere, because no one ever shared the same experiences and feelings.

Until I discovered Asperger's, and was knocked on my ass by seeing person after person describe the inside of my head. I cannot explain how profound, shocking, and ultimately enchanting that was...but then again, I doubt I have to, here.

Clinically, I have all the requisite major traits, and most of the myriad commonalities. A little information from my childhood, which shows and/or hints at Autistic/Aspergian behavior. And I married my childhood best friend, so he's able to back up a lot of things, giving an outside perspective on the Weird Little Girl I've always been.
The only real "flaws," in how I present, is that I can be extremely well-spoken, due to hefty verbal gifts, and the fact that I'm not only a woman, but generally very well-groomed, thus breaking a few stereotypes.

I'm currently seeking diagnosis through the psych department of a nearby university. One of those PhD programs through which students will dissect your brains, quite cheaply. To be honest, it would make me feel better to have an official-on-paper-and-everything diagnosis, but mostly I'm just trying to make my kids' diagnosis easier, by being able to say "Look, I have it, too."

Now, this psych clinic has never before diagnosed AS, but were very eager, and assured me they felt confident they could do it. Rather like excited puppies, lol. I have a fresh-faced young man who's doing an excellent job of remaining stone-faced, while I answer all the basic psych eval questions, over a few interviews. So far, it's been just that: basic stuff. My husband goes with me, to help me understand what I'm being asked (I still have problems with needing questions to be VERY precise, or else I'll get confused, ramble all over the place, and not really answer anything), and to add things that may not occur to me - my long-term memory is fantastic, but I don't always realize what may be relevant.
Anyway, even though the question have not been geared specifically towards AS, my answers have been Aspergian enough to make my husband crack up laughing, many times. So, I do feel that the point is being made, lol.

Next, I'm scheduled to take a very generic personality inventory, presumably to see if I have the issues they'd expect to see, and no other obvious red flags. And then I think, unless I demand more, the evaluation process will be over - a couple interviews and then testing is their format for every issue/disorder.

I'm getting nervous, now, that I have not been "AS enough." I didn't know how to handle that, from the beginning, and have tried to choose a moderate path. See, I can fake normal. It's horrible to look at, and gives me a headache, lol, but it works fairly well. I can make my voice all Acceptably Perky, and repeat all the banal things people want to hear (small talk). The problem, is that this is a routine, rather than natural, and it devastates my IQ; I cannot really THINK, and fake social, at the same time, so I sound like a goober.

Meanwhile, "Smart Me" stares (sometimes to a harsh degree) while the other person talks, then shows sliding, uneven eye contact while speaking. To think well, I have to look at the floor, or off into space, much of the time. My natural voice is low, and usually flat, unless I'm very amused at what I'm saying. My humor is so dry and/or absurd that very few people get it. I don't show much in the way of gesturing, and have minimal facial expression. Not totally stone-faced, just...very restrained. I have a LOT of stims I do with my hands, and may get up and pace, when I really get going, verbally.
The above is Me, naturally. The above also seems (to me, anyway) like it might appear as attention-seeking behavior, in a psychiatric evaluation. After all, didn't a very polite, friendly-sounding girl call them up for an appointment? Wasn't I very normal-looking, in the waiting room? It just seems like I can't very well get behind the closed door and then totally drop the mask and start looking/sounding all scary.

What I've been doing, is refusing to slip into that weird, fake-ass "social mode," while at the same time, trying to keep a lid on some of my eccentric behavior. I stay in my seat, and do not pace. I let one hand do whatever sort of small finger-movements it likes (because I really don't know what I'm doing, unless I look over and see it), but keep my arms pressed down, so I don't start rubbing all over my legs, or twirling my hands around, or whatever crazy-looking thing might happen, lol. And I never, ever rock; the second I start to move a little, that way, my husband leans against my arm and I stop moving.

Hubby says I should really just let it all come out, but at the same time, he admits I might be right about looking "too AS." I keep pondering and pondering it, and have decided I should at least tell the guy evaluating me the truth, before the end of the process - just let him know that what he saw was me trying to "be myself," without looking TOO weird.


The other, related problem, is that Asperger's and all related research is now my special interest. I've always had a thing for medicine, especially neurological issues, and psychology has been an interest on and off, for more than a decade. So, upon "discovering" Asperger's, and realizing that something finally explained my life (and my kids), it took all of five seconds before that fascination became obsessive.
I don't know everything. But I do know a LOT more than the person evaluating me.

I've been through this sort of thing, with doctors, due to my being so well-read, in medical subjects. Almost no doctor likes that, and I doubt mental health professionals do, either. And obviously, it's idiocy to walk in as a patient, tell them what you have, prove your diagnosis in a droning series of lectures, advise them on the current research/diagnostic tools, and then basically just say "Okay, so you just sign HERE."

I've admitted to him that psychology and medical science are "interests." I've gently advised that I do tend to be a bit voracious, in learning subjects that interest me. I've made self-effacing jokes about knowing too much about Asperger's, and being a pain in the ass. But where is that line? Where is that point at which I will start looking like a hypochondriac, one of those patients who diagnose themselves with every latest condition?


I've read a lot of you WP posters saying that you took in huge, novella-length manuscripts, describing your history of AS traits, and basically diagnosing yourselves. Most of the anecdotes I've read have been positive: the doctor laughed and considered it proof you had AS, or found the documents very helpful, etc.
But does it ever go the OTHER way? Have any of you brought in these huge lists of traits and such, only to have the person evaluating you go "Oh, you're OBVIOUSLY just obsessed with getting this diagnosis; you must not have AS." Any horror stories like that?

It's just....ARGH. My whole life, I've used too many words. Talked too much. Read too much. KNOWN too much. The whole obsessive interest thing has bitten me in the ass so often that it's really one of my deepest secrets, now; I fight all the time, NOT to seem obsessive about anything. Even my husband, who understands it's just how I learn, still gets irritated by it, from time to time. So, I have this massive paranoia about sounding like I know too much, and now, now when I'm being evaluated for a syndrome that HINGES on this sort of thing, I STILL feel like I need to hide it, or else appear like some totally different kind of nut.


I know this has turned into yet another ramble. $%#@. Basically...what ARE your horror stories, where diagnostic interviews are concerned? Who's had someting blow up in their face to the degree at which you left thinking "OMG, IF ONLY I'D NEVER SAID/DONE THAT ONE THING."
Where are the land mines, here; what should I avoid doing or saying? Help me fake normal just enough to avoid getting labeled with something weirder than Asperger's.

Just be yourself!

Bring your baby books (if you have them,) statements from your family about your growing up or phone numbers for family (after you've spoken with them about it) and you should get your diagnosis. That's what I did.

i would like to hear what you find out as well, i am having many of the samae thoughts /experiences as you. i am hoping to get insurance approval for a diagnosis soon myself

Hi. I agree with the PP, I took my baby book, old school reports and my mother filled in a questionnaire for me. Give them as much information as you can. Your husband will be able to give them any information you might miss. At one of my interviews they asked me many questions I simply didn't know the answer to because it wasn't something I'd ever think about. They asked me if I used gestures when I wanted to draw someone's attention to something. I turned and asked my husband, "Do I?" To which he replied that I never did. I learned something new about myself right there so it's good for them to have another person's perspective.

I wouldn't worry so much about how you act/portray yourself. After all, if it really was that easy pretending to be or passing as "normal" then wouldn't we all have nothing to talk about? The fact is we will usually come across as a little odd. The chances are that although you may think you are coming across in a very typical way, they will probably see right through it. They are trained to look for signs and you are probably giving away little signals without even realising. At my interview, the Dr commented that during all the sessions, not once did I shake or nod my head to show agreement with any statements. Little things like that are beyond your control and not something you'd even think about really.

If you want to show your stims by letting them through you should tell about them. I'd think you should tell exactly what you told us - that basically you do this and that, but you try very hard not to because you have learnt it's seen as really weird by others and you often try to control or suppress to your best ability what you are aware of. That is an important thing, you know.

Just let your true self come through. I can't help but stimming sometimes, and my psychologist made a note of my stereotypy as he called it, and he said I was Bill Gates of birds, but I just can't bring it up to him for some reason, and plus the mental illness thing they are focusing on. I didn't know about the university thing, I called a university myself and they wanted to charge 4 thousand dollars for a dx. So this is an unofficial thing? I might be interested in that.

welcome to WP. Your brain sounds delightfully familiar to me.

Just be yourself and be yourself. You are who and what you are.


I took around 30 pages of written self-diagnosis info and my ex-partner wrote a few pages too, which was very helpful.

I might add, the clinical psychologist who dx'ed me is an ASD specialist. HE did not read my written pages until after his dx of me.

Last edited by millie on 23 Jun 2009, 2:54 pm, edited 1 time in total.

You don't need to bring anything other than your Aspergian personality. That's what's being evaluated, not your baby pictures. If they're following professional procedure, it's actually the battery of tests they will put you through that will determine final diagnosis, not an interviewer's opinion. I don't know whether or how being tested by newbies to the disorder will affect any analysis of the data, but I will tell you as a fellow Aspie, I could diagnose you as one of us just from your long, rambling obsessive opening statement. Welcome home.

millie said

Me too- I had to have a little giggle. When I am excited about conveying information I have a tendency to try and say it all at once, going off on little tangents because I have to cover all the bases. I personally would like an official diagnosis although the only tangible way it would change my life is if I decided to apply for disability and I would only do that for the medical coverage of which I have nada now. The truth is I can work but I don't do well with long hours and stressful situations. I am presently getting meds management at a non profit mental health facility in my town. I was in counseling for years but when my therapist retired I decided not to continue. The possibility that I am on the spectrum (I know I am to some degree) makes me think I would benefit from re-entering therapy with the idea of specifically improving those skills I am lacking. One of the reasons I discontinued was I was at an impasse. I couldn't explain to my therapists why I couldn't get a better job or why I couldn't have a relationship, just that I couldn't. The first time she had ever heard of Asperger's was when I told her that my son had been diagnosed. There is a new psychiatrist there who I have met once for meds management. I mentioned Asperger's to her as a likely explanation for my life long troubles and that my son had AS and she said it could be but " diagnosis is for insurance companies". If I decide to go ahead and request an evaluation and if I can afford it on a sliding scale, I'm sure I will be asking myself the same questions tiffofdoom, but my peculiarities would probably shine through anyway. I mentioned to the nurse for my son's psychiatrist that I thought I might also be ASD and she responded in such a way that made me think she already thought so. ( She's awesome-gave me her direct line #). I enjoy your posts tiffofdoom

What I forgot to say was getting an official diagnosis would be beneficial because I have a perverse need to dot my i's and cross my t's. I'll obsess about it if I don't.

Baby books contain things like developmental milestones, temperament and hobbies of young children so has very little to do with baby pictures. A lot of this information can be forgotten over time but with the baby book, it's all there in black and white. With the tests I went through, a lot of the questions were based on my early childhood so the baby book proved to be invaluable.

Hi tiffofdoom - welcome to WP!

I think I understand your concerns about not wanting to tell the doctors what you think is wrong with you - but then again, people do that all the time ("I fell out of a tree & I think I broke my arm," "I'm achy & throwing up - I think I have the flu," etc.) It gives the person making the actual diagnosis a place to start. It's their job, as professionals, to decide whether the stated symptoms add up to AS, or something else.

It's interesting to think that a psychologist might rule out a diagnosis of AS, because the patient stims, can't maintain eye contact and has a special interest!

Also, I think it would be a bit surprising if someone with AS reached the age of 30 without developing certain strategies for "fitting in" (at least for short periods of time) - but Trystania is right - you probably don't act as "normal" as you think you do - it's the little things that give us away.

Best of luck in the remainder of your evaluation!

I have had the same problem
people thought I had aspergers at first, until I got obsessed with it, and that made them uneasy, and they thought that I was trying to use it to be decietful

What I learned during my diagnosis and evaluation was that if I was nervous, my autistic traits stuck out more--so being nervous is actually an asset! It did get me stuck with "anxiety disorder", but I really don't believe I have significant anxiety... nor does my current counselor, for that matter. It was just that during the interviews, I tended to be in new situations, out of my element, and as a result didn't have so much brain space left to consider what kind of impression I might be making or what the interviewer might be thinking. Turns out that was a bonus. I apparently ended up presenting a pretty good picture of what it's like to be me... they even saw a meltdown. (Yeah, stupid me should've gotten more sleep....)

I just wanted to say I really appreciated this thread. I can idenfity with so much of what you said, TiffofDoom.

I think that "since you think you have it you must not because I'm the doctor and you're an idiot" thing is something that mainly happens with "experts" who have something to prove. Such doctors have their own thing going that has absolutely nothing to do with the patient, or that has to do with some past patient. Usually a doctor (or intern, student, whatever) who is generally pretty knowledgeable but doesn't have too much experience with the disorder at hand will actually be better. They'll listen more, be more interested, and will make up for anything that they don't yet know by finding out.. and after not too long, will know more than the person that's already claiming to be an expert... Usually once someone decides they're an expert in something, they feel no need to learn anything else about it, and will demonize anyone who tries to point out anything they might have overlooked. That's an issue that's in the mind of the "expert," not the patient.