clinical psychologist
After about two years wait Monday 21 May saw the first appointment with the clinical psychologist. This is the latest stage of a process started around September 2004. This was during the recovery period from a hernia operation. Kopake an opiate-based painkiller had caused all sorts of vivid waking dreams, strong sexual feelings, paranoia and upset, and had been ditched. While that got rid of the waking dreams and sexual feelings, the other problems lingered, and issues around social anxiety reasserted themselves. Hence shambling round to the GP in pain and asking to referred somewhere, anywhere. Hence seeing the psychiatrist in December that year for a box-checking exercise that left no one any the wiser. In fact given the failure to communicate clearly what the "diagnosis" meant or what the next step was several months passed before the GP was approached for referral to the clinical psychologist. Which brings us up to date.
It's kind of early after an initial assessment appointment to make any analysis of how well things are going. We still haven't finished filling out all the standard box-check tests to determine between depression and stress etc. However, it does feel this time as though someone's listening, even though ultimately the strategy will be our old friend CBT. Cognitive Behavioural Therapy, it's like the penicillin of mental health, only not as good.
So far there has been the chance to foreground social phobia as the major cause of anxiety, and to raise the possibility of Asperger's Syndrome as a cause. Although not wanting to get too far into idle and ill-informed speculation that might muddy the picture, the occasional use of MDMA as a form of self-medication has been adduced as evidence.
As there have been various posts on this in the past (SA vs AS etc) there will be further updates on this process as it unfolds. In particular any developments as regards determining whether autistic spectrum disorder is present. Because it won't be helpful to do so there will NOT be weekly updates from the sessions.
Except - update on 2nd session 4 June - this really isn't going to work. Going to have to go back to the GP and ask for an appointment specifically related to autism diagnosis. The clinical psychologist is fine, and the CBT will be useful short-term in some discrete areas, but from past experience this doesn't seem to be an issue that's amenable to 'thinking around'.
For instance the sessions started to concentrate right from the start on the 'social event' - actually meeting people, being in the pub or at the party - and of course conversations can be difficult to instigate, sustain or keep up with. But if there are friends there, and if for whatever reason conversation's relatively easy (for instance if people are in my face in a good way, or I'm high) then then that situation isn't a problem. There are two other areas that are at least as problematic, crudely: anticipation and follow-up.
Anticipation is getting out and into pubs or gigs or the cinema or galleries or events or even clubs/societies on my own. It's instigating contact or going into situations where contact might happen.
Follow-up is arguably the most important of these issues to address. It's letting people know that you're interested in maintaining contact. Exchanging numbers, meeting up with people on future occasions - actually daring to phone people would be a good fucking start.
Now a diagnosis of autism probably wouldn't help in dealing with these, but it's hard to see that CBT could be any more effective - especially when the presence of a friend and/or MDMA can make anticipation and the social event hardly problematic at all. Admittedly drugs wear off, and follow-up still has be done by me, and CBT might help play a role there. But I can't help thinking that a diagnosis, or even a distinct non-diagnosis would still be helpful. At the very least it would be some kind of clarity and one less thing to worry about.
You have no idea how frustrating and upsetting this is. Knowing consciously what needs to be done and even how other people go about it, knowing that you have reasonable conversational skills and the ability to be quite good company, but after all that being unable to put it together or use it. It's like being able to see quickly how to solve a complex puzzle but lacking the motor skills to carry out the task. Or worse, having the motor skills, but lacking proper control over them.
It's kind of early after an initial assessment appointment to make any analysis of how well things are going. We still haven't finished filling out all the standard box-check tests to determine between depression and stress etc. However, it does feel this time as though someone's listening, even though ultimately the strategy will be our old friend CBT. Cognitive Behavioural Therapy, it's like the penicillin of mental health, only not as good.
So far there has been the chance to foreground social phobia as the major cause of anxiety, and to raise the possibility of Asperger's Syndrome as a cause. Although not wanting to get too far into idle and ill-informed speculation that might muddy the picture, the occasional use of MDMA as a form of self-medication has been adduced as evidence.
As there have been various posts on this in the past (SA vs AS etc) there will be further updates on this process as it unfolds. In particular any developments as regards determining whether autistic spectrum disorder is present. Because it won't be helpful to do so there will NOT be weekly updates from the sessions.
Except - update on 2nd session 4 June - this really isn't going to work. Going to have to go back to the GP and ask for an appointment specifically related to autism diagnosis. The clinical psychologist is fine, and the CBT will be useful short-term in some discrete areas, but from past experience this doesn't seem to be an issue that's amenable to 'thinking around'.
For instance the sessions started to concentrate right from the start on the 'social event' - actually meeting people, being in the pub or at the party - and of course conversations can be difficult to instigate, sustain or keep up with. But if there are friends there, and if for whatever reason conversation's relatively easy (for instance if people are in my face in a good way, or I'm high) then then that situation isn't a problem. There are two other areas that are at least as problematic, crudely: anticipation and follow-up.
Anticipation is getting out and into pubs or gigs or the cinema or galleries or events or even clubs/societies on my own. It's instigating contact or going into situations where contact might happen.
Follow-up is arguably the most important of these issues to address. It's letting people know that you're interested in maintaining contact. Exchanging numbers, meeting up with people on future occasions - actually daring to phone people would be a good fucking start.
Now a diagnosis of autism probably wouldn't help in dealing with these, but it's hard to see that CBT could be any more effective - especially when the presence of a friend and/or MDMA can make anticipation and the social event hardly problematic at all. Admittedly drugs wear off, and follow-up still has be done by me, and CBT might help play a role there. But I can't help thinking that a diagnosis, or even a distinct non-diagnosis would still be helpful. At the very least it would be some kind of clarity and one less thing to worry about.
You have no idea how frustrating and upsetting this is. Knowing consciously what needs to be done and even how other people go about it, knowing that you have reasonable conversational skills and the ability to be quite good company, but after all that being unable to put it together or use it. It's like being able to see quickly how to solve a complex puzzle but lacking the motor skills to carry out the task. Or worse, having the motor skills, but lacking proper control over them.
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