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How autistic people & their talking therapist / hypnotherapist can create a therapeutic relationship

How autistic people & their talking therapist / hypnotherapist can create a therapeutic relationship

How autistic people & their talking therapist / hypnotherapist can create a therapeutic relationship – a guest blog by Kathy at Arrive Therapy.

If you’re considering cognitive therapy or hypnotherapy as an autistic person – maybe to help with areas such as anxiety, self-efficacy, confidence, relaxation, self-esteem, social anxiety etc – you may be concerned about whether it’s for you.

In our blog ‘Can hypnotherapy, Hypno-CBT and mindfulness tools help autistic individuals’, I wrote about possible barriers to taking up talking therapy or Hypno-CBT for autistic individuals – these included (but aren’t limited to) –

 

1. A barrier to a good working alliance (therapeutic relationship) with the therapist, due to autism’s ‘socio-communication’ characteristics.

2. Difficulties with interoception (our ‘body feelings’) may reduce awareness of sensations and emotions.

3. Issues of cognitive flexibility may affect one’s ability to consider alternative possibilities (e.g. in terms of thoughts, beliefs and behaviours).

4. Sensory sensitivities may affect the efficacy of practiced tasks between sessions.

In this blog, let’s look a little more at autism’s ‘socio-communication’ characteristics, and how that may affect an autist’s choice of talking therapist or hypnotherapy practitioner. Obviously if you’re a fan of spectra.blog you’ll know that autism is widely considered to be a set of neurology configurations affecting the individual’s processing abilities, at varying levels – hence the term ‘spectrum’ in the diagnostic phrase, ‘autism spectrum disorder’ – so, no two autists are the same!

 

Is autism hyperfunctioning of neural circuitry?

One interesting theory (developed by Kamila and Henry Markram, and Tania Rinaldi) proposes that autism is a mental overload. The Intense World Theory proposes that autism may be described by hyper-perception, hyper-attention and hyper-memory, with the brain’s major functions working at increased capacity that leaves little ‘energy’ for social interactions.

The Intense World Theory also supports the idea that rather than a lack of empathy (a common myth), autists experience over-sensitivity in the field of empathetic responses. Many autists agree with the concepts behind these theories, and the idea of hyperfunctioning of neural circuitry, and a state of over-arousal for autistic individuals. The lack of energy’ (or spoons – see this blog for a definition) for social interactions extends to talking therapy too!

Socio-communication and autism

Whether or not you agree with theories like this, socio-communication characteristics (or difficulties) are definitively a key area for autistic people. Modern theorists agree that the ‘issue’ doesn’t just lie with the autistic person however, but cite a double empathy concern.
This considers the fact that two or more individuals of differing neurologies (e.g. autistic and neurotypical or non-autistic) often communicate in a different way than two or more people with a similar neurology will do. (Autists are for example often drawn to other autists, or ‘sensitive’ types. It is usually a subconscious ‘attraction’ based on neuroception.)

Many aspects of autistic social presentation are described by diagnosing clinicians as being ‘atypical’ in autistic individuals, including abnormal facial expressivity, irregular use of gaze, lower rates (or unusual timing) of expressive gestures, and unusual speech patterns.

These communication differences sometimes mean that autistic people may find socialisation difficult if it feels out of their control, includes large numbers of people, is worsened by sensory issues, or relates to areas that are difficult for them – for example, induces social anxiety, shame or embarrassment.

Autistic bandwidth

(Of course, some autistic people, although this isn’t exclusive to autists, are non-verbal, or can communicate verbally at different levels on different days. This warrants a different conversation and another blog post – one for another day!)

Autists may also sometimes feel ‘overloaded’ – through the experiences of their day, the surrounding environment, and any number of factors that have consumed their ‘emotional bandwidth’ on that day, or at that time.

Talking at length with them, and talking at all sometimes, can be an extra drain on their bandwidth and resources.

Hence, because autists may communicate in subtly different ways, talking therapists may need to adjust their processes to suit the individual.

Why autism’s ‘socio-communication’ characteristics are not a barrier to Hypno-CBT therapy

 

If you’re considering cognitive therapy or hypnotherapy as an autistic person – maybe to help with areas such as anxiety, self-efficacy, confidence, relaxation, self-esteem, social anxiety etc – you should work with a therapist who understands autism.

Some examples of what you should expect as an autistic client, if you’re seeking Hypno-CBT include:

1. The hypnotherapist knows that your body language (something that behavioural hypnotherapists take into account a great deal in their therapy) may present differently. E.g. your facial expressivity, use of gaze, expressive gestures etc may be different, and not indicative of what you’re feeling.

2. The hypnotherapist knows that your speech patterns may also not be indicative of what you’re feeling. As autists, sometimes we may seem ‘flat’ and neutral, when in fact we are very content or happy.

3. Your therapist knows that you may need extra processing time – this may be to find a certain word, visualise a scene, or process an emotion.

4. The hypnotherapist is aware that initially, the social anxiety presented by working with a new person (a stranger initially) may exacerbate the issue they would like help with. Understanding these issues and putting the client at ease means the required working alliance or relationship can progress.

5. The room (if it is a face to face meeting) is sensory friendly – the hypnotherapist can find out in advance any requirements regarding lighting that may need to be met. Factors like traffic noise, buzzing electrical devices and conversations from the next room, could all affect the working alliance for autistic people, in terms of distractions.

6. (It is important to note that working online, e.g. via Zoom, may be preferable for autistic people, as the online environment may be deemed to be more comfortable and ‘safer’, from a neuroception point of view.)

I hope this blog has helped allay fears about developing a therapeutic relationship or working alliance with the therapist, due to autism’s ‘socio-communication’ characteristics. We will look at some of the other areas listed at the start of the blog in forthcoming articles!

Read more about therapy and autism at Arrive Therapy’s Hypno-CBT blog.

#neurodiversity#autism#autismacceptance#neurodivergent#actuallyautistic#asd#autistic#neurodiverse#autismspectrum#aspergers#differentnotless#autisticpride#autisticadults#inclusion#anxiety#highlysensitiveperson#hsp#empath#highlysensitive#highlysensitivepeople#empathproblems#selflove#nothingaboutuswithoutus

Using self-efficacy, presence, insight and cognition when dealing with a heightened autistic child

Using self-efficacy, presence, insight and cognition when dealing with a heightened autistic child

Using self-efficacy, presence, insight and cognition when dealing with a heightened autistic child – a guest blog from Kathy at Arrive Therapy (Hypno-CBT & cognitive behavioural therapy):

Green graphic stating - Efficacious - in control of your actions, reactions & boundaries Present - aware of your emotions, and of the importance of Now Insightful - understanding the effect of your beliefs and self-talk Cognitive - aware of your neuroception & processing styleOur ethos is based on four pillars, which are, in order to make EPIC life changes:

Efficacious – in control of your actions, reactions & boundaries

Present – aware of your emotions, and of the importance of Now

Insightful – understanding the effect of your beliefs and self-talk

Cognitive – aware of your neuroception & processing style

 

However, it can be hard to put this rather abstract concept into practice; so let me give you an example. I support and advocate for autistic people as well as families of autistics, and this is a real life scenario from a parent support group that I am involved in.

“I wish you would die, Mum”

A child (it could be a neurodivergent child, or it could by a neurotypical child – the principles are the same); is quite angry. He or she is saying something like this to his parent (or relevant care-giver): ‘I wish you would die, Mum’. Our first instinct is often to react with what our parent would have said to us; this usually takes on one of two forms.

The angry parent. ‘Don’t talk to me like that.’

The hurt parent. ‘After all I do for you! I am so upset you’d say that to me’.

Are we using dated parenting phrases?

If we are using words our parents said to us (who were using words their parents said to them, etc etc), we quickly start using Victorian parenting phrases when we’re in the 21st century!

The more Adult (and ‘detective’ or curious) way of looking at it is to ask: what’s the child afraid of? Autistic individuals can’t always express their feelings (they can swirl around inside us, being felt, and not expressed ) – maybe here, for this child, they’re afraid of rejection – they feel a connection has been lost with the Mum – they’re fearing rejection and they protect themselves by creating the rejection first.


So, sometimes you can almost reverse what a frustrated child is saying, to work out what feeling is driving their words. Saying something Adult to them like: ‘Well that’s a sad way to feel, that must feel difficult, but I am not going anywhere, and I love you. Let’s talk when you have calmed down’ attempts a reconnection , and doesn’t enforce the rejection.
Let’s look at how we used the EPIC ethos here:

Efficacious – in control of your actions, reactions & boundaries.

You didn’t react in a knee-jerk way. You responded in an Adult way. You didn’t let your own experiences dictate the conversation / situation. You halted an unhelpful reaction.

Present – aware of your emotions, and of the importance of Now.

You’re a parent of a hurting child – you let that response (or role) lead the way. You focussed on the moment – in which the child is heightened – and suggested discussing it later – this means neither of you will be so reactive and heightened at that time.

Insightful – understanding the effect of your beliefs and self-talk.

‘Don’t talk to me like that’ and ‘After all I do for you.. I am so upset you’d say that to me’ are your beliefs about how a child should speak to their parent and vice versa. But are they really YOUR beliefs, now, as a parent? Or are they your parents’ beliefs? Does your self-talk tell you to instil more discipline?

Cognitive – aware of your neuroception & processing style.

If you wanted to yell: ‘Don’t talk to me like that’ or similar, you were probably triggered – this is your neuroception at play. It probably took you to an unsafe place – somehow, you felt defensive, even child-like. If you felt more ‘fight or flight’ than engaged, you were not in a safe place to explore someone else’s hurt. By recognising this instinctive reaction, you reduced your own feeling of unsafety or defensiveness.

I hope that this example has been useful to showcase how we can be more relational with our children, and can be more Adult in our reactions! Kathy Carter.
(Kathy’s book Autism from A to Z’ is available on Amazon.)

Read the Hypno-CBT Arrive Therapy blog HERE.

#mindfulness #healing #selflove #wellness #cognitivebehaviouralhypnotherapy #hypnoCBT #hypnotherapy #neurodiversity #autism #adhd #neurodivergent #actuallyautistic #autismacceptance #autismparenting