Talk Therapy Not Working?

[bentHnau]

Several times now, I have come across the idea that talk therapy does not do much to solve the psychological problems of people with Asperger's Syndrome (most recently, on this list of characteristics: List of Asperger’s Syndrome characteristics - Autism-World

I want to know if this is true for members here who have experienced therapy, and why it might be true, or why it might be true for some manifestations of AS and not others.

I think that there is something to be said for therapists' unfamiliarity with the cognitive styles that characterize Asperger's Syndrome. On the other hand, I would expect a competent and experienced therapist to be able to adjust...but whether or not that actually happens, I can't say. Perhaps their frustrated patients give up and end therapy before adjustment can take place.

I had a therapist who told me outright that she did not believe me as I struggled to explain to her my relatively narrow social inclinations. Following her (very conventional) social advice, I ended up in several ugly social situations. Her expectations of normality became so palpable, I found myself telling trifling lies to support those expectations. As I barely understood myself at that point, we did not progress and I eventually decided to stop seeing her.

My hypothesis is that, whenever this is true, it comes down to the success of therapy being too dependent on emotional connection and "typical" social interaction between the therapist and client, and, to a lessor extent, therapists being blinded to the true personalities of their patients due to their confidence in the applicability of neurotypical psychological models.

 

[The Penguin]

I found that what she said was wrong. Though I never had an expirence like that, mine gave up on me. I can't remember why since it was 2 years ago but I was not surprise she gave up on me as she was not doing anything helpful for me.

 

[apsie]

My hypothesis is that, whenever this is true, it comes down to the success of therapy being too dependent on emotional connection and "typical" social interaction between the therapist and client, and, to a lessor extent, therapists being blinded to the true personalities of their patients due to their confidence in the applicability of neurotypical psychological models.

I've never been to a therapist, but it sounds plausible.

 

[AsheSkyler]

I've never been to a therapist, but I've been to a counselor and various doctors about other things. I also find it highly likely they care more to try to make you typical (or to get you "fixed" so they can boot you out the door faster) rather than teach you how to work with your strengths without severely aggravating your weaknesses or creating new ones in the process.

 

[DogwoodTree]

Over the past couple of decades, I've been to professional counselors, lay counselors (through church-related programs), and a psychiatrist. With none of them has the actual counseling been all that helpful (nor the meds, for that matter).

This latest round of attempts, I was working with pastors at my church. We met face to face regularly, but that rarely accomplished much. One thing that made a difference this time is that they let me email them throughout the week about whatever was going on in my head. For whatever reason, I'm able to be more open in my writing than I can be in real life, so this was the first time I was able to discuss certain things. Even though it was very lonely this way, because I had to face some really tough stuff with no one there to interact with moment-by-moment...it was still a lot more productive than the acting and shutting down I always resorted to when counseling face-to-face.

So for me, I think part of the problem with traditional talk therapy is that I just can't let anyone behind the facade, no matter how hard I try, at least not to the depth that needs to be done in order to make real progress. But writing it out and communicating by email worked much better.

 

[zurb]

Several times now, I have come across the idea that talk therapy does not do much to solve the psychological problems of people with Asperger's Syndrome...

I want to know if this is true for members here who have experienced therapy, and why it might be true, or why it might be true for some manifestations of AS and not others.

I haven't been for counseling or therapy but I too have seen this idea many times. I think it is partly due to the therapist being unfamiliar with Aspergers and how aspies think. But I also think part of it is that the base issues are neurological not psychological (though obviously the two are related). It's harder to change something that is hard wired than something programmed in. And even that which is only programmed is pretty deeply embedded in one's operating system due to experiencing Aspergers from birth. It's very different from dealing with a traumatic event in teenage years for example.

 

[gonzerd]

I went to several classic talk based therapists over the years and never got much from it. In a way it even exacerbated the problem by not feeling understood. A huge waste of money and time. At one point things got so bad I wanted to have myself checked in at a hospital, saw a really bad psychiatrist, but really really bad, the guy didn't listen, didn't let me speak, just asked the same old questions about family and such... Completely dominated the conversation, which wasn't really a conversation. He made a phone call to a different hospital, told me to go there and literally pushed me away, and I do mean literally, as in "we don't want your kind here". I went for an appointment there and could check in straight away, but I decided to wait 'till after the weekend. Best decision ever. I consider myself very lucky. A friend of mine talked about my case to her psychiatrist the very same day (coincidence) and he vehemently warned not to go there, because it's such a bad place. "Once you go in, you never get out." (Exact words, but translated.) After some back and forth through voicemail (never spoke to the guy in person) he referred me to a highly regarded diagnostic clinic specializing in things like autism, which set of the 10 month process of getting the eventual diagnosis. He was very clear that if there's a suspicion of autism, one should get diagnosed first. Regular therapies, talk therapy, group therapy would most likely only worsen the problem. Once I got to the specialized clinic and talked to people there I felt understood almost instantly. Even the person behind the counter seemed to know how to listen. These people had experience, knew what they were talking about. They dealt with people like me all the time. It was such a big relief.
Once I got the diagnosis I started reading the books, reading experiences here and posting my own. I learned a lot from that and started feeling a lot better. Problems still existed, but at least I wasn't sidetracked in NT ways of dealing with them. When I'm feeling depressed for example, I shouldn't go out and see more people every day. Social pressure is part of what's causing the problem in the first place. We need time on our own, that's something the regular psychologists never seemed to grasp. Which is understandable. It might be good advice for NT's, but not for me. I didn't have any therapy afterwards, just this and a social worker to help me where needed, but always at my own request (things like finding a dentist and such.)
In my experience it's absolutely essential to find the right doctors who have knowledge of and experience in dealing with autism. I'm sad to say this isn't easy. It took me a couple more years to finally find a suitable general practitioner, which happened only past week. I still have to go for the first time, but I have good hope. I only went to my current doctor twice, partly because at the first meeting he just shrugged when I mentioned I've been diagnosed with autism, saying that wasn't important. Guess he'd rather subscribe bad antibiotics to kids who's parents pop in every time their kid sneezes. (Bit of a tangent there, sorry, but I see that kind of thing as a huge problem.)

Anyway, bottom line is this: if you think you need therapy, but also think you might be on the spectrum, get diagnosed first, and always ask for referrals, or search yourself, for psychologists, psychiatrist, whatever, who are specialized in your specific set of troubles, or at least have some knowledge or experience in dealing with it, who are open minded enough to go along in your view of the world, who have learned to take time and actually listen, because what matters to an NT might not be what matters to someone with ASD. It will save you a lot of time and heartache.

Edit: I'd like to add, if anyone here is from Belgium and looking for a good place to be diagnosed, I'm willing to give addresses and such. I can't get you in, I can't get you an appointment, but at least I can point you in the right direction, because I think it's really important. It took me several years to find out and I'd been on the brink of suicide many times in that period. For me it always took more than an hour by train just to get there, but is was very much worth it.

Edit 2: I know I'm editing a lot today, but I just want to point out I don't mean to say that all traditional "NT" therapy is bad, just saying that specific problems ask for specific modus operandi.

 

[DogwoodTree]

Problems still existed, but at least I wasn't sidetracked in NT ways of dealing with them. When I'm feeling depressed for example, I shouldn't go out and see more people every day. Social pressure is part of what's causing the problem in the first place. We need time on our own, that's something the regular psychologists never seemed to grasp. Which is understandable. It might be good advice for NT's, but not for me.

That...that is a truly helpful insight. This helps validate the urge I felt but couldn't explain, when I figured out my dx (self-dx), to create distance between myself and the people who were trying to help me work through some stuff. I knew they cared...it just felt like everything they said to do caused more problems than it solved for me.

 

[Ste11aeres]

Problems still existed, but at least I wasn't sidetracked in NT ways of dealing with them. When I'm feeling depressed for example, I shouldn't go out and see more people every day. Social pressure is part of what's causing the problem in the first place. We need time on our own, that's something the regular psychologists never seemed to grasp.

I remember reading something by the largely forgotten psychiatrist Conrad Baars, where he gave the advice to his reader that for the sake of their psychological health they should avoid the mindless drivel of most socialization. He thought that time spent in silence alone in nature was a much better thing to be doing.

 

[gonzerd]

That...that is a truly helpful insight. This helps validate the urge I felt but couldn't explain, when I figured out my dx (self-dx), to create distance between myself and the people who were trying to help me work through some stuff. I knew they cared...it just felt like everything they said to do caused more problems than it solved for me.

You're welcome. All I can do is just share my own experience. As you say, it's not that they don't care, but the usual methods don't work for all people. It's an important thing to realize. Not finding the right kind of help, the right set of ears can lead to a lot of resentment and frustration, and before you know it you get so turned of by the whole idea you're not open to any kind of help whatsoever, and then it's too late. I don't want to go into too much detail, but it nearly made me do some very, very stupid stuff. Luckily in a fit of rage and desperation I mentioned it to a friend, who came over straight away to change my mind. Not that I still had the strength at that point, as I was two weeks into a hunger strike by then. Dark times.

 

[gonzerd]

I remember reading something by the largely forgotten psychiatrist Conrad Baars, where he gave the advice to his reader that for the sake of their psychological health they should avoid the mindless drivel of most socialization. He thought that time spent in silence alone in nature was a much better thing to be doing.

Don't know him, but he sound like a wise man. I've visited several psychiatric wards throughout the years, starting when I was 6 or 7, to visit my mother and later on for friends, and they always came of as extremely stressful places to be. People being dragged across the floor, thrown into isolation cells (that was back in the 80s, I hope that practice has diminished a little by now), screaming. All these different cases together. It's like putting a rape victim next door to a potential rapist. In my view the only reason people find rest in such a place is because they are being drugged up on medication.
If I ever win the lottery, which I won't, because I don't do the lottery, I'd like to find some freestanding houses in the woods or so, fill them up with literature, music, stuff to do and let people in need stay there for a few months. There could be specialized doctors coming round every so often to talk, to check up on things, as it's important not to loose all connection with other people, but at least there'd be some real rest there, some time to concentrate on oneself and get away from it all. I'm sure there are cases where constant surveillance is needed (severe hallucinations for example), but most of the time people just want rest, real rest, so they can find the strength to deal with whatever problems they face.

 

[etbe]

Alexithymia - Wikipedia, the free encyclopedia

The Wikipedia page for Alexithymia is worth reading. One thing it says is "psychosomatic illness or substance abuse is frequently exacerbated should these individuals enter psychotherapy". Finding anecdotal evidence to support that claim is easy if you associate with undiagnosed Aspies who can afford to see a psychologist.

Even without the Alexithymia issue there are lots of ways that psychologists need to change their practices to better suit Aspies. As a trivial example shaking hands with a client would be a good thing for an NT client but often bad for an Aspie client.

It's quite reasonable for a psychologist to try things that have worked in the past. If a client is different from average in some way then a diagnosis really helps the psychologist to develop treatment that will work well.

http://www.walnet.org/llf/ROSENHAN-BEINGSANE.PDF

David L. Rosenhan wrote an interesting research paper “On Being Sane In Insane Places” about pseudo-patients admitted to psychiatric hospitals. It seems that psychiatric staff were totally unable to recognise a sane person who was admitted even though other patients could do so. It also documents how psychiatric patients were treated as sub-human. One would hope that things had improved since 1973, but it seems likely that many modern psychiatric hospitals are as bad as was typical in 1973.

 

[JamesBond]

Yes my son who is the Aspie thinks talk therapy is a total waste of time too. He has been to Counsellors and Psychologists but unless t hey are extremely well versed in how an Aspie thinks, it's a total waste of time because they give you advise that just doesn't compute. Your better to take advise from someone who knows you well and understands your issues.
We actually had one psychologist admit that my son totally confused him with what he said and the way he thought!
Is it any wonder my son won't bother with ay of them any more!

 

[etbe]

JamesBond: I don't think that talk therapy is a waste of time, merely that it's useless and damaging if the psychologist doesn't realise that they are dealing with AS and/or Alexithymia.

If the psychologist knows what issues they are dealing with and knows how to deal with them then I think that talk therapy should do some good in call cases.

As for your son wanting to avoid psychologists after bad experiences, that's not uncommon or unreasonable. But I think it would be good to suggest to him that things can work out better with a different psychologist, it's good to have that option available in case it's needed in future.

 

[JamesBond]

JamesBond: I don't think that talk therapy is a waste of time, merely that it's useless and damaging if the psychologist doesn't realise that they are dealing with AS and/or Alexithymia.

If the psychologist knows what issues they are dealing with and knows how to deal with them then I think that talk therapy should do some good in call cases.

As for your son wanting to avoid psychologists after bad experiences, that's not uncommon or unreasonable. But I think it would be good to suggest to him that things can work out better with a different psychologist, it's good to have that option available in case it's needed in future.

JamesBond: I don't think that talk therapy is a waste of time, merely that it's useless and damaging if the psychologist doesn't realise that they are dealing with AS and/or Alexithymia.

If the psychologist knows what issues they are dealing with and knows how to deal with them then I think that talk therapy should do some good in call cases.

As for your son wanting to avoid psychologists after bad experiences, that's not uncommon or unreasonable. But I think it would be good to suggest to him that things can work out better with a different psychologist, it's good to have that option available in case it's needed in future.

Elbe we have tried 3 so far and the good one left town. We have none who specialise in the condition ow in town. That's the main problems, so son figures, why bother