Aspergirls, anxiety, and the therapeutic process
This evening, I read a piece that Todd VanDerWerff wrote following the series finale of In Treatment. Every now and then his words will come back to me :
“Therapy, at some level, is performance art. It’s a deliberately created space where people come together to engage in an artificial construct meant to get at deeper truths but not really guaranteed to do so. Therapy only works if all of the players agree to the artifice. The second anyone realizes that it is, to some degree, bullshit, the whole edifice falls apart. That’s not to say that the idea of therapy is bullshit or that real insight can’t be gained from going into therapy. But therapy as we understand it is a construct built by therapists and patients over the course of a century, and the “roles” played by both parties are as firmly entrenched as actors on a stage performing to an audience. Deeper truths can be found within that construct, but both parties have to be willing to agree to the artifice. And that’s not always the case.”
As an Aspergirl, I find my life is filled with scripts, some I intentionally created to know what to say in a difficult situation (e.g., talking to a supervisor at work about a potentially problematic situation) and others that I inadvertently use on a daily basis, such as in a coffee shop making conversation with stranger. I’ll find myself asking what the person sitting in the booth beside me is reading or studying and follow-up with questions based on those interests. I’ve gotten quite good at the process over the years, and yet I still wonder if I’m bothering them. That’s because inevitably I’ll lapse into a monologue about my own interests and then feel self-conscious. “Am I talking too long? Do you need to get back to what you’re doing? Do you even care what I’m saying?” Some of these statements remain in my sea of thoughts, while others I attempt to verbalize.
So how does this idea of scripts fit into the therapeutic process you might ask, dear reader? As an Aspergirl with an anxiety spectrum condition, I’ve been to a lot of intake interviews over the years. Such sessions consist of semi-structured interviews and behavioral observations, which in themselves are highly scripted. Therapy itself can be scripted as well, but it’s difficult for me when a therapist won’t acknowledge the reality of the situation. As much as I share, they’ll always be the ones guiding the session, asking the questions, and in turn, editing the script. It makes sense to me as someone with child and adolescent counseling experience and as a patient that, “Therapy as we understand it is a construct built by therapists and patients over the course of a century, and the ‘roles’ played by both parties are as firmly entrenched as actors on a stage performing to an audience.”
My anxiety alters the way I manage social scripts, both the ones I’ve created and those that are part of my daily experiences. When someone provides constructive criticism, my lizard brain automatically jumps to all the things I supposedly did wrong that day. My anxiety deeply affects my perceptions of the world, even as I take my psych meds and use the cognitive-behavioral tools I know so well.
Even in therapy, I worry about how I’m perceived. The waves of anxiety get smaller and smaller, but they never seem to go away entirely. And so I continue to hope that “deeper truths can be found within that construct” as I seek out mental health professionals who attempt to understand my experiences, but can also acknowledge that they will never fully understand me. That’s okay, good even. The women therapists over the years with whom I’ve enjoyed working have been amazing listeners who only asked questions because they wanted to better understand my story.
In hearing others’ stories we better understand our own.