I have had extensive therapy, as one might expect for a recovering drug addict who is also Schizophrenic. I have had mindfulness therapy, Acceptance and Commitment Therapy. I’ve had Cognitive Behavioural Therapy, trauma therapy, psychoanalytic therapy. I’ve also had courses of therapy that use mixed approaches. Thanks to the NHS here in the UK, I have recieved all this for free. The problem is that while free, it was time limited.
Here is why that has been a problem for me as an Autistic person.
So often, therapists have said that they are able to work with my admittedly rather complicated profile of experiences. In particular, they will often claim that they have experience working with Autistic clients. The problem is that fundamentally, they don’t have a clue. This has left me with a difficult decision; educate the therapist or endure hours of inappropriate therapy.
People don’t come to therapy because they are in a good place. In the UK, a lot of therapy is gatekept behind “thresholds” of distress. Most (if not all) NHS trusts currently operate on a framework of crisis-driven intervention, which means that a person has to be in crisis before they receive support. Why then are we expecting Autistic people to waste their spoons and therapy sessions teaching a therapist what life is like as an Autistic person?
When we approach a therapy session, we come with the expectation that the therapist is the expert. Being faced with a professional who has little knowledge outside of awareness courses and mandatory training not only places the onus on the Autistic person to educate them; it undermines our confidence in the effectiveness of therapy. Having a level of confidence that therapy can work is vitally important to the process.
Therapists who do not understand Autistic experience will often employ behavioural strategies and infer thought patterns that are overtly incorrect. This can leave Autistic people feeling like therapy is more of an exercise in gaslighting than something there to help them. When faced with this, Autistic people will often feel forced to explain Autistic experience to their therapist. This means that time is wasted, and the process itself can often be intensely triggering, making any crisis worse.
This is why therapists need to spend time engaging with the communities that they work with in not only a professional context but also in the context of being the learner to willing educators. It is not okay for therapists to expect free labour from those in crisis.
This is perhaps one of the biggest accessibility issues in the world of therapy. Until such time that it is resolved, Autistic people are going to be left out in the cold during their time of greatest need.