How do you tell your Therapist...?

I'm giving Cognitive Behaviour Therapy (CBT) another go - albeit again I'm becoming disheartened by the process. These so-called professionals really aren't geared to deal with an autistic perspective at all.

The Practitioner specialises in 'anxiety issues', and readily admits he has no idea about autism - saying I'm the 'expert' (god help me). He seems intently focussed on the issue of 'panic attacks', even though I say to him I don't consider myself as ever had one. Yet he focuses on anxiety issues with the attention worthy of an autistic! Okay, I do suffer anxiety with the best of Autistics, but for me (cognitive/sensory) overload is far more of a problem. If anything, as a defense mechanism (or attempt to redistribute internal resources) I tend to go into a catatonic state when suffering from overload (unless persistently exposed, whereby I can reach 'meltdown' and lash out), rather than the hyper-aroused state I would assume is a panic attack.

Part of the problem is that I'm having trouble explaining to him the difference between 'panic attacks' and '(cognitive/sensory) overload'. Indeed, I'm seemingly just not getting across to him just how complex and deafening the autistic mind can be, and how exhaustion results from trying to process the sheer volume of thought, rather than a build up to a panic attack.

Does anyone have a clear-cut and concise way for me to explain the difference between a 'panic attack' and '(cognitive/sensory) overload'?

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  • I think we could talk and talk until we’re blue in the face and some people will never hear us.

    My psychiatrist is excellent. He’s really good at spotting autism in order to diagnose but I can tell (which is a wonder for me!) but I can just tell that sometimes, he hasn’t got a clue what it’s sctually like. Which made me realise, how could he? I’m just grateful he’s so good at spotting it. He does help me though regardless of his inability to really stand in our shoes.

    For example. I have pathological demand avoidance and he made me realise that I’m not really avoiding things. It’s actually, self preservation. Since he made me realise that, there has been a huge shift in how I treat myself at times when I used to think I was avoiding stuff. Now I know I’m actually looking after myself.

    I have a support worker now who told me she knows little about autism, but she’s researched it and because she’s open to learning more and she sees me as a person, not just an autistic person, she has been able to help me.

    However, my work coach at the job centre has worked with adults with severe autism and she has a step daughter who’s autistic so the help that she gives me is something else.

    I realised, after having a meltdown in front of her, that I have never before been around somebody who actually understands a meltdown and knows how to deal with it. She was amazing and she taught me how to deal with the aftermath.

    So although I get help from all 3, there’s a definite difference in the help I get from my work coach who has actual hands on experience of working with people with autism.

    The mental health team just kept trying to tell me it was anxiety and depression when I knew it was none of those but I could never get them to see that. Mental health nurses are very prescriptive in their approach. It’s the way they’re trained and I could not get them to see it wasn’t anxiety and yes, they gave that subject the level of attention worthy of any autistic person!

    There’s a gap in the market for workers with experience of autism and certainly the mental health teams are not trained in autism. I think we all have a lot to learn.

    The only thing I could sugggest would be to contact somebody who works specifically with autism and if funding is an issue, you could get it paid via social services in the form of a direct payment or through a health budget which you don’t contribute to. 

    There’s an organisation in the uk who charge only a nominal fee and I’m sure there are others but that’s the one I found when I was looking for support specifically for adults with autism.

    I see it as part of my job now to inform and educate others about autism. I tell everyone I meet, shop keepers the lot, I can’t not tell everyone I come into contact with but in terms of support, when we need support, we don’t want to be the experts, that doesn’t make sense. Yes of course we know ourselves better than anybody else but we wouldn’t be at the therapists room if we didn’t need some support and guidance.

    I think it comes down to the level of freedom you have in the relationship as to how much help the other person can be, regardless if they understand autism or not but the mental health teams don’t offer that level of freedom that’s needed to allow the support to be the right support.

    My support worker is from the local authority social services wellbeing team and I’m so grateful to her. I wouldn’t be where I am today without her support and the support from my work coach at the job centre.

    When I get back to work, I’ll be specialising in working with people with autism, there’s a real need for it.

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