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Therapy that doesn't involve talking

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susipeg 18 Jul 2014
It's got to be a contradiction in terms, hasn't it?

My question relates to a dear friend who suffers debilitating anxiety, but also has such deep difficulties in communication (at times can't string a sentence together - think Asperger's or somewhere on the autism spectrum) that any form of therapy that involves talking is a horrifying prospect and he won't do it. He's not prepared to contemplate medication, either.

But it seems to me that there must be people out there with expertise in helping people who find it unusually hard to talk/communicate.

Any ideas? I ask because there are mental health professionals on here, as well as folk who struggle with many difficulties of their own, and I am always impressed by the level of kindness with which this sort of query is met.

Thank you in advance.
Susipeg
(not my usual username)
In reply to susipeg:

Massage can help people with this problem, human interaction without words.
 full stottie 18 Jul 2014
In reply to susipeg:

Art therapy
 ThunderCat 18 Jul 2014
In reply to full stottie:

> Art therapy

Yeah, was going to suggest art therapy. I know nothing about it mind - but it seems like a good medium for communication if 'traditional' methods aren't going to work?
CraigB 18 Jul 2014
In reply to susipeg:

Your friend could consider online CBT. Or try self-help books as a starting point. That might get him/her to the point where face to face talking therapy might be more doable.
 Dauphin 18 Jul 2014
In reply to susipeg:

http://www.opencentre.com/

'Body work' used most commonly as part of an integrative approach but can be very useful on its own. Quite amazing to witness first hand how the body and the mind are kind of the same thing, how bodies hold experience. Too much brain can be a bad thing as we inhabit a physical world.

Good luck.

D
In reply to susipeg:

I'm not a mental health expert, but a fairly lowly vet. We do, though, deal with a lot of behavioural issues and states which, by necessity, require management through non-talking methods. And the common thread in any approach is to recognise that whilst therapy from an experienced professional is key to success, so is creating awareness of the patient's understanding of the world amongst those closest to him/her.

You're already a good friend by virtue of your wish to help. One of the best steps you could take next would be to get really clued up on what makes your friend tick. You might already have a diagnosis on which to research further; or you might be working in the dark. If the latter, a useful start would be to look at the following:

1) All cats have Asperger Syndrome - this is actually a picture book, written for kids whose siblings have Aspergers, which explains why they behave as they do, but from a position of describing 'normal' cat behaviour, as it's analogous in many ways. It's available to buy, but there are usually some slide shows on YouTube involving scanned copies. It only takes about five minutes to read.

2) Slightly more involved is Pathological Demand Avoidance Syndrome, which is characterised by extreme behaviour when sufferers are placed under stress. Its position as a separate syndrome is controversial, but it's a pattern of behaviour which can be recognisable in many on the autistic spectrum and an understanding of the triggers can help you to help your friend to avoid stressors.

Your friend may not display any characteristics described in the above situations, but they are a good place to start if you want to understand some of the difficulties s/he may face with the world. But having a more concrete diagnosis to go on would help immeasurably and for that you obviously need assessment.

Martin
 marsbar 19 Jul 2014
In reply to susipeg:

Another vote for online cbt. Mood gym is good. Exercise is good for anxiety if you can maybe get him walking. Maybe get him to write a list oc stuff that is strssing him. Template to follow...

Wrong planet is a forum for aspies and other neuro diverse types which is somewhere he may find helpful.

People on the spectrum have a lot to deal with just getting through daily life so it may help to just help with daily tasks but ASK first. Is the anxiety OCD type stuff? There can be an overlap.
 gribble 19 Jul 2014
In reply to susipeg:

Some good suggestions here. It does occur to me though, what does your friend want? If he has a defined outcome/target in mind, it may present the incentive to get there.
 flopsicle 19 Jul 2014
In reply to susipeg:

Mindfulness. Great evidence base, widely available, addresses anxiety and no need to talk. Starter downloads are available online and there's little in the way of risks so it's safe to play with.
 Carolyn 19 Jul 2014
In reply to susipeg:

Temple Grandin's books (perhaps the most recent, The Autistic Mind/Brain or something similar) might be of interest to him - she's got Asperger's, and she explains a lot about how/why autistic brains are different, and how that works in practice (including a bit about her anxiety). Not therapy, but having an explanation might help?
 riddle 19 Jul 2014
In reply to susipeg:

I agree with stroppygob, massage would be a place to start.

Try and find someone trained in Connective Tissue techniques. The Institute of Sport & Remedial Massage website has a directory or therapists.
 Paulos 19 Jul 2014
In reply to susipeg:

Do research on google into mindfulness and Acceptance and Commitment Therapy (ACT). It has some pretty good evidence. Good luck
 freerangecat 19 Jul 2014
In reply to flopsicle:

> Mindfulness. Great evidence base, widely available, addresses anxiety and no need to talk. Starter downloads are available online and there's little in the way of risks so it's safe to play with.

I was going to say the same. I found the mindfulness for dummies book very interesting and am now working through life with full attention (http://windhorsepublications.com/life_with_full_attention_a_practical_cours... - cheaper from Amazon though). I wish I'd had the second book years ago...

A MBSR course might be a good idea if there's one available close to the OP's friend. There is also the mindful way through anxiety book that I've seen online. I have the books i mentioned earlier because they were recommended to me - the first by a doctor and second on another forum, but there are many out there, and some good websites (of mindfulness research centres mainly).

Cat
 abr1966 20 Jul 2014
In reply to susipeg:

Does your friend have Aspergers syndrome or is it just difficulties with anxiety? I suspect that if their anxiety is significantly impacting on their day to day life any 'self help' or online help won't be too helpful...... It may work but it's unlikely to in my opinion.
Short term meds with some therapeutic help offer the most consistent outcomes but any good therapy has a good relationship between the client and therapist at the core.
There are some good websites like; Mind, roysl college of psychitry, bps etc that your friend could get useful information from. Beware of psychobabble sites as there is plenty of this around....
Best wishes..
susipeg 20 Jul 2014
In reply to susipeg:

Very many thanks to all for your kind and helpful thoughts.

Lots to think about here.

In terms of what my friend can cope with, I suspect that on-line CBT and mindfulness are the ways forward. Your thoughts have been very helpful to me too as I try to think of things I haven;t yet thought of and to explore ways of understanding and helping.

Thank you!
SP
susipeg 20 Jul 2014
In reply to maisie:

<<Pathological Demand Avoidance Syndrome, >>

Thanks Martin - I hadn't heard of this before, but looking at the website although not a perfect match there's definitely something like this.
 abr1966 21 Jul 2014
In reply to susipeg:

> <<Pathological Demand Avoidance Syndrome, >>

> Thanks Martin - I hadn't heard of this before, but looking at the website although not a perfect match there's definitely something like this.

This is not an accepted label/diagnosis in either DSM or ICD....
Ask yourself the question....what if the demands are pathological? It may be a bit off the thread subject matter but in my area (childen's mental health) this is an often cited concept peddled by parents where the actual issues relate to safeguarding.
In reply to abr1966:

Yes - as I say, there is some controversy about seeing the collection of behaviours as a stand-alone diagnosis, as the criteria for inclusion relate to behaviours which are common to a number of ASDs. And it's certainly over-diagnosed by parents whose kids may/may not be at the lower end of the spectrum, in much the same way as labels like ADHD are grasped at to excuse bad behaviour and crappy parenting (remember purple children a few years ago?).

But it's certainly the case that many people on the ASD demonstrate extreme and/or misplaced responses to situations which stress them, and are unable to cope with what we would consider to be everyday issues. So if susi is looking to understand her friend better, then a certain amount of latitude is reasonable if it helps her to do so.

Martin
Tim Chappell 21 Jul 2014
In reply to susipeg:

I'm sorry to hear of your friend's troubles. My best wishes to him.

I suppose what helps most is love and support, but I dare say you're doing that already.

Maybe a silent retreat in a monastery? When I was at college there was an opportunity to go to Caldey Island every year. I never went myself--because for a motormouth like me, the idea of shutting up completely for 48hrs was much too scary But those who find speech scarier than silence might well benefit.

http://www.caldey-island.co.uk/monks.htm
 rallymania 21 Jul 2014
In reply to susipeg:

a dog?

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