More considerations

I often find myself considering the thorny issue of mental health. Sadly, it would seem, in my humble opinion, that mental health is considered the poor relation to physical health. What constantly amazes me is it doesn’t seem to change. Mental health, at the moment, seems to be geared to dealing with the emergencies, the headline grabbing moments, rather than concentrating on maintaining a good mental health. I wonder if we all maintained a good mental health if these drastic measures would be needed as much, and how much this country might save?

It seems too simplistic really, but mental health does impact on everything – physical health, work, relationships, how we interact with others, and so on. If and it’s a big if our mental health was good, and we were in a good place, feeling optimistic, how would this impact on the morale of the country? Maybe I’m just a naive hopeful individual, but if we truly took care of this, I feel things would be very different.

I am still surprised when faced with the mental health stigma, clients reporting they haven’t felt able to tell family and friends, they are in counselling. I suppose I am so used to being in the world of counselling, it’s hard to comprehend. During training, I undertook weekly counselling sessions for three years, it was amazing. I learnt so much about myself, how I am in relationship, and the things I wanted to change. I would not hesitate if I ever felt the need again to return to it. Counselling is brilliant, well, I would say that, but it gives you the opportunity to explore all sorts of issues with someone who is non-judgemental and non-oppressive, where else would you get that? I can only hope in the coming years this stigma changes, it needs to for the sake of people’s health.

If it could be proved that concentrating on mental health would lead to actually saving money maybe those in charge of the purse of the nation might let some go to the provision. Currently my experience is that clients struggle to find any help with waiting lists stretching far in the future without any chance of it being changed. A diagnosis of Asperger’s can take up to two years for an adult, unless, of course, you can pay for it. The provision for care after you receive the diagnosis is piecemeal at best. I have clients who would benefit from support, but there is none. As for the P.I.P system, well, don’t get me started! It seems to be highly unfair and draconian in it’s view of mental health – again adding to the stigma. I am hopeful things will change, the more these issues are in the news and are on social media, the more people will talk about them. So keep posting!

 

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Hypersensitivity

This is something I had not really considered when I first began working with those on the Spectrum Or perhaps a fairer representation was I had not realised the impact it has. It is with the gift of hindsight and a diagnosis I began to realise my son had suffered with it from an early age – hiding behind the curtains on a bright sunny day, removing clothing, the preference for particular well worn clothes, the absolute need to shut himself away after interaction with the world. All of these are signs of hypersensitivity. Many of my clients report hypersensitivity, things which are easy for us N/T’s to manage suddenly become extremely problematic. For instance, I had one client who described having a shower as rubbing a cheese grater all over the skin.  Others struggle with bright sunshine, or bright light, heat and sound. But there are some on the Spectrum who don’t. Throughout this blog, don’t forget the wise words of Dr Stephen Shore,  a professor at Aldephi University who has Asperger’s – ‘“If you’ve met one person with autism, you’ve met one person with autism,” every one on the Spectrum is an individual. Agreed there are certain generalisations, however, I see the criteria of a diagnosis as a gateway to reaching that particular individual. This knowledge can assist you when working with Aspie’s, but it can hinder, don’t forget to greet them as the amazing individuals they are.

Therefore, it seems only reasonable to make sure the therapy space can accommodate this, as much as possible. Perhaps wait until you use strong smelling cleaning products in the room if you are due to work with an Aspie. Make sure there the possibility to shut out bright sunlight, or be prepared to turn off any lights – I have found completely avoiding fluorescent lighting works. Check the temperature of the room, even if it is cold outside, the room must not be over warm. Don’t wear bright patterned clothing or wear strong perfume. If there is the chance of loud noises – fire alarm testing is a good example, make sure you warn the client, or change the session time to avoid it completely. The loud piercing noise of an alarm will cause the Aspie physical pain, hard to imagine perhaps, but it will really hurt. If there is an unavoidable loud noise, be prepared for the Aspie to shut down for a bit or take part in some ‘stimming’. The client might need to be quiet for a while just to process what had happened. The stimming is behaviour which an Aspie will use to soothe themselves. For instance, a client may rock or stroke clothing. Temple Grandin, American professor of animal science and famous Asperger’s spokesperson said, “When I did stims such as dribbling sand through my fingers, it calmed me down. When I stimmed, sounds that hurt my ears stopped. Most kids with autism do these repetitive behaviors because it feels good in some way. It may counteract an overwhelming sensory environment…” Adults may return to this behaviour when feeling really overwhelmed.

I suppose the most we can do in the counselling environment is to be aware, take the time to understand what each individual Aspie needs. Remember these three ‘rules’ from the National Autistic Society;

  • be aware. Look at the environment to see if it is creating difficulties. Can you change anything?
  • be creative. Think of some positive sensory experiences.
  • be prepared. Tell the person about possible sensory stimuli they may experience in different environments

 

It may take time, but it is truly worth it, to help your client trust you and to feel comfortable in the session.

Eye Contact

Eye contact – something seemingly simple to the neurotypical types. It is fated as showing how trustworthy you are. Often you hear people saying, ‘I don’t trust him, he never looks you in the eye.’ I hadn’t really considered this until Autism came into my life! It’s strange how looking at just two small parts of a person can mean so much. It is something easily taken for granted. But what if you can’t do it? What if this seemingly simple action causes you actual physical pain? How can you, therefore, manage in a world which puts so much emphasis at staring into the eyes. The eyes are lauded in fiction – the windows to the soul (quote from Thomas Phaer)  ‘Never bend your head. Always hold it high. Look the world straight in the eye.’ (Helen Keller). Like I said all this emphasis on two small areas of the face.

It is my understanding eye contact for those on the Spectrum is extremely difficult, and that, I think, is putting it mildly. I had a client who decided to make himself fit in, he would try and use eye contact. He was seeing me weekly so he told me this one week and returned a week later to share with me the results. I noticed when he entered the room how drained and tired he looked. I was rather concerned. He went onto explain how he had made himself stare into other peoples eyes, but it had made him exhausted. He described how much effort it took him to do this, how after such an episode, he would have to go home and sleep. I enquired if this effort was actually worth the damage it seemed to be causing him? His answer has stayed with me ever since ‘how else will I fit in?’

If I, as a neurotypical, writes someone off as untrustworthy just because they are not looking at my eyes, who am I missing out on? Is it so crucial? The simple answer is, no. I feel it is absolutely imperative those on the Spectrum do what they need to to keep themselves safe. Please don’t put yourself through this pain, just to look me in the eye. It’s fine. If you feel you can look at me for a bit then look away, that’s okay. If you feel you can’t look at me at all, that’s okay too. I am still going to be there as your counsellor, waiting to be invited into your space, listening to you without judgement. I don’t need you to look me in the eye.

Mental Health

I believe mental health is crucial. It is something, perhaps, that can be taken for granted. There are lots of definitions for poor mental health, but very few for good mental health. Indeed, during my training,  it proved an interesting topic to discuss. If a client enters into counselling, it would seem they are suffering from poor mental health, but what is it they are looking to achieve. What is good mental health?

I struggle with the search for happiness – not happiness itself, but the belief we should be happy all the time. Should we be happy all the time? Is it an unreasonable hope? I feel happiness is a fleeting feeling, it’s wonderful when it happens, it creates lovely memories, but does it create a difficult standard to achieve. Are the other feelings which naturally happen ignored?

Good mental health is where you feel okay, that’s it, okay. So when things happen in life, you are able to cope with the range of feelings you may experience. I suppose a good example of this to help highlight what I mean is the death of a loved one or relative. This is such a difficult time, so many feelings to deal with, all in one go. I believe whatever you feel at such an awful time is okay. You could feel numb, angry, lost, confused, shocked, relief, and so on. And there is an important caveat to this – you take as long as you need to deal with these feelings. If you can do that, and manage to get through, then surely, your mental health is in a reasonable place? If these feelings start impacting on your everyday life, then maybe, it’s time to seek some support.

Good mental health is possible. Take time to do the things you enjoy, take time to just relax. Recognise you will have many different feelings throughout the day – you may go from happiness right through to sadness, and all feelings in between. It’s okay to feel like this. Also, concentrate on today – realistically we all have appointments to attend, meetings to go to, and so on, these will be in the future. However, today is the one thing we can live with, deal with, and get through. Tomorrow will wait.

Recognising your mental health is not in a good place is a difficult process. Sadly, there is still a stigma attached to mental health, but one in four of us will suffer with mental health issues. That’s a lot of people! Your brain is an important part of you, you need it. So why don’t we take care of it? If you broke your leg, you wouldn’t be expected to continue walking around. The brain is exactly the same – if there is something not quite right, seek help. Talking therapies work, simple. Find a counsellor you feel you can work with. Remember you are the expert on you, you know what you need, and the type of person you can work with. The hardest thing is to admit you need help, you need assistance to get through this period in your life. Then you have to contact a counsellor! I am always in awe of every single one of my clients who have made that choice to feel better. You’re on your way to better mental health.

 

How I began

Second year of training as a Counsellor was when it became real! I had to find a placement to try out all I had learned on the unsuspecting public. Scary prospect not only for them, but for me too. I was lucky enough to find a placement with 4C’s in Wymondham, Norfolk and awaited my first client. It was going reasonably well, when I was approached by the manager of the service. Immediate panic, I was a trainee I was bound to have done something wrong! But no, she wanted to know about my experience with those on the Spectrum as she had been told I had someone with Asperger’s in my family. Well, that was easy, my son had received a diagnosis when he was seven years old, after a lot of battling to be taken seriously, and not to be dismissed as an hysterical mother which happened a lot. I confirmed this with the manager, to which, came the most astonishing reply, ‘Oh, you’re an expert then, you can see clients who are on the Spectrum’. Are you kidding me?? I am not an expert at all, plus the added problem – I am neurotypical. Admittedly, I had read a bit on the Spectrum, purely to try and understand what my son needed, and to find a way to communicate with him, but an expert, no way. It was after this small, and almost insignificant exchange that I began working with those on the Spectrum. Without wanting to sound patronising or melodramatic – it was the best thing I ever did. 75% of my clients on the Spectrum, and it is an absolute privilege to work with them. Yes I get it wrong sometimes, but I work constantly to connect with them, to assist them in the neurotypical world. And there is my biggest irritation – some, not all neurotypicals try so hard to make those on the Spectrum neurotypical. Why? Would it not be more beneficial if us N/T’s try to adapt? Moan over, why have I decided to set up this blog, well, it’s multi-reasoned (not even sure if that’s a word, but it sums up how I see it). I would like to raise awareness about therapy for those on the Spectrum – it works and it really seems to help. Also want to raise awareness about Asperger’s from a neurotypical view and finally, I am, hoping to write a training programme for counsellors. Lots to do! Let’s about it for now, here we go………..

Counselling

Counselling works – there is scientific evidence to back this up, all to do with neural pathways and so on. There is a focus on CBT – it would seem it is because evidence was collected and published. But it doesn’t work for everyone. I work regularly with those on the Autistic Spectrum and it would seem from my experience – CBT does not work for those on the Spectrum. Not sure why, have to admit, I haven’t investigated it further, but the responses from my clients back this view. In my years as a counsellor, most of them had had some CBT which left them confused and, sadly, feeling worse. So, note to self, don’t use CBT when with an Aspie Client.

Counselling with those on the Spectrum becomes a very different animal to the stereotypical – how do that makes you feel stuff – I have to work hard to build up trust with clients, after all, they have, very often, been met with frustration, irritation, and boredom. All of which eat away at their confidence. Trust – hard to quantify perhaps, but so crucial to the therapeutic relationship, I am tempted to say, without it, I am not sure you can have a therapeutic relationship, but that’s another discussion for another time.

Therapy needs to fit the client, not the other way around – this is even more important when working with those on the Spectrum – you have to modify how you work. A simple example would be – how loud is your voice? Have you ever considered you might be too loud? You might feel you speak at an ordinary decibel level, but for someone on the Spectrum, it might feel like you are bellowing at them through a megaphone. Not sure counselling training ever points this out? This is just to highlight, the small details, one has to consider when you’re working with those on the Spectrum.

There are so many things I have modified to be able to work with these clients. It has been so worth it, clients have left counselling feeling much better, this is down the hard work they put in too. I am going to use this platform to highlight these small changes which were needed in the hope, someone reads it, and utilises it. I suppose I would like to change the societal view of Autism – big ask, I know, but it saddens me there are many on the Spectrum who aren’t working or studying. As a society we are missing out on an amazing group of people who have so much to offer. Rant over.