Stuggling with Intensive CBT

Back before I was diagnosed with, or even thought about, having Autism I was struggling with my mental health. I looked at PTSD and Complex PTSD, both of which came out as a negative result. After meeting with a consultant psychiatrist he advised that I need assistance dealing with trauma which started in childhood and continued in various forms throughout my adult life. He suggested, and referred me for Intensive CBT. 

Forward on 18 months or so and I have been diagnosed with Autism and realise that a lot of my issues and behaviours could be attributed to my then undiagnosed Autism. Three weeks ago I have now started the Intensive CBT for GAD (General Anxiety Disorder) and am struggling to believe it will help me. The therapist has explained that my anxieties with fit into two categories which are 'Real' and 'Hypothetical'. She then went on to say that regarding the Hypothetical anxieties I need to just "forget about them and move on" and that she can only help with the "real stuff".

I am not an expert in Autism but I'm pretty sure that's like asking me not to breath, eat or drink. I need help dealing with things when my brain is flooded with hypothetical anxiety, as this is what leads onto the meltdowns and socially unacceptable behaviour. 

Does anyone have any thoughts or suggestions. I have done some online searching and it appears the ABA may help but it seems more aimed at people with learning disabilities, which I don't have.

Thanks

  • CBT doesn't always suit autistic people, so I'm not surprised to hear that you're struggling to see how it will benefit you. I had the same experience with CBT (for anxiety and depression) before I was diagnosed. The therapist and I agreed, part way through, that it wasn't going to help me, due to my then-probable neurodivergent traits and wiring.

    In respect of finding a more suitable form of therapy - coupled with a therapist who understands autism - you might find the following book helpful, as I and several others here have done:

    The Autistic Survival Guide to Therapy

     "In this candid, witty and insightful exploration into therapy, Steph Jones uses her professional and lived experiences as a late diagnosed autistic woman and therapist, as well as consulting therapists from across the world and tapping into the autistic community, to create the ultimate autistic survival guide to therapy.

    Steph confronts the statistics, inadequate practices and ableist therapists head on and poses the questions of how we can make therapy neurodivergence-affirming and how to create safe spaces for autistic individuals. With strategic and practical advice to help recognise the 'red flags' of a dodgy therapist and provide a clear roadmap to finding your confidence and setting the appropriate boundaries with a new therapist, Steph has every question answered."

  • My son had CBT for over a year and seemed to not benefit much at all, and I had CBT for about 3 months and actually found it very beneficial. I think it can vary a lot - there’s an element of luck in terms of who you get allocated to you on the nhs. I think I was very lucky to get a therapist with a lot of expertise and empathy. So it could just be that your therapist isn’t a very good therapist! 
    I certainly think it’s odd that your therapist says she can only deal with one type of your fears and not the other - fear is fear and if it’s a problem for you then she needs to support you with it. So I think it’s very strange that she should say that to you. I would ask her more about her reasons for what she says regarding that. 

  • I've had CBT before and found it useless. The brilliant psychotherapist who went through the autism assessments and gave me my diagnosis said she wasn't surprised I'd never found it helpful and is recommending a ND-specific therapist for my anxiety/depression, because she said CBT assumes an NT brain

  • So basically what I struggled with in the CBT (and in some aspects of the hypnotherapy I have just finished up with) was where it was essentially saying "your thoughts are wrong, it's your way of looking at it that is the issue." Rather than seeing this as a call to reframe my negative self talk, it comes across as yet another way I fail. Like, I'm the expert at telling myself the things I do and think are wrong, I don't need therapy to confirm that for me. What I need therapy to do, is ask me why I have such a negative self view, for example. And then help me find positives to focus on.  

  • CBT needs adapting for people with autism. I'm not clear whether she is aware of this or not.
    https://www.nice.org.uk/guidance/CG142/chapter/Recommendations#interventions-for-coexisting-mental-disorders

    Is she actually aware of your diagnosis? She needs to be.

  • Thanks for sharing, I appreciate it. 

  • Thanks for the reply. I have had a look at it, it looks really interesting. I am a slow reader so will read it later.

  • I did CBT for anxiety some years ago, before I knew or even suspected I was autistic. I found parts of it helpful for that, and aspects of my self hatred. I have since had some CBT for depression and did not find it helpful at all, in fact, it even made me feel worse. 

  • Cbt didn't work for the type of anxiety that I had. It wasn't worry based but stress from a chronically overloaded brain. I found this link a few weeks ago which I think shows how anxiety can have a different root cause for neurodivergent individuals. 

    neurodivergentinsights.com/.../autistic-anxiety

    I find mindfulness practices are more helpful.