MHM Magazine

34 | MENTAL HEALTH MATTERS | 2024 | Issue 5 MHM common Autism Spectrum Disorder (ASD) experiences? And suddenly, everything fell into place. This was it -the missing piece of my puzzle. Armed with this insight, I approached my psychiatrist in our next session. It was a vulnerable moment—I could feel my hands wringing, my heart racing, and my voice faltering. “Just say it,” he prompted, noticing my discomfort. “I think I may be autistic,” I blurted out. He frowned, opened my file, and after a quick page through he rolled his eyes and responded, “No, you’re very social, you can’t be. But you should see my one client who is autistic—he’s an accountant and only thinks about numbers. He sits there with his wife and …” “Could this be real?” I thought to myself as my head began swirling and his voice faded into the distance. In counselling training, we learn to respond with curiosity and validation. We’re told NEVER to disclose details about other clients. “Am I being filmed? Is this a trick?” I could not fathom how this supposed mental health professional was breaking the most fundamental ethical rules. My face grew hot. My jaw clenched. My ears rang. Was he still talking? Oh, look, he’s ushering me out. I cannot speak. All my energy is focused on remaining upright, one foot in front of the other. I pay for the session and fawn my way out of the room. I vow there and then never to make a client feel the way I did at that moment—unheard, invalidated, and small. I received my official ASD diagnosis a few months later through the Neurodiversity Centre of South Africa, a month before my 37th birthday. It felt like a rebirth—a new understanding of myself. It also left me questioning: how could I not have known? After all, I was fine growing up. But I realized that, actually, I wasn’t. As a child, I was explosive, emotional, rigid, and labelled as “impossible”. I had sensory sensitivities, displayed compulsive behaviours, and struggled with selective mutism. I was obsessed with cats and birds. I lined up my toys, organised by colour. At school, I had no friends, learning only through observation how to fit in. Even when I played the role, I became the target of bullying—months of torment that left me eating lunch alone in the bathroom and feigning illness to miss as much school as possible. I had endless issues with food, I started habitual binge drinking at age 14, I self-harmed, I was diagnosed as bipolar, and was perpetually plagued by auto-immune conditions. Ok, maybe I wasn’t ok. So, why did I think I was? Because my woefully behind-the-times psychiatrist’s narrow idea of autism matched mine; we both saw the little boy rocking in the corner playing with a train. The difference between him and me was that he should have known better. But this story isn’t to assign blame, it’s to shed light on neurodivergence for what it is, a spectrum with many different presentations. Additionally, I hope it serves as a reminder to those who have been practising for a long time to truly listen to their patients, to be infinitely curious, to embrace new paradigms and to provide a space that at the very least, doesn’t leave patients feeling dismissed and foolish. Despite my diagnosis being an overwhelmingly positive catalyst in my life, I do have to acknowledge the very real experiences that accompany the bad days. My biggest challenge is learning to recognise my limits and advocate for myself. My conscious awareness of my limitations is still developing. For example, I used to engage in seemingly basic tasks such as grocery shopping and appear to be functioning just fine. But when I got home, I’d fight with my kids, scream at the dog, and weep with guilt for an hour under my duvet. My new understanding is that tolerating the sensory overwhelm of the mall, the infinite number of grocery decisions, and the compounding exhaustion of the weeks’ social interactions requires a great deal of masking. When I finally return home to what I expect to be a safe space, I’m met by a child asking me to make dinner. Cognitively, I know that this is an innocent request, but it’s unconsciously interpreted as an unmitigated attack and I crumble. You might be thinking, “Everyone has a limit, we all get overwhelmed.” You’re right. The difference is that there isn’t a day that goes by that is easy for me. Although I consider myself extremely capable, every morning I wake up at least a little bit terrified of what’s to come. There is a tangible pressure to every moment of every day, even when things are going well. It’s like trudging uphill through an invisible mass of sludge. Nobody can see it, but it’s there and it’s heavy, and it’s real. Every thought is laboured, every decision is an effort, and every action is a workout. And this has nothing to do with needing a perspective shift or being a pessimist—I work daily at improving myself mentally and physically. I’ve read the books, I’ve watched the podcasts, I’ve seen the specialists. This just is how I am. And it’s hard. And although it may not look like it’s hard, it would be really great if you believed me. I don’t need you to, because I’ve become confident in my self- awareness and self-advocacy, but, it would be nice if I didn’t have to advocate so hard all the time. I still catch myself questioning whether my diagnosis is accurate because my imposter syndrome has a very large megaphone. But it doesn’t erase the ever-present feeling that I don’t belong in this world, that everyone knows something I don’t, that I see things so clearly when others can’t. Sometimes it’s easier to ignore than others, but no matter how much knowledge I gain or how many strategies I learn to survive—or even thrive—it’s my base state of being. I’ve made massive progress and I’m extremely proud of the self I’m learning to love fully. So, I accept it all, in all of its messy splendour. Because I am both a mess and a splendid one at that. References available on request. MHM | 2024 | Volume 11 | Issue 5 | Living With Autism H