Relationship Advice

NAS24859 said:

I certainly prefer a cheery and optimistic therapist to once who focuses on negative.

Haha, thank you for this. I must admit it did make me smile. I agree that it is really important to cherish the positive aspects and people in our lives, its very true. However, in therapy, I think it might be equally valuable if your therapist does focus on the  problems and 'negative aspects' of your life that have likely brought you to therapy in the first place. 

NAS24859 said:

It does appear as though your 'bashing' BlueRay by suggesting they are a fraud and can't be a therapist because of their viewpoint. 

Its not BlueRays 'viewpoint' I am questioning as she/he seems (to me) to be a very interesting person whose posts I genuinely enjoy (and appreciate) immensely, a genuine sentiment I have often shared with her on here and highly likely will again. I also respect how supportive she/he has been to others on here too. 

(* with regards to the Faith/Spiritual Healer comment, this was not actually intended negatively in ANY way at all, I am genuinely interested in hearing more about this as I find it utterly and absolutely fascinating, and this (comment) came from a previous comment BR made when she/he said they didn't even have to meet in person or even know the name or presenting problem of a client but could work with them therapeutically on a 'metaphysical' level as she IS a qualified and accredited Metaphysician. And I was not aware that the NHS employ those...are you? ) 

In my 'viewpoint' my queries were more coming from a place of...if you were a mechanic (and really interested in cars) and you heard another person talking about car engines that run on candy floss, wouldn't you be tempted to challenge and ask questions about that? Wouldn't you want to know more about those engines? Can you imagine a mechanic alive who would not query that from a place of curiosity or utter surprise if nothing else? 

And, in my mind, this is what I have attempted to do here, by stating my premise and expecting that premise to be challenged until I change my viewpoint. Have you never told a person in your life that you believe (from your own personal knowledge or experience base) that the information they are offering is incorrect or inaccurate? Not their opinion. But the information they are offering about a topic being discussed? 

As one of those 'pesky negative people' who notice things though... I am extremely interested, however, in how it seems possible (to me) that everyone who does challenge or disagree with anything BlueRay says (who him/her self is not backward in challenging or disagreeing with others on here, which I respect) are being systemically shamed and pushed off here though.

An interesting social experiment/phenomenon in progress, no?  And all the time you keep wading in to tell me how wrong I am to challenge the (what I am finding to be confusing and conflicting) information that I keep reading, my actual questions (about therapy) remain unanswered. Which is totally fine, no one has to answer them if they don't want to.    

However, thank you kindly, but I have no intention of being shamed or pushed off here for sharing my own 'viewpoint' as it were.      

AngelDust said:

It is real shame that you seemingly felt the need to dismiss my genuine experiences and concerns about the state of our NHS by reducing ('reductio ad absurdum') my observations and opinions to the ramblings of a ‘negative person’ guilty of ‘NHS bashing.’

I didn't perceive BlueRay comments in the same way as you Angel Dust. I work in the public sector (education) and have the same experiences of Blue Ray. Many of the people I work with focus on the negatives and due to this become unable see the positives. This attitude doesn't help and instead leads to low morale and poor performance.I had this attitude initially, as that was the way I was brought up and it caused me a lot of upset and distress. When I started focusing on the positives and doing what I could to change the negatives it made my working life a lot better. Rarely are things all good or all bad. I certainly prefer a cheery and optimistic therapist to once who focuses on negative.

It does appear as though your 'bashing' BlueRay by suggesting they are a fraud and can't be a therapist because of their viewpoint. 

Hi BlueRay,

It is real shame that you seemingly felt the need to dismiss my genuine experiences and concerns about the state of our NHS by reducing ('reductio ad absurdum') my observations and opinions to the ramblings of a ‘negative person’ guilty of ‘NHS bashing.’

I think instead it is really important that people who work in the NHS face this reality in order to better fight this situation in an attempt to enable better services for our patients. And although it is very true that whining about something does not make it go away, it is equally true that being silenced about it, as I feel you have attempted to silence me, (or being in denial about it) does not make it go away either. 

What I will offer is that, I have openly questioned you (with kindness intended and an open heart) about your work as I had believed we may have much in common and could discuss so much. However, instead, whenever you offer information about your alleged ‘therapeutic’ work or role, I tend to only gain more confusion from this than less. This naturally leads to my asking more questions as I am interested in this field. But it appears that my questions tend to make you defensive, lash out and start swearing instead.

I cannot help trying to make sense of the things people say, until they make sense to me. I am also guilty of being 'hypersensitive' to incongruence, and I can tend to get stuck on a subject until it makes sense. I know my thought processes are ‘flawed’ in this way and therefore open to making mistakes. This is why I question.  

I will therefore reiterate however, that, very little you have ever kindly offered has enabled me to believe that you are a qualified 'therapist.' What I currently do believe/understand, however, is that you work or have worked in a 'supportive role' (of some kind) within Mental Health Services and that your personal 'therapeutic approach' (which you described in another post) is more consistent with that of a Faith Healer, if you believe in a Supreme Being or a Spiritual Healer if you believe in a Divine Energy? 

I could just as easily focus on all the ways in which the mental health services are failing people, but what benefit would that be to me or anybody else?

I worked with people who were so ground down with all the failures that they were losing, and in some cases, they had lost their passion for doing the job. And still, the services are failing, so I don’t see any benefits to focussing on failures.

The NHS and social services are riddled with people who’s language, behaviour and actions centre around the failures. They talk about it and yet, the failures are still there and to top it off, they no longer like their jobs or who they work for. 

I’m not saying I don’t encounter failures but that my focus is on what does work, what’s working, how can we make the best of what we have. 

The mental health services were unable to help me but I didn’t see that as a failure. I just saw it as it was. They were unable to help me. My help came after I got the autism diagnosis and my work coach at the job centre thought outside the box and arranged for me to have support from a local social services team. 

Most professionals I meet who work in the NHS are painfully aware of just how much the NHS and mental health services are failing people, nationally and they are no fun to be around. They don’t enjoy their jobs, they don’t like their employers, they seem to focus more on what the services don’t do rather than what they do do and they’re miserable to be around. I just choose to focus on all the incredible good they are doing. Like I said, they gave me my diagnosis and that was the best thing anyone could do for me.

People have the unreal expectation now that the nhs and the mental health services, can magically wave a wand and suddenly make their lives better and when they don’t, they complain and say the service has failed them. Yet they are also often the first people to turn to the very services they condemn when they need help. For example, if they get cancer, they will turn to the nhs which doesn’t make sense to me. They spent most of their time talking about the services in a negative way yet they’re the first people they run to at the first sign of a difficulty. 

Nurses and doctors and IAPT therapists etc are trained in a very specific way and most of their training is put together by the pharmaceutical industry. They study ill health, they don’t know much about optimal health so now we’re turning towards health as opposed to maintaining/managing illness, it’s going to take a long time before they find their place within society. Like most of us, their role in society is changing and they’re still a bit unsure of where they’re going. People go to the doctors with all sorts of things that a doctor hasn’t got a clue about but they have to some how do something otherwise the patient will say they failed them. It’s a tough world. I just think the people who are prepared to work for s**t wages in the nhs, the ones who genuinely love their jobs and focus on that rather than the failures, don’t deserve all the negativity that comes their way. 

I found them to be excellent and know a lot of other people who have benefited also.

Sadly, I don't often see many of those people on here.

Even now (almost daily) there is currently three or four posts going on where people are struggling to access the professional help and therapeutic support they actually need from our mental health services. 

I am, however, really pleased when I do hear that someone has benefitted. And I agree, I too really prize and value our NHS. 

However, the language and the conceptualisations you offer are not consistent or congruent with a knowledge base nor lived experience I would expect a professional working in mental health services to possess.

Most professionals I encounter working in Mental Health are only too painfully aware of just how much the NHS and the Mental Health Service is failing is patients, nationally. 

I therefore simplistically reiterate; I think you are very lucky that you have not encountered the same in your local area. 

I tend to work with what we have and make the most of it but in every area I’ve worked in, they’ve had an excellent IAPT service. 

The mental health service is undergoing huge changes as they attempt to move to a recovery model but far from limiting the services, they’re actually expanding them. In terms of they are now bringing in more mindfullness techniques.

Many of the therapies are based on the cognitive behavioural therapy model as they have found those to have the most effect. But I don’t get involved so much with what other people are doing. I do my work to the best of my ability and I stay away from hot topics. I do though have conversations with the psychiatrists, psychologists and other therapists and they are all looking more towards a recovery model, which is a huge shift in how they work. This is something new for the NHS and is going to take a huge cultural shift but they’re doing their best. 

I think the highly qualified therapists who don’t follow the cognitive behavioural model would be best suited working outside of the NHS so they can have the freedom to work in the way they work best. I’ve found there’s so much more freedom when working independently although one of my longer term goals is to somehow bring my work back to the people who access NHS support as I found they also benefit greatly from my work and I enjoy the more hands on approach I have with those clients. 

For me, I don’t get involved with the debates. I see how the NHS services are evolving to a more recovery/therapy based model, despite the onslaught they’re under from the pharmaceutical companies so I think they’re doing a great job. We’ve come along way since the days of dipping people in cold water while strapped to a chair, to try to relieve their mental torments so for me, it’s all good and this shift, to a recovery model, is going to take a long time, a lot of effort and a lot of changes and a lot of money. 

The NHS have to work to evidence based practices so they have to make the best of what they’ve got. There are however, many more so called ‘alternative’ avenues to good health these days so people have now got more opportunities available to take their health in their own hands and seek out support that they think will work best for them. 

I think we’re living in pretty incredible times, in terms of diversity. People no longer have to rely on the nhs/pharmaceutical companies to help them manage their symptoms, they can now seek out services that aim to work at the level of the cause to achieve optimal health and vitality. It’s currently not so easy to get long term studies done in the so called ‘alternative’ fields as most if not all, large scale studies are funded by the food and pharmaceutical industry but there’s enough evidence around to give people the confidence to listen to their own bodies/listen to themselves and seek to find the cause to their difficulties and then the solution, in diet/lifestyle choices as opposed to drugs and long term therapy. 

I’m hugely grateful to the NHS. They gave me my diagnosis of autism and for that, I will always be grateful to them because it changed my life and made me realise I do belong on this planet, that I am a human being afterall. So I can’t knock the nhs at all. They’re also currently looking after my dad who is undergoing treatment for cancer, very well. Their methods are in almost total opposition to my approach to health but this is what my dad wants and I’m grateful the service is there for him. The nhs might not get everything right, all the time, but neither do I, so I can’t judge them and I wouldn’t, especially not after getting my diagnosis and from behind the scenes, most of the people who work in the nhs are very hard working, good honest down to earth people who don’t earn a great wage but they do an incredible job. On my first day working in a nhs mental health team I basically insulted the lot of them but by the time I left that contract, I had seen what an amazing job these people do, day in day out. I couldn’t do it, even if I wanted to, my autism wouldn’t allow it, so I take my hat off to them and I saw their value by the time I left. So I won’t knock anybody who works in the nhs or the organisation. It’s doing its best and I think that’s all any of us can do and for those who don’t like or want to deal with the nhs as the primary source of health care support (like me) there are plenty of other options.

The nhs might be free but it’s not compulsory, we don’t have to use their services. 

Yeah, this has been my experience NAS24859 of IAPT. I found them to be excellent and know a lot of other people who have benefited also. Glad to hear it worked for you too

No, I still believe IAPT are this restricted. They are built on a 'business model' premise of offering quick fix, short term therapy being central to their whole approach to mental health. 

I just believe that any other therapy is hanging on for grim death in small pockets throughout the NHS which, I AM glad to hear, some IAPT services are still choosing to refer a select few of their clients to. 

AngelDust said:

And I don't think IAPT really do offer anything but CBT and I believe this is national, not local.

I'm glad that you're beginning to see that the service isn't as restricted as you first suspected.

Thats fantastic.

Bearing in mind that 4 of the 6 therapies you mentioned are CBT based. 

I'm very satisfied with the service I’ve received from my IAPT service and would go as far to say they are excellent too. I was first seen within two weeks of my referral. You don't need to have a diagnosed MH condition either. I accessed their counseling services as I was experiencing a lack of libido.

Some of the therapies my local NHS service offer are:

• Behavioral Couples Therapy
• Cognitive Behavioural Therapy (CBT)
• Dynamic Interpersonal Therapy (DIT)
• Psychosexual Therapy
• Eye Movement Desensitisation and Reprocessing (EMDR)
• Group Therapy

If the OP's NHS trust offer free couples counseling this could be a good starting point to explore how you could communicate more effectively. My local NHS provide this service through Relate.

Hi BlueRay,

I think it possible that you may be the only individual I have ever encountered yet who was satisfied with the treatment they received via IAPT. And you are definitely the only person I have ever heard describe IAPT as excellent. 

And I don't think IAPT really do offer anything but CBT and I believe this is national, not local. Their national website supports my premise, with their statement as follows...

'IAPT services are categorised by offering Evidenced based psychological therapies: with the therapy delivered by fully trained and accredited practitioners, matched to the mental health problem and its intensity and duration designed to optimize outcomes.'

'Evidenced based Psychological Therapies' means CBT, which I think everyone working in mental health knows only too well, particularly therapists.

And 'matched to the mental health problem' means suitable for the mental 'illness,' (such as anxiety and depression) which the person has been 'diagnosed' as having. 

As you work in Mental Health, I am sincerely surprised that you seem unaware of this huge 'cultural' change in mental health services (via IAPT, particularly though the influence of N.I.C.E) that has come about these last ten years or so. A phenomenal change which has seen highly qualified therapists and counsellors of all other therapeutic approaches (i.e not CBT) being systemically driven out of the NHS in droves in favour of 'quick fix' CBT. 

The UKCP even published a 2015 report (available to view online via 'googling') into the 'deterioration of public psychotherapy provision in the NHS,' further highlighting this common cause. 

This knowledge and debate is an ongoing and a very passionate 'hot topic' amongst therapists and people who work in mental health services and has been for several years now, even founding (national) action groups against the CBT/IAPT monopoly of therapeutic NHS services up and down the country. 

You are therefore very lucky and potentially unique if your local area has remained exempt from this well known and widespread travesty. 

Hi NAS36906, yes, I can see you love your boyfriend very much and that you only want the best for him. 

Thank you for the further clarification regarding the diagnosis. That makes things a lot clearer and he’s certainly not alone in his thinking. You could try to reassure him and let him know that the diagnosis would be for him, to help him better understand himself and that he wouldn’t have to disclose it to anybody else if he didn’t want to. It might take him a while to actually process that information, as you know, we don’t process all information at the same rate, so he might just need a bit more time. Get him to watch the Chris Packham program with you ~ make out it has just come in randomly ;)

Asking for help and admitting perceived weakness’s is often seen by some people as a sign of weakness, however, you are a living example to him that that is not that case. You would not have come on here asking for help if you didn’t possess a certain amount of inner strength. He could learn a lot from you. And yes, if he’s struggling right now, I would also be thinking like you, that an assessment would certainly be a good place to start for him to get some understanding and clarity around his current situation. I agree with you wholeheartedly. In fact, I have a friend in a similar situation and I would love to suggest to her that she might want to think about getting assessed. I think you’re in a better position than I am seeing as how he is your boyfriend. So yeah, I empathise with you on that one. 

Ok, I understand better now regarding part B. That’s an excellent question and I admire you for asking. You are already a long way there just by even asking this question, i.e. how can I better communicate. The best advice I could give, in such a short space of time, would be to listen to a guy called Marshall Rosenberg. He has revolutionised the way people communicate with his simple (although not easy to practice ~ it takes practice) method he calls non violent communication. I’ll put a link here to one of his workshops. He also has a book and both the book and the workshops are saying the same thing so it would depend on how you learn best as to whether you read the book or watch him in action. He died a few years ago but his work continues to gather strength across the world. 

I love how you’re putting so much effort into your relationship ~ it’s something I used to dream about getting in a partner (I never got it). Learning this style of communication is an ongoing process ~ I’m still learning and haven’t had much practice of it over the last 12 months or so due to my burnout, but I’ll be getting back to it because it’s the best way of communicating that I’ve ever found. 

As I said before, your boyfriend is very lucky to have you and I deeply admire your approach and I am sure you will get the non violent communication because you are already asking the right questions, which this answers. 

https://youtu.be/4LuPCAh9FCc

If you’ve got any other questions, please ask. 

Hi NAS36906,

There quite a bit of information on our website which might help.  Of course you may already have found it, but in case you haven't the following links might be of use:

This page has information for partners of autistic adults: http://www.autism.org.uk/about/family-life/partners.aspx

And this page has lots of information about diagnosis including some of the benefits: http://www.autism.org.uk/about/diagnosis/adults.aspx

There are also quite a few links on these pages which will take you to other sections of the website which might also be useful.

I hope that helps.

Regards,

Kerri-Mod

Hi AngelDust

I didn’t realise the IAPT (Improving Access to Psychological Therapies) Services were so sketchy across the country.

They provide an excellent service where I currently live and also in other areas of the country where I’ve worked and lived. The IAPT services that I’m familiar with are self referring services or people can be referred by their gp or any other support worker. They provide a counselling service as well as CBT (cognitive behaviour therapy) and other therapies. The IAPT service was established by the government in 2005, so it maybe that it hasn’t reached all areas yet or maybe some areas don’t offer a full range of services. However, the OP (original poster) could contact her local gp surgery and they’ll be able to sign post her to local services. There will be some kind of counselling support service available as local authorities have a big drive now to offer preventative services so it would be unusual for her to not be offered some kind of support.

It doesn’t sound like the OP uses local services routinely and certainly if she doesn’t address her need for support regarding getting her emotional/psychological needs met, it will lead to depression and anxiety. I have used this service myself towards the end of my last relationship when I was in a similar situation to the OP so I have no reason to believe she won’t be offered similar support. I have certainly never come across an IAPT service that required users to have a diagnosis of a mental health condition. They are more about the prevention of mental health conditions.

That’s interesting to note, however, that IAPT service are not the same across the country. I never considered that, thank you. They have always provided an excellent service wherever I’ve lived in the U.K, however, I’ll bare that in mind from now on. Thank you. 

Thanks for all the feedback,

I thought I would clarify a few things

I love him exactly the way he is, he is one of the best people I know and I really just want what is best for him.

I thought a few people misunderstood the second part, and I understand the concerns about diagnosis, so I thought I would clarify.

A) I know from personal experience diagnosis is a decision that is up to the individual.

I know that if he doesn't think it will have benefits he won't go, but his reasons seem to be based on stigma rather than genuinely thinking he doesn't need support.
He seems to think that if he gets a diagnosis it's a sign of weakness, and if people ever found out it would impact his career.

I haven't pushed him on it, but the only reason I was thinking about asking him to do it is because he is struggling right now and I think it would help. But I accept it is his decision as the end of the day.

B) I'm sorry that I wasn't clear, but those communication tips are for me, not for him. Sometimes, he can't understand the way I'm feeling, and I have difficulty expressing it.

If he understands he is wonderful. He is really good when he realises something is wrong, but I am not always the best at explaining what is wrong. The problem is with me, not with him. 

When he is thoughtless, it is normally because I haven't communicated how I am feeling properly.  

Basically I am asking for advice about how to best communicate when I am upset about something, but without making him feel like he completely responsible for me or that I am blaming him for how he has reacted in the past.

The NHS provide free counselling services which are often very good.

Come now BlueRay, working in the NHS as you do...you must know this advice (above) is misleading. The NHS do not offer free counselling,  the best they offer is group or short term CBT via IAPT, and this is only through referral by a GP for an existing and 'diagnosed' mental illness, such as anxiety or depression for example. And IAPT services are certainly not (sadly) available for people to use to routinely discuss or seek advice regarding their relationship difficulties. 

Getting a diagnosis of autism is a very personal thing which can be life changing as well as pretty traumatic. It can be an extremely positive thing but it is also often accompanied by a lot of loss and grief, so it has to be a personal choice.

It is not a good thing to try to persuade somebody to get a diagnosis. Nobody, other than the actual person, can say whether they think it will be a good thing for them or not. If he was asking for reasons why other people decided to go for a diagnosis and what their experiences were etc, that's a different matter but it doesn't sound (from what you have written) that he is asking that.

As for communication tips. It sounds like you want some tips on how to control his behaviour to make him behave in ways that meet your needs. Maybe a taser gun? Every time he doesn't behave how you want him to you can give him an electric shock and eventually he may behave how you want him to without the gun.

If you're upset about something, then it would be more helpful for you to deal with that. Face it, do some inner work around it or whatever you need to do but don't expect someone else to make it go away by giving that responsibility to them. Even if your boyfriend did do these things that you want him to do, so that you could feel better, it would only be temporary and what if he's not around the next time you get upset, how will you stop being upset then?

You can't control everybody into doing what you want and I'm sure your boyfriend can't be with you all the time.

The NHS provide free counselling services which are often very good. It might be worth your while contacting them and they'll be able to give you some support around how to manage your emotions etc. When you take your focus off your boyfriend, and put it back with yourself, you can find ways to learn to deal with these situations more effectively and I'm sure your relationship and communication with your boyfriend will improve dramatically. And if he sees you taking responsibility for yourself and taking such good care of yourself, he might be so impressed that he decides to start looking into the possibility of getting a diagnosis. And when he does, you can direct him here where he'll get lots of support and he will be luckier than most of us, because he'll have your loving support as well which is priceless. Many of us dream we had a loving partner to support us with our 'autism'. He's a lucky guy as I'm sure you are too to have him in your life. It's not always easy being an aspie or being in a relationship with one but he's fortunate that he has such an understanding and accepting partner in his life. Best of luck.

Although you found getting a diagnosis helpful, it doesn't mean your boyfriend will or that he should want to. Can you accept your boyfriend as he is or would you only able to be happy if he changes? You say he can be mean and thoughtless and that this causes problems. If his behavior hurts you and he doesn't want to change would you be better off ending this relationship and trying to find someone who can meet your emotional needs?

If he isn't interested in getting a diagnosis, why are you working to convince him? It sounds like, at the moment, he doesn't want to be persuaded. He may not feel it's necessary, or that it will bring him benefits, or might believe that the benefits will be outweighed by the negatives. It's a very personal choice, and it sounds like you have already given your opinion.

And again, you want to give him communication tips but it doesn't sound like you're looking for any for yourself? It isn't fair for you just to try to teach him to do things your way. Compromise is essential. He might 'need you' to do certain things for him, too.

I'm not saying that this doesn't need work from him, but it seems very much about your wants in this post. Have you discussed this with him, in detail, without just focusing on your side?