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TOPIC: Asking for guidance for therapists

Asking for guidance for therapists 10 months 2 days ago #39654

  • navydad
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Hello all,

I am a clinical psychologist working in the Student Psychological Services at a university in the US. I started working with a student about a year ago who seems to have complete aphantasia, which I had not heard of before. Because nearly all standard psychotherapy approaches require access to one's internal experience, including visual images, it quickly became apparent that most of what I had learned in decades of clinical practice was useless with this student. I had to significantly adapt what I was doing and we have spent most of our time trying to understand how the student experiences things and how s/he functions in the world, including mundane tasks like grocery shopping and driving places. I have come to view aphantasia like the way I view Asperger's: a different way of being in the world that has advantages and disadvantages in different contexts. This is not to minimize the challenges, but it is important to recognize and work with the advantages.

The student I am seeing had seen a therapist previously and the experience was frustrating and unhelpful, mainly because the therapist seemed (by the student's report) to get frustrated by the student's inability to answer open-ended questions or describe his/her internal experience and seemed unwilling or unable to adapt his approach to the student. The student has told me that it is helpful to gain a better understanding of how his/her brain works and we also worked to get her/him help with the specific academic problems caused by the aphantasia. The student, by the way, is very intelligent and talented and with the appropriate help, s/he does well academically.

My purpose in starting this thread (I apologize if it is being discussed somewhere else in here and I'm happy to go there) is to hear from people about how a therapist can help. At this point, I haven't seen any convincing evidence that the condition can be changed significantly, so my intent is not to "cure" anyone or "teach" them to access visual images and other internal experience, but to help them work around their limitations and play to their strengths.

So I am asking about people's experiences with mental health professionals: what has helped and what has not?
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Asking for guidance for therapists 10 months 2 days ago #39655

  • Fon
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Hello.

I'm a sufferer with an extensive interest in psychology.

I would imagine that you are trying to make the patient "open up" and explain things within your paradigm so that you can guide them.

You need to use the patient's paradigm. If they are intelligent, then you need to role reversal. Explain your end goal, and ask the patient to ask you questions to achieve this goal (As if they were the doctor)

Listen carefully to how they frame the questions, and how they criticise your answer as not being in the direction they want the answer to follow.

Then use the same technique they have applied with you, to them.

There are different paradigms with people like us. You may not be aware of them, until we are forced to explain them. (sometimes we are not aware of them either, until you force us to explain them, and then explain how you actually feel and that its different to us.)

Hope this helps,

Fon
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