Psychologist/Psychiatrist For Asperger Adult In DFW area?

[amfh]

Hi, new here, and not sure where exactly to post this request for help, so I'll start "Generally".

Can anyone recommend a psychologist/psychiatrist/therapist is really GETS adults with Asperger's Syndrome in the Dallas-DFW area?

Our son is 35, lives independently in his own house, has worked in his job for 11 years. He was dx'd with Asperger's at age 9, the first year it appeared in the DSMIV (I realize AS has been lumped into ASD now). Lots of intervention early on, and he was always mainstreamed in school (recommended by his therapist at age 5). Very high IQ, in T & G classes, went to college but could not cope.
It would take a little while for you to realize he's on the spectrum if you met him today.

Bottom line: He still experiences pretty extreme social anxiety. He self medicates with alcohol (he also takes a prescript drug - not a good combo). He doesn't drink to excess EXCEPT when pressured socially.
Long story short:
He has asked me to help him find a new therapist (his last one - since age 18! - have mutually agreed she cannot continue to treat him. She has never really 'believed' he was AS - another long story, just kept trying diff drugs)

This time, he wants a psych who KNOWS Autism Spectrum Disorders. He did do a course of Transcranial Magnetic Stimulation a year+ ago - no help at all. He's interested in Cognitive Behavioral Therapy, or maybe even IOP (Intensive Outpatient Procedure) to help him know how to deal with his social anxiety and not turn to alcohol.
I've looked extensively and many therapists claim to know AS, but I thought I'd come to the folks who REALLY know who does and who does not.

Any help, please? Please?

 

[Mia]

I've found a few listings through the Autism Society of America, for your area.

https://source.autism-society.org/autismsource

My suggestion would be that you call and do phone interviews with the professional, before you make appointments or visit someone. There are very few professionals who specialize in adults with autism. So the search for them may be difficult.

Tips for interviewing:

Questions for Your Prospective Therapist, From Your Own Couch

I'm in Canada, and unfamilar with how things might work in the United States. Although in general I would suggest that you find someone with experience with autistic adults.

 

[amfh]

Thanks so much, Mia, for taking time to reply.
This is a link to resources I had not found before - it is appreciated and I will search the results. At first glance, yes, most seem to be geared to children/adolescents, but we'll contact some individually to inquire about therapy for adults.
Yes. It *has* been difficult to find therapists with experience with adults, which is why I thought to reach out to this and another forum for Asperger's/ASD. Thanks again.

 

[VictorR]

Unfortunately both lists that I would consider come up blank for DFW Metro Area.

That being said, of course lists are non-exhaustive, and many providers also provide services via online meetings so if you're unable to find someone in DFW, maybe someone further out but close enough for an occasional in-person visit might work?

Other Autism's vetted list of specialists who diagnose and work with those with adult ASD, and also with women

Neuroclastic's list of specialists who diagnose and work with those with adult ASD

 

[Crossbreed]

At first glance, yes, most seem to be geared to children/adolescents, but we'll contact some individually to inquire about therapy for adults.

Some who provide children's services are willing to see adults, if you ask.

If there are no services listed in your area, you can call the various autism organizations in your area and get their recommendations.

Autlanders, Thriving Outside of the Box: Finding Support Resources in the USA...

 

[Thinx]

Has he read up on Aspergers and autism himself? My feeling is, a lot of the anxiety we may feel in social situations is due to neurological processing issues that mean we actually can't process the complex communication fast enough, compared to most neurotypical people, which is confusing and disorienting, we may feel exposed and certainly my best strategy in unstructured social situations even after a lifetime of work on this, is to sit down in a corner and wait till it's finished.

Understanding about autism and how it makes my brain different, and quite a lot of therapy over the years, has helped with any issues I can change that may have caused anxiety in the past, but I still can't do unstructured social interaction.

The solution I ve found is to focus on social situations that include structure, like interest groups (including therapy groups) or classes, any thing that is somewhat organised and where I can adequately manage breaks or free time by either sitting in my seat or having a wander about.

Knowing that the cause is neurological and unchanging despite my extensive efforts, and doing therapy around my insecurities, has led to me understanding what I can change and what I need to devise a strategy to get around. That lowers anxiety.

 

[amfh]

Unfortunately both lists that I would consider come up blank for DFW Metro Area.

That being said, of course lists are non-exhaustive, and many providers also provide services via online meetings so if you're unable to find someone in DFW, maybe someone further out but close enough for an occasional in-person visit might work?

Other Autism's vetted list of specialists who diagnose and work with those with adult ASD, and also with women

Neuroclastic's list of specialists who diagnose and work with those with adult ASD

Thanks for trying, VictorR...

 

[amfh]

Thanks, Crossbreed...this comment from your Autlanders link is exactly the problem:
"Do not trust every counselor that says that they know autism." In our search so far, a LOT of therapists/psychs include Asperger's/autism in their list of "conditions they treat". But how to really KNOW? That's why I thought to come to message boards to seek perhaps someone with actual experience of a good therapist.

 

[amfh]

Thinx, yes, he is 35 and was dx'd at age 9, had seen a Yale professor at age 3.5 who first mentioned the autism spectrum. Since then, my life revolved around seminars, (Temple Grandin was an early one I attended), Tony Attwood, many more, to learn about all this pre-internet. My first message board was in 1992 right after we got a home computer. Son is very, very well versed, he lurked on the Wrong Planet message board about 10 yrs ago. He's read all he can. He has learned to navigate the neurotypical world very well, IMHO, and the last huge hurdle for him is the social anxiety issues.
You offer excellent advice, though. But he is occasionally faced with interaction that is absolutely necessary, that he must get through. He needs to learn how not to self medicate with alcohol in order to get through them.

Has he read up on Aspergers and autism himself? My feeling is, a lot of the anxiety we may feel in social situations is due to neurological processing issues that mean we actually can't process the complex communication fast enough, compared to most neurotypical people, which is confusing and disorienting, we may feel exposed and certainly my best strategy in unstructured social situations even after a lifetime of work on this, is to sit down in a corner and wait till it's finished.

Understanding about autism and how it makes my brain different, and quite a lot of therapy over the years, has helped with any issues I can change that may have caused anxiety in the past, but I still can't do unstructured social interaction.

The solution I ve found is to focus on social situations that include structure, like interest groups (including therapy groups) or classes, any thing that is somewhat organised and where I can adequately manage breaks or free time by either sitting in my seat or having a wander about.

Knowing that the cause is neurological and unchanging despite my extensive efforts, and doing therapy around my insecurities, has led to me understanding what I can change and what I need to devise a strategy to get around. That lowers anxiety.

 

[Magna]

Has he read up on Aspergers and autism himself? My feeling is, a lot of the anxiety we may feel in social situations is due to neurological processing issues that mean we actually can't process the complex communication fast enough, compared to most neurotypical people, which is confusing and disorienting, we may feel exposed and certainly my best strategy in unstructured social situations even after a lifetime of work on this, is to sit down in a corner and wait till it's finished.

Understanding about autism and how it makes my brain different, and quite a lot of therapy over the years, has helped with any issues I can change that may have caused anxiety in the past, but I still can't do unstructured social interaction.

The solution I ve found is to focus on social situations that include structure, like interest groups (including therapy groups) or classes, any thing that is somewhat organised and where I can adequately manage breaks or free time by either sitting in my seat or having a wander about.

Knowing that the cause is neurological and unchanging despite my extensive efforts, and doing therapy around my insecurities, has led to me understanding what I can change and what I need to devise a strategy to get around. That lowers anxiety.

I agree with everything Thinx has written here and I have had the same experiences.

I would add that your son feels anxiety and has difficulty with social interactions, some of which he can't avoid. I would suggest he analyze/list the things about the social interaction that give him anxiety and try to work around those which is the strategy that Thinx recommends.

Examples:

Is he better with one on one social interaction?
The larger the crowd, the greater the anxiety?
Is being able to listen in a social setting challenging?
Is speaking to others in "real time" challenging?
Are there sensory issues that cause him anxiety in social situations? Sound? Smell? Light? Which ones?
What about preparation for social situations? Does he feel he has enough time to prepare in advance? Would doing to the place of the social interaction in advance help?

If it helps to give some examples from my own life:

I am sensitive to sounds and my brain can not filter out background noise. This problem increases with the level of noise in a setting and is also compounded by the number of simultaneous conversations going on around me since my brain automatically tries to listen to all conversations at once and can't. No amount of therapy be it CBT or otherwise will change that for me. To ease the anxiety caused by loud environments, I have found that wearing clear (nearly invisible) high fidelity earplugs has been a "game changer" for me. They do a great job with filtering some of the noise but they also blend background noises together into something indistinguishable and turn it into more of a "white noise" for me which allows me to focus on a conversation I'm having with someone, for example.

I also have difficulty with instant "real time" conversation because I have to process what someone is saying and I have to think about (I think in pictures) how I'm going to respond. No amount of therapy, be it CBT or otherwise will change that for me.

Going to a place I've never been before to interact with people in an unfamiliar unstructured social setting is doubly difficult. I'm hyper aware of and distracted by the new surroundings. No amount of therapy will change that for me. Going to the place beforehand helps (ie a workaround) so I become familiar with the surroundings and then I'm less distracted by them.

I agree that the importance of troubleshooting and working around issues can't be overstated. This is a much better approach than seeking some sort of "magic bullet" to "fix" (ie "cure") someone of things that are hard wired in their neurology.

I wish him the best and I'm betting you're very proud of him for being an independent man and for him wanting to address the challenges that he has.

I wish you and him all the best.

 

[Neonatal RRT]

@Thinx is on the right track with this.

Social anxiety is common with folks on the spectrum. It is a combination of (1) psycho-social experiences that were perceived as negative, (2) the prefrontal cortex, hypothalamus, cerebellum, etc. (neuroanatomical issue) not allowing us to process the vast amount of subtle communication signals in a timely manner for proper social interaction, as well as, (3) some degree of neurotransmitter imbalance. Many transmitters can be imbalanced,...serotonin, dopamine, oxytocin, vasopressin, epinephrine, ACTH, cortisol, GABA, glutamine,...a bunch of them. By how much and how little will vary from person to person.

Alcohol and other "depressant" drugs are, unfortunately, a common "go to" for those seeking anxiety relief. Unfortunately, it may trigger an elevated sense of anxiety when the alcohol affects wear off,...so you "hit the bottle" again. A feedback cycle. Which suggests that the imbalance is an excessive amount of "excitatory" neurotransmitters-to-"inhibitory" transmitters. It is this "over excitation" that is the underlying mechanism behind the excessive mental exhaustion when dealing with social interaction,...and why, in part,...the social avoidance and lack of social motivation many of us experience. Many of us just feel awful,...physically. I work in healthcare, busy hospital, very environmentally and socially stimulating. A few 12-hr shifts for me,...it means the next day being a total "lump" or sleeping the day away,...to recharge the "batteries".

ROLE OF DIFFERENT NEUROTRANSMITTERS IN ANXIETY: A SYSTEMIC REVIEW | INTERNATIONAL JOURNAL OF PHARMACEUTICAL SCIENCES AND RESEARCH

Alcohol and Anxiety: Causes, Risks and Treatment

 

[Thinx]

If the issues are very occasional, and if alcohol use was working for him, I don't see why he shouldn't carry on with that strategy. Very occasional use of alcohol as a crutch isn't the same as addiction. Depending on whether he's using alcohol in work time or at work of course. That's inappropriate.

However, if the issues are more than occasional, and the use of alcohol does feel like it's bordering on addiction, then he might want to re evaluate how absolutely necessary the interaction is, and what alternatives there may be to it.

Anxiety is a messenger waving a flag that says, 'Do Something Different' on it. We are uneven, but we have some great strengths. A good therapist will work on strategies with him.