Is CBT harmful for Autistic Adults (Effects of Cognitive Behavioural Therapy nobody talks about!)

Is CBT good for autistic people? As you may be aware CBT or cognitive behavioral therapy is one of the most popular well-researched and effective therapy methods out there. But does it work for autistic people and can it even be harmful in some cases? In this video I'll give you a quick rundown of what CBT is, what it's really good for and also critically what it's not so good for, to hopefully help you decide if it's right for you. Hi everyone, Paul Micallef here from Autism from the Inside. I make weekly videos sharing the human side of autism so make sure you hit subscribe to get the latest content. So is CBT good for autistic people? Well, spoilers, perhaps this is not the most radical statement in the world but CBT is not the magic panacea for absolutely every single mental health challenge that we may face as human beings in the world. So logically it should not be shocking or controversial to hear that CBT is really good at what it is designed to do and not good at what it does not do. Unfortunately in practice it often gets recommended as the thing to try first even when it may not be appropriate. For example I recently got a GP referral to see a psychologist for anxiety and depression and pretty basic stuff like that. And when I read the referral letter it recommended CBT. So fortunately these days I've learned to have a quick chat with my psychologist before our first session just to make sure that they're a good fit for me and we identified in the first five minutes that CBT would not be the appropriate method for us to try and we found a different type of therapy and we're trying that now. So that all worked out fine but I do think it's interesting that the first suggested option was CBT and we had to actively rule it out before thinking about other therapies. So what is CBT and what is it good for? So it might sound kind of complicated at first, this fancy name cognitive behavioral therapy, what does that mean? It's actually a lot more straightforward and intuitive than you might think. CBT relies on the very powerful idea that our thoughts have a strong influence over our emotions right that's the cognitive part and you know what else influences our emotions and how we feel? Things like past experience, emotional conditioning and and behavior patterns that reinforce the stories we tell ourselves about our lives. That's the behavior part and when you put these things together how we feel is strongly influenced by our thoughts and also strongly influenced by our patterns of behavior you have behavioral therapy. Massively oversimplified I know but that's CBT in a nutshell. So if that's a little bit too theoretical let's take a really really stereotypical example of a fear of dogs for example. So the way it works is let's say one day I was scared by an aggressive dog. The next time I see a dog my body remembers that I've been in this situation before and so I feel unsafe again preemptively even before anything has happened. If I then take the action of moving away then suddenly the fear and the feeling of being unsafe goes away and I learn to avoid dogs because of this negative emotion that I feel and all of a sudden I'm developing a pattern of behavior of avoiding dogs because when I see one it makes me feel unsafe so I avoid them and then I feel better and I think that's a good thing and next time I'll do the same thing and it's a self-reinforcing pattern. The problem with this self-reinforcing pattern is that it gets further and further and further away from reality so the very first time I got scared well there was probably something to be scared of then whereas if I start avoiding every dog because of the fear that I feel around it it's got actually nothing to do with the real safety of the actual situation it's all to do with my conditioning of something that happened a long time ago rather than the immediate situation. So what is CBT and how does it help that kind of situation? So CBT is essentially a set of tools to help disrupt that self-reinforcing pattern of behavior. For example instead of habitually avoiding every dog that I see I could ask myself the question the rational logical question is this dog unsafe? Is this situation safe or unsafe? And if the answer is actually the situation is safe then I can notice that my feeling is out of proportion to the actual situation. I could then choose a different behavioral reaction and instead of avoiding the situation I could choose to stay in the situation a little bit longer and give myself a new experience to break the pattern. If I have a positive experience and suddenly oh this dog is actually really friendly I actually am having a good time this is a positive experience maybe I don't need to avoid every dog that I see maybe I can make a decision is this particular situation one that I want to engage in and very often the answer will be actually a lot of dogs are really fun and playful so maybe I can allow myself to have that fun playful experience. So CBT is a tool or a set of tools helping you to question your own beliefs and change patterns of behavior that have become a problem. In practice this is fantastic for tackling very common everyday mental health challenges such as anxiety and depression when that anxiety and depression is exacerbated by negative thought spirals and unhelpful patterns of behavior. In my case for example I'm not depressed because of negative thoughts I just feel really flat and lifeless for no good reason and things that I do which are really positive things which you would think I would feel positively about I just don't feel positively about. The technical name for that is anhedonia very common in depression where things that would normally make you feel good are no longer having that effect. So back to CBT there are lots of things that might cause or exacerbate anxiety and depression and it just so happens that having negative thought spirals is really really common especially in the neurotypical population. Hence why CBT is very popular and very effective in a large number of cases. The problem is if you're a hammer everything looks like a nail. Hammers are fantastic tools but if you try and use one to hammer in a screw then you're probably going to do a lot of damage and end up with more harm than good. So how does this relate to the autistic population? Well in my experience the majority of autistic adults that I see both in my coaching practice and in the community tend to be struggling with a few fairly universal things. Things like unmasking and burnout, building self-confidence, getting in touch with a true sense of self especially if you've been masking for a long time and finding good and appropriate ways to express what you've previously kept hidden. So if you're struggling with those things that is almost the opposite of CBT. CBT helps you to slow down and check your thoughts and emotions rather than acting on them straight away but if you've been masking you've been doing that too much already. I don't need help suppressing my emotions I need help to get in touch with and feel and express what I have currently been suppressing too much. Another way to think about this is that CBT helps people to take a more rational approach and if you are already an incredibly rational person who likes to stop and overthink and can get in trouble because that overthinking process prevents you from acting out on on your thoughts and desires and everything like that then CBT helping you be more rational is unlikely to be helpful and instead you're probably going to want a therapy that helps you to pause your rationality, pause your logic and get in touch with how you actually feel about a situation so you can learn how to express that in a more helpful way. Ultimately the most important thing is that my thoughts and feelings align with the reality of my situation. If things are legitimately not okay at the moment then thinking positive is actually just avoiding the problem and problems that we avoid do not go away they grow and grow and grow in the background unchecked until they eventually are so big that we absolutely cannot ignore them. So if you are the kind of person who has been thinking positively for too long and has not expressed appropriate negative emotions around your situation which is actually really challenging at the moment then perhaps a therapy that would be more helpful for you at the moment is one that can help to bring your thoughts and feelings closer in alignment to the reality of the situation that you're experiencing. So I guess in conclusion in my experience I've noticed that a lot of autistic adults tend to be high masking and already good at being very logical and very rational and suppressing and putting a check on their emotions and their thoughts and feelings and if that's you then it's unlikely that CBT is going to help in that particular situation since it encourages you to do the very thing that probably caused most of these problems in the first place leading to masking and burnout and eventual overwhelm. So fortunately there are a lot of therapies out there and CBT is only one of many even if it is the one that people often go to to start with so I'd encourage you to talk to your psychologist or counselor about which type of therapy and which approach they use and finding one that's actually going to be beneficial for your situation. When I saw a psychologist for the first time I didn't realize that there were lots of types of therapies and I didn't realize that they were all quite different from each other and so I kind of had this feeling that it was a little bit useless but I didn't know any better and I just pushed through because I thought that's what you do and this must be what therapy is and 12 months later it was a huge waste of time and a huge waste of money and I wish I knew what I know now around the fact that it's really important to find a therapist who connects with you really well that's actually a big part of the process that the relationship you have with the mental health professional and the other thing is that not all therapies are appropriate for every person so finding the right type of therapy is also very important. I've also learned that talking to your therapist about this kind of stuff can be a really good gauge to figure out how much they're going to listen to you and to figure out how much you feel like you're on the same wavelength because if you're feeling that they're not really understanding or they're trying to push something on you that doesn't quite feel right that may be a red flag that you'd be better off finding someone else that you have a better connection with. So now that I know what therapy is or at least what it can be and how beneficial it can be I recommend that everyone should have a mental health care professional to talk to if possible to take our mental health as seriously as we take our physical health otherwise thanks for watching I hope you found this valuable I'm curious to hear what you think if you've had an experience with CBT does it work for you have you found other therapies that other types of therapy that have worked for you I'm curious to hear your experience in the comments otherwise thanks for watching and I'll see you again next week. Bye

Channel: Autism From The Inside

Views: 97,631

Keywords: Is CBT harmful for Autistic Adults, autism, autism spectrum disorder, asd, what is autism, autistic, autism experience, what autism feels like, paul micallef, paul micallef autism, Effects of Cognitive Behavioural Therapy, CBT for Autism, Cognitive Behavioral Therapy and Autism, Cognitive Behavioral Therapy for Adults Autism, CBT For Burn out, Autistic Masking and Therapy, Autistic Burnout and Therapy, Depression and CBT for Adults, What is CBT Autism, Autism in women therapy

Id: YtalhGeKVNM

Length: 12min 6sec (726 seconds)

Published: Thu Mar 23 2023