[TheNorseman]

I've been going to therapy on and off with several different people over the past few years. I've mainly wanted to talk about self-esteem, depression and other related issues. I mentioned to the therapist I'm seeing now that my parents think I have Asperger's. Since then my therapist has been fixated on me having some kind of social disorder; she doesn't really seem to think I have Asperger's but instead thinks I have social anxiety. This is getting away from what I wanted to talk about and what my goals were; building confidence and learning to be content with myself the way I am. The "what's wrong with me" conversation is the kind of thing that I've dealt with from my parents for years, and a lot of the reason I have such low confidence.

The dialogue with this therapist was slowly drifting in that direction, but I still thought that things were going fine. In addition to actual goals a lot of the reason I've gone to therapy is so I can openly talk about my feelings and not be judged, which I don't feel like I can do in the family setting given the quality of those relationships. Therapy has gradually made me feel better over the past few years because of that. Despite that, in our last meeting before Christmas, my therapist told me that she didn't think we were getting anywhere and that she wanted to get me diagnosed for some kind of social disorder. I felt fine about that at the time and was giving it some thought, but when I went home for Christmas things went badly, and when she called to give me contact info for places to get tests done, I became extremely depressed afterward.

I've asked friends for advice and they say that I need to assert myself and restate what my goals are when I go see her next. I'm not sure how I feel about going back; the comfort level I felt with her has been damaged. Does anyone have advice?

From what you've written, you don't seem to feel the need to go through the diagnosis, and personally, from your description of what you're looking for in therapy, it doesn't seem like there is a reason for you to go through a formal process. How does your therapist describe getting this diagnosis as being helpful in your therapy? In other words, has she talked specifically about how she sees this knowledge as changing or enhancing your goals in any way? A lot of times, a therapist will need a diagnosis if they feel that medication will be helpful or if they want to use a specific approach to therapy (example: A diagnosis of Bipolar can lead to medication and significant improvement in a person's ability to respond to psychotherapy or a diagnosis of Borderline Personality Disorder can lead to a decision to recommend that the client engage in Dialetical Behavioral Therapy).

I would really recommend that you go back at least one more time and talk with her about exactly what you've said here. It seems that the relationship up to this point has been good, but has been slowly going in the wrong direction in your view. Let her know that. Get her to specifically articulate WHY she sees getting a diagnosis is important. If she can't do that, I'm guessing that she's just frustrated and feels that you are spinning your wheels in therapy and she's grabbing at something or anything. Getting a formal evaluation is expensive and she should have a pretty good explanation/assessment of why you need to go through that process and how it will improve or enhance your treatment. Good luck with whatever you decide.

PS You might be thinking why go back if I don't agree, but I strongly urge you to go back and assert yourself in this situation. It's fine to leave, but give yourself the chance to stand up for what you think or believe. It's often a great opportunity to grow in therapy and if she doesn't seem willing to listen and explain adequately, you know for sure it's time to move on.

[stopdog]

I would interview some new therapists.

[missbella]

I know conventional wisdom advises to be assertive with therapists when there's a disagreement. However, I think there should be the caveat that provided there's a history, the relationship had been good, and there's the expectation the talk will go well. It's not the client 's place to train the provider. I think the bottom line is what you hope for from therapy. I'm unsure how important labeling a person is; the important thing is the treatment.

[PinkFlamingo99]

Originally Posted by missbella

I'm unsure how important labeling a person is; the important thing is the treatment.

Fully agree. If she can't give you adequate treatment as a person with a unique set of concerns and needs a test to know how to proceed, I would be concerned.

[ListenMoreTalkLess]

I think that one of the skills that is often helpful in therapy is to learn to say when it's not working for you. A straightforward statement at the beginning of therapy, as in "I'd like to talk today about X" may be all that's needed to correct the direction. You don't need to make a big deal out of how she's focusing on this an you want to focus on that, or be confrontational.

I think that this issue will raise itself with another therapist, because no one can be so attuned or mind-reading or otherwise perfectly matched with you so that sessions will always go exactly as you want. I have many times had to tell my therapists that I needed something different and they (3 in long term therapy) were able to accommodate me, not always right away and not always perfectly.

But this seems how it is to me in interpersonal relationships in general, that I need to ask for what I want and cope maturely when i don't get it; that communication improvements in therapy helped me in outside relationships.

[TheNorseman]

Originally Posted by Jaybird57

I would really recommend that you go back at least one more time and talk with her about exactly what you've said here. It seems that the relationship up to this point has been good, but has been slowly going in the wrong direction in your view. Let her know that. Get her to specifically articulate WHY she sees getting a diagnosis is important. If she can't do that, I'm guessing that she's just frustrated and feels that you are spinning your wheels in therapy and she's grabbing at something or anything. Getting a formal evaluation is expensive and she should have a pretty good explanation/assessment of why you need to go through that process and how it will improve or enhance your treatment. Good luck with whatever you decide.

PS You might be thinking why go back if I don't agree, but I strongly urge you to go back and assert yourself in this situation. It's fine to leave, but give yourself the chance to stand up for what you think or believe. It's often a great opportunity to grow in therapy and if she doesn't seem willing to listen and explain adequately, you know for sure it's time to move on.

I think I would like to go back if things could be like they were before, I just wanted to know if that was a good idea and what to do if I did go back. I think that she feels like we haven't made any progess and wants to hone in on a specific problem.

Originally Posted by ListenMoreTalkLess

I think that one of the skills that is often helpful in therapy is to learn to say when it's not working for you. A straightforward statement at the beginning of therapy, as in "I'd like to talk today about X" may be all that's needed to correct the direction. You don't need to make a big deal out of how she's focusing on this an you want to focus on that, or be confrontational.

Well, she was under the expectation that I would start work on getting an evaluation over Christmas (since it takes some time) and we would talk about it when I returned. If I didn't do it I would probably need to talk about why.

I also feel that I don't need to be diagnosed or labelled and that my therapy can be successful without that. I wonder if your T has had a moment of self-doubt? It seems surprising, since therapy is usually considered to be slow process, that she is questioning this now (I'm not quite sure how long you've been seeing her). I think I'd want to understand why she is doubting.

[ChipperMonkey]

Find a therapist who SPECIALIZES (key word!!!!) in Aspergers/Autism. Do not go to a generalist who lists 15 different disorders they treat. Otherwise you're just spinning your wheels. (I say this about many different disorders.)

[Bipolar Warrior]

Of course you have to do what feels right for you, but I am inclined to want to hear a professional out before rejecting their ideas. She could very well be wrong, but isn't it worth exploring? My parents were convinced for years that I had Aspergers, but as an adult I have seen three different psychiatrists and two therapists and none of them have said anything about that. They all agree with my diagnosis of bipolar disorder. I grew up being bipolar, not autistic. It's easy to mistake one thing for the other, especially when you're younger.

I can relate to things going badly over the Christmas break. During my three-week break from seeing my therapist at university I had a complete meltdown and sent her several emails saying I felt like a hopeless case and that I wanted to stop seeing her. I lost perspective on pretty much everything because I had too much time to myself to think negatively and beat myself up. I'm quite depressed at the moment, and felt awful about seeing her yesterday, but I went anyway and I felt much better afterwards.

I guess what I am saying is that I think you should go back and talk to your therapist again. Maybe at the end of that session you'll decide that she isn't the right therapist for you because you don't agree with what she's saying, but at least you'll know for sure that moving on is the right choice. From what you have said here, I see no harm in having one more session, just to clear things up.

Also, try not to get too caught up in the "what's wrong with me" aspect of it. Maybe you have Aspergers, or maybe you have an anxiety disorder. Or maybe you have neither of those things? And if you get diagnosed with something, that doesn't make you "wrong". Believe me, I have been made to feel "wrong" my whole life for not being able to control my emotions, but I'm not "wrong", I just have a mental disorder that makes things a little bit harder for me. I'm actually glad I have the diagnosis, because now I know, and my parents have stopped trying to diagnose me themselves which is a relief!

Good luck!

[BudFox]

Originally Posted by TheNorseman

Despite that, in our last meeting before Christmas, my therapist told me that she didn't think we were getting anywhere and that she wanted to get me diagnosed for some kind of social disorder. I felt fine about that at the time and was giving it some thought, but when I went home for Christmas things went badly, and when she called to give me contact info for places to get tests done, I became extremely depressed afterward.

How does one test for a social disorder? And what would this accomplish? Many of these labels are merely descriptions of behavior, and not a diagnosis at all. If someone says you have "Social Anxiety Disorder" that tells you nothing about underlying causes.

Have you considered seeking medical evaluation rather than psych evaluation? Some consider Autism spectrum conditions to be brain disorders, or more generally physiological conditions that can be improved with treatment.

I don't mean treatment as in psych drugs to tweak brain chemistry, I mean things like detoxing the body and brain from heavy metals, fixing a leaky gut and leaky blood brain barrier, addressing systemic inflammation, mitigation of disease-causing electro magnetic fields/radiation (wifi, cell phones, cordless phones, etc).