Support for adults

Sorry to say there's little support out there for autistic adults. Try your GP see if they have someone you can talk to. You might get lucky and find someone with experience of autism. I found a doctor just like that, I was really lucky.

I'm also lucky to have a very understanding mental health nurse who offers me a lot of support.

As I said, I spoke with the GP and I was treated with six sessions with a completely untrained CBT operator. They did more harm than good, he had no clue about ASD

Sadly most GPs have no understanding of autism. Have you tried a CBT specialist outside of the NHS? I've heard they can be helpful for some people.

Sadly most GPs have no understanding of autism. Have you tried a CBT specialist outside of the NHS? I've heard they can be helpful for some people.

NHS choose to adopt CBT just because it was the cheapest of all therapeutic options. 

I agree that CBT is not helpful, not in my experience anyway. Before I knew I was autistic I had a couple of courses of CBT for anxiety and actually ended up worse afterwards.

The NHS standard therapy is quite patronising and automatically assumes that all thoughts and fears must be faulty and irrational and need to be fixed. They seemed to think that I must be fearful of making a fool of myself or being judged but I didn't think like that at all. 

Also there can be a tendency for therapists to blame the client if their therapy isn't having the desired impact. I was led to believe that it was my fault in some way, that I wasn't trying or pushing myself hard enough. That I was being deliberately un-cooperative when I couldn't identify or adequately communicate my thoughts or emotions. 

I now understand that it was perfectly rational for me to feel anxious and avoid places and situations where I would experience sensory overload and trigger meltdowns. The key is understanding what is rational anxiety and what isn't. It is the sensory environment that needs adapting rather than the thoughts.

There is an interesting article here (co-authored by the well respected Tony Attwood)

https://attwoodandgarnettevents.com/can-cbt-be-helpful-for-autistic-adults-part-1/

https://attwoodandgarnettevents.com/can-cbt-be-helpful-for-autistic-adults-part-2/

A couple of relevant sections from the links above:

"Our clinical experience indicates that for many autistic clients, repeated exposure to the painful sensory experience does not lead to habituation. Any graduated exposure programme needs to accommodate the autistic person’s sensory profile, otherwise, there is a significant risk of increasing the person’s anxiety"

"We are increasingly recognising the potential for autistic burnout when demands exceed coping abilities or burnout as a response to stressful life events and long-term camouflaging (Higgins et al 2021; Mantzalas et al 2021).  Recovery is protracted and may last months or years.  Burnout affects mental health, energy levels and cognitive abilities. According to Higgins et al (2021), the degree of cognitive confusion and overload associated with autistic burnout could limit the effectiveness of conventional CBT. For example, many clinicians may treat depression using the traditional CBT methods of behavioural activation and increasing social contact. Both these methods are likely to increase burnout leading to a worsening of symptoms."

Yes, my experience of cbt has been similar. I've given up on therapy for the time being, because in every instance I knew it was pointless before the end of the first session. The practioner didn't get it, I was way ahead of them and they seemed unable to grasp what I was telling them. Maybe this was a double empathy thing in some cases, I don't know. 

In any case, none of it was remotely useful. 

I didn't know that I was autistic then and neither did they. It may well be better with a practioner who started from an understanding of neurodiverse people. 

Yes autistic people usually do have a very well developed negative intuition, I would say that we have too much baggage and safety behaviours for most practitioners to be skilful enough to break through with declaration alone, especially considering that they have 8 weeks to do there job and there organisation usually wants them to go for big results..

When I talk to the practitioners you can usually only riff with them for so many session before they start stick to the programmed responses..

DeSpereaux said:

Sure autistic people do develop and manifest behaviours over time, by the root-causes of that behaviour are often not considered, and we are seen as difficult or not trying

The therapists I have worked with have all recommended exploring whatever is the root cause then developing new coping techniques that are more acceptable.

There needs to be a degree of the CBT process involved in us changing the behaviour as most behaviours have been present since childhood and are deeply ingrained into our ways of living.

I have found that many autists are not willing to try to change their behaviour in a coping technique, even when it is detrimental to them. There is often a very black and white way of thinking for these people which makes it hard to show them a shade of grey that is a better alternative.

The only progess there was when they started to really want to change.

Complicated creatures we are.

A lot of the training surrounding CBT is psychological in nature and it seeks to train you out of your issues, it seeks to change your behaviour and have you believe that you should just do it, there isn’t a lot of consideration for the neurological aspects of autism. Sure autistic people do develop and manifest behaviours over time, by the root-causes of that behaviour are often not considered, and we are seen as difficult or not trying.  
But there are versions of CBT that are tailored to autism, I’ve not found a CBT autism practitioner, but I have found it helpful to research on my own and to challenge a practitioners thoughts. I think they it ultimately falls into the realm of counselling if the practitioner is not skilful enough.

I've never had CBT but I've heard from some people it worked for them but not everyone finds that. I personally think rather than trying to cure aspects of our autism talking therapy and offering support and encouragement is much more worthwhile and better. When I was speaking with my doctor daily my life improved massively I felt heard and understood. But finding a good therapist who understands is difficult.

I don’t see how cbt helps people with autism when our brains are wired differently. It won’t rewire my brain. I don’t mean to sound rude I would love to know if I am wrong. I am willing to try anything, however having had cbt in the past through nhs for depression, I found it quite patronising and it didn’t help me. The lady who diagnosed me said this could be because they were communicating neurotypically and I didn’t have my diagnosis back then to tell them. Have you found it successful if they are aware of autism? I thought maybe this is a gap in the system

If you found that you weren’t ready for CBT, then the talking route is likely going to be more useful for the moment, maybe counselling? 
If you think that you don’t want to talk about present behaviours, and you’d like to account for your psyche and look for root-causes, then perhaps psychotherapy..?

Good luck with that. I hope you can find someone. I had a therapist with the NHS and he was awful. Didn't understand my autism and had me sectioned, seems to be their answer to autism for a lot of people.

CBT is complete, absolute bullshit. I am trying to find a decent therapist that does not cost an arm and a leg.