Failure In Therapy

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Hi. I was diagnosed as Aspie at the beginning of the summer and have been in therapy. She had asked me what I wanted to work on and I said communication skills.
Well we only had one day where she showed me a sheet of paper with different facial expressions and that's all we did. Maybe she was trying to gauge my ability to read faces and thought I could read hers better that way. I just can't seem to always read hers because she's a person in front of me with body gestures.
I also get confused or slightly offended by things she says like "but everyone has that problem", but that's normal, you're too intelligent to have that problem"...those are the statements that leave me confused so I don't ask about those. How do I? I think her approach is CBT if you were wondering.
Well in my last session I had a moment of shutting down. Tried to say I was ok when I wasn't. I'm a terrible liar and it showed. She has a way of making it seem like she's trying to get me to take too much blame. I know she's jokingand while II'm not mad at her I have beaten myself up for shutting down, for not saying things aren't working sooner, and for past therapy attempts. I have been in and out of therapy for the past 17 years.

I called and talked to her about how I was feeling and she asked me what we could do. Truthfully I have no idea ,but I suggested working on ToM skills.

After that I started thinking about my failures and how all this makes me feel. To figure out my feelings I have to look to my past to help piece things together.That led to painful past experiences. These memories can be extremely difficult for me since I have a good long term memory. I lapsed into a state of major depression that lasted over a week. I just came out of it. I am diagnosed with major depression as well.

This is hard. While I can work on and improve my communication I can't change the way my mind processes thoughts or feelings. This has a high probability of making it seem like I'm not truthfully trying. I am!

She does genuinely care for her clients and is willing to work with me but I don't really know the best methods and approaches.

What are the best therapies for ASD adults?

If you are curious I believe she is a LCSW..could be wrong. She is 25 so she probably graduated only a few years ago and I don't know if she has much experience with ASD clients particularly adults.

A patient can't fail therapy, a therapist can.

The best therapy depends on what you want to get out of it.
In order for it to work you also have to have good therapist.

What do you want to get out of therapy?

For me the best therapies where:
- Mindfullness based cognitive therapie
- Haptonomy
- PMT
- Creative therapy

That where also the therapies where i had great therapist, the ones who understund me the best.

I also have the tendancy for my eyes to drift away from her as I do with all people.

It sounds like you need a therapist with a specialism in autism spectrum disorders because they should be able to understand your way of communication better and they should also be able to communicate in a way that's clearer and easier to understand for you.

If you trust your therapist and feel relatively comfortable with her, then you have something to work with. You don't have to assume responsibility for the success of your sessions; just be honest with her. Share your moments of discomfort and just ask when you have questions. In the research I did, participants reported that "reverse stigma" (where we are told nothing's wrong or we're "too intelligent" to have a certain problem) can be very damaging. Your reaction is very normal - it can shut us down. Reverse stigma sometimes takes the place of careful listening, and if you feel your therapist does this at times just tell her. Try to express yourself again and tell her if you feel heard the next time. No matter what techniques she uses, it is the work you do in the session together that makes the most difference. If you start to feel you can't work with her, tell her that as well. Addressing problems together may be where the most important work is done in therapy.
Good luck!

I think you need something more specific to work on in therapy that generally ToM skills or communication skills.
I suggest that you make a list of situations in which you have communication problems and work on learning communication skills applicable to those situations.
The same with ToM or anything else, find real-life situations in which you have specific problems, then work on learning skills or emotionally dealing with those problems.

I have experienced the same, mostly too because standard therapy is useless for me. I know how things are now and I do not need them to tell me common sense any more, what I need is support and guidance in social situations and for them to help me by providing me with social situations or meetings. They couldn't provide that, so they couldn't help me which just made my situation worse. It seems, at least in my area, that almost all support for autism goes towards children and parents. Once you have turned 18 almost all the support falls away at which point the only things you get are anti-depressants and common anxiety therapy.

First, some background. I have a B.S. in Psychology, and I work in the mental health field, so I am biased in a certain direction. I am also an aspie who has been in therapy for several years.

Both my school learning and my personal experience receiving psychotherapy point to one fact: experience matters! If you are working with a therapist who has no experience working with a person who has autism or AS, that person will not be able to help you. They won't understand how you are experiencing things and interpreting things. We, as aspies, have a unique way of interpreting the world. We also have mental blind spots that NT's don't have. Only a therapist who has worked with aspies will be able to pick up on the thought patterns that come with AS or the emotional issues that come from living with AS. I would suggest getting another therapist. When doing the initial interview with your potential new therapist, ask that person if they have experience working with adults who are on the autism spectrum.

As far as specific approaches go:

The best book I have ever read about AS is a self-help book. It was written by a Licensed Psychologist who specializes in helping adults on the autism spectrum. The book is called "Living Well on the Spectrum" and the author is Valerie Gaus. It follows a simple problem-solution format providing examples of common problems people with AS have and helping you come up with ways to address the problems that are bothering you.

What my therapist did for me when I asked about social skills was have me read "How to Win Friends and Influence People" by Dale Carnegie. It's a pretty good book. There are also books on etiquette that you can pick up at pretty much any book store.

Two simple but powerful suggestions for socializing I got from my therapist:

1. Don't try too hard.
2. Practice eye contact (You can look just below or above the person's eyes if looking in the person's eyes is too hard)

The role my therapist played in helping me:

When I first started going to therapy, I was a teenager and it was because of depression. I've seen several therapists, and I've been in therapy of one kind or another for half my life. The last therapist I had was the best one by far. He was the only one who knew anything about Asperger's Syndrome. What my therapist did for me was confirm my self-diagnosis, help me come to terms with having AS, and help me with my other issues taking my AS into account. None of the other therapists were able to help me as much because they just did the basic medication and CBT stuff you do for depression. They missed the AS diagnosis, so a huge part of my problems went unaddressed. This guy saw the whole picture.

Well your therapist sounds useless. Have you considered a psychiatrist and medicinal treatment. Seventeen years is a long time to bang your head against the wall of therapy.

I would have thought that for a therapist to be effective, experience with ASD people would be pretty important. Otherwise the therapist isn't going to understand the client very well. For example, as far as I know, most "ordinary" therapists use a face-to-face approach and simply assume that's got to be good. But for ASD people, it could hamper everything. I don't see why facial expressions need to be exchanged for a session to work.

I don't think that failed therapy is entirely the responsibility of the therapist. There's something in the notion that the client has to help. I suspect that clients often fail to take control of the sessions, sometimes because the therapist wants to control the process (which may or may not be right, depending on the nature of the therapy), other times because the client doesn't feel able to criticise or contradict the therapist. But I wouldn't blame anybody. Talk therapies are quite hit-and-miss.

You seem unsure about what the contract is when you say that you think it's CBT. Really the therapist should know that it's important to be clear about the contract (particularly about how much intervention there may be), but I guess a lot of them don't mention it.

Some of them tend to apply their pet theory too liberally. Some of my counsellors discouraged my use of written notes, although for some clients it's the only way to get much out of the sessions.

What about speech and language therapy. Has anyone tried that as an adult. We are looking into that for our 21 year old son. She thinks she can help, but I have not seen anyone who has talked about SPL therapy for adults. Anyone have thoughts?

She's trying to make you feel better and failing miserably...

"but everyone has that problem", but that's normal, you're too intelligent to have that problem" are exactly the kind of things normal people say to each other all the time, she's probably pulling faces at you whilst she does it too....

It does prove that she is at least trying. Perhaps try talking at her for a while, show her your mind and make her understand she needs to take a different approach. Ask her to do research into autism and quiz her on it at your next session, teach her how to deal with autistic people. Be stubborn and force her to see things your way. It might not get you the help you need but the next autistic she meets shouldn't have such a rough time.

Put your foot down and tell her why it's not working, you already know she recognizes your intelligence.