Below is a link to a blog post about Steve Asbell’s Autistic Masking Quiz, which asks questions to help adults determine if they have been “masking” their autistic symptoms, or perhaps to help someone identify if they’re possibly on the spectrum at all. I hope we can eventually get to a point where the “masking” isn’t needed, and doesn’t cause the potential mental harm that comes from denying your true self.
I’ve said this briefly before, but I have seen this line crossed so many times now that I decided it needs an entire post. Just to forewarn you, this may turn into a bit of a rant because this is a subject near and dear to me.
Spiritual guidance (SG) and therapy are NOT the same thing. They are also NOT interchangeable.
Speaking as a guide, I would never attempt to diagnose or treat a mental health issue. Even with my background in counseling, I am not licensed, so this is not within my scope of active practice. If I feel that therapy would benefit the client, I will readily and gladly recommend it. Having opportunities to engage in both SG and therapy can be extremely beneficial; it allows for both mental and spiritual healing with professionals working within their proper boundaries and areas of expertise.
Speaking from the experience of working as a therapist, I get alarmed when I see guides start to act more like therapists. Guides have a unique duty and focus, which is the spiritual well-being of the client. This is not the same as the mental well-being. There are many aspects of spiritual practice that, in a mental health setting, may appear to be signs of pathology. Visions could equal hallucinations. A bond with nature may be seen as delusions of grandeur. I like to use the “harm question” to distinguish the two: is this person’s beliefs or experiences causing harm (of any kind) to themselves or others? If not, SG can continue. If so, I will get other professionals involved promptly.
The other issue with blurring this line is the flip side of the coin: guides who are unable to recognize mental health issues at all. I have seen a self-proclaimed guide completely miss what to me were obvious signs of depression in a client, and instead they chastised the client almost relentlessly for being “unmotivated.” The client was called lazy, insubordinate, childish, etc. The “guide” threatened to abandon the client and stop communicating with them if they didn’t do as they were advised.
This is not good therapy or spiritual guidance. Honestly, this isn’t even respectful. This is bullying. Rather than punishing a client for not following instructions (which, by the way, you shouldn’t be spending your time as a guide doing, anyway), a guide would seek to understand the roadblocks that the client is putting up. A good therapist does this as well. There is always a reason for blockages, and they are rarely there just because the client is “lazy.” Punishing the client by fussing at them or threatening to basically abandon them is not going to get you to the reason. It only alienates the client or leads to dependency with the client constantly trying to please the guide. The client in this example should have been referred to a therapist to address the depression symptoms.
I could probably go on forever with this post, but those are some of the bigger issues I’ve seen when two different practices/approaches collide in ways that they shouldn’t.
Can you think of other ways that these lines could be blurred, and/or how to prevent this from happening?
I’m adding in an extra chapter to this series because of what went down on my personal Facebook last night.
Knowing that some of my Facebook friends are practically ABA zealots, I decided to write a segment I sometimes call “Unpopular Opinion.” In this one, I put the ABA community to task for not appearing to listen to the autistic adult community when they give their critiques and suggestions for ABA and how it is executed. I also noted how ABA has monopolized the autism field, leaving little room for any other approaches. I then ended with a dig at the new healthcare bill by Republicans, adding that if it goes through then all of this may be a pointless rant. Then I sat back and waited for the incoming torpedoes.
They didn’t come, at least not exactly.
One person did come on defending ABA as the only evidence-based practice. I then explained down thread what I called the “Catch-22 Carousel.” ABA gets funding and put onto insurance because it is evidence-based, which takes away from funding for other approaches to conduct research to…prove they’re evidence-based. That aspect of the conversation stopped soon after I made that point. When they asked where the research was, I pointed them to Stanford’s Annual Autism Symposium, which takes place in about two weeks. They genuinely seemed interested in attending.
What really made the conversation, though, was the intrigue from others over other parts of the post. I had a great conversation with one former coworker about the effects of the healthcare plans on autism services (which included our job prospects), and another conversation about offering more support to autistic adults and what that should look like (employment/workplace support was high in priority). Just about everyone agreed that there should be a variety of therapeutic services for families and clients to choose from, and to not have that is a detriment to our overall goals and why we entered this field to begin with.
Most of my Facebook friends are ABA enthusiasts, so their silence did not surprise me. I was actually impressed with the ABA Specialist who wanted to hear more about the research into the other approaches, as opposed to just ignoring or shutting down when I made my point. Another friend from back home mentioned the PEERS approach, which I had never even heard of. My rant led to a new approach (at least new for me), and I am now going to go learn more about it.
Some of the parents, meanwhile, simply liked, loved, or thanked me for the post.
The conversations that sprang from that post made me think beyond my viewpoint, go and research some things as I was replying to others, and led me to new ideas. Sometimes speaking your truth can lead others to do the same, and sometimes, everyone listens and learns something in the process.
This is an article that came out this week about how often autism and ADHD not only coincide, but also why they may be more similar than first thought. Many of my autistic clients certainly have some of the major indicators of ADHD, and this has been a suspicion amongst those of us in the field for quite awhile. I also appreciate the detail at which the brain function similarities are explained. Check it out below (first link is the news article, second link is the study itself):