CBT, reframing, social issues, & adult autism

[Cairistìona]

I started CBT the week that I started my benzo taper about a month ago.

I am very glad that I did and really wish that I had done it a long time ago -- long before I considered any meds.

So far all I have really done w/ the CBT is reframing: writing down what my anxious thoughts, reframing it with a positive one and naming the cognitive distortion.

Now that I've had to really look at the stuff that makes me anxious all day and confront them I have noticed a pattern.

A lot of it comes from feeling like I have or am going to act inappropriately in social situations. I feel like I have to try so hard just to act normal and remember to look people in the eyes while they talk (while being afraid that I may be staring) and remembering to smile appropriately and just make the correct facial expressions in general.

I know that a lot of my issues can be attributed to anxiety and OCD (which I have been diagnosed with in the past); but I really feel that there is something more.

I have 2 children in my family that have been diagnosed with Autism and PDD-NOS. And ever since they were diagnosed I wondered if I was somewhere on the spectrum.

I know that I would be high-functioning or else I would have been diagnosed as a child. I spoke early, etc. But there were weird things like my walking on my toes until about 2nd grade that were not looked into back when I was little that might raise a red flag nowadays.

I actually chose my last pdoc bc she was supposed to have experience with autism but when I asked her about it she just smiled and said that if I were autistic that I would *know* it. Which I think is a silly thing for a doc to say. From my experience being around high functioning people with autism -- it's not terribly obvious -- especially to them. And it is really annoying because her solution was to up my Paxil and Clonazepam dosages and when that didn't work switch ADs, etc. And I feel like my real issue was never addressed at all.

I am wondering if I need to see someone who specializes in adult autism for a diagnosis. But on the other hand I wonder if it is a waste of time and money (it seems to be easier to get insurance to pay for a child's diagnosis).

I wonder if expressing my concern to my therapist and looking at other therapies (to try after CBT which is itself reccomended for autism) that are beneficial to people with autism would be enough to help me.

[carolyn]

I'm so glad the CBT is working for you.

One question -- what would you be looking for with a diagnosis? Would you do anything differently than you're already doing?

[pboy]

Originally Posted by Cairistìona

Now that I've had to really look at the stuff that makes me anxious all day and confront them I have noticed a pattern.

A lot of it comes from feeling like I have or am going to act inappropriately in social situations. I feel like I have to try so hard just to act normal and remember to look people in the eyes while they talk (while being afraid that I may be staring) and remembering to smile appropriately and just make the correct facial expressions in general.

I know that a lot of my issues can be attributed to anxiety and OCD (which I have been diagnosed with in the past); but I really feel that there is something more.

I have been thinking along the same lines lately. I think that medications such as paxil can effect your 'social processing' and make it more difficult to socialize and do simple things like speak while making eye contact. Since starting on Lexapro, it has caused me problems with my social life. I also have to remember to smile at the right time, otherwise I look blank. I was starting to think this must be similar to autism.

I think also that because SSRIs can blunt your emotions, it means you may not feel the appropriate emotion in reaction to what is happening, which is what causes the anxiety. This is why I firmly believe that my social phobia was actually CAUSED by Paxil (it was NEVER half as bad before I went on it).

The only way that helps me around this currently is trying to imagine any emotions I lack as 'energy forces'. For example when my friend is getting enthusiastic and passionate about whatever he's talking about, instead of wondering why, I try imagine that I have a similar feeling inside me. I just try to fake it as best I can.

[pboy]

Originally Posted by Cairistìona

I wonder if expressing my concern to my therapist and looking at other therapies (to try after CBT which is itself reccomended for autism) that are beneficial to people with autism would be enough to help me.

I found a site here that explains about social skills training for people with emotional problems:

http://www.minddisorders.com/Py-Z/So...-training.html

[Cairistìona]

I guess I would be looking for some validation for something that has been bothering me since adolescence -- that's when I first became aware that I acted weird bc of teasing, etc.

As far as what I would be doing differently, I guess accepting that I have a developmental disorder and not worrying abt a possible personality disorder instead.

I think that a diagnosis would help me to get better guidance from therapists about focusing not only on my anxiety but having things like social skills training, etc. -- stuff that I should know and feel like I have to try so hard to learn -- even as an adult.

Maybe find out what kind of accommodations they could offer when I start taking classes again. If I had a reason for why sometimes I feel so spaced out and don't comprehend what is going on / being said -- then I think that I could find ways to work around it.

Originally Posted by carolyn

I'm so glad the CBT is working for you.

One question -- what would you be looking for with a diagnosis? Would you do anything differently than you're already doing?

[Cairistìona]

Yes, I agree with the ADs making this worse in some ways.

In my case my social/anxiety issues led me to the benzo and then to the ADs -- so I can't blame it all on the meds.

I do think that I got derailed for a while bc while the meds didn't "fix" my social inadequacy, they made it easier for me to ignore. I am mortified looking back at how obnoxious I was bc I just didn't care until later.

I'm sorry to hear that you have the issues with smiling as well. I'm not blank, though. I would rather be -- I've been told that I make "mean" faces and I am totally unaware of it. I really try to work on keeping a "neutral but pleasant" face now; but it does not come naturally and it is uncomfortable and I'm not sure how pleasant it really is since it is so forced.

I feel like I'm having to "fake it" every minute that I'm not alone or just with close family -- and I hate it.

Originally Posted by pboy

I have been thinking along the same lines lately. I think that medications such as paxil can effect your 'social processing' and make it more difficult to socialize and do simple things like speak while making eye contact. Since starting on Lexapro, it has caused me problems with my social life. I also have to remember to smile at the right time, otherwise I look blank. I was starting to think this must be similar to autism.

I think also that because SSRIs can blunt your emotions, it means you may not feel the appropriate emotion in reaction to what is happening, which is what causes the anxiety. This is why I firmly believe that my social phobia was actually CAUSED by Paxil (it was NEVER half as bad before I went on it).

The only way that helps me around this currently is trying to imagine any emotions I lack as 'energy forces'. For example when my friend is getting enthusiastic and passionate about whatever he's talking about, instead of wondering why, I try imagine that I have a similar feeling inside me. I just try to fake it as best I can.

Thanks for the link! I have been searching for things related to social skills training for a while.

Originally Posted by pboy

I found a site here that explains about social skills training for people with emotional problems:

http://www.minddisorders.com/Py-Z/So...-training.html

[pboy]

Originally Posted by Cairistìona

Yes, I agree with the ADs making this worse in some ways.

In my case my social/anxiety issues led me to the benzo and then to the ADs -- so I can't blame it all on the meds.

I do think that I got derailed for a while bc while the meds didn't "fix" my social inadequacy, they made it easier for me to ignore. I am mortified looking back at how obnoxious I was bc I just didn't care until later.

I'm sorry to hear that you have the issues with smiling as well. I'm not blank, though. I would rather be -- I've been told that I make "mean" faces and I am totally unaware of it. I really try to work on keeping a "neutral but pleasant" face now; but it does not come naturally and it is uncomfortable and I'm not sure how pleasant it really is since it is so forced.

I feel like I'm having to "fake it" every minute that I'm not alone or just with close family -- and I hate it.

Well, I can relate to this too. There are many times that I find it 'painful' to smile so it becomes more of a grimace and actually puts people off. Its not always blank. Its also hard for me to tell what emotions Im putting across to people, so Im never sure what Im doing wrong. Many times I have seen people looking at me as if Im weird, and getting annoyed at me. Since I went on paxil, I believe I was severely derailed too from a lot of social interaction I should have got at a young age. I became obnoxious too - I started shoplifting, something that would have mortified me before going on paxil, and now years afterwards.

One of the few solutions to all this was to learn to focus my attention on the external world and pick up social cues. It helped with eye contact and memory. The more I focused internally and worried about how I was coming across, made me more self conscious and anxious. I wish I had a full answer though because meds complicate the picture further.

[Cairistìona]

Yes, this is something I really need to work on.

I guess it is so overwhelming bc this seems to be something that comes naturally to everyone else and I have to study it to know what to look for as far as social cues and then try to remember them when I am in a social situation.

And it's true that focusing on other people rather than myself makes me less self-conscious.

I love reading etiquette and public relations books bc it gives me an ideal to work with.

Originally Posted by pboy

One of the few solutions to all this was to learn to focus my attention on the external world and pick up social cues. It helped with eye contact and memory. The more I focused internally and worried about how I was coming across, made me more self conscious and anxious. I wish I had a full answer though because meds complicate the picture further.

[Cairistìona]

Thanks again for the link!

I've ordered all of the books listed as resources on the site through my library and one of them: Messages: The Communication Skills Book by Matthew McKay is very good so far.

It is not targeted towards people with autism or emotional problems; but it covers everything from basic skills (like listening) and then moves to more advanced ones (body language) and specific (family, conflict, couples, public).

Just reading it on my own has been helpful and I have been able to try some of it out already; but I also think it will be a good thing to bring to my therapist so that I can better explain the things that I need help with.

Originally Posted by pboy

I found a site here that explains about social skills training for people with emotional problems:

http://www.minddisorders.com/Py-Z/So...-training.html

[pboy]

Hey that's great

I might look into getting it myself too