When Coping Skills Become Compliance Skills for Autistics in Therapy.

When coping skills become compliance skills for Autistics in therapy.

Autistics, their loved ones and clinicians want to know - what therapy modalities are right for autistics? And, which ones are "neuro affirming"? These are the wrong questions.

FIRST - Western psychology, clinical psychology, neurotipicality, therapists/clinicians and mental health love categorizations and skills, and they love an acronym:

Autism, Skills, Compliance in Therapy

DBT Dialectical Behavior Therapy

ACT Acceptance and Commitment Therapy

IFS Internal Family Systems

CBT Cognitive Behavioral Therapy

EMDR Eye Movement and Desenitization Reprocessing

SFBT Solution Focused Brief Therapy

.........

Most of these come with manuals of steps, concepts to be delivered to a client/patient. There are skills with specific names, definitions and ways to practice those skills. There are instructions.

SECOND - this works for people who think, process, create change, perceive, learn and heal with this multi-layered type of organizing, including an organized and prescribed delivery. This is not most autistics. Most autistics do not categorize the same way, and many autistics are socialized to follow categories and instructions even if it's not how they see the world. Herein lies the danger of these models for autistics. It's not the models themselves, it's HOW they are used, and when coping skills become compliance skills.

A complying autistic and a complying therapist are not therapy.

THIRD - "Which models of therapy are best for autistics?", this question becomes, HOW can the models be spacious, remove instructions and categories, be delivered with an ellipsis (...).... and reduce the risk of autistics complying?

FOURTH - Giving you a model with steps to find an ellipsis is antithetical to the proposition. I can say that it is a space-place to drop into that influences how you are being, how you are in dialouge, what you are paying attention to. Teaching the skill of "Observe" from DBT, for example does not require it to be a "skill" nor does it require a set of instructions. There is a "...." in there, to linger in, to invite others to linger in, to make the skill of "Observe" one's own.

FIFTH - If you're a clinician working with autistics and you cannot find that ellipsis and cannot let go of the categories, instructions, definitions you are likely complying as well....

-keep practicing

-refer out

-consult

SIXTH - If you're an autistic in therapy, listen and witness yourself and ways that you are complying with suggestions. Introject, interrupt, share how and when it is happening in sessions. If you and your therapist cannot work collaboratively to make room for a "....", then find another therapist who can.

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*Recent post, "How the socialized autistic learns to comply in therapy."

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Thank you for being here!!

-Kristina Bravo, LMFT & Community Psychologist