Thursday, 27 February 2014

Big picture or small details?

small details
This is one of the questions that I was asked in the phone assessment the other day.

I'm not actually sure what the right (autistic) answer is supposed to be. I also don't know what my answer is.

When I was a programmer (a very successful, rapidly promoted and highly rewarded programmer) I was only good once I'd absorbed the entirety of the system I was working with. I was fortunate - I joined the development team during a smallish phase of development. The next phase was big, and I took the high level documentation home and read it.

And read it. And read it again. And drew diagrams (object heirarchies), and underlined bits, and took it back into the office and somewhat diffidently, given that I was a beginner, lowest of the low, not even on the proper programming grade, asked about some of the bits that didn't seem to tie together with what I understood of the system as it existed.

It turned out that the new features were going to require a fairly comprehensive redesign of the system as it stood, with some quite extensive new programming. Which wasn't obvious from the outside, so hadn't been flagged up by the analysts, and none of the senior programmers had looked at the analysis documents yet, as they were busy working on the previous phase.

So, is that small details or big picture? I can hold the big picture in my head. I knew my way around that system blindfold. But I have to be able to understand it to do it. And to understand it I take it apart, right the way down to individual code snippets at times.

I did exactly the same when I moved to a new company and a new system.

It made me slightly unpopular at times :/

But once I was in the support department, heading up the java team, I came into my own again, because understanding the system lets you zero in on the details that might be causing you problems. And once I understand the system, I find that easy to do in a way few people seem to. I've joked before now that I think in objects - it's a good way to split things up.

Now if only I could do that with my life I'd be sorted. But I can't. And don't think I haven't tried.

Wednesday, 26 February 2014

Ten questions.

Yesterday afternoon the phone rang.

I don't like answering the phone - never really have. So I'm at a disadvantage instantly. The voice on the other end introduced herself - I've no idea what she said her name was. She said she was a mental health link worker with a triage team? and wanted to know if I felt comfortable going through an assessment questionnaire over the phone to see whether I should be passed on for referral for autism assessment.

What I should have said was no way.

But I'm not particularly assertive. Especially if you catch me unawares.

Before the questionnaire she asked some questions about my background and why I suspect I might be autistic, those were fairly straightforward to cover, although not in great detail as I wasn't prepared.

Then on to what she called the AQT. Ten questions, each to be answered as strongly agree, slightly agree, slightly disagree or strongly disagree.

1) You hear noises other people can't?
Seriously. This is an assessment question? Yes, as it happens I can. Was driven up the wall by the sonic mouse repeller we had, even though I'm half deaf. I could hear it ticking. Very irritating. Does this mean deaf people can't be autistic?

2 - You can tell what people are thinking from facial expressions.
No. Not particularly.

You find it easy to do more than one thing at once.
You see the big picture rather than the small details.
You find it easy to refocus on task once you've been interrupted.
You categorise or collect things.

You find it easy to tell the intentions of characters in books.
Eh what? I can tell what I think the intentions of characters in books are. But books aren't real people. Characters in books have to be slightly predictable or the book doesn't hold together. Real people aren't like that, they don't have to be internally consistent. You're going to base an autism assessment on fiction?

I can't remember all the questions. Usually I'd be good on something like this, recalling the details of a conversation. But I was very stressed during this - a pass/fail test effectively without warning, and I didn't know what the criteria were. (Oh, there's another question. Something about perfectionism.)

We got to the end, and she tallied it up and started umming and ahing. You're borderline for referral she said.

Seriously. You're going to assess an intelligent (highly intelligent actually, but let's not brag too much) woman over the phone with what feels like an internet questionnaire and tell me you can tell that she's not autistic enough to talk to a specialist.

I didn't react well to this idea. So not well that I will be being referred to the adult assessment team. I didn't know that we had an adult assessment team - google tells me it started taking referrals in October. This might explain why the first GP said I would have to be referred out of area for assessment.

So, another step taken. Is it just me though, or is this starting to feel like a comedy of errors?

Wednesday, 12 February 2014

Seeking diagnosis - or external validation?

Yesterday I rang the GPs for yet another try at getting a referral for possible diagnosis of aspergers/ high functioning autism. 

They have a new system now - you ring, speak to a receptionist, then get a call back from a doctor who arranges an appointment if necessary. Except yesterday they didn't have any (female) doctors' slots left, so I rang back today, and was told that they shut at 1 for training, so I was pushing it. (No, they didn't tell me that yesterday. Thank you.)

That was around 11 am. So then I waited for the phone to ring. And waited some more. And it didn't ring. 

Until 3 o clock, by which point I'd assumed it wasn't going to, so wasn't prepared.

Why do you want a referral? 

I want to understand myself. 

I also want other people to appreciate how difficult I find the world. I want to be able to say no, I don't find meeting people difficult just like everyone else does, I find it physically exhausting and draining. I want to be able to explain executive function issues, and repetitive thoughts, and difficulties with social interaction when other people find it acceptable to lie and fabricate stuff and I just don't. 

At which point I start to feel like I'm whining. I'm not whining. I genuinely want to understand myself. I don't want to be fobbed off again, by being advised to find a church (yes, a doctor told me that), or by being given a link to online CBT (1 I can't do it, 2 it doesn't help anyway). Or by being medicated. Most medications do nothing except clog my brain, they don't help. 

Yes, I've had medication. Counselling. Advice to join a church. I've been struggling with anxiety and depression my whole life - except I think I haven't. I think really I've been struggling with thinking differently, reacting differently, feeling other, and lesser and wrong. And I don't want to feel all of those things any more. I want to accept me, and learn how to handle the bits of the world that give me difficulties, and find the confidence to be up front. 

I worry that asking for a diagnosis might somehow backfire on me. That people will somehow think I'm not the person I've always been. Or that I can't cope with my children (I can, at least as well as other parents do anyway!). I worry that I might not get the diagnosis, that maybe I am just normal and actually incompetent. 

It was a difficult conversation, not least because it came out of nowhere. And doing it over the phone? Ugh. The gp kept asking me questions, then telling me to slow down because she was writing things down. And then she said she'll refer me to community mental health. But apparently not to the mental health nurse, instead this time it will be a psychiatrist.

I don't know whether I'm going to get any further this time. But at least I've tried again. 

It is utterly ridiculous that it is *so* hard to get help with this kind of issue. Or am I whining again?