Autistic Reflections on CBT - Part 2
So the question is begged: why therapy?
Autistic people are often denied – and learn to deny - their needs in childhood, with the result that they either don't know their own needs or lack the confidence to express them and assert them.
The claim is that therapy enables autistic people to discover their needs.
Since most autistic people are raised within families and societies with a neurotypical value system, they need to learn what needs they have, that these needs are not the NT-needs of wider society, and that they have the right to express their needs and have them met. The needs of autistic people are often buried deep, hidden, unknown, and inarticulate. Autistic people often feel guilty about having needs that are different from others and deemed 'difficult' in a social context. They are certainly made to feel guilty about having such needs and expressing such needs.
Building resilience and resistance is essential to expressing and asserting one's needs. A good start here is to keep this simple question at the tip of your tongue:
“Is this really necessary?”
Is this task you have been set really important? Why, for whom and for what? Is this task really something that you have to do? Or is it something you are doing because NT people are telling you it is something that you have to do? Understand the distinction between needing to do something and having to do something. Is the task that is stressing you out really important? To whom? Do you need to do it? If it is something that you personally don't need to do, merely a demand from NT people, then it's not important and not worth stressing over.
These are good questions to ask. I referred above to the nervous breakdown I suffered grace of being overworked in an office. I knew at the time that not a single one of the tasks I was charged with undertaking were remotely important. On the contrary, they were worthless and pointless, and the sense of their futility added to my stress and frustration. I was doing them because I was being forced to do them as a member of the group in that particularly pointless organisation. I bottled all the frustration at the futility up until I exploded in a rage. The result was a nervous breakdown, leaving me resting up for the best part of a month. Strokes and heart attacks lie in wait for those who internalize all these external pressures. Ask yourself for what you are prepared to give your life? Imagine dying of a heart attack or stroke as a result of merely doing some pointless thing others have forced you to do. And knowing that those others won't be at your funeral. They'll carry on doing their pointless jobs in their pointless organisations, just to survive to see another pointless day in their pointless existence (I feel free to put it this way because I know for a fact that those organisation men and women 'in charge' knew well the pointlessness of their activities - they told me often enough, saying they would be happy to move to another job if could).
Ask of anything, is it worth your time and talent, is it important, is it really necessary? If it is none of these things, then don't waste your energy and concern on them. You can do what the pointless people do and become a place-sitter, a functionary, resign and reconcile yourself to the mediocrity of organisations and institutions, become accommodated and cynical, live the buried life, go racing in the streets …
You can give up.
Or you can do something much healthier. Unearth your needs, express them, have the courage to be yourself, blaze a trail, set an example, fail by your own efforts and not by others' instructions, dream big, work hard, hit the heights, stay grounded. It's a good lesson to learn.
Autistic Enculturation
Asdis comes next to Autistic Enculturation – autism as a culture.
This concerns an understanding of what will help autistic people and what will not. Psycho-education, telling people what NT people know about autism, isn't going to help autistic people. Autistic people telling people what they know about autism is. Autistic enculturation refers to autism as a culture, a different lifestyle. It tells autistic people that it is OK to do things differently, that you can have a different lifestyle. Establishing the cultural difference between NT people and autistic people makes it possible for autistic people to ask: does this fit my needs? and for professionals to ask: does this suit my client? Both the autistic person and the therapist must be able to question the prevailing NT culture.
Asdis finds a positive in therapy in this quote:
“Therapy gave me the confidence to start making connections outside of sessions and ultimately allowed me to find my tribe. I firmly believe I would not be here today had I not connected with a therapist. I had virtually lost hope. Talking gave me hope, and for that I am immensely grateful.” (Sonny Hallett, quoted in the Scottish Survey of Autistic Adult's experiences of counselling, 2020).
In light of that quote, it is worth making the point that everyone's needs are different. Some are in much more parlous conditions than others. In speaking with others about autism, I learned that I am
considered a strong communicator, confident and articulate. Hence my critical and rather negative comments on therapy should be set in the context of my high abilities. I could respond by saying that my confidence quickly dissipates the more social a context becomes, but the point is made that I am not without confidence with people. I worked in the local community and took time to talk to one and all I met to become a known 'local character.' So when I say a decent job you enjoy doing, regular contact with others, being embedded in ties of kinship, friendship, and neighbourliness is infinitely superior to therapy, I recognize that it is those things that so many who turn to therapy are lacking. But having discussed with anxiety with numerous fellow sufferers over the years, it is plain that the mere act of talking with others, lending them your ears and having them listen to you also, sharing your experiences, is the best therapy of all. I participated in an anxiety class at the local adult learning college just before Lockdown. The members of the class kind of listened, made sporadic efforts to take notes, and took the handouts home. It was apparent that the real uplift came from the mere act of being together as a group and gossiping about events and experiences. I'm wondering what happened to society, in its diremption and atomisation, that made such basic social anthropology so hard to achieve that people stand in need of therapy merely to build the confidence to talk to others.
It's all about understanding. By being able to perceive the difficulty of the task from the standpoint of an autistic person, a neurotypical person will acquire a more realistic view of the difficulty of a task. This would be an enormous help. Time and again, from childhood into adulthood, autistic people struggle with tasks deemed to be easy, with their struggles being taken as evidence of stupidity, laziness, stubbornness, lack of confidence etc. More often than not, neurotypical people fail to understand why autistic people find it so hard to accomplish tasks that they find so easy, putting expressions of difficulty down to lack of application, lack of confidence or just plain stubbornness or stupidity. This does immense harm to an autistic person's sense of self-worth. Autistic people can find simple tasks difficult and exhausting, only to have neurotypical people constantly telling them that they are easy, that everyone else does them without complaint, that they have no right to feel tired since 'it's the same for everyone else.' An autistic person soon learns that they are not entitled to seek support if a task is deemed easy to accomplish. Like 'everyone else,' you are expected to accomplish such tasks unaided and without support. They remain difficult and tiring, and autistic people learn that they are alone.
When evaluation proceeds from an autistic standpoint, it soon becomes clear that these tasks are extremely difficult and that autistic people need support. This change of perspective changes things completely. Autistic people are entitled to ask for support and should be able to get it. A little support can make a whole lot of difference.
I am a great believer in self-advocacy and teaching people to assert their needs. Assertiveness means being strong, clear and confident, not aggressive. It means knowing your true worth, knowing your needs, and being persistent in asserting that to which you are entitled. I also believe in developing the citizen autist within the context of a plethora of mutual aid societies, creating an autistic grassroots. Again, I recognize that not all autistic people will have the confidence to become so powerful and assertive (hence the emphasis on mutuality and solidarity). It is, however, important to teach autistic people to have the nerve and know-how to ask questions and not be satisfied until answers have been given. It is often necessary to ask impertinent questions to obtain pertinent answers, especially when one is dealing with authorities, institutions, and organisations that promise much in their public image but deliver little on the ground. I await the happy day when I approach some body or other in search of help and find that I receive more than I had asked for. Up
until now I have had to fight every inch of the way for the most meagre, miserable, inadequate help, all of which has come with onerous obligations and strings attached. ,
My uncle once took me to task to ask 'why are you always asking questions?'
To get pertinent answers it is often necessary to ask impertinent questions. Shy bairns get nowt. Seek and you will find, ask and you will receive.
Ask: is this task really necessary? Do I really need to do this?
Asdis gives this question as an example:
'Can it be done in a way that suits me?' In parenthesis she writes: 'if you don't like to phone you
could try to email.'
This is a common issue for autistic people. I hate making phone calls. I can do it, but find it uncomfortable trying to follow a voice over the phone. I also hate making myself available to receive phone calls. I rarely if ever answer the phone and keep my mobile switched off. I tell people this, give my reasons, have them agree to send me an email, only to have them phoning time and again! At first, I put it down to their being so used to phone contact that they forget my request and slide back into their normal patterns. When it persists, it becomes clear that they simply don't understand why an autistic person may struggle with phone calls. When it becomes clear that they will never change their behaviour to accommodate my request, I conclude that they simply don't care and have no intention of making changes. This comes back to assertiveness. I make my needs clear, I present reasons for my requests, I secure agreement. As soon as it becomes clear that people are not listening I severe links. For the reason that I have learned by hard experience that the people who 'get it,' get it quickly, and those who don't never change, merely persist in behaviours designed to send your stress levels soaring.
Why am I always asking questions?
Because people who are silent and unquestioning get trampled over, trampled down, and buried.
CBT says that the more you do certain things, the more you will get used to them. It's not a bad idea. As an Aristotelian in my philosophical heart, I agree that you are what you repeatedly do. Since that is so, it is a good idea to make sure that the things that you do are good for you and facilitate a flourishing existence. I wholeheartedly agree with a social philosophy centred on habits, social practices, character construction, modes of conduct, and the acquisition and exercise of the virtues as qualities for successful living. So far so Aristotelian. This social philosophy will 'work' for most people. Human beings are social beings, meaning that an emphasis on socialisation will bring out the best in people. But autistic people are not most people. They are very different kind of people, with different approaches to socialisation, communication, and interaction. To the extent that CBT is premised on NT ways of thinking and being it will not only fail, it will do harm.
This person says
“One thing that was suggested was that 'by doing things you will get used to them.' I understand the logic there, but I still don't like many social interactions and I am 39. I have tried. My self-confidence is as low as ever.' (Jon on National Autistic Society's chat, 2013).
As much as I love old Aristotle and ancient philosophy, even a touch of Stoicism, we see here the limits of philosophy and science in face of the atypical experience which is autism. I have had infinite variants of this same argument, always the assertion that 'you will get used to it in time,' whatever the particular nature of the 'it' involved. My response every time is to say I was told I would 'get used to it' x amount of years ago and never have. At this point, others put my negativity down to fear and trepidation born of bad experiences past, which will be dispelled as soon as I try again. Because it is fear alone which is holding me back, because you overcome your fears by confronting them, because you get used to things the more you do them. And any number of the stock in trade cliches in the neurotypical handbook.
I have got used to saying that 'people don't listen' and 'people are not listening.' The truth is that they do listen but don't understand; they think they know better and so ignore. I must admit that I do relish being told that CBT is 'backed by philosophy and science,' because it gives me the opportunity to inform my enlightener that I am a philosopher with a PhD in the subject, and consider Stoicism a tired philosophy for a tired age of failing experts and empty institutions. As conversation stoppers go, it works every time.
But, yes, I must confess that in my philosophical work I do argue for the learning of good habits, the need for practice and the formation of good character, the acquisition and exercise of the virtues as qualities for a flourishing existence. This will 'work' in the main. It's a view that is central to the vision of 'rational freedom' I develop in my philosophical work.
But there is a strong case for arguing that the central themes I organise my philosophical work around are so prominent because they reference things I, as an autistic person, struggle with. It just so happens that a world of displacement, disconnection, and ex-communication also struggles with these basics of human flourishing.
Neurotypical people repeatedly tell autistic people that the more they do things, the more they will become natural to them. There is a strong case to be made for habituation (in all senses of the word within communities of practice). I've made that case in my philosophical work. But it isn't necessarily true in all cases. Since there are good reasons why an autistic person struggles to do certain things in the first place, simply doing them over and again is not going to help. The problem is not one of familiarity and habituation. There is a need, then, to find an alternate and better way of doing things.
Asdis asks 'is there a simpler way for you to do this task?' She emphasises that it is important to simplify tasks. Her meaning is clear and cogent. Many autistic people have been taught to do things the way that NT people do them. The problem is that autistic people may find this extremely difficult and so seek their own distinctive way. Asdis describes this as a 'a simpler way,' but that isn't necessarily the case. I have a friend who long ago noted that I have 'the knack of getting all the right results by all the wrong means.' My way is the better way for me, but would be considered by neurotypical others to be overly complicated rather than simpler. Of course, my overly complicated, often indirect, way of doing things is far easier for me than the supposedly simple and direct NT way. For a simpler and better way read a way that is in tune with your unique autistic being.
Autistic people are used to being told to do things in a neurotypical way. Nowhere is this more apparent than when it comes to socialising with others, with the NT way being considered the normal way.
Communication and cooperation
Communicate! Express yourself. Express your needs. Let people know what you are about.
OK, I'm bold in print, at a safe distance from others. I wrote earlier of the advice I gave to the mother of an autistic son: 'have the courage to trust your own instincts and judgement, you are far smarter than you may know.'
'Is that what you do?' she asked in response, correctly intuiting that people who give out good advice may not always do what they tell others to do. It's not easy. I am notorious for not asking for the things I want, need, crave, desire and dream and long for. Autistic people have been on the receiving end of negative experiences for so long that they can tend not to believe that life can ever get as good as they may dream and desire. So they keep their needs to themselves. Having asked for help only to have it constantly denied in the past, they learn not to ask.
'Ask!' is easily said, but not easily done. I return to the points I made on self-advocacy, assertiveness, mutuality, and solidarity.
Social interaction is a minefield for autistic people, with overwhelming sensory demands (light, sound, movement of people), and any number of communication lines to keep track of. There is a flow and rhythm to conversation that autistic people can find hard to follow, eventually giving up on participation and merely focusing on the tasks of endurance and survival. Social interaction puts immense pressure on an autistic person's processing speeds and working memory. This point can't be emphasised enough. Whilst autistic people can look slow and stupid, in seeing and hearing everything at once they are processing x times the information that NT people are, their brains working at a million miles an hour, their senses working overtime.
The problem is frequently misdiagnosed as social anxiety. I did it myself when going to my doctor complaining of 'psycho-social anxiety.' She had heard my complaints before, sent me on an anxiety course, and seen no resolution. She listened carefully and raised the possibility of autism. The social anxiety is not a cause of the problem but a consequence of it.
So how do autistic people typically deal with the problem?
The most common response of autistic people to the problem is to withdraw from the social situation, stay outside of the group, and isolate themselves. They have simplified the situation by cutting communication lines back to whatever they feel they can handle. They have solved the problem of too much information by cutting information back to the minimum. At extremes, autistic people just isolate themselves, keep themselves to themselves and seek no contact with the outside world. Which is to solve one problem by creating another. The reality of the buried life is the silent sorrow of the unspoken word.
The most common response to the problems of social situations is no solution at all, merely the continuation of the problem of social interaction in another form. A proper solution to the problem is to meet with just a few people in a safe, quiet, and familiar place. Here is a place where autistic people find it easier to follow conversations, where there are fewer lines of communication, and where they have time and space to work out what they want to say, how to say it, and when to say it. The problems of holding thoughts in one's head, of knowing when to speak, of spotting breaks in
conversation are either removed or simplified.
This 'better solution' offered by Asdis will come as no revelation to most autistic people. I am verbal, eloquent, and articulate one-to-one or in tight groups of three. Beyond three and I start to lose my bearings and close down. There is a stark contrast between how loud and lively I can be one-to-one and how quiet and withdrawn I am in a social group. The 'better solution' is one which autistic people have learned by their own experience. It is, however, not the solution which autistic people are taught. The social interaction and communication which characterises NT socialisation is the model which is presented to autistic people for them to follow. The results are predictable. Time and again, autistic people are pressured into entering social situations which they are not equipped to deal with, suffering stress, and becoming overwhelmed.
Do people learn?
The first response of people, which too often is their only response, is that 'you will get used to it,' 'confront your fears.' Such views presume that the NT model is a fitting one for all equally. They are ignorant and, when persistent, harmful.
You need to develop the strength to insist on doing things the way you prefer. By doing this, you change the difficulty and address problems on your own terms, at your own pace.
The problem is that NT others who persist in the 'normal' ways of functioning won't necessarily allow you or follow you. Whereas formerly you may have been inclined to isolate yourself, by asserting your needs and preferences you may well end up isolated anyway as a result of being abandoned by those stuck in their own grooves.
Letting Go of the Past
As the webinar closes, Asdis makes a point which I found a little jarring, even if I understood it. She said that there is a need for therapy to avoid focusing on the past. Given that past experiences loom so large in understanding and coming to terms with one's autism, this struck me as counter-intuitive. She notes that people talk about the past in most trauma therapies. How could they not? The past is key to the diagnosis of autism, with examples of past events and happenings serving to add some heteronomous flesh and blood experience to abstract diagnostic criteria. Asdis' point is a good one: healing emotional wounds will not fix your executive functioning. Having identified a problem, the task is to resolve it. There is a danger of constantly returning to the past for examples to prove a point, so much so that a person comes to get stuck in the past. Not only will healing not happen that way, you may well find that you are constantly reopening old wounds. You cannot change the past, only your future. Asdis therefore insists that people do not dwell on the past more than is necessary. People can pour over every detail of their past as if it offers some decisive proof of your condition. The fact is, though, that the need for such proof has gone with diagnosis. There is also the feeling that somehow there will be a healing and closure the more you can find and explain every negative moment in your past. This is the belief, common in therapy, that if you can unearth every forgotten or repressed trauma in the past you will have some sort of epiphany. It's an illusion. All you are doing is raking over the same old details in constant search of new ones. You already have enough information to enable you to move on in knowledge of who you are. Dwelling on the past won't resolve the problems that beset autistic people because these concern successful functioning in the present. Resolving past issues will not resolve present issues. There is a danger of concentrating ones energies on fighting past and long since lost battles past, to the neglect of challenges that exist in the present. There is, therefore, a need to focus on making changes in the present. Knowing what your needs were in the past and hurting over how they were thwarted won't be of any help in the present, for the very reason that your needs will have changed. Knowing your needs in the present will change your quality of life in a way that a focus on your frustrated needs in the past won't.
There is a need, then, to focus on the present with a view to making the changes which will bring about a future worth having.
The past is a cemetery of broken promises, lost hopes, and shattered dreams. Dwelling on them consigns you to a permanent defeat, depriving you of a future. The past is a hopeless place. The future will always belong to those who have hope, those who have the faith and courage to be able to live forwards into mystery. 'People need to believe that something fun will happen in the future,' writes Asdis. Fun and frolics are fine, I can't get enough of them. But I think we can write of reasons and goals of a future willing in much nobler terms. But I do like how she puts getting a job on the same plane as getting a gerbil. Whatever makes you feel glad to be alive and look forward to the future will do it. We all need something to look forward to and someone to report back to from the outer frontiers of existence.
And CBT? Asdis says that she 'does without CBT because it's completely useless' to get autistic people to do worksheets, homework etc because they forget about it, they have memory problems and they have executive functioning issues. She states that all psychologists are expected to measure everything. Is something isn't measurable then it doesn't exist, if something isn't measured then it isn't important. Such measuring isn't psychology, it is an inhumanism, one which fits the mad mechanarchy of a world in implosion. I don't care for it and neither does Asdis. She doesn't measure. She doesn't tick boxes. She reads between the lines of the standard questions which, in being standard, always miss out the key details.
It's what makes people happy that is important – and that is related to what people want and need, their confidence in asserting themselves, and the extent to which they are heard and understood.
Asdis ends with this quote:
“You are not broken, you do not need to be cured of [being neurodivergent]. You need support, validation, good coping skills. You need and deserve acceptance.”
(Sonny Hallett, quoted in the Scottish Survey of Autistic Adult's experiences of counselling, 2020).
There is plenty that autistic people can do for themselves, things they need to work on, good habits that they can develop. I'm all in favour of developing autistic agency and initiative. Heaven knows, if we waited for the help and support of 'society' to come to the rescue, we will be waiting forever. My trainer at the gym gave me the name of Mel Robbins as someone whose motivational work is worth checking out. One of her key wake-up calls is 'no one is coming!' If you have a problem, you had better start seeing what you can do to sort it out, because no one is going to do it for you. In “You Want it Darker,” Leonard Cohen writes of the “million candles burning for the help that never came.” Autistic people learned the lesson in their earliest days that their pleas for help will be unanswered. It thus strikes me as strange to see how many diagnosed adults – myself included – having so many false hopes with respect to social support and institutional help. It seems that that support and help will never come. Not unless it is forced from below by way of an autistic grassroots movement. There is a need to move beyond autism awareness and understanding to insist on autism acceptance. Awareness is merely the recognition that something exists; acceptance involves a change of behaviour in light of awareness and understanding. Acceptance is a condition of support and help. Autistic people have a responsibility to do what they need to do, but shouldn't be expected
to exhaust themselves in the attempt to do more on account of wider society's failures and abrogation of responsibility. It's an age of 'be kind' 'virtue signalling' 'social justice warriors' – over to you. Autistic people need caring, sharing neurotypical people to step up to the plate and put a shift in for the cause. At present, the accent is falling almost exclusively upon autistic people to make all the running. It feels like taking on society as a whole. And that can't be done. By focusing on discrete individuals, therapies have people attempting the impossible. It seems somewhat redundant to argue that such therapies will not work. To criticise a therapy for not working is to presume that it is being offered as a solution to a problem in the first place. I have learned enough about institutions and organisations over the years – by way of direct experience and academic research – to know that more often than the point of many actions is not the solution of problems, merely to give the appearance of something is being done when in fact nothing is being done – the problem is being buried, to save resources being wasted on people written off as worthless. It's all performative. To the extent that the scandal of wasted lives and potentials continues with mass acquiescence instead of outrage and protest, the pretence of support and help being offered by existing institutions is 'working.'
It's time to get awkward, speak out, and be blunt, no matter the upset it may cause. If CBT works for you, then fine. The same for mindfulness, meditation, and medication. My instincts told me that these were a taste of time from the very first, a cheap and cheerless strategy designed to save institutions that could care less resources that they don't have in any case. If that sounds negative and cynical, bear in mind that I didn't reject any of these things when offered them. I suspended my better judgement, suppressed my instincts, and tried them to see what they had to offer. I can see how they could work for some people in some contexts. There really is no substitute for a productive orientation to the world, a decent job, an embeddedness in community life, family, faith, civic involvement, patrie, being part of all that you see. Therapy is something that appears and grows in the absence of all these healthy social connections, like a toadstool growing upon theputrefaction of society. Myphilosophical work focuses on that putrefaction and the moral and social transformation required to restore health. With therapy, it seems as though autistic people as discrete individuals are being charged with the task of saving themselves in the absence of the requisite societal changes. For my part, long walks in town and country, exercises in the gym with my wonderful trainer, and hours listening to Francoise Hardy improve my sense of well-being much more.
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