Therapist DOs and DON'Ts

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Part 2

You know what I did do instead of focusing on getting good GPAs, so, I would have a better chance in college? I drank, did drugs, got pregnant at age 17, spent most of my adult life as a single parent and have many many regrets.

Tell those kids that every little decision that you make in life is important and that just 1 wrong decision, even seamingly minor ones, can alter your future in such profound ways, that you can spend a whole life time struggling and suffering, when you could have achieved dreams instead. I wish someone would have encouraged me and told me that.

People do not let anyone talk you out of your dreams. It is better to try and fail, then to not try at all. At least you know you tried. My mother loved me and had good intentions. She did not know that I might have Asperger's. She thought she was saving me from pain. I should have been stubborn as usual and said, "no. I want to try this no matter what."

People like Einstein, Bill Gates and others would have never been siccessful, if they had listened to the naysayers in their lives and I am quite sure they had them.

I think I'd like them to start by agreeing a contract with me, to commit to x sessions in order to talk about problem y.........it would be highly desirable if y were known before the start, but I'd also want to be reassured that y could still be unknown to me and that I might come in thinking that y was one thing and then discover in therapy that it was something else....so the subject would only be a guideline.

I'd like them to start by asking me what the problem was, skilfully coming in with the right questions to help me discover the answer.....ultimately the hope would be that I'd have turned a dump of unrelated sketches into a clear notion of what the underlying problem was.....seeing the storm in the mind to be a conflict between 2 things that couldn't be resolved....e.g. realising I was trying to get the comfort of an alcohol habit without the concomitant discomfort (not that I ever had that problem myself).....the counsellor would need to be able to gently nudge me towards unpicking my denial, examining my deepest and most frightening feelings without the fear of an authority figure stamping all over them. So that nonjudgemental, supportive, patient atmos would be very important. I doubt that any show of leadership would do anything but harm. I might begin to trust the counsellor's opinion, but I'd expect a good counsellor to avoid giving much in the way of opinions, and to avoid letting me set them up as a guru. I think people really do have to find out their own stuff for themselves, and that others can only point the way, and even that can be counterproductive if it's done too much.


Awareness of AS, deep awareness, such as might only be possible for an experienced Aspie who has studied psychology. I don't know if NTs can ever really understand what we go through like we understand it, though I don't say it's impossible, and of course even Aspies get non-Aspie problems.

That alone would have been brilliant for me - I'd have had a diagnosis and somebody to help me understand how it was affecting me.....a lot of my guilt feelings might have been allayed. A bit of good was done by my first counsellor, who was very nondirective and (I believe) quite wise, so I got some pointers, but it took decades for me to discover the significance. It would have been helpful to me if I'd had somebody to really fill me in on what relationships were all about, what unwritten rules I was breaking that were messing up my social life. But I don't know if I could have been persuaded to open up very much at that age. I guess the best thing would have been to just offer me ideas that were calculated to clear the blocks, and hope that I'd take them on board. But the necessary distancing (to avoid transference) would have probably meant that I wouldn't have been able to open up very much, so unfortunately I'd probably have needed so much warmth from the counsellor that transference would have probably become troublesome.......I don't know if transference can be managed and give a better result than the alternative, but if it can, I suspect it would be an expert only" thing that most humans just aren't capable of.

I guess what I'm saying is that the chemistry with the counsellor would have to be right....a different person might need a different chemistry......so lists of rules for counsellors can never be enough alone.....the rules change with the client.......I can see counselling working better if the counsellor specialised in a particular type of client....you could have one for those comfy with more authority, one for sworn anarchists, etc.

I got this from a doctor at LSU's Infirmary one time:

"Do you always have such a flat affect?" I don't remember much about what I answered. But the truth is, in a Clinical situation I also try to be diss-passionate about health/emotional issues.
I'm trying to adapt to the enviroment!

I just hope I someday can get a conselor/doctor/therapist that listens to MY questions. I flatly asked about the meanings of female body langauge & flirting to my female counselor. Never got too much useful out of that, I've since discovered females like their air of mystery.
*******
I'd enjoy someone who could listen to my experiences, no matter how weird. And would also discuss philosphy, world views, even religion (as long as they don't try to recruit me. I always had churches AND cults do this at college. Never fell for it.). I sometimes like just a free flowing conversation, like I used to have with the few friends of my Inner Circle. I want this person to be able to know a little about my world.

Sincerely,
Matt

PS to above Reply:

I also tend to be restrained talking to people about highly emotional issues because sometimes I get overwhelmed if I'm asked to recall how something made me feel. My memory is generally so good that puts me right back at THAT moment. It could potentially get UGLY.

Do: Understand that I am not exactly the same in your office as I am in the outside, everyday world. I have trained myself so carefully to seem "normal" that the way I behave in your office may not bear much resemblance to how I behave in everyday situations. What happens in a therapist's office is pretty predictable. What happens in the world with random people and situations and demands is not. Letting go of that perfected persona is very difficult for me when I feel compelled to use it, but I could not maintain it every day, all the time in daily life.

Don't: Underestimate how hard I have had to work to create that outward persona. I'm 43 years old. I am miles away from where I was as a child in understanding NT behavior and what is expected of me. I am not going to behave like a child with AS, or even a much younger person. From what I know of myself, and others have told me, I have made huge advances in the last 10 years. That's because I have worked really hard to make myself fit in with the world so that I can achieve my goals, not because I do not have AS. Seeing the real me with all of my very real difficulties and imperfections might take time, patience, and a discerning eye, as well as ears that truly listen.

I am not sure if I have an ASD or not so I may well be an NT but I can say that I am not a fan of therapy for a number of reasons. In the most part it seems to make things worse rather than better as I come away from the therapy session feeling more misunderstood and yet more frustrated than I was feeling in the first place.

As others have said, talking about my feelings does not necessarily help as this really does not solve my problem. Neither does it help if someone just offers comfort without any kind of practical solution in sight. I know they are trying to be nice, but it really does not help much at all.

It would help if therapists would listen to NT's as well as Aspies a little more closely. I have been telling therapists since I was 12 years old that 'I cannot mix with people" and it was either ignored or I was met with the words "if you relax it will happen naturally". Neither of which really helps me! I am now 36 and still have the same problems socialising. Granted my present diagnosis is Depression and Social Anxiety (I have never been tested for an ASD) and I can feel anxious in some social situations, but I know from the times where I have not been socially anxious around someone, that my social problems don't just disappear. I still find socialising hard work and exhausting even when I am not anxious.

Neither do I appreciate therapists turning everything I do into a symptom of depression. Ie I keep my curtains drawn during the day mostly because my eyes are light sensitive, not because I am depressed. I wear my pyjamas in the house because they are more comfortable than day wear and don't irritate my skin so much, however they are not what I wear to sleep in so yes I did get up and get dressed today, thank you. My desire to eat the same flavoured Ice-cream every Saturday is not OCD. I happen to like that flavour and really don't want to eat a different one. No I don't like my routines disrupted but not because I think something awful will happen, but because for me personally, I function better with them, am happier with them and seem to get more done with them than without them. I like them...if I didn't I wouldn't have them! Please stop trying to change them! Stop it! (that goes to all therapists everywhere!).

Also I am not obsessed with my hobbies, I am merely very passionate about them!

So to conclude I ask:

Do: Ask and clarify
Don't: Make assumptions!

And one more thing...Just because someone has emotional issues such as Anxiety and Depression, please stop talking to them slowly like they don't understand anything. The number of therapists I have seen who seem to talk to me slowly and then proceed to tell me the obvious is unbelievable! Ok I have emotional issues and I can be socially awkward but academically I am an A grade average and have never been called anything less than extremely intelligent by the colleges I attended.

Really I am not slow, therapists can talk to me normally. If there is something I don't understand I will ask for clarification!

(That last one is one of my pet peeves when it comes to therapy).

I'm seriously thinking of printing out your post and give it to the psychs I meet. Perfect.

I'm glad if it can be of assistance

Indeed...You should always pursue your dreams!

I had to pull out of a University course I was getting A grades on 10 years ago to care for an elderly disabled mother. The responsibility was left to me because I was the girl in the family and because my family were not exactly fans of education (they did not seem to think it was important and considered my degree to be a waste of time despite my grade average. I am the only one with academic ability out of the family members I am aware of, except for maybe my mother, who showed some promise in her youth but never pursued higher education for various reasons).

10 years later and I have my second chance at finishing my degree. There are plenty of naysayers and I have lost several online contacts/friends over it due to arguments that broke out over the amount of study time I needed (they wanted to chit chat whilst I wanted to get on with my work). As a result, and because I was upset, I pulled out of my course for a few hours before contacting the University and asking to be put back on my module again. I almost lost my place and had to jump through hoops to get it back due to various complications that had arisen!

The odd thing was, is that I was more heart broken over losing my chance to do my degree than I was over losing some friends. Yes I felt sad over my friends departing but I felt physically sick over almost losing my place on the course!

I am only 36, there is still time to pursue the thing I love most in life....academics. When I am studying it is the only time I really feel like myself. It is the only time I am genuinely happy. It excites me, it's fascinating and it gets the blood pumping around the veins again. I bound out of bed excited about it in the mornings and I go to sleep with my text book next to me at night so that I can fall asleep to happy thoughts about it. I also pop a dvd about geology or palaeontology on at night before bed as those are my two areas of interest at the moment. Rock on David Attenborough (isn't he great?).

I feel like I am back doing what I should have been doing with my life after being lost in the wilderness for years. It feels amazing!

Never let naysayers stop you from doing what you love....you never know where it might lead.

Yeah that was what I found useless about it - no practical advice. And for the most part I was seeing school counselors and the like who were actually supposed to give practical advice about school, and yet they were no help at all regarding any of that. My high school g.c. basically told me a fairy tale about college, and I was not at all prepared for it. My life would be totally different now, if I had actually gotten some useful advice about picking the right college and getting the most out of it.

Looking back, someone should have realized I would be in way over my head at college! I had no idea what to expect there. In particular I had no idea what it would be like living in the dorms and if I had known, I would have picked a school closer to home so I could commute. I thought I was better off going to a small, private college away from home and it turned out to be one of the worst decisions I ever made, and it threw my whole life off track in a way I can't seem to rectify.

I was already floundering in high school, and someone should have considered whether I had ADHD and/or learning disabilities. NOT just assuming I'd be fine when I went to college. And all they wanted to talk about was "feelings" and "depression" and "relationships" and that sort of thing.

Talking about feelings doesn't serve any purpose, unless it leads to better practical advice. I can deal with my feelings, and I have always been better off dealing with my feelings in my own way. I can not deal with life situations where I don't know what to DO. And I can not deal with situations where knowing what has to be done is so overwhelming that I don't know where to begin or what steps to take.

I'm SUPPOSED to go to therapy, or at least it's recommended for people like me. I don't go though but I think the worst therapists are the ones who make things awkward.

Rhiannon,

You just said what I was struggling to say up there.
Thanks!
Matt

I've found the overall demeanor and openmindedness of therapists has made me trust them more. I've been seeing a therapist for about six ms. now and can't think of anything she's done wrong because she's so professional and calm. She's a Godsend. She's down to earth, laughs a bit, doesn't pretend to be perfect. I had a few other therapists who were a little rough around the edges, I think they're downfall was not sticking to the book of professionalism and/or trying too hard to relate. I was younger maybe they thought they had to do more to reach me.

Take patients seriously. Don't assume you know what they are going through. Don't put words in their mouths because if like me when a doctor said my shut downs were allergy related, I went through decades of dietry constraints and went round in circles trying to find the problem with no success.
Never do what my previous doctors surgery did and limit my access to drs to once a year, and then the appointment time is just three minutes while you time me looking at your watchthe whole time.

I know there is a difference between general doctors and pyscologists, but the approach I have had off past doctors (I have very good ones now) has made it very difficult to actually open up and disclose any personal information to the medical field.

I have only briefly seen a pyscologist and it was such a relief that they had patience with me and it was one of the most liberating experiences I have had... Because I realized, that for the first time in my life they understood me and didn't jump to conclusions.

DO act extremely calm, impossible to freak out, like a friendly robot.

DO NOT have too many feelings about my problems, even if the feelings are sympathy, because now I have to deal with your feelings as well as mine.

DO NOT encourage me to act shy, even if it's just by being extra nice to me when I do.

Be, like, fifty, so that I cannot become attracted to you and freak out about it.

DO be really good at asking me questions to get what I mean from me.

DO give homework.

DO occasionally talk to me about fall leaves or history books.

DO have a sense of humor. (Optional.)

DO test me a bit. I told my one therapist handing things to people freaks me out, and she responded by handing me a business card. That was good. (Optional.)

(Personally.)

these 'do's and don't's' can go for possibly therapists working with individuals who are ND or specifically, therapists working with individuals in therapy who are anxious.

don't overwhelm the patient with too many questions, too fast, vice versa, cooperate with their pace of communicating.

don't be too quick to revert to medication. there's better ways, for example, meditation, encouraging a light ritual to relax the patients mind, allowing the patient to communicate in other ways if they're to anxious; drawing, singing, colouring, dancing, music, food.

don't occupy the space or talk for the patient. give the patient time to find their own way of communicating.

when a patient may transition from talking about their interests to becoming more aware and transitioning into discovery/that they are possibly on the spectrum (possibility) or discovering general self awareness, don't start bombarding them with compliments or discouragement of their realisations, as its possible that they are as overwhelmed by it, as the therapist may be intrigued. let them 'disassociate' from the realisation that they may be on the spectrum or general awareness, in their own time and their own way. if they are overthinking things, in particular if they are auditory over thinkers (i believe there is sub-conscious thinking and those who think consciously auditorily), at this point, maybe DO refer the patient to an occupational (sensory) therapist or creative therapy or another form of therapy that sways away from just talking and over thinking. that goes with any form of overthinking. if the patient is transitioning into a psychotic breakdown, information overloads, delusions, find another form of therapy rather than just talk therapy.

correlating to above paragraph, don't assume that the patient is a natural talker. ask! does the patient enjoy talking or do they not? if not, don't force them to speak. offer them creative therapy or other ways. i personally found it to be damaging as i transitioned to speaking about the world and interests to disassociating from my own mind in therapy. i'd have just said that i don't need to speak and would prefer to communicate via sensory stimuli or art or music, but how is the therapist meant to know, unless the therapist asks or if the patient is to anxious to say so...?

don't govern what the patient says. the therapist is getting paid to communicate with the patient, not to be discouraging the patients words.

does the patient have a favourite smell? taste? does the patient enjoy light stimulation or is the patient overwhelmed by light or overwhelmed by curtain smells? it's easy to create light shows, i personally find them to be relaxing and less overwhelming than being in the actual world and these days, i'm a sensory seeker rather than being overwhelmed by sensory stimuli. accommodate the patients sensory needs in all directions and be creative about it!

do put plants in the therapy room. there are scientific studies proving that plants have benefits on mental health recovery and even physical illness recovery.

i hope to become a creative sensory therapist so i'll keep this list here for myself to refer to also.