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'?
Obviously, Evan deserves the best possible support available but, as we know, resources are limited due to NHS underfunding and although I have no personal experience of private therapy for Evan's issues, any private provider will not be cheap since it is a specialised service and if carried on for an extended period will cost a considerable amount of money. By 'dodgy' I simply meant Evan's therapist did not seem to be relating to him as he would have liked and I can only judge things from what Evan has reported. CBT is not guaranteed to work but that does not mean it is inherently inadequate; it requires the right kind of approach by both therapist and patient and like any tool will only be as effective as the participant's efforts put into it. An individual may not be ready to gain the most from such an approach, in which case deferment of CBT might be better and alternative solutions explored. If a person really wants to participate in whatever treatment is selected so much the better but ultimately it is up to an individual to take a degree of responsibility for their own progress - there is no magic formula I'm afraid.
But you are right when you say some form of therapy is better than nothing because even if there seems to be little progress at the time, by sticking to it and becoming used to the concepts involved in CBT one will inevitably modify one's thought patterns to some degree, although, naturally, this can take time. Also, by not giving an approach a reasonable trial, it can lead to skepticism about other approaches, leading to a general cynicism regarding any treatment, which would be highly unhelpful. As to hard work - well, isn't anything worthwhile thing in life worth some effort? Nothing is going to fall into our laps by us being passive. We really do have to make things happen with the help of the right kind of support. There are no free lunches, I'm afraid.
Evan, it may not be the case that your therapist doesn't know the difference between a panic attack an a sensory overload ( I would be shocked if he did not, in fact, know if he is a qualified person) but that he simply wants you to be aware of what is going on within your body when you experience an overload thereby giving you a bit of insight into how your body responds and, hopefully, giving you a little bit of cognitive control over your responses. Presumably, this is all part of the CBT treatment which is aimed at exercising your conscious mind which can alleviate your automatic responses. I think the thing to remember is that it is an ongoing process and isn't easy at first but you need to persevere as things should get a bit easier over time. Like any new skill it requires practice and more practice for real progress to be made. Evan, nobody was born to win Wimbledon or receive a Nobel Prize; such things have to be strived for through hard work and determination. Basically you have to work with what you were born with and never forget, the human brain is very pliable and can learn almost unlimited skills when necessary. If that was not the case, human beings would not be here today.
That’s very well said lostmyway
I had this revalation (to a deeper degree) a little while ago. I guess I knew it at an intellectual level, but since learning about my autism, and finding different ways to see things/approach things, it made me realise (and I told this to my psychiatrist) that I can learn new things, I just wasn’t aware of many of the other things/ways before due to focussed thinking etc. Which are all great things, if I focus them towards what I want to achieve.
I was always offered the opportunity to train in CBT, to use with my clients (when working in the NHS), but I always declined the offers. I was working effectively with clients anyway, so it wasn’t a necessary.
But I have never heard it explained the way that you just explained it. It has changed my views on it completely. I was never against it and I have seen it work with many people and indeed it has been used with me at times in my own therapy sessions.
But I never understood it in the way you just explained it and suddenly, I can see it’s significance and value and why it works.
It’s essentially, the same work as I do but at a more psychological level, whereas metaphysics goes deeper, but they’re both doing the same thing. I knew all this on one level of consciousness but you have helped me to see it in another way now whereby I can really see it for what it is. Thank you.
Thank you, BlueRay. I'm glad you found my comments of value.
Yeah, really valuable, thank you. In fact I’m going to write it down and read it often because it sometimes takes information like that a little while to kind of settle in my brain. If that makes sense. Words are a bit like floating bubbles to me and when I do manage to anchor some of them together in a way I can understand, I still have to keep going over it or it’s like the words seperate out again and go off for another float around the world! Lol! This description I just know is going to be very helpful for a lot of people so I don’t want to forget it.
I had a similar experience with my CBT.
Prior to being diagnosed with ASD, after one session of CBT, the person I saw told me that I was not suitable for CBT and discharged me.
A few months ago, after being diagnosed, I was referred again to CBT. This time I had a different experience.
Although it didn't necessarily improve the issues I had etc, I found that being able to spend an hour talking to someone who knew very little about me and was paid to listen and give advice, actually made me feel better about myself. Admittedly, she also said that she had no real knowledge and experience in dealing with patients who had ASD, but she did refer me to the Richmond Fellowship in the hope that they may be able to help me in ways that she was unable to.
Unfortunately, I am still waiting for The Richmond Fellowship to get back to me (they sent me an acknowledgement letter a few months ago, but have yet to actually offer me an appointment to see someone), but hopefully this will be another step in the right direction.
Thanks. I get that, which is why I'm forcing myself to persevere.
However, words like "panic attack" and "panic disorder" are thrown around an awful lot in the sessions. And again, when I (inarticulately?) tried to explain 'overload' to him, he just smiled at me and said "so in essence, it's a panic attack!"
That still doesn't feel right to me.
Plus, he's got me doing 'homework' specifically on modules about 'panic attacks'. Reading them is interesting, but some of it just doesn't sit with my experience - like I never feel an impending sense of doom or death etc.
I dunno. I'm gonna stick with it, but I'm frightened I'm a Neurodivergent Cat who's being trained to fit a Neurotypical model by a Dog, who just can't understand why I don't bark.
In these situations, I always change the word if that feels better, so for example, whenever I read or hear panick attack, I change that in my mind to say sensory overload or whatever I was applying the work to. Then with the rest, you take what applies to you and leave the rest. The information is general, not all parts are going to sit with everyone so you just leave those parts. This is to help you so take what helps and leave the rest.
You’re not being trained in anything. This is simply a method, that when understood and adapted for your own personal needs, can be helpful. It’s a new way of thinking and approaching situations so it’s not going to feel natural at first, because it’s something different, but even so, not all of it is going to apply to you and it’s not supposed to. Your mans job, the guy you’re working with, is simply to help you understand this model, help you to see where and how it can relate to to, help you to adapt it to your needs and help you give it a try. Nobody knows whether it will work or it won’t. It doesn’t matter either way. If it does, great. If it doesn’t, great. You now know what doesn’t work and you may also have some tips on what may work, so you can try a different approach.
It’s trial and error and if you give it a go, like you are, you might find it has no beneficial effect for you or you might find that you love it and it helps you tremendously. The purpose is to enjoy it, get to know it, get comfortable with it, adapt it to meet you’re own needs, leave the things that don’t apply, etc etc.
Sounds like you’re doing well so far anyway with giving it a chance and keep a healthy dose of scepticism at all times
Yeah, I mean I simply can't imagine that Evan's therapist doesn't know about stuff like the difference between a panic attack and a sensory overload so, like you, I'm inclined to think that the therapist is using the idea of a panic attack to somehow get Evan to respond in a way that would be more helpful to him when he does experience a sensory overload. The thing is we need to remember that the human mind can be trained to interpret something in one way or another that is often not really objective yet beneficial in terms of motivating an individual. In other words, given exactly the same situation, two people might not necessarily make the same interpretation of it, where one person might take a very negative approach while another might be up-beat and optimistic, yet objectively, it is exactly the same set of conditions that each person is experiencing. This is probably what CBT aims at accomplishing by attempting to modify an individual's interpretation of a set of conditions so as to promote a more positive outlook. Easy to say, I know, which is why it takes time and a lot of effort. He's trying to kind of 'trick' Evan into looking at things in a better way, although maybe the word 'trick' is not the right one here. Point is, if it works, it's worth exploring. It's a bit like trying to change the course of an oil tanker. There's a lot of resistance because the tanker has 'settled' into a particular course, so it's gonna take time and effort to change that, however, through persistence it can be achieved.
Yeah, again well said. I couldn’t agree more. I’ve been in therapy more or less consistently since I was 16 but eventually over the years, with all the hard work and I effort I put into it, I ‘got there’, but it wasn’t without it’s trials and failures and down right disasters, lol, but I kept plugging away. If you don’t give in until (until you get there) you will always get there.