CBT…? Never Worked for Me. Why?
An Adult Autistic Perspective
I’ve been struggling with an article on #CBT & #Autism/#Neurodiversity for years.
Sigh. Spoons.
It occurs to me that any therapy based on purely Cognitive techniques…
even throw on some Behavioral rubber-band-snapping special sauce on the side…
Is inherently abelist. (What IS Ableism?)
Cuz the base techniques of CBT demand abilities that not all of us have.
How could COGNITIVE Behavioral Therapy NOT be inappropriate for autistics?
It’s based on the study of neurotypical populations. Worse yet? Usually white, university students are the subjects. They’re looking for a few quick bucks from the “honorarium” they get paid. Researchers are looking for cheap, easily available subjects.
Problem is… MAYBE 3% of those subjects were autistic? And ALL of THEM, to enter university had healthy IQs and functioning skills???!
At least on paper?
You can immediately see researching brains that are demonstrably, neurologically different than ours? Trying to “fix” our brains is…
Ridiculous?
Seems our neurodivergent cognitive processes are fundamentally different than at least 97% of the subjects they researched.
Kinda negating all such research? For us?
Now, the “Behavioral” part of CBT?
Basically rat training. If you shock me enough times. Sure. I won’t go through that door. AND I will struggle mightily to only have an INTERNAL stroke… rather than an external meltdown.
And the researcher… or teacher… gets to check the box, “Cured.” Cuz we’re no longer a nuisance to them. And we continue to quietly die. Invisibly. Politely. Inside
That kind of aversion from a stimulus… based on fear or pain? True for every living thing at an evolutionary level above a paramecium. Any cell, afraid it can’t pass on its genes.
Like rats. Or kids. Cuz… FEAR works. PAIN works. Especially on immature, scholl kid minds.
The cognitive part?
Substitute “executive functioning,” for “cognitive.” As in the thing largely missing from my autistic forebrain. Like decision making. Knowledge of internal states. Thinking two things at once…
Let that sink in. The entire therapy is about monitoring individual thoughts for “cognitive errors.” Then replacing them with correct ones.
Hundreds of decisions, distinctions, prioritizing, social cue processing. Ya know, per second. Executive functioning. A process that NEVER became automatic for me. As clinician after clinician cheerfully reassured me it would.
Should sound familiar. To autistic folks. The nightmare of Autistic Masking. That nearly all of us go thru.
So, look, we KNOW MASKING doesn’t work. Or FEAR. Or PAIN. We are dying from them already.
That’s all the words we need.
Every Neurodivergent population has a different cognitive profile.
Autistic, ADHD, AuDHD, dyslexic, dyspraxic…
We’re DIFFERENT thinkers than the typical population. We’re even different from each other.
And get this… Many of us overlap different diagnoses. Each with differing cognitive styles.
An autistic who also experiences ADHD thinks and acts differently than an autistic who is dyslexic. At least to my trained observation. (I was a mental health social worker for 10 years.)
We require GENERATIONAL studies of representative populations before we should be recommending these techniques.
True for most coaches, therapists, etc.
Fuck #ABA. Fuck #CBT.
A rant. Soon to be a formal-ish article. And podcast.
#ActuallyAutistic #Adhd #Neurodivergent
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