Good therapy or bad therapy

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My wife is finishing her training as a counsellor. She started this before our son was born and so clearly before autism entered our world. Now, since diagnosis, she is thinking that when she starts her own practice she would like to specailise in counselling parents of kids with special needs and perhaps autistic people as well. Her training has been in the humanistic schools, specifically "Person centered" "Gestalt" and "Transactional Analysis". I have seen that CBT is often cited as being useful for people on the spectrum but was wondering if anyone had any experiences, good or bad, of other psychotherapy approaches? Should she refocus and do extra training on CBT? Or would the person centred approaches be useful, specifically to people on the spectrum?

The other idea we had was to offer this as a skype service. This was initially to be able to fit in with say a stay at home mothers schedule but I guess that would be useful for autistic people as well. Then therapy could be accessed from home!

Anyway its probably a few years before she will go into private practice and she certainly feels she needs some more autism specific training before trusting herself with autistic clients but it would be interesting to hear opinions now so she can guide her training.

Offering Skype service sounds wonderful to me. I would very much be interested in that. Even though I have work and I do my shopping etc, and I even have a special interest that has to take me outside, anything where I DON'T have to journey to yet another location, particularly on a regular basis like therapy sessions would be, is really great.

My main piece of advice would be for your wife to drop the F-word from her therapy vocabulary. The word I'm talking about if "FEELINGS" and also "feel", as "How did that make you feel?" I'm saying this because "person-centered" and "gesalt" often function as euphemisms for the Rogerian therapy, the one with the infamous "How did that make you feel?" question.

The quickest way to make an aspie permanently lose trust in you is to grill him about his feelings. Because, honestly, not knowing how someone would feel while being bullied (to use one example) makes you look like a unqualified therapist at best, and a blithering idiot at worst. And the quickest way to make an aspie think you're a sorry excuse for a human being is to not believe his answers about feelings, as in "No, that's not how you really felt; try again." (I'm using a male pronoun because women generally have an easier time identifying emotions, and by extension, faking them when necessary.)

CBT can be questionable too, although less so than Rogerian. Mainly because it blames the patient for having "wrong" thoughts, under the logic that they lead to wrong emotions, which lead to wrong actions. But thoughts are far easier to aspies to work with than feelings, so many aspies have benefited from this form of therapy. Not to mention having a clearly defined "right" and "wrong", a far cry from the confusing---not to mention false---agenda of "there are no right or wrong answers" used in the person-centered therapy.

I've been through lots of therapy, most of it counterproductive, because the therapists never realized I had Aspergers. In retrospect, I have grounds to sue them for malpractice.

Never ask an Aspie "who he is." He'll just get totally flummoxed. Advice: 1) Drop all Rogerian analysis. 2) Transactional Analysis is useful for neurotypicals, but not useful for Aspies whose brain wiring (fusiform gyrus not used to identify people) is markedly different. 3) Burn anything written by Alice Miller (whose own suicide at the end of her life should disqualify all of her theories - imho). 4) CBT as such does not work; but "BT" (behavioral therapy by itself) does work.

Never ask an Aspie to change his pattern of thinking. He'll just get confused and upset. Focus on social skills, on movement, on posture, on voice, on facial expression and body language. Focus on changing behavior and I promise, he'll do wonderfully, and all the other stuff will follow along.

Good luck.

P.S. Your username is very unsettling and strange.

Thanks for the tips people. Will feed this back to my wife.

It is a name I have used on-line for over a decade now and stems back to when I used to mainly argue with religious people and be involved in atheist and secular activism. This was pre-kids and so pre-autism entering our lives. Now I focus my energy on more important autism related issues rather than arguing about why religions are nonsense. I guess I just got used to the name it and stuck with it all over the interweb. But rest easy I'm not evil or religious! In fact I'm probably more acturately described as the opposite on both counts! Maybe I should change it to "Thequiteaniceguyacctuallycompletelynonreligiouperson"?

My therapy was counterproductive too. CBT places blame on the patient, which is seldom helpful. I was constantly abused and to be told my abuse and emotional damage was my own fault was horrible and made things worse. That's why to this day, invalidation of my abuse is the biggest trigger for my Autism meltdowns. I've also had PTSD for years without a diagnosis, so that wasn't considered in my treatment strategy.

I agree w/ JSBACHlover that social skills training is going to be the most helpful.

The Skype idea is genius. I'd love to do it myself. Not good for agorphobics though.

I sorry you had to go through that.

I've been through therapy a few times. I don't know what "type" exactly, but I felt like all of it was counterproductive and therefore a waste of time and money, so I didn't stay long.
It would often be them asking me a lot of open-ended questions, which I've always had extreme difficulty answering. My mind goes blank and I get anxious, so I just end up saying "I don't know".

And I couldn't agree more with JSBACHlover and Aspie1.

I had a great therapist about 25 years ago. I don't know what specific type of talk-therapy it was, and I think it may well have been CBT, but she never made me feel wrong or to blame for what I had been feeling. In fact, my therapist was all about examining how "normal" is it to feel shocked and hurt by bullying in childhood, or rejected and lonely within an emotional neglectful family, etc, etc, and whatever the case may be (those were a couple of my own specifics).

She was incredibly helpful in pointing out the legitimacy of my reactions, and then helping me emotionally heal from them and be able to move on with a stronger and more positive, re-framed image of my own strengths.

There are some negative experiences in this thread and I'm sorry that people have had those bad experiences. But my experience of talk therapy was a positive one, and during the years that I saw my therapist, I felt like I made more progress in my own healing and then new found self esteem than I did before or since. And this was even 25 years before I -- or anyone -- identified that I was on the spectrum, because it was 1993 and adults weren't even yet on the radar of having possibly been the "undiagnosed generation" so to speak.

About that --- I don't blame my therapist for not recognizing it, because of the above sentence -- adults who had already somewhat struggled through a so-called normal life were not yet being recognized as possibly undiagnosed autistic if high functioning -- and also because she simply was not qualified as specializing in autism issues.

She was a counselor/therapist qualified to identify mental health issues such as schizophrenia, bi-polar, depression etc (I only had depression, by the way) but only a specialist who has trained in autism will "spot" a high functioning autistic adult in 1993....That's my defence of my own therapist, anyway.

She DID identify me as what I look back upon now as the closest thing you could GET to "possible autism" by categorizing my childhood as "The Lost Child" -- a type with characteristics of introversion, needing a lot of time alone, special interests, attaches to objects rather than people, has a rich inner life but is drained by outer life, and whose issues went unnoticed and emotionally neglected by the rest of the family.

Today, a general purpose therapist might see that as a red flag to possible HFA and would have sent me to an autism specialist. But this was 1993 and Asperger's syndrome, although discovered by Hans Asperger's in the 40s, was still yet to be " a thing" for adults to be identified with in the 90s.

I still gained a lot from my therapy -- maybe I just got lucky with the particular individual I had for a therapist. She never blamed me -- she DID ask me "how did that make you feel" but when they ask you that, it's not because they don't themselves know!! !

They ask it a a TOOL to draw you into your experience of your recollections and to examine possibly unexamined reactions. It worked for me. There were some things I'd squashed down for years, and when she made me look closer at my feelings about that incident or person, I reconnected with the stuff I'd pushed down and never worked on. And then we worked through it.

Anyway, I just wanted to defend therapy because there's a lot of trashing on this thread suddenly. And not every experience will be a bad one or a blaming process.

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Rogerian-type therapies have their uses, for things like depression and anxiety and empathy teaching, even in the autistic population.

NEVER give an Aspie "unconditional positive regard." I would NEVER, EVER again trust a therapist who did that to me. I HAVE to know if I'm just flat-out wrong and flat-out messed up. Unconditional positive regard is detrimental to an accurate self-assessment and therefore detrimental to functionality and mental health.

On the flip side, the kind of blaming, "hide-it-at-all-costs," "act-normal-or-expect-to-have-no-worth" Skinner-box behaviorism metaldanielle describes KILLS. I went through that, and came out of it sicker than I went in (went in with grief and depression, came out suicidal with grief, depression, crippling anxiety, agoraphobia, and possibly OCD or PTSD). I was in my early 30s at the time, and had some experience base with which to refute what I was taught. If I had been ten years younger, it would have been utterly devastating.

Be willing to use different schools of therapy, different approaches-- because what works on one autistic with one set of issues will not necessarily work on another autistic with another set of issues.

I don't believe my therapist did "unconditional positive regard" on me -- I'm not familiar with that phrase but obviously it doesn't sound like a healthy thing for ANYONE to have, whether NT or spectrumite.

My therapist wasn't a "Anything you do or feel is just GREAT and you're the GREATEST!" kook....

I'm just trying to say, she was supportive about getting me to have a healthier framing of everything, the good and the bad. The good things I was denying and the bad things I was denying. The good things from others also, and the bad things others were responsible for themselves.

She didn't try to make me have whatever that is you're talking about -- I'd be a raving f*****g egotist if that were the case....and I'm not, in fact, a raving egotist. I still have to work on my self esteem.

BirdinFlight, I'm not against therapy. I still recommend it to people who might benefit. I just don't want anyone to have to go through what I did.

A lot of Therapy's problems is incompatability between treatment style and patient. I'm sure one of my therapists was probably great for other people, but her style was all wrong for me. For example, when I didn't feel like talking, she's sit there silent hoping that boredom or awkward silence would convince me to talk. As an Aspie, that didn't work on me. My current therapist knows to prompt me after a couple minutes, because after that amount of time, I'm not just formulating thoughts or working up the courage to say something difficult. However, another therapist just mocked me like school bully. She's not a nice person in her personal life either, and probably has her own issues.

I think a therapist should educate themselves in the different therapy techniques and what type of patients they work best with. Even if he or she can only be proficient in a few, it's good to know when a patient would be better off being refered to a different therapist with different techniques. And be flexible enough to adapt to individuals.

ASPartofMe, thanks

BuyerBeware, I was 8. I've always had a strong conviction that my abuse was not my fault. Idk where it came from, but if I didn't have it, I'd probably be dead. I'm still in therapy. despite all of this. I've finally been able to make progress within the last couple years. I hope you do find/ have found a better therapist.

Rogerian psychotherapy is all about "getting in touch with my feelings" to determine my "true self" so that I might achieve "self-actualization." It's not about right or wrong, which is actually why it is so incredibly dangerous. Rogers' own daughter used his therapy to justify leaving her husband and three children. Rogers, at the end of his life, was very upset about how some were taking his theories because, personally, he was a fundamentalist Protestant.

Anyway, most therapists incorporate many of Rogers' theories, but they usually try to balance it with Ellis' CBT, which allows for a more right vs. wrong / healthy vs. unhealthy approach.

The thing about Aspies is that we can't find our core. So by actually just telling us what to frigging do to fit it - black and white, right / wrong - then we're fine. We Aspies are not fancy-shmancy people!

So the fancy-shmancy psychotherapists I've had were the ones who made something really simple into something very complicated. That's why I don't like them. They're like the kids on the playground who kept changing the rules as the game went along.

^This. I completely agree.

I haven't been in any kind of counseling or therapy since I was a teenager. But that is what I remember the most about it, being asked over and over again how I felt, how something made me feel, how I was feeling in that moment, being asked to close my eyes and really feel the feeling, etc. And yeah not being believed when I gave an honest answer. It was extremely annoying and it made me think the counselor was a total idiot with nothing to offer me. It just went round and round and didn't accomplish anything.

What actually might have been helpful...bear in mind I was gifted but struggling in school, and undiagnosed with anything at that point in time...is if someone had set aside the silly talk about emotions, and had actually instead investigated whether I had any symptoms of a developmental disorder or learning disability. And then the focus could have been on learning to live with those symptoms rather than talking endlessly about feelings.

You are welcome

I had a therapist do that. We did a number of activities/exercises that involved drawing. Now, I'm a horrible drawer. Unless it's a diagram, a floorplan, or a flowchart, anything I draw turns out looking like crap. But when I drew pictures and such when she asked me to, she'd say it looks great. I was 13, which means I was well aware of my strengths and weaknesses. The compliments felt baby-ish, patronizing, and fake. It would be far better if she said something like: "Whether or not you like your own drawing, it's good enough for the activity/exercise we're doing; this is not an art class." That would be direct, sincere, and even complimentary. But of course, that would actually make sense, and NT therapists can't have that!

I had a way of fighting back against that. I borrowed a psychology book from the school library, and memorized all the emotion words. Then I regurgitated them during therapy as I saw fit. The words didn't have to make sense or even be right; they just had to sound gushy and melodramatic. (For example, "victimized like a kitten surrounded by rabid dogs", rather than "bad".) Only when I did that, I got complimented on my---wait for it---honesty!