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But apparently I was unconsciously projecting some kind of “I don’t like strong emotions, you’d better avoid those” field, and my patients were unconsciously complying.

I wish I could say my supervisor’s guidance fixed the problem and I learned to encourage emotional openness just as well as my colleague.

A few years ago I had lunch with another psychiatrist-in-training and realized we had totally different experiences with psychotherapy. As per the textbooks, there should be a climactic moment where the patient identifies me with their father, then screams at me that I ruined their childhood, then breaks down crying and realizes that she loved her father all along, then ??? ” or “Maybe you feel like screaming at me right now? So I figured the textbooks were misleading, or that this was some kind of super-advanced technique, or that this was among the approximately 100% of things that Freud just pulled out of his ass.

We were both in the same training program, studying under the same teachers. In particular, all her patients had dramatic emotional meltdowns, and all my patients gave calm and considered analyses of their problems, as if they were lecturing on a particularly boring episode from 19th-century Norwegian history. I wish I could get my patients to have dramatic emotional meltdowns. I tried, I even dropped some hints, like “Maybe this reminds you of your father?

Then Isabelle overheard a lady just down the beach. Essentially, the woman blamed Jessica for not keeping closer watch on her daughter — for neglecting to teach her the importance of not getting into a car with someone she didn’t know. “It’s like, ‘My friend, you have no idea,’ ” Jessica says. And when the doorbell rings, Jessica will leap over a coffee table to intercept her.

“She was telling her kids, ‘OK, let’s go to the Dairy Queen,’ ” Jessica says. In fact, because of Isabelle, Jessica has had to rethink even the most basic elements of her day-to-day life. It’s not just Jessica and her family who must be vigilant.

These are the sorts of questions everyone navigates all the time, usually with enough success that when autistic people screw them up, the rest of society nods sagely and says they need to learn to understand how to read context.

Just as there’s a spectrum from smart to dumb, or from introverted to extraverted, so there’s a spectrum in people’s tendencies to interpret ambiguous situations in a positive or negative way.

This means that it is essentially biologically impossible for [them] to distrust.

As Isabelle got older, the negative side of her trusting nature began to play a larger role.

” And later, my supervisor was reviewing one of my therapy sessions, and I was surprised to hear him comment that I “seemed uncomfortable with dramatic expressions of emotion”.

I mean, I am uncomfortable with dramatic expressions of emotion. As a therapist, I’m supposed to be quiet and encouraging and not show discomfort at anything, and I was trying to do that, and I’d thought I was succeeding.

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