I've had therapy and counselling a few times in my life for social anxiety, but it's ineffective because they're trained to councel neurotypicals. I'm autistic with ADHD.
Is there no autistic therapy on the NHS? (With a therapist who is autistic and trained to councel autistics). I could only find one such service on the website and it's private only.
If they exist, how do I access them, please? I feel like only a neurodivergent therapist could help.
The NAS have outlined how CBT could be adapted for us autistic people in this document:
So many responses and so many on the same page, thank you!
My most recent CBT therapist was lovely and she taught me some things about the mechanics of FFF (fight, flight and freeze) which was fascinating and I'm glad for the knowledge. She diverted from the usual tactics and went into identifying what my main stress factors were because I'm alexithymic and struggle to identify my stress.
In my final session she told me that I was right, my fears, worries and stresses were all rational, I just need to find a therapy that helps me to tackle situations before they spiral, but the existence of such a therapy has been denied by the people I've spoken to.
Might NAS be able to talk to NHS and discuss the foundation of a cognitive management therapy for neurodivergents?
I think there's often a lot of working out what people are expecting of me so i can play along.
Yes this is part of masking where we are people pleasing instead of showing our honest responses. I don’t really understand why some people can get offended if you say you don’t like their present, it’s just a preference.
You're right about animals and I feel sometimes I can intuit with my pet more so than my partner can.
Pets can be very loyal too, this can help to balance out the unpredictability of humans. What pet do you have? As the saying goes ‘a dog is a man’s best friend’ (if you have a dog).
I discounted Luke Beardon when I first read it but now I can see I think I'd been brainwashed by CBT. Now I think he's spot on.
Luke Beardon’s work is definitely accurate, he has such a great understanding of our autistic community, even though he is not autistic. I already have one of his books ‘Avoiding Anxiety in Autistic Adults’ it is so brilliant and useful, I have highlighted and annotated multiple sections and have asked for one of his other books for Christmas. Luke’s Beardon’s work is very simple really because as humans we are all products of our environment.
Thanks, it’s great that you were able to find an autistic counsellor who understood you and that some strategies from CBT are useful for you.
The present receiving example is a good one. I think there's often a lot of working out what people are expecting of me so i can play along. Like when someone's telling a story and I don't know what they're talking about or can't tell if it was positive or negative so how to respond. Or other times I feel my response is over the top and the falseness makes me uncomfortable.
You're right about animals and I feel sometimes I can intuit with my pet more so than my partner can.
I discounted Luke Beardon when I first read it but now I can see I think I'd been brainwashed by CBT. Now I think he's spot on.
I don't regret anything because I didn't know at the time all I can do is move forward.
I hope you eventually found the help you needed.
Yes definitely anxiety does depend on the root cause.
‘I think it does depend on the root cause. Ive realised that people by their very nature are unpredictable and I need a huge amount of certainty. I think some of my "social anxiety" isn't about worrying if people think badly of me, it's that I cannot read if a situation is ok. I need definite signals. Even with people I am mostly very comfortable with’
Humans are incredibly unpredictable and difficult to understand sometimes, I think that’s why some of us autistics have a deep and very natural connection with animals. Animals are usually much simpler and calmer and they have no expectations of you providing you meet their basic needs.
Yes some of social anxiety could definitely be based on confusion in NT environments because a lot of the time signals are conflicting. I need definitely signals and honesty too, I am not great with implication.
A common example saying thank you for a present even though you face says you obviously don’t like it or responding to the question ‘how are you?’ with ‘fine’ despite the fact that your face.
No you know you are autistic I imagine you regret putting yourself through situations which caused sensory pain/overload. The realisation of being autistic hopefully means you can be kinder to yourself.
Yes I understand what you mean about anxiety and being in the right environment. To quote Luke Beardon’s brilliant golden equation- ‘’Autism + Environment = Outcome’
It’s great that you had an excellent experience with a therapist, that must have been beneficial for you.
I think it does depend on the root cause. Ive realised that people by their very nature are unpredictable and I need a huge amount of certainty. I think some of my "social anxiety" isn't about worrying if people think badly of me, it's that I cannot read if a situation is ok. I need definite signals. Even with people I am mostly very comfortable with. Also the feeling of being overwhelmed by information and the sensory aspect....you cannot desensitise yourself to it. I have put myself through this regularly because I was masking and didn't know I was autistic. So in effect doing my own "exposure therapy".long before I'd had CBT. Anxiety got worse not better because it wasn't the right environment. I also think my "GAD" was there but masking autistic burnout and stress. This was never picked up but also I sometimes have difficulty explaining myself to get across what I need.
CBT has given me some tools though which work in the right context. I had an excellent therapist overall. I've taken part in group sessions and online stuff. I never felt listened to with those and it made me worse. I was made to feel my thought processes were irrational but it seemed to me that I was the rational one.
And rational indeed in the face of the different information our sensory systems give us. There is no 'differently thinking' or CBTing that away. It's more akin to the person with a physical ailment living daily with extreme pain. It's about coping with our reality not thinking our way to pretending our reality does not exist.
Yes indeed we do need NTs to understand, especially in mental health as especially as so many of us remain unidentified for so long. We cope until we don't. At that point an autistic person who has no clue they are autistic will land on the steps of mental health services
Yes exactly, we usually are identified as autistic when we are struggling and in significant distress. This is because the diagnostic criteria is based on a distressed autistic person instead of an an autistic person who has a positive autistic identity and is in a supportive environment. Therefore many young autistics perceive being autistic negatively because of the situation they were in when they were identified. Their introduction to understanding their own autistic experience is often negative.
At that point they are vulnerable to misdiagnosis and effectively being gaslighted by services designed for an NT mind - oh boy, have I been there?!
I understand what you mean about being vulnerable to misdiagnosis because at that point you probably have no energy/potential ability to think clearly in order to question your diagnosis. I am sorry you have had to experience this, that must have been be very difficult for you. Now you know you are autistic that must have lead to a lot of reflection and reframing of your experiences.
If they could get as far as seeing us when we present - in an ideal world, then get us a speedier route to diagnosis and point us toward autistic therapies, developed by autistic people and delivered by fellow autistic people, that would be great AND save them a shed load of time and resources.
Yes this ideal world sounds perfect, our own Autopia!
But if they were at least well informed enough to recognise that when we can't relate to or get anything out of their therapies we aren't naughty, challenging or non-compliant children, we just might have a different neurology altogether and be quite rationally anxious in an alien world.
Yes it’s so important to understand our different neurology and that the strategies that typical therapy uses are often not beneficial because they are only based on one perspective/solution to a situation. Also understanding of our neurology and why our needs differ could take quite a while because often mental health services still operate using the medical model, this is one of the reasons why the basics of CBT are about changing your thought patterns. Our anxiety is definitely rational given we exist as a minority culture and that often clashes with majority NT culture and ways of being human.
Yes indeed we do need NTs to understand, especially in mental health and especially as so many of us remain unidentified for so long. We cope until we don't. At that point an autistic person, who has no clue they are autistic, will land on the steps of mental health services. At that point they are vulnerable to misdiagnosis and effectively being gaslighted by services designed for an NT mind - oh boy, have I been there?!
But if they were at least well informed enough to recognise that when we can't relate to or get anything out of their therapies we aren't naughty, challenging or non-compliant children, we just might have a different neurology altogether and be quite rationally anxious in an alien world. If they could get as far as seeing us when we present - in an ideal world, then get us a speedier route to diagnosis and point us toward autistic therapies, developed by autistic people and delivered by fellow autistic people, that would be great AND save them a shed load of time and resources.
I've tried three therapists.
One had an autistic step son, which I expected meant she would be more understanding but actually she wanted to "cure" me.
One was autistic herself. She helped in some ways, but when I tried to explain the difficulties I had with my mother, she spent 20 minutes talking about her own experience which was the opposite of mine- she had to learn to see her mother as a person, while I was struggling with the fact that my morher was too much person and not enough mother.
My current therapist is NT, but he works with a person centred approach that validates what I say and he is willing to adapt to what I need. For example, when I explained that I had difficulty understanding what other thought about me and couldn't read their reactions, he went on to clearly and specifically state his positive feelings about them. I have never felt so very seen in my life.
I've been seeing him now for 6 months, as opposed to the other two who lasted the 6 week minimum. It's really working with him. He also lets me do once a fortnight as once a week is too much pressure and gets me fixated on the issues. The longer break lets me wind down in between. Also we work online, which means less stress of going out and all that entails.
So I don't think it's so much about the neuro status of the therapist themself, but on how much they are willing to listen and understand.
This is why, even after CBTing myself through a situation, I am still anxious. I understand we can thought challenge stuff but it often doesn't work. I have kept myself in anxiety provoking situations TRYING to CBT without syccess. Sometimes it does help but it depends on the root cause of anxiety.
Yes I understand. Keeping yourself in anxiety provoking situations as part of CBT is about tolerating your anxiety because sometimes therapists think you will be ‘desensitised’. This can work for anxiety like OCD sometimes though, like you say it depends on the root cause.
This doesn’t work for autistics because firstly our nervous system works differently and cannot be desensitised, our responses are natural and instinctive and secondly by listening to our anxiety and leaving situations we can understand our autistic neurology better and set boundaries. Leaving situations that are distressing/anxiety provoking as an autistic is self care.
After that, I had an autistic counsellor and it was one of the best things I've ever done. You can also go on BACP and filter through therapists who specialise in autism. I don't know ...I dont think it matters how much an allistic person knows about autism but I don't think there's any comparison to lived experience.
It’s great that you had a positive experience with an autistic counsellor, this just further highlights why we need contact with other autistic counsellors who understand us on an instinctive level. The foundation of good therapy is building a trusting relationship and that must have been so much easier because you didn’t have to explain autistic experience.
I completely agree with you about lived experience, we are the experts on our own autistic experience!
My anxiety was not disordered or in need of treatment it was a result of being in an environment that was not autistic friendly
This is why, even after CBTing myself through a situation, I am still anxious. I understand we can thought challenge stuff but it often doesn't work. I have kept myself in anxiety provoking situations TRYING to CBT without syccess. Sometimes it does help but it depends on the root cause of anxiety.
After that, I had an autistic counsellor and it was one of the best things I've ever done. You can also go on BACP and filter through therapists who specialise in autism. I don't know ...I dont think it matters how much an allistic person knows about autism but I don't think there's any comparison to lived experience.
You may find this video interesting, it is about the importance of autistic social identity for wellbeing:
The video is brilliant!
We need seperate sevices run by other autistic people.
Yes I completely agree, we need our own Autopia! (perfect world for autistic people).
Having said that, in our current society we still do need neurotypical people to understand autistic mental health, including overwhelm and burnout. Neurotypical therapists should also understand what positive autistic identity and mental health looks like and how connections to our own community, culture and unmasking can really help us to improve and maintain our mental state.
From my experience, connecting with my own autistic community has been invaluable, really positive and given me a very strong sense of passion, belonging and collective identity. I feel very proud to be part of my autistic community. In my own opinion, connection with my own community is the best source of support for my own mental health.
