Therapy - a positive

That's hilarious!!! But I don't see how they can object to you using technology during your sessions if they make you do it in person so I'd look into that. I'd also be tempted to raise a complaint about accessibility but that would have to be up to you.

Thanks for the suggestion. Sometimes I wonder how much it would cost to hire an actor for a coupe of hours and give them a script. I'm joking but it would work for me!

It doesn't happen to me very often at all but in moments when I'm very upset or as you say there are just too many things in my head at once and I can't formulate what to say. But when it does happen I really can't manage words. It's a long time since it last happened but I guess therapy triggered both of those things

I really wasn't sure about her up to that session. I didn't feel like she was really getting me or my needs but something seemed to click that week.

I'm surprised they are pushing phone call over online calling to be honest. My area prefer it not to be a phone call. If you did face to face could you type into your phone for it to say out loud?

I think I know this really but it just feels frustrating as it feels like another circumstance where neurodivergent people are disadvantaged as our needs can make these processes take longer.

I will try to discuss that with her once I know how many sessions we're having.

Well exactly. And I do understand them putting a limit on the initial number of sessions but I think the therapists should be allowed to extend as many times as they consider necessary. Surely they should be able to professionally decide whether their patient needs more therapy or not. I think in the long run it would actually reduce capacity as people would actually get discharged fully rather than re-referred time and time again.

I cannot remember how many sessions she initially told me I had. But I know she told me it could be extended once but then she made it sound like that would be it. I will question it again though. I will see whether the first extension gets approved first.

I get like that at times. "Situational mutism" (SM) is what the cool kids call it these days (drs. call it "selective mutism"). If I'm struggling with emotional overwhelm (upset, RSD, etc.), words just seem to get stuck. I open my mouth to speak and I can feel my throat just lock up. It's like I have several different things in my head that I want to say and I can't decide which words should come out, so nothing happens and I'm left hanging. I can usually manage one- or two-word answers to direct questions, but not much more than that. "Yes", "no", and "go away" are my favourites. It can take me an hour or two before I'm more regulated and can speak again in general, but it could be several days before I can approach the topic that triggered the SM in the first place, at which point everyone except me has moved on, so there is not much point. I'd probably just end up SM again, anyway.

I used to think I had a stammer when I was a kid, but I think it was just SM (I'm late-diagnosed). It can also happen when I get a bit excited or anxious, such as when delivering the punchline to a joke. It can be very embarrassing.

It's great to hear that your therapist understood your situation and was able to guide you through it. Sounds like you've got a keeper there. I hope it works out for you.

Thanks for that, yes it wouldn't be ideal but I could maybe work with that. They are insisting on face to face or phone call though and are refusing to let me use text only. I've started a post asking for advice on this. Thanks again!

It's great to hear that you're making positive progress with your therapy! 

Expecto_Patronum said:

I am now a little concerned however that as it is through the NHS and has a limited number of sessions and has taken so long to get going that we will run out of time before we've really dealt with the things I need to deal with. It seems such a backwards system.

Expecto_Patronum said:

I'm not sure how many sessions I've had but it's been more than 4.

Expecto_Patronum said:

The therapist said she can ask to extend by a few sessions but then that's the limit.

If it's any comfort / reassurance, under NHS England, for various types of therapy, the normal number of sessions can range from five to 16 or 20:

NHS - Types of talking therapy

In my case, when I began my course of NHS counselling, I was initially told that I could have a total of eight sessions. However, based on my ongoing need, this was subsequently extended to 12, then to 16, and then finally to 20 sessions in total.

At the end, it was recommended that I continue counselling, and I was provided with a list of low-cost, local counselling services to consider.

My suggestion would be to share your concerns with your therapist and ask for some clarity about how many more sessions you definitely can and/or might be able to have in total, depending on your progress.

Expecto_Patronum said:

It feels as though they have been somewhat wasted but I just wasn't ready to share with her, I didn't feel comfortable enough.

With therapy you do need to take the time to build the trust so you can be open otherwise you are not telling the therapist the full story which means they can only do a partial job. You can't force the pace of these things unfortunately.

It is good you know what works though so you can take this away as a win along with any other progress you can make in future sessions. Don't worry about there not being enough time (there never is in life I find) but keep the focus on the moment and what progress you can make here and now.

Ask in the next session if there is an option to go privately just in case - then you will know for sure and if it isn't an option then you can ask for recommendations of therapists they know with experience in treating autists.

I'm glad you've had this break through and that you can have more sessions. I wish the NHS allowed someone to have as many sessions as they need, I know it would slow things down, but it might be a case of do they want it done fast or do they want it done right?

Last time I had therapy continuing with the same person privately wasn't an option, she wasn't allowed to as an NHS therapist. I don't know whether it'll be different this time as they have outsourced to a private company. I'm not sure how many sessions I've had but it's been more than 4. It feels as though they have been somewhat wasted but I just wasn't ready to share with her, I didn't feel comfortable enough.

It's not so much being judged, it's more an extreme difficulty talking about anything that makes me feel strong emotions. I find it so difficult I just can't find the words. I will see how my next session goes and then think about writing things down.

My therapy is online. I'm not actually sure if it is an option I've never thought to ask but sometimes in these video calls they have a chat box. I wonder whether this would be an option for you? You'd be on the call but could type instead of talking. Just a thought.

Expecto_Patronum said:

I feel like we finally had a breakthrough in a recent session

This is great - finding a tool to open that access for you is something you can use for the rest of your life now. If you can focus on this as a win then it was a great breakthrough.

Therapy is often a journey that takes a few sessions to build trust, understand your issues and find what approaches work for you to talk about the things that are important to you. If this is as far as the NHS sessions can go then it is still a win - and if you can keep the contact then as and when finances allow you can always go back privately to take one more step on the road to covering all your issues.

I found it took about 4 sessions to uncover the facts / issues etc, about 10 more to "unpack the trauma" to work out what childhood issues were still influencing my reactions 40+ years later and to work on healthier responses and self improvement on a range of fronts.

Thereafter I only check in a few times a year with my therapist but that has become largely social and a "checkup" which I don't really need but like to have.

My therapist said everyone has different time needs and you often don't know what these will be until you have opened the vairious locked doors in their minds during the unpacking phase, and even then not everyone can progress at the same speed as they are of varying capabilites and often suffer setbacks.

At £50 a pop the sessions aren't cheap but they may be worth considering on a slower, pay when possible approach. Just a thought.

Anyway, congrats on the progress.

I appreciate your positivity, it's nice to hear something positive about therapy. I'm currently struggling with the community mental health team, as they won't accept text communication which for someone with selective mutism is causing problems. Anyway I just wanted to say thanks for spreading a bit of positivity.

For now, really hold onto that positive breakthrough. Being able to share your feelings in a way that works for you, and having that recognised and supported, is truly amazing. I'm really rooting for you and hoping you get the extensions you need to continue this progress.

You should also be able to give them stuff in writing too, if it is too hard to say.

I wrote stuff down between sessions, then summarised the key points and prepared items I wanted to cover.  I emailed them or presented them at in the first 5 mins. But I am older now, I don't know if I could have done this at 20 or 30.

It also meant I didn't have to try and remember and could order my thoughts.

You have to use the sessions efficiently. It is hard to start and break through the wall, but if you can you can then talk more openly. Don't fear being judged, they have probably heard it all before, and worse, and they will not think anything bad, look down at you or say anything nasty. It just requires a little bit of trust.

Good luck in the remaining time.