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C2V
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21 Dec 2015, 9:23 pm

Are any of you, or have you been, in therapy? If so, what kind? What sort of format did it take, and what did you gain from the process? What techniques were effective, which less effective? How often did you meet? Was success or failure dependent on the kind of therapy it was, or was some "click" with the therapist personally important? Which therapies in your experience are most suited to autistics?
I'm just about ready to give up which is unfortunate as the only reason I was there at all was due to a lack of any other options. It simply is not working at all.
Before I made the decision to try therapy, which is completely against my nature to begin with, I deliberately did not prepare myself. I did not research the hell out of the whole subject so I would know exactly what the therapist was doing, which techniques they were using, which theories from which schools of thought they were employing, what response or end result they were expecting from me - so I would not be able to control the process at all and stop any genuine insight into my situation from being made. I did not want to go in with my front all prepared as I always do, and achieve nothing. I attempted to be as honest as possible without any background noise.
Perhaps in hindsight rigorous research would have been better, as I could better understand what is supposed to happen and how this is supposed to proceed, because I really don't see the point here. I get in there, I talk about whatever I have been thinking about or an issue I had, and I leave. It is 99% me talking, which I am NOT good at, either physically or metaphorically.
Therapy has not "worked on" my problems. I have not changed. I have not gained insights or learned to alter my more destructive behaviour.
I was under the impression (and maybe someone can correct me if I'm wrong) that a) a therapist has more knowledge and insight into the human mind than I do and b) I was going to therapy is order to learn why I may be behaving in the ways that I am, and learn about alternative methods to change or improve that behaviour.
I didn't expect to just go in there and talk to myself endlessly. If I had the answers myself I would have no need to go at all. I am good with being educated, and using that information to think in new ways and mindfully change. I do not "just need to talk." I need to understand and act. I suppose I was expecting some kind of advice, to be exposed to theories about behaviour and psychological modification that I could consider and trial in action.
What is therapy supposed to be like? Is my disconnect likely to be because of me, or is this therapy ineffective in itself?
Opinions? Experiences? Insights?


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kraftiekortie
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21 Dec 2015, 9:33 pm

I've been in therapy many times, starting when I was a tiny little kid. I had no speech until age 5 1/2.

I am not now presently in therapy.

I believe some are good, some are indifferent, and some are bad.

When I was a kid, "play therapy" dominated. As an adult, some variation on Freudian methodology was usually employed, with an (irritatingly) Rogerian element attached to it.

I am not one who believes in relying on my therapist to help me live my life. There is danger, I find, in allowing a therapy to have so much control. I know people who won't do "boo" if the therapist tells them not to do "boo."

The one good thing about therapy: it provides you with an objective ear. They are not your parents, lovers, friends, etc. (though I hope I never get a crush on a lady therapist!)

There's one truism: If a therapist falls asleep while you're talking about yourself, quit the therapist right away! That actually happened to me!



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21 Dec 2015, 9:56 pm

It's a misconception that therapy is mostly you talking about yourself. That is old-fashioned Freudian technique, and I don't have a great deal of respect for it. Anyway for autistics, you need to have a dialogue going, and get feedback from the therapist as well as suggestions about what stuff means and what you might try. You might look around for a cognitive-behavioral therapist (CBT).

This might surprise you, but you do have the right to tell your present therapist you don't feel the therapy is helping you, and ask them to help you find a cognitive-behavioral therapist. You also have the right to just cancel your next appointment and never go back, but sometimes hashing it out involves more growth for you.

I would encourage you to continue to seek therapy but talk with your next therapist about what you didn't like about this one, and work cooperatively to set some therapy goals. For instance, a goal of therapy could be to support you in trying some new behaviors around other people, and assess how that feels and what seemed to work well or poorly.


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Ettina
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22 Dec 2015, 9:17 am

What do you want out of therapy? What kind of therapy you need will vary widely depending on what your goals are.

For example:

Anxiety/depression - treated with talk therapy and/or drugs

Poor social skills - treated with social skills training

Poor self-care/independent living skills - treated with occupational therapy



Ivory
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22 Dec 2015, 11:14 am

I've been in therapy on and off for the past 15 years and it's been very useful to me. Interaction with a therapist has worked the best so far - not just talking, but having a dialogue about what might be going on and how he/she perceived it. I feel I've learned a lot about myself. One of the things I've learned is that I don't think/feel/behave in the same way that most people do, so this is the first thing I mention when I meet a new therapist, so that he/she knows firsthand. I've had the priviledge of having a therapist for 5 years who understood that and fully supported who I am. Since then, I've changed therapists twice, not because they weren't skilled enough, but because I felt I'd learned all that I could learn from that person and needed a change. Although it's expensive, I feel it's important to "shop" for the right therapist, and during the first interview, I'm the one who asks the most questions to him/her, to ensure the fit will be good and we'll both be comfortable.

That being said, you can make a list of what you're looking for in a therapist and ask lots of questions to them. Also, maybe there is a therapists organization where you live that could refer you to professionnals who would match your criteria.

Good luck!



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22 Dec 2015, 12:08 pm

I've been in therapy since I was 12 and most of the therapists I've dealt with have multiple approaches they can take with you. Some patients want to talk or vent. Other patients just want tools (like CBT or Mindfulness) they can put in their tool kit and don't want to spend a lot of time on the couch. My needs have varied on that front but I realized you have to be pretty direct and let your doctor know exactly what you require at the time. If they can't provide what you ask (or fall asleep on you - like with Kortie) then move on to another doctor.

Some of my best therapy experiences were from books. I got exactly the info I needed, learned it, and saved money in the process. However, I also had great therapists (where the bond of trust was strong) that helped me refine techniques I had book-learned and gave me great insights into my own behavior.

Best of luck with everything. Hope you find a good doctor or at least some good books. I can recommend some reading if you'd like.



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22 Dec 2015, 7:20 pm

I am in going through therapies right now. I'm not diagnosed asd but I have traits.

What didn't help: 10 years ago seeing the counsellors that my university had. I had a very schizoid experience, meaning I had no idea what was wrong just that I wasn't happy. Poor self awareness does that.
-1 on 1 with a counsellor the past 4 months. Largely just frustrating, feeling like he's not doing anything, feeling like it's a waste of time.

What did help: CBT. Just finished a group course of it, 20 sessions of 1.5 hours over 20 weeks. I was very surprised it is as useful as it has been. Shocked as I knew what CBT was at basics, and thought I would hate it. Instead I found it eye opening. I feel like I've been deprived of basic everyday skills that deal with emotion processing and basic human interaction skills. This class (is was a classroom) showed me those things, which are both autistic things to be bad at.

I am furthering my education by taking an in depth emotion processing course and I might do a follow-up dbt group focused on using the skills I learned from earlier.

Since my family life growing up has some negative things in it, I do want to do proper psychotherapy at some point, but being able to process my emotions first; feel them, understand them, live with them, lead them; is necessary before I think psychotherapy would work.

I am quitting 1 on 1 with my current therapist although having him did give me a chance to build trust from another person, an excersise I desperately needed. I will be able to call him up to schedule if I feel I need to.

I am also getting out so much out of some stuff because I need/want to change.

It has helped me alot also to know that I am not changing who I am, but rather just changing behaviors. I am in fact growing a stronger sense of self than I had.

Sfhelp.org is a pretty cool website that sprung me into action. I was following that therapy for awhile on my own while on my waiting list for a government paid therapist. Interesting concepts; I lacked some of the said awareness though.

Lastly I am using weed in a therapeutic way, another self discovery.

I needed change in my life, I was falling apart.


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BeaArthur
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22 Dec 2015, 7:32 pm

I am finding these replies to be very informative. The take-home lesson seems to be that the wrong kind of therapy is a waste of time and money, but don't give up, try something else, and the rewards can then be substantial.


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C2V
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23 Dec 2015, 1:01 am

Quote:
It's a misconception that therapy is mostly you talking about yourself. That is old-fashioned Freudian technique, and I don't have a great deal of respect for it. Anyway for autistics, you need to have a dialogue going, and get feedback from the therapist as well as suggestions about what stuff means and what you might try. You might look around for a cognitive-behavioral therapist (CBT).
This might surprise you, but you do have the right to tell your present therapist you don't feel the therapy is helping you, and ask them to help you find a cognitive-behavioral therapist. You also have the right to just cancel your next appointment and never go back, but sometimes hashing it out involves more growth for you.

When I read that I immediately thought "Yes! That's what I'm after!"
I thought a proper therapeutic dynamic would involve me presenting with a certain issue, and the therapist relating that issue to their training and experience and helping me to "unpack" (catch-phrase someone taught me for this kind of process) that idea, deconstruct and understand it fully, then we can both think of ways for me to solve this issue. That requires dialogue, as you put it. Another facet of my current therapy situation that makes me uncomfortable is the one-sidedness of it. I feel like a show monkey. The therapist does not give back, and when they do, I am running into yet another of the reasons I had been so anti-therapy my whole life - the A=B judgement. Maybe I'm arrogant but I don't think life is ever that simple. Example of this sort of interpretation may be you're a jerk to your girlfriend because your mother didn't love you enough. Come on. People are complex, and a little more effort is required to understand than this sort of facile attempt.
I had indeed been researching CBT approaches and people who have experience working with autistics. I have been accused in this setting of "taking a scientific approach to life." It seems that CBT may be more productive with someone with a difference engine for a brain than just talking and not understanding the reason behind all the waffling. I don't have a lot of respect for the technique either - letting me endlessly rant about how confused I am does not make me less confused. I have decided it isn't working, and am starting to look elsewhere.
Quote:
What didn't help: 10 years ago seeing the counsellors that my university had. I had a very schizoid experience, meaning I had no idea what was wrong just that I wasn't happy. Poor self awareness does that.
-1 on 1 with a counsellor the past 4 months. Largely just frustrating, feeling like he's not doing anything, feeling like it's a waste of time.

What did help: CBT. Just finished a group course of it, 20 sessions of 1.5 hours over 20 weeks. I was very surprised it is as useful as it has been. Shocked as I knew what CBT was at basics, and thought I would hate it. Instead I found it eye opening. I feel like I've been deprived of basic everyday skills that deal with emotion processing and basic human interaction skills. This class (is was a classroom) showed me those things, which are both autistic things to be bad at.

This is interesting. Maybe I'm mistaken, but I always assumed I was self aware because I'm introspective, always self obsessively trying to work out what the hell is going on. I thought people with poor self awareness didn't think about themselves at all, just thought about external stimuli (which ironically is the way I prefer to operate, but I can't seem to get away from the self-focus, which I recognise as an obsessive issue). But maybe I'm in your boat. I know life is not working out and neither am I, but I may really be blind to the causes of this. Because you're right. Talk therapy with me doing the vast majority of the talking to me seems like a total pointless waste of time.
Since two people have mentioned CBT now and the literature I have been reading about what works best in cases of both autistics and alexithymics, I think this is the most sensible option to be looking into.
Quote:
What do you want out of therapy? What kind of therapy you need will vary widely depending on what your goals are.

For example:

Anxiety/depression - treated with talk therapy and/or drugs

Poor social skills - treated with social skills training

Poor self-care/independent living skills - treated with occupational therapy

That's interesting also and seems to be a developing trend in this read. Basically the problem I presented with (over a YEAR ago now and I still have no results) was a functional one. I assumed I had some kind of breakdown/autistic burnout/whatever, which erased any form of operational functioning I had. Things have been slowly building back up through my own efforts (meaning I can speak most of the time and keep myself alive living alone) but I still do not function effectively as an adult in an adult world. Inability to keep a job, inability to understand and form connections with others, inability to manage myself personally. All I am able to do is not die, basically.
What I need is to understand what is going on, and find functional ways with which to improve, so I CAN live a functional, productive, and I hope happy, life. This may well be CBT, but what it certainly is not is pure talk therapy.
Quote:
Although it's expensive, I feel it's important to "shop" for the right therapist, and during the first interview, I'm the one who asks the most questions to him/her, to ensure the fit will be good and we'll both be comfortable.

That being said, you can make a list of what you're looking for in a therapist and ask lots of questions to them. Also, maybe there is a therapists organization where you live that could refer you to professionnals who would match your criteria.

This is good advice. It certainly crossed my mind to default to my list technique and list everything, go in there and hand them the list. But I considered this may also be a good way to come across as a whackjob :wink:
I will certainly be more interested this time in understanding the person and their practice more fully - what theories they apply, what their training has been in, have they any experience with certain aspects which apply to me, which therapies they use, etc. I have to make sure anyone else I see is not of the school of thought of talk therapy. It doesn't work. I will be interested in CBT but you're right, they have to be a good fit this time.
Quote:
I am not one who believes in relying on my therapist to help me live my life. There is danger, I find, in allowing a therapy to have so much control. I know people who won't do "boo" if the therapist tells them not to do "boo."

This wouldn't be a problem for me. I'm generally noncompliant. If someone presents an idea, and if it seems sensible, I will acknowledge and test the idea, and monitor results. If it then proves to be useless I will dismiss it. If my own determination seems more sensible I will pursue that, no matter what anyone tells me.
Quote:
Some of my best therapy experiences were from books. I got exactly the info I needed, learned it, and saved money in the process. However, I also had great therapists (where the bond of trust was strong) that helped me refine techniques I had book-learned and gave me great insights into my own behavior.

I have read one book of the school the therapist utilises (ok so I did do that much research) but I can sneakily pick and choose what to acknowledge without someone there to call me out. Which is another reason I have had so little faith in therapy in the past - I am able to fool them so easily (in the form of employment psychometric testing) and no one has ever seen through the facade or called me on my bullshit.


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23 Dec 2015, 10:31 am

There are good therapists and there are bad therapists.

My last therapist I saw for five years. Sometimes every two weeks, sometimes only every month or less, depending on cancelled appointments and stuff. Honestly I think she was terrible, but it was still better then nothing. The biggest problem I had, was that she didn't seem to understand autism well at all, and never even really acknowledged that I was autistic. Despite the fact that several professionals had already diagnosed me with it. She would still talk like "if" I have autism... So the advice she gave me was mostly worthless. But again, it was still better then nothing.

Now I have a new therapist for the first time in about a year. I'm cautiously optimistic that this new therapist will be better. She really seems to understand autism well. She talks about it a lot. I think it's going to be interesting to see how it's goes with this therapist.


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nick007
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25 Dec 2015, 8:36 pm

I tried it before but it did not work well for me. The guy didn't believe I had Aspergers & thought I could easily grasp things I couldn't. He thought I had a personality disorder instead & didn't realize I had certain things limiting me. I don't know what kind of therapy it was thou & I didn't try it for very long.


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25 Dec 2015, 9:28 pm

I never really understood the bases of therapy until I started seeing my new therapist, I just thought it was a waste of time, energy and money.

However I now understand 'Therapy' my therapist knows that unless she leads the session by asking questions I am not likely to talk, when I reflect back on what I have learned it pretty impressive, I never used to understand my emotions but now I recognise them, I have also been learning to deal with anxiety and how I respond to it, I understand myself and my actions/inactions better.

I have also been working on sensory issues reguarding touch, when someone touched me the feeling would stay with me for a very long time and would leave me feeling violated, agitated and uncomfortable for hours and it was very negative, I have been working on this, so when I still feel that touch, I put it in to perspective .....was it a friendly touch? Was it just in passing? Or whatever? I am learning to just 'let it be' and move on, instead of feeling negative...its led to fewer meltdowns.

On our last session she mentioned that I fit the criteria for PTSD and was wondering if I'd like to work on it......although I now understand therapy better, I'm not sure I want to deal with all of it, since I'm doing so much better with the skills I have learnt.


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25 Dec 2015, 9:42 pm

kraftiekortie wrote:
There's one truism: If a therapist falls asleep while you're talking about yourself, quit the therapist right away! That actually happened to me!


Oh wow, I thought I was alone in having that experience! Back when I was in high school, the therapist I was seeing fell asleep during one of my sessions. I was a bit shocked and had absolutely no idea what to do, so I just sat there quietly until he woke up maybe five or ten minutes later. He blamed it on cold medicine, but I felt kind of bad about it, like am I so boring that I can't even pay someone to listen to me? 8O But now I look back on it and laugh! :lol: :lol:

To the OP: I was in therapy for most of my childhood and didn't really find it helpful, but some people do. I think in my case I probably would have been better helped by social skills classes and the like rather than just talk therapy.



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25 Dec 2015, 9:55 pm

I have read several times the best predictor of success in therapy isn't the actual type of therapy being used but the overall connection between therapist and client.



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25 Dec 2015, 10:12 pm

betruetoyourself wrote:
I have read several times the best predictor of success in therapy isn't the actual type of therapy being used but the overall connection between therapist and client.


I have read that too. BUT was that with adult autistics? I guarantee you it was not. When they do studies like that they look at a population such as unipolar depressives assigned randomly to this group or that group, and any developmental disabilities or personality disorders are exclusions from the study. The reason this is necessary is to reduce the variance so that a small effect of "therapist/client connection" or "type of therapy" is not overwhelmed by other sources of variance.

When they start doing this kind of study using a population of adult autistics, then you can extend the finding to adult autistics. But until then, the finding is interesting but worthless.


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26 Dec 2015, 8:23 am

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I have read several times the best predictor of success in therapy isn't the actual type of therapy being used but the overall connection between therapist and client.

This is what concerns me. I don't do "connection" with other people. It's something I have never experienced - with my parents, 'friends,' girlfriends, anyone. If successful therapy is contingent on personal emotional connection, I have doubts that I'm even capable.


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