Countdown to diagnosis

Hi everyone, 

I've been undergoing autism assessment by a team of Clinical Psychologists for the last few weeks.  I hear the outcome later today.

I am a woman in my late 50s and the component parts of my ASD assessment are as follows:

  • Initial assessment with psychologist (1.5 hrs)
  • Full developmental history meeting with psychologist (1.5 hrs)
  • AQ / EQ questionnaires (completed at home and handed back to psychologist) 
  • Developmental history (written autobiographical information supplied by me)
  • Developmental history questionnaires (completed by parents/siblings & emailed to psychologist)  
  • Narrative account of issues and challenges (emailed by husband)
  • ADOS-2  with two different psychologists (1 hr) followed by analysis of results (1 hr)
  • Multi-disciplinary Formulation Meeting (professionals only) 
  • Feedback meeting - psychologist + me (1 hr) 
  • Post assessment follow-up sessions - optional (3 x 1 hr)

I first emailed the service provider requesting information on 10 August. 

The Formulation Meeting will be held sometime next week (mid November). This is where everyone in the team gets together to consider all the evidence and reach conclusions about likely causes of difficulties, and potentially helpful recommendations. 

I will get feedback from a psychologist at a meeting next Friday 16 November. 

Although I am paying for this assessment privately, the provider re-invests any profit into providing services for autistic people.

I looked up 'formulation' and it seems this is a psycho-social group decision-making process, combining narrative accounts with evidence derived from the application of ASD diagnostic criteria. This approach aims to reduce the risk of individual bias by promoting creative thinking and collaborative problem solving.  

Needless to say I am looking forward to finding out what diagnostic decision has been reached. It will be fascinating to see if the professionals agree with the conclusions I reached by reading, reflecting, and talking to people in this community!

There are varied formats for assessment so it would be interesting to know what other people's experiences have been. 

  • I don't know about autistic people being optimistic, people in general are a mixed bag, but one things for sure, if we apply ourselves to something, autistic people have a whole lot of focus. I think that our brains can eat us alive at times with that focus, if it's channelling itself negatively. Channelled correctly it's a very powerful tool to have at our disposal. Sometimes it feels like I've got more than one brain, with all of the thoughts running around, but it's not ideal because I've only got one skull! When there's something that makes all of that energy go into one place it's such a relief. If I focus it into despair, which I can, it can become an odd source of comfort. That's not ideal. Placing that focus into something positive, or even inane, can be a great thing.

    I know personally for me, if there's a problem, it's best to address it. Negativity affects the person who's having it piled on them, the people around them, and even the arsehole in the scenario! It brings out the worst in everyone emotionally. When the situation is over, regardless of the way it ends, explosively, with civility, or just a fade, everyone feels better. It can even do the arsehole good. 

    As you say you've got through dark times. Now is a time where there has been a lot of light shone in, use it, and don't lose yourself. There are a lot of ways to lose who you were before the diagnosis, but I don't think that will be the case.

    I feel much more confident now I know I really am different to most other people.

    Speaking personally, I don't mind if I'm different to people or not. I just got to know that all of the things that I thought were going to crush me weren't. My sensory problems are pretty intense, and I thought all of my life that I was going mad. That was the thing that I needed from all of this.

    Stay positive!

  • Thank you so much for this. I read somewhere that autistic people often have an incredible abiiity to deal with adversity and remain optimistic. I have certainly got through some very dark times in my life. I feel much more confident now I know I really am different to most other people.

    I have started applying for other jobs and looking into self-employment. This will give me an escape route if I need one. As well as being an intrinsic part of who I am being autistic is actually an additional qualification!  

    In my experience, if you just keep going, in spite of not being able to see a path ahead, a way forward will open up. 

  • No problem whatsoever, Sunflower. I think that you are taking the right actions yourself. Being proactive always helps quell the fears that can take over when we don't make that leap. I think that it will be far more beneficial whatever the outcome. ASD can be a fertile ground if there are seeds of doubt planted.

    Well I think you have had some great luck there! Having someone in your corner who "gets" it all, is an amazing stroke of luck. You taking the bull by the horns has led you to a pretty good place by the sound of things!

    I think reading through Lonewarrior's, Jonesy's, and your last few comments, that there is light at the end of the tunnel. Things tend to iron themselves out in ways. There are good people out there too.

    Best of luck with it all, and I think you will be OK.

  • Imagine working only with men!

    Trust me LW, women are no better. I worked with a whole floor of women at one place. The behaviour was vicious. The bullying was far more duplicitous, cold, and calculated. I'm not saying that men can't be as equally bad, but if it was out and out social bullying, and mindgames, they'd honed it to a fine art.

    The section I worked on was ran by three older ladies who were very, very, bitter towards younger ladies, some were basically girls. 17 and 18 year olds. They were so cruel towards them, I think because they were younger. Some real insecure shallow ***. They'd also work out who had more to lose by being in trouble, or not getting their contracts renewed. If they heard in a passing conversation that someone was in debt or struggling, they would turn the screws. It wasn't the chest beating, ritual mating dances, that men do. It was meticulous. There was one woman manager there that was admittedly a "sex tourist", divorced, and absolutely vile. There was a guy who was from Jamaica who was trying to get citizenship, he was a really nice guy, quiet, good looking though, she propositioned him for sex, and told him she'd get him fired if he refused, as he was still in his probation period. He refused. He made a complaint, and it wasn't even looked into, because she was pally with HR. Sure as ***, he was fired. She knew it could have jeopardised his application. There was a culture of caste ranking in the Indian girls. That was vicious. They picked on all of the Dalit girls. It all ended when a guy who was a higher caste, pulled rank on them, he hated the caste system, but the two main culprits never did it from that day. I don't know what he said, or how much status he had but they wouldn't even look at him from that day. We were going to report them all, but he said not to, because they'd turn it into a race thing. He'd sort it out. I could go on and on. It was a nest of vipers. 5 men and I'd say 40 plus women. I got out of there as quickly as I could.

    At break times they are either discussing sport which invariably means disagreement as to who is best, or the worst thing watching videos on mobile phones, They go looking for the most extreme video possibly  in some kind of attempt to prove how strong or extreme they are?

    I like a bit of sport but not as far as it to turn into a bone of contention. I know the kind you are talking about, the "tough guy by proxy". They had a guy who was in with some guy that all the other guys at work were in awe of, an ex-criminal, he'd always say to them "I know so and so", and "I was with". I fucking hate it when grown men are fanboys like that. I knew the guy too, he's actually a quiet guy now, and not the type to mix with the guy who was talking all of the rubbish he was. What does who you know have to do with anything, lol. We are grown men! That stuff grates on me. We got into a disagreement over some invoices in the warehouse, he started being threatening, and started talking about the guy. "I know so and so", I said "Is he here now? Here phone him", and gave him my phone with his number showing on the display. He went white, then walked off. He didn't mention him again. From that day on people thought I was some kind of tough guy. What a pathetic bunch. The guy was just someone I talk about history and comics with, been friends since school, he's as nerdy as they come by the "mating dance ritual" crowds standards. Far from a chest beater. I've worked with some real planks. I'd be here all night. I could go on and on.

    I told him to his face. It felt good, he was stunned and thought he was a mate.

    Lol, I can picture it. Loves the spectacle of violence, but just froze at the prospect of confrontation. It's like a form of LARP, or cosplay when you think about it.

    I am not a laugh like the others, but a few do and accept me for who I am, they have respect for me and I give respect back. 

    Who's to say that? Something that's funny to one person isn't to another. You might be a howl. I find that's the best way to be at work. Let people know as little as possible about me, and give respect to everyone until I see reason for someone not to get it.

    Yep I used to get that one too! "Brainache" "Keeno" etc. Some men never progress past this level and there were some girls who joined in as well.

    It's a thing I don't get. It's a skill, and a talent. I've seen people feign ignorance, as not to step out of the mold. You know that they know much more than they do. I went to junior school with a girl and she was really clever. She went to senior school and pretended to be the opposite, just to fit in. I'd get so frustrated with her. She got her degree this year at 40. She said "I had to do better, I wasn't happy". She saw me start laughing and laughed herself. I think that she knew what I was thinking. Good to see she beat that mindset though. Nice girl.

  • Really good advice, I am leaving it to my union rep to discuss Absence Management Interviews. She said that Occupational Health will advise on any ASD related adjustments needed for my return to work.

    I am incredibly lucky that my Union rep is very well informed about autism through previous employment. It is refreshing not to have to explain everything from scratch. It is helpful having the Union as a buffer between me and a stressful work situation. 

    Thank you for giving this such careful consideration, and for making such helpful suggestions. 

  • I may end up with no one wishing to work with me? I am not a laugh like the others, but a few do and accept me for who I am, they have respect for me and I give respect back. 

  • Sunflower replied. “The problem I often come up against at work is that getting along with people sometimes means ignoring or endorsing unpleasant behaviour. It's almost certainly an ASD thing to get so hung up about this. I'm well aware of my many failings but they don't include being deliberately nasty or cruel to others. I try and make excuses for people who act like this - maybe their unhappiness is the cause - but I'm not sure I can be around them too much, as it eats away at me. Ultimately I end up challenging their behaviour, usually with disastrous consequences.”

    Imagine working only with men!

    It feels like one long continuous lads night out! They seem to compete to get a reaction or a bit like them upping the stakes to make sure they are seen as better or equal in whatever the subject matter.

    At break times they are either discussing sport which invariably means disagreement as to who is best, or the worst thing watching videos on mobile phones, They go looking for the most extreme video possibly  in some kind of attempt to prove how strong or extreme they are?

    The level of depravity seems to be what gives them credibility amongst the others.

    Often they will say “here have a look at this!” To which I used to say ok but look away and pretend to be interested,, it poisoned my mind hearing the content let alone watch it.

    Since the realisation of who I truly am and why I no longer try to fit in.  I tell them straight. I do not wish to watch such nasty horrible things like that, I do not find it funny or nice seeing somebody subjected to such nastiness “.

    They look stunned! Then say “ jeez it’s only a bit of fun mate”.

    They have lost all sense of right and wrong. Constantly looking to find ever increasing extremes in order to get a buzz out of it.

    This includes practical jokes that seek to hurt or cause maximum distress.

    They include beatings by others say out on a Friday night! The worst by far are the videos showing sexual acts, totally sick. One once found a video showing an execution which hadn’t yet been banned. 

    I no longer even work with one individual and have said I will not have him working with me ever.

    when asked why I now tell them why. Because everything he does and says is to cause distress 

    , He hasn’t anything nice to say and do not want his negative mind near me.

    I told him to his face. It felt good, he was stunned and thought he was a mate. 

    I speak my mind now instead of just masking to fit. It caused me to much suffering.

    long reply, no apologies it’s who I am. 

    Me being me and accepting I do not have to just be what everyone expects.

  • Good advice not to lose myself in the midst of all this reflection. One thing I did just remember was being taught various tools and techniques to improve communication when I was a social worker. It always seemed slightly dishonest to ask a question in a way designed to elicit a certain response. Now I am beginning to think that if I do want to reduce miscommunication there are times when I may have to use conscious communication rather than being my natural, unfiltered self.

    It's hard mulling it all over. One thing you've got to ask yourself is was it stressful using those techniques? They might work better than the alternative. I didn't have an idea about masking, but I discovered that the way I masked was to be goofy. I was the class clown at times, at work I'd always be goofy, and I'm goofy around my friends. It helped, I still come across as weird, but it helped me relate to people. To be honest I'm not even sure if it's a mask (see how I'm second guessing myself, even after more than two years!), I find it easy to do. It's got me into as much trouble as out of it though! If I say what's in my head all of the time though I'm sardonic, direct, and a bit too observational. Like I say though, all this stuff about masking, and the like can be a bit of a double edged thing. I can't mask my tics, stims, or speaking to myself and singing, I don't care to either, that would be far too stressful. I think it's a hard place to start at an older age. The only thing I can say is do what is going to be least stressful in the long term.

    The problem I often come up against at work is that getting along with people sometimes means ignoring or endorsing unpleasant behaviour. It's almost certainly an ASD thing to get so hung up about this. I'm well aware of my many failings but they don't include being deliberately nasty or cruel to others. I try and make excuses for people who act like this - maybe their unhappiness is the cause - but I'm not sure I can be around them too much, as it eats away at me.

    I'd always I think that you can only control what you do. Trying to control the situation for other people can cause more problems than it solves sometimes. I wouldn't say it's an ASD thing to feel like that, there are lots of peoole that don't like bullies, or the atmosphere they cause. That environment is draining on everyone. Don't think that other people are OK with it, generally they aren't. If you step in everytime though, it can also stop the person being bullied from finding the strength to fight back. That's a journey that some people need to walk. They find something from it. I don't have to be all pally and cordial with an arsehole either. If I find someone like that I'm going to be ice cold around them. It's my right. I look back at some of the things over my life with bullies, and they can make me become the bully. I can go quite far, too far. It's a fine line. It eats at me too, but I've had to learn to let things take their natural course, only stepping in when it is absolutely necessary.

    Ultimately I end up challenging their behaviour, usually with disastrous consequences.

    I can totally empathise with where you are coming from. I can become the monster, or make a situation where no-one comes out better off. I used to be a team leader for a while, and I didn't tolerate bullying. There were only two rules, the work gets done, and no bullying. Everything else was OK, the team ran itself. People generally tend to be more productive, and happy with less rules, imo. There were two ladies who were on my team, and the one was a real nasty *** to the other lady. She used to directly put her apperance down, and her life outside work. One day she was showing her a picture of her daughter, and she said "She's not a looker, is she?", that was too much for me. Apparently it made the nice lady cry. I disciplined the bitchy one, and they kept their distance. I was working late with the lady that was being bullied, and she said that she didn't like the wedge that had been driven between them. I said that she treated her like a lapdog, and she wouldn't have it. She enjoyed being a subservient punchbag. I was dumbfounded.

    I quote Lao Tzu a lot here it seems, but the third paragraph sort of rings true in this excerpt of the Tao Te Ching, in the sense of those situations.

    http://thetaoteching.com/taoteching38.html

    If I have to use strategies and techniques to placate bullies it will simply become too exhausting. Sooner or later things will fall apart anyway, so I'd rather remove myself calmly now. I am checking my assessment of the situation with my union first, just to make sure the behaviour is unacceptable and I'm not being too sensitive or overreacting. 

    I think with the way you feel, this might be the best thing. I wouldn't mention bullying, or name names, but put the onus on them to accomodate you. When you have got your feet under the table in the acceptance of your condition, then you have a stronger position. You never know it could just be part of the fallout period. I'd do as much as I can in that sense, but don't jump to any conclusions of what you are or aren't capable of. I know I've said it ad nauseum, but this will be a very strange few months for you. I'd try and keep it sweet until you know where the land lies, with both yourself, and your work situation. If you make a definitive decision at any point, that you don't want to be there anymore, then look elsewhere.

    I'd just say be patient. Let everything do what it's going to around you, and work on yourself. Like I said earlier you can't control everything outside of your head, but you have to try and control what's going on in your head. That's the most important thing at the moment.

  • There is no "real world" and some other world, there's just the world.

    I don't think anyone was implying anything else. If you've ever been to therapy, you can hear some really idealistic, impractical stuff. I'm far from a nihilist, idealism is just as silly as nihilism in my opinion.

    To which I'd reel off a list of disastrous relationship/friendship/employment things that have happened, repeatedly for decades, never mind could have happened!

    Lolololololol, I've had that conversation too. My therapist at the time was lovely, but seemed a little bit idealistic and naive. I only think that she's could understand things from her point of view, her upbringing, way of life, people she interacted with, e.t.c.. I got asked that question a few times, and yeah, when you reeled it off, she could see why you were vigilant! She said "Oh..." a few times. I learned some practical things though, after a while we got past the realm of rhetorical mantra. She taught me some great stuff about prioritising, and how to let go of things. That rhetorical stuff though, lol, when you answer it with a practical example can fall flat.

  • Good advice not to lose myself in the midst of all this reflection. One thing I did just remember was being taught various tools and techniques to improve communication when I was a social worker. It always seemed slightly dishonest to ask a question in a way designed to elicit a certain response. Now I am beginning to think that if I do want to reduce miscommunication there are times when I may have to use conscious communication rather than being my natural, unfiltered self.

    The problem I often come up against at work is that getting along with people sometimes means ignoring or endorsing unpleasant behaviour. It's almost certainly an ASD thing to get so hung up about this. I'm well aware of my many failings but they don't include being deliberately nasty or cruel to others. I try and make excuses for people who act like this - maybe their unhappiness is the cause - but I'm not sure I can be around them too much, as it eats away at me. Ultimately I end up challenging their behaviour, usually with disastrous consequences.

    If I have to use strategies and techniques to placate bullies it will simply become too exhausting. Sooner or later things will fall apart anyway, so I'd rather remove myself calmly now. I am checking my assessment of the situation with my union first, just to make sure the behaviour is unacceptable and I'm not being too sensitive or overreacting. 

  • Just thinking about a quote I posted on another thread. When my house of cards tumbled down, things actually fell into place.

       

  • Former Member
    Former Member in reply to Trogluddite

    There is no "real world" and some other world, there's just the world.  Many people struggle with trying to understand and find their place in it, for some it comes more easily.  But we're no different in many respects from anybody else, except that maybe we have unusual requirements/expectations.  The question is, how can we get find our place in the world?

  • but life in the real world causes stress. Full stop. You can't fully avoid your stress levels going up.

    Oh yes. I used to have a bit of a joke about it with my last therapist (she was actually very good, and took my gallows humour in her stride.) When she'd do that typical CBT thing of asking; "if you did do [that social thing] that makes you anxious, what's the worst that could happen?"

    To which I'd reel off a list of disastrous relationship/friendship/employment things that have happened, repeatedly for decades, never mind could have happened!

  • You can't really 'treat the symptoms with meds'. The autism related issues are subdued a little, to make life a little easier.

    There is no cure for autism. You can just become more insightful about what triggers and causes your anxiety, or how to diminish your stress levels or to avoid getting stressed out all together.

    From my point of view it's all well and done and blabla but life in the real world causes stress. Full stop. You can't fully avoid your stress levels going up.

    My psychiatrist is being paid a fucking fortune but can't understand this. Summed up well and concisely. I really wish you were my shrink!

  • My employment situation is complex. I have five contracts in three departments with the same employer. One is permanent - 10 hrs per week, one is a rolling contract 18.5 hrs per week, and then I have three casual contracts for additional hours 'as and when required'. 

    That in and of itself sounds complicated! The employment market is beyond repair with all of these contract shenanigans. I had a permanent contract in my last job, I'd worked pretty hard to get to that, but unfortunately my mental problems and habits got the better of me. Trust me I know that contracts can be very complex, it's just silly in a lot of cases. I've worked lots of jobs, in lots of fields, temping, part-time contracts, and a few real, honest, "old style" contracts. It doesn't sound that you have an ideal situation. Any person who may have a health problem, condition, or situation that is less than ideal, is more or less over a barrel with the convoluted and precarious nature of these uncertain contractual arrangements.

    I think from what I can see you are really being proactive, and not letting it eat you up. That's one thing that I can say I think is the right thing to do in my opinion. It's best to get it out of the way, rather than be in some limbo. You are looking for something else, but hedging your bets at your current job. I generally get on with people at work. I'm the type of guy that clocks in, gets his head down, minds my own business, but if someone does start singling me out, I'll go in head first. I'll usually confront them directly. It's a part of me I hate sometimes. It's bad. I've said some things that were career suicide in white collar jobs, and done some things that were worse in blue collar jobs. Someone poked me in the throat once at work, let's just say that neither of us ended up in HR that day. However, I found blue collar work was far less stressful socially, people were far more honest.

    For the purposes of the ASD assessment. I have been running my life story through my head picking out examples of when things went wrong. Now I am playing it through again paying attention to all the positive things. 

     

    This is a part that I can give you some advice on. I did say that there is a feeling of fallout, and as Blank and Jonsey said "mourning". I sort of had an identity crisis. I didn't know much about autism at all, one of my friends has an autistic son, I knew how to act around him (another got diagnosed around the same time as me, that's another story), a few other things, but nothing that would prepare me for my own diagnosis. I was playing back everything in my head, relationships, trouble I've been in, things in childhood, the state of my mental health, what would have happened if I was diagnosed earlier, what could have been, so on and so on, and how autism had factored into it all. Also things that my autism had given me, that had made certain things easier. In the end I started to feel like a big ball of autism. I'd disregarded my personality, identity, and sense of self, for a bunch of things that I'd read, listened to, or came to my own conclusion over. I'd forgot that I was the same person for 38 years, and I hadn't transformed because of a piece of paper. Yes, I knew I wasn't going mad. Yes, I knew the things that were symptoms of autism, and now I had strategies I could learn. I'd say that there is a sort of culture to autism, and some people might not like this, but in my opinion, it's not always a positive thing. It's like a cookie cutter, blueprint mentality that can be shoved at you. There is diversity within neurodiversity, more simply put individuality. You are still the same person, that's the thing not to let go of. You just have answers, strategies, and explainations. Keep the positive stuff, there's nothing to change there, and work on the stuff that you find negative or a challenge. Make a list of both. You are yourself before you are autistic.

    I always say this but a wise lady said to me "I have autism, autism doesn't have me", the day I heard that and sat and thought about it, *** started to make sense. I can't thank her enough. I still struggle from time to time, but that helped me more than anything.

  • Yes it is really difficult. I have had quite long periods in my life when I didn't contact my parents for exactly that reason. What made me quite sad today was my mum telling me she had asked a psychotherapist friend to have a chat with me after a massive scene as a teenager which I now recognise was a meltdown. My mum was told there was nothing the matter with me and it was good that I was able to act out at home.

    Of course when I was a teenager in the 1970s people didn't think of autism where girls were struggling to cope. I explained to my mum that it may have been better to have lived most of my life not knowing. I might have had stringent limitations imposed on me, or imposed them on myself if I had been diagnosed earlier. As it was I muddled through somehow until recently when the house of cards finally came tumbling down. 

  • Tried to reassure them that my difficulties were nothing to do with their parenting.

    I've struggled with that one with my own Mum. Over the decades, when I've had my severe depressive episodes and alcohol abuse, she has always questioned whether her and my Dad's parenting, or their separation, are to blame for how my life had ended up. I have never at any time believed that to be the case.

    Wish my mum could find some peace through acceptance like I feel I am beginning to do.

    When I did talk to my Mum about my diagnosis, we realised the similarity between us, and with other family members, particularly her younger brother (I didn't meet him much, as he's as reclusive as me, but the similarities between me and my uncle were always very striking.) It makes her self-blame for my condition all the more ironic, as her acceptance and understanding of my autistic traits meant that I always felt I had a sanctuary of sorts at home.

    Like your Mum, she never has a moment when she's not worrying herself to death about something, and like me, lies awake half the night with tormenting thoughts going through her head. She finds some sanctuary now that she's retired and can dedicate herself to her beloved garden, craft hobbies, and my brother's kids, and my step-Dad couldn't be a more fitting partner for her.

    Unfortunately, with the way that my life has turned out, I feel that I'm often the worst of her worries, and I often lose touch with her for long periods because I get so anxious about what I should say to her about my problems - she worries like hell if I'm honest with her about them, or invents her own worries if I keep quiet about them, and she's someone that I could never try to deceive by wearing my usual mask.

  • Thank you so much. I've had a lovely quiet day today - just me and my dog - she is a bit poorly so has been sat on my lap dozing most of the day. I had a really nice chat with my elderly parents on the phone this morning. Tried to reassure them that my difficulties were nothing to do with their parenting. I am absolutely convinced they are both autistic. Wish my mum could find some peace through acceptance like I feel I am beginning to do. She's tormented by anxiety and depression. One of the factors in my decision to seek diagnosis was the wish to avoid ending up as distressed as my mum. I am so relieved to have a diagnosis as it will help me manage my life better and let go of painful things in the past. 

  • That's great news, Sunflower, especially to hear that it's lifted your spirits and you've had some feedback that can be put to use in coping strategies. Congatulations!

  • You can't really 'treat the symptoms with meds'. The autism related issues are subdued a little, to make life a little easier.

    There is no cure for autism. You can just become more insightful about what triggers and causes your anxiety, or how to diminish your stress levels or to avoid getting stressed out all together.

    From my point of view it's all well and done and blabla but life in the real world causes stress. Full stop. You can't fully avoid your stress levels going up.