I feel wronged by a psych tester who didn't see my AS

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Hi, I'm a self-diagnosed Aspie as of 3 years ago, and I'm currently a therapist intern working toward having my own private practice. I'm warning you that this is a long post but, hopefully, an interesting one.

I recently got a report back from the psychologist who performed several tests on me in the past few weeks, since I wanted to see whether I could get the Asperger diagnosis for professional purposes. (I don't need it for identity or for anyone to tell me I have it in order for me to know I do. I'm a secure, perceptive, and confident person.)

She got me almost completely wrong, so I sent her some clarifications of the facts she blatantly screwed up and also her extrapolations based on those falsehoods. Facts she got wrong include her thinking my mother was bulimic (nope, anorexic), that I didn't receive enough caring as a child, that I binged before purging when I was eating disordered 6 years ago - no, I only used to purge, and that I'm currently depressed, "chronically distressed," lonely, insecure, empty, and uncertain about my identity, sexual orientation, and values (I'm settled in all areas). Wow, how did she totally mishear what I told her? I'm happy and fulfilled and have a good relationship with both parents (versus just my mother) and my boyfriend, despite a few small troubles and growing pains. She also thought I tattooed my body "in order to get back at her father." Haha. I did it IN SPITE of his preferences to the contrary, not BECAUSE OF them. That's an important distinction. I just follow my personal values and preferences, no matter what the consequence. In fact, the first time I really "rebelled" per se was buying a car he didn't want me to get. And, even then, it was a healthy act of individuation.

She said that, because I don't seem to have problem with eye contact, I don't have Asperger Syndrome. This demonstrates an incomplete knowledge about the syndrome, since it's more complicated than that and since many Aspies have a stiff, unwavering gaze. Actually, eye contact makes me uncomfortable and tires me very easily, but people don't see that because I hide my discomfort and do it anyway in order to make others comfortable and to gain their liking (if I care). It's because eye contact is so exhausting over time that I'm afraid I may not complete all the requisite therapy session hours with clients in time to sit for the licensing exam. I have to have a lighter schedule than most for this reason, and I'm interested in doing internet counseling down the road when I have the option. I want the Asperger diagnosis in order to possibly get an extension from the licensing board on the time window for accumulating hours if needed.

And there was a lot more. I'm now seeking a professional who knows more about these disorders, since I mistakenly thought she did when I started out with her. It sucks that I've probably wasted time and money.

For now, this is the last e-mail I've written her:

[I asked for another meeting to make corrections but then decided to just e-mail the clarifications and meet later to pick up the corrected report.] "I hope you don’t mind. I just feel that I spent so much money, so I’d prefer an accurate depiction rather than a distorted caricature based on misinformation. Please do not take any offense. You did get a lot right on here, but I may have also misled you at points. Anything I didn’t touch upon here was correct in the report, which is great.

Please see the attached document when you have time."

In response to the psychologist's claim that self-diagnosing gets in the way of knowing and developing myself and my relationships, serves as my way of finding identity, and interferes with my functioning:


The reason for my self-diagnosing is not so much for identity but for practical concerns so that I can problem-solve around any problems. Recognizing my sensory issues, for example, has led to many useful solutions (wearing special glasses in therapy sessions has made me “hear” more of what clients are saying). Explaining such things to people I’m close to helps our relationships because then things are not taken personally and problems can be worked around more effectively (such as needing more alone time and being more assertive about avoiding uncomfortably overstimulating environments). I only diagnose SO THAT I can function better. I am aware of all the other aspects that make myself up and base my identity on my abilities and personality characteristics. Being a therapist (and, ideally, a good one) and a balanced person with both personal limits and caring makes up far more of my identity than any notion of Asperger or other diagnoses. So I feel your conclusion that diagnosing gets in the way of knowing myself and having good relationships is false. Diagnoses are only descriptive, not definitive, and they serve a practical purpose. I’ve been cautious to only see them that way. I feel you don’t see my already deep understanding of my personality traits. Nothing you’ve told me has been news. What I was searching for starting 3 years ago was a reason for having neurological experiences that others don’t, which made me feel different. Now, I’m at peace because I know it’s not just “all in my head” or that I have a poor character or work ethic. And I can move on and work on other aspects of myself more effectively due to this increased self-acceptance. It’s been very positive for me.

I fantasize about sending this letter if she refuses to correct her report after reading my clarifications, but I'm not going to send it. It was a way of coping with the anger for me:

"I am disappointed that you assumed so much without asking for clarifications from me, and then denied them when I later did. I have come to find that a good therapist or tester is one who asks plenty of questions about both the past and present, but you’ve decided to focus on the past and assume it is the same as the present, on top of taking on a few ideas – some true and some false - and twisting them based on your personal biases rather than matching my actual story. It’s possible you were also misinformed by [my former therapist], who too had difficulty understanding me - largely due to an incomplete knowledge of the way autism spectrum disorders work.

What you have basically done is reverted back to the “refrigerator mother” explanation of autism symptoms (in my case, “refrigerator parents”), which has since been revoked by the psychological community. You have essentially stayed in the middle ages of the psychological field’s knowledge due to your bias that all behavioral symptoms are due to emotions, and any biological claims are evidence of somaticizing unmanaged and unexpressed feelings. Evidence of my good emotion management and excellent progress in my parental and romantic relationships speaks contrary to such a notion, and my biological discomforts do in fact have obvious organic causes. I have struggled through my emotional problems and successfully overcome them, yet my Asperger symptoms remain due to neuro-gastrointestinal reasons. Who’d have thought that something physical could affect the emotional realm, right? Actually, it’s common knowledge in the field these days.

The lack of understanding I’ve had from my parents and from more than one psychology professional now was caused by not knowing the facts and by presumptuous interpretation without adequate exploration of my experience. If you had recognized that neurological difference caused many relationship problems and misunderstandings, you would see that your explanation is the reverse of the truth. You mistakenly assume it was the other way around, probably due to ideas about the normative population and to your bias toward emotion versus science and biology. Both must ALWAYS be taken into account.

My young appearance probably betrays my level of wisdom and awareness, but I feel I didn’t have the chance to express these sides of myself. You asked focused and guiding questions, and then time was up. I often felt our talks were incomplete, but I didn’t say anything because I wanted to trust your process.

When an intelligent and aware client approaches you saying they believe they have an autism spectrum disorder or AD/HD without any anxiety or mood problems, it is more than likely that a biological component is central and actually the primary cause of the person’s past or present troubles – physical, emotional, and relationship problems. I feel you have not studied these disorders well enough to know their true nature, and hence, assess for them. "If you think you have Asperger syndrome, you probably do," says Michael John Carley, Executive Director of Global and Regional Partnership for Asperger Syndrome (GRASP). The symptoms are far too specific and distinctive to be created by psychosomatic means.

I was expecting to be referred to a psychological tester who was more expert on the subject of pervasive developmental disorders, since I initially asked the referrer specifically for an assessment of Asperger. I blindly trusted that I would be given one. After testing, you referred me to other, “more seasoned psychologists” within that scope of practice. I was quite peeved to find out you weren’t one yourself and feel that my family’s money was wasted.

The main lesson I got out of this experience is learning not to trust that every psychologist knows enough without asking them first about their experience in working with Pervasive Developmental Disorders (PDDs). I also learned that I tend to focus on the negative sides of my experiences toward perceived authority figures because I’ve historically had little sympathy and understanding from them in the past and want to elicit it. Therefore, I leave out some of my positive perceptions about my functioning. This is an issue that can be worked on in therapy and that can be healed by experiencing truly understanding future authority figures in my life. Unfortunately, my experience with you has been the opposite, and that bothers me. I hope that one of the psychologists you referred me to can give me a more corrective experience, which must necessarily go along with a good understanding of the truth about my neurological functioning and how it affects my daily life.

I would like to revoke my release of information so that others cannot access the faulty report you have made up about me. I know that HIPAA law requires that clients have the option of revoking authorization to release information. If you refuse, I will take legal action without hesitation, since a friend of the family is a lawyer.

Thank you for your time, and I expect your response in the next few days."


We shall see what happens, but I'd love to hear reactions to all of this.

Last edited by anathemaviolet on 12 Mar 2008, 12:05 am, edited 1 time in total.

It does appear that you do have a point. Based on my own experience of getting a DX, many profesionals are still quite un-informed about the whole autistic spectrum, as if they expect an austistic person to be a non-verbal savant or raving eccentric. Its my opinion that, in my case, (and possibly yours also), that AS is a condition that you can learn to live with, not an ilness that needs to be cured. After all these years of knowing I didn't 'get it' I feel so much more at peace with myself and the world now knowing why I am this way, I am just wired up differently, not ill.
Perhaps the psychological community think that if you seek their services, then there's something wrong that they can do something about; it must be a let-down for them to find out that you, an 'unqualified / lay person' knows more about yourself than they do, so you do not 'present' as an aspie according to their criteria.
So little is still know about AS it should be no suprise that you get treated this way. As I've pointed out times before, AS is a spectrum disorder, some have it worse than others, but that does not mean that you will not be affected by it in some way

If you can keep a lucid conversation going whilst maintaining relatively "normal" eye contact, I doubt a professional would give you a diagnosis of AS (this is in my experience anyway). Most I've seen go by how you appear rather than what you say; how you say it too is looked at. I could force myself to look at someone, but I won't be able to talk for example, or hear what is said by the professional.

The stiff and unwavering gaze is there, staring at her when there's a lull in the conversation with this gaze for example, no matter the context of the situation (fully jovial and yet you still have the stiff gaze). This "blank" look is probably exhibited less than the aforementioned impairment in eye contact, i.e., looking away and showing emotion on your face rather than blankly staring into her eyes.

I had a miserable experience with a "professional," who was really only a psychological tester, someone in the business of giving I.Q. tests. I completely botched the block design test, although I scored above average in vocabulary and general knowledge. She characterized my intelligence as average, although I have taken I.Q. tests before and scored well above. She told me that, basically, I should not have been doing as well as I did at college and she wondered how I even made it to my classes. She asked stupid, irrelevant questions about my childhood and was no help to me whatsoever. If I truly did have a disability, it went undiagnosed. AS wasn't even a known diagnosis in the 1980s in this country. Other people got help for various disabities campuswide, but I felt like I was treated like a crazy person or defective. Since my condition didn't limit academic performance, it was concluded there was nothing really wrong with me, and that I was a spoiled brat. Well, maybe I am spoiled, but that's beside the point.

So wait, you want a diagnosis? Why?

Ive often just wanted to go and get a diagnosis though I cant be bothered paying for it. If I did I know I wouldnt be able to make eye contact enough.. many job interviews I have been to have suggested "more eye contact" as a feedback tip for me.

I would like to suggest "less eye contact" as a tip for them... but anyway..

I'm sorry you had to go through all this. Like you said, in the future, look for a professional who is used to dealing with Pervasive Developmental Disorders. I got really lucky, because the Autism Resource Center in my state is right down the street from me and the director of it evaluated me (and told me I have AS). She then referred me to a professional who is very educated on the subject of the autism spectrum, and she also determined I have AS.

So I think you're right - you need to be very particular about who you see from now on. We forget that we are hiring these doctors to help us.

You know that the world has gone bad, if the experts read into the old stereotypes.

I think you should go and see a psychologist who works with people who have AS day in and day out and ask for an assessment.

At my first contact with health professionals I was told that I don't have AS and I had not even been assessed yet. I was diagnosed only when I went to someone who actually works and helps people who have AS. One thing that I think is important is to go and be assessed with an open mind because there is a chance that you may not have AS. In my case I thought I had AS but I did not know 100%. I felt wronged because I felt that the person who said that I don't have AS was going to deny me a proper assessment.

So you know how to go about "treatment". Self-diagnosis will never equate to being certain you have one of the disorders in question; if you have social anxiety plus OCD rather than AS for example, the treatment is entirely different.

Other disorders that can appear as AS to the inflicted individual, can be effectively treated with CBT and medication therapy.

Sadly, experiences like these are not uncommon. I think for two main reasons:

1) The full autism spectrum has only more recently been recognized; therefore, it takes time for symptomology to be fleshed out (they come up with a starting list like the DSM but then slowly add more to the profile over time). Therefore, while all this is happening, it takes time for the broader concepts to disseminate through the professional fields and be put into practice. So a lot of people, especially now, are working off older profiles/stereotypes, as the fields slowly try to catch up (though the larger fields always lag behind the true expertise)

2) Let's face it, currently diagnosis is an art, not a science, and there are just some REALLY sh***y "artists" out there. The mental health fields are overwhelmed with workers, but they honestly don't all have the talent to be in the fields they're in.

I went through something similar: initially I sought out a diagnosis from my psychiatrist (he was a resident just out of medical school). He said "no". Then I set up an assessment with a child psychologist (bad idea). He said "no". My therapist, who specialized in Personality Disorders (not developmental disorders), said "no".

Finally, I had enough sense (and was stubborn enough to still think I was right) to step back and realize "These people don't have the necessary experience!" So I finally sought out an assessment at a local autism center. Ba da bing: AS was confirmed. I took that assessment to another Psychologist for the official stamp.

These are ALWAYS the things I recommend to people if they're seeking out a diagnosis for an ASC:

1) find a professional who is VERY experienced with ASCs (if that's possible in your local area);

2) find a professional who has experience diagnosing people in your age range (don't just go to someone who has experience with kids; as kids we usually present more severe so his/her concept of ASCs may be different and you may risk not getting the diagnosis);

3) find someone who has experience diagnosing your sex-- this is especially important for females, since diagnosticians usually have less experience diagnosing us and more with males, but we may present differently (or less obviously), so it's important to find someone who is aware of this.

If it's possible, following these three things will give you a much better chance of getting accurately diagnosed. I always say avoid the local psychologist or psychiatrist EXCEPT for the referral. Then go to someone who knows what they're doing.

This is an excerpt from the book "Cognitive-Behavioral Therapy for Adult Asperger Syndrome" which my therapist photocopied for me:

Myths about AS:
-People with AS are always aloof and uninterested in other.
-People with AS have no relationships.
-People with AS do not make any eye contact.
-People with AS lack empathy for others.
-People with AS are intellectual geniuses.

There are longer explanations in the book, if you want to look at it or show it to a professional.

so they can officially say they have aspergers of course. a dx isnt going to do anything for you unless its severe enough and you use it to get some benefits or something

also i hope this doesnt come off the wrong way because thats not my intention but if your looking for an As diagnosis more than likely you dont have it. i relise alot of professionals dont always catch a correct diagnosis, but im not suprised that people looking for one dont always get one

I am sure that some people might look for a diagnosis thinking that they have AS when they don't have it, but they must surely have some problems that they need help with if they are seeking a diagnosis. If they are not diagnosed they may be able to get help or a different diagnosis which would suit their problems and get them help.

richardbenson - I have to take issue with your statement that if one is looking for an AS diagnosis, then more than likely one doesn't have it. I'm not sure how that could possibly be the case. Are there those out there who think they have AS that don't? Absolutely. But there is also a large segment of people here on WP who have been told over and over again about their "problems/quirks" that it got them thinking about AS and prompted them to get a diagnosis.

I dislike sweeping generalized statements about how one would be diagnosed with AS. People with AS take many different paths to receive a diagnosis and some started on that path on their own.