In over the transom this weekend from Research in Autism Spectrum Disorders is a discussion of anxiety as it relates to treatment of autistic patients. It’s limited, if only because it revolves around talking only to eight people, and all eight of them only practitioners, and I think I only have a few quick things to note.

First, it strikes me as peculiar but perhaps not unsurprising that seven of the eight practitioners involved “indicated that psychological therapy was often very difficult for their clients on the autistic spectrum, due to challenges in identifying and understanding emotions” apparently without considering the possibility that since not just the methods but the formats themselves of psychotherapy are designed for and around neurotypical brains, a therapy sessions might itself be stymying the autistic brain’s monotropism.

Speaking for myself, even in relatively stress-free situations I’m limited in the degree to which I can multitask in socially-performative situations. In the high-stress socially-performative circumstance of a session of psychotherapy? You mostly can forget about it altogether.

Where’s the discussion, then, of the idea that psychotherapeutic formats themselves might be causing cognitive stress—or distress—in autistic patients, and how that might explain the “challenges in identifying and understanding emotions” these practitioners are identifying as a result of these sessions?

Second, and just as peculiar-but-unsurprising, is that in the paper’s section discussing the study’s limitations, nowhere do the authors suggest that talking only to practitioners and not to any actually-autistic people might be such a limitation.

Third, and all of that said, there’s at least an indication from these eight practitioners that absent much real empircal guidance on anxiety in autistic people, some practitioners are taking that as motivation to try to adapt existing therapeutic approaches to an autistic specific and to “think outside the box”.

Unfortunately, I continue to search in vain for such a practitioner covered by my insurance, and so am left only with a forthcoming phone appointment with my primary care physician to discuss medication to help address the anxiety spikes of the last few months.