Is Therapy Without Diagnosis Only A Band-Aid?

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I am seeing a therapist on Tuesday for the 1st time since I was 18 (when a psychiatrist misdiagnosed me as bi-polar and prescribed 300 mg of lithium because I was explain drug addiction, but he felt incorrectly it was a bi-polar disorder due to my genetics).

I do not think she has a background in autism, but I was not able to get a straight answer of any therapist with my HMO that did. I am thinking of putting everything on the table to explain my self-diagnosis and why I feel that way. There is also a genetic principle in my case because my great grandmother had undiagnosed autism which was blatantly obvious to everyone around her due to extreme desire for isolation and giftedness without depression symptoms.

However, part of me is thinking about just worrying about the result of my ASD and coping better with that. I do not think that will help because it is a band-aid not appropriately considering the underlying issue. I do not hate people, I just don't feel. Putting on an act every day makes me tired. I also recognize that days that I need to be more social, I am spent very early. On days that I am able to work on my own stuff with very limited interaction, I feel I can work at least 10 hours without issue. I am beginning to realize my body language which makes me get in my head even more and less able to focus on what I was trying to say in the 1st place.

I guess what I am thinking is that I know what works for me, but I just have a hard time with the energy to keep doing it and withdrawing more and more. Even though it is going to cost a lot and maybe I may hit road blocks on my way to an accurate diagnosis and treatment, it may be worth it in the long run.

I do want to contribute and continue "the act" of appearing eccentric/officious, but kind and witty with my "dry" brand of humor. It would be nice to want to communicate with friends I let slip (although I do not feel the need). It would be great to know why holidays and events are special. It would be wonderful to know people that pass or get critically ill and have a deep feeling of sadness/greater appreciation of their life. Regardless of my formal diagnosis and treatment, I have a difficult time of seeing how that can really improve.

I am grateful that I have a forum that I can say what I never shared with anyone because I know many of you are going through and/or faced the similar personal ordeals.

Ultimately, I am trying to figure out what is best for me going forward and it would be great to see how people in their 30's on up have been able to deal with the experiences I am working with.

And what makes a diagnosis not a band-aid? You seem really willing to accept it when people say something's wrong with you.

The reason is I am willing to accept a professional opinion is that I have ignored/rejected it for a long time. i was 1st aware a few years ago. My marriage almost ended and had no idea why. She needed to explain to me the information she shared with me and I never understood why that was a problem. I took a couple on-line tests that clearly suggested Asperger's.


Instead of pursuing treatment, I went and worked on coaching myself up better. It is somewhat effective and worked on things that helped save my marriage, but she is sticking with me even though she knows that the amount of my change has a limited ceiling. Very recently, I confided in her that I have an ASD. She seriously said that she knew and was trying to subtly tell me all along. She said I am not dysfunctional, but has protected me from situations that make me anxious like social events and the like. My son restricts friends from coming over because he too recognizes I get uncomfortable and anxious. The entire time I have worked very hard on not projecting it, but it's like a beast that's getting harder to mute.

I have no friends. I have a number of acquaintances, but I am too pre-occupied in what I am doing, that I do not let anyone in. I wish I could feel the need to reach out and talk to friends, but my interests and theirs are different. I would prefer to email and text rather than talk anyway - I rarely pick up the phone for calls.

I know this is something outside of my control and will only get worse instead of better unless I get professional assistance. My problem is that I am getting older and it gets worse without real treatment as you get older. I am experiencing it 1st hand. I do not want to isolate from people, but I have much greater interests than socializing. Sometimes, I think I select those interests because the are pursuits that are independent for the most part.

Therapy and getting to know you is quite good, but as well I'd say that there's something nice, hard, and concrete about following the formal procedures for a diagnosis.

Thanks beneficii -

I have difficulty convincing myself that a therapist without experience with ASD can effectively treat someone that has an ASD. Without a shadow-of-doubt, I have one because I spent the past three years trying to disprove it while it was getting worse. I like the confirmation of the professional diagnosis as well because with that logically comes more effective/better treatment. Far more important than the formal diagnosis is the appropriate treatment for the ASD. Can you get to that point without a formal diagnosis?

The thing is, I don't think any of the formal procedures are very formal. Typically it involves a conversation(which is way too quick for my tastes), though I would prefer if MRIs were available or screening to detect autism spectrum traits.

Apequake, having no friends is okay. I also have no friends, it's a life of solitude. Occasionally I feel jealous or depressed over it, but then I simply remind myself that my solitude is mostly a preference. I try not to let it get me down.

Hi MoonCanvas,

My wife is my friend. I never get depressed over not having friends - I just think that's odd because it is my own doing and choice. I am more than okay with acquaintances, but I was pointing out somethings that make it worth having me evaluated for. Maybe with proper treatment, I might enjoy having interests that I can include other people.

I admire that many of you are comfortable with meeting and being friends with others like you IRL via conferences and stuff. In my current state, regardless of the amount of time and correspondence I have with others on here, I cannot see myself ever desiring the IRL interaction even with people that are similar to me (and I really like myself). I would like that desire, so maybe therapy (with a basis on working with the ASD end of it) has helped others make it over that hump.

How can you talk about the efficacy of a process that is intended to diagnose a condition you don't believe is real?

Marriage counseling probably has the best success rates of any therapy. I would suggest that you and your wife start there. A good family therapist will certainly consider your concerns about your own dx, and he/she will give you both tools for making your marriage stronger.

My marriage is stronger now than ever. After I talked to her, recently, she explicitly told me that she will support me all the way as long as I continue to work on it. I do not isolate from her as much. She will not even go to counseling. She feels that it is worthless for her because she is very stubborn and resistant to change.

I want to be a better husband, father and more comfortable socially. Every day out there is SO tiring and I am getting worse at acting like any "normal" quirky NT. Before a few years ago, I thought I was just another quirky NT and most people thought and behaved somewhat like me.