My therapist knew I had Asperger's but didn't tell me

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Magliabechi
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21 Aug 2008, 2:05 pm

dougn,

Although a psychologist or psychiatrist may responsibly withhold their ideas about your condition for a short period of time, (such as during a session for assessment) it is profoundly irresponsible for them to withhold their beliefs about your condition from you for any significant length of time.

I would strongly suggest that you evaluate what you are gaining from this relationship and consider terminating it unless his behaviour improves.

As for the drugs, unless you want to be dependant on them for the rest of your life, there will never be an easy time in your life to do it- now is the best time, but tell your prescribing doctor beforehand and reduce the dose over a period of weeks. ( And ask the people around you for tolerance beforehand in case withdrawl symptoms make you cranky. )


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21 Aug 2008, 2:20 pm

Now probably is one of the better times to quit drugs. You generally dont have many tests or papers due for the first few weeks of school. Its better to go through withdraw now then during finals.

And yes, if I had known about AS when I was 12, then going through school would have been much much easier on me. I cant believe he was so irresponsible to keep this information from you. I would ask what you plan to accomplish by staying with him for any longer. Its not as though therapy is needed for AS.



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21 Aug 2008, 2:55 pm

pandd wrote:
In my opinion your therapist has acted in an unacceptable manner. You have a right to make informed decisions about your health care and you cannot do this if you do not have all the facts. I am disturbed that your therapist appears (in my opinion) to have usurped your autonomy in this patriarchal manner.
I totally agree with this point about informed consent.

And I agree with other points about trust.

The whole thing about your therapist fearing that you might have reacted negatively, well what kind of inept therapist chooses to totally avoid such a thing over a course of years?

I can't understand if in the short-term a therapist might be waiting for 'the right time' to raise a particular issue, so as not to cause upset or harm, but to avoid it for years smacks of either laziness at best, they couldn't be bothered to help you work through the issues arising out of your being informed of the diagnosis, or at worst negligence.

Totally out of order imo.



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21 Aug 2008, 4:06 pm

Look at my sig, I knew he was bringing up Asperger's up a little too much recently... when he mentioned it again I asked, and sure enough he's thinking it's possible, with a "Maybe".


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dougn
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21 Aug 2008, 10:41 pm

The more I think and talk about it, the less I like this situation. Perhaps this is because everyone else who hears about thinks it is a terrible situation. So far I have only come across one person who thinks my therapist's non-disclosure may have been excusable. In fact, everyone else seems to think I should be more upset about it than I am, though I am getting more and more upset about it. At the very least, everyone seems to think that it would be understandable if I were very upset. A number of people (including one who is herself a social worker) have suggested that I should just sack my therapist outright.

Then of course there is the matter of my psychiatrist, who I haven't even spoken to about this yet. I will see him this week and I am already dreading it. I've never dreaded seeing my psychiatrist before. I'm pretty sure that's not how you're supposed to feel about your psychiatrist. Either he knew and he didn't tell me (in which case, oddly, I think I'd be much angrier with him than with my therapist), he just didn't know I had it (in which case I'll think he should have), or in the most complicated situation of all, he actually disagrees with my therapist and thinks I don't have it. Three bad options.

As for the medication, I have been wanting to try giving it up for a while now, but I need to re-evaluate the whole thing now in light of what I have recently found out.



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21 Aug 2008, 11:02 pm

Well why not just keep away from both of them until you know what you feel.



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21 Aug 2008, 11:34 pm

A lot, maybe even most, shrinks don't believe in telling the patient their own diagnosis no matter what it might be. It isn't just with AS diagnoses.

Their thinking seems to be it will upset the patient or make them 'become' the diagnosis in a permanent way. Which to me is really idiotic, and on a par with the way medical doctors used to keep serious physical diagnoses from patients. In those days the patient was not told and their family warned not to let them know.

As for what to say to the shrink, just tell them how it made you feel. Surprised, betrayed, disappointed, whatever it may have been. That's what they want anyway, is to know how you feel.



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21 Aug 2008, 11:35 pm

I am very strongly biased in this matter, so in regards to my comments to you dougn you probably should keep in mind that regardless what we all think, whatever decision you make, you are the one who must live with the direct consequences (not us).

It is important to keep in mind that whatever others might wish were the outcome, they do not have to live with making that happen (or attempting to make it happen). It's a lot easier to talk about what ought to happen when one is not involved in making it or happen nor has to live with the direct consequences.

That being kept in mind.....this really does upset me a lot.

If we keep in mind that people seeking mental health services do not lose their basic human rights as a result, it's difficult to see how this conduct can be justified.

If a health practitioner suspected a physical ailment was implicated in a condition they were treating you for, but lacked the expertise to even determine if you have the condition they suspect or what role it may play in comprehensive treatment and care, but they did not refer you on to someone who has the expertise to determine the facts relevant to your current care, this skirts dangerously close to practicing outside of their field of competency (if it does not cross the line entirely), and this would be true if you were fully informed and chose to take the risk with your own health.

This practitioner had not even informed you of the apparent lack of clarity that might apply to your overall care. I am not entirely convinced your practitioner has reasonable grounds to claim that you consented to treatment (which the practitioner probably needs since you are an adult). I do not know the law relevant to your jurisdiction. If the standard requires that an informed choice be made for consent to be legally plausible, I fail to see how consent could be achieved in the circumstances.

And it does appear to be implicated in causing you avoidable and unnecessary harm.
It is difficult to not interpret the distress you feel at facing your psychiatrist as an unnecessary harm arising directly from an avoidable (and perhaps even unethical or unlawful) breech of trust.

It may be in your interests to approach this with as little anger and as much compromising understanding as you can bring to bear, but I cannot help but wish serious consequences arose for those who in my opinion have violated your trust and your autonomy. It is difficult for me to see how these circumstances can fail to constitute the stripping away of your right to reject medical intervention. In many jurisdictions that right is protected in law. You may wish to be fully informed about the relevant legal and professional standards that apply locally (to you) before you make any ultimate decision about how to respond to your discovery.

I wish you the best whatever you decide to do. I am dismayed you have found yourself in this situation and hope things work out from here as best they can with the least heart-ache and nuisance to you.



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21 Aug 2008, 11:56 pm

It could also be, at least in part, that the psychiatrist knows so little about As or who to refer you to for further treatment, that they kept it to themselves in fear of being wrong in diagnosis (I am thinking of their phrasing 'suspected' you had it) or looking foolish. Even shrinks are people too. ;)

I'd advise getting past or around the anger at least for now, and at least try to talk about it face to face. But express how it made you feel. Maybe write a bit of it down, and hand it to them, even. If you think you might lose your temper about it in the session but don't wish to lose your temper.

I do think it stinks but there are innocent (i.e. not malevolent or purposely damaging) explanations including their ignorance and bad training.

The question after the smoke clears is: Now what? I hope they have some advice for you.



dougn
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22 Aug 2008, 1:05 am

He made it sound like a lot more than a suspicion - he said flat out that I fit the criteria for AS.



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22 Aug 2008, 1:39 am

Ok. Then I refer back to my prior post, in which shrinks for some inscrutable reason feel that a patient or "client" as they prefer to say, should not know their diagnosis. I dont agree with that tactic myself but almost all of them believe that.

If you ask one what they'd say your diagnosis is they will say it isn't important or they don't like to say. I think it is anachronistic and again, it is like the old days with medical doctors. Even today a lot of those also don't want a patient to 'know' too much.

It's really stupid in my opinion but not necessarily purposely malevolent. If that helps.

*I just thought of something else. Some of them think it's better for the patient to find everything out for themselves, which I think wastes time and is patronising but I can see a value in it I guess. People tend to see more value in what they discover than in what another person tells them. So he or she may have felt that way too.

Ask them why, and feel free to tell them how it made you feel that they knew and didn't tell you.



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22 Aug 2008, 2:05 am

Hi Dougn,

It's a confusing time for you now and things all at once getting a bit close, propably. Take your time. That you now know what you have or better, what you are is best and could and will be the beginning of better times. I trully hope so. Try to see it that way. Not really as a problem but see it more as a challenge.

Read about it and try to be sure that this is the deviation you have. I can't tell. But.... When you build a bit of self-confidence, AS isn't really a bad thing. It has beautiful features. Try to find out what you really love or like and focus on those things rather then to stay in negative vibes.

Try to build a bit of assertiveness, I know that's tough for almost all autists (and for NT's as well) but try to let no one walk over you. Stand up for yourself; you're good as you are.

Best of luck to you,
Ceesjan

P.S. I'm not sure we can help you here on WP but you can always tell your story or pop a question here. When needed, do so.

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22 Aug 2008, 3:13 am

Well, evidently he didn't think I should know this diagnosis. Next time I see him I will go into this in a lot more detail, anyway.

I am relieved to know I have AS, I just wish the circumstances in which I found out were a bit different.



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22 Aug 2008, 9:37 am

there are still professionals out there who deny that Asperger's exist


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22 Aug 2008, 11:46 am

I assume mine thinks it exists if he thinks I have it.



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22 Aug 2008, 2:57 pm

the only good psychiatrist i ever had didn't like me at first. she said i was too blunt and caustic. once she asked 'pretty clever, aren't you?' and i told her my iq. she asked, and i normally don't blurt it out but it seemed relevant for my brain doctor to know. after a few sessions she liked me, probably too much, and i liked and trusted and respected her. at maybe the 3rd or 4th session i told her that i had worked with a guy in a group home who had pdd-nos and i had never heard of it, and that's when i learned about autistic spectrum disorders. i didn't think i had the exact criteria for asperger's but i was well within pdd-nos territory. she told me that she already knew that, but she wasn't going to diagnose me because there was no treatment she could prescribe for it, and i had enough diagnoses already. that made sense at the time, but i soon learned that only a psychologist could officially diagnose, and it took a lot more effort than a few hours of meetings. because of the bureaucracy at that place, and their focus on mentally retarded children when it came to autism, i never would have been diagnosed there.

before that an experienced and bright psych tech i new figured out that i had it, and later an experienced and bright psych nurse figured it out. it would have been totally obvious when i was a kid, but no one had ever heard of these things then.

a social worker or therapist definately can't diagnose you, and so probably wouldn't bring it up for fear of being unprofessional. i'm pretty sure stuff like that is frowned upon in their professions. when i worked at group homes it was forbidden to say in our documentation that someone seemed depressed, because we weren't psychiatrists and couldn't make or comment on diagnoses. but now that it's out there you should be able to work on your social worker to get an official diagnosis - they're the best ones to connect you with those kinds of services.


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