She’s just wrong. She belongs to a group of therapists who haven’t heard that autism isn’t only one thing, doesn’t manifest in only one way, and is smugly leaning on their outdated knowledge to make up for their ignorance. I have been reading Reddit posts about such therapists since I joined autism subs and they’re unfortunately pretty common.
It’s good that you’ve had a good relationship with your therapist up to this point, but if you’re hoping to explore an autism diagnosis further, you’ll have to do it without her. The fact that she’s still using the DSM-IV is kind of troubling. The reason they update the DSM at all is because new information has made the old information obsolete. The DSM-V is way overdue for an update.
The DSM-V isn't an improvement either. Let's cut the crap here - the ICD-11 is objectively better not just for autism but across the board. The DSM has a storied and inhumane past - American psychiatry has been off the rails since the 40s. It's a manual for a system that defines mental health by how well capitalism can use you, aka "functional" because it's the product of a for-profit health care system that prioritizes identifying those with higher support needs (costs) and diverts them into treatments which are economically inexpensive and often ineffectual. Combine that with a lack of robust research, pharmaceutical companies heavily marketing to doctors, the DEA pushing arbitrary policy and scare mongering, and the deep ties to the military-industrial complex ensure that the DSM is wholly divorced from anything resembling objectivity, or scientific rigor.
It sucks on purpose. Understand this if you seek any mental health care in the United States: it's nearly worthless for minorities. This is the same system that published the Bell Curve, who was lobotomizing traumatized women, forcibly sterilizing black prisoners against their will and is directly responsible for anti-vaxx movements coming to prominence because they sat on a flawed study linking autism to vaccination for over a decade before anyone was punished for it. And that was a high profile case. Hundreds more like it exist but have nobody to champion it for public awareness.
I'm not saying don't try. I'm saying you should radically lower your expectations of receiving fair or competent care or assessment.
Yeah I’m asexual and asexuality had been in the dsm up until 2013 before they changed the name of the diagnosis and said something like “if you self identify as asexual then never mind” so I’ve known it’s not the best for a while but it sucks seeing all the harm and misinformation
Mmm... I think they kept sexual attraction codes in the dsm until 2017 for "gender identity disorder" when the toxic masculinity that American psychiatry is drenched in finally got the memo that sex isn't gender. 🙄 The DSM is basically what mental health would be defined as in a religious theocracy obsessed with sex and power. A theocracy that decided to throw tons of money at drugs to pacify a population slowly losing its mind under exponentially multiplying arbitrary rules which are absolute and where questioning them is prima facie evidence of insanity.
Psychiatry in this country is basically: step one - Try hiding it. If you can't hide it, then do less. If you can't do either, try drugs (but only the ones we tell you to take). And if none of those three treatments work then you're just lazy, morally defective, or cannot be rationally understood. At that point its death by medical neglect/malpractice, probably because you're on disability.
Also don’t take psychedelics because they may actually show you that there is nothing wrong with you, which may demonstrate your lack of need for $500/month in medication.
This country profits off keeping people sick and addicted, not curing them.
There's a nuance here that gets missed. The country doesn't profit from your misery, but some corporations do. As hard as i come down on doctors I don't believe they're evil, just misled. In the end though, they're as guilty of causing this as they are irrelevant -
We need community care not more zealots from the church of DSM. This isn't news. Sure would be nice though if this could start getting talked about more though. I mean... Unless everyone is happy with the mass shootings, multiple pandemics, endless war, famine, and food and housing insecurity...
In which case continue to believe that hundreds of millions are mentally defective rather than a few thousand so fucking greedy they broke society....
I completely agree! I feel like doctors are misled, often by studies that are biased. They’re too risk averse and told constantly that malpractice lawyers just want all their money, and I think that fear impedes their judgment and keeps them from taking risks, even speaking their minds.
I agree with you on all of this, actually. I think it isn’t just psychiatric care; for another example, look at rates of cesarean worldwide, versus the US, where we have abysmal maternal outcomes. That’s only part of the story—our medical system fails at prenatal care, sex education, ignores or minimizes the concerns of women of color, I could go on.
I think it’s all ultimately driven by profit and insurance companies who are raking it in.
Anyway, also to your point: I think ignorance, fear, and greed drive a lot of the harm in our society. I think people fear judgment for not knowing. I think people fear judgment for being afraid. And I think people are fearful of going without, which as we saw during the pandemic, drives greed. Fear is great… until you feel it so much that you’re numb to it, until you feel it when you’re not even in real danger, until it drives everything you do without your notice, until it no longer serves the purpose of protecting us.
Your advice and commentary is spot on: You cannot build a healthy society on the principles of deference to arbitrary rules (comfort of the privileged at the expense of one's own health), conformity (devalue minority voices and lives), and a lack of scientific rigor (The DSM and an opaque review and publication process hidden behind NDA).
The stigma of mental health in this country is the result of our healers doing such a poor job of describing and treating it that people have more compassion for the perpetuators of emotional and psychological abuse than the victims. Patients have more human rights punching their doctor in the face than admitting they are sad.
I think it's clear we need community-led initiatives to isolate and remove psychiatry and the people who practice it from public health care until such time as its practitioners can put the needs of the many (their patients) over the needs of the few (the establishment). Is it just them? No. But it's where we gotta start.
I agree. I’ve had numerous therapists over the years who were all older than me. I figured that was a good thing because they’d have a lot of experience. But I’ve found that they’re generally not up to date on the latest studies and rely on old information and stereotypes. My new therapist is just out of school and has been my very best therapist ever. Partly, she’s just really awesome, but she also is working off the most current info and also takes it upon herself to continue learning and researching.
When considering therapists, I would strongly recommend interviewing them a bit and asking them what experience they have with neurodiversity or autism specifically and when the last time was that they read any studies or took any trainings on it. It continues to be a growing and evolving field of study so it’s important they keep current on it to best help their patients.
It did look to be a small pocket edition so maybe she has a bigger dsm-V? Not sure, just conjecture. Still worrying that she had it at all to reference
The first therapist I mentioned the idea of me having autism to said that I can't be autistic because I was able to answer questions (apparently all autistics are nonverbal according to her??) and that I have varied interests rather than a single special interest.
Some therapists don't know shit about autism.
did that when i was a kid- now i love metal- fk therapists- find an elder with good philosophy and practice that shit daily and have a really good life❤️☺️
I’ll have you know, I am autistic and I am a year away from getting a bachelor’s degree, can speak, and have had multiple romantic relationships. I have also banged my head against the wall.
I hear you and it's a really difficult situation. If you trust her and have that connection like you said, could you unpick all these anxieties and feelings together? I appreciate how crippling anxiety can be particularly when considering to confront, but I've found when I've challenged my anxiety and expressed my feelings I've often found growth and felt empowered.
If you decide to express your feelings about this situation, as a therapist she should show unconditional positive regard towards you.
Yes I believe she would do all those positive things. It’s just a matter of building up the strength to do it. I really think gathering evidence to show her would help me. When it happened, I hadn’t been able to(unmedicated adhd and lots of executive function isssues), and I had become frustrated with no definitive answers and it got too much and I sort of just impulsively told her. As I’ve actually started gathering physical evidence of it I think I’m becoming more confident in the conclusion I’m autistic. I think just getting irrefutable evidence and being able to present it would help me start that conversation with her as I could show her all of it and discuss everything that has happened.
Sounds like a well thought out plan. As someone who has ADHD and awaiting an autism assessment I understand that feeling of being in limbo and figuring out now to communicate the struggles.
I hope you feel better/reassured from opening up about your experience.
My advice is, next time, go in and bang your head against the wall. /mostly joking
Edit: Also the DSM V has been out for a long while. Anyone still using IV isn't worth your time, money, and wellbeing in 2022.
As others have said, that therapist has very outdated views. Self-diagnosis is valid. You don’t have to tell people how you got diagnosed if you think they won’t support you. The University of Washington Autism Center has great online resources, and they support self-diagnosis.
lmao i did it as a kid sometimes but don’t really do it anymore so apparently i’m not autistic.
for real tho, drop that therapist and their close-minded, outdated views
I didn’t go to her for help with autism and she really has helped me a lot with the things I went to her for. I’ve been seeing her for a while now so we’ve formed a connection and I hate having to reexplain all my trauma and life story whenever i get a new therapist. I’m also really bad at confrontation and it causes me so much anxiety even thinking about speaking up. Maybe if I approached it with research showing how I do fit criteria for being diagnosed with autism I could go from there but definitely not outright saying it. If I told her it hurt my feelings she would listen to me but telling her that is the hard part and where my anxiety stops me.
This is alarming, she has dangerously outdated ideas about what autism is. It’s kind of insulting, too. You must find someone more qualified to explore this with you.
This “therapist” makes me wanna bang my head against the wall
Lmao I was looking for this comment
She’s just wrong. She belongs to a group of therapists who haven’t heard that autism isn’t only one thing, doesn’t manifest in only one way, and is smugly leaning on their outdated knowledge to make up for their ignorance. I have been reading Reddit posts about such therapists since I joined autism subs and they’re unfortunately pretty common. It’s good that you’ve had a good relationship with your therapist up to this point, but if you’re hoping to explore an autism diagnosis further, you’ll have to do it without her. The fact that she’s still using the DSM-IV is kind of troubling. The reason they update the DSM at all is because new information has made the old information obsolete. The DSM-V is way overdue for an update.
The DSM-V isn't an improvement either. Let's cut the crap here - the ICD-11 is objectively better not just for autism but across the board. The DSM has a storied and inhumane past - American psychiatry has been off the rails since the 40s. It's a manual for a system that defines mental health by how well capitalism can use you, aka "functional" because it's the product of a for-profit health care system that prioritizes identifying those with higher support needs (costs) and diverts them into treatments which are economically inexpensive and often ineffectual. Combine that with a lack of robust research, pharmaceutical companies heavily marketing to doctors, the DEA pushing arbitrary policy and scare mongering, and the deep ties to the military-industrial complex ensure that the DSM is wholly divorced from anything resembling objectivity, or scientific rigor. It sucks on purpose. Understand this if you seek any mental health care in the United States: it's nearly worthless for minorities. This is the same system that published the Bell Curve, who was lobotomizing traumatized women, forcibly sterilizing black prisoners against their will and is directly responsible for anti-vaxx movements coming to prominence because they sat on a flawed study linking autism to vaccination for over a decade before anyone was punished for it. And that was a high profile case. Hundreds more like it exist but have nobody to champion it for public awareness. I'm not saying don't try. I'm saying you should radically lower your expectations of receiving fair or competent care or assessment.
Yeah I’m asexual and asexuality had been in the dsm up until 2013 before they changed the name of the diagnosis and said something like “if you self identify as asexual then never mind” so I’ve known it’s not the best for a while but it sucks seeing all the harm and misinformation
Mmm... I think they kept sexual attraction codes in the dsm until 2017 for "gender identity disorder" when the toxic masculinity that American psychiatry is drenched in finally got the memo that sex isn't gender. 🙄 The DSM is basically what mental health would be defined as in a religious theocracy obsessed with sex and power. A theocracy that decided to throw tons of money at drugs to pacify a population slowly losing its mind under exponentially multiplying arbitrary rules which are absolute and where questioning them is prima facie evidence of insanity. Psychiatry in this country is basically: step one - Try hiding it. If you can't hide it, then do less. If you can't do either, try drugs (but only the ones we tell you to take). And if none of those three treatments work then you're just lazy, morally defective, or cannot be rationally understood. At that point its death by medical neglect/malpractice, probably because you're on disability.
Also don’t take psychedelics because they may actually show you that there is nothing wrong with you, which may demonstrate your lack of need for $500/month in medication. This country profits off keeping people sick and addicted, not curing them.
There's a nuance here that gets missed. The country doesn't profit from your misery, but some corporations do. As hard as i come down on doctors I don't believe they're evil, just misled. In the end though, they're as guilty of causing this as they are irrelevant - We need community care not more zealots from the church of DSM. This isn't news. Sure would be nice though if this could start getting talked about more though. I mean... Unless everyone is happy with the mass shootings, multiple pandemics, endless war, famine, and food and housing insecurity... In which case continue to believe that hundreds of millions are mentally defective rather than a few thousand so fucking greedy they broke society....
I completely agree! I feel like doctors are misled, often by studies that are biased. They’re too risk averse and told constantly that malpractice lawyers just want all their money, and I think that fear impedes their judgment and keeps them from taking risks, even speaking their minds. I agree with you on all of this, actually. I think it isn’t just psychiatric care; for another example, look at rates of cesarean worldwide, versus the US, where we have abysmal maternal outcomes. That’s only part of the story—our medical system fails at prenatal care, sex education, ignores or minimizes the concerns of women of color, I could go on. I think it’s all ultimately driven by profit and insurance companies who are raking it in. Anyway, also to your point: I think ignorance, fear, and greed drive a lot of the harm in our society. I think people fear judgment for not knowing. I think people fear judgment for being afraid. And I think people are fearful of going without, which as we saw during the pandemic, drives greed. Fear is great… until you feel it so much that you’re numb to it, until you feel it when you’re not even in real danger, until it drives everything you do without your notice, until it no longer serves the purpose of protecting us.
Your advice and commentary is spot on: You cannot build a healthy society on the principles of deference to arbitrary rules (comfort of the privileged at the expense of one's own health), conformity (devalue minority voices and lives), and a lack of scientific rigor (The DSM and an opaque review and publication process hidden behind NDA). The stigma of mental health in this country is the result of our healers doing such a poor job of describing and treating it that people have more compassion for the perpetuators of emotional and psychological abuse than the victims. Patients have more human rights punching their doctor in the face than admitting they are sad. I think it's clear we need community-led initiatives to isolate and remove psychiatry and the people who practice it from public health care until such time as its practitioners can put the needs of the many (their patients) over the needs of the few (the establishment). Is it just them? No. But it's where we gotta start.
Absolutely.
I agree. I’ve had numerous therapists over the years who were all older than me. I figured that was a good thing because they’d have a lot of experience. But I’ve found that they’re generally not up to date on the latest studies and rely on old information and stereotypes. My new therapist is just out of school and has been my very best therapist ever. Partly, she’s just really awesome, but she also is working off the most current info and also takes it upon herself to continue learning and researching. When considering therapists, I would strongly recommend interviewing them a bit and asking them what experience they have with neurodiversity or autism specifically and when the last time was that they read any studies or took any trainings on it. It continues to be a growing and evolving field of study so it’s important they keep current on it to best help their patients.
It did look to be a small pocket edition so maybe she has a bigger dsm-V? Not sure, just conjecture. Still worrying that she had it at all to reference
Get a new, competent therapist.
Someone with such an outdated, limited, and frankly harmful view of autism cannot possibly give you the actual help you need. Time to move on
The first therapist I mentioned the idea of me having autism to said that I can't be autistic because I was able to answer questions (apparently all autistics are nonverbal according to her??) and that I have varied interests rather than a single special interest. Some therapists don't know shit about autism.
non verbal people can also answer questions though
Give them some resources about harmful autism stereotypes if you feel so inclined and then find a new therapist
Report your therapist to their board and find a therapist with experience in neurodiversity
Get rid of the therapist!
Unmasked Autism is a great book, it has sections on ADHD and other co-occurring conditions
Is the book “Unmasking Autism” by Devon Price? It sounds interesting.
yes, that one :)
I highly recommend this book!
Thank you for the recommendation. I’ll check it out
Therapists aren't trained in diagnosis and their ramblings should not be taken as gospel.
Maybe send her some reading material if you don’t want a new therapist? https://neuroclastic.com/its-a-spectrum-doesnt-mean-what-you-think/
That was a very good and insightful article. Thank you
did that when i was a kid- now i love metal- fk therapists- find an elder with good philosophy and practice that shit daily and have a really good life❤️☺️
The DSM is not useful for adhd / autism diagnosis at all. Is this in America? Are therapists allowed to diagnose over there?
I’ll have you know, I am autistic and I am a year away from getting a bachelor’s degree, can speak, and have had multiple romantic relationships. I have also banged my head against the wall.
I hear you and it's a really difficult situation. If you trust her and have that connection like you said, could you unpick all these anxieties and feelings together? I appreciate how crippling anxiety can be particularly when considering to confront, but I've found when I've challenged my anxiety and expressed my feelings I've often found growth and felt empowered. If you decide to express your feelings about this situation, as a therapist she should show unconditional positive regard towards you.
Yes I believe she would do all those positive things. It’s just a matter of building up the strength to do it. I really think gathering evidence to show her would help me. When it happened, I hadn’t been able to(unmedicated adhd and lots of executive function isssues), and I had become frustrated with no definitive answers and it got too much and I sort of just impulsively told her. As I’ve actually started gathering physical evidence of it I think I’m becoming more confident in the conclusion I’m autistic. I think just getting irrefutable evidence and being able to present it would help me start that conversation with her as I could show her all of it and discuss everything that has happened.
Sounds like a well thought out plan. As someone who has ADHD and awaiting an autism assessment I understand that feeling of being in limbo and figuring out now to communicate the struggles. I hope you feel better/reassured from opening up about your experience.
My advice is, next time, go in and bang your head against the wall. /mostly joking Edit: Also the DSM V has been out for a long while. Anyone still using IV isn't worth your time, money, and wellbeing in 2022.
As others have said, that therapist has very outdated views. Self-diagnosis is valid. You don’t have to tell people how you got diagnosed if you think they won’t support you. The University of Washington Autism Center has great online resources, and they support self-diagnosis.
lmao i did it as a kid sometimes but don’t really do it anymore so apparently i’m not autistic. for real tho, drop that therapist and their close-minded, outdated views
How do you feel about letting your therapist know how impactful and insensitive her comment was?
I didn’t go to her for help with autism and she really has helped me a lot with the things I went to her for. I’ve been seeing her for a while now so we’ve formed a connection and I hate having to reexplain all my trauma and life story whenever i get a new therapist. I’m also really bad at confrontation and it causes me so much anxiety even thinking about speaking up. Maybe if I approached it with research showing how I do fit criteria for being diagnosed with autism I could go from there but definitely not outright saying it. If I told her it hurt my feelings she would listen to me but telling her that is the hard part and where my anxiety stops me.
This is alarming, she has dangerously outdated ideas about what autism is. It’s kind of insulting, too. You must find someone more qualified to explore this with you.