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post-diagnosis feelings

discoplant

i was diagnosed with asd last year. my report recently came through and i cannot stop reading it, which is causing me a lot of anxiety. it is very deficit based, which i understand is necessary due to the need to evidence the criteria for diagnosis - but i’m having difficulty not internalising it.

i’m also currently training to be a therapist and i am very stuck in a mindset of, now someone has concretely said that i find things difficult or display certain behaviours, that this is going to make me a ‘bad therapist’ by neurotypical standards etc.

i was wondering if anybody had any advice or guidance on how to get out of this thought pattern?

  • Hi  

    For transparency, I am a physiotherapist of 25 years.  So to answer your fears of being a "bad" therapist by neurotypical standards...  My experience is that I'm reported by patients as being "marmite" - love or hate but seldom in between.  Some like the thoroughness, insight and care that as an autistic person I appear to have.  Some hate the fact that I keep trying to help people when I haven't the social insight to realise that there's something else on the agenda...

    From a perspective of most therapies having a diagnostic and therapeutic algorithm to follow, there will probably be a structure and likely a script to follow that will improve with practice.  Playing this act will generate behaviours and although it might be "learning another mask" it will get you through for a while I suspect.    By the time that you "come into your own" with the task you may identify that your process analysis and strategies are significantly different from NT colleagues.  So be prepared to demonstrate good clinical reasoning and practice right from the start with people who may call you out for being different.

    For me personally I'm more inclined to "bottom-up" rather than "top-down" systems analysis.  Takes a while to bring together hyper-awareness of the small but important features into the bigger picture analysis for autistic people too...  Structuring your sessions will help with this.

    As for the diagnostic criteria messing with your head - yep got that!  How does someone with social communications problems work in an environment that relies upon social communication?  I'd answer - training and reflective practice.  System 2 thinking versus system 1. 

    Keep an eye on how a therapy job can sneak up on you for how flipping draining it can be.  Success is rewarding and re-energising but the number of sessions where it's working towards success will radically outnumber the "great that's sorted".  It's tricky not to have people drag you down if you have issues about spotting what your own mental state is.  Keeping that balanced is problematic for me personally.

    If you're anything like me, the biggest issue is staying true to the professional and moral responsibilities in situations where neurotypical society and workplaces can play fast and loose with these things.  I have a lot more problems with managers than patients...

    As  and  have said if you get a chance to work more with other autistic people then maybe the match will be less complex - in my experience they're often a lot more rational than NT people!  All the best

  • I second A's response. We need therapists who are autistic friendly. Go for it, pass the courses, then learn how to help us too!

    I recommend The Autistic Survival Guide to Therapy by Dr. Steph Jones. She is autistic and a therapist.

  • I have been through multiple rounds of therapy over the last few years and the lack of knowledge about ASD is really depressing.

    You have the opportunity to be a very good therapist indeed for ND folks - one that actually understands.