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Can anyone recommend a good book/site that goes through step by step how to make your way through the world as an #autistic adult who's been mollycoddled all their life and has no clue how the grown up world works? I want to be independent, but everything is just a blank void. I'm using ChatGPT to help demystify the process of becoming independent, but I'd really like a real human's guidance. Preferably from a UK perspective.
@actuallyautistic things like walking you through the process of renting or buying property, budgeting, etc. It's all so overwhelming and scary, but for my own mental health I need to move out the family home once I have enough saved up and hopefully get my Cytech. Even travelling alone outside London freaks me out. I don't know if traditional #CBT works for this type of anxiety. I feel scared to do these things, because all I have is this big blank with no personal experience. #autism #anxiety
@SilverArrows @actuallyautistic
It's important to remember that everyone, no matter who, is apprehensive and often fearful when it comes time to leave home. And I really do mean, everyone. Also, that no-one knows how to do things like opening their first bank account or renting property. This is why parents generally have to go with us and help us through these things for the first time. If we're lucky, that is. Otherwise, it's generally just blunder along and hope that you're helped by a friendly member of staff.
The autistic anxiety that goes along with these things is, though, unique to us. A lot of it comes from simply not having the relevant information. Of not being able to prepare ourselves with doing the research and thinking through the various options ahead of time. There may also be anxiety that is more indicative that you're trying to move too far outside of your comfort zones, too quickly. This, I think, should be listened to. For example, you may not want to leave London, because you're comfortable there and know you have a far greater chance of coping there, than anywhere else. It's always worth remembering that our anxieties and fears may only look irrational from the outside and to someone who doesn't understand us. They're often based on perfectly logical reasoning, from our point of view.
If you have no luck finding help from the various organisations, or mentoring programs. Perhaps you could just pose your questions to the autistic community here. Most of us are older, have gone through this and may well be able to give you the information you seek.
@pathfinder @actuallyautistic thank you. I've been trying to explain to my CBT therapist but she doesn't understand at all.
The feeling I get when I think of these things is that void. Travelling within London to new places also made me so anxious I avoided it for a long time, but now I can carry a map on my phone (and I screenshot every map area I need just in case) and can use street view to see beforehand, I can fill in that void and can break past the anxiety.
@pathfinder @actuallyautistic unfortunately my therapist is taking the approach that my anxiety comes from thinking bad things are going to happen, whereas it all comes from being uncomfortable around anything unpredictable and unfamiliar, including people and places.
I asked her to research autism related anxiety over the Christmas break, because after 6 sessions, I've made no progress. She's focusing on self esteem but that's a side effect, not the cause!
@SilverArrows @pathfinder @actuallyautistic
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they sound clueless, that's such a classic, everybody's supposed to think they're perfect
@punishmenthurts @pathfinder @actuallyautistic I tried to tell her in my first session and she said, she doesn't know anything about autism and she's not here for that.
I printed out the NAS page on anxiety which starts with "autistic people experience anxiety differently from non autistic people."
And she said, yes, this all looks the same as regular anxiety. It's overthinking.
If I ask for another therapist it will be another 6 month wait as I'm with the NHS.
@SilverArrows @pathfinder @actuallyautistic
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I couldn't get past this argument, it would be about me teaching them, and I suppose you may have to. So sorry. 
@punishmenthurts @pathfinder @actuallyautistic in my first session, I was explaining how social situations are difficult and require my brain going into overdrive trying to process everything and recall scripts etc because I can't function in a social situation without that. I spent about 5 minutes trying to explain to her it's not just overthinking and her insisting yes it was.
I will literally just pull out random scripts that make no sense if I don't do all this.
#autism
@SilverArrows @pathfinder @actuallyautistic
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FFS
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"overthinking" - so CBT? Where they try to teach you to stop and think? That's what it was in the little course I took. That's bloody gaslighting, saying one thing one second and something the exact opposite the next - I'm sorry, I'll talk you out of everybody if you let me, I fired my BetterHelp guy and he wasn't nearly this bad, he was taking the lessons, I thought.
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Again, I couldn't try to tell them my troubles until they learned something. NT psych was what they said to me all my life, and it never resonated a bit.
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I'll stop, like I say. I got a bad attitude about it all. Sorry. 
@punishmenthurts @pathfinder @actuallyautistic CBT worked really well for my blood test #phobia. By the third session, I went from panic attack at just being told I need a test to actually having a full blood draw.
Even though again, she was working on the premise that I was scared I'd bleed out or something. Whereas it was just fear at someone pointing a sharp thing at my veins haha. But the exposure therapy worked. She was the one who encouraged me to try again for autism assessment.
@SilverArrows @punishmenthurts @pathfinder @actuallyautistic so, CBT is amazing for some things, and has no evidence showing no real efficacy for others.
Phobias are THE thing that CBT is best at.
Unfortunately CBT can't treat every mental challenge.
@datum @SilverArrows @punishmenthurts @pathfinder @actuallyautistic
Goodness, if phobias are what CBT is best at then I'll be sure to stay away from it entirely. I've seen how it treats them and it's just brutal compared to more advanced things like NLP.
@murdoc @datum @punishmenthurts @pathfinder @actuallyautistic it worked really well for my phobia though. I suppose it just depends on the person 
@punishmenthurts @pathfinder @actuallyautistic oh man you don't wanna hear about my first attempt to get an #autism assessment.
But just in case you're in the mood for rage:
https://mastodon.social/@SilverArrows/113600066816173495
Luckily my GP is on my side (he still remembers when I spoke to him about it in 2016) and so is the phobia therapist, who made it my homework to try again for an assessment. So I'll keep trying.
@SilverArrows @pathfinder @actuallyautistic bookmarked for tomorrow, it's late, but I will
@SilverArrows @pathfinder @actuallyautistic
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ha - I saw a link, I thought it was going to be a blog, LOL. Geez.
@punishmenthurts @SilverArrows @pathfinder @actuallyautistic
Yeah, CBT doesn't work for autistics. Full stop. You can't tell us to 'think about it differently.' We literally can't.
My thoughts are with you and hope that either your current therapist wakes the hell up, or that you're able to find a more appropriate one.
one thing about our effed up system over here is that I was able to shop around for someone who's covered by my remaining COBRA coverage, AND who is #ActuallyAutistic AND #auDHD.
@punishmenthurts @pathfinder @actuallyautistic I found this when rummaging through my autism folder. I don't remember who Justin is, I'm assuming it's someone on deviantart.
So if you do want to read more details of Dr Whatsup, it's here:
@punishmenthurts @SilverArrows @pathfinder @actuallyautistic Every time I hear "CBT" I think about that old joke:
"Doctor, it hurts when I lift my arm."
"So, stop lifting your arm. That'll be $200."
That's CBT, except for psychic pain.
@callisto @punishmenthurts @SilverArrows @pathfinder @actuallyautistic
Wonder how close we are…
“Hello there
Customers on Platinum 360 365 Plus health plans or higher may enjoy complimentary access to Pollyanna, our AI-powered CBT chatbot. Just tell her all your personal problems* and let her advise you how to think and feel like a happy, motivated and productive worker-consumer moving forward.
Best
Hernia Deakin
Head of Resource
*The user consents to their data being shared with entities including, but not limited to, credit agencies, insurance companies, third party promotional partners, and political bodies. The vendor accepts no liability for any loss or damage incurred.”
@callisto @SilverArrows @pathfinder @actuallyautistic
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Have you had this before?
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-yes, once when I was a kid
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Well, you got it again!
@punishmenthurts @SilverArrows @pathfinder @actuallyautistic
Well, you should have fired your betterhelp guy. Whatever betterhelp is, It does not follow HIPAA requirements and sells your data. This is data that should be private.
@punishmenthurts @pathfinder @actuallyautistic
I'm hoping that she did do her research over the break.
On my last session she asked if I'd describe my relationship with her as good. I said neutral. And I think she took it personally and then I had to people-please by saying it's just me, not her.
But it is actually her.
Has anyone tried traditional #CBT for #autism related #anxiety and did it help?
@SilverArrows @punishmenthurts @pathfinder @actuallyautistic I know someone who's ND who tried CBT for anxiety.
She found it helpful for some causes of anxiety and not others.
Specifically: it helped with social anxiety, but not with background anxiety. It helped reduce the escalation within a panic attack, but didn't seem to reduce panic attack frequency.
[Edit for clarity: she's ND but not Autistic. Every autistic person is different but other people in this thread are saying that CBT for anxiety in autistic people has not helped them. It would not surprise me if CBT is effective for moments of limbic overdrive in Autistic people, but not for other kinds of anxiety, but I am not a medical health practicioner]
@SilverArrows @pathfinder @actuallyautistic that’s one problem with CBT: personally I think CBT seems to be all about side effects and nothing about causes. It’s very facile. But it can help to develop a little resilience, to then engage in more in depth therapy. Unfortunately, it is difficult, if not impossible, to access anything other than CBT on the NHS
@clarkiestar @SilverArrows @pathfinder @actuallyautistic
CBT does seem to be the gold standard for a lot of things these days, but the more I learn about it, the more I can't help but find it overly simplistic and well, I can't think of a better word right now than 'primitive'. Even its exposure therapy, which is lauded for its effectiveness, is slow, less effective, and painful compared to something like NLP. It's infuriating because we do know better ways of doing things, but psychology is the slowest branch of science to change. Or perhaps it's just psychotherapy that's slow to change, I'm not sure.
@murdoc @SilverArrows @pathfinder @actuallyautistic I think that government has latched on to it as an easy and cheap “sticking plaster” option. Can be done in online group sessions. Churn people through. But it’s not the right thing for everyone, and doesn’t resolve long term underlying causes
@clarkiestar @SilverArrows @pathfinder @actuallyautistic I wad learninging about Perceptual Control Theory and its implications on therapy the other day and came across something called the Method of Levels in a talk by Mansell.
I haven’t fully explored the academic and scientific thought on it but its main idea is what you’re saying, to change the perception of the patient in order to change their behavior
@SilverArrows I hope she reads and grows as a therapist. But I really hope you can find a therapist more useful to you.
@SilverArrows @pathfinder @actuallyautistic I'm not at all glossing over how hard it is to access therapy ... but need to share my experience that literally 30 years of intense therapy with NT practitioners untrained in neurodivergence, just made me a more proficient masker.
I've just had my first two sessions with a neurodivergent and ND affirming therapist, and the difference is just about making me cry all by itself. I'm a senior citizen getting decent therapy for the first time in my life.
@SilverArrows @actuallyautistic
In some respects she is right. We do overthink the bad. But, this is our way and, as long as it doesn't become obsessive, perfectly natural and healthy. There's no point just hoping for positive results all the time. That just sets us up for a harder fail, if things go sideways. Which they are far more likely to, one way or another. Preparing for the worst enables us to better deal with reality.
She's also right that we tend to have self-esteem issues. But so much of that stems from living in the wrong world. The more you accept yourself and the ways you need to accommodate yourself to live within a much better world, even if it is not one that others recognise, the better.
@pathfinder @actuallyautistic the thing is, with the travelling, I wouldn't even call it overthinking, because when I think about it, all I feel is that void and it stops there. There's only one tangible fear, and that's getting lost (both mentally and physically). There's no more thought. It's more like that void is a road block and now I can't proceed. And that makes me avoidant. And this is what got me slapped with an anxiety disorder NOS diagnosis.
@SilverArrows @actuallyautistic
A perfectly reasonable fear and one we all have. There's nothing more upsetting than getting lost. But, this is why the prep work is necessary. It gives us the comfort of control and enough awareness to allow ourselves at least some flexibility to circumstances once we get there.
Constantly going against this need and not embracing it. Of feeling that it was a failure to need it, or that you had to do it the "normal" way, is bound to build up resistance into a potential blockage. It's like deliberately handicapping yourself and then still blaming yourself for not being able to do something as easily as you should.
@pathfinder @actuallyautistic yeah, that last part is a thing I've felt a lot. Everyone else I know can do it. My colleagues can just catch a flight last minute alone, move home multiple times, go places they've never been before and not have to do all this obsessive planning.
Before I realised I could be autistic, oh boy did I used to hate myself. I thought it was all down to me just being a failure. That I just sucked and was immature and it was my own fault.
@SilverArrows @actuallyautistic
Oh, yes! We have an immense and hidden abilty to see ourselves as broken and worthless, because we can't. It's so much better when we finally realise that the rest of that sentence should also have been, because I can't, because I'm not supposed to. I don't work that way. I function perfectly normally my way.
@SilverArrows @pathfinder @actuallyautistic my mental map is that some things are just high stress. If I'm stressed while driving, for instance, it's not because I'm worried about some specific bad thing occurring, it's just because lots of snap decisions under pressure in an unfamiliar place is hard to navigate at the best of times.
Having accepted that, my focus is on prepping, recovering, and limiting the stressful things I put myself through. And building the skills I need to do it stressed.
@SilverArrows @pathfinder @actuallyautistic So if I had a goal to be able to navigate outside of London, I would think about how I could build that skill incrementally. What I should research ahead of time, whether I want to visit alone or in company or maybe more than once. Where would be a good place to experiment.
And what I could do to limit the time spent on the high stress bits and build in recovery times.
But the only way I know to reduce the anxiety is to build that skill.
@SilverArrows @pathfinder @actuallyautistic
how embarrassing is it for their profession that in this day and age, therapists mostly still don’t know the first thing about neurodiversity so each and every one of us has to help them (get more educated which is their job) rather than get the help we come for?
The one time I went I ended up giving that therapist a book on autism in adults. Ridiculous.
holly 
️
@SilverArrows @pathfinder @actuallyautistic Before my #autism diagnosis I had tried CBT for social anxiety: it made things worse. My autism therapist said this is common for us because the cause of our anxiety isn't wrong thoughts about a situation, and that more exposure without coping skills causes more avoidance. She recommended ACT or DBT (tailored for autism) instead. I'm in the process of finding someone for this, but everything I've read on them makes them sound WORLDS better than CBT.
@holly @pathfinder @actuallyautistic
That's exactly it!
My next session is Thursday and I hope my therapist did as she promised and researched autism-related anxiety.
@SilverArrows @pathfinder @actuallyautistic I hope so, too. The basic difference is that ACT and DBT don't try to tell you you need to think differently, but instead say, yes, you are really dealing with difficult, painful feelings. Here are some skills for coping with them and for dealing with conflict while preserving your values and getting your needs met. This podcast has the clearest description of DBT I've ever heard (despite being written for a different audience) https://www.additudemag.com/webinar/dialectical-behavior-therapy-dbt-for-adhd/
@holly @pathfinder @actuallyautistic
OMG, I just read this:
Autistic Anxiety and Anxiety: What’s the difference
https://neurodivergentinsights.com/blog/autistic-anxiety
And this is exactly how it is for me! I have a hard enough time naming my feelings, so when I got labelled anxiety disorder NOS I just accepted it. But actually describing it as overwhelm as its own thing makes much more sense. It's that feeling of knowing I have to process new input in real time when that's not a thing I can do.
@SilverArrows wow, thank you so much for sharing this! This article absolutely nails the feelings I have, that therapists always wrongly describe as "anxiety". I call them stress, distress, overwhelm (different levels/parts of the scale).
@SilverArrows @pathfinder @actuallyautistic That's it exactly, wow!! I kept telling my CBT therapist that I understood the concepts, I wasn't holding onto maladaptive thoughts, the problem was the -feelings- when socializing, not thoughts. Her theory was the feelings would change as I had more positive social experiences, but since the feelings were never addressed I just became more socially avoidant to get away from them. Overwhelm and dread: perfect words for it!
@SilverArrows I needed this, thanks. I am very late diagnosed, lived with anxiety all of my life, mostly untreated, and just recently saw this TEDx video which helped me identify a lot of what is actually going on...in other words, it's not an anxiety disorder, it's autism, it's overwhelm, it's shutdowns, but I had no words for it. https://www.youtube.com/watch?v=cF2dhWWUyQ4 @holly @pathfinder @actuallyautistic
@holly @pathfinder @actuallyautistic I gave it to my therapist at the end of the session.
1. She's saying since I haven't had my assessment yet, she can't work on the assumption that I'm neurodivergent.
2. She said overwhelm is still the same as anxiety.
I hope she'll read it before the next session, but I get the feeling that, ironically, she has very rigid thinking on this one. I'll have to find my own strategies for the overwhelm and just deal with my other life baggage with her.
@SilverArrows @holly @pathfinder @actuallyautistic That's so frustrating. In your place I'd want to ask her "I've not been assessed for being neurotypical either, why are we assuming I am?"
@Zumbador @holly @pathfinder @actuallyautistic I'm not sure she knows what neurotypical means.
@SilverArrows @holly @pathfinder @actuallyautistic Silver Arrows, I'm so sorry you're having to deal with that. Must be really frustrating.
Here are some articles I found helpful about neurodivergent affirming therapy. Please ignore if you've already received too many resources! Just in case you find these helpful:
https://michigancrs.com/neurodiversity/can-a-neurotypical-therapist-treat-neurodivergence/
@Zumbador @SilverArrows @holly @pathfinder @actuallyautistic You don't need an assessment to be non neurotypical. You get to self identify and don't have to be treated as broken or having a "disorder".
@SilverArrows @holly @pathfinder @actuallyautistic have you considered changing therapist and finding one that is ND or at least understanding of autistic people's needs?
@iridella I'm with the NHS, we don't get to choose and I'm not paying £400 a month for private. That's literally half my wages 
Ironically, it was my previous needle phobia therapist who was really clued up about neurodivergence and pushed me to try again to seek an assessment. I was there for phobia therapy but my first homework was to call the NAS! 
@SilverArrows okay, I understand.
Another important thing you can do is to find a group of autistic people meeting locally. It's great to talk about something that bothers you and, instead of being met with the usual puzzled look of the neurotypicals, being with people who can relate and have gone through similar issues already.
Since you want to get out more, meeting other ND people can help you without the additional effort of masking the whole time.
I'm really thinking that I'm going to ask to be put on the waiting list for a different therapist. I feel like this one is trying to fit me into a preset box, it's almost like she's pushing her thought processes onto me. She frequently cuts me off when I'm trying to tell her about things that are significant to me. She said she's got an experiment for the next session, so I'm kinda curious just to see, but after that, I feel like I'm just wasting my Thursdays.
@SilverArrows @actuallyautistic
"She frequently cuts me off when I'm trying to tell her about things that are significant to me."
That, by itself, would be enough of a reason to drop this person.
@SilverArrows @actuallyautistic Yeah no, it sounds like she has an agenda, she's clearly not listening, and it's time to let her go.
I've been to "therapists" like this. The worst one threw me under the bus and helped kill my marriage because she thought my ex was an interesting case and wanted to pursue her own agenda. The second worst ones just wanted me to do worksheets. 
I know it's hard to find a good therapist, and getting them up to speed is a chore. But it's easy to fall into the sunk cost fallacy (we've already come this far, I've invested so much, maybe it'll get better).
Sounds like you know in your gut that she is not a good fit. I wish you luck in finding someone who listens to and respects you.
@arisummerland @actuallyautistic tbh I had a bad feeling about her from the start, when she said the thing about not knowing anything about autism and how she's "not here for that." She might have taken it as a chance to learn, but she had to wait for ME to ask her to research it (and I don't think she even did).
I didn't want to rush to judgement, and decided to give her a try. But yeah, I've just never really gelled with her. She doesn't really seem to want to listen.
Sounds like a clear no!
@SilverArrows @actuallyautistic i'm so sorry you had this experience. I hope that you can find somebody who understands neurodivergence, and who will listen to you.
@arisummerland @actuallyautistic was there a way to report that therapist? That has to be against some code of conduct, no?
@SilverArrows @arisummerland @actuallyautistic
I’ve had lots of therapy over the years, & have a degree in psych. (It was a while ago. Things have hopefully changed for the better in all areas.) The best therapist is one who adapts their approach to suit you. The best theoretical approach is the one that suits the individual client.
CBT sounds like a good, solid approach, but is generally unsuitable for autistic people.
My latest therapist immediately focussed on ways to nurture my nervous system when I mentioned that I thought I was autistic, and was diagnosed ADHD.