Therapist Do's and Don'ts

[Lukas]

I think that the best thing a therapist can do is to offer support and openly acknowledge that ASDs aren't something to be cured. So often NT people try to fix those of us with ASDs. I grew up not knowing about my Asperger's and everyone either tried to to tell me how to "act normal" or they pitied me. True, most of the time neither of these reactions are done consciously. But anyone who can make an effort to treat us as people who happen to have ASDs (rather than ASDs who happen to be people) will be accepted much more readily.

I've seen several therapists, not all of them helpful. The best therapists helped me find a way to help myself cope with my differences. The worst therapists tried to make me like my NT peers. My favorite and most helpful therapist was never afraid to tell me when he didn't have an answer to a question. The worst thing anyone can do for an aspie is lie. If you don't want to tell us something, "I'm not comfortable answering that" or "I don't know" are both perfectly good responses.

I completely agree.. while most therapists I have seen seem to seek a 'cure' .. those I have now are just trying to help me survive and prosper in an NT world. That comes with my own understanding of how the NT world works. (Its easier to learn Russian). That is all I ever really sought from the beginning... acceptance and understanding... not a cure. I just needed to know where I fit in the world. I'm rather glad there is a name for it now..

 

[karla]

For me a very important thing is to respect what the patient wants to talk about. I have been with therapists that want to force me to talk about something just because they feel it is an issue, when in reality it wasn´t an issue for me. In that case, the therapist it´s just projecting him or her self. You should just be a guide, not try to "fix" that person in the way you think it´s right. Listen and be a guide. Also, before I got my diagnose, a therapist told me he didn´t believe me. That made me feel bad, because I was sure of it. I think it´s very important to know that the patient knows himself better than the doctor does, and he or she should listen. And also don´t treat the patient as a child (if he/she isn´t) just because he has asperger syndrome. Once was with a therapist that made feel stupid because she talked to as if I was 10, when I was 28.

 

[Dan Metevier]

I had issues getting inside the box throughout my life in all aspects... Somehow I could not tolerate that enough to make it through employments, assignments, etc.

Thank you!! Patience and persistence paid off. I have now a great team of people working with me... I am also very thankful that ASD/HFA is being recognized and diagnosed.. it is making life much more acceptable for me knowing where I stand in relation to the rest of the population now...

Great! If you don't mind me asking, what has helped the most? You mentioned "knowing where I stand in relation to the rest of the population (the box?)." How did that happen and how can I help others with this? Thanks.

 

[Dan Metevier]

For me a very important thing is to respect what the patient wants to talk about. I have been with therapists that want to force me to talk about something just because they feel it is an issue, when in reality it wasn´t an issue for me. In that case, the therapist it´s just projecting him or her self. You should just be a guide, not try to "fix" that person in the way you think it´s right. Listen and be a guide. Also, before I got my diagnose, a therapist told me he didn´t believe me. That made me feel bad, because I was sure of it. I think it´s very important to know that the patient knows himself better than the doctor does, and he or she should listen. And also don´t treat the patient as a child (if he/she isn´t) just because he has asperger syndrome. Once was with a therapist that made feel stupid because she talked to as if I was 10, when I was 28.

Yes, I call this "therapist-centered therapy," where the therapist directs the process without the consent of the person they're working with and believes they have the answers, etc. I have, in most cases, found the opposite to be true. I like the concept of the "guide" as if someone is on a journey and you might know some of the pitfalls or the local language or have some thoughts about how to maneuver through a situation. But this type of information should only be provided if/when the client wants it. My view, at least.

 

[epath13]

Therapist is supposed to be a mirror, not a judgemental wall. They need to reflect, listen, figure things out and try to see patient's experience from the patient's perspective. Then the therapist can suggest solutions that may be helpful. That's all. A lot of therapists forget what their job is and let their judgemental human side take over the process...

 

[Dan Metevier]

Therapist is supposed to be a mirror, not a judgemental wall. They need to reflect, listen, figure things out and try to see patient's experience from the patient's perspective. Then the therapist can suggest solutions that may be helpful. That's all. A lot of therapists forget what their job is and let their judgemental human side take over the process...

Well said. Thank you for this. I entirely agree. Back in the 1940s, a psychologist named Carl Rogers developed a way of doing therapy, called "client-centered," that was exactly what you described. He based it on research he and his followers did of what actually seemed to make therapy successful (imagine that!). There are still people who practice in this manner, although sometimes it's called "person-centered" these days. Unfortunately, most therapists have gotten lost in what I call the "medical model," where they think of themselves as the "doctor" who knows what's best for the "patient." I am sorry if you have been judged in a therapy situation. They say "First do no harm." That seems harmful to me.

 

[Dan Metevier]

Hi. I want to say a very big thank you to everyone who has responded to my initial questions about what a therapist should or should not do. What is interesting to me (although not all that surprising) is that the responses you've given me are virtually exactly the same as I would expect from any group of "neurotypicals." I believe there are "common factors" that make therapy work, almost regardless of who or what diagnosis/condition is involved. You're helping prove me right. Thanks again!

 

[Moviefan2k4]

The one thing I despise from every professional counselor or therapist I've seen, is they always end up using this question about a problem: "What are you going to do about it?"

I always want to scream at them, "If I knew what to do about ANY of this, do you really think I'd be coming to you for help? What kind of idiot do you take me for?"

 

[Spiller]

in some cases, I've wondered if much or most of the therapy could/should be done via email,

I have issues with not being able to communicate effectively or thoroughly on the spot, face to face. Combined with emailing would be ideal for me, time to think about responses and 'verbalise' clearly instead of trying to stutter it out, back tracking..etc.

 

[Dan Metevier]

The one thing I despise from every professional counselor or therapist I've seen, is they always end up using this question about a problem: "What are you going to do about it?"

I always want to scream at them, "If I knew what to do about ANY of this, do you really think I'd be coming to you for help? What kind of idiot do you take me for?"

Yes, of course. Good thing to keep in mind. Thank you for this. I don't ask that question for the reasons you stated, but it's still good to keep in mind that often people come to therapists as kind of a last resort, after they've determined that they don't know what to do next. Thanks again.

 

[Dan Metevier]

I have issues with not being able to communicate effectively or thoroughly on the spot, face to face. Combined with emailing would be ideal for me, time to think about responses and 'verbalise' clearly instead of trying to stutter it out, back tracking..etc.

Thanks for reinforcing this idea. Also, I find that silence and patience are essential, allowing the person to do whatever they need to do in the moment, so to speak. Also, allowing the person to be in an "I don't have a clue" place, if that makes sense.

 

[Lukas]

Great! If you don't mind me asking, what has helped the most? You mentioned "knowing where I stand in relation to the rest of the population (the box?)." How did that happen and how can I help others with this? Thanks.

In my case, the mere knowing was enough for me. Being an Aspie has given me a socially acceptable niche in which I can fit. I am no longer alone in the world.

I have been innately alone my whole life, save my dogs. I have seen counselors since I was about 8 years old. All could tell that there was definitely something sitting me apart from my peers but none could really put their finger on precisely what it was. I felt like I was walking through life in the dark. Without a foundation on which to stand or place my life decisions, every decision I made felt like an hypothesis. I could not relate well at all with peers and did not know why or what I was doing wrong. Depression and isolation was the live standard. I would ask questions that nobody seemed to have answers for. "just do the best you can".... "life is tough"..... "you can do it if you try hard enough".... etc... etc... Doing the best I could usually meant I would outshine the boss and end up unemployed. (Careful what you ask an Aspie for, you just may get it..

When HF-ASD was discovered in my case (at the age of 49 by my very awesome psychologist), that educated me as to my personal foundation. I knew then why I was different and with further and now more specific and directed research, I am able to better realize why my communication was failing, how to converse and behave around others in such a way that they can better understand both me as a person and the subjects I discuss. The mere knowledge of having HF-ASD showed me my strengths and weaknesses and now I can base life decisions on those discoveries thus life is getting much more livable and much less depressing.

I don't think I will ever fully understand the box, but it really doesn't matter. Now I have a box of my own and a ground from which I can relate with my box bound neighbors. Now, I seek employment that can work with or enjoys my eccentricities and plays to my strengths. I seek only friends that can embrace my 'weirdness'. Before I was trying desperately to be a 'team player' and failing at every turn. Now I'm just being me.. I am finding that people are accepting me more now than before...

With HF-ASD, I feel like I have an address in the city of life and am not looked at as a homeless person anymore rather a citizen and an, albeit strange, member of the community of humanity.

 

[lostinspace]

In my case, the mere knowing was enough for me. Being an Aspie has given me a socially acceptable niche in which I can fit. I am no longer alone in the world.

I have been innately alone my whole life, save my dogs. I have seen counselors since I was about 8 years old. All could tell that there was definitely something sitting me apart from my peers but none could really put their finger on precisely what it was. I felt like I was walking through life in the dark. Without a foundation on which to stand or place my life decisions, every decision I made felt like an hypothesis. I could not relate well at all with peers and did not know why or what I was doing wrong. Depression and isolation was the live standard. I would ask questions that nobody seemed to have answers for. "just do the best you can".... "life is tough"..... "you can do it if you try hard enough".... etc... etc... Doing the best I could usually meant I would outshine the boss and end up unemployed. (Careful what you ask an Aspie for, you just may get it..

You describe my experience very well, but I was never able to find a therapist who understood me, let alone was able to help me. I saw something like a dozen of them, starting in 1990 and ending in 2006, which is when I gave up on therapy completely after being very bitterly disappointed with every therapist I encountered.

Not one single one of them said anything about Aspberger's or anything related to it. It was as if they were completely unaware of the idea. I have often wondered what would have happened if one of them was familiar with it. As it was, I stumbled across it about two years ago by accident.

 

[Dan Metevier]

Now I'm just being me.. I am finding that people are accepting me more now than before...

I really enjoyed reading your whole posting. It brought a tear to my eye, it was so beautiful and I'm so happy for you. I picked out the above sentence as particularly profound and wonderful. I'm glad you found a way to "just be (you)."

 

[Dan Metevier]

You describe my experience very well, but I was never able to find a therapist who understood me, let alone was able to help me. I saw something like a dozen of them, starting in 1990 and ending in 2006, which is when I gave up on therapy completely after being very bitterly disappointed with every therapist I encountered.

Not one single one of them said anything about Aspberger's or anything related to it. It was as if they were completely unaware of the idea. I have often wondered what would have happened if one of them was familiar with it. As it was, I stumbled across it about two years ago by accident.

I'm sorry you had this experience with therapists. To be honest, I don't recall any mention of Asperger's within my graduate school coursework. I encountered a young man who was diagnosed with Asperger's in a "shyness" group I ran while an intern on a college campus. This was my first exposure to the word and to someone who had this diagnosis. I suddenly realized that, during 20 years in the computer industry (psychology is my second career), I had mingled with plenty of people like this. Later still, I was doing couples counseling with a female therapist and her husband. After a few sessions, I turned to the wife and said, "Have you considered the possibility that your husband has Asperger's?" This turned out to be a revelation for her and, while she could not save her own marriage, she went on to form a support group for women who were married to men with Asperger's. Ever since then, I've tried to get the word out to fellow therapists to be aware of this possibility. I'm glad you "stumbled across it" eventually.

 

[Lukas]

Thank you VERY much Dan!!!!!!!

To lostinspace.... I have found you have to be rather vigilant and VERY proactive in finding the right team... I have no problem anymore in educating my counselors if needed. I currently have a new one who admitted knowing very little about ASD... so I tell her about it myself and give her books to read...She is very open and cool about it all and is really helping me and encouraging despite her lack of knowledge pertaining to Aspergers. LOL, the patient educates the doctor. But in reality, Aspergers in adults remains rather new I think in the realm of psychological diagnosis. I have found also that even in the medical profession doctors rely more on what symptoms you describe than tests in diagnosing some things. If I were you, I would telephone or research around and find counselors/psychologists who are familiar with Aspergers... then set up an appointment with them. Try college or university clinics perhaps... they usually are on the uptake on the latest and greatest. Finding a teammate like Dan is a rare find.. but he seems to be spreading the word nicely.. I would consider giving it another go... having a professional support system has done me worlds of good. Its rather like looking for a gallery to exhibit art... or a record company to record your songs... you may get a million no's but it only takes one yes.

Not to be changing the topic.. just making a comparison... Aspergers reminds me of the transgender issue in that they are both very new and both slowly being understood and recognized in the contemporary world. It will remain a bit of a struggle until the world acclimates to these newly discovered human aspects. We all just have to hang in there..

 

[Dan Metevier]

LOL, the patient educates the doctor.

Sadly, this is where most of my best learning has come from. Thank you for the compliment in the meantime.

 

[King_Oni]

Thinking about my pending visit and intake for possible therapy, here's something I would consider an important "do" for any therapist.

Look at someones situation and see what expectations are. See what point B should be and where the client wants to go. And see how they want to go from point A to point B. I've heard too many bad stories about therapists who force their own ideas and ideals through to shape someone into something they shouldn't be.

I'd expect expertise to come in the form of suggesting and thinking along about how to reach point B, not to force how to get to B as well as telling someone what the end result (that same point B) should be.

Textbook thinking when talking mental help never sat well with me and this here seems to be a prime example of "doing it by the book".

 

[Dan Metevier]

Thinking about my pending visit and intake for possible therapy, here's something I would consider an important "do" for any therapist.

Look at someones situation and see what expectations are. See what point B should be and where the client wants to go. And see how they want to go from point A to point B. I've heard too many bad stories about therapists who force their own ideas and ideals through to shape someone into something they shouldn't be.

I'd expect expertise to come in the form of suggesting and thinking along about how to reach point B, not to force how to get to B as well as telling someone what the end result (that same point B) should be.

Textbook thinking when talking mental help never sat well with me and this here seems to be a prime example of "doing it by the book".

I agree 100%. In my experience, there is too much emphasis in a therapist's training on what "good mental health" is all about and what "psychopathology" is all about. Many (most?) therapists seem to feel the need to push people toward whatever their concept is of good mental health (e.g., getting along well in a "neurotypical" world). The fact is that the therapist works for the person (the person is the customer, who is always right, right?) and this seems lost on both therapist and customer. Too many therapists want to play "doctor" and be directive about the agenda, process, etc., of therapy. In my view, it works best to let the person lead the way (unless there is the possibility of harm to self or others) and let the therapist be a guide, of sorts, if appropriate and what the person wants. Just saying.

Also, see my blog article about psychiatrists, which could be about therapists too: Your Psychiatrist Works for You! | Trail Mix

 

[AsheSkyler]

Sadly, this is where most of my best learning has come from. Thank you for the compliment in the meantime.

I won't fault you for it. I have very little respect for school myself because at best the most school ever did was get me vaguely familiar with terminology. The real world has never been anything like what schools and colleges said it should be like. If my accounting class had given each student a plastic shopping bag full of crumpled papers smelling of cigar smoke possibly manufactured in the 20s along with dead bugs and unidentifiable stains, not all of the invoices and statements present in the bag for the timeframe given, and told that was all the information they would receive, I don't think there would have been many people continuing in the profession!