What's your view on a therapist openly showing they're autistic?

[AuroraBorealis]

I finished medical school and plan to continue my career in child and adolescent psychiatry. However, I am unsure as to whether - and if yes, how - it would be advisable for me to show that I'm on the spectrum. Both to my colleagues as well as to my patients.
I'm asexual, too, and during internships I wore a rainbow flag keychain but never mentioned it, and no one asked in detail, although some patients showed some interest. Obviously, I never mentioned it to anyone. Since I wasn't aware of my autism then, I didn't give any thought as to how open I want to be with that.

I don't mean displaying a huge banner on the wall saying I'm autistic, or actively bringing it up in conversation with patients. But I do use fidget toys, for example, and I'm wondering if using them during therapy sessions would be seen as unprofessional. Also, I'm wondering if it could put some patients more at ease, if I was fairly open with being on the spectrum. On the other hand, though, I don't want to seem unprofessional or give some colleagues or patients a target on me. I'm fairly good at masking at work, and I'm starting to suspect if mental health and getting people to open up about their feelings might even be a special interest of mine. I go at it very analytically and I am good at it. But I could probably be more relaxed and authentic at work if I didn't hide my autistic mannerisms.

What are your thoughts? How would you feel (maybe also as a child/teenager or a parent) if you had sessions with a therapist/psychiatrist who's openly autistic? Do you think it's unprofessional to have a fidget toy as a therapist or wear an autism pride gadget or something like that?

 

[TBRS1]

Personally, if I were seeing a therapist, I would prefer one on the spectrum because such a person would have a far, far better first hand understanding of my issues than a non-ASD therapist who could, at best, have a technical understanding.

I would literally advertise it. In this case, being on the spectrum becomes an asset - especially if you specialize in working with ASD folk.

Or, if you use a finger toy, you could (should) explain why so your clients don't imagine you aren't focused on them. That would be courtesy, because you know how others often misinterpret stuff like that.

 

[tazz]

I've seen counsellors and psychologists. I wouldn't mind at all if they mentioned they were autistic or asexual. It wouldn't be something I felt I needed to know, and I wouldn't mind if they said so. But I think something like objects you fidget with might be worth mentioning. In my experience the therapist always went out of their way during the first session to mention things and find out whether I'm ok with it or needed something different to make me feel comfortable - for example the light and noise in the room, whether and why they might take notes, the fact that there was a busy office next door and I might hear people coming and going but that they can't hear what we're talking about, wearing a mask (during covid), the seating arrangements and so on. They always seemed very open to making changes in order to help me - and I kinda think that's how it should be. They are there to provide me with a service. They are at work in a professional capacity. So making changes to enable me to get the help I need is primarily the therapist's responsibility. That said, I also understand that the therapist is human too so if they said they have a condition (wouldn't even need to name it) which means that they need to fidget, I'd try to adapt myself. In my case, I wouldn't have a problem with the therapist fidgeting. But, if for whatever reason the therapist couldn't work without it and it was also something that was very off-putting for me, then I'd expect to have a grown-up conversation about it and if no compromise can be found, then maybe I need a different therapist - but that is quite normal, to perhaps go through one or two therapists before finding one you can get on with.

 

[Jumpinbare]

I would appreciate the honesty of a therapist. You say you mask well, but I thought I did too, but some friends saw through it anyway I found out later.

 

[Judge]

Elation, exaltation, etc.

Particularly after having to deal with a therapist who came across only as a disinterested HMO bureaucrat.

 

[Gerontius]

Am autistic and asexual. I'd probably be more open around a therapist like that. But--

- I grew up with a strongly reactionary personality. This cancer of the mind makes one less likely to trust people not in the "in group" which for me was rural people, conservatives, and a sub-fraction of Catholic conservatives. Pretty narrow field of people. Well, I would have been creeped out by LGBTQIA stuff or tried to over explain life as I saw it (in which I was perfectly "normal") to someone who I saw as Different. Gross and weird but it's how I grew up.

I worry about safety in some states and towns for openly queer psychologists working with minors because that gets called "grooming" by the cable news viewing public, and I have met people advocating the death of any "pedophile"

- this would be perfect advertising for your practice as a ton of people who are either autistic or queer do need therapy, but get tired of having to mask. I've heard bad things about that, and have repressed a few memories of that. Guy claimed I can't be autistic because I speak and can start and run an automobile.

- I'm lucky that when I was going to therapy the doctor at least acknowledged ace people exist and that it's quite common among autistic people. I don't have any support and I just kinda get through it. But if I needed a therapist and found out they were also ace and on the spectrum I would be absolutely thrilled.

You seem nice.

Please do be yourself and if you have to mask a tiny bit at first then build the professional relationship with each client and see how much disclosure is ok for each one.

Trying to be positive and not rain on any parades here because we need therapists like you out there!

 

[kenaij]

I would say open up about it. Specifically for younger people and their parents. Having a therapist, someone who you could say has profesionally succeeded in life could bring so much hope to them. The children could see they can do anything they want and that their autism does not have to be something that holds them back. And it can give the parents hope their children will be able to succeed. And that autism is no reason not to be able to.

We should normalise autistic traits in the sense that the world around us sees the stimming, toys and other mannerisms more and more. So they don`t look at your young patients strangly when they are grown up and don`t want to mask all the time.
I think you can play a very important part in this change.

I work at a school and I am starting to more openly stim and show my mannerisms to the students and people I work with. We have some autistic children at my school and I want to show them it is okay to be themselves. I was never shown that (never realised it is very likely autism until about 1,5 years ago) and felt I needed to behave like everyone else. My alien behaviour had no place in the world. I don`t want my students to feel the same. It is hard to feel comfortable showing it. But it is starting to feel more and more 'normal' to show.

 

[AuroraBorealis]

Am autistic and asexual. I'd probably be more open around a therapist like that. But--

- I grew up with a strongly reactionary personality. This cancer of the mind makes one less likely to trust people not in the "in group" which for me was rural people, conservatives, and a sub-fraction of Catholic conservatives. Pretty narrow field of people. Well, I would have been creeped out by LGBTQIA stuff or tried to over explain life as I saw it (in which I was perfectly "normal") to someone who I saw as Different. Gross and weird but it's how I grew up.

- this would be perfect advertising for your practice as a ton of people who are either autistic or queer do need therapy, but get tired of having to go mask in front of the "Christian counsellor" types. I've heard bad things about that, and have repressed a few memories of that. Guy claimed I can't be autistic because I speak and can start and run an automobile.

- I worry about safety in some states and towns for openly queer psychologists working with minors because that gets called "grooming" by the cable news viewing public, and I have met people advocating the death of any "pedophile" which is awfully contrary to law, order, and the consistent life ethic of Cardinal Bernardin. However, I have seen lots more yard signs with "dead pedophiles do not re-offend" than I've seen signs reading "get over yourselves, it's not political."

- I'm lucky that when I was going to therapy the doctor at least acknowledged ace people exist and that it's quite common among autistic people. I don't have any support and I just kinda get through it. But if I needed a therapist and found out they were also ace and on the spectrum I would be absolutely thrilled.

You seem nice.

Please do be yourself and if you have to mask a tiny bit at first then build the professional relationship with each client and see how much disclosure is ok for each one.

Trying to be positive and not rain on any parades here because we need therapists like you out there!

Thank you for your view. Just to clarify: I wouldn't disclose that I'm ace. I think that's too personal to share with my clients - maybe unless it's a very select case where it might be beneficial for the patient's journey to know, but even then, I would probably not disclose it. Me wearing a rainbow key chain at work is more about showing the (frequently) queer kids I deal with that this is an open space where they can talk about anything. Also, I'm not the only team member wearing something like that. Where I live, it's fairly common among health care workers and you don't know if they themselves belong to the queer community or if they are cis-straight allies.

I'm more unsure about the spectrum part. Fortunately, I don't live anywhere where I would have to fear for my safety in either case.

 

[Gerontius]

Thank you for your view. Just to clarify: I wouldn't disclose that I'm ace. I think that's too personal to share with my clients - maybe unless it's a very select case where it might be beneficial for the patient's journey to know, but even then, I would probably not disclose it. Me wearing a rainbow key chain at work is more about showing the (frequently) queer kids I deal with that this is an open space where they can talk about anything. Also, I'm not the only team member wearing something like that. Where I live, it's fairly common among health care workers and you don't know if they themselves belong to the queer community or if they are cis-straight allies.

I'm more unsure about the spectrum part. Fortunately, I don't live anywhere where I would have to fear for my safety in either case.

That's awesome then that you live somewhere like that. I'm stuck in the deep south until I can bail out.

The keychain idea sounds genius in that regard; you're probably dealing with kids like that often. I know one of my friends growing up is very queer and they do not have a supportive family so they would have benefitted greatly.

As for the spectrum part, it maybe is more dependent on the public perception of autism, unfortunately. Your colleagues would be ok with it and not try to put you down? I sure hope not anyway.

 

[Magna]

@AuroraBorealis As an autistic person I've been to therapists who had little to no knowledge about autism and that was really bad combination. In fact, I'm convinced based on my own experiences that a non-autistic therapist or one who knows little to nothing about autism can make for a damaging scenario for the autistic person. Based on my experiences I would NEVER see a therapist again who wasn't autism experienced/trained/autistic themselves.

You're not talking about going into practice with other autistic people though. From what I gather you're talking about being autistic and hiding it at this point and you're wondering if you shouldn't hide it.

If you happen to have a client who is also autistic in the future come to you, an autistic therapist, would you tell your client they should hide their autism and continue to mask as they go about their life (e.g. work, family, friends, etc). That was a rhetorical question more than anything else. I think I'll die a little inside if your answer to this rhetorical question would be, "Yes.".

 

[AuroraBorealis]

@AuroraBorealis As an autistic person I've been to therapists who had little to no knowledge about autism and that was really bad combination. In fact, I'm convinced based on my own experiences that a non-autistic therapist or one who knows little to nothing about autism can make for a damaging scenario for the autistic person. Based on my experiences I would NEVER see a therapist again who wasn't autism experienced/trained/autistic themselves.

You're not talking about going into practice with other autistic people though. From what I gather you're talking about being autistic and hiding it at this point and you're wondering if you shouldn't hide it.

If you happen to have a client who is also autistic in the future come to you, an autistic therapist, would you tell your client they should hide their autism and continue to mask as they go about their life (e.g. work, family, friends, etc). That was a rhetorical question more than anything else. I think I'll die a little inside if your answer to this rhetorical question would be, "Yes.".

Obviously, my answer to that question would be no. However, I need to think about what might make my clients feel uncomfortable, or what might make me less credible as a professional. Also, I find it very difficult to myself apply the same advice I would give my patients (hypocritical, I know, but mainly based on fear of rejection and of negative repercussions).
Right now, I haven't started my career yet. My experiences in the mental healthcare system were as a medical student without such a big need to represent the team, since I was only there for quite short periods. Also, I didn't know about my autism then, although I know now that I've been masking. I'm going to start working in a while and I'm going to represent being a doctor and the medical team, both to the patients as well as to their parents.
In my studies, I haven't met a mental health worker who was openly autistic, so I have no reference. It would be quite unusual for me to openly identify as being on the spectrum, and quite a step to also be open about it to my colleagues and to my superiors. I'm afraid that they might take me less seriously as a professional and that it might make some patients uncomfortable. That's why I am asking for opinions.
It would be a big risk, but it might also make me a better therapist if I was open.

 

[Aspychata]

Perhaps just display a sign like ask me about autism if you should desire. That way you aren't forcing or creating more conflict in a client's mind. I believe a lot of psychologists and psychiatrists are usually in that profession seeking answers for themselves. But l am glad my psychiatrist didn't burden me with" you know l am bipolar." Later, l discovered as much. I am not equating bipolar to autism, it's just l don't want to talk about you when l am there to discover my issues, and being charged for our conversations.

 

[Hypnalis]

I don't think there's a completely middle ground.

For example, you could specialize in psychiatry for people on the spectrum, and possibly (probably I think, these days) attract extra patients. But I'd expect others to look elsewhere.
FWIW I can see it being a very good choice. I have no data to back that up, but personally (speaking as an IT guy who's very far from your situation in life if I was in your position, I'd be all-in on some form of "young ASD" support - partly to do things I think need to be done, but also because I think it would be a goldmine.

But imagine a patient unexpectedly learning something that makes them uncomfortable about a mental health professional who's treating them.
For example I don't care who treats "physical" issues as long as they're a qualified professional. But I'd need a different kind of trust with a mental health professional. Certain kinds of surprises (quite small ones) would negatively influence that.
(If that's not clear I can provide examples, but hopefully the point is clear.)

FWIW I don't think being ACE is similar, but there's a (different) downside risk. That domain has become chaotic. Naturally a lot of people can't be bothered engaging at all, so they walk away.
I doubt there's a corresponding benefit for you. Unless perhaps you specialize.

 

[Kalinychta]

Why would you need to mention your personal life to your patients, though? You’re there to talk about them, not about you, right? Whenever I’ve seen therapists, psychiatrists, or doctors of any kind the focus has always been on me. I wouldn’t have known or cared if they were autistic.

My stim is rocking, and I never do it in public, and certainly not at work. I stim to relieve stress and heightened emotions (both good ones and bad ones), so I think if a doctor were using fidget toys I would become distracted and nervous because I would think they were anxious or impatient or nervous themselves. Is stimming between sessions an option?

 

[AuroraBorealis]

Perhaps just display a sign like ask me about autism if you should desire. That way you aren't forcing or creating more conflict in a client's mind. I believe a lot of psychologists and psychiatrists are usually in that profession seeking answers for themselves. But l am glad my psychiatrist didn't burden me with" you know l am bipolar." Later, l discovered as much. I am not equating bipolar to autism, it's just l don't want to talk about you when l am there to discover my issues, and being charged for our conversations.

Thank you for your input! The idea with the sign is quite good, I will think about that.
It's interesting what you say - I've made the experience that most people I've encountered who work in mental health have some kind of connection to the field, be it by having a condition themselves, be it by having made experiences in the past.
However, I didn't get the impression that many were in that profession "seeking answers to themselves", and I'm sorry, if you've made that experience. In my opinion, having some personal background in psychiatry is very common and often even helpful when working in mental health. But you should have worked on your own stuff enough prior to be able to not entangle it with the patient in front of you.
It's also not what I meant. I wasn't thinking on just casually telling my patient. I was thinking more on the way of masking less at work, but consequently showing more of my autistic traits, like fidgeting, needing silence or wearing headphones when working alone, and maybe displaying some sort of discrete sign to signal patients and parents that they can talk to me about autism (so the sign idea really isn't bad)

 

[AuroraBorealis]

Why would you need to mention your personal life to your patients, though? You’re there to talk about them, not about you, right? Whenever I’ve seen therapists, psychiatrists, or doctors of any kind the focus has always been on me. I wouldn’t have known or cared if they were autistic.

My stim is rocking, and I never do it in public, and certainly not at work. I stim to relieve stress and heightened emotions (both good ones and bad ones), so I think if a doctor were using fidget toys I would become distracted and nervous because I would think they were anxious or impatient or nervous themselves. Is stimming between sessions an option?

I've made the experience that many patients, especially young ones, tend to be more relaxed and find it easier to open up if they have some kind of image of you. Obviously you shouldn't tell them loads about yourself. But I've found that e.g. many LGBTQIA+ patients (and there are really a lot of them in child and adolescent psychiatry) find it easier to talk to a therapist who wears a rainbow flag gadget, even if that therapist never mentioned anything or if the topic in the session doesn't have anything to do with sexuality/gender identity. So, since I never met another mental health professional openly on the spectrum, I wondered about people's opinions. I don't mean to talk about it - as you say, the session focuses on the patient, obviously. But I thought, maybe it's easier for a teenager who maybe suspects being on the spectrum to bring that topic up if the therapist is neurodivergent. Or that parents of autistic kids might also find it easier to open up about certain stuff. I don't know, I've never seen it. I expect people have different preferences, too.

I could probably stim in between sessions. I realise that stimming in a session could be very distracting for the patient. I would need to be open to my colleagues, though, since in the hospital you're barely ever alone in a room.

 

[kriss72]

Why would you need to mention your personal life to your patients, though? You’re there to talk about them, not about you, right? Whenever I’ve seen therapists, psychiatrists, or doctors of any kind the focus has always been on me. I wouldn’t have known or cared if they were autistic.

Yes, my experience has also been that the focus was on me, but still - I think all of them have told me that they were NT's... but I think they have done it to try to help me, like use examples of their own experiences to make me understand that I'm challenged by things NT's aren't.

My stim is rocking, and I never do it in public, and certainly not at work. I stim to relieve stress and heightened emotions (both good ones and bad ones), so I think if a doctor were using fidget toys I would become distracted and nervous because I would think they were anxious or impatient or nervous themselves. Is stimming between sessions an option?

hmm... before my diagnosis and acceptance of it, I think I might have benefitted from it, in the way that if I saw someone else do it, I would be less shy/masking and have been more open to stim myself. These days I'm almost constantly fidgeting when outside, I still moderate it and try to keep it discrete but I'm not shy about it.

 

[Kalinychta]

I've made the experience that many patients, especially young ones, tend to be more relaxed and find it easier to open up if they have some kind of image of you. Obviously you shouldn't tell them loads about yourself. But I've found that e.g. many LGBTQIA+ patients (and there are really a lot of them in child and adolescent psychiatry) find it easier to talk to a therapist who wears a rainbow flag gadget, even if that therapist never mentioned anything or if the topic in the session doesn't have anything to do with sexuality/gender identity. So, since I never met another mental health professional openly on the spectrum, I wondered about people's opinions. I don't mean to talk about it - as you say, the session focuses on the patient, obviously. But I thought, maybe it's easier for a teenager who maybe suspects being on the spectrum to bring that topic up if the therapist is neurodivergent. Or that parents of autistic kids might also find it easier to open up about certain stuff. I don't know, I've never seen it. I expect people have different preferences, too.

I could probably stim in between sessions. I realise that stimming in a session could be very distracting for the patient. I would need to be open to my colleagues, though, since in the hospital you're barely ever alone in a room.

Oh okay, that makes much more sense. Except do you think you’d really have to tell your colleagues? We have a tendency to believe that we stand out more than we actually do. Your colleagues might not even notice you stimming. If they did, they would probably just think it’s a quirk or something you do to relax. Or they might suspect you were autistic on their own.

When I’m at work I don’t think my autism or anything personal about me is anyone’s business. Announcing it would feel like an “apology” sort of, too.

 

[AutisticMilly]

My current therapist is autistic and is open about their diagnosis. At the end of the day, NTs don’t understand a lot of the causes of our issues. Autistic people experience mental health issues differently, and to me, it’s much easier to not have to explain my differences to someone who may or may not understand what I’m saying.

 

[paloftoon]

It is okay to fidget with toys if it makes you feel comfortable as you are supposed to feel comfortable in a therapeutic space as long as you aren't hurting anyone else physically or anything like that.