What can I expect from Therapy?

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Excellente'.

btbnnyr - I thought about your question some more. I forgot to mention one other factor.

My evaluation, while seemingly thorough, consisted mostly of neuropsychological testing and questionnaires with little time spent on actual discussion with the diagnosing Psychologist. While I was with the Psychologist for ~ 6 hours, we spent < 30 minutes actually talking about my history. Yes, I did provide the diagnosing Psychologist with a bunch of written material covering my history. But we spent little time actually talking about it.

Based upon my readings of Wrong Planet, it seems like a LOT of people are diagnosed on the spectrum using little or no neuropsychological testing. In other words, rather than neuropsychological testing, the diagnosis is based entirely on a series of in-depth discussions (about various topics including childhood development, …).

So, I was kind of hoping that the Psychologist (that I am now seeing), based upon actually talking with me about my history, would get to know me better. And from there, could simply confirm (or not) that diagnosis.

So she agreed to work on the things you wanted to work on? That's good. I hope things work out well.

Based on your long self-report document, your long diary, and your participation on WP, I don't think that in-depth discussions about your history or traits can be untainted anymore by all the stuff that you know and think about in relation to autism and you having or not having it. So these discussions are probably useless unless they are used for therapy to help you deal with different aspects of daily life, which this psych seems to be focusing on.

Besides discussions and psych tests, the diagnoser would also have observed your behavior and interactions with them. Were those noted in the diagnostic report?

Thank you. Knowing me, I am quite certain I will post most in this thread, as I go through this journey.

btbnnyr – Thanks for your response.

I had wondered this myself. I even brought this up during this week's session. I have no doubt that confirmation bias (I believe that's the correct term) comes into play here. It is quite easy to think of things in my past or things that I experience in the present which support the diagnosis.



I just re-read the diagnostic report. It talks about certain behavioral observations (being tentative, not holding eye contract, tremulous speech, nervous affect, flat facial expression). I was pretty nervous. Which wasn’t a surprise. I would think anyone going through a diagnosis like this at age 50 would be somewhat nervous. It talks about how I verbally mediated tasks. Apparently, as I talked through tasks I also made noises (I didn’t remember doing that). It mentions how I bogged down in the details and over-focused on the minutiae. It mentioned that I counted on my fingers (can’t remember when I did that). It even mentions the way I gripped the pencil (not certain what the significance of that is).

There was also a section on Social/Emotional. I am not certain where this Psychologist figured this stuff – from talking to me – or possibly from the results of one or more tests (including Rorschach). It pretty much says that I a) lack coping capabilities; b) worry too much; c) relate to others in an immature manner; d) am extremely detailed oriented; e) have self-esteem issues; f) don’t deal well with unstructured situations; g) am self-critical. I had forgotten how pointed some of the observations were. I remember being pretty upset the first time I read the report. Unfortunately, the observations are pretty accurate.

You can expect to sit on a couch and discuss your problems with someone who you dont know while he or she just nods and maybe occasionally scribbles something on a notepad. You can also expect to pay big money for this. Personally, I dont see any use for it and I feel that I would get allot more out of talking to other people who actually have the same mental issues as me and possibly have found ways to cope with them.

I never had this exact experience, but I agree with the conclusion. Mt therapist, after awhile started telling me that I wasn't really all that bad off, and that I don't appear to be "autistic."

Al725 - This makes a lot of sense. Thanks for sharing.



Prof_Pretorius - This is sort of what my wife says (things are not that "bad off"). And, this is true. Things could always be worse. I am hoping the "after awhile" does not happen in my case. I definitely want to "time box" this thing (as I don't want to remain in therapy forever). And for me, therapy forever is > ~ 4 months. As it is very expensive. It would be one thing if I was clinically depressed. But I am not (at least at the present time).

Whether or not I appear to be "autistic" during these sessions. Hmmm. That’s an interesting one. I know she will say I have pervasive worries and sadness and a multitude of obsessive compulsive traits. As those are more obvious (and have existed since early childhood). Of course, therapy isn’t a typical human interaction (at least for me). I don’t typically talk about myself (and my problems, challenges, etc.) to anyone other than my wife (and, I suppose, folks on WP - LOL). To facilitate these discussions, I spend hours thinking about what I plan to talk about. I will then write it down in my journal. I probably wouldn’t be so obsessive about this, if it was free. But it’s not.

My therapist told me that since I'm married, and have close friends, I must not be "autistic."
I later pressed her on her knowledge of the subject, and she told me that her specialty is keeping doctors and nurses sober after they've been caught doing meds.
It's a bit odd in these 'enlightened' times that even therapists think of autism as Dustin Hoffman in "Rain Man."

Not really. If they don't have experience treating people with autism, they don't know about it. Therapists learn by working with different populations of people. I know about all there is to know about drug addiction and addiction in general because it has been my whole life for the past decade (personal, academic, and professional). I also know a lot about the diagnoses that are often co-morbid with addiction. I know nothing about how to treat a person who is schizophrenic because I don't have experience with it. I wouldn't have the first clue how to affectively treat that person (even if the person wanted help with a drug problem).

The APA Ethics Code says psychologists should not treat a person unless they are competent in treating the condition the person has. If they are not competent, they should refer the person to someone else. I doubt many psychologists follow this part of the ethics code. For practical reasons (no one to refer the person to), ignorance (they don't know what they don't know, which is often the case with AS in the United States), or just hubris (thinking they can wing it because they are such good therapists).

Sorry, I know I am rambling. But it is important information if you are looking for a therapist. I lucked into my current therapist. He has a lot of experience with people who have the exact issues I am dealing with right now. But from now on, I am going to ask any potential therapist what populations they have experience treating. It took me way too long to find a therapist who knew anything about autism.

I say just know that you have form of autism spectrum something and work with this therapist to deal with the issues in your life that you listed, or if you find her unhelpful, then follow some posters' advice to end therapy and deal with these issues yourself now that you know you have some form of autism spectrum something and what you understand about your traits as you go. I don't know how long ago you were diagnosed, but maybe it was recent enough that you are still working out what are your traits and how they have affected you so far and what to do now.

Well, I am hoping, after reading the diagnosis and speaking with me over the course of several sessions, that she will come to this conclusion. Or, perhaps some other one.



I was diagnosed about 10 months ago. And, in many ways, I am trying to figure out (assuming the diagnosis is true):
a) What does it mean (to me) to have this diagnosis
b) What do I do now (knowing that I have this diagnosis)

In many ways, I feel like I am simply wasting my life away (since I was trying to fit into a scheme that wasn't really meant for me). Then again, maybe that (wasting my life away) what was always meant to be (whatever that means).

Is that why getting a 2nd opinion about your diagnosis was #1 on your list?

By the way, I can really relate to this. In fact, that is part of what my therapy has been about--learning more about what my diagnosis means on a practical level and coming to believe the diagnosis.

I think so. Plus the fact that others in my family who are in the mental health profession have expressed doubts. Let me be clear, I know there's something different in the way I experience the world. It's been that way since as far back as I remember (back to 4 or 5). I just want to understand it. And, then figure out how to be at peace with it.

Earlier today, I just completed my fifth session of therapy, with the Psychologist. As a reminder, I chose this Psychologist, because she supposedly has experience working with people on the spectrum. Her dissertation was on Autism. Prior to meeting with her, I explained that I wanted to get a second opinion on my original diagnosis.

During some of those sessions, I described why the confirmation of my prior diagnosis was so important (which I also explained in this thread).

So, today the Psychologist mentioned something interesting. She felt that Aspergers should have remained a separate diagnostic category (and not be included within the Autism Spectrum Disorder). That she worked with a lot of low-functioning autistic children and didn’t believe the DSM-V diagnosis fit most high functioning people (those with Aspergers or HFA, I suppose).

I was curious if this is a common belief for therapists and diagnosticians.