Therapy

Talking Therapy (counselling) was certainly helpful to me. It did however require me to advocate for myself and ask for in person counselling. Neither phone, nor video call works for me. A neurotypical person only receives like 5% of all communication when they only have voice to go by. Video calls also minimise the available information. So for me, I like to give myself all the information to potentially give me a higher chance of interpreting tone, and reducing misunderstandings. 

The last counsellor I worked with attempted to take an approach that highlighted Transactional Analysis. This was before I had my diagnosis, and officially considered myself autistic. It was helpful though. So to, was Psychodynamic Therapy. It's difficult to come across on the NHS, but it can have its uses. Both require you to be honest and fairly open to the process. So that means a counsellor or therapist that you trust, get on with, and feel understands you.

The most important thing I think is going into counselling with a clear idea of what you are hoping to achieve. 

For example, I've self-referred for counselling again post-diagnosis. My aim and the answer I'll give when they ask 'what do you hope to achieve' is: to put the autism diagnosis into context. To explore how it has affected me in the past, and reanalyse what I consider to be 'normal'.

Previously, my aim in counselling was to work on some long standing traumas and understand how the past experiences were affecting what I thought was depression. Having that clear idea of what I hoped to get from the process aids both yourself, and the therapist to understand where you're going. What the point of the process is.

Thank you. My therapist is trying to understand but I don't think she's really getting me at the moment or what would help. I find it really hard to explain so I don't think we're quite gelling at the moment.

I think part of my problem is I'm struggling to have a specific aim. I just want something to get better. There's so many aspects to my mental health, I just don't know how to pick the right one.

You said you wanted to improve depression and anxiety.

Seems you want to look at what makes you anxious. If some things do and some don't, then what is the difference. What is it you are worried about. What negative outcome do you fear and does that come from somewhere.

If you are anxious about everything, then are the tomes of day or places that are less bad. Is there a pattern. You could try writing things dow

I think a lot is just fear of newness. So make things less new, try to do more thing, maybe with some help initially to build confidence.

For the depression, assuming you are not just burnt out and overloaded in which case fix that, what is it that you don't have that you would like to have. Are these things true, i.e. fact check them. Are there are simple things you could fix. Small wins will build.

Only you know you, so you might need to be a detective.

Your therapist ought to try to steer you

I didn't know where to start so just info dumped everything bad that had ever happened to me. It was traumatic as I revisited everything. I did it myself then just presented it all and hoped to find an answer. Partly it was just unburying things, but mostly it was the prompts and help to understand them that helped.

When you are not hiding things and you understand them you have less to fear and you feel more in control.

Social anxiety is a big thing but the problem with treating this is they just want me to do things that make me socially anxious. For neurotypicals this can bring down the social anxiety and maybe it works for some autistic people but I know for certain it won't help me, it would just increase my anxiety by a lot.

Being judged is another big one. This covers not only the social but things like getting things wrong. I did raise this issue but the therapist then went down the line of have you asked them. No of course I haven't asked them, I'm socially anxious and rubbish at communicating. 

The other big one is uncertainty. Again the general approach to work on this seems to put yourself in uncertain situations. Well that's been my entire life and I still struggle and I need some level of certainty in order to survive. So I don't know how I improve that issue.

My evenings are the worst time as I have time to think. We tried to work on this but got stuck in a loop because she kept asking me what would help and I kept saying I don't know nothing I've tried has worked. She kept saying well what would you want to try and I'm like if I knew the answer to that I probably wouldn't need the help of a therapist.

Social anxiety is a big thing but the problem with treating this is they just want me to do things that make me socially anxious. For neurotypicals this can bring down the social anxiety and maybe it works for some autistic people but I know for certain it won't help me, it would just increase my anxiety by a lot.

Being judged is another big one. This covers not only the social but things like getting things wrong. I did raise this issue but the therapist then went down the line of have you asked them. No of course I haven't asked them, I'm socially anxious and rubbish at communicating. 

The other big one is uncertainty. Again the general approach to work on this seems to put yourself in uncertain situations. Well that's been my entire life and I still struggle and I need some level of certainty in order to survive. So I don't know how I improve that issue.

My evenings are the worst time as I have time to think. We tried to work on this but got stuck in a loop because she kept asking me what would help and I kept saying I don't know nothing I've tried has worked. She kept saying well what would you want to try and I'm like if I knew the answer to that I probably wouldn't need the help of a therapist.