Not Sure What Kind of Treatment or Professional I Need

I've been dealing with issues since at least middle school that I've only sort of started seeking treatment for. I went to a student health center counselor my senior year in college, then I tried a counselor that my dad's employee family member referral program found and that didn't work out and recently I tried a counseling place that I found through Psychology Today. I don’t know if I’m being picky or overthinking it but nothing seems to be quite working out.

The guy through the student health center suggested I might have social anxiety but he was pretty dismissive of a lot things that bother me and saying that I was going to need to learn to get over things like my fear of driving (I can drive and do drive every day because of necessity but I’m always nervous and I struggle a lot if I have to drive somewhere I’ve never driven to before). He also said that I must not be too bad since I managed to be in a sorority. The next two counselors also sometimes tried to use my being in the sorority as evidence that I couldn’t be that bad.


The first counselor I saw after college was in her 70s and foreign and sometimes I feel like this made it hard to communicate with her. She would do a lot of lecturing about how my generation no longer does things how hers did or whatever and I didn’t really see how that helped me. I couldn’t go back in time and live my life the way she did hers. I did not click really well with her exercises. She had me choose toys to represent me and other people I was dealing with and explain why I chose them to represent me or someone else and then had me act out conversations with them which just felt weird to me. It felt like she focused on things that I didn’t think were the things that needed focusing on.

When I tried to discuss the things that I was struggling with, like how I was a mess at cleaning and did not know how to go about organizing my new apartment and felt overwhelmed by things like that, she just told me “focus on one box at a time. That’s it.” And this is where I wonder if I am the problem because I see how that should be good advice but the idea that it was so simple but I can’t seem to make it that simple in my head just made me feel worse and incurable. One time she threw out that I could have inattentive ADHD (she kept insisting that it was ADD and that I was wrong that the new DSM had lumped it all as ADHD just with different types). When I asked if that’s something I should get a proper diagnosis for and learn how to cope with she brushed that aside and told me I could try simple things like using a stress ball to focus. I also had a hard time scheduling appointments with her and she took a lot of phone calls while I was in session with her. I stopped seeing her when she had to cancel one of our weekend appointments on me last minute and I never got around to rescheduling with her.

Last year I looked for a place near me through Psychology Today. I filled out their intake form and they placed me with a foreign guy somewhere in his 60s or 70s. He said that I was dealing with a mixture of depression and anxiety and possibly had “high functioning autistic characteristics.” He said that since the most recent DSM took Aspergers off that you just described that as someone having “autistic characteristics.” I thought it was more degrees on the spectrum but he always used the word “characteristics” and sometimes when I would mention finding how to act in certain situations hard he would say “well some of that is your autistic characteristics.” When he brought that up I did do some reading on Aspergers since I figured most of the stuff would still be using that term and while I had always dismissed it when I learned about Aspergers in school, I saw when I was reading online that it can present differently in females and doesn’t always get recognized as easily because more things focus on the males, and I fit a lot of descriptions of females with Aspergers, especially with what a weirdo I was as a kid (and really still am but I have improved a lot since then). When I tried to approach him about getting like a formal diagnosis he was all "why do you feel you need it? Do you think it will help with your treatment?" and all this stuff that makes me feel self-conscious about trying to push it.

When we’d talk he would interrupt me a lot before I was done finishing my sentence or even to getting to what my point was. A lot of his interruptions were to tell me random stories that I guess were supposed to help but they were either super boring or just made me realize that he really should’ve let me finish because he clearly didn’t get my point or what I was actually having a problem with. Some of his stories were about other patients that he said were similar to me but I was clearly doing better than them because of points a, b, and c, so I shouldn’t worry so much. He made me super uncomfortable once with the weird college story he told me when I mentioned how I’m into reading feminist stuff and then had to explain the current feminism movement to him and then had to assure him that I don’t hate men. He would also raise his voice a lot and practically start shouting and I’m pretty sensitive to raised voices so I really didn’t find this helpful. I haven’t seen him in a few months since I had to cancel to do defense driving school for a speeding ticket and never got around to rescheduling.

So I guess where I’m at is I don’t know if I just don’t have the right mindset and that I didn’t make the right effort to have these people help me or if my instincts were right that they were just not a good fit for me. I’ve been depressed since middle school and I go through periods where I get this feeling in the pit in my stomach that everything is bad and nothing in my life is good and I contribute nothing good and nothing I try to do to distract me seems fun. On good days I still have the general glum about how I don’t know what I’m doing with my life career wise, I have a very limited social life, I’ve never really dated (and kind of still don’t want to) when at 25 I’m supposed to have and my peers are getting married and having kids. I have trouble concentrating on doing things or keeping up with self-care. Also my apartment is a disgusting mess and I have no idea how to fix that and get overwhelmed when I try. I also still get super nervous and awkward in social situations, I hate making phone calls, I hate dealing with situations or people I haven’t dealt with before, and I still have the insecurities about being invited to things and all that. I also get frustrated with how scatter brained I am, how much I procrastinate, how much I forget to do things, how I can feel like I had something in my hand only for it to disappear because I forget that I put it down, and how I’m kind of awkard physical (as an example, I cannot figure out how to get thing on the gas pump that’s supposed to let it fill up without me holding to go up). I also now wonder if I have ADHD or high functioning Autism because those people brought it up but never formally diagnosed me and I don’t know if I should pursue that or not. So I have no idea what to do about finding treatment

Hi. No one here can tell you what type of treatment or professional you need really. It's a pretty personal discovery to find out what is going to work for you personally. It's really good that you have had the courage to seek treatment before and that you have been persistent with trying a couple of people.

There are a few different types of people you can see: counsellors, psychologists, psychotherapists or psychoanalysts. Those are the main professionals that most people seek out. There is variation in what training they have done and what methods they work with. By the sounds of it, you don't like anything too "out there" like the toy exercise that you did, so you might want to choose someone who has a method that you don't feel too put off by. Keep in mind though that generally we all have an unconscious resistance to changing our way of relating/thinking because it has developed out of a need at some point in your life, so the chances are that whatever therapy you end up doing, at some point you will feel uneasy because essentially it is aiming to change something about you and change is not comfortable. I suppose the important thing is to try and discern which problems in therapy might actually be due to the therapy being inappropriate for you and which problems are actually just your viewpoint of the therapy. Problems with your viewpoint of the therapy are actually an important part of therapy and can give an opportunity for learning and rethinking thing. Certainly some of the experiences you have had with therapy so far sound less than ideal but without actually being in the room with you, it's difficult to know if you just particularly strongly noticed the things that weren't so great about the treatment or if actually you just noticed the things that weren't so great about the treatment a normal amount.

Diagnosis is important only really for getting the right treatment. Most professionals you see will be silently speculating what problems you have in order to help you better anyway. And their view over more time of getting to hear from you might change their ideas about that anyway. So you don't necessarily need to be told your diagnosis unless you feel strongly about knowing, need it for reimbursement of the fees from insurance etc, or unless you particularly want to research further into your issues or to be able to create more understanding about your inner self to your loved ones. You can ask any potential therapist you might see what their stance is on diagnosis if you'd like to know where they stand on giving out/making diagnoses.

Perhaps an idea to help you find out what treatment you might find helpful is that you could look up the different types of professional and work out what types of treatment you might think might work best for you. The sort of general, over-arching problems you mention in the last paragraph make me think you might like to find out a bit about psychotherapy maybe because that is talk based rather than exercise based, and focusses more on looking at yourself and how you are thinking about things and going about things rather than someone else trying to give you answers, advice or techniques. But just have a look through the different types of professionals and see what you reckon sounds right for you. Then you can get more specific with investigating who you might go to.