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How did asd diagnosis change therapy approaches?

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Hi! I wasn’t sure how to sum up my question in one sentence, but, if you’ve previously been diagnosed with anxiety/depression and done therapy for that eg CBT... then diagnosed with asd... how did this change the approach to the issues you were having? Do therapists still tackle the issues the same way, or does the asd diagnosis change things?

I guess I’m asking this because I’m still trying to work out whether to pursue a diagnosis (I’m terrified to do this!). I’m wondering if I could be approaching certain issues I have (like difficulty going new places, rigidity around rules and plans etc) in a specific/new way that might be more useful if I do in fact have asd. Or whether part of a diagnosis would be recognizing that the years of therapy didn’t make a new person out of me because maybe I’m never going to change (and then how do I deal with that?)

I hope they makes sense. Just thinking out loud at you. Thanks for reading :)
 
Well, I don't think your question covers all the potentially helpful options here. Having ASD is only part of who we are, so therapy can often be useful, in my experience, growing up when no counsellors therapists or anyone much, factored in autism. I did a lot of therapy, which I paid for out of my earnings, and it helped me cope with life.

I also trained as a counsellor, family and relationship therapist, and learned a lot from this too. I subsequently trained others in these areas for many years. I came across interaction with young people with Aspergers and their families as a therapist relatively late in this journey, by which time I was able to recognise while reading about autism, the missing piece of the puzzle for myself.

Training in the area of autism is still rare for therapists. Therapy approaches have developed without much awareness of neurodiversity, and also have often suffered from problems such as competitiveness between their founders or developers, as to what is the best way to help clients.

Latterly this has begun to give way somewhat to recognition that there are a number of useful, well researched and well founded approaches that can benefit clients, and that the most important variables are 1) the specific needs, wishes and situations of the clients, and 2) the ability of the therapist to use the approaches in a way that is helpful to the client.

Sounds obvious? Well, many therapists would still argue that it isn't even true, and that their particular approach that they happened to train in, is always best... it's a baffling phenomenum, but maybe not so different from some other fields, or even some fields of science and medicine, where reputation and influence can sometimes slow progress that would be helpful.

So I guess I am saying, you won't necessarily get therapy that is different or that is delivered with an informed awareness of autism, although it's possible that you might.

On the other hand, therapy may be useful despite this, if it's reasonably well suited to you and your needs, and if the therapist is capable and respects you as an individual.

Plus, you may feel you would be able to be your own adviser and advocate in respect of effects of autism on you, and in making adjustments to therapy tasks or recommendations so that they fit you better. Ideally a therapist would want you to do this, if they do not have much knowledge of autism themselves. Therapy actually isn't something any expert can do to or for you, it really only works if the individual actively participates.

However in my experience, therapy that is delivered from a position that the therapist is the expert, is all too common. This can be seen as more like behavioural training, where you are taught to behave in certain ways so you seem more 'normal'. It doesn't approach you as a respected and unique individual, and is unlikely therefore to have any useful long term effects.

Specifically, CBT is great for some people, and not helpful or liked by others. It can also depends on the ability of the CBT therapist to deliver it, as to how helpful it can be. One variable I have noticed with clients reactions to CBT approaches, can be whether they prefer emotional recognition and approaches to approaches based on thinking things through.

If the former, CBT may not work well for them, as it is essentially cognitive and uses tools based on using thinking to change behaviours, whereas some people are more comfortable with approaches that start with their emotions, and help with their feelings. A good therapist can use CBT to help a feelings oriented person, or they may have other approaches to offer that are more feelings based, like EFT, emotionally focussed therapy, or similar.

Finally, what terrifies you about pursuing a diagnosis? It sounds like you think if you were to have autism, you wouldn't be able to change anything about yourself? This is not true at all. Autism is part, not all, of who we are. I have changed plenty about myself, over the years, and often without anything like the best help or the therapy I would have liked, but in quite effective ways nevertheless.

For example, one aspect of us is our ability to develop relationships with others. Research shows that people with autism have developmental attachment styles much the same as anyone else. This means that our security levels in relating to others can improve if we work in therapy to develop ourselves, and indeed if we just get some practice in relating and opportunities to spend time with others in ways we find useful or enjoyable. This is not about learning social skills, but about learning how to attach to others in ways that make us feel better, and that are mutually enjoyable. Many people miss out on learning how to do this in childhood due to parents being stressed, or ill or depressed, or for other reasons, such as poverty, or their needs going u noticed at home or school, which may apply to many with autism. But people with autism are able to improve their levels of secure relating much as Neurotypical people can.

When autism is said to be unchangeable, it doesn't actually mean you as an individual can't change anything about yourself. It means, you can't change that you are autistic, as opposed to neurotypical. There are some aspects of being autistic that won't change, in my experience these are around processing slowly and being rather disorganised, missing social cues, getting confused finding my way in new places etc.

Different people will have different effects of autism, but even these we can work around. It's like being left or right handed, or being good at sport rather than languages, it's just differences, and everyone is different.

Hope this is helpful, sorry it's so long!
 
We all change anyway, it's nature.
Be your own adviser like Thinx says.
A neat trick I learned for sticking to my "rules" and breaking them at the same time was, for example, to only stick to it every other time, or only every third time. (If I forget where I'm up to I count forwards or backwards according to whim).
Being single and not working, a way I've invented to get things done is to do 10 minutes of this, 10 minutes of that, 10 minutes of the other, then particular issues don't get too "in my face" (intense), and before I know it I'm getting a glow of achievement and enjoying the variety with it.
Another things is, in my space, I use shelves (with those wire holders): go up the walls to save going up the wall!
Make your "problems" work for you and not against you!
 
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I live in France ( not French) and I was terrified too, of pursuing asd and terrified of not pursuing it and especially because I read everywhere, that aspergers is not recognised in France and females are not recognised as having aspergers.

I was seeing a psychiatrist and was diagnosed with ptsd, social phobia and anxiety. I tried, for some inane reason, to insist I suffer depression, but did not fall for it, because I know that I do not. Even though many of the things I was describing ie obsessions, taking things literally; not understanding social things, he not once pursued those and it was only when my husband approach the subject of getting me tested for aspergers, did something happen. He, the therapist, tried to unhinge me with questions of: why do I want to be diagnosed? Of what benefit etc, but happily, I had already gone over those sort of questions in my mind, so was not put off too much.

I was transferred to a neuro therapist and surprisingly, got an appointment within a couple of weeks. Vastly amused when she got me to do the aspie quiz, but in French and then tested me on a few other things and said that she would contact me again, with another appointment to see an expert in autism. However, she did contact me, but it was to go and see her again. She informed me that my test came back as typically on the spectrum and noted that I stimmed a lot and became obsorbed in what I was doing. She also told me that it was obvious I have a brain freeze with numbers as she could see me panic when I was confronted with numbers.

She also told me that most surprisingly, the expert had a space in his diary and wanted to see me. Surprising, because it takes months to organise an appointment.

He was very kind and just wanted to describe my childhood and since my memory is long, I was able to give a detailed account and at times, he wrote furiously, so I guessed I had said something of interest and in the end, said that he wanted to see me once more, but he had no doubt I was on the spectrum!

Weirdly, despite all the testing, in the end, it came down to ticking boxes on a piece of paper to say: to what degree did I suffer when a child. It seemed nothing else was accounted for, which I found strange and I did not even get an official document to say that I am on the spectrum.

It has been a huge benefit to me. I am medically insured for 10 years and I am a little bit more assertive when I say about my needs. Neurotypicals love professional diagnostics and my husband was with me at all times, so he fully takes it on board that I am on the spectrum.

It is wonderful from feeling a fraud and saying: I could be on the spectrum, to I AM on the spectrum and even though I am not a classic case ie I do not have a montoned voice. I am also expressive and not particularly a genius, but no one questions me now, because of that formal diagnosis.

Do apologise for the book.
 
Well, I don't think your question covers all the potentially helpful options here. Having ASD is only part of who we are, so therapy can often be useful, in my experience, growing up when no counsellors therapists or anyone much, factored in autism. I did a lot of therapy, which I paid for out of my earnings, and it helped me cope with life.

I also trained as a counsellor, family and relationship therapist, and learned a lot from this too. I subsequently trained others in these areas for many years. I came across interaction with young people with Aspergers and their families as a therapist relatively late in this journey, by which time I was able to recognise while reading about autism, the missing piece of the puzzle for myself.

Training in the area of autism is still rare for therapists. Therapy approaches have developed without much awareness of neurodiversity, and also have often suffered from problems such as competitiveness between their founders or developers, as to what is the best way to help clients.

Latterly this has begun to give way somewhat to recognition that there are a number of useful, well researched and well founded approaches that can benefit clients, and that the most important variables are 1) the specific needs, wishes and situations of the clients, and 2) the ability of the therapist to use the approaches in a way that is helpful to the client.

Sounds obvious? Well, many therapists would still argue that it isn't even true, and that their particular approach that they happened to train in, is always best... it's a baffling phenomenum, but maybe not so different from some other fields, or even some fields of science and medicine, where reputation and influence can sometimes slow progress that would be helpful.

So I guess I am saying, you won't necessarily get therapy that is different or that is delivered with an informed awareness of autism, although it's possible that you might.

On the other hand, therapy may be useful despite this, if it's reasonably well suited to you and your needs, and if the therapist is capable and respects you as an individual.

Plus, you may feel you would be able to be your own adviser and advocate in respect of effects of autism on you, and in making adjustments to therapy tasks or recommendations so that they fit you better. Ideally a therapist would want you to do this, if they do not have much knowledge of autism themselves. Therapy actually isn't something any expert can do to or for you, it really only works if the individual actively participates.

However in my experience, therapy that is delivered from a position that the therapist is the expert, is all too common. This can be seen as more like behavioural training, where you are taught to behave in certain ways so you seem more 'normal'. It doesn't approach you as a respected and unique individual, and is unlikely therefore to have any useful long term effects.

Specifically, CBT is great for some people, and not helpful or liked by others. It can also depends on the ability of the CBT therapist to deliver it, as to how helpful it can be. One variable I have noticed with clients reactions to CBT approaches, can be whether they prefer emotional recognition and approaches to approaches based on thinking things through.

If the former, CBT may not work well for them, as it is essentially cognitive and uses tools based on using thinking to change behaviours, whereas some people are more comfortable with approaches that start with their emotions, and help with their feelings. A good therapist can use CBT to help a feelings oriented person, or they may have other approaches to offer that are more feelings based, like EFT, emotionally focussed therapy, or similar.

Finally, what terrifies you about pursuing a diagnosis? It sounds like you think if you were to have autism, you wouldn't be able to change anything about yourself? This is not true at all. Autism is part, not all, of who we are. I have changed plenty about myself, over the years, and often without anything like the best help or the therapy I would have liked, but in quite effective ways nevertheless.

For example, one aspect of us is our ability to develop relationships with others. Research shows that people with autism have developmental attachment styles much the same as anyone else. This means that our security levels in relating to others can improve if we work in therapy to develop ourselves, and indeed if we just get some practice in relating and opportunities to spend time with others in ways we find useful or enjoyable. This is not about learning social skills, but about learning how to attach to others in ways that make us feel better, and that are mutually enjoyable. Many people miss out on learning how to do this in childhood due to parents being stressed, or ill or depressed, or for other reasons, such as poverty, or their needs going u noticed at home or school, which may apply to many with autism. But people with autism are able to improve their levels of secure relating much as Neurotypical people can.

When autism is said to be unchangeable, it doesn't actually mean you as an individual can't change anything about yourself. It means, you can't change that you are autistic, as opposed to neurotypical. There are some aspects of being autistic that won't change, in my experience these are around processing slowly and being rather disorganised, missing social cues, getting confused finding my way in new places etc.

Different people will have different effects of autism, but even these we can work around. It's like being left or right handed, or being good at sport rather than languages, it's just differences, and everyone is different.

Hope this is helpful, sorry it's so long!
Thank you for your insight!
To answer your question - I am scared of pursuing a diagnosis because I feel like a fraud and that I’d get laughed at if I even suggested the idea. I’m not scared of the diagnosis.
 
I guess I’m asking this because I’m still trying to work out whether to pursue a diagnosis (I’m terrified to do this!). I’m wondering if I could be approaching certain issues I have (like difficulty going new places, rigidity around rules and plans etc) in a specific/new way that might be more useful if I do in fact have asd. Or whether part of a diagnosis would be recognizing that the years of therapy didn’t make a new person out of me because maybe I’m never going to change (and then how do I deal with that?)

Firstly - Hi and Welcome

Secondly - whether to get a diagnosis. There are lots of people in here who are self diagnosed. Whether you go for the formal diagnosis or not is your call. There are lots of threads where people are arguing for or against.

What you might consider doing is looking at which parts of your behaviour make more sense if you were on the spectrum. THis might make things easier for you to understand and perhaps accept.
 
... I am scared of pursuing a diagnosis because I feel like a fraud and that I’d get laughed at if I even suggested the idea. I’m not scared of the diagnosis.

That sounds like what Donna Williams calls "exposure anxiety" (which NTs also get sometimes incidentally). Figure out whether you have a deadline to decide or a flexible timeframe to continue thinking; then think up whether a diagnosis will help you open doors for yourself (which is what it is supposed to be for); that might give you enough confidence to go ahead with seeking it; also check out who is best qualified. You are entitled to research how to help you take a full part in making up our society along with others, each in their unique way.
 

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