The man arrives 10 minutes late to the session. I’m restless from having to wait and engage in small talk with the female clinician. He arrives in the room with an air of superiority, introduces himself and then approaches me, far too close. He ruffles the fur on my assistance dog’s head and says “he’s a cutie.” His vest requesting to give space and not touch, ignored.
He settles in the seat across from me with his clipboard and speaks to the female clinician. Briefly, he addresses me and tells me what the format of the session will look like. I tell him I’m recovering from a migraine currently, so might be slower to process and communicate. He takes no note and proceeds to ask questions frequently and without room to consider my answers.
He starts by asking me what “symptoms” I’m experiencing in daily life. I tell him that I cannot be employed and work regular hours. I tell him I have almost no responsibilities in our home. We have a cleaner, my partner handles the bills etc. All I have to do is manage my work. He then asks what I want to gain from an assessment, is it for the purpose of support? Before I have chance to answer, he comments that being “high functioning” I’m likely not to receive much support. I immediately feel invalidated and on edge. The use of terms “high” and “low functioning” triggering me.
He begins to poke holes in my autism assessment. He questions whether another assessment should be completed because I didn’t previously have an ADOS-2 as part of the assessment. I explain that because I’ve got experience of administering the ADOS-2, it likely wouldn’t have been appropriate. He tells me the ADOS-2 is the gold-standard tool. It’s not. I hold myself back from stating that the Autism CRC guidelines are moving towards the use of the MIGDAS assessment.
Halfway through the assessment, he moves a side table onto the rug between us and puts his right leg up on it. For some reason, I feel intimidated by this action and it feels highly inappropriate to the setting. I retreat in my seat. The dog adjusts his position on my lap to manage my stress response. The man comments that he thinks my dog is falling asleep on me. I respond that it’s called pressure therapy and he’s trained to do this to manage my anxiety. He makes no comment. Disbelief is evident on his face.
During the assessment, he asked me questions about my mental health. He wanted to know about when my depression and anxiety started. I vulnerably informed him of my self-injury which started at 13 and a suicide attempt at 22. What he said next made me wish I’d never opened up to this man. “Was it just the one attempt?” “Yes” I whispered, feeling that my one experience was somehow now not enough. “Just” being the operative word. We moved on from the topic, as if I’d declared something meaningless, like my favourite colour was blue.
It had taken me 3 years to even consider going for an ADHD assessment. I couldn’t bare the thought of being dismissed yet again. I’d spent the ages of 12 to 29 being constantly invalidated by medical professionals who thought they knew better. I was told my chronic pain was all in my head. Told that my debilitating gut issues were “just IBS.” As a teenager, I was told that my depression, anxiety and suicidality was “just hormones.” So many medications had made me feel like a zombie and I was denied treatment for my mental health over and over. It was brave of me to even approach an assessment.
And with just one hour, I was feeling unable to access an ADHD assessment. I couldn’t bare the thought of going through it all again. I knew the man already thought it was a personality disorder and not autism or ADHD. I wasn’t prepared to put myself through it all again. So, I’ll continue to support ADHD myself by listening and learning to strategies and peers. I’m not ready to go through medical trauma just to be invalidated yet again.
Clinicians, do better. This is the impact your approach can have on clients. Read here how to make your assessments more neuro-affirming.
