How do you find talking to therapists?

I can see how CBT could help some people, but the way it was administered was very algorithmic and didn't involve any listening on the part of the therapist. The goal of identifying and changing self limiting beliefs and behaviours makes sense but it has to take into account specific challenges individual patients may have, and this includes taking account of the impact of autism (and ADD in my case). The therapist really just had a checklist she was working through and displayed no obvious understanding of mental health issues (or basic empathy). I have since read that CBT doesn't work for most autists.

The person centred therapist, nice as she was, didn't help guide me toward anything. Each session was basically her saying "what would you like to talk about today?" and then me rambling for an hour.

This is why I thought a coach might be a better option for me.

Iain said:

I would be looking to find out why I cannot get to reach the understanding when guided

This is assuming the guidance was there.

I read an article a couple of weeks ago about how unregulated the psychotherapy industry can be. I think it's important to find someone who is registered with BACP. 

Deleted User said:

She didn't offer any help, guidance, advice.

This is the way therapists are trained - for meaningful breakthroughs they need to guide you to make your own discoveries / revalations otherwise the process is quite disempowering.

There is a good article explaining this here:

https://www.psychologytoday.com/us/blog/relationship-and-trauma-insights/202212/why-your-therapist-isnt-giving-you-direct-advice

In your shoes I would be looking to find out why I cannot get to reach the understanding when guided - there may be something blocking your self reflection (self sabotage perhaps) so I would put some effort into unpacking this as it may help you connect with the normal processes in the end.

I was about to create a similar thread when I found you beat me to it.

I was in therapy before my diagnosis. Remotely delivered CBT therapy provided by my work. It was dreadful. It was basically me spending an hour every week being told I'm wrong about everything and need to try harder. It was gaslighting and I think it damaged my self esteem.

I later spent six months seeing a "person centred therapist". That started a few months before my autism diagnosis and ended a few months after. She was lovely and it was nice talking to her, but all she did was listen. She didn't offer any help, guidance, advice. Any random person could have done that and charged a lot less.

And for the last couple of months I've been seeing a coach instead (something a few people on here have talked about). I have one session left. And it's led nowhere. Again, no real help or guidance that wasn't completely obvious or freely available with a simple google search.

It is possible I have been unlucky three times, but I now feel that therapy is just a racket that unskilled people use to extract large sums of money from vulnerable people.

I'd love to be told I'm wrong.

There's several different therapy styles and finding one that suits takes time. My therapist is good because she replies in absolutes, making it clear that it's her views on what I've said, and avoids too many "thinking" questions. 

This means for me, she challenges me, and gets me to do all the heavy thinking to reframe my thoughts by telling me where I'm going wrong, and if I can't see her viewpoint, we discuss it.

Mind you, my main therapy focus is cPTSD, and I'm tackling a handful of events at a time from various points of my life. Plus she's both an ASD and trauma specialist, so she directly fits my needs.

A "person centred" approach worked well for me for a while. It is clinically recognised (in a NICE guideline for clinicians) that CBT needs adapting for autistic people. Of course that doesn't help if: 1) autism hasn't been recognised, or 2) if the clinician isn't aware of or isn't bothered about professional guidelines. Applying "normal" CBT methods is probably going to be hard or impossible for most autistic people.

That's awful! I guess I've been lucky with my therapists, apart from one. I think I probably subconsciously apply a very quick test. If they aren't actively listening and taking me seriously I'll pull the plug straightaway, as there's no way that would go anywhere. That happened once, when someone was more keen to lecture than to listen.

Thank you.I've never been a big believer  in it , due to the ridiculousness of it being  touted as a solution to a 1001 different things . 'Late middle aged/just become a pensioner?  Suffer from botty pops that repeat and repeat? CBT will solve that problem'.

I see a person centred therapist myself. It's very unstructured, it's more like just having a conversation. It works way better for me. 

FM, That's awful and abusive of the practitioners to do that to you, someone who's already vulnerable and seeking help.

With my more recent therapists, whilst I've been happy to tell them of my traumatic early life experiences, I've also told them that unless they're intruding into whats happening for me now, I dont' want to go back and revisit them as it just retrumatises me and is unhelpful. Some accept this and others don't and see it as denial or a scab to be picked at, instead of a well healed scar that's just there. I won't see the ones who insist on picking at the long healed scars.

The first therapist I ever saw just sat there not looking at me and looking totally bored, I think I only went to about 3 sessions as I felt better talking to my cat who at least mrrped and purred in the appropriate places.

I never found CBT worked for me either, what it did do for me was symptom subsistution, I'd gone because I'd had to give up driving because of panic attacks and nightmares, I'm able to drive again, but under limited circumstances and never on motorways, but I developed social phobia. It's almost the exact same set of fears etc, just transfered onto a different situation. I certainy wouldn't have it again and I'd be sceptical about recommending it to someone else.

I've seen quite a lot of therapist since childhood. It's been pretty mixed. I think my best experiences have been with RMNs and the worst with GP surgery counsellors.

One once seemed so focused on the importance of a trauma anniversary date it caused me quite a bad breakdown. I think I would've let the day just pass if she hadn't kept bringing it up and she wasn't offering me any skills or additional support, just asking how I felt about the day, making it much more significant than it should've been. But others have saved my life.

One of the main problems I find though is only so many sessions (sometimes as little as 8, that barely gives chance to get started. The longest I've seen the same person in adulthood was 18 months with a few follow-ups afterwards) are offered with the NHS, then you're just left on your own until the next referral comes through. 

I did briefly try better help, but gave up after 3 sessions, I should've asked to change therapists as that was an option but I just didn't.

 I've never found CBT helpful, just invalidating. DBT has been very helpful for me. I've completed it before, but many years ago as an inpatient, I probably wasn't in the right place to fully embrace it back then. I'm currently in outpatient DBT and it is a revelation (hardworking though, so much homework!). Maybe it also helps that the RMN I have my in person 1 to 1s with is the one who spotted and facilitated my ASD diagnosis and is able to modify the therapy for me, so I'm pretty lucky there. You only get about 15 months though, so hopefully I'll be 'cured' within the next 6 months

I do find it very hit and miss, but generally having someone I can talk to without judgement is very helpful. It helps put things into perspective for me and helps me figure out what I'm feeling (alexithymia). Sometimes I find they can say something seemingly small and simple that just makes me stop and go 'oh, why didn't I think of that'. 

But it is hard work, and as I am constantly reminded, they are just there to guide me, it's up to me to implement the changes and find my own eureka moments, they are not going to hand me all the answers.

For me being in therapy makes me feel safer, like I have a safety net, someone to hold me up when things get too bad, who I won't have the added guilt of putting my emotions/thoughts/behaviour on. But it has to be a good one, a good fit to work. You need to be able to trust them, that they won't judge and that they will catch you if you fall.

Those sound like terrible experiences, and certainly I can see why you'd be untrusting of therapists with what you've been through.

I've seen 2 trained therapists, and an untrained day centre worker who was supposed to help with my anxiety and lack of confidence/self esteem. The first therapist was foreign(European) with less than adequate  verbal skills. He came out with comments like 'All boys rebel against their mothers by the time they are 7'. I had a very disconcerting session where he said nothing to me and I couldn't initiate a conversation. That went on  for 20 minutes! Those sessions ended when I caught a bug/had flu and couldn't attend. My wife phoned on my behalf and was treated like crap. There was no way I was going back after that.

The 2nd therapist hit me quickly with two major whammies (1) He was seeing me because the rest of the psych team were fed up with me (2) 'If you  want to be a good person..' as though I was a criminal type of person. What I needed and wanted was help to cope better with stressful situations.

The third person,a woman, told me I lacked confidence and then oafishly went out of her way to criticise me. After 4 sessions or so she announced that she was a member of a 'small religious sect' . I   wrote several pages that were aimed at getting her to know me better, and stop the crap she'd been  coming out with . That offended her religious sensibilities, and she reported me to my care coordinator. That was an awful,psychologically triggering, situation, as thanks to an incident at prep school, when I was 9, being reprimanded or punished when I've done nothing wrong is a major trigger that has a bad effect on my mental well being.

After all that I very much doubt I could ever trust another therapist/untrained 'therapist'.

Hi Cat, thanks for your reply. I'm glad that therapy has helped you - I'm not against it at all, I just can't see it working for me. But we're all.different

That sounds like CBT. It works well for a lot of people. But I don't think it works so well for me, because the 'reframing' feels like criticism or gaslighting, which I have received enough of anyway, in life. It also seems kind of superficial - like, I can explain the 'right way to think' about a situation but that doesn't necessarily make me believe in it.

By far the most therapeutic way I can interact with someone is for them to truly listen to me and give me space to express thoughts and feelings in a natural kind of conversation. I know some autistic people like structured sessions with a clear goal but I need it to be only loosely structured, in order for me to build up the nerve to say what is really bothering me. If it's too structured, we get nowhere because I will stick to what I am (relatively) comfortable talking about.

I think it's a 'person-centred' approach but I'm not sure about the terminology.

Oran G. Utan said:

For anyone that uses a therapist, how do you find your engagements with them?

I had 2 therapists with only a passing textbook knowledge of autism and they were no help but when I found one who had autistic children herself and understood the issues in depth it made the world of difference.

Your therapist sounds like they are using techniques that are known to be ineffective for most autists so I would ditch them and find one who understands our minds better - one who has taken that journey with autists before and who knows the issues deeply and personally.

That being said, they don't need to be autistic themselves - in fact that may make them less well suited due to the risk of them being triggered or having their own issues.

I find with the right therapist you can tell them at the start of the session what you want to focus on and be able to pause during the session to say "are we staying on track here"? to stop the conversation veering off course. The reason can be that we sometimes subconciously sabotage talking about sensitive stuff by steering the conversation to something else.

If the relationship feels right you can tell quickly. I found being treated as an equal (but different) adult and being open to having my assumptions challenged from time to time got me thinking in the wayt that allowed the difficult stuff to be dragged into the light and looked at analytically.

When appropriate talking through emotional responses to things and being willing to be vulnerable were approaches it took some time and patience with, but the results were quite remarkable for me personally.

For the negative stuff, when this is looked at in a cold, analytical way it becomes clear to me that this was a fear response and when reviewing situation after situation it was clear it was either unhelpful at the least and damaging at the worst so learning to let go of it was a relief.

I think you shoud be able to talk comfortably with a therapist about all this sort of stuff and haven open conversation where you get to ask anything and they can do the same with no opt-outs. If it is difficult to talk about then there is a reason and you need to open up that reason to understand it, so face the discomfort in order to progress.

That has been my experience and my thoughts on your situation.

Pixie, if done properly therapy isn't a crutch it can be life changing and life saving, having someone walk beside you through your personal tanglees forest and ask if thats wood or a tree can make you see things from another perspective. A therapist is someone you can be honest with, but who dosen't know you outside of the therapy room and has no biases or preconcieved ideas about you. They can also be someone, who in a crisis, holds your hair out of the way whilst you emotionally vomit, this in itself is good, you don't need all that stuff inside you and having a safe space to let it out is good.

I've had a few years of therapy on and off, and whilst I can't say life is always a bed of roses, I do feel better about myself and when the negative self talk starts up I have tools to deal with it, like reality checking. That is, I have a thought about myself or a situation and the doom loop starts, I've learned to pause and ask myself how likely is that to happen really? Therapy has given me tools and taught me how to use them to fix myself, different therapists can have a different tool box too. As to worth, well how do you measure that? For me it's not being haunted by ghosts of the past so much and held back by them, the ability to hand back the negativity to someone that they have placed on me. We all have someone like that, often a teacher or someone who's inner nagativity was stuck on us and stayed and been internalised, it's not nor ever was ours, things like empty chair exercises help to shed give it back to the person it belongs to. It sounds daft, but it really does work, it's very powerful to be able to stand in your adult self, hlding your child self by the hand and saying to that person, 'how dare you lumber this child with such rubbish!'

Yeah I think you're head of me on the train of thought I was going down. I do want my therapist to give me that eureka moment where things all come together and make sense. But it doesn't seem like that's going to come, and that's probably my expectations being misaligned.

I did also want the treatment to be focused on my autism. It seems like it makes sense, but maybe I need to loosen up on that idea to give room for other things.

You're right, I do catastrophise pretty well. The roadblock I put up for myself is "What if I commit to all of these changes, and find out none of it was worth it?". And yeah it definitely feels like a reasonable line of thought based on logic and experience. I want to have the outcome guaranteed before I try, which life rarely allows us.

For me, not knowing what the outcome will be is a negative outcome in and of itself. Even if I do something experience has taught me will turn out fine, like getting on the bus and going to the local retail park, leaving to do it feels like stepping into the woods at night, watching and listening for predators for that off chance something does go wrong.

I'll stick with the therapy for now. If nothing else I've got a sunk cost fallacy going on where I really want to extract something valuable from it.

Not knowing if something will help until I try it, has been a pretty big issue for me. I feel like it negates our ability to evaluate a situation and make an educated guess at the outcome. Yeah, in the end it's just a guess, but if those guesses consistently show up as correct, then it's hard to give the situation reasonable doubt the next time.

I guess brass tacks is that making changes is the only thing we can do, so I agree with you there. I have negative biases I need to be able to put aside in order to explore those changes. And yeah your interpretation of therapy is a thought I've been lingering on. Ultimately if I'm not the one making differences, then the therapy is just spending money to vent.