Published on 12, July, 2020
Good evening,
I would like some counselling. I am currently having CBT provided by the NHS in my area but it is not helping at all. Does anyone have a list of approved registered therapists or list of other services that might provide longer term therapy?
I am an adult who was diagnosted ASD in her early 50s (two years ago).
Thank you very much.
Hi Recombinantsocks (I still get mental pictures of my odd sock bag with your user name)
I think one of the problems with CBT was best summed up by my big sister who has children on the spectrum but has no diagnosis herself (a classic example of ND success because her special interest is now a big part of her job).
She had a course of CBT, but found herself thinking "but I already do this most of the time and I've now got to the point where I can't rationalise these problems, they are too big"
She like me benefitted from mindfulness (adapted slightly to compensate for some ND quirks) and does well on Venlafaxine rather than the SSRI class of drugs.
We both use TA, particularly when dealing with family challenges such as our most NT sister being particularly insensitive to things such as the need to plan!
Recently she's been amazing helping me come to terms with the possible future we will be dealing with in a woefully under resourced system for supporting adults with spectrum disorders. A real example of directive counseling about how to look after myself and SO while still doing the advocacy.
I personally believe the single most important factor in successful therapy is the therapeutic relationship...and finding a good match is critical. Having said this I do counsel others and one of my biggest successes was with someone I never expected to return after each session because I didn't sense a connection. She clearly did and she was so appreciative of the tools and skills based approach I took on behaviour change.
Provoking and challenging a patient is not regarded in T.A. as beneficial - whereas as to facilitate and enable them is.
Provoking may not have been the best word to choose and I certainly didn't mean challenging in a confrontational manner.
English isn't my strongest subject! I did look up https://www.collinsdictionary.com/dictionary/english-thesaurus/provoke though which has two meanings for provoke. 1. to anger insult or annoy 2. to rouse cause or produce. I definitely meant the second of these two alternative meanings.
Oh - sorry; do mean the warning was that you bore most people rigid with T.A. talk?
Is it then that you wish to discuss the composition of the Child, Parent and Adult ego-states as being psychological fragmentations - which although having characteristic similarities; they are in fact traumatically divided and suppressive states of mind that are prone to resequencing - i.e. through the sub-conscious, pre-conscious and semi-conscious sub-stratums of conscious awareness?
I am Aspergian and rigidly fascinated with T.A. ;-) So no boredom is ever possible for me when regarding it as a subject matter.
I can bore most people rigid on TA :-) Even people who use it professionally
QuirkyFriend said: Deepthought, I will warn you and apologize to our original poster that one of the features my DCD shares with ASD is special interests!
Deepthought, I will warn you and apologize to our original poster that one of the features my DCD shares with ASD is special interests!
For what reason will you warn me or are you warning me? As I am uncertain of what you mean by it.
I was introduced to TA as an 8 year old (my family is very ND accepting) and although my narrative voices don't have separate identities they do have distinctive features...my critical Parent is very precise sounding when I use it (all my siblings have similar and we refer to it as channeling our grandmother).
I work a lot with people who make bad choices for their health and when interviewing I will be watching for signs of their ego state shifting as we work through exploring decision making.
I've found I have to be careful when I introduce the idea because it can look like mind-reading if you just blurt out "when you make a mistake you have an internal narrative that tries to justify the choice because being good is too hard"
The other special interests include numbers and patterns in populations. My SO is an epidemologist. We often talk about the different rates of thinking patterns.
recombinantsocks said: All they can do is to provoke the patient into challenging themselves about their own behaviour.
QuirkyFriend said: I recommend starting with TA for kids which is finally back in print and would say every adult and child who is neurodiverse will benefit from reading it.
I recommend starting with TA for kids which is finally back in print and would say every adult and child who is neurodiverse will benefit from reading it.
Yes, definitely, although I and many others think it would serve well as national curriculum material for every child and parent perhaps.
QuirkyFriend said: Even with neurotypical people I find they don't have an understanding that their internal voices have roles and you can either work with them or.fight against them.
Even with neurotypical people I find they don't have an understanding that their internal voices have roles and you can either work with them or.fight against them.
About sixty-percent of people do not have an understanding of their internal dialogues as they are subconscious operations for them ~ and what they become aware is the product of their internal dialogue.
So rather than thinking for instance about eating at home, cooking one of several meals, ordering a take-away from one of several different places, or whatever and from wherever else - they will become aware of the final answer; even if someone else has to come up with it for them!
About thirty-percent of people will have a more partial understanding of their internal dialogues - such as being in two minds about what to do and where to go etc.
About ten-percent of people have a more complete relationship with their internal dialogues - and such people are generally referred to as being neurologically divergent. Hearing the voices of or even becoming one of several individually distinct personalities are a couple of the more severe categorisations of neuro-divergency.
P.S. The percentiles given above are vague approximations only.
Very true. The research evidence says CBT ain't much use for neurodiverse people
That might be literally true. i.e. it is less likely to work for neurodiverse people. That does not mean that it does not work for any ND people. It does not mean that it cannot work.
CBT, and other techniques like TA etc, rely on people realising that they need to change their behaviour. It does not mean that they have to change their psychological traits, reflexes and impulses but you have to be able to learn to respond differently to "attacks" from your social surroundings. You have to learn to be more defensively skilled in understanding yourself and understanding what sets you off and what gets you into trouble.
A therapist cannot force a patient to come to this realisation. All they can do is to provoke the patient into challenging themselves about their own behaviour. I think A lot of people fail to take advantage of therapy because they expect the therapist to do all of the work; i.e. to perform a cure on the patient. CBT does not and cannot work like that. People expect to go to their doctor to get some medicine to cure their disease but a lot of mental health requires the patient to do the work themselves.
TA gives you a framework for understanding how humans behave towards each other. I mentioned to another poster here that TA might explain his selective mutism.
Even with neurotypical people I find they don't have an understanding that their internal voices have roles and you can either work with them or.fight against them
There is a psychological process developed by Eric Berne MD called Transaction Analysis, or T.A., and he wrote a book called GAMES PEOPLE PLAY The Psychology Of Human Relationships ~ which explains all the systematic steps and stages involved with societal behaviour patterns.
G.P.P. was the first book I read when I started studying western psychology twenty six years ago - and I have referred to it continually ever since. One of it's nick-names as a book amongst some psychologically and sociologically inquiring Aspergians is, "The Manual." It was first published in 1964 and it is still not outdated, and CBT was actually in fact adapted from T.A.. The reason for the adaptation was basically that T.A. works according to the patients ability - rather than by the therapeutic stop-watch and funding allowances.
CBT is itself as a therapeutic process extremely good for pre-adolescents, and pretty good for adolescents, but thereafter decreases in effectiveness for more mature people ~ given that peoples linguistic-synaptic structures become more neurologically fixed and set as time goes on.
CBT deals more with systematic methods of communicating - cognitive dissonance and resonance and so fourth - rather than exploring the experiential mechanisms of personal interactions and social transactions that have proven to be behaviourally counterproductive, productive and neutral. The point of T.A. is to achieve an experientially balanced state of awareness by working with what is there ~ rather than as such with what people imagine should or should not be there.
Basically with C.B.T. it is pretty much how to think, speak and behave appropriately - spot the potential glitch there perhaps with A.S.D.. Of course though, one person's medicine can be another persons poison, so when it comes to any therapy it is important that it works for the individual - regardless of whether it works for anyone else or not. Obviously the same applies with therapists, in that the most proficient therapist can pretty much make any therapeutic process a really good one.
With G.P.P. being the rules and regulations manual, there is also a modern therapy manual called T A Today A New Introduction to Transactional Analysis, by Ian Stewart and Van Joines ~ so if you are more inclined to working out your own problems in your own way and at your own pace; it is definitely worth considering. Also, T.A. Today (second edition) is the current training manual for becoming a transactional therapist if anyone feels so inclined.
:(
Thank you very kindly :)
That's the one.
Thank you for your reply Oktanol. I would say more or less everything you have written applies to me too. In my area the NHS provides CBT but it is very much aimed at people with depression and anxiety. I do have some depression and anxiety but what I really want is some "life training" on how to negotiate life in a neurotypical world. My depression and anxiety originate from there... If that makes sense. It's the CBT that's rigid, not us... :)
Thank you for your reply. By British Association of Psychotherapists, do you mean BACP (British Association for Counselling and Psychotherapy)? I shall search their website. Thank you once again.
Just out of interest: In what way does it not help? The counsellor doesn't understand you or their techniques don't seem to fit you or you don't get better or...? I'm just asking because I found exactly the same up to the point you have described so far and it really surprises me that they couldn't do better. I was told I must be too rigid for CBT but somehow I don't quite agree that it's only me who can't make it work. I found this self-help-book-like low intensity CBT rather upsetting because to explain certain concepts they used examples and these examples were just so far away from any issues I had, in fact I sometimes wished to have the problems these example people had. It's not because I can't do abstract thinking. If a counsellor asks me again and again how something makes me feel, I respond and then she isn't satisfied and tries to find different words for my feelings (which do not fit), then I wonder if she is perhaps too rigid to divert from the questionnaire she must have in her head or to accept answers that don't fit the catalogue of answers she will have in her head too. Or another one told me every week that work is too important for me. Everything that I told her is important to me too didn't count, no idea why, she never explained it. I don't even know what would have counted. Well, if I'm too rigid because I can't stop work being important to me, then is she not just as rigid if she can't stop telling me that it's too important to me (which I think is objectively seen not even true when things at work are fine, but they were everything but fine and therefore I couldn't switch off the (as it turned out totally justified) worry, which perhaps I could have if work wasn't important, but somehow she missed the point). They found me flat and it seemed to irritate them - isn't that a bit rigid too? They could just have decided that this is how I am when we discuss upsetting topics and that's it. Somehow it made me wonder if others do really respond as expected.
I've had a few sessions with a counsellor as part of the ASD assessment now, she has mild ASD herself. No idea if it will help but she is the first counsellor who doesn't constantly get things that I say wrong. She sends me a letter after each session summarizing what was said and I'm absolutely amazed how accurately she describes my feelings. It's just what I've said really, so in a way I would have expected everyone to get it right, but perhaps the others did listen, then interpreted it the way they or some other people would feel and then concluded that I felt the same but couldn't express it adequately (maybe because I'm not a native speaker or so). Guess someone who constantly gets me wrong will never be particularly helpful, so chances may be better this time.
So to make it short, I totally agree with QuirkyFriend that you need someone who has experience with people with ASD, otherwise they will be busy all the time making you fit into their (rather rigid?) concept instead of developing a concept around you.
British Association of Psychotherapists. If they say they have experience of ASD on their listing ring and ask more about their experience.
Finding the right fit for therapy is hard work. You want someone who understands you but is also willing to challenge you.