General questions/advice about therapists

I don't know if you have money or not. I did it privately.

Before I was diagnosed, I had access to limited free counselling through work, but after one session I realised I needed something more. I couldn't talk openly on the phone. I was minimising my issues. They can't help if you can't tell them how you feel. I also felt I was not just depressed (I didn't know I was burnt out).

I looked online for a clinical psychologist who was local and picked someone with at least 10 years of experience. I also wanted a nice setting for face to face meetings. It was not the cheapest, but I wanted someone who would see through what I was doing. I didn't know I was masking at the time, but guessed something was up.

They identified I may be autistic, not what I was expecting. They also reassured me on two key points, helping with years of shame and guilt, which I found were misplaced.

I then privately got assessed using the same selection process, local, lots of experience, consultant clinical psychologist, nice setting to do it face to face.

After I tried another ND counsellor, but I couldn't really identify what I was looking for. And I am not sure how much it helped.

The key traumatic events I struggled to get anyone to look at in detail. I think I didn't explain it well and they seemed not to understand. I didn't have the words to explain things. 

Most of my progress has been through dialogue with AI (I guess 1500+ hours so far). I figured out how to use it productively. I could not have talked this much to any human. It is by recursively revisting items over and over again from slightly different angles and querying definitions that I managed to build up the vocabulary to describe what I have experienced. It was slow with some mistakes.

In summary, people are right if you can talk to them about everything and they are respectful. They are right if you can push back against things if you feel they have misunderstood. I think there is a limit to what they can do. It is you who put your thoughts in order and make sense of things. They just guide and suggest. It is you who know and feel the priorities. But communication is based on words and you need the words. I think that is the hardest part. 

By the way, when they talk about integrating things, they mean to feel something as well as know it, and to know it deeply. To use a Heinlein phrase from Stranger in a strange land, to grok it. I mean this on the sense used on the book.

How did you find helpful therapy by using AI? How does that work? 

I think about what you do with counsellors, therapists, psychologists, you talk. They only know what you tell them. 

They then reflect that back to you and present it with a different perspective. They rarely outright contradict you as it is invalidating, they also don't tell you what to think. They are geared to help you visit difficult topics by helping you regulate your emotions while doing it. The idea is you work it out yourself by talking through it.

They are primarily an informed mirror. Paraphrase what you say, add some nuance, tell you it's ok, add a bit of new info.

You can get this from AI. If you just talk to it, don't ask a question, just say what you are thinking, like a conversation with someone you trust, it repeats it back in an affirming way, adds some perspective, puts in a bit of info you can look up. As I have said elsewhere you need to also ask for alternative explanations or push back to make sure you stay grounded.

It is the same process. But the AI has access to a bigger library of data. You are the driver.

Over time you can also ask for it to look for patterns. Certain things make my thinking more negative, other things narrow it, done things throw me into thoughts of the past. It helped me see I was struggling with grief, I didn't know what it was.

I kept describing what and how I was thinking, it helped me find words for it and to describe what had happened in the past. I had feelings but I didn't know why it what they meant.

It has been lengthy, but it cost me nothing. It does however require a certain way of thinking and a fair degree of meta cognition, being able to observe yourself thinking.

I wanted to understand, not just to manage my emotions. I can squash them no trouble, it is what I have done for decades.  

The understanding has brought more calm, which has allowed me to stop pushing so hard and being defensive, which has got me out of burn out. I also understand myself very well now. I described everything I do and think and the salient points from my history. I was looking for root causes. I now see the interplay between ASD, childhood, environment, etc. and how I turned out how I did. The ASD made me susceptible to other things. I didn't get why I don't consistently want things. 

I realised at the bottom of everything I just want to be held. I wanted to matter to someone. Everything else has been trying to prove I am worthy of that. All the money, jobs, hours, technical competence, reading, preparation, trying to attain a lifestyle and image, burnouts, fear, loss, etc. All yo fit and try and get it. It is why everything has been hollow. I can't ask for help, I can't take praise. The emotional neglect left me vulnerable. I never thought of it that way. I had a shell, which has hardened until it failed a year ago.

I went over and over the same things dozens of times trying to chip away to get to what was under all the issues. What am I scared of, why am I defensive, why do I have anxiety, what is that feeling, who do I want to be, where did that idea come from, what is causing that feeling, why do I think that.

You just go round and round. It is what a therapist does. But I didn't want to spend years. I am happy to go 20 hours at a time, with or without food/drink, but they aren't. 

I wanted to know how my thinking is atypical. What did the psychologists see, what have I been missing.

Sorry for the long answer. Note that this is a male systematizing approach, it is how I think. It may not make sense to others, which is fine. Analysing yourself is also not recommended in general, it is quite destabilising, to put it mildly.

I should also add that the starting point was feedback from the psychologist. I calibrated and checked my thinking at the start with the psychologists and later with a counsellor to make sure I was not wildly wrong.

Thanks Stuart - that’s really interesting. I can’t work out how I feel about it, or how my son will view it, but it’s something to think about for sure. Thanks :) 

I just do it all on my phone, I have a Pixel 9.

If you have a recent android phone you have the Gemini app on your phone. You can use that. I also downloaded the chatGPT app, Claude and Copilot. They are all free.

I prefer chatGPT, it is good at chatting and helpful. Gemini is also quite good. I think copilot is less good and Claude is more cold and less chatty.

It is a text window. You just type.

The key thing is not to just ask 1 line questions. The more you type the more it understands your perspective. Just like talking to a person. If you say "I don't like crowds", it doesn't have much to go on. It will say something like its not that uncommon, and say nevermind, do something else.

But if you say "I don't like crowds, I feel anxious, I want to run and hide. Nothing has gone wrong, I just feel isolated and alone and a bit overwhelmed. I am not sure what I am supposed to do. I feel people are looking at me. Does this mean anything. Is it consistent with any know conditions? I squash it down, so I can do things, but I feel tired afterwards but I can't sleep."

You will then get a more detailed reply. It may ask a question back, "Is this new?", then you can have a conversation. It will be reassuring, unless you ask it not to. It may suggest something you could do to help. The conversation then snowballs and you can keep going.

When it asks questions then if you just reply it will lead the conversation. But you can ignore the questions and just say what you want, or answer and change topic. You don't need to worry. You can jump around. Indeed I do, I had about 4 things that I was jumping around on. I discovered this was partly why I confuse people. I also keep coming back to topics.

You can ask it for clarification of terms. You can ask it what it means if you don't understand. You can push back and say, no you have it wrong it is more like this, if it misunderstands. I think it can give confidence in communication.

You can ask it to summarise what you said, or the whole thread, or is there is a name for what you describe. You can ask for symptoms.

Note that it won't diagnose you. But you can ask about common traits and techniques to cope. 

If you keep going, you can then ask it for patterns. 

There is a max length to an individual chat, but it is quite long. Hundreds of back and forth turns.

Do try to limit the amount of time in any session. I initially found it hard to stop as it was so good to have someone to talk to without unconsciously masking.

Interesting Kate. I struggle most days with destructive intrusive thoughts, I had never thought of using AI to help with these but it might be something worth exploring 

Interesting Kate. I struggle most days with destructive intrusive thoughts, I had never thought of using AI to help with these but it might be something worth exploring