Sure Josh.
How about we start by rethinking some of your lingo. I know the term "mental disorder" hit me in the face when I read it... and I'm not even AS.
I might also note it does folks little good to receive diagnosis and "treatment" from professionals who know/understand less about their condition and what helps them than they sometimes do. I promise if you hang around a bit you will actually learn quite a bit from these folks.
Mom
Josh wrote:
"can you explain to me why posters on this board prefer terms like "autistic" and "aspie"? "
EvilZakkie's answer is as good as any I could give to this, but I would also add that how the person views it has huge impact and bearing on "treatment". Following is a piece from Mike's journal. He is LFA. not AS but perhaps it will help:
Hricko writes:
I want to write to tell the world how unique and special autistics are. I know it is difficult for a parent to see this in a disconnected child, but to understand the underlying issues of each individual is to empower the process of change and growth such that the autism does not become who they are, but rather a processing problem to overcome and cope with. I understand the dilemma of my counterparts. To “be” is autistic. To not be is “the world”. One loses oneself in the processing problems and the battle becomes about who I am – whether I am. Some give up their sense of self to become an automated puppet created by Lovaas- like therapy. Others reject change as defining, or more accurately, undefining self. It is what they are taught by the way people treat them that ends up defining the battle. I am autistic. Does it mean who I am, something I have like a disease. or just a processing problem. I have contemplated this for years. How much more difficult it must be for an Aspergers individual whose processing issues are not in the physical but as interests. Making a determination whether it is who I am is so much harder for them and I am not sure the answer is the same. Only the treatment is the same, not therapy, but humane. If people understood at outset that I could not see and hear at the same time, I seriously doubt they would have spent years commanding me to pick an object. Good evaluation is a precursor of effective treatment. Knowing how to help is contingent on knowing the actual processing problems faced by each individual. We need to listen to those within the autistic community to learn the problems and how they manifest. You need to start evaluating with the mind and eye of an autist not a normal person. To do that will effectuate a big change. "
Mom
"It worries me that Asperger's and related conditions are seen as mental disorders, that we have a "disease" that needs to be fixed."
I don't like it even to be called asperger's syndrome b/c that termonology is associated with a group of symptoms that together are characteristic of a specific disorder. Most of the greatest minds have been associated with this "disorder". While I do not have one of the great minds, I do have a good mind. I just have to work so hard at presentation so people don't get mad at me. I am always surprised when I work so hard to do and say things in a "normal, friendly way" and people get really offended. Nonetheless, I am a valued contributer. What do you think would happen if I came out??? Would people be more understanding and tollerant or less so?
Josh,
It is not enough to USE PC terminology to refer to us or anyone. PC lingo is just a start to getting the right frame of mind primed.
I hear you speaking of us (the shrinks) and them (the aspys or any other group that has a DMS label). When you do that, you lose [the DMS labeled] because you've put up a barrier. A barrier decreases empathy. It seems subtle, and you appear to be doing it innocently (and it may be encouraged by your profs), but it will off-balance the relationship and put it at risk. We are all people (shrinks & clients) and therefore more alike than different, and our differences are those only of degree; not actual distinctions.
Medical (DMS) diagnoses are a way to shortcut descriptions about people. They become dangerous if this becomes a way of thinking about people. With that said, aspys TEND to be bright and see things from a different angle, giving birth to amazing innovations (the most incredible thinkers have been diagnosed aspy posthumously), but on the other hand, we TEND to have fewer intimate connections. We need to take greater care to learn empathy, and our words and actions are frequently misunderstood. We are out of sync. This TENDS to make us lonely, which COULD lead to depression.
Even though our language TENDS to be superficially typical, there is SOMETIMES a deeper difficulty with pragmatics, social register, hyperlexia, or figurative language. I couldn't lie until I was in my 40s. There can also be a TENDENCY to be idiot/savant with spatial information in very odd ways. For example, I scored pretty high during formal testing for spatial intelligence and am the queen of shortcuts, but I will, nonetheless, occasionally become very confused and get lost in an area I am totally familiar with (it can be scary). Many of us have been teased for being slightly to very odd, so SOME of us may be a bit suspicious or defensive. SOME of us comfort and relax ourselves with small obsessions or routine. And despite being innovative thinkers, we TEND to have struggles with creativity. It’s just not our bag. But we can be very imaginative.
Many of us become more typical with age, or can at least pass better, or care less or are better able to use some other coping mechanism.
Those of us who are lucky forge careers where our innovative or imaginative thinking is highly valued enough that our out of syncness is overlooked or even thought of fondly. We can be a bit eccentric.
All this said, each of us is an individual and you will need to forge a unique relationship with each client no matter what the DMS label is. Maybe I’ve only described myself and not a single other person on this list. This is a journey you’ll need to take yourself!!
Josh,
Kassiane wrote, " It's really not worth it to make eye contact, when instead I could just explain to my friends and new people that I don't usually make eye contact"
If NT knew how stressful it was to sustain any more than a quick glance, I hope they'd stop asking for this, and I am an SLP (speech therapist). I also forgot to mention the anxiety and insomnia, but I might only be speaking for myself.
Janet
Hello again,
Sorry for the delay and thanks again for all the replies.
I noticed a couple themes in the replies that I would like to address.
First, I noticed that some individuals who sought out help did not receive what they were looking for. Specifically, it sounded like they were not listened to. I am sorry to hear this but I want you to know that their are professionals out there that care. Listening is perhaps the most important skill of any mental health professional. Sadly, it is also one of the toughest skills to teach/learn.
Second, I really appreciated all the input I received regarding terminology. I have a feeling some of the terms I use are being misinterpreted (i.e., clients, product). I am willing to explain any why I use these terms if anyone is interested. However, for the sake of simplicity, I am willing to stop using them for now. Additionally, I want to thank EvilZakkie and Hrick for clarifying the term "aspies."
Thanks to everyone for helping me better understand the goals of this site and it's members.
Before I go, I do have to admit that I am still confused/concerned about the way self-diagnosis is portrayed here. I have noticed a number of threads with individuals tossing around psychiatric terms and asking others for advice regarding diagnoses. I respect the rights of individuals to seek out information on the internet and to identify with labels that seem to fit how they feel. Still, I would like to point out one important thing I have learned in my training; each individual sees the world, including themselves, through a filter that is composed of their thoughts, feelings, and memories. With this in mind, I would not even recommend for a diagnostician with years of experience to try and diagnose themselves.
Individuals should be very skeptical of taking diagnostic or treatment advice over the internet. Even online assessments can be misleading and incorrect. If you have any questions or concerns about how you are feeling I would suggest meeting with someone who has appropriate training.
Best,
Josh
by the time the dsm included aspies, I had been dealing with it for fourty years. One shrink used the term "reality-based delusions". A medical diagnosis just might not be that helpful anyway and may contribute to missing the individual who has come to you for assisstance. Have you heard of the concept, "role release"?
We really do know ourselves best. I wasn’t simply seeing what I wanted to see in the pages of Temple’s book. I had spent years considering myself, compulsively thinking and rethinking about who I am. And I was right.
Josh, I didn't self-diagnose, but I already "knew" by the time I found someone who would take me serious enough to evaluate me.
I think you nailed it April. The shrinks don't own it afterall...
I think I said it best, in my last comment.
Really, you shouldn't use psychiatric terms and ask for informal advice from people with similar experiences? Leave that only to the professionals, right?
As we've said before, some people are simply looking for better self-understanding. Whether these same people would benefit more from official diagnosis and/or therapy, rather than questing curiousity and introspection, is not for you to decide.
Yes you did Batman55 - I am proud of you for your confidence in bringing this back to our attention. You give a great deal to this forum
Josh,
Kassiane wrote, " It's really not worth it to make eye contact, when instead I could just explain to my friends and new people that I don't usually make eye contact"
Actually, I wrote it. Perhaps my signature quote threw it off.
Sorry, earthmonkey - i bet it was done in my early days before I got the hange of the quote thang. I might have corrected it on the spot if there'd been an edit button.
Well, once I became convinced of having Asperger's, I would have kept going to health professionals until I found one who could/would give me an official diagnosis. It was that important to my family and myself that I get some answers to the questions that plagued me since childhood.
I think this may say more about the world we live in than you.
I am intepreting your statement to say you felt isolated by your differences and the offical dx gave credibility to your uniquness
It's why I'm pressing for a simpler assessment procedure based on the Cambridge AAA model for those who would like to 'know' rather than those who want to have medical/employment benefits or adaptations.
When taking this assessment, does one put a number in both
yes AND no
or
YES or NO
Why do they have both; its just confusing?
Additionally, I believe the results obtained by individuals that self-administer this test are questionable if not useless (I know this sounds harsh but I am being honest).
Josh
Could you please explain yourself?
Jos,
I think you're coming at the concept of diagnosis in entirely the wrong way.
The single most important thing is whether or not the diagnosis is going to help. It doesn't matter whether the person is "really" autistic or "really" NT. If someone is NT and you treat them like an autistic, they're not going to benefit from it, and same goes for treating an autistic like an NT. So really, you shouldn't be looking at "does this person fit x criteria?" You should be looking at "person has x trait which will benefit from being treated y way" and if you come to the conclusion that this person's traits benefit from being treated as autistic traits, then call them autistic. If they don't, then look elsewhere.
Take me, for example. I'm outgoing, I'm generally OK with people, I make eye contact most of the time. However, I was nearly kicked out of school, I'm terrified of phones, I can't go anywhere new unless someone leads me, I can barely manage to take a shower more than once every two weeks, I frequently run out of clean clothes because I couldn't manage to do laundry, I am underweight and lost weight for years even while I struggled to gain weight because I forget to eat, and I can't make new friends unless they go out of their way to be nice to me. Obviously, I'm not normal. So what do you do to help me? Well, let's look at one problem- let's start with the group of things I have trouble with that all fall under the umbrella of "Executive Function" tasks. Obviously I'm not "lazy" because even a lazy person would be able to remember to eat and would consistently eat more than 300 calories a day (which is all I manage some days). Furthermore, I clearly want to be able to do these tasks and am miserable not being able to do them. So something is making it harder for me than it would be for a normal person.
Now, if you don't already know what executive dysfunction is, I suggest you watch this video: http://www.youtube.com/watch?v=9fUi1EYq6Rs
What Amanda does here is a more severe version of exactly the same problem I have. It takes a lot of concentration to do something once I've initiated it, but for me the biggest problem is starting it in the first place. For example, I may get out of bed in the morning and say, "I am going to go eat breakfast". But there's a lot involved in that. I could get sidetracked into something else anywhere along the way to the kitchen or even once I'm in the kitchen, although usually once I have food in my hand I can handle the rest.
So you're going to need to gear your way of treating me towards helping me find ways to lessen or deal with my executive dysfunction. The easiest way to do that is to treat me like an autistic person, since it's the same problem typically found in autism. If you treat me like I'm lazy, punish me for forgetting things (which, incidentally, a teacher did to me once, resulting in a nasty regression, spiral of depression, and nearly getting kicked out of the school), or worse, assume the inability to eat is a sign of anorexia (it isn't- I actually am terrified of losing any more weight), you're going to make things much, much worse. So, even if the executive dysfunction were in and of itself the only autistic trait I had, meaning that I'm "not really autistic", it's still best to treat me like I am autistic. This is where you see that the diagnostic labels are, really, kind of silly and don't need to be "100% accurate 100% of the time". After all, what your job is is to help people. And I can't count the ways self-diagnosing as autistic has helped me overcome my problems. It's probably one of the best things that ever happened to me. No, I don't fit the criteria 100%. That's not the important part. The important part is how it's helped me overcome the significant problems I face and understand myself, and how it's led me to be part of a community that's like me and understands me in ways even the best meaning and most knowledgeable of NTs usually don't.
So that's where we're coming from. Don't dismiss self-diagnosis as delusion. In many cases, it's the best way a person has of helping themselves when no one else can or will.
This is a really great post
Josh,
I'd gladly take Hrick to you anytime. Best of Luck in your chosen profession.
MomofHrick
Hi,
I am a doctoral student in a clinical psychology program and I am very interested in autism. My experiences working with children/adolescents with autism spectrum disorders and their families have impacted both my research and career goals substantially.
I found this site through a posting on fark about autism speaks (AS). As I checked out your board, I noticed that many members here are suspicious of mental health professionals, professional opinions, and AS.
I would like to know what I (as a mental health professional) could do to make clients with suspicions, such as those posted on this board, more comfortable with utilizing mental health resources.
At a minimum, I think everyone deserves access to someone who can help them clarify whether or not they have a mental disorder and would benefit from treatment. While I agree with the views posted on this board that treatment is not always necessary and can be undesirable, I fear the internet leads people to "go it alone" sometimes when reliable and useful resources are nearby and accessible.
(To clarify, I do diagnose and assess but do not currently provide medications or treatment for ASDs. And just in case it pops up, I will not provide professional opinions over the internet. I am in the graduate school grind right now so I may take time responding to postings but I will do my best.)
Thanks,
Josh
ATM: Firstly, jos111, let me recommend a new screen name, jos118. It has a cool flavor to it. It ends in "18". Also, number that are multiples of 37 tend to have a subdued, sort of hidden, flavor. That is not necessarily bad, mind you, just with less "pizzaz" than numbers ending in 8.
Secondly, I must say that you are not yet a Professional. You claim to be a mental health professional, but you have yet to earn your doctorate. You have not yet earned your Ph.D, and you have not yet become a clinical professional, at least as of my reading your post. Therefore, your role is to learn, from your teachers, and from us.
That requires you to exercise more humility. I believe that you will get a better response if you do. Then, you will become more than merely a doctor. You will become a healer. I believe that you have the potential to be this, from my interactions with you. However, you have to put aside the arrogance and learn a little bit from us.
Happy Purim, jos111. I will credit you with coming to us. I appreciate that.
All the best.