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I am going to ask a GP to refer me to a therapist that can help me overcome my social anxiety problems.

I'm concerned that when I eventually see a GP they will not refer me to a therapist, even though I should have got therapy in the very first place and I really need it. When I was younger than I could remember, I was diagnosed (afaik) with ASD (or "mild autism"). I never knew this until I was a teenager but was often appointed with speech therapists during school. But I'm fairly certain that I've been misdiagnosed, and that the real issue is selective mutism (this is a social anxiety related problem where a person cannot talk to people who they do not know). The recommended treatment is CBT.

If you have an anxiety related issue how do you deal with it? Do you think this will help me, and if it's possible to get this help in the first place?

I know it needs to be me who overcomes this, but i'm 20 and clearly can't get over it without help. I literally cannot make new friendships or talk to new people because of this, and it's about time I tried to fix this myself since I did not get the help when I was younger. unfortunately SM is harder to overcome the older you are/the longer you've had it :/

TL;DR: Do you think CBT will help with selective mutism, and has it helped you if you've had this treatment? (and out of curiosity, have you heard of selective mutism?)
 

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It was the key that unlocked our autistic son when he had hit bottom and we found him in a mental institution for total dis-regulation leading severe unsafe and self destructive behaviors. CBT helped him participate in the process, prior to that it was all just words, "bla, bla, bla", none of it stuck or made sense to him. Once he was able to understand feelings and correlate them to the words and the rest of the world, things started to make sense to him. He wanted to be successful, CBT allowed him to be (more anyway).

ASD is a spectrum, you can be all the way to one end of it, and still have it. It's a difficult diagnosis to work with, so discounting it because you don't "feel Autistic" may be counterproductive for you. Our son is highly functioning, rather social, and communicates pretty well, despite being autistic.
 

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ASD does not make sense though. I was never like this for example;

Some children with ASD like to stick to the same routine and little changes may trigger tantrums. Some children may flap their hand or twist or flick their fingers when they’re excited or upset. Others may engage in repetitive activity, such as turning light switches on and off, opening and closing doors, or lining things up.
Also I didn't benefit from any of the speech therapy I had. It's much more of a social anxiety related issue, like I can't the words out, and get too nervous to know how to respond.

CBT helped him participate in the process, prior to that it was all just words, "bla, bla, bla", none of it stuck or made sense to him. Once he was able to understand feelings and correlate them to the words and the rest of the world, things started to make sense to him.
This does not seem like the same problem I have either. This seems much more accurate in comparison;

The expectation to talk to certain people triggers a freeze response with feelings of panic, rather like a bad case of stage fright, and talking is impossible.
This is literally the problem. I can't say what I want to say, even though I understand people and language. Also a support worker who had SM themselves also recognised this in me.
 

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Firstly Im not comfortable with recommending therapy so I will just give my own views on it.

CBT can be effective, but theres more to it than just seeing a Qualified Practicioner.
Theres homework.
But I believe if someone puts 100% effort into it, change is possible.
Not overnight as there is no magic bullet but a step in the desired direction.
Ive done it on myself a lot and overcome several insecurities and anxieties with success and also created some effective habits.
However I did spend a lot of time with a pen and paper analysing my behaviours and feelings.
But overtime there was a shift in my mindset.
 
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Sounds like an anxiety disorder. CBT will help with that too.

My son also has a diagnosis of GAD and ADD/ADHD. His psych told us he called this the Trifecta of disorders, the 3 very often go together in high functioning "Asperger" kids. We spend about 70% of our time helping him with his anxiety, the other 30% is split with ADD and autism-specific issues. Getting the CBT "tools" to help him through an anxiety attack was what made the biggest difference in getting the attack to stop, and to debrief so we could learn from it for prevention sake.

Not the first word in your diagnosis summary : "SOME". It is there for a reason.

It took 3 years to get an accurate diagnosis for our son because ASD didn't seem to fit him all that well either, until we dug deeply and started measuring things, gathering data.

I'm not here to diagnose you, I'm not qualified. I'm just suggesting you do not discount it.
 

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Yes, SM is a form of an anxiety disorder, and a person who has it almost always has it coupled with social anxiety.

Just hope my GP or whoever will not peg me as autistic and or offer the wrong treatment. Or worse, do nothing :mad: even if the autism is there, it's not a major problem, it's the anxiety that prevents me from doing anything social.
 

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I worked with a therapist who used some CBT techniques with me for episodes of intense anger I was experiencing. It worked very well and I still use the exercises I learned years later. I believe that I too have some anxiety issues and I think learning to choose and control your thoughts can be very powerful in overcoming it.

I have heard of selective mutism but don't know much about it. My husband is a teacher and one of his students has a condition that may be this, or similar, though, now that I think about it - he has talked about how the student does not speak except when she feels very comfortable in an environment. He was thrilled one day when she spoke with him. Anyway, I'm sorry that you've had challenges with autism misdiagnoses. ASD is "trendy" but still a frontier with many mysteries and is perhaps sloppily over-applied at times.

I do think you should request a referral regardless... you have little to lose and much to gain being that you can always leave a therapist with no obligation to return. You can also do some research on your own. I just Googled my primary concerns and my location and spent a few days sifting through options to find some therapists who seemed up my alley. You should be able to email many offices for details like whether they accept your health insurance if talking on the phone is an issue.
 

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Yes, SM is a form of an anxiety disorder, and a person who has it almost always has it coupled with social anxiety.

Just hope my GP or whoever will not peg me as autistic and or offer the wrong treatment. Or worse, do nothing :mad: even if the autism is there, it's not a major problem, it's the anxiety that prevents me from doing anything social.
Selective mutism is more of a coping mechanism for social anxiety. It would be interesting to see them separated.

Selective mutism is also correlated with some autism a lot. There's really no point in debating the semantics though. If you have a good therapist they actually shouldn't tell you "what you have" because that gives you the idea that your experience is permanent. Unless you are a proponent of some kind of mental illness pride. You are only as autistic you and other people decide to label you. For people reading about illnesses on the internet they think they read all of the symptoms and diagnose themselves. Call me autistic, it doesn't mean I match all of those symptoms. That's not really important anyway.

Cognitive Behavioral Therapy helped me and I have had selective mutism for a much longer period of time than an ordinary person with selective mutism which isn't an ordinary person to start with.

The thing you have to completely get out of your head is the nonsense that you have no control over your own emotions. That doesn't help you at all. Half the therapy is the doctor, but the other half is you. The doctor gives you the tools to help yourself and can guide you, but if you don't apply and implement then you will not feel better. That is because you actually do have control and there is no magic. Most other forms of therapy strike me as unappetizing and not cutting to the chase. Good thing I was never involved.

Essentially this is not about you having somebody to talk to. It's about you understanding how your emotions work and applying that knowledge to change the way you think. Anxiety is fear, fear can be overcome. I think drugs are stupid for this task. Taking drugs for social anxiety is like taking alcohol to enjoy social situations. Same thing. Bah!

More talk on the matter, I have been diagnosed with aspergers and obviously have had selective mutism. They don't "treat the aspergers." There is no such thing as that. They help with social issues which includes anxiety and relating to other people. Which isn't much different. It would be killing two birds with one stone if you had both. Except that you don't kill aspergers, it is always there ready to rear its ugly head.

Did you have selective mutism toward all of your peers for 20 years? It is rare in general and when it does happen it usually is fixed in childhood because somebody notices and feels the need to fix it. In my case my parents didn't really know so it just slipped under the radar for a very long time. If you are as I am, I do not see why autism would be ruled out. In most cases it is a different story than mine where it lasts so long. But whatever, autism is what it is. It's probably something someone would reject initially because it sounds bad. But after a while you realize that everything wrong with you is actually autism the whole time.
 

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Selective mutism is more of a coping mechanism for social anxiety. It would be interesting to see them separated.

Cognitive Behavioral Therapy helped me and I have had selective mutism for a much longer period of time than an ordinary person with selective mutism which isn't an ordinary person to start with.

The thing you have to completely get out of your head is the nonsense that you have no control over your own emotions. That doesn't help you at all. Half the therapy is the doctor, but the other half is you. The doctor gives you the tools to help yourself and can guide you, but if you don't apply and implement then you will not feel better. That is because you actually do have control and there is no magic. Most other forms of therapy strike me as unappetizing and not cutting to the chase. Good thing I was never involved.
By emotions do you mean no control over yourself? Regardless, if I did get therapy I would try my hardest to co-operate. I know it will take my own effort as well as theirs.
How long did you have it, 20 years?

Did you have selective mutism toward all of your peers for 20 years? It is rare in general and when it does happen it usually is fixed in childhood because somebody notices and feels the need to fix it. In my case my parents didn't really know so it just slipped under the radar for a very long time. If you are as I am, I do not see why autism would be ruled out. In most cases it is a different story than mine where it lasts so long. But whatever, autism is what it is. It's probably something someone would reject initially because it sounds bad. But after a while you realize that everything wrong with you is actually autism the whole time.
I heard it's rare, that's what makes people doubtful.

Basically I was always extremely shy, then it got worse when I started going to secondary school, which was more overwhelming because there were hundreds more students and I was surrounded by people I didn't know. I remember peers asking me questions and trying to make me speak. Sometimes a person would come up to me and say "are you the girl who never speaks?". Most of the time I would only nod and shake my head, or just one word replies. It wasn't because I didn't understand the situation, lack of interest or not wanting to talk to them, yet that's what everyone thought.

They did notice, and I got speech therapists occasionally, and meetings held with my parents. But I remember finding those sessions unnecessary and not really helpful. That's why I want to know exactly what it is, so I don't get therapy that just seems like a waste of people's time. It was strange how no one did anything else though, perhaps they were expecting my parents to do something. They pretty much just let me be silent.

Autism/aspergers could be the explanation, but really the only thing I want to work on is talking to people in the first place, even if I do have other characteristics related to autism. The only thing I see as an issue is not being able to communicate to people, so that's the only thing I would want to address in therapy.
 

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By emotions do you mean no control over yourself? Regardless, if I did get therapy I would try my hardest to co-operate. I know it will take my own effort as well as theirs.
How long did you have it, 20 years?



I heard it's rare, that's what makes people doubtful.

Basically I was always extremely shy, then it got worse when I started going to secondary school, which was more overwhelming because there were hundreds more students and I was surrounded by people I didn't know. I remember peers asking me questions and trying to make me speak. Sometimes a person would come up to me and say "are you the girl who never speaks?". Most of the time I would only nod and shake my head, or just one word replies. It wasn't because I didn't understand the situation, lack of interest or not wanting to talk to them, yet that's what everyone thought.

They did notice, and I got speech therapists occasionally, and meetings held with my parents. But I remember finding those sessions unnecessary and not really helpful. That's why I want to know exactly what it is, so I don't get therapy that just seems like a waste of people's time. It was strange how no one did anything else though, perhaps they were expecting my parents to do something. They pretty much just let me be silent.

Autism/aspergers could be the explanation, but really the only thing I want to work on is talking to people in the first place, even if I do have other characteristics related to autism. The only thing I see as an issue is not being able to communicate to people, so that's the only thing I would want to address in therapy.
Like I said, addressing autism is basically addressing social anxiety. You may or may not have it, I'm not trying to say you do. But if you do that's basically being treated for social anxiety. I haven't really been "treated" for autism. If my recognition of sarcasm is delayed or not there, they aren't going to sit there and coach you on what sarcasm is. What you don't realize is how intermingled autism is with social anxiety and depression. Personally, I don't know what it means to treat the symptoms of autism that don't actually completely overlap with social anxiety.

Here is an example that one of my therapists showed me. Suppose I was to walk out on the therapist and go home. He could react in multiple ways.

He could get sad that I'm leaving and he has no more patient.
He could get angry that I'm leaving.
He could be happy because it freed up his time so he could go on a date.
He could be indifferent and not care.

This seems pretty simple. But in actual situations people aren't really cognizant of the fact that the way they react and feel largely depends on how they perceive a situation. So if you cannot loosen your brain to change your perspective, absolutely nothing will change. I remember going up in class and presenting was like really that every would want me dead if they saw me. Did I have to think that? Did I have to feel that fear? No. That is actually a lot more in my control than it would have ever seemed at the time. This is why I have difficulty being depressed for a long period of time because I catch the thoughts and perspectives then modify them. It's like a computer catching an exception.

I think I had a speech therapist once and it was indeed the stupidest exercise I've come across. Learning how to communicate with express and all that is not a treatment for anxiety. Then the speech therapist would probably say, "Ok go out now and talk to at least one person." That has never worked. That was a waste of time.

That's not what CBT is anyway. But the point to get across is that the doctor cannot reach into your brain and rewire it so that you stop having anxiety. It's actually thing you actually have to do yourself. It's your mind. Beyond that there is a point when you actually do have to go out there and speak to people. There's no mental trick that cures you and makes you normal. It's just understanding how it works. So perhaps if you do go out there and feel uncomfortable, you have an understanding of how such a feeling emerges and how to change your thinking or perspective to make that feeling go away.

In my own case I never really did unmute myself to my initial peers. But when I moved to a different high school I took it as an opportunity to start anew. So I started talking to people there and the more you do the easier it gets. It's a fear like any other, you have to confront it eventually. If you are afraid of a completely harmless dog you aren't really going to convince yourself to stop being afraid of it without actually going up and interacting with it. There is no mental persuasion, a doctor cannot trick you into being not scared anymore. He can give you the appropriate tools to cope with anxiety which is not selective mutism but something more constructive. Just do it, I assure you that isn't garbage. It's not sitting on a chair and telling someone your problems. They actually want to help you change. Lose the idea that feelings "should be" a certain way and manipulate that into "you should be happy."

I was talking to my friend's girlfriend the other day and she was mad at him so she said she was going to go scream at him. That's a completely unproductive way of dealing with one's emotions. Even though it's such a such concept, I think in that moment she failed to consider or even know that she didn't have to scream. She didn't have to be aggressive or anything. There's no justification for it but she thought it was the only option. He did something wrong, so she should be angry right? No. She could be whatever she wants to be, preferably happy. You have to loosen your thinking. By the way it's not controlling yourself if the "uncontrollable" emotion was never there. There's a different between controlling your anger and not being angry when you don't have to be. When you are cured of anxiety, you are not controlling your anxiety with some deep breathing exercises, you are not feeling anxious at all.

This is REBT which is more forceful but essentially the same concept by everyone's favorite pyschologist.
 

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I used to have severe social anxiety and now I don't, so yes I do recommend it. You can find your own therapist if you are worried the GP won't refer you to one, and it's probably best to do so on your own anyway (going to a woman for me was important, for example, as I was terrified of men).
 

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I am going to ask a GP to refer me to a therapist that can help me overcome my social anxiety problems.

I'm concerned that when I eventually see a GP they will not refer me to a therapist, even though I should have got therapy in the very first place and I really need it. When I was younger than I could remember, I was diagnosed (afaik) with ASD (or "mild autism"). I never knew this until I was a teenager but was often appointed with speech therapists during school. But I'm fairly certain that I've been misdiagnosed, and that the real issue is selective mutism (this is a social anxiety related problem where a person cannot talk to people who they do not know). The recommended treatment is CBT.

If you have an anxiety related issue how do you deal with it? Do you think this will help me, and if it's possible to get this help in the first place?

I know it needs to be me who overcomes this, but i'm 20 and clearly can't get over it without help. I literally cannot make new friendships or talk to new people because of this, and it's about time I tried to fix this myself since I did not get the help when I was younger. unfortunately SM is harder to overcome the older you are/the longer you've had it :/

TL;DR: Do you think CBT will help with selective mutism, and has it helped you if you've had this treatment? (and out of curiosity, have you heard of selective mutism?)

CBT can work . It’s the most common therapy, but the most effective is CBT with psychoanalytic therapy.

If you want message me your problems, and I can step you through CBT with psychoanalytic therapy. It’s actually more simple than you think.
 
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