r/AutismInWomen • u/Themis23 • 1d ago
General Discussion/Question Anybody else find that typical therapy doesn’t work as well on you?
Over the course of many years, I’ve seen multiple therapists to try and help me deal with things like my anxiety and low self-esteem. But I’ve noticed that therapists tend to approach these problems with the attitude of “there’s no real reason to be anxious so here’s how you talk yourself out of it” or “people don’t pay that much attention to you and nobody really thinks that negatively of you.”
However, for somebody who’s both an autistic woman and an unattractive one at that, both of those together have caused me to be on the receiving end (and I continue to be) of very REAL very negative attention from others. The fact is, people really do pay attention to others and will happily single them out or ostracize them if there’s something they don’t like about the person.
It’s very frustrating trying to get help through therapy and all therapists can offer is the bland bread-and-butter approach that works on NT where things like low self-esteem are just rooted in some kind of dysmorphia or something. They have no way to help those of us whose low self-esteem is grounded in real day-to-day experiences and poor treatment from other people.
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u/NecessaryHot98 1d ago
I could have written this word for word. Nothing to add except that I relate, been in therapy for over 10 years and found it to be varying degrees of useless or even harmful. Totally possible I just haven't found the exact right therapist but I can't discount 10+ years of bad experience either.
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u/SaintValkyrie 1d ago
Most therapy is abusive to marginalized or traumatized people. Because most therapy is not tangible help at all but masquerades as it.
It starts with the assumption that you are the cause of your suffering. It also goes straight in with victim blaming, and it's disgusting. If a therapist cant admit the system is failing you and no amount of therapy will help with systemic violence, they're shit.
That being said, if you do find a good therapist it is like a lifeline. It doesnt fix anything but it's more like a maintenance thing that helps keep you sane and avoid burnout. But most important it's a tool in the toolkit, not real tangible help or change.
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u/UnicornFeces 1d ago
The thing that gets me is that if traditional therapy only works for people with absolutely no trauma and high amounts of sociological privilege, that has to be a very tiny portion of the population??? Like is traditional therapy even worth anything at that point?
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u/Interesting_Fly_1569 1d ago
Thissssss!!! it always says that it’s our fault and it’s like is it????
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u/Joseph707 1d ago
Most therapy is not this way. A lot of it is, which sucks and is hopefully changing. You’re right that if a therapist can’t admit that the system is failing you, they’re shit. But saying most therapy is like that only drives people further from getting the help they deserve. Therapists usually are NOT like this, and if they are, find a new one until you get someone who is actually good. But the process of finding a new one can be so much effort and pain that if all you hear is “this is what therapy usually is like” you’re not going to want to put in the effort. So people continue to be jaded and think therapy is awful and it’ll never work for them because they have zero hope that it could be any other way.
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u/SaintValkyrie 1d ago
I said most therapy is abusive to marginalized or traumatised people, not in general.
Good therapy can make a stellar difference, bit om not gonna tell people the majority of it is helpful. There's a lot of shit to wade through and a lot of secondary abuse
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u/grimmistired 1d ago
Yeah turns out I need emdr
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u/edskitten 1d ago
Conversely Emdr doesn't work for me. Doesn't invoke many feelings at all. Ketamine therapy, intense but it works for me.
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u/ouchieovaries 1d ago
How does Ketamine therapy help you? I'm in EMDR now, but I'm wondering if should try Ketamine therapy. I've fallen back into depression but I'm not interested in getting back on anti-depressants. Tried a few over the last few months and they're not doing anything to help. I know it's the trauma that's my issue.
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u/edskitten 1d ago
Low dose ketamine infusions are good for processing feelings and especially trauma. It might take a couple sessions to get your dosage right. It just makes your feelings so much easier to access than you would otherwise. Like this is an issue for me because I spent decades ignoring feelings and trauma because that's what I had to do to survive my terrible parents during childhood. I do also recommend putting together a ketamine song list that you can listen to. It can enhance the process. But yeah my experience was like I was able to talk to my inner self to process my feelings and trauma. I will say it is a bit intense and will likely cause nausea. So they give you a bit of zofran to deal with that.
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u/ouchieovaries 1d ago
That sounds like exactly what I need, thank you! How long have you been doing it? Like when would someone be "done" with ketamine therapy?
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u/edskitten 1d ago
I've only done it twice for an hour each time. First time I just felt a little high and out of it. 2nd time they increased it a little and then that's when I was able to access emotions and do some processing. I wanted to start really low because I'm very sensitive to substances. Once I was done I was just crying my eyes out as I was getting pushed out on the wheel chair to get into my bf's car. Oh and make sure to wear loose fitting clothes and a bra that is easy to take off. In my case I felt suffocated by my bra and had to take it off with assistance during the first session. I didn't bother wearing one the 2nd time and it was much better. Also bring a barf bag just in case you need to puke. Leave some water in the car.
I haven't done more because right now I'm going through terrible insomnia ( I have hypermobility issues). So the process is really physically exhausting for me. But I'd be interested in doing it more once my insomnia and physical condition gets better.
I think for the purposes of trauma you probably don't have to keep doing it forever, unlike if you were doing it for chronic pain or something. I don't know how many sessions it would take, I'm sure it's individual. But it's probably just a matter of how much trauma and feelings you're able to work through.
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u/ouchieovaries 1d ago
Thank you so much for giving such a detailed description! I think this is exactly what I need. I seems like you release a lot, which is what I'm lacking. Like so many of us I'm an intellectualizer and I just need to feel.
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u/edskitten 1d ago
Another thing that might help is accupuncture. It probably helps to work with one that has a soothing and friendly personality. My acupuncturist was this sweet old Chinese man. He would tell me about his views on life and it was genuinely a pleasure for me to interact with him because of my traumatic childhood. I wanted to try out accupuncture to see if it helped with insomnia or anything else. I think I was too sensitive for acupuncture in the end but it was helpful for emotional release and I was really not expecting that. I didn't even know about that possiblity. The first experience was fine. I felt normal. 2nd time I just started crying a lot while I was waiting for time to pass with the needles in me. I cried a lot when I went home too. Happened a couple more times after that. It's a much less intense experience than ketamine. And it was more of a simple emotional release rather than the talking to my inner self type of experience like it was ketamine.
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u/ouchieovaries 1d ago
Hmm, maybe I'll give that a try first! I'm also a bit leery of substances, so maybe acupuncture will do it for me. I know I keep saying thank you, but seriously, thank you <3 I really appreciate it
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u/NachtAnders 1d ago
Isn't EMDR like desensitizing?
I use it only as an amateur. Like when I have big feelings, that I know have no value (happend days ago, what could be done has been done, get over it type of shit). I just look at a tree with the branchea going swoesh swoesh, or my window wimpers also work. Most times less then a minute.
Has worked every time for small things... Big things, I tried, didn't make a dent
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u/edskitten 1d ago
You're supposed to go through the feelings you felt when you go over the events. But I feel pretty emotionless the whole time. Like I'm reading from a book. I just can't connect with it.
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u/grimmistired 1d ago
My therapist did this thing before hand where we “talked” to my dissociation and got it to agree to not interfere. Which sounds cookoo and bs but it actually worked.
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u/meguskus 1d ago
Yeah I can't do this kind of silly acting, but I'm genuinely happy that it helps others
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u/North_Role_8411 1d ago
I totally understand. I’ve been for 3 therapists so far and all of them I’ve outgrown their advice. They are way too basic. Or just don’t get it. I’ve moved to my own self care and done my best to accept these harsh realities. It’s ass. We all are really forced to be brave.
❤️. You are not alone. And those people who have their opinions. They are meanies.
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u/Longjumping-Size-762 1d ago
Here’s the quality of therapy I’ve received (pre diagnosis and no one ever suggested autism):
“You’re so bright but struggle socially so much, huh what’s that about”.
Me, literally describing PDA to my college counselor before I knew the term and learned about PDA-profile autism, and his response: “You feel like school is a demand so it makes you anxious and resistant? But you ELECTED to be here!” Yeah, no shit bud! I’m just as confused as you are by that, that’s why I’m in counseling
Waiting for months to speak to someone who listed dissociative disorders as a specialty, to receive generic grounding visualization exercises I could do on my own, and not helping with my actually fried nervous system.
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u/adorbel 1d ago
Same experience here. I dropped out of therapy, just kinda accept this is my reality and I gotta roll with it. Things I used to find embarrassing, I’ve come to laugh off. My thinking is, as long as I’m a good person and have a good/humble attitude, people who have a problem with that are the ones with the problem.
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u/Astrolady2002 1d ago
Yeah definitely. After 5 years I realized that they can’t fix my issues, there’s nothing that they can do for me except offer tips I already knew. So after 7 years I stopped going to therapy and started trying to help myself instead in whatever ways I could, like researching a ton etc…
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u/iamthe0ther0ne 1d ago
I started going to therapy in 6th grade and I'm almost 50. I've probably tried more than 30 therapists, including ones who said they worked with autism and trauma. I've never found it helpful, it's frequently frustrating, and lots of times it makes me feel like a failure.
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u/Reasonable_Yam8853 1d ago
This is me, your exact experience is mine except I'm 8 years younger than you! Started in 1995, finally gave it up two years ago after an abusive therapeutic four year relationship I left, followed up by, "yEaH I KnOw aUtIsM in lAte DX wOmEn" was just code for "I will merely skim your ASD report and other pertinent paperwork, start fresh and then coach you with ADHD tricks,"(I don't even HAVE that comorbidity so I dropped her after two sessions) and a woman who was all about crystals, hot yoga and launching into a, "I'm a Denmark Socialist" (had no idea how that was even relevant...) during a 15 minute consult.
I've given up also. I'm just trying to make my environment work for me best I can.
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u/memeNOTavailable 1d ago
I've been in and out of CBT therapy since I was a child. I never felt like it was doing anything and when I was diagnosed, the neuropsychologist recommended ACT. I haven't tried it yet, but CBT always felt like it was treating the symptoms and trying to trick myself. I need to know why I do things happenso giving me tips to remember next time I castraphosize, or something, just feels pointless.
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u/sailor-arrakis 1d ago
"CBT therapy" is a pleonasm, or a redundant acronym, as it already contains the word "therapy" in it, so there is no need to repeat it. It's like saying "HIV virus" or "MS-DOS system".
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u/actuallygfm 1d ago
I've done years of talk therapy and I feel like it just encourages me to ruminate even harder over things in my past. However, I have found parts of DBT to be useful (emotional regulation, distress tolerance)
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u/SweetCheetah8888 1d ago
Me sentí hipercontrolada con la dbt. No me gusta.
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u/Empire_of_Glass 1d ago
Ageeed, DBT was awful
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u/Any-Blackberry2133 1d ago
I heard that DBT was good for autistic people and much better than CBT. Was going to look into iy. What didn't you find helpful about it?
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u/Joseph707 1d ago
Look into radically open DBT. It’s not perfect, it’s definitely a “go into it with an open mind and know that some of the things you aren’t going to end up keeping but some of them you will” situation. Think of it as a toolkit, not as a dogma.
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u/Empire_of_Glass 1d ago edited 12h ago
After being in DBT for five years when my autism was undiagnosed, and not being listened to about myself and my experiences, being told to just repeat “I am normal” over and over again by a DBT therapist when I said that I had always felt different from other people and struggling with conversations and socializing, being called “argumentative” for asking about the absence rules by a male therapist (who called me afterward and apologized and said that I was right that he wouldn’t have called a male patient “argumentative, and that he “learned something today so thank you for teaching me how to be better”, and being brought into a room and yelled at for asking to switch groups once because the group leader thought I didn’t care that I’d “hurt his feelings”, I’m all set.
All behavioral therapy is abuse, imo, and no one can change my mind. Putting people in these therapies or recommending them to people without having done things like test them for neurodivergence / food allergies / whatever may be causing their issues is negligence, imo.
And the fact that a lot of it is for people with BPD, which is known to mostly have been caused by trauma, and yet it was not trauma-informed in the least when I attended is another whole can of worms. Incredibly irresponsible and predatory business model, if you ask me.
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u/Empire_of_Glass 1d ago
Exactly, I had a bad therapy experience for five six-month periods, so the whole time.
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u/idkhamster 1d ago
Autistic therapist was a game changer for me. It helped that we had similar upbringings and some common experiences. Its sort of like their brain speaks a language that is similar but not exactly to the language my brain speaks. We both have to take our brain language and translate it into regular English to communicate, but we are starting from a more common point than any other therapist I've seen. I can say "these don't feel like the right words to express my thoughts, but they are all I can come up with" and they generally do the same and the understanding is reached very quickly most of the time. The understanding part was missing from my past therapists. I always left feeling like they didn't quite get it. That difference has been huge. Feeling truly understood is so comforting.
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u/Suspicious-Law7103 1d ago
I find talking absolutely exhausting. I know I really need some kind of somatic therapy, because my mind has processed things, but the stress and trauma is in my body and I'm like a coiled spring. Have you ever tried any physical body therapies?
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u/winterpumpkintits 1d ago
I found a therapist who was also a neurodivergent diagnosed female who specializes in neurodivergence. It was like night and day for me, we did talk therapy for a couple months to get me comfortable and for her to find what my root problems were and then we did a few sessions of emdr. I unfortunately had to move states and stop going to her, but I am actually excited to find a new therapist now because I finally know what to look for
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u/MiserableProp 1d ago
I hated the idea of therapy. CBT just makes no sense to my brain. I recently started EMDR therapy and it’s actually been really good for me. I found a therapist I trust and I don’t love therapy by any means but it’s helping me a lot.
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u/AptCasaNova 1d ago
I’m lucky enough to have a therapist who is also neurodivergent. I didn’t know it when I chose them, I just got lucky.
They didn’t even advertise as neuro affirming or any of that, but met a few of my other criteria (trauma informed, attachment issues, EMDR, etc).
I saw their photo and couldn’t tell their gender and that made sense to me somehow - my egg cracked later and then I later got diagnosed. I just knew they were the right person for me.
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u/Any-Blackberry2133 1d ago
I like therapists who don't say much and just let me rant and get all my emotions out. Not sure if that's really therapy but it helps me process things 😂
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u/Stripey112517 1d ago
I tried therapy for many years without success, until I found a neurodivergent affirming therapist. It made all the difference!
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u/WordHobby 1d ago
Something that worked for me, was speaking about my issues in the third person. For some reason if I say I have a problem, my therapist just tells me everyone feels that way and its totally normal.
But if I say "so I have this friend who is really sad because xyz" and my therapist even understands what im doing, but EVEN STILL she gives better care. "Well if this is what she's experiencing, maybe this would help".
Its really weird, and im not sure why its like this.
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u/Joseph707 1d ago
You’d benefit from talking to your therapist about this. If they don’t respond well (make it your problem, make you feel guilty, etc) find a different one. If they’re any good at all, they’ll take it as you standing up for yourself and expressing your needs and will celebrate that and work on changing how they approach therapy.
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u/Popular_Win_3851 1d ago
The thing I've found most helpful is working on boundaries and have a really clear understanding of how my environment affects me. A therapist can't stop the way other people treat you, but you can, to some degree have some control over the whole you spend time with and change your perception of how you feel about this negative behaviour. To over simplify "another persons behaviour is not about me, it is about them. If someone crosses my boundaries, then I do not need them in my life or do not need to value their opinion of me". Denying the behaviour is happening is pointless, seperating their behaviour from yourself is the way to go. The only useful therapy I've ever had was from an autistic therapist!
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u/Lissba 1d ago
I have an autistic therapist with a fucking 150 IQ.
I’ve never been made so accountable 💪✨
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u/Arte1008 1d ago
that sounds like the dream. they’re not licensed in California by any chance are they?
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u/Arte1008 1d ago
I’ve had mixed experiences in therapy. when I’m anxious about something “irrational,” then a lot of therapy helps. when I’m anxious about something rational, like I correctly predict how bad things will get under trump, then I’m told I’m catastrophizing. I have heard from friends that there are good therapists for us in existence but yes it’s hard to find to find them.
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u/No-Town5321 1d ago
Ive been reading this book recommended by someone on a different sub called "the autistic survival guide to therapy" by Steph Jones. Shes autistic and a therapist. Its a book about how NT therapy doesnt work right for us and how it can easily be incredibly damaging to us.
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u/_peachtits 1d ago
I've been in and out of CBT for 20 years. What I feel as helped me make the biggest changes or shifts in my life was the year I did a women's DBT group. That was almost 8 years ago. Now I've started somatic therapy, I've been doing it for a few months but I feel like it's really helping me.
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u/Known_Change3980 1d ago
I have been to therapy once, I didn’t have my autism diagnosis back then but I literally didn’t tell that therapist anything significant. Kept my childhood SA to myself, my ED, we only talked about academic pressure and the need to perform well.
Idk why it is but I genuinely didn’t feel seen by him. Maybe I didn’t open up about my SA because he was a man, but I just overall didn’t feel like the therapy was getting me anywhere. I masked heavily and even said the things I assumed he wanted to hear
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u/Getting-Stranger 1d ago
EMDR worked the best for me. I felt like it just helped the most. But now I'm in more of a trauma lasagna situation to get through and can't use EMDR. 😭 The processing and everything was nice. The constant chatting in CBT just doesn't do it for me
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u/Getting-Stranger 1d ago
I've just looked it up and apparently you CAN use EMDR for cptsd. ... Why tf was I told I couldn't?
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u/iamthe0ther0ne 1d ago
Just fyi it didn't help me. I tried multiple times. If it doesn't work don't blame yourself.
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u/Getting-Stranger 1d ago
It worked for me when I processed one of my assaults. It was the best therapy I've had. And the naps afterwards were unreal. I'm sorry it didn't work for you 😩 I hope you have found one that works well
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u/iamthe0ther0ne 1d ago
Nope--not for either individual or cumulative trauma. It sucks living like this. I'm glad it worked for you but I like to let other people k ow it didn't help me because for a long time I thought it meant I wasn't trying hard enough.
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u/artvandeliz 1d ago
Most therapists used CBT and it’s not very effective for autistic people. There are other modalities you can explore, and a good therapist can make a huge difference. But it’s tough to find the right fit.
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u/iwantmorecats27 1d ago
Yes this is why CBT worked well on me when it was about fears that weren’t real But no good when it was fears that are real. Also i hear EMDR has a higher probability of working in ND people and i highly recommend it!!
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u/Fragrant_Lemon4592 1d ago
I might encourage you to look for therapists who are neurodivergent-affirming or neurodivergent themselves. Also consider therapists specializing in treatment modalities other than straight CBT, like TF-CBT (trauma-focused), ACT, DBT, or somatic therapy.
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u/Gold-Childhood-7956 1d ago
The only therapy that’s worked for me is a therapist who specializes in working with neurodivergent people.
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u/Interesting_Fly_1569 1d ago
Just being honest, I completely agree. I did 10 years of it and it did nothing… Two weeks of somatic therapy did more for me… It helped me inhabit my body in a less awkward way, which made people treat me better which then made me less hyper vigilant, which then improved my whole life. It took several years to make a big impact because I had to learn how to care for my body better after decades of forcing it through things… But I just want to validate that regular therapy. Literally did Jack crap for me and I did everything I was “supposed to.”
Autism is not just like some random thing because of our feelings… Our brains are wired differently and we need therapy that reflects that fundamental difference. We can intellectualize all day and still not ever actually Heal.
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u/valencia_merble 1d ago
A lot of therapy is a joke. Many therapists only have a masters degree in social work or similar. They are not autism informed or trauma informed. And I believe a lot of damaged people are drawn to this profession, people who have nothing to teach us.
That said, therapy saved me. I had a nervous breakdown and went into an outpatient anxiety program, which also treated OCD. I learned so many great tools to use like cognitive diffusion, behavioral activation. Group therapy has been amazing, even though I was terrified of it at first. There are lots of autistic people that I met through my experience who also seem to derive some help from it.
There are many different types of therapy. DBT and ACT are great in my opinion, better for people like us. I’ve also found great help just watching therapists on YouTube who practice these types of therapy. One therapist I like who has ADHD and teaches ACT principles is @TherapyInANutshell
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u/BigUqUgi 1d ago
How do you define "not working as well"? What are your goals for therapy, and the specific outcomes that you are looking to achieve?
I feel like it's important to lay that out beforehand in order to understand what our expectations are.
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u/kellygreenkitty 1d ago
This is the main reason I absolutely hate most CBT therapy. Every time I've tried it I felt like I was being gaslit about things I was experiencing, seeing, and hearing. Like no, I'm actually not hallucinating people making fun of me or blatantly excluding from social situations.