Solution Focused Asperger Syndrome
The Service User’s Expertise: Experience into Practice
Genevieve Edmonds and Vicky Bliss describe their fruitful therapeutic encounter with each other
Genevieve is a 24 year old service user/survivor with diagnoses of mild Asperger Syndrome, depression and anxiety. She works UK-wide in the field of Asperger Syndrome, autism and mental health giving training, workshops, talks and general peer support and advice. She is the author of The Asperger Guides (Sage/Paul Chapman Publishing) self help guides. Genevieve is part of Missing Link Support Services, who support individuals ‘disabled by society’ using solution focused approaches.
As a somewhat tired and cynical individual who by her early twenties had received a myriad of therapies including talking therapies for anxiety and depression, and later a diagnosis of mild Asperger Syndrome, I wasn’t really interested in seeing yet another well-meaning ‘therapist’. Even less was I interested in meeting one with a name like ‘Vicky Bliss’! For me it conjured up images of a ‘perfect’ psychologist-type dressed in immaculate clothes and shoes, who had that tone of voice that was perhaps a little too soft and sympathetic, who was perma-happy and who never got depressed herself. Worst of all I imagined someone who felt she had all the answers and the knowledge of how to fix me, after all she was the ‘expert professional’! I was there to be fixed and changed wasn’t I? If I was such an expert in fixing myself, wouldn’t I have done it by now? Even if I didn’t want to fix myself, I wasn’t exactly happy. Anxiety and depression aren’t exactly something to aspire to, are they?
I’ll never forget the first session of Solution Focused Brief Therapy (SFBT) I had with Vicky. She was everything I hadn’t imagined. I knew quite a lot about the different kinds of therapy for people who had mental health difficulties/ differences, but not about SFBT. I have to admit I was very taken aback during my first session with Vicky. Nothing was mentioned about SFBT, but it sure was different to the sorts of therapeutic exchanges I had experienced in the past. I have to admit in the back of mind I had this niggling concern: “was this lady really qualified? Did she know what she was doing? Did she even care?” She seemed to be asking a lot of rather random questions.
A few sessions later though I had succumbed unknowingly to the powers of solution focused approaches, and (even better) went away with some self esteem and hope for the future.
Why, if I had received so much support from other more ‘problem-focused’ therapies, had I not felt better or hopeful before? Why had I often felt worse, more negative, with even less energy at the end of these sessions? Was I stubborn, would I not acknowledge the issue; did I not want to get better? No. What I had been searching for all of this time was someone to acknowledge that I was a person, that I was not a diagnosis, or a problem, or that my ‘self’ was the sum of my mental health notes.
Actually I didn’t want to change myself much at all; I wanted to know how to cope. I wanted to have my own expertise acknowledged. I wanted someone to acknowledge all of the coping strategies I had used, that I hadn’t even been aware of myself. After all I was still here wasn’t I? I must have been doing something right? I learned so much about myself from the SFBT sessions, and not only was it is good stuff, it was useful stuff! I wasn’t dependent on the therapist to fix me. In fact I’d never wanted to be ‘fixed’. I wanted strategies and solutions to help me help myself. After all, who knows me better than me? No-one but me. What Vicky did was remind me and bring to the fore all of the skills and coping strategies I did have. I had suffered difficulties on and off for a long time, and yet… I was still here and going strong! No-one had ever focused on that before. The things that really struck me when going through the sessions were the exclamations of genuine amazement from Vicky (“Wow!”, “How did you do that?”, “Good on you” and so on). I went away from sessions feeling like a truly competent individual.
In terms of having a diagnosis of mild Asperger Syndrome (AS), SFBT has worked a treat. For the purposes of clarification, Asperger Syndrome is classified in the DSM-IV- Revised Text (APA, 2000) as a mental disorder affecting verbal and non-verbal language use and comprehension; difficulties with social interaction and problems with inflexible thinking often leading to all-absorbing interests and obsessions (well that’s the problem-focused way of looking at it). I had always known that much of my anxiety and depression stemmed from being ‘different’ and feeling alien (which was later explained by a formal diagnosis of Asperger Syndrome) from my neurologically ‘typical’ peers. However, I wasn’t really interested in changing the way I was, label or no label. What made me anxious and depressed was living in a world where seeing things from a unique perspective (as many an Asperger individual does) can be isolating, confusing and frustrating. The cure for Asperger Syndrome, it seems, is to allow an individual their own world, which is one without others to bring social challenges.
Asperger individuals have a different, minority brain wiring which I would like to think of as a difference rather than a disorder, which brings as many positives, and in the right environment, more positives than negatives. Living in a minority, however is tough and it is not surprising that many AS individuals suffer from high levels of anxiety and depression. Having good psychotherapeutic support for this group is necessary and in this case bad mental health support is worse than no support. Since doing this work with Vicky a while back now, and learning what this work was all about, I have been bitten by the Solution Focused ‘bug’. Ok, so I still have AS, I have still have anxiety and I still have depression, but they are much shorter-lived and I come out more positive and stronger every time I have episodes of illness. I am now encouraging Vicky (who unsurprisingly is often anxious and exhausted herself, not being a perfect professional fixer) to develop the approach to be used to positively support Asperger individuals. At the moment training those who work with AS individuals who will listen in using the approach is as far as we have got. Money for research would be nice, but for the moment anecdotal evidence is looking good. Plus, we are writing a guide too, entitled A Preferred Future: Using Solution Focused Approaches to Positively Support Individuals on the Autism Spectrum. It will be published by Jessica Kingsley Publishers in London soon, so if you are interested to know more, look out for it.
Vicky’s Bit
Vicky has an MA in Counselling Psychology, and is currently completing the MA in SFBT at the University of Birmingham. She has over 25 years’ experience of working with adults who have intellectual disabilities, autism or mental health problems, most recently as the Managing Director of the Missing Link Support Service in Lancashire, UK.
How I laugh to learn that Gen wondered whether or not I was actually qualified as a therapist! And it is wonderful to learn that not being a ‘perfect’ psychologist-type is part of what works for some people because I feel like a bumbler in rumpled clothes probably ill suited to my figure (because my mum has stopped dressing me now) and I wouldn’t be at all surprised to learn that a faint whiff of animal scents follow me into and out of every room. My best guess is that it is easy for people to see by the outside of me that I have no therapeutic plan on the inside of me, and I would understand if people were a little concerned by this chaos.
The truth is, neither of us, before entering into a discussion, know whether or not I am qualified to be a therapist for any one particular person. Gen didn’t know if I was qualified to be her therapist, and neither did I in the beginning. As it turns out, apparently I was!
I remember meeting Gen in her home, noticing her wonderful facility with spoken language and her obvious experience with noticing problems. As happens with SFBT, every mention of a problem hides some sparkling coping skills and exceptions, and Gen just laid one after another in my lap for comment. She had strengths sneaking up and surprising us both! It quickly became apparent that Gen was yet another perfectly reasonable person in a perfectly unreasonable situation – I just keep meeting people like this! The people around Gen, such as co-workers, people at University, and unfortunately past mental health care workers, had been skilled at making it appear as though Gen, herself, was responsible for the fact that they didn’t understand her. It didn’t take us long to discover just who the crazy, crooked thinking people were in this particular scenario and start co-constructing a version of the future where Gen got to be herself and get what she really really wanted and mobilise her resources and look at neuro-typical people (i.e. ‘normal’ folk) for the illogical yet emotionally gifted people they were. HA! ‘Gen with the problems’ has now written three books to help other people with autism and even better, has chosen me (the disorganised pseudo-professional) to coauthor her fourth book! How brave is that?
She is also an accomplished public speaker who has touched the lives of many people and given hope and help where there was none before. Gen, along with every other ‘therapee’ I meet, was, and continues to be, a gift to my education and to the richness of my life. It is extremely gratifying to learn that I had a useful role to play in helping her to move forward and a great relief to know that I didn’t have to be well dressed, problem focused or typically professional in order to do it. All I had to do was notice and name the existing competencies, strategies, strengths and skills which positively tumbled out and piled up around her whilst drinking tea and talking about horses.
Well, ok. We talked about other things too. And sometimes I only drank water. And always there were positive things going on which Gen worked out how to do more of whilst I said “wow” and ”how did you do that?!” quite a lot. Is this a good job or what?
Reference:
APA (American Psychiatric Association) (2000)
Diagnostic and Statistical Manual of Mental
Disorders: 4th Edition – Text Revision (DSM IVTr).
Washington DC, US: APA.
Reprinted with kind permission from: Solution News: The Journal of the United Kingdom Association for Solution Focused Practitioners • volume 2 issue 2 • June 2006