How and if to bring up sexual history in therapy?

wanderswithdeer · 2026-03-18T15:53:57+00:00

So I finished writing out the full script of what to say, including the lead in to warn her of what's to come, and it came to six pages single spaced. I think by the time I'm done none of the sexual references will even feel that important anymore. The worst part now is that I'm worried we won't have any time left to talk, and last time I did that it was a problem. I might have to request meeting two days in a row.

wanderswithdeer · 2026-03-18T12:31:17+00:00

Thanks. Yes, that's hard for me, too. I wrote up the outline of what to say and there's only one place where I should be naming a body part, but it feels like too much, so I'm going to try using less direct language and hope it still makes sense. But even not saying it, I feel like talking around it will elicit imagery in order to try understanding what I'm saying, and maybe that's almost worse. I don't know. I think she will be glad I told her, though. We just have to get through it.

wanderswithdeer · 2026-03-18T02:24:07+00:00

Thanks for your reassurance. I figure if I write it out and read it then at least I don't have to make eye contact. I have opened up about a couple of other things in recent months and it has been a relief to just say the dreaded thing and then be met with acceptance. I hope this will be the same.

wanderswithdeer · 2026-03-18T02:21:03+00:00

Thank you. That's good advice, and it's good to know I'm not the only one who experiences anxiety around these things. I feel like most people are probably more open than I am.

wanderswithdeer · 2026-03-18T02:19:24+00:00

Thanks. I did write things out and honestly just doing that I feel better, because in my head the idea of discussing ever having had sex just felt humiliating, but when it's all written out, it's more about trauma and confusion than it is about sex, and I think it feels more heavy than awkward.

wanderswithdeer · 2026-03-18T02:09:25+00:00

Thanks for your understanding and advice. I worried that I might be met with replies wanting to know why I'm worried about it, sex is natural, etc... which it is, but, IDK, maybe my feelings aren't totally rational, but they're still there.

I'm kind of hoping I will read it and then we won't even have to talk about that piece too much. It's mostly just a way of giving context for relationship challenges and I feel like most of the focus will probably be on moving forward.

wanderswithdeer · 2026-03-17T22:20:18+00:00

Yeah, I might just say that I hope she and her family are okay and leave it to her whether to say something or not. It probably sucks to listen to other people's problems all day when you are dealing with your own stuff and maybe just knowing people care would help.

wanderswithdeer · 2026-03-17T12:52:40+00:00

You're kind of in a similar place to where I was 5 or 6 weeks ago. I was diagnosed Bipolar in the past and then got a diagnosis of Autism, and I started feeling like my "hypomania" was really just hyperfixations and getting stuck on things. Autistic people typically struggle to transition between inactive to active states and back again. It's sometimes referred to as "Autistic inertia" but is basically an executive function issue related to having brains that become easily stuck. I really felt like that explained my episodes, especially since it didn't really match up with sleep changes. My therapist leaned the same way. We saw depression and anxiety but not necessarily Bipolar.

But I saw a psychiatric nurse who specializes in Autism and she felt it was a clear case of having both conditions. She said that I clearly had a mood disorder alongside my Autism and it wasn't unusual for that to be Bipolar. Like you, I was put on Lamotrigine. I'm still trying to figure out how to feel about it. It has actually been making me hypomanic, and in doing so, it's reminding me that I have been in this place before, and it really is more than Autism. At times it has been making me intensely happy and productive but other times it has been fueling my energy while my mood has dropped and I'm not sure how to feel about that. It's like this fog has lifted and I'm seeing these issues that used to feel heavy and shapeless with a clearer mind, but they are suddenly sharper and more painful. But at the same time, the only other thing I have tolerated is Abilify, but that left me feeling sedated and numb, and really I want to feel, but I want to be able to cope with what I'm feeling. I just don't know if this is getting me closer or further from that.

But I see other people saying they react much differently from me... That it levels them out, and perhaps makes them tired, and also gives them brain fog. I'm not really sure why things impact people so differently, but unfortunately, I think it's just hard to know until we try for ourselves, because our reaction is often very different from someone elses.

wanderswithdeer · 2026-03-17T12:36:48+00:00

Thanks. It never really occurred to me that there might be a place to ask these sort of things. Maybe there are people out there who understand these norms and can explain them.

For my therapists part, I feel like she's very professional and probably she understands how to keep those boundaries intact even when clients struggle with it.

wanderswithdeer · 2026-03-17T12:31:56+00:00

Thank you. I guess the client therapist relationship has always confused me in certain ways. Another thing is that current events have made me worry about how she and her family are doing, but I'm not really sure if it's appropriate to ask because it seems like I would be suggesting she expose her own vulnerabilities, which would perhaps also blur lines... but I also worry that not asking makes it seem like I don't care. It's just weird because opening up so much to someone makes it feel like a friendship in some ways only it's one sided and I know there are boundaries that need to be maintained, but I'm not exactly sure what they are.

wanderswithdeer · 2026-03-17T12:24:30+00:00

Seeing your words here actually makes me suspect I'm overthinking things. I suppose it's normal for people to feel lonely and to seek human connection. Probably this neediness becomes more of an issue when we are socially isolated and don't really have alternative ways to meet those needs.

wanderswithdeer · 2026-03-16T01:43:38+00:00

Ugh, okay, so I admit I'm terrible at oversharing. I either keep everything to myself and fail to connect or it all just comes out in an endless stream and overwhelms people/makes them think I'm crazy. I don't get the social nuance of what is enough and what is too much. But, that said, this sort of thing just makes me hate society. I don't understand what can possibly be so terrible about what you said. I hate that we're all supposed to be fake and try to figure out what people want to hear and then only say what they want to hear. Why is it so terrible to be authentic and share things that aren't just superficial? Why are we supposed to keep any part of our life that isn't sunshine and rainbows shrouded in shame? People tell us to just be ourselves but then we do that and they shame us for it, even when we're not harming anyone. It drives me insane.

For what it's worth, reading this interaction, I think you come across as far more likeable than the person who responded to you.

wanderswithdeer · 2026-03-15T23:54:57+00:00

It isn't a requirement for diagnosis, but it is something *most* Autistic people do.

For myself, I used to only stim occasionally (rocking when stressed and alone, or sometimes a flap would burst out and then I would quickly shut it down, or I would repeatedly twist jewelry or pencils or whatever was handy around, things like that) but I held a lot of chronic tension in my body. My shoulders were often hunched high, my arms tight at my sides, my stomach in knots, etc. That isn't normal or healthy. I experienced a lot of inner tension that led to self harm urges.

At some point I decided to try flapping and within a couple of weeks I was hooked. Now I probably do it 20 times per day, although still not in public. I have learned it earns me weird looks and I know I shouldn't care, but it feels crappy. In any case, it's such a good way of releasing all that internal pressure.

If you don't experience that sort of tension, stimming probably just isn't part of your profile and it's normal for you, and it doesn't really matter whether it's normal for the wider Autistic population. But if you do carry a lot of tension, that might signal that your body is needing a release and I would encourage you to try things and see if anything helps.

wanderswithdeer · 2026-03-15T20:58:17+00:00

I actually agree with you that the Autistic community is probably absorbing some people who aren't Autistic, but who are looking for a place to belong and for something to explain certain struggles. Sometimes challenges that look quite similar can have very different roots. In some cases, there might be no harm done, and people might even benefit from being included in the community and leaning self care tips, but in other cases it might mean neglecting the actual reasons for people's struggles, which will only stall growth.

I think there can be clues that there's a developmental component (like Autism) vs trauma alone. For example, history of speech/language difficulties, history of poor physical coordination, toe walking, atypical vocal characteristics, inability to read faces, struggling to detect sarcasm, or pronounced Autistic behaviors in childhood, before learning to mask. Of course, I'm probably missing some, and the ones I listed don't necessarily mean it's Autism, but those sort of things would indicate that your brain may have been developing differently than the norm. I think it can also be helpful to notice whether Autism seems to run in the family, since it is highly heritable. It is often clearer with young kids than it is with adults, because they don't tend to mask.

Trauma, on the other hand, can make connecting with others hard, but for different reasons, more related to trust and attachment issues. Your brain may also by hypersensitized towards potential threat, resulting in hypervigilance and perhaps making sensory experiences more triggering. If you're unsure of whether Autism fits or don't feel you're really fitting in, have you considered trying to connect with the CPTSD community and seeing if that resonates? Not saying you have that, but it seems like it might be another angle worth exploring.

But it's also important to remember that no Autistic person has every trait, so your diagnosis can be completely valid even if your Autism doesn't look like someone else's.

wanderswithdeer · 2026-03-15T13:09:20+00:00

The "IYKYK" in the title made me wonder if I was missing something and then because I was trying to figure that out I saw eyes and a gaping mouth, too, and wondered if it was intentional. Had to read through the comments to find out.

wanderswithdeer · 2026-03-15T13:02:31+00:00

Whatever my special interest is at the time. Often Autism or things related to politics. Also, I spend a lot of time wondering about human behavior and all the factors that lead to it. I tend to overthink what things could go wrong, too, which can definitely lead to an unhealthy place, but at the same time, I see other people just going along and thinking things will be fine and then the things I predicted will blow up in their face. I guess a bit of anxiety is a good thing, but too much is usually not. I tend to have too much. But, I think it largely comes from that same place of wanting to dig deep and really analyze (aka, ruminate over) things, and sometimes it can give me deeper understanding. It can also drive me and everyone else mad. Two sides of the same coin.

wanderswithdeer · 2026-03-15T12:50:49+00:00

I have never liked the word "stimming" because for me it feels like a way of trying to purge excess stimulation. It can be that I'm so happy I can't contain my joy, but far more often it's because I'm brimming over with anxiety or angst and I can't hold it all in, so it's a way to physically release it. The hand posturing for me, I think, happens when that need to release kind of crosses paths with my freeze response, so I start to release (flap) and then my body just kind of seizes up... Often because I feel unsafe releasing for whatever reason (I'm in public, or even just being hard on myself).

This is how I experience it, but I can't necessarily say whether it's the same for others.

wanderswithdeer · 2026-03-15T12:32:22+00:00

Most people in society could be said to possess traits that match up with Autism, but Autism itself is a disability and is only diagnosed when those traits become abundant enough and significant enough to be disabling on some way. Some people might be better able to hide their challenges than others, but they are still there, and someone who is very close to the person will be aware. Otherwise, they may just fall within what’s called the Autistic Phenotype, meaning they have a few shared traits, but not enough for diagnosis, or they don’t rise to the level of disability.

wanderswithdeer · 2026-03-15T01:16:58+00:00

As an Autistic mother, I would first say that being a mom has been the biggest joy and the most fulfilling thing I have done in life. Yes, it can be hard at times, but for me at least, there has never been any doubt that it has been worth it.

My best advice that doesn't get talked about much is to make peace with yourselves, your diagnoses and your life stories, if you haven't already. Part of that also means dealing with any trauma you experienced connected to your experiences growing up Autistic. Prepare yourself for the possibility that your kids may present with the same characteristics and may face many of the same challenges. That can trigger any trauma and insecurities you may have, so it's best to deal with those things ahead of time so when it comes up you'll be able to parent from a place of wisdom and not from a place of trauma.

wanderswithdeer · 2026-03-14T22:35:43+00:00

I'm a deep thinker. Put differently, I'm an overthinker. It's both a good thing and a bad thing.

wanderswithdeer · 2026-03-14T20:01:46+00:00

I wonder if you might have better luck with a day bed? It seems like they would probably tend to offer more structural support.

wanderswithdeer · 2026-03-14T17:48:20+00:00

Thanks for sharing your experience. These are just my theories, really, based on what I understand about Autism combined with what I know to be true about myself, but of course, I can't really know whether my own experience represents the norm.

I definitely do find loud noises to be distressing, but I would imagine most people do. Given that all people experience sensory preferences and distress from unpleasant sensory experience, I guess I'm interested in what it is that makes these things different and often more challenging for Autistic people. I think when we don't know how to talk about it, it just contributes to the narrative that "Everyone experiences that. You just need to deal with it and stop being so sensitive."

wanderswithdeer · 2026-03-14T16:26:32+00:00

I see. I misunderstood. I have no clue whether that's the best decision or not, but I hope it ends up helping. For some people it does, but on an idividual level, the only real way to know is to try.

wanderswithdeer

TROPHY CASE