If you were ND but didn't realise, and you went to see a psychotherapist and the suspected that you were - would you want to know?

[Blinn]

Name change for this.

I am a trainee psychotherapist and have a client who didn't declare any neurodiversity, however has strong ND traits. Struggles with worrying about "boring" people when talking about their special interest. Always aware if people are talking about their special interest then thinking a lot about how to talk to them about it. Always felt different, is always aware of how they 'present' to others, is a 'different person' in different social situations among other things. Gets overwhelmed and exhausted trying to 'fit in'in social situations.

I have talked to my supervisor and practice manager and they say just meet the client where they are and don't offer advice, which is what I'm currently doing.

I've done some CPD on neurodiversity but that was more about working with clients who are living with ND already.

I really value this client and want to do the best for them. They seem to enjoy the sessions and have told me how much they are helping.

I wondered what people who are ND thought about this?

It kinda doesn't matter whether someone could correctly identify themselves based on your posts. In fact it's almost worse because there could be multiple people reading this and incorrectly identifying themselves as your client and you've just damaged multiple therapeutic relationships. Not to mention all those reading this wondering whether their therapist chats about them with strangers on the internet.

@Blinn I do think this is worth reflecting on? It isn't just the facts that you need to consider. You need to consider the potential for harm from incorrectly identifying as your client.

Perhaps you could approach MNHQ yourself and ask them to withdraw this thread?

👏🏼 Absolutely this.

This type of behaviour damages us all. It damages the reputation of the profession. My psychology and psychiatry colleagues in the NHS used to be sneery about counselling and psychotherapy, because they'd say it's an unregulated minefield and full of people who have read a bit of Rogers and think they know better than everyone else, while being quite unconsciously incompetent. Some of it was, of course, unfair snobbery. But then you see people defending Facebook and r/therapists as an appropriate place to share client material and I can see their point.

You can’t be serious.

This is actually making me think twice about therapy, which I guess is where others are saying the harm resulting from your post comes in.

It doesn’t matter whether your client can be identified. The fact is, that it’s a violation and a breach of trust.

Such a good point.

It's also unsettling to think a therapist would seek advice from randoms on the internet.

The only really excellent therapy I have ever had was with a properly qualified psychologist. You could tell the difference in quality. It was the only time my brain couldn't "see through" how they were working if that makes sense. They were really powerful sessions.

Agree as someone who has had therapy.

On your query it may be harmful if the person sees it as negative. Also there is not support and long waiting lists for diagnosis. Say you mention this and I as your client agree. Your short sessions end.

I now have a potential diagnosis, maybe for things that I find painful or embarrassing (it’s really hard sometimes knowing I can’t communicate well.) A long wait to find out potentially no support after.

Then what? For me iate diagnosed a lot of what ifs and some anger about my life being different if I had social support and diagnosis as a child.

It's how I found out that I am autistic, so I would say yes. My therapist gently suggested it to me; at first I was in complete denial but I then went away and read up on it, concluded that she was right, booked an assessment and it was confirmed after a lengthy assessment process. The knowledge has been life-changing.

Yes, definitely. For many years I was getting fobbed off by various GPs. Every so often I would get overwhelmed with everything (I described it as, 'stop the world, I want to get off) and need to take time out for a couple of weeks until my brain was rested and I could continue with my day to day activities.

Earlier this year, I had a telephone consultation with a private psychotherapist. Within half an hour, she said that although she couldn't make an official diagnosis, she thought I had ADHD. I cried with relief! My GP then referred me for an initial assessment with the local NHS provider who agreed with the psychotherapist's provisional diagnosis, plus also thought I might be on the autism spectrum. I now have a two year wait for formal NHS assessment. At least I now know what is wrong with and it makes coping so much easier!

It depends on what knowledge she has of autism - if none and the only autistic people she has knowledge of are those severely disabled by it then being told she is autistic could be traumatising.

Wait a few more sessions and then tell her she shows signs of ND and PTSD if you still think she does. It is her medical information and she has a right to know it. Keeping it from her will just lead to distrust in medical professionals which is very common in those with ND and mental health conditions.

I agree that this is unethical. I could certainly identify myself from the information you’ve given. And as a current therapy client it’s made me worry that my therapist might be posting about me on fb or Reddit, so you’ve sown doubt there.

Also, interesting series of articles in the Guardian today about therapist malpractice and the lack of regulation of psychotherapy and counselling. Apparently one of the biggest reasons for a massive rise in complaints about therapists abusing their position is “giving medical diagnoses, including… autism”. Be very careful.

www.theguardian.com/society/2024/oct/19/psychotherapists-in-england-must-be-regulated-experts-say-after-abuse-claims-rise

@FavouriteYellowChair you would be within your rights to ask your therapist if they are a member of any online forums and to speak with them about what you've seen here and the doubt it's placed in your mind about what your therapist might be up to online. Good therapists absolutely don't do this, ever - and if yours is one of the decent ethical ones, they will immediately reassure you that this is not something they would do or find acceptable.

I do also think OP knows at some level that what they have done here isn't right. If they are so determined to defend it, and think it's entirely fine, I would challenge them to show this thread to their placement provider, supervisor or one of their course tutors and ask them whether they think what's been posted here is a breach of confidentiality or their professional body's code of ethics.

I bet they wouldn't do that.

This happened to me, from a clinical psychologist - told me I probably had ADHD and rejection sensitive dysphoria then said I couldn't access the NHS. It was an upsetting experience that brought up a lot of shame; needless to say I didn't return to that person. I'm happier self-identifying now because it avoids the risk of bad treatment but that does mean its harder to access formal supports.

On another note, it seems that there are two issues in this thread - the ethics of talking about client work and the experience of ND people receiving tentative suggestions that they could be ND. If OP could amend their posts to remove identifying detail, this could be an interesting and informative discussion as to how or whether to tell someone that they may be ND. This issue doesn't just arise in formal settings, it also happens in social and family situations as I can testify.

Having mulled on this further, I think the whole premise of the initial question is incorrect because to get a fair range of responses the OP should also be asking: "if you are not ND and your therapist mistakenly thought you were - would you want to know?" Because as we've established therapists cannot diagnose and so there's a reasonable chance that they're wrong about their client. What then? What harm could that do?

being a therapist myself and having supported a family member through camhs, seeing numerous different psychologists, I think there's definitely a solid place for psychotherapists and counsellors. Psychologists have a more pathologising approach to mental healthcare, a more diagnostic medical model based approach. They ask what's wrong with you, rather than what's happened to you. In my personal (as well as professional) experience, psychologists will see you as a conundrum to be fixed, rather than a wounded human being. NHS models often provide quick fix sessions of CBT via a mental
health nurse or psychologist, which barely touches the sides. I often work with "rejected by camhs" clients and "cbt didn't work for me" clients and "i just need to
talk to someone and be heard" clients.