Do psych nurses get the conversational difficulties we have?

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firemonkey
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14 Dec 2017, 5:04 am

When I was mentioning my social interaction difficulties to the nurse yesterday she said I was ok one to one. I saw that as something of a dismissal of my issues. I pointed out to her it was because it was factual(we were going through my life history). I also pointed out I have great difficulty initiating conversations and making small talk.

I could never just go up to someone and start a conversation, but if they approached me ,and talked to me, I would be polite enough to reply as best I could.

I personally don't see that being 'ok' one to one within a certain context is a sign that that applies across the board. Unless the thinking is if you are on the spectrum you are just bound to be antisocial , and not engage in conversation whatever the background factors. If you can engage with conversation at all then somehow you don't have problems that way.



Dear_one
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14 Dec 2017, 7:50 am

I've been trying to break in a new counsellor. I don't think she knows the difference between self esteem and self confidence. I'd guess that 10% of psych nurses have a clue about what they are doing, and .1% are good at it.



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14 Dec 2017, 11:56 am

firemonkey wrote:
When I was mentioning my social interaction difficulties to the nurse yesterday she said I was ok one to one. I saw that as something of a dismissal of my issues. I pointed out to her it was because it was factual(we were going through my life history). I also pointed out I have great difficulty initiating conversations and making small talk.

I could never just go up to someone and start a conversation, but if they approached me ,and talked to me, I would be polite enough to reply as best I could.

I personally don't see that being 'ok' one to one within a certain context is a sign that that applies across the board. Unless the thinking is if you are on the spectrum you are just bound to be antisocial , and not engage in conversation whatever the background factors. If you can engage with conversation at all then somehow you don't have problems that way.



I've seen autistic people be okay one and one so what are doctors talking about when they say any of them are doing okay with talking? That tells me nothing.


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Trogluddite
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14 Dec 2017, 12:04 pm

Yes, I have encountered this problem quite a bit. I've also tried explaining it in a similar way without ever seeming to get the message across. Once I'm in the consulting room, the social rules are a piece of cake. It's always my turn to speak whenever the doctor/nurse stops, and the questions always require accurate, honest answers. Hardly any of the traits that make socialising difficult are brought into that situation and there are few distractions. I don't have to judge what mood anyone is in; only one person speaks at a time; sarcasm and facetiousness are less likely etc. etc.

I also think that because a lot of people feel anxious, are very tired, or are in pain when they see a doctor (why else would you?!), almost anyone is more likely to show slightly unusual body language, prosody and eye contact, so that autistic differences in non-verbal communication don't stand out so much against the "background noise" of stressed out patients dealing with discomfort.

The most recent CBT counsellor I saw was the only clinician I saw who really understood any of this. She had previously had some experience with autistic people, though it wasn't her formal speciality. She was the only one who immediately understood the importance of context and the idea of "masking". The counselling was much more successful with her than with any of the three or four counsellors I had seen before her.


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fifasy
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14 Dec 2017, 12:32 pm

This is why I'm so sick of life. It is always the same patronising nonsense from non-Aspies. "Oh but you're doing so well at talking to me. Your social skills are better than you know!" They never believe what I tell them. They assume being alright in formal medical appointments trwnsfers to being okay in social situationw in general. Or they say "But I'm sure you can learn." They just can't be bothered to understand.

I basically give up on most human beings. I think getting them to care or develop an enquiring mine about what they don't have to is almost impossible.



GiantHockeyFan
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14 Dec 2017, 1:16 pm

Couldn't have said it better myself. It's very easy for me to have a structured, formal conversation with a professional. Having a casual conversation with a work colleague or another person at the mall for example is NOT in any way, shape or form comparable to it. I remember seeing a medical specialist who came across as downright brilliant and very likely on the spectrum somewhere. I bet if you put that 'brilliant' doctor behind the counter at the local McDonalds he would fail miserably.



firemonkey
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14 Dec 2017, 2:02 pm

You've all put it so well. I may be wrong, you can call me to task if I am, but I sense that too many professionals see us either as slobbering idiots ,or to the other extreme that our issues are inconsequential and we are coping just fine.



Dear_one
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14 Dec 2017, 2:05 pm

There is a general assumption that IQ can substitute for EQ, by the people with roughly equal scores on them. They are not aware of the difference.



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14 Dec 2017, 3:10 pm

^^Yes, and we come up against the barrier that, unlike IQ, EQ is most often not engaged in consciously. It functions mostly sub-consciously and is ever-present, so is taken for granted. For people that have it, it is impossible to imagine not having it because there's little conscious awareness of having it in the first place - it's only when there is a problem that it is considered as an explicit "ability" or "skill".


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bethannny
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14 Dec 2017, 9:37 pm

I think we appear to do better ''socially'' in these types of settings because we know what we have to talk about and the interaction is predictable with a mental health worker. Where as out in the real world we have to wing it and it's MUCH harder to know what to say and keep the conversation going because it's much more ''unpredictable''.

When I was younger I'd do supposedly ''great'' with a counsellor (and I'd get the ''you suuuuure don't seem Autistic'' trope) but just terrible with my peers to the point where I no longer bothered to talk when I wasn't feeling I could handle the challenge.



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15 Dec 2017, 5:38 am

fifasy wrote:
This is why I'm so sick of life. It is always the same patronising nonsense from non-Aspies. "Oh but you're doing so well at talking to me. Your social skills are better than you know!" They never believe what I tell them. They assume being alright in formal medical appointments trwnsfers to being okay in social situationw in general. Or they say "But I'm sure you can learn." They just can't be bothered to understand.

I basically give up on most human beings. I think getting them to care or develop an enquiring mine about what they don't have to is almost impossible.


It is very annoying. So often when you're just trying to be factual, such as stating you have some social difficulties, it always seems to get interpreted as low self-esteem.