Part I of the online intake is here. Now onto part II. Sorry about the font changes. WordPress is so annoying for no reason.
Do you have any current or prior medical issues? What recommendations or treatment did you have? Is there any family history of disease?
Medical/neurodevelopmental history includes gastroparesis, restless legs syndrome, autism, ADHD, hypertension, kidney function that worsens with dehydration, neurocognitive disorder, and tachycardia. I see a PCP and a psychiatric nurse practitioner. Recommendations have included medication, sleep study evaluation, and testing for memory concerns. Family history includes hypertension, diabetes, and dementia.
What social activities and relationships do you engage in? What important social relationships do you have? Do you belong to any social clubs or organizations? How do you like to spend your leisure time?
No social activities. My leisure time is mostly solitary. I spend time researching topics, coloring, reading, listening to music, being in nature, and learning about astrology or tarot.
What spiritual practices and cultural influences are important to you? What other cultural groups do you identify with? How do you celebrate culture and spirituality in your life?
No spiritual or religious practices. I don’t really identify with any specific cultural groups. I sometimes enjoy online communities related to things I enjoy doing, like reading or astrology. I don’t celebrate traditional holidays, but I do sometimes acknowledge the start of astrological seasons.
What was life like as you were growing up, both at home and in school? Did you meet developmental milestones on time or experience any delays? What were your friends like when you were younger? What was school like for you?
Bullied almost daily all throughout school, but I liked learning. Home was a place where I could be freer and less stressed. Not sure about developmental delays. I was in speech therapy for a few sessions around age 5 or 6 to work on pronunciation. School report cards always mentioned that I never talk, am quiet, or only talk when someone else initiates. But I was able to speak. I may have tied my shoelaces a little later than most. And I was always clumsy. Bad handwriting.
I didn’t have many friends. I had one best friend, but she moved away before 8th grade, and I did not really have one after that.
I tried to be invisible at school. On the days I wasn’t noticed, those were good days, and I was fine. I disliked being called on, group projects, and gym. I had trouble thinking on my feet, group work lacked structure, and gym was difficult because I was clumsy and usually picked last. I did enjoy going to the library, science, literature, and math.
What strengths and abilities are you bringing to sessions?
Strengths: self-aware, honesty, pattern recognition, good at seeing reality, written communication, persistence, and direct communication.
What else is important to know about you?
I appreciate honesty and direct communication. I have visual memory and visual-spatial deficits. I have poor working memory and low specificity in recalling autobiographical events or their exact temporal order. I need therapy to stay concrete, practical, and realistic rather than focused on reframing, positivity, or increasing social activity. I don’t need traditional talk therapy to process feelings.
I left out some of her questions and some of my answers. Whew. Too much with the bad WordPress formatting.
Had the “intake” session today. She was almost exactly what I knew she would be, but she slightly believes autistic burnout is a thing but doesn’t fully understand it. Yet she doesn’t believe in alexithymia! There’s way more written about alexithymia in research and books than about autistic burnout, so that seems to be a “you are going to talk about feelings” stance, but clinicians quickly learn that that doesn’t work for me, so they quit.
My known feelings are often delayed by weeks, months, or years, so good luck with that. We only have 9 sessions left (there’s an end in sight – hallelujah). I will have more to say later. Um, I have delayed processing. I don’t apologize for the jokes. Normal therapist unfamiliar with autism, so the only way to get something out of it is to get her to not focus on neurotypical norms. Is that possible? Completely? No. But maybe 50% of the time, or I’m wasting my time and energy.
A definition of alexithymia, but leaves out the delayed part:
Two main facets of alexithymia: a so-called cognitive dimension, characterized by the inability to identify, analyze, and verbalize feelings; and an affective dimension, which involves emotional processing and the imaginative capacity to attribute emotional significance to events. (Toronto Alexithymia Scale)
So, I describe it as delayed emotional recognition related to alexithymia, because some people are delayed, so calling it a total “inability” doesn’t fit… but “inability” in the moment? YES! (Not 100% of the time, though)