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A Question Regarding Complying With Therapy

Balldez

Active Member
Here's a hypothetical. You are an adult who get a diagnosis somewhere on the spectrum. You are offered therapy designed to help you function and be less stressed out. You are also told that the therapy could make things easier on your loved ones.

In your experience are asperger folks more or less likely to comply with therapy of are they about the same as others?

What would you tell a stubborn patient/loved one who is refuses to get help?
 

Bolletje

Overly complicated potato
V.I.P Member
I think compliance is more dependent on personality and motivation than on whether or not one is on the spectrum.

I also think it's hard to effectively motivate someone into going to therapy, as it's internal motivation that counts most.
 

Gracey

Well-Known Member
The choice will always remain with them.

You can't help someone who doesn't want to be helped.

See the therapy for exactly what it is, offered to assist, not cure, brainwash and so on.

Check that 'stubborness' isn't actually fear of the unknown or upsets routines.
 

Major Tom

Searching for ground control...
V.I.P Member
I think therapy is one of the best resources available, but you have to comply and want it to work. Just like anything in life, you get what you give. I think this applies to any human being, not only those on the autistic spectrum.
 

Suzanne

Well-Known Member
V.I.P Member
That is one of my biggest fears with seeing a psychiatrst, because if I disagree with him or her, can I just go along with it, just to get what I need? I cannot answer that, until I am in the room.

I am pretty sure I will be offered medicine for my extreme social anxiety and know that if I decline, this will probably go against me, getting financal help from the state, which would involve me lying. In effect, like the person in a mental hospital, ordered to take pills, but all they do is cause comtose effect and not much else, so the patient hides the drugs or throws them down the toilet and then has to pretend.

Now the thing is, due to my background, I am a good liar and so I can sadly meet a person's eyes and just about lie and be believed and this happens when self preservation is on hand. Otherwise, I do not lie and hate it.
 

Gritches

The Happy Dog
V.I.P Member
A therapeutic relationship carries the designation as being a type of relationship because, like other relationships, you get out what you put in all other factors being equal.

That said, I resisted therapy pretty hardcore as a kid. It was because I didn't want to be there. I didn't want to be there because other people were sending me there because I was a problem for them. It seemed like a punishment to me. My parents had the attitude like they could just drop me off at the brain repair shop and say "our son is broken, can you fix him? Oh, and it's almost winter, could you put snow tires on him and check his fluids? See you in 60 minutes, k thanks"

It was later on when I had reached an adult level of maturity, when it was my decision to go and when it was me that directed my care that I started to really get it.

Some people are ready for therapy. Others will resist. It's not like getting a shot in your arm; forcing someone into therapy usually just makes things worse and builds resentment for therapists. If hypothetically you wanted to get someone into therapy that they will benefit from, your best bet would be to let him pick the therapist even if nobody knows anything about them, let him switch therapists if he wants (because if things go wrong, then it'll be blamed on that therapist instead of therapists in general), and maybe beforehand spend lots of time and gentle effort getting him actually interested in the topic of psychology (it would lessen the fear of the unknown, give him something to talk about with the therapist, and increase his knowledge of this very broad and deep topic in general).

The success rate for talk therapy is dismally low (about 7% see any benefit whatsoever) and it's because we're so accustomed to going to a professional, giving them money, and then getting what we paid for. Great for getting a new muffler on your car, not so great when you're essentially paying the mechanic to make you install the muffler yourself.
 

Flammie91

Well-Known Member
Ive found therapy to be kinda redundant, I had seen counsellors, psychiatrists, social workers, you name it for a period of about 20 years. I just kept expecting more from it than what was offered. I wanted to vent and basically for someone to point me in a particular direction or lead me to a some sort of substantial support, whatever that might be.. all most of them done was kinda chastise me with these vague concepts and phrases, and the medication I was offered did nothing for me only slow my metabolism and suck the life out of me. They give you the impression theyre going to actually offer a service to you while basically telling you that you have to do all the work, but I have a lot of trouble with complex tasks and navigating things, even after all this time. I just dont understand the point of it all. What is it that they are doing? If anything its just leading people astray and confusing them all the while they can be focusing on their problems and trying to solve them themselves.
 

Judge

Well-Known Member
V.I.P Member
Therapy might be a limited tool of sorts regarding the spectrum of autism. Though it would always be alarming to me to hear any person employed in the medical field who treats it like a potential cure. :eek:
 

OkRad

μῆνιν ἄειδε θεὰ Πηληϊάδεω Ἀχιλῆος οὐλομένην
V.I.P Member
i agree with Flammie. If you do not respond to all their tactics, you are "not complying". You can put your whole soul into it, but to them, You are not trying. You are trying WAY harder than the next guy, but it is YOU that is the non compliant one because it does not work.

In cancer care, if a treatment does not work, NO ONE blames to patient. No one says, "You just did not want it work. It will only work if you make it work."

In my thinking, if it does not work, it is not the fault of the client. Maybe the client is smarter than the therapist. Maybe the therapist has a bias. Maybe the therapist can't connect, maybe the therapist has a drug problem or getting a divorce, or losing a home.

I know is medical care, the dr matters, if he has done a procedure , etc........so I understand that human contingencies matter. But in mental health care, why is it the patient is ALWAYS blamed?
 

Judge

Well-Known Member
V.I.P Member
I know is medical care, the dr matters, if he has done a procedure , etc........so I understand that human contingencies matter. But in mental health care, why is it the patient is ALWAYS blamed?

IMO I suspect the dynamics of any hierarchy. Where those in control must fundamentally remain in control. Whether they actually know- or not what they're doing.

Or as others more simplistically comment on in terms of what "rolls downhill".

That said, how many of us unequivocally believe that the best of what psychiatry, neurology and psychology have to offer is presently adequate or superior in the treatment of Neurodiversity? In a system where politics and economics seems all too often to drive such considerations. A far cry from the concerns of Hippocrates.
 

vangelis

Behind the Mask
I am considering therapy so interested in reading the views above. Before seeing anyone I have decided to write all my thoughts down, almost like an abridged version of my life story. This way I can get all the crying out of the way first hopefully so that if and when I see someone I won't waste time and money just sat there blubbing. I don't think all my issues are down to AS, some are parental related and some from a relationship I had as a teenager. There is plenty of material for a therapist to tackle I am sure and I know it is up to me fundamentally to deal with it but it might be nice just to open up to someone as I have had a somewhat hidden life until now and for some reason it is now getting to me.
 

Bolletje

Overly complicated potato
V.I.P Member
@OkRad I understand where you're coming from. However, I also feel like therapy is a two-way street. When I first started seeing a therapist I did not see the point of doing assignments, because I felt like the therapist was just supposed to figure out what was wrong and fix it. I didn't see the point of doing assignments that made no sense to me. Suffice to say, I didn't make a lot of progress.
It wasn't until years later that I had a therapist that really went over treatment options with me, let me pick which appealed most to me, and explained why I had to do the assessments. That time around my therapy was very successful because the assignments gave me insight into my patterns and responses, made me discover this by myself, instead of having someone else tell me. It made me a lot more capable of, and motivated to, take on my problems in therapy.
 

Balldez

Active Member
That is one of my biggest fears with seeing a psychiatrst, because if I disagree with him or her, can I just go along with it, just to get what I need? I cannot answer that, until I am in the room.

I am pretty sure I will be offered medicine for my extreme social anxiety and know that if I decline, this will probably go against me, getting financal help from the state, which would involve me lying. In effect, like the person in a mental hospital, ordered to take pills, but all they do is cause comtose effect and not much else, so the patient hides the drugs or throws them down the toilet and then has to pretend.

Now the thing is, due to my background, I am a good liar and so I can sadly meet a person's eyes and just about lie and be believed and this happens when self preservation is on hand. Otherwise, I do not lie and hate it.

I hear ya. A lot of people are skeptical of shrinks (the ones who medicate) for good reason.

Here is a suggestion for anxiety. In the 1960 there was a psychologist named Albert Ellis and when he first came out he was considered a heretic because he admitted that psycho therapy didn't work much to the chagrin of his colleagues. Ellis created something called Rational Emotive Therapy known today as Rational Emotive Behavioral Therapy or REBT. It works well with phobias and anxiety.

What REBT practitioners do is instead of listening to a patient babble on about their stuff, REBT practitioner assigns tasks or exercises to the patient. In your case they would probably ask your to think rationally about your reactions and emotions involving inter-acting with people in social situations. Ellis would have his patients walk up to strangers and say, "I just got out of the nut house. Can you tell me what year it is?" You may be terrified to do this whereas other people would get a kick out of it. The more you do it the easier it gets.

The important thing is this. It's best to not care what people think and never apologize for telling the truth.

When it comes to lying or telling the truth, I see it like this. If someone is my enemy if it is in my best interest to lie to them I will lie. Some people don't deserve to know the the truth. Honesty is not always the best policy. When it comes to good people, they deserve the truth even if the truth hurts. If you lie to a person who can do you harm lying is justified.

You really don't want to get a reputation as a liar among people that matter.

If I had social anxiety I would not hide it and I would tell people in social situations that I had it. This is where everyone needs to be honest. We get thrown into this life without invitation and we get dealt the cards we are dealt. It's really kind of cruel if you think about so when somebody judges you unfairly it's best if you let it slide and consider the source. Anyone who would judge you for the cards you were dealt, is not worth your time.

Don't be ashamed of yourself but be ashamed of your behavior if that behavior is shameful and try to do better.
 

Balldez

Active Member
I think compliance is more dependent on personality and motivation than on whether or not one is on the spectrum.

I also think it's hard to effectively motivate someone into going to therapy, as it's internal motivation that counts most.

In the case of the people in my life who I now thinks they have something called "pseudo-aspergers" personality and disposition seem to go hand in hand with the disorder.

If you get a chance to read my intro, my step son and wife think they have aspergers. I don't think they even come close to the criteria but in spite of that, I suggested that they talk to a professional. They refuse and continue to crap all over the people around them. If they would give it a try they would have nothing to lose but their inflated egos and crippling neurosis.
 

Bolletje

Overly complicated potato
V.I.P Member
In the case of the people in my life who I now thinks they have something called "pseudo-aspergers" personality and disposition seem to go hand in hand with the disorder.

If you get a chance to read my intro, my step son and wife think they have aspergers. I don't think they even come close to the criteria but in spite of that, I suggested that they talk to a professional. They refuse and continue to crap all over the people around them. If they would give it a try they would have nothing to lose but their inflated egos and crippling neurosis.
I have read your intro, and responded to it. I understand your frustration but if your wife and stepson don't want to see a therapist there's not a lot you can do.
 

WittyAspie

Well-Known Member
V.I.P Member
A therapeutic relationship carries the designation as being a type of relationship because, like other relationships, you get out what you put in all other factors being equal.

That said, I resisted therapy pretty hardcore as a kid. It was because I didn't want to be there. I didn't want to be there because other people were sending me there because I was a problem for them. It seemed like a punishment to me. My parents had the attitude like they could just drop me off at the brain repair shop and say "our son is broken, can you fix him? Oh, and it's almost winter, could you put snow tires on him and check his fluids? See you in 60 minutes, k thanks"

It was later on when I had reached an adult level of maturity, when it was my decision to go and when it was me that directed my care that I started to really get it.

Some people are ready for therapy. Others will resist. It's not like getting a shot in your arm; forcing someone into therapy usually just makes things worse and builds resentment for therapists. If hypothetically you wanted to get someone into therapy that they will benefit from, your best bet would be to let him pick the therapist even if nobody knows anything about them, let him switch therapists if he wants (because if things go wrong, then it'll be blamed on that therapist instead of therapists in general), and maybe beforehand spend lots of time and gentle effort getting him actually interested in the topic of psychology (it would lessen the fear of the unknown, give him something to talk about with the therapist, and increase his knowledge of this very broad and deep topic in general).

The success rate for talk therapy is dismally low (about 7% see any benefit whatsoever) and it's because we're so accustomed to going to a professional, giving them money, and then getting what we paid for. Great for getting a new muffler on your car, not so great when you're essentially paying the mechanic to make you install the muffler yourself.

The muffler analogy is golden. Bravo sir, bravo.
 

WittyAspie

Well-Known Member
V.I.P Member
I have found that a good friend is far better than any therapy. I don’t open up to people that won’t do the same for me. I don’t feel like I can trust them. I also tend to feel zero human connection with mental health professionals. Interactions feel scripted and fake. Maybe that’s my problem, not theirs, but either way I prefer talking to a friend.
 

WereBear

License to Weird
V.I.P Member
If they would give it a try they would have nothing to lose but their inflated egos and crippling neurosis.

What would be left? Seriously, narcissism comes from a missing developmental stage. They are not whole people. You take away their coping mechanisms and they might be only a black hole of rage and need.

There is a therapist who has written an excellent study of Estranged Parent Forums. These are mostly people with narcissism who were so abusive, and unashamed of it, their children have cut off contact. The therapist explains the limits of therapy with such parents: they are essentially three year old brats, and after a couple of years of grueling therapy, they would end up five year old brats.

This particular issue is that deeply rooted and difficult.

No one is likely to participate, and afford, enough years of therapy required to actually make them functional people. I imagine even the therapist would burn out over something that would consume a large segment of their career. So, in our current state of knowledge, they can't be helped.

Only avoided. I'm sorry.
 

Balldez

Active Member
What would be left? Seriously, narcissism comes from a missing developmental stage. They are not whole people. You take away their coping mechanisms and they might be only a black hole of rage and need.

There is a therapist who has written an excellent study of Estranged Parent Forums. These are mostly people with narcissism who were so abusive, and unashamed of it, their children have cut off contact. The therapist explains the limits of therapy with such parents: they are essentially three year old brats, and after a couple of years of grueling therapy, they would end up five year old brats.

This particular issue is that deeply rooted and difficult.

No one is likely to participate, and afford, enough years of therapy required to actually make them functional people. I imagine even the therapist would burn out over something that would consume a large segment of their career. So, in our current state of knowledge, they can't be helped.

Only avoided. I'm sorry.

I'm a big believer in tough love. Therapists are constrained by their time and codes of conduct and they are really not in a position to teach these people humility and empathy for others. Because Cluster B persons lack empathy they shrink cannot explain it to them by citing examples. Maybe if cluster B person was humiliated enough they would learn humility and respect for others. Maybe if they were made to suffer greatly they would have some sympathy for people who suffer greatly.

While I am against corporal punishment for children I would advocate it for certain adults.

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Since brains have plasticity why not see if an aggressive active form of therapy could be effective. But even if it is ineffective and there are no brain changes maybe they would act pseudo-normal?

This would have less chance of working on a full blown autistic suffer as the autistic brain is structurally different than a normal brain but it seems to me that if the structure is there, then the brain has the potential of being made normal.

If I were a judge and had to sentence a criminal cluster B type I would feel much better about ordering corporal punishment with regression therapy rather than warehousing them in prison which really is cruel and mostly ineffective. Sometimes these monsters learn empathy in prison group therapy but most of the time they don't.
 

WereBear

License to Weird
V.I.P Member
If beating people up worked... it would work. I am not at all an advocate of "tough love" because it doesn't work. It just adds more stress to what is likely a high stress situation in the first place.
 

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