Psychiatrist overstated my symptoms?

Hello all,

I got my diagnosis last year, late on in life.

In the first session, which was with a psychologist, she referred to me as being very able in masking my condition through learned responses over the decades and that, as I have a pretty decent level of intelligence, a degree and post-grad, am able to analyse and respond appropriately much of the time, although it has never been or felt natural.

can hold conversations, but I do sometimes have to get people to repeat themselves multiple times for information to sink in. I find the process of figuring out when I should be talking / responding tricky at times and often make abortive attempts to say things. This seems to have become worse over time.

In the second session, and in the report, the psychiatrist said I am not able to follow conversations / cannot sustain conversations. This is sort of true with people I do not know, but I can keep a conversation going with people I know. He is correct that I use very formal language much of the time. I have to be VERY familiar with someone to relax into speaking less formally, or have to put huge energies into masking. I think the psychiatrist overstated this somewhat, although I did not think to challenge it at the time, being relieved to finally have a diagnosis.

I am able to sustain short conversations with strangers, but often only with great effort, or if it is something I know about. I am not a fan of small talk.

I used to have a job as a teacher, which involved interaction and conversation, but this almost exclusively based on knowledge / discussion of my subject specialism.

I am going to be seeing Occupational Health in the near future, and worry that if I mask too effectively it will seem to contradict the diagnosis.

Any advice?

Thanks.

  • I had the Occ Health visit today - the nurse was very supportive and realistic.

    Confirmed the many things I'd already thought would be said. It was relatively positive. Now to see if my workplace will adhere to recommendations.

  • I think this is a good point- they need to justify the diagnosis in the report so will put in any autistic traits that they pick up. When I read my report it also made me sound a lot more ‘deficient’ than I feel... and it took me a while to come to terms with it. I want to be accepting of autistic me and see the positives in my autistic traits. I also found that when I initially learnt about autism I would realise that some traits i had thought were perfectly ‘normal’ were in fact typical autistic. I think it was even harder for me to see the autistic traits myself as I grew up with an (undiagnosed) autistic mum (we realised when i was diagnosed that she has very similar traits so is most likely autistic too) and later on at uni most of my friends were neurodivergent - plus during my studies and my work I can mainly talk to people about my special interest (science) and i avoid many situations which i would struggle with (like groups etx)- so i think all of that makes it harder to see our own autistic traits. Don’t let the comments from the psychiatrist dent your confidence or doubt yourself- there is nothing wrong with being autistic- and in terms of communication we just have a different way of communicating to neurotypicals. There are even studies showing that communication between autistic people is just as efficient as between neurotypicals but issues arise when autistic and neurotypical peoplr try to communicate with each other

  • Had a brief conversation with my wife about this, and she identifies that I am OK when I know people well and am comfortable with them, but that I can be very quiet in other circumstances.

    I think it is the case that when I know someone well I understand their conversation patterns, and that they understand / have become used to mine, or that I will dip in and out of conversations and they are ok with it.

    When I get involved in deeper conversations they are almost exclusively based on topics that are my special interests. I can maintain special interest conversations as I know what I am talking about. Seems obvious really.

  • Perhaps we need a new, kinder definition of 'odd', 'weird' and so on. My definition/criteria would be: 'Does this person do any harm?' If not, then they aren't odd.

  • Perhaps I don't mask as well as I thought.

    I must admit, I do play a 'role' when at work. Whilst working in school I was the character of the teacher. Likewise in other workplaces. I don't socialise with colleagues at all, and rarely have done in the past, so I don't think they know the real me at all.

  • Perhaps my masking isn't as good as I think it is. I have been considered odd in pretty much every social / work / family situation for my entire life.

  • OH will see the whole report. To be honest, I was having an anxious day as it was such an overwhelming and important experience.

    I think you may be correct that, as an expert, he saw the autism as being obvious, given our lengthy discussion, and therefore clarified the difficulties I have "underneath the mask" as it were.

    OH should be focussed on the help I need. I think they request the report just to confirm a diagnosis, to ensure I wasn't faking a disability!

  • Maybe to the assessor it was really obvious you were autistic but they needed to write things in the report to sort of "cement" this against the criteria because you are so high masking. Not about looking for things which are not there but picking up on subtle things in order to show you do meet the criteria. Also they have to go off what happened on the day. It might be you had quite an anxious day so you might have had more difficulties. Would OH see the full report or do they just need to see the result? Maybe with OH focus on the bits of the report which relate to what help you need.

  • I learned to rely on principles of kindness. Affording respect, dignity, never cruel never cowardly... from here, it seems much more easy to understand matters of being polite. But I also took theatre classes and didn't realise how much I'd fallen back on to them for social 'skills'. I also never realised socialising wasn't supposed to be this exhausting. LOL

    We don't mask well. The Jungian mask is a term for those who do it effortlessly. I like the term camouflaging a little better. Or perhaps in my world I should start calling it a 'bit of theatre'. Good luck! 

  • Hello. Slight smile

    I think that a keen, truly professional eye will detect any masking we do. That might sound optimistic - and perhaps different to others' experience - but I don't think our masking is as effective as we often believe it to be; something frequently gives the game away, and a capable pro will be sharp enough to notice.

    Best of luck with your appointment. Slight smile