Published on 12, July, 2020
Hi. I'm new and I'm looking for some opinions and advice from some other people like myself.
I'm 22 years old and I've been completely reliant on everyone my entire life. I cannot step outside the house alone, make phone calls to people I don't know and pretty much any social situation, involves me getting close to having a breakdown.
In the last few weeks, I have started having intensive therapy to help me with my anxiety that has ruled my life.
For as long as I can remember (I was diagnosed at 12 and have been under therapy for years), I have been taught safety behaviours. Things such as, planning before a situation, rehearsing what to do or say, having someone with me for support and now, I've been told that these aren't good for me. I've been told to push through the anxiety and deal with it without my safety behaviours, because apparently, this will reduce my anxiety overall, naturally.
When I was 12, it was confirmed by a highly thought of psychiatrist that having Asperger's, lead to the fight or flight section of my brain, to basically overwork itself, causing me to feel fear at even the smallest of things.
The thought of pushing myself through anxiety, scares the hell out of me. I'm terrified from the moment I wake up, so making myself do things in order to face the anxiety and deal with it, makes me physically shake.
Is my therapist right? Should I force myself through the anxiety, or will it make me worse?
Depends my anxiety starts in the morning before I go to work, I push myself through it.
But if I find myself in the negative situation I was anxious about like being tormented by someone or being given a task that you can't understand and being performance tested on it and wanting to escape these situations and having to suffer that for hours on end is very harmful.
Yeah, be wary of CBT... it seems that the newer approach is ACT (Acceptance & Commitment Therapy): https://en.wikipedia.org/wiki/Acceptance_and_commitment_therapy
ACT is developed within a pragmatic philosophy called functional contextualism. ACT is based on relational frame theory (RFT), a comprehensive theory of language and cognition that is an offshoot of behavior analysis. Both ACT and RFT are based on B. F. Skinner's philosophy of Radical Behaviorism.
ACT differs from traditional cognitive behavioral therapy (CBT) in that rather than trying to teach people to better control their thoughts, feelings, sensations, memories and other private events, ACT teaches them to "just notice," accept, and embrace their private events, especially previously unwanted ones. ACT helps the individual get in contact with a transcendent sense of self known as "self-as-context"—the you who is always there observing and experiencing and yet distinct from one's thoughts, feelings, sensations, and memories. ACT aims to help the individual clarify their personal values and to take action on them, bringing more vitality and meaning to their life in the process, increasing their psychological flexibility.
I think ACT 'fits' the neuro-atypical experience better than CBT as it allows for the idea that 'stuff IS hard' and rather than trying to 'push through' (like a neuro-typical could/would/should) it says "Yeah, I'm having a hard time and this is giving me anxiety - and that's OK - but I can experience this without it shutting me down AND I don't have to 'get over it', this is who I am, this is and (probably) always will be something I find hard..."
There’s an article by Johnny Profane - Confessions of an Anxiety Junkie
https://theaspergian.com/2019/12/07/confessions-of-an-anxiety-junkie/
Might give you a different slant on it.
Boating taxonomist has said what I was trying to say but couldn't find quite the right words for. I totally agree! For me the push through it CBT approach has only ever worked for less rational fears, not genuine autistic difficulties. Based on some bad CBT experiences I've had on reflection I think I'd run a mile from a therapist that said what yours has to be honest.
Is your therapist experienced at treating autistic people?
My understanding is if the things that are causing you anxiety are due to underlying autism issues, just trying to 'push through' the anxiety may not help because a large part of your anxiety may be because those things are genuinely difficult for you to do. If anxiety is less 'rational', a CBT approach of 'push through and do the thing, see it's not so bad, feel less anxious the next time' can be helpful for a lot of people, but if it's something you actually genuinely struggle with, that might be a much less effective approach. E.g. I recently spoke to someone who said before they got diagnosed, they got pushed to keep doing social stuff (under the understanding it was 'just social anxiety') in a bid to push through it, and they found it ended up making their anxiety much worse, because the underlying reason was that they had trouble understanding other people and social situations were therefore very difficult for them, and that didn't change with exposure.
The things you talk about being 'safety behaviours' are very much coping skills from the difficulties that come with being autistic. They're things I know i do in order to navigate things like social situations and other things to generally get by in life (and with them, I would say my anxiety issues day to day are minimal); I know without them, everything would just be even more confusing. I would have more difficulty communicating with people without my scripts, I would cope less with change, because I rely on being able to plan contingencies that let me know 'if this goes wrong it's okay because I've got x, y and z as options', they're about functioning as much as not being anxious-so being able to function less and struggling more would definitely make me more anxious, not less!
I'd say from my experience this can help but be careful with it. As original prankster says I also think that the key is to take it slowly so you don't overwhelm yourself and cause a meltdown, burnout which is counterproductive. Does the therapist have experience working with autistics? I'd say make sure they do as i think theres a difference between a safety behaviour and a strategy and also a difference between what works for NTs and autistics. Eg for me wearing noise cancelling head phones in noisy/busy places is a strategy not a safety behaviour. If i don't use them my overload/overwhelm INCREASES over time, rather than decreases, because its sensory hypersensitivity causing overload not anxiety. Im not actually scared/anxious of the place just overwhelmed by it because there is too much going on. Big difference.
It depends on what's meant by 'push through' - one of the things my therapist taught me was a technique to 'defuse' anxiety by understanding that it's OK to feel anxious but you don't have to let that anxiety control you.
The idea is that you take whatever is making you anxious and 'abstract' it to the pint where it's 'just words' and you can observe yourself reacting to the words rather than the situation e.g. you're in a crowded, noisy venue and it's making you anxious...
1. Write down (or visualise) the thought "I'm trapped in a noisy, crowded room" - read it 3 times and really 'engage' with it
2. Above the first line write (or imagine) the words "I am having the thought that..." - read the the two lines together i.e. "I am having the thought that I'm trapped in a noisy, crowded room" do this three times...
3. Above the new first line write/imagine "I am noticing that..." - read the three lines together i.e. "I am noticing that I am having the thought that I'm trapped in a noisy, crowded room" do this three times...
By this point you should (hopefully) have been able to 'pull back' from experiencing the situation 'live' and made it into a more manageable thing, you can then take more rational action e.g. you read/think "I am noticing that I am having the thought that I'm trapped in a noisy, crowded room" OK, so you should now be kind of observing your self and can think "Maybe I'll go outside/to the toilets where it's quieter so I can get my head together" or "I don't think I have the spoons for this right now, I'll make my excuses and leave..." or something, but essentially you buy yourself 'space' to see that you're getting anxious and 'defuse' it before it spirals out of control...
This approach isn't about 'forcing yourself to keep going', which (in my amateur opinion) is likely to just lead to a burnout or meltdown once you get away from the situation, it's about accepting that you are having a completely legitimate response but you don't have to let it control you.
For me, my anxiety gradually got worse with age. The fear was relatively manageable as a young adult. However, from twenty-five onwards, I couldn't stay in a venue much longer. The last few hours before an event are excruciating.
hi,speaking from my own experiences with anxiety,ive had it a long time im 54 and was diagnosed aspergers with complex ptsd both come with a side order of depression and anxiety,so i only got diagnosed at 53.
i pushed through my anxiety purely because at the time i didnt know any better,i planned my pushes very well so i was always in control.
slowly slowly is the key to it , small steps,maybe plan something the day before and write it down as a reminder,i find if i give myself more notice it helps me prepare.
clearing up the leaves is written down for me tomorrow,so when i get up im already focusing on a challange.
just my thoughts i hope they go some way to helping you.