Therapy question: Social situations are making me depressed and paranoid should therapy for OCD or Aspergers be priority now?

[Orwell1984]

I am stuck.

I have been going to CBT weekly since January this year until I finished with the therapist today as my health has gotten worse over the months.

The main problem is down to social interactions and dealing with rejection and insensitivity from others. Other problems have been mixed up with this so I have not been able to focus on tackling an OCD issue. Other troubles regarding work and other things became priority nearly on a weekly basis. I don't 

The CBT has not worked for me. I think I need some other sort of therapy. I don't know what.

I want to know, particularly from people who have OCD and aspergers and have social problems what the focus should be on in therapy and through which type of therapy? Because I'm not paranoid and hyper vigilant and that is down to stress of not being able to deal with life through social interactions. Autistic shutdown? Possibly. What to do?

Thanks everyone x

[snowbear]

Hi Orwell,

Before looking for alternative kinds of therapy, let's look at whether the CBT you've been having has addressed the right problem in the right way. 

48 minutes ago, Orwell1984 said:

The main problem is down to social interactions and dealing with rejection and insensitivity from others.

Dealing with rejection and insensitivity from others starts with understanding how you interpret the things you experience.

In fact, it starts with the understanding that feeling rejected and feeling you've been treated insensitively is itself an interpretation rather than 'reality'. 

That's a big concept to get your head around!

Instinctively we react by saying 'but I can tell when someone's treating me badly, it's not just me'   And to an extent we're right to think that way.

But our perception 'I've been badly treated' is only the start of things, not the endpoint. Having an awareness of that is key. 

How we respond next is crucial. 

The response to 'I'm being treated insensitively' is a choice. You can react with anger, withdrawal, contempt, or curiosity. 

You can interpret rejection and insensitivity as a form of personal attack, as an unimportant triviality it's ok to ignore, view it as an opportunity to reflect/grow and help the person who's behaviour caused the 'problem' to grow/reflect, or any number of other options.  

How you personally interpret rejection/insensitive behaviour should be the focus of your CBT. And looking at how you can change your response so the outcome is different. 

We can't control what happens to us, but we have complete control over how we think about it, how we react to it and how we behave in response. 

Negativity from others doesn't have to be a challenge and Asperger's/autism doesn't have to be a barrier to learning how to control your response. 

I'd ask for another round of CBT, and this time focus on your perception and interpretation of social situations. And then work on changing your response so no matter how other people act you are the one in control of your feelings.  

 

[Orwell1984]

Thank you so much snowbear. Been clicking 'refresh' on this for an hour and so glad someone has replied with great advice thankyou x

[Wonderer]

Hi Orwell, I wonder, have u always had the same social issues or have they been exacerbated since ur OCD got worse? If the latter applies then I think tackling the OCD will help with the social issues. I know that my sons therapy was tweaked a little from the standard treatment because of his Aspergers, mostly focusing on the behavioural aspect rather than the cognitive because he struggled with the cognitive side due to black and white thinking from Aspergers, another thing is that I too struggle with social interaction, it has been mentioned that I may have Aspergers myself but I’ve not gone on to find out officially but it wouldn’t surprise me, I’ve basically just had to push through the scary feelings associated with socialising and even though they still crop up I tend to find nothing is as bad as I think it’s going to be once I’m there, I keep my circle small, I have two best friends and that’s the way I like it, I do know others through them but would think of them as mates rather than close friends. It’s also a good idea to talk to ur friends about ur social issues and they can be of a support to u and understand when things are a bit much for u so they don’t feel too disappointed if u need to leave if need to take time away while out with them.xx

Edited June 9, 2018 by Wonderer

[Orwell1984]

I wish it were that simple. I make myself socialise and I do enjoy some of it but it depletes my energy massively and I get headaches, suddenly get exhausted and it feels like an out of body experience. Then it takes me ages to recover and I feel really bad about myself for this happening  so I could either avoid everything and be a hermit, or socialise and rely on alcohol too much and end up exhausted despite efforts to perform. After a while people realise it does not come naturally to me and dump me cos something is different about me that they perceive. So this is how it goes for me. Or why else do they dump me? I hate it

[Guest OCDhavenobrain]

13 minutes ago, Orwell1984 said:

I wish it were that simple. I make myself socialise and I do enjoy some of it but it depletes my energy massively and I get headaches, suddenly get exhausted and it feels like an out of body experience. Then it takes me ages to recover and I feel really bad about myself for this happening  so I could either avoid everything and be a hermit, or socialise and rely on alcohol too much and end up exhausted despite efforts to perform. After a while people realise it does not come naturally to me and dump me cos something is different about me that they perceive. So this is how it goes for me. Or why else do they dump me? I hate it

Sorry to hear that you feel that way. I didn't understand what you wrote before about being hyperawre of yourself, i feel like i am hyperaware of others around me, but i think that is because i have some social anxiety and general anxiety. 

I don't think you should give up the therapy against OCD yet. 

[Wonderer]

19 minutes ago, Orwell1984 said:

I wish it were that simple. I make myself socialise and I do enjoy some of it but it depletes my energy massively and I get headaches, suddenly get exhausted and it feels like an out of body experience. Then it takes me ages to recover and I feel really bad about myself for this happening  so I could either avoid everything and be a hermit, or socialise and rely on alcohol too much and end up exhausted despite efforts to perform. After a while people realise it does not come naturally to me and dump me cos something is different about me that they perceive. So this is how it goes for me. Or why else do they dump me? I hate it

Oh I can totally relate with u, I am the same, I’m ok with just a friend or 2 out for a meal or the cinema but if it’s a big gathering or a party I feel exactly as u describe and need to be at home for the next day or two to recover, my son would be the same. It’s really good that u still make yourself socialise though, they maybe don’t perceive you to be different but possibly recognise that u don’t seem to really like socialising and so the invitations become less, I have lost a few friends this way to be honest. Are there particular places you find easier to handle? Maybe try and get out on your terms rather than others? Have you any friends with Aspergers? It might be a good thing to see if there are any social groups for people with Aspergers in your area, meet people who will totally get it xx

[Em00]

I'm not sure entirely what you're struggling with, but I know after learning I was autistic it was a steep learning curve to learn how to best cope with social situations. I find them very draining so make sure I balance them well with down time. I've also got some support from a local autism charity. 

[Orwell1984]

I am going to focus this week on getting information from the national autistic society and I'm going to look for social groups for people with aspergers. Truth be told I'm scared the group's will be like a pity party full of people feeling sorry for themselves or else be full of people who are very autistic and not on the same level as me. It'll make me feel even more different and sad that I'm so different from the rest of society. I will have to take the chance that it won't be bad. But nothing has worked out so far so I'm not very optimistic. Exhausted after night out last night. Was home early as well. Stayed out long enough as I deemed was socially acceptable and not to be rude. It all just feels like I have to do these things to keep in the 'normal' group and buy myself more time from not being rejected once again. Had I not gone out, I feel I would be more close to being rejected sooner. 

[Orwell1984]

[Orwell1984]

So what do you treat first - OCD or autism stuff? Hate this. With trying to do both at same time and priorities switching, it has meant I have not recovered in CBT therapy and not made progress. So what should be treated first and stuck to? I think it should be social situations but I don't know and my decisions have not helped me thus far. 

[Guest OCDhavenobrain]

16 minutes ago, Orwell1984 said:

So what do you treat first - OCD or autism stuff? Hate this. With trying to do both at same time and priorities switching, it has meant I have not recovered in CBT therapy and not made progress. So what should be treated first and stuck to? I think it should be social situations but I don't know and my decisions have not helped me thus far. 

Why do you want to treat your problems with social situations first? How will that take away your obsessions and all the anxiety linked to them?

Also is there a possibility that you could accept that you have some problems with social situations? Is it the end?

 

And i would like to say something, which i don't think you should take as a deathsentence, but i have read that autism and OCD often come together. The comorbility is pretty high, i also read that people with both had harder to overcome OCD, now i have no idea why that should be the case but could it be because of the problems with identify feelings when having autism? THat is a problem when having OCD, am i right here? My point is that i think that autism could be used as a reason not to attack OCD, so i would personally advice to take that leap. 

 

Whatever you have or not have do i hope that you find some peace from all this anxiety, because i am pretty certain you don't need to feel all this anxiety. 

Edited June 10, 2018 by OCDhavenobrain

[Angst]

Hi Orwell1984.  I think it is great that you have reflected, gathered information and opinions and then taken the initiative. It might be that one group might be very different from another. See how it goes. Treat it as an interesting experiment.

Great strides are being taken in CBT with the use of virtual reality. Where patients interact with avatars in a variety of social contexts. Hopefully we will move from trials to full implementation in the near future in the UK.  You mentioned in an earlier post about feelings of paranoia: Daniel Freeman at the Institute of Psychiatry estimates that 40 per cent of the general population experience paranoia in some forms of social interaction and the risk is greatly increased if you have high anxiety. His team have done some of the pioneering work in this area of therapy with the use of virtual reality.

Edited June 10, 2018 by Angst

[snowbear]

8 hours ago, Orwell1984 said:

 It'll make me feel even more different and sad that I'm so different from the rest of society. 

Whoa!!    Stop right there, missus. VERY important idea here to get your head around.

You are not different from the rest of society.  

You are part of society. Society is inclusive. 

'Normal' people aren't one group. People who are on the autistic spectrum are still normal people, people who are bringing diversity and variety into the mix that IS society. 

Defining yourself by a condition/diagnosis is damaging as well as incorrect. Do yourself a huge favour and get out of the habit of thinking about yourself that way. 

You may be 'on the autism spectrum' but equally you are 'on the spectrum of normal society.' 

Ditch the 'them and us' thinking. Seriously. It's harmful in so many ways. Ditch it. Now. 

[PolarBear]

Agreed.

Think about this: Take all the people who will never have a mental illness/disorder/challenge or major physical ailment like diabetes or cancer and they would ne in the minority. So who's normal?

[Em00]

8 hours ago, OCDhavenobrain said:

 

And i would like to say something, which i don't think you should take as a deathsentence, but i have read that autism and OCD often come together. The comorbility is pretty high, i also read that people with both had harder to overcome OCD, now i have no idea why that should be the case but could it be because of the problems with identify feelings when having autism? THat is a problem when having OCD, am i right here? My point is that i think that autism could be used as a reason not to attack OCD, so i would personally advice to take that leap. 

Personally I find being autistic means I have very rigid thinking, that in turn makes ocd more difficult to deal with. I have a lot of 'obsessions' with ASD too, but not distressing ones like my ocd. I think A LOT!! 

[Em00]

8 hours ago, Orwell1984 said:

I am going to focus this week on getting information from the national autistic society and I'm going to look for social groups for people with aspergers. Truth be told I'm scared the group's will be like a pity party full of people feeling sorry for themselves or else be full of people who are very autistic and not on the same level as me. It'll make me feel even more different and sad that I'm so different from the rest of society. I will have to take the chance that it won't be bad. But nothing has worked out so far so I'm not very optimistic. Exhausted after night out last night. Was home early as well. Stayed out long enough as I deemed was socially acceptable and not to be rude. It all just feels like I have to do these things to keep in the 'normal' group and buy myself more time from not being rejected once again. Had I not gone out, I feel I would be more close to being rejected sooner. 

I see being autistic as having a different 'operating system' and getting diagnosed was like getting the right manual so now I can live better to my strengths and cope with my struggles. I certainly don't see it as something that needs 'treating'. Autistic people have many strengths. 

[Guest OCDhavenobrain]

21 minutes ago, Em00 said:

Personally I find being autistic means I have very rigid thinking, that in turn makes ocd more difficult to deal with. I have a lot of 'obsessions' with ASD too, but not distressing ones like my ocd. I think A LOT!! 

That could be the reason, makes sense. I think it could be good to be aware that it can get a little bit harder to recover when you have both, so you are prepared, but it is also important to realize that just because you have both you don't need to have OCD for life. 

And i really don't see the need to attack problems with social situations before one can be able to treat OCD. I wouldn't call the thoughts about how one have problems in social situations for pure OCD, one can have such problems, but i think it could be that Orwell goes over this because he feels down by it.

Edited June 10, 2018 by OCDhavenobrain

[Orwell1984]

6 hours ago, Em00 said:

I see being autistic as having a different 'operating system' and getting diagnosed was like getting the right manual so now I can live better to my strengths and cope with my struggles. I certainly don't see it as something that needs 'treating'. Autistic people have many strengths. 

Hi, where did you find help for living to different strengths and coping? I don't know where to get this as an adult.

 

5 hours ago, OCDhavenobrain said:

And i really don't see the need to attack problems with social situations before one can be able to treat OCD. I wouldn't call the thoughts about how one have problems in social situations for pure OCD, one can have such problems, but i think it could be that Orwell goes over this because he feels down by it.

The thing is, I have been going to CBT since the start of this year and I have not made much progress because other things relating to social interactions st work were causing me huge distress and had to be tackled first so I could react more appropriately  at work. So I didn't tackle my OCD on its own and only tackle it. I know it needs a whole lot of focus by itself in therapy. The social situation problems were more immediate problems to deal with because I had to cope in work. But i don't have the right tools to cope because I'm not coping. 

[Em00]

8 hours ago, Orwell1984 said:

Hi, where did you find help for living to different strengths and coping? I don't know where to get this as an adult.

There is a big gap in provision for autistic adults, I don't know what they think happens to autistic kids when they grow up...

I got to do a mini post diagnosis course after I got diagnosed, which was helpful. There's also an ASD worker in our local cmht. Plus my therapist is very clued up on ASD and bears that in mind while we're doing therapy. We did some work on balancing social stuff and activity as it was causing me a lot of problems. I've read a lot of books, blogs etc. Joined a group on Facebook that is helpful. The local autism charity also runs social groups and mini courses on socialising and life skills. I struggle with the social groups because I find social situations so challenging, but I try and go easy on myself for that. 

[Guest OCDhavenobrain]

To me it seems lile this have become an obsession for you.

I would attack the OCD first of all.

And dont beat yourself up because you experience problems in socoal situations

Edited June 11, 2018 by OCDhavenobrain