The Autism-Expert Spectrum

I’ve started seeing a new therapist. He’s a Clinical Psychologist, PhD, and although his advertised expertise is in helping people with sleep disorders, chronic pain, and mood and anxiety disorders, apparently his own sister is autistic, and he has a long-standing personal and professional interest in autism, as manifested in his professional training and especially the various autism-related research articles he’s co-authored and published in a variety of peer-reviewed professional journals.

So after interviewing me for 45 minutes last Friday afternoon, this kind gentleman informed me that in his opinion, with regard to my location on the so-called “autism spectrum”, he’s inclined to see me as being near some hypothetical “borderline” (his word), which I understood then and still take to mean that I’m somehow not actually autistic (perhaps like his sister is autistic), but am perhaps, say, merely autistic-ish.

And even though I rather like autistickish[1] to describe myself — hence the name of this blog — somehow I still felt wounded or invalidated by this man’s (initial) assessment of me. It felt like an insult of some sort. In the session I tried not to seem wounded or insulted, and definitely didn’t try to defend myself against the slight, but in the days since I have been somewhat preoccupied with this incident. My mind keeps returning to it, replaying it. I keep trying to figure out what I will say to him about it in our next session. I definitely feel a significant urge to defend myself, which is a key component of the “ultimately self-defeating” lifelong habit #2 that I wrote about in my recent post Validate Unto Others….

Basically, I feel somehow invalidated by him, and now I feel the urge to reciprocate his invalidation. I’ve considered various approaches to this. I might criticize his apparent assumption that a 45 minute interview is long enough to reach some sort of conclusion. In comparison, my initial ASD diagnosis came only at the end of a full day of psychometric tests and interviews, and has since been corroborated by a psychiatrist at a prominent university autism clinic who trains medical students in autism related topics and who has been interviewing me almost monthly for a year and a half.

I might ask him whether he’s afraid that fully endorsing my ASD diagnosis might one day lead to his being accused of fraud by an insurance company. If he is worried about that then the conflict of interest between his wish to help me and his wish to protect himself from ruthless insurance companies could be affecting his judgment.

At the moment my favorite approach would be to postulate first a spectrum of autism expertise that ranges, say, from “has seen a few episodes of The Good Doctor” to the collective of the World’s 100 leading autism researchers; along with a hypothetical “borderline” that separates the real autism experts and everyone else; and then ask him how close he thinks he is to that borderline.

Yeah, that’s the old me. As I explained the other day, I’m committed to changing this habit, which implies that I should really be trying to figure how to validate him in some way.

But at the moment I’m at a loss for how to do that. Let’s call it a “work in progress”.

Suggestions welcome!


[1]I think the k is required in the spelling to clarify that the c in the suffix is hard and not soft as it is in words like mysticism, criticism, ostracism, etc.

Image Credit: hschmider on Pixabay.

22 Comments

  1. I think many people would have the same first reaction and thoughts. Kind of like a young child saying “Shows what you know!” *sticks tongue out*😂😂 It’s probably not a good idea to go that route though.
    My opinion (we all know what that’s worth) is you should just be honest and tell him what you felt and thought. Showing him this post, as Rach commented, is not a bad idea.

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  2. Perhaps in his great wisdom he might be able to share his ideas on how you could best overcome the challenges he has identified that are consistent with autism. He might get so excited at the opportunity to share his expertise that he keeps on running with it in the autistic direction.

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      1. If it was me, I’d be interested to know on what grounds did he come to that assessment. It’s not challenging his authority or anything, merely asking as a patient is entitled to, about my own condition. Only then will I be able to respond to his observation.

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      2. Yes, that’d be a challenge for me too. I can only imagine when I get his report or when he is explaining his grounds, I’d be going through those grounds in my mind, one by one, thinking of counter examples to refute.
        It might also be useful to let him know, if he doesn’t already know, about your previous assessment and diagnosis. And if you do appear confrontational, that’s because you’re now confused about the two conflicting diagnoses. That’s only reasonable excuse, sorry, I mean reason 😜

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  3. I think of autism not as a spectrum such as a colour spectrum, but as being many spokes on a wheel. The wheel consists of many spokes, which together comprise the attributes of what it is to be human. Some of the spokes represent the various characteristics which are used in the diagnosis of autism. For example one spoke might represent the ability to read body language, and another might represent the degree of rigid or flexible thinking. If one thinks of the outer end of each spoke as being at the savant/genius end of a skill/ability/trait, and the hub end of each spoke as possessing absolutely no skill/ability/trait, then the average position for neurotypicals is midway along each spoke.

    For those characteristics that are used to determine whether or not one has autism, neurotypicals will be very near the centre of each spoke, but the average for autistics will be between the centre point and the hub. How near the average is towards the hub is how I think many people determine “high functioning” and “low functioning”.

    My average position for autistic tendencies probably lies just inside the halfway mark, which is probably why I wasn’t diagnosed until I was sixty. But some characteristics, are very near the hub. I’m incapable of recognising non-verbal forms of communication and cannot “read between the lines”. I’m unable to recognise individuals by facial features, and I’m hypersensitive to light, sound and smell and can easily get overwhelmed by external stimuli. On the other hand I dislike rigid routine. Some skills such as tying shoelaces and doing up buttons still require mental concentration, but at one time, I could keep track of 40,000 lines of program code in my head for a system I developed for my employer.

    When you state “borderline”, to me that means that the average of your autistic characteristics is just inside the halfway mark. But that doesn’t preclude some characteristics being near the hub of the wheel. It just means that some other characteristic(s) lie somewhere outside the centre point of the spoke(s) to bring your average nearer the centre. You can still gain a benefit from help/assistance for those characteristics that are nearer the hub.

    Don’t forget that the spokes used to determine a diagnosis of autism changes over time, which is why some people perceive there’s an autism epidemic. There’s a possibility that under the new DSM-V definition of autism, many people who have been diagnosed as being on the autism spectrum in the past would not be diagnosed as such under the new criteria. That doesn’t mean that they don’t need assistance. It just means that they are unlikely to get the assistance they need/deserve.

    If I were you, I would continue to see the psychologist (for the time being at least), and try to direct him towards those traits you feel are “most autistic”. I agree with others here who have suggested showing him this post (and our comments). If he’s to be helpful to you, he has to be able to understand where you’re coming from. He doesn’t have to agree, just understand.

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