Tag Archives: therapy

I will never really trust the psychiatric community

So I have mixed feelings on the psychiatric community in general. Therapists, psychiatrists, psychologists, counselors, the lot. I mean, they can do a lot of good. I have managed to have good experiences in therapy, and I the meds I am taking are helping me a lot. I strongly believe that mental health does count as health, and that psychiatric problems count as medical problems.

But I do think there are some problems. And I don’t just mean “need a find a therapist who’s the right fit” kind of problem. For instance, there’s the racism problem that I talked about before. Not necessarily overt racism (though I’m sure there’s at least some of that too), but more the subtle, insidious sort of racism that people who try to be decent can still fall prey to. The kind of racism that leaves us with inexplicable differences in autism across races, later ages for non-white children to get diagnosed, and very few people talking about it or even acknowledging the problem.

However, that is not the problem I am here to talk about. I am here to talk about the suicidal problem.

I think I’ll just say it outright – I will never, ever, tell a therapist or psychologist or any sort of psychiatric person if I’m suicidal. NEVER. I think the way they handle it is atrocious, and ultimately causes more harm than good. If nothing else, their methods cause ME more harm than good, and their ham-handed approach does not tend to allow for any sort of nuance or personalization of treatment.

I’ve been an inpatient in a psychiatric hospital (or “mental ward’ as my dad likes to put it) on three occasions. I’ve seen callous, uncaring nurses, overworked doctors and nurses alike, reduction in the patient’s humanity, even in the “better” places. I’ve heard that they do help some people and that’s great, but they have never, ever helped me. If I should ever need help because I am suicidal, a hospital is NOT the right answer. It isn’t even close to the right answer.

Yet it’s the only answer that the psychiatric community at large seems willing to give. There’s just nothing else. I once was watching a discussion about this online and saw a therapist defend this position. The line of logic was roughly “if they are admitting to being suicidal than they obviously want help, so we hospitalize them.” This blatant display of “hospital = the only answer” really disturbed me.

Now, I’ve already talked about what I think are healthy ways to talk to a suicidal person. If absolutely nothing else, they would help me and I doubt I’m alone. Ultimately, though, hospitals “help” by reducing privacy, reducing choice, reducing independence, and a high degree of intrusiveness. It’s true, it’s likely to keep patients alive. But for me, that’s about all it’ll do. Instead of addressing underlying issues, the treatment that is supposed to keep me “safe” would only exacerbate the problem. My depressions are often triggered by feelings of helplessness and dependency and lack of choice. Taking all those things and shoving them in my face is harsh and cruel and will only serve to make my feelings worse. Yet do therapists think about that, about who I am and how I would respond and what I might need, if they were to hear that I am struggling with suicidal urges?

Nope.

Until that changes, I simply will not share any suicidal thoughts I may have. It isn’t actually difficult for me – I almost never share when I’m feeling that way anyway. Not even with those I am very close to, so keeping it from a group I consider to be high-risk is not in the least bit difficult. Also, it really doesn’t say anything good that I categorize people who are supposed to be there to help as “high risk.” In fact, it would take an extreme degree of trust and confidence for me to share thoughts and feelings like those, no matter how much I might want to ask for help. That’s just the way it’s going to be.

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Horseback Riding

I'm on a horse

Ok, this week’s post is running a little late.  I have a number of blog ideas meandering around in my head, but I think after last week’s post I want to do something lighter.  So instead, I’m just going to blather about ways horseback riding challenges me.  Yeah, entirely self-serving here.  No horseback riding for a month!  Two weeks in and I miss it so hard.

Horseback riding has challenged me in many ways that I never predicted.  I mean, I always vaguely (sorta) knew that there was more to it than just sitting on a horse’s back and hanging on, but I never realized just how much.  How very, very much.

One thing I’ve been becoming increasingly conscious of lately is just how much I wind up off in my own head.  It’s (usually) relaxing in there and easier than staying connected to the world.  Horseback riding, however, really pushes me to not do that.  Largely because on a horse, I can’t do that.  Or rather, I could, but it would be a terrible idea.  I’m not on lesson horses anymore, and the horses I ride expect me to be in charge, and will take advantage of me if I slip.  Not so much maliciously as sometimes they just wanna do their own thing.  So riding helps teach me to stay connected, even when sometimes I want to slip off.

Riding involves multitasking.  Lots of multitasking.  Here’s a quick off-the-cuff list of things I have to keep watch on while riding

  • leg position
  • rein tension
  • my posture
  • the horse’s posture
  • what I am doing at that moment
  • what I am planning on doing next
  • any other people in the ring
  • hand position
  • keeping myself relaxed
  • proper balance

And all of those things are just for while walking.  The list gets bigger if I’m trotting, and bigger yet if I’m cantering.  On the plus side, many of those, with practice, become increasingly second nature.  Muscle memory, motor cortex, however you like to think about those things.  And the more things start to come naturally to me, the more things my teacher throws at me to keep me challenged.  There is SO MUCH to learn.  Plus, it’s an ongoing process.  I learned the rough basics of how to post in three lessons.  It took me a few years to get enough of the details down that my teacher stopped throwing new things at me about it, and I’ll probably always keep learning in smaller ways for as long as I ride.

Riding forces me to interact with other people.  Not a lot, and I’m still woefully awkward with the other people there, but I can’t get away with just silently slipping around.  At minimum, when passing other people who are also riding, I am expected to call out “inside!”  When I heard someone behind me call that out, I am expected to keep myself to the outside and not swerve in front of them.  My teacher likes to yell things at me from across the ring, and at least sometimes I am expected to answer by yelling back.  And I can tell you, that was not an easy thing for me to do at first (still isn’t comfortable, but not as challenging as it used to be).

Riding is scary, at least to me.  It took over a year before I stopped being scared just to get on a horse.  Multiple years to stop getting heart palpitations before trotting.  I still get very nervous while cantering.  But if I want to get better and learn new things, I have to do the things that scare me, and keep doing them until I’m comfortable.  And then do them more.  It’s challenging, but it’s also awesome.

Conclusion: riding is AWESOME and at least for me, it qualifies as a form of therapy.  ^_^

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SIB

This is a topic I’ve been thinking about writing for a while now, but it’s another one that is fairly challenging for me to write about, both in terms of my own history and in the fact that it’s a fairly delicate subject matter, and I hold unorthodox views.  It is also a potentially triggery subject matter for readers, but I will try to write it in as un-triggery a way as I can manage.
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My childhood

This is going to be a somewhat more personal post.  Shortly before I went for my assessment, I talked to my dad a few times about the fact that I was doing it.  Among other things, he also informed me that my childhood did not match up with what he read about Asperger’s, so if I have it, it must be “adult onset” or some such thing.  Yeah, there’s no such thing as adult onset AS.  It’s a developmental disorder.  Of course, he also only bothered to research for one day, and informed me that he wasn’t able to find any information about AS beyond someone trying to sell a book, so I’m not sure how he wound up so convinced that nothing showed in my childhood.  In any case, it’s something I’ve been feeling defensive about ever since (yes, my dad can still have a significant negative emotional impact on me.  I’m working on it).  So I’ve been slowly putting together notes on what I remember of my childhood that does indicate AS, and I figured I’d write a post about it.

1. I can recall, quite distinctly, that I struggled with metaphors.  I can remember asking my mom was “read between the lines” meant and not getting a satisfactory answer.  In fact, it took me years to figure out what that phrase meant.  The explanation “read what isn’t written” just relies on more metaphors and is not helpful for a person who needs a literal answer.  I still struggle with metaphors, by the way.  I have no idea how people can have intuitive understandings of them, largely because I don’t have that intuitive understanding.  At all.

2. I did not make eye contact.  Ok, confession time.  I have trouble knowing if people mean “looking at someone’s eyes” or “looking directly at a person” when they say “eye contact.”  That said, regardless of which they mean, I tended to lack it.  In fact, I lacked it so much people would scold me for it.  Eventually I learned to force myself to look at people despite my discomfort, and sometime after that I learned to force myself to look at faces.  I still don’t look at eyes if I can help it.  Anyone’s eyes.  Not even my boyfriend’s eyes.  I think they’re brown, but I’m not sure.  As it is, I am only comfortable looking directly at people if I am very comfortable with them as people.

3. Also from a very young age I engaged in a lot of black and white thinking.  I can remember seeing a therapist when I was quite young who told me I thought in black and white and I needed to see shades of gray.  I had no idea what she was talking about, as the spectrum involves colors and I’m not color blind.  It took me a while to figure out that it was a metaphor for absolutist thinking, and far longer to start recognizing how I engaged in it.  In any case, it was a lifetime thing.

4. Directly related to the last point – I viewed anything I did or made as only having two options of success – it was either perfect or it was horrible.  Any error, however slight, meant that it was worthless.  This is another issue that I still struggle with that definitely stretches way back into my childhood.

5. Also mentioned above – I was seeing therapists from a very young age.  Even as young as elementary school.  Clearly, my mom knew something was off about me.  However, no one figured out what it was, so I just bounced around therapists on and off and no progress was made.

6. I was, and am, very literal.  To the point that I can remember once being scolded for it.  When I was very young, my mom did the usual mom thing and told me to not talk to strangers.  So I did what she told me to and refrained from talking to strangers.  At all.  It turns out what she meant was that I wasn’t supposed to run off and start conversations with random people.  If a stranger simply said “hi, how are you?” while she was around, I was still supposed to reply.  Not knowing that, I said nothing any time a stranger addressed me at all, and my mom gave me a minor scolding for it.  As can be predicted, I was mostly confused.  It’s hard for me when I get in trouble for doing what someone instructed me to do.

7. I had trouble with playing pretend, though apparently there was an exception for that when I was playing with my brother.  I can remember trying to play the way I saw other people playing, like having imaginary friends or tea parties with their stuffies or some such.  It never worked well for me.

8. In middle school, I wound up with an ED diagnosis.  As it turns out, at about the time that happened (late 80’s, early 90’s) it was not uncommon for people who turned out to have AS to be diagnosed ED.  Once again, it was very obvious that something was wrong.  It was not so obvious what it was, since nobody knew about AS yet.

9. In school I was bullied.  A lot.  Badly.  Well, maybe not TOO badly as I was spared most of the physical violence you hear about sometimes.  Still, it made school very horrible for me.  Needless to say, kids tend to target those who are different, and those who are vulnerable.  I was both.

10. Even as young as kindergarten, I had few friends and a great deal of difficulty in socializing.  I was socially ostracized by all but a very small number of people in elementary school, and as the years passed that number of people dropped, basically to 1.

11. I had tantrum problems.  For me tantrums were never about manipulation, despite that accusation being leveled against me.  They were meltdowns, and they were about feeling overwhelmed and/or triggered.

12.  People seemed to have a difficult time reading my emotions.  For example, once when young (elementary school aged, I think) I was entered in one of those childhood beauty pageant thingies.  Mostly I remember not understanding what was going on in the time leading up to it, when there was clothes shopping and explanations as to what I was supposed to do.  Then it was time for the pageant itself, and I absolutely froze in terror.  I managed to mechanically walk to the different points on the stage, but I wasn’t able to make myself to the pirouettes and such things as cute little girls are supposed to do.  Afterwords, I was informed that I was angry.  None of my protestations or explanations that I was afraid were heard.  Looking back, I view that as a rather significant example of how I apparently projected my emotions incorrectly.  I have another example or two, but this paragraph is getting long.

Having now written that list, I think overall it does indeed add up to indicating AS even in my childhood.  I suspect that if AS was known then as well as it’s known now, I would have gotten a diagnosis in either elementary or middle school.  And now if my dad tries to tell me that I couldn’t have had AS in childhood, maybe I can reference this list.

ETA:  Oh! I thought of another one!

13. I had incorrect facial expressions while young.  I do not remember if it happened all the time or if it’s more that my expressions were erratic (probably the second one), but I know it was a thing.  At one point, someone scolded me for having incorrect facial expressions and pointed out that I was smiling while angry and frowning while happy.  My initial response was anger – how dare this person tell me that my facial expressions are wrong!  They’re MY expressions!  Eventually I figured out that facial expressions serve a communicative purpose so it was counter productive if they substantially differed from the norm.  So I put a lot of effort into correcting it, but I still sometimes lapse if I am particularly tired or particularly stressed.

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therapy

As is apparently normal for aspies, I have a history of failed therapy.  As such, I’m kind of leery of psychiatrists and psychologists and therapists and the like.  Nonetheless, I am trying again!  The hope is that with the diagnosis and with a psychologist who specializes in working with aspies, things might go better.  Especially since from everything I hear, aspies do not respond to typical therapeutic practices the same way that NTs do, which is why so many of us have histories of failed therapy.

In any case, my first therapy appointment was yesterday.  I’d say it went fairly well, and I’m feeling hopeful for the future.  I got to ask her my various questions about Asperger’s that I had been wondering about after I did some looking around, she asked me some questions, and we went over some initial problems to address in the future.  This is going to be specific, targeted therapy, that involves identifying specific problems and helping me find solutions to them.  Apparently I have a bit of a head start as I have already found my own solutions to many problems aspies face, but there are definitely things that I have not figured out, so hopefully this will help.

The plan is for my next session to specifically target helping me re-define my concept of friendship.  I guess we’ll see how it goes.  In the meantime, I have homework!  It just occurred to me that this blog might not be a bad place to put some of what I write for therapy.

Entirely unrelated to the above – I want to think up a new name for this blog.  I like to pretend that someday people might read this, and I’d like these hypothetical people to be greeted by a better name than what I have.

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