| (continued from top-level comment) ------ [from a comment] > I've been diagnosed with cPTSD, GAD, Depression, and ADHD. Depression adds to what we were just talking about. See, one of the key symptoms of depression - or more specifically of major depressive disorder, which is what you're talking about - is that it warps perception. Not to the point of actual delusion, but in a way that works more like mild colorblindness. It's not that you can never see anything positive, it's that in the absence of very strong signal, you'll default to more negative interpretations (in the same way that a mildly colorblind person CAN tell the difference between red and green, but often needs clear contrast and cue to do so). This was something I fundamentally misunderstood about depression. During my worst years, when someone told me I was depressed, I'd get upset with them. Of course I am! Everything's terrible and unfixable and I'm a horrible human being! Why wouldn't I be depressed? I didn't understand it until I was on an antidepressant for the first time. (Or rather, after it started working a few weeks in.) For the first time I could remember, I could operate without the constant screaming voice of negativity and pressure towards negative interpretations of everything that, until then, I thought was just "me". But medicated me wasn't not-me. It was just me without a voice that, today, I don't really think of as part of "me". I think of it as a chronic illness I have to manage. At the end of the last section, I talked about the idea that your thought processes don't focus on the rewards of your actions. What I'd suggest is that that's because, right now, you can't feel them at all. The power of a reward comes from (a) intensity, (b) certainty, (c) proximity, and (d) what I'll call "salience": - An intense reward is the difference between "making a million dollars" and "getting $20". Obviously, bigger rewards help more. - A certain reward means the degree to which you think the action will result in the reward. Video games are often appealing because they set up an artificial environment in which certain rewards are always available, for example: if you finish this quest, you WILL get a +6 sword of orc slaying. - A proximate reward means you don't have to wait too much. The classic marshmallow test is an example of this. I would argue that what it is testing was the innate tendency the study subjects had to discount future rewards, which is a classic symptom of executive dysfunction. And that's because... - A salient reward is one you can "feel", not just know exists. The more you can feel the reward NOW, the more you can connect the reward to the task, the more the task itself feels inextricable from its reward, the more the task itself takes on the rewarding color. But if you, like me, suffer from executive dysfunction, this is very hard to do! Depression hurts a, b, and d. It dampens intensity almost by definition - a lack of pleasure from otherwise-pleasurable activities is a key symptom of depression. It lowers certainty because it will underestimate your chances of success (and when you struggle with executive function, there's a vicious cycle of "I won't succeed so why even try?"). And it cripples salience because it fills your consciousness with negative immediate problems and leaves little room for visualizing and enjoying future rewards. Again, this is not YOU doing something wrong. This is an illness you have that is making things that are easier for others harder for you. It's not impossible to overcome, it just requires more deliberateness. My advice is this: one, you may or may not be in a position to try to push yourself to do better right now. Depending on your life situation, you may need to rest and work on building a better immediate environment (both externally in your living spaces and internally in your mental landscape first. But once you are ready, pick ONE thing, focus on THAT, and figure out WHAT IT IS YOU WANT from that thing. To use my recent weight loss as an example, I started losing weight shortly after a chair broke under me. It felt horrible. I felt humiliated by how my body was. That HURT. It provided immediate emotional salience to my weight. And so, when I got a little momentum a few months later, I had the emotional leverage to start dieting and exercising more. I developed hard rules (exercise by climbing a nearby hill to X height every other day, 2000 calorie hard cap) that gave me a success criterion, where I could feel good as long as I'd done those rules. The task I needed to do was not "lose weight". It was "manage to follow these two rules today". And then tomorrow-me would follow them tomorrow, and the next-day-me would follow them the next day. 784 days later, I'm still following them, because there's an immediate salience to stopping: the second I stop, I won't get it back, and that will hurt IMMEDIATELY. I'll feel terrible if I stop. I don't diet because I'm motivated, I diet because stopping dieting would hurt more than dieting does. And that's how motivation usually works. I'm going to go do my work after this post because I'll feel immediately terrible if I don't, not because it means I'll get paid for getting someone a job in a month. (continued in one more comment) |
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> I am desperate for a coach. The therapists I’m currently seeing are not providing actionable advice. We spend most of our sessions introspecting and self-validating, which has run its course.
Given that you've got some form of ASD - so do I - it's possible you're misinterpreting the advice they're trying to give you.
I got frustrated with my therapists because I felt like they were trying to tell me I was "wrong". That there was something wrong with my logic. What I didn't understand is that they were trying to show me that there was something wrong with the INPUTS TO my logic. In the same way that it's not "illogical" to be colorblind, it's not "illogical" to be depressed - but it will feed factually inaccurate estimates into your consciousness in a way that can result in distorted behavior.
Imagine a thermostat that works perfectly, but whose temperature sensor is set 10 degrees too high. The AC will always be on, even though the thermostat is working perfectly! It's correctly interpreting incorrect inputs.
You're the thermostat. And because you can ONLY see the world through those distorted inputs, it's hard to see that they're distorted at all. They just look like the world.
What therapists are good for - or at least what they were good for for me - was helping to point out patterns of behavior and teach me about the repeating cycles in my own life. They could point out that my judgements one week differed from my judgements another week because one session had been in a particularly bad depressive episode and another had been during one of my rare breaths of air. (My particular depression takes the form of something more akin to a baseline-lowered bipolar II; I get occasional mild hypomanic episodes but it's usually just getting back to baseline-ish health.)
They could also help me understand my emotions as things somewhat distinct from myself. And just like inattentive ADHD might make it hard to focus on your own life, emotional processing problems from ASD can make it hard for us to understand our OWN emotions, too. We can't always read ourselves any better than we can read other people. Insofar as we're not naturally talented at emotional processing, we need help to understand ourselves. Or we at least need a lot of hard work at it.
As a concrete example, something I always hated was advice to "practice self-care". How the hell was I supposed to practice self care? I already wasn't doing anything, I was already eating like Jabba the Hutt, I was already playing video games all day! How was I supposed to go any easier on that than I was?
But from my current understanding, I can explain it a little better.
Remember how I've been framing all of this as a sort of environmental barrier? Well, self-care means "devote your energy towards environmental improvement and towards replenishing the emotional energy you're expending trying to overcome that environment".
For example, for me, self-care is not not cleaning up my room. It is, in fact, cleaning up my room. Why? Because a cluttered environment is distressing and distracting for me. It creates an environmental barrier that worsens my mental health. And as a result, it adds a tax to everything else I do. I'm paying "interest" every day I don't clean my room, so cleaning it is like paying down credit-card debt for someone in financial trouble. It's a way to stop the rate at which things backslide.
Or for me, self-care is not playing video games all day every day. Because what that often is for me is avoiding things that are distressing me. They're still there, they're still distressing me, I'm just not focused on them (so they can never become salient enough to act). Instead, I have to take care of those things that bother me, THEN go play video games to let my brain wander the way it wants to after burning some of that energy.
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The broad point I want to make here is this: you are trying to make big, sweeping changes to your life. You can't actually do that. What you can do is make small improvements that start to tilt your life in the right direction. And then down the line, you'll have more tools to make other small improvements. It's a process of building momentum, not a thing you do all at once. You cannot "change your life". You can take one small action that will eventually lead to a chain that will, almost imperceptibly, change your life eventually. That's true even for neurotypical people, but it's especially true for you and me, buried as we are in multiple layers of emotional and motivational processing problems.
You CAN beat it. You just can't beat ALL of it TODAY. And you are NOT a bad or broken person for struggling. You're just a human being trying to do something very hard.