A psychologist’s epic fail on autism treatment

Dear Dr. Jim,

I’ve been all over therapy, or it’s been all over me.  I’ve spent literally half my life with it, on and off, drifting from therapist to therapist and method to method, trying to find one that would work for me.  So when you let me down and violated my trust in CBT group the other day, I wasn’t shocked or even surprised.

I’m sure you have plenty of rationalizations for what happened.  You were trying to help, I didn’t ask you to stop (said to a victim of sexual violence?  Really?) or I’m just not trying hard enough.  But the fact is, your assurances of safety and disinterest were meaningless, and I knew it, because you judged me the moment you walked in the door.

I know what you saw.  A dumpy blue-mohawked young woman with a dozen piercings, rocking in my chair and rubbing my hands, staring blankly at the carpet, saying nothing and engaging with none of the other participants’ conversations.  I probably looked like something the cat dragged in to you.  I needed you to quit looking and listen to me instead, but you wouldn’t.

You tried to shake my hand and I avoided it, partly because I already suspected you had Older White Male Asshole Syndrome.  So I suppose we both prejudged, but in fairness, you were the professional in control of the whole situation and supposedly the healthy party.  And in any case, I would have loved to see you even try to prove me wrong.

In any case, perhaps that offended you, or maybe you just really hated the way I looked, or maybe you’re just a jerk, because within a minute of sitting down, you were bullying me with smug down-talking veiled only by being ostensibly directed at no one in particular.  You talked, without prompting, about how it’s “easier to make yourself feel depressed” (emphasis mine) when you “hunch over, hang your head, don’t look up and smile.”  You lectured that if you just fake something long enough, and get good enough at faking it, then you are not faking it anymore because it’s now a part of you.

By that point I was really getting quite irritated that we weren’t talking about things that might actually be helpful, as well as humiliated because it had to be clear to everyone in the room that I was the true addressee, given that I was the one looking at the floor.  So I spoke out.  I told you that I didn’t agree with you, because some people have skills that others lack, and as a result some things will always be harder for me than for most people.  Practice music all I like, I said to you, but I will not be playing alongside Yo-yo Ma, ever; lift weights all I like and I’ll still never look like Arnold Schwarzenegger, thank god.  And I can max out my acting-normal ability, but it will always be work to me.  I will never have the same experience of social situations, or of life in general, that a neurotypical person can, and the corollary is that they can’t have mine either.  Sometimes there are hard truths about people and life that we can’t just fake away.

And so it began.  An hour and a half of you badgering me with repeated phrases like “That doesn’t just happen magically” (as if that was my assertion?  Really?) and “Something will work, you just have to keep trying” (as if I wasn’t?  Just because I disagreed with you?)  Watching me get more and more agitated, pulling my hair, biting my fingers, stammering and losing my voice, trembling all over. You patronized me with leading questions:  “Tell me how you learned to ride a bike.”

Inside my brain, stupendously large eye roll.  Just make your fucking point, I’m not eight years old.

“You’ve used the training wheels long enough.  At some point you have to just take them off.”  Wow, thanks, that’s the most insightful thing I’ve heard all day, man.

“What do you think will happen if you just let yourself look people in the eye and speak up and smile?  What is that voice telling you?”

Bite me.

I clung to my ability to fight back at you because I felt so violated by your conduct, and I didn’t want to give you the satisfaction of forfeiting.  But I’m not much good in a test of mental stamina.  You sat there and watched me have happen one of the things I fear the most in life:  Melting down with a bunch of people looking at me.  Even when I broke and insisted in broken sentences that I needed to go home right away, you just raised your voice over mine and imperiously “suggested” that I “stay and try a different way of doing things.”  Thanks for that: five more people than before have now seen me lose my voice, clamp my hands over my ears and dash out of a room.  You are very, very good at this.

Regarding your bicycle sophistry, I think another analogy was more relevant.  I actually really like brussels sprouts, but hypothetically, let’s say I don’t.  But I really want to eat them because they’re healthy and everyone else in my family loves them (again, speaking hypothetically, of course; I live with the picky IRL.)  So a few times a week, I roast up a plate of brussels sprouts and force myself to eat them.  At first they really make me gag, but after a long time I’m able to get larger quantities of them down and not feel completely miserable.  However, I still do not enjoy them one bit; they are simply a means to an end.

What you were suggesting seems to be fixating on brussels sprouts and determining “something will work, I WILL ENJOY THESE FUCKING BRUSSELS SPROUTS!” and psychoanalyzing the early-childhood origins of my loathing of the humble sprout.  Whereas what I wanted to do, which seemed much more reasonable, was to say, “Okay, doc, I don’t enjoy brussels sprouts but I can eat them when I need to, so now can we move to the fact THAT MY FUCKING LEG HAS GANGRENE AND TWO OF MY TOES HAVE FALLEN OFF?”

Why is it apparently required that I love every part of myself and everything I do?  Does every quirk, every deviation, in a person really have to be hammered out in pursuit of some idea of a fully actualized, enlightened individual, whatever those words even mean?  Seriously, I come in for a transmission overhaul and you’re pressuring me to do body work first?

Yes, I don’t make eye contact.  Yes, I am not very animated but I am very fidgety.  Yes, I stare blankly and it makes me look like I’m pissed off.  No, I’m not pissed off (well, I wasn’t.)  No, I do not usually stare at the floor, but there wasn’t anywhere else to look that wasn’t covered with a person.  And guess what?  On the piece of paper in your hands there’s a little word “ASD”– I assume as a PhD in psychology you are familiar with Autism Spectrum Disorders and the initialism.  You could have shown some sensitivity to or at least acknowledgment of that, but that would have required thinking critically and taking the time to treat me like a human being.

Why is it so hard for you to accept that some things about me that annoy you, that you don’t think are normal or positive, are not in fact things I want to change?  That while they may not define me, they are part of me as I know myself, and not a part I hate?

Why is it so important to you to verify your kneejerk assumption about what I am, to justify it with contempt of any understanding I have of myself?  You had never met me once before Hell’s Therapy Session, and yet you casually didn’t deign to mention a diagnosis from a psychologist who saw me weekly for over a year, because that wasn’t what you had already decided was my Problem.

That’s honestly one of the worst things about having suffered trauma and being open about it.  People start seeing it everywhere.  You aren’t a person to them anymore, you’re just a walking tragedy.  They want to feel sorry for you, but they easily become frustrated when you don’t meet their standards of “getting over it.”  At the same time, every negative thing about you they want to ascribe to your trauma, as if it remade you from scratch.  You no longer have quirks or foibles, only symptoms.  You can’t be who you are, you can only be ill.

So congratulations on joining those ranks, on being so preoccupied with your perception of another person’s trauma that you didn’t want to know anything else.  And thank you for reacting the way you did, when you did.  It saved me a lot of trouble by confirming exactly the kind of person you are.

Regards,

-mhc

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s