How do you find talking to therapists?

For about maybe seven months now, I've been using BetterHelp for private therapy. I can't say I've found there to be any progress, though I'm not sure I'm going in with the right expectations. My therapist tries to get me to reframe my thoughts. Use less negative language, try to imagine more positive outcomes to situations, that sort of thing. "What would it be like..." is her common language for this. To which my response is often along the lines of "Well that would be unrealistic because xyz". She also tends to point out my "yets" as hopeful, despite my assurance that it's just to avoid an absolute statement. I can't tell if I'm being too rigid and set in my ways, if her approach is ill effective for autism, or a bit of both.

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

  • I don't talk to them, I'm sure I'd find it difficult and uncomfortable. 

    You say she asks you to imagine more positive outcomes, but if your experience is that most outcomes are negative, maybe you're going to feel like you're kidding yourself? 

    I don't know what sort of things she suggests to end the statement "What would it be like..." - it sounds to me as if she's suggesting you try a different way of thinking or of doing things? If so, you don't know if that will help until you do it, and for people who have poor mental health and low self esteem I think they may struggle to imagine that anything will make their life any different.

    Feeling happy or contented relies on us leading a life that feels like we are achieving something and that we have support from people who care about us. If you're not happy with your life, in my opinion you have to change things in your life first, then the way you feel will change. For example, if your job is causing stress, think about another one you could do that you'd prefer. If you missed out on further education and think that would help you get a better job or raise your self esteem, look into courses and funding/student loans. If the people in your life are causing you to be miserable, think about whether you would be happier without them. If you don't have friends or feel lonely, look at what you can do to gain friends - joining groups that do activities you enjoy, for example.

    It's only my opinion - I'm not a medical professional so please don't take it as advice - but I think that therapy is just a crutch to try to get people to carry on just doing the same thing, pretending that the way they think about it will make them happier. Maybe it does for some, but for me only practical changes have ever helped.

    I hope things improve for you.

  • I see a person-centred therapist who's also autistic, which makes matters much easier.

  • I think your therapist is right to try and get you to reframe your thoughts, it sounds like your thoughts are a railway track with stuck points and everytime someone wants to go in a different directions you shoot off down the negative track. It sounds ot me as if she's trying to help you with catatrophising, somethine which autists are really good at and believing that the worst case scenario will be the inevitable outcome of any action. It's a really hard cycle to get out of because it all seems so logical and experience based, but it dosen't have to be this way, you can have other options and experiences than this doom loop. I wonder if like many autists, when you think about doing something new or different, a negative outcome is easier to imagine than not knowing what the outcome will be? Us autistic people often aren't very good with the unknown and the unpredictable, we want consistency and constancy, when in reality we have to get our heads around the fact that the only constant is change.

    Stick with it and try and allow yourself to imagine a scenario where things go well, you don't have to tke it outside your head yet, but just let it sit there for a bit.

  • I find it can be very easy to take responsibility for my difficulties, because the world has taught me that I am different and often wrong, and I've internalised a lot of this. Any relationship is at least two-way, and that includes therapy relationships. It sounds like your therapist hasn't found a way of working with you that fits in a supportive way with who you are, and I'm wondering if there's an option to try a different approach (with this therapist or another one). Also wondering if you have a sense of what you mean by progress - what would that look like for you? (You don't have to answer here unless it would be helpful). The Neurodivergent Therapists directory has some amazing people. Sadly the fees can be a real barrier but maybe worth having a look? I hope you find the right person, I've found it can be so transformative. 

  • Ive done a number of months now and have found it has generally been good. It's however not what I expected in many ways, I thought I'd just be told the answers, but realised it's about working with the therapist rather than being "taught". having shifted my expectations a little I have found Being able to offload, get some validation on my own opinions of my state, or not if it turns out I'm wrong, has been really good. 

    Initially I also thought it would be more focussed on my autism and how to manage that specifically. But the fact that it's more focused on my mental health, which is impacted by my autism, is actually helping. 

    In all honesty, Took me a while to realise mental health and neuro divergent  conditions are two different things and that mental health is the "state" we are in, it's the stress, anxiety, depression that anyone can feel as  result of something happening and how we respond.

    There's many things that are the same for everyone when it comes to mental health, it's just the causes and our reactions that can differ due to conditions like autism, so many of the methods will work, while others won't as the conditions violently over rule the generic methods. I've also heard that some "generic " methods can actually make things worse for autistic folk.

    I too tried CBT via the online program that the NHS provide, it had a few useful pointers and I think provided some mechanisms to help cope with generic stuff (fight flight being triggered, too much forward thinking or looking back , mindfulness etc ) but generally I found being autistic, my reactions to certain things really don't fit, so in some cases the methods stood up like a candle in a hurricane.

    It's really interesting hearing other people's experience and opinions on this. Always up for a good book too if there's any recommendations. I had started on "unmasking autism" but I found it hard to get into somehow. 

  • I recommend the same book as Bunny. It can help you work out if your therapist is a good fit. Some neuro typical techniques don't work as well for us. Before my therapist moved I ended up accepting that she was good for venting/talking but maybe not great for fixing. I really liked her and was sad to see her go. Talking was still good. In the future I would look for a therapist that had autistic experience.

  • I've had mixed experiences: pre-diagnosis, I didn't find CBT at all helpful. Post-diagnosis, I was much better informed about what to look for from therapy or counselling, thanks to the book below - and I'm now benefiting from ongoing sessions with a counsellor who is also neurodivergent themselves.

    You might also find it helpful to borrow or buy this book, too. It includes discussion of various types of therapy and counselling, together with advice on choosing the right therapist or counsellor - all from an autistic person's viewpoint. Several others here have found it very helpful, too:

    The Autistic Survival Guide to Therapy

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