Discarded by Talkspace
I gave up on a therapy session 15 minutes into a 60 minute session.
Three weeks ago, I was diagnosed with both autism and ADHD after a long, thorough diagnostic process — which I documented in a recent podcast episode. It involved multiple structured interviews, a deep-dive into my life history, and validated assessment tools completed by both myself and family members. The psychiatrist who conducted it spent several hours with me over Zoom. The final report ran 35 pages. It felt, for the first time in a long time, like someone had seen me — really, properly seen me.
I spoke with my primary care physician about it, and she recommended I continue talking with a psychiatrist. So off to Talkspace I go, to kick off that process. That, it turned out, was a ludicrous experience, and the first time I ended a one-hour therapy session after just 15 minutes.
I came into that virtual meeting hopeful. I wanted to explore what my diagnosis might mean in terms of treatment — whether that included medication, more structured therapy, or anything else I should be thinking about. I’d already done what so many people don’t: I sought out an evaluation, I paid out of pocket for care that insurance wouldn’t cover, and I came armed with documentation. I had questions. I had energy. I was ready to begin building a support plan that made sense for my newly understood neurotype.
Instead, I left the call feeling utterly dismissed.
The Diagnostic Dismissal
From the beginning of the session, I had the sense that something was off. After the mandatory name and date of birth exchange, I briefly explained my recent diagnosis. I expected the conversation to start there — with curiosity, compassion, or at the very least, a question like: “Can you tell me more about what you’ve learned so far?”
But the first real piece of feedback I received wasn’t a question at all. It was a criticism of how the diagnosis was conducted. The provider immediately took issue with the fact that the evaluation had taken place via telehealth — despite the psychiatrist being licensed and experienced in neurodevelopmental conditions, and despite the process itself being aligned with best practices for adult autism and ADHD assessments.
She told me, repeatedly, that I needed to be seen “on site,” that I should get brain imaging done to “see if different areas of my brain were affected,” and that my diagnosis might not be legitimate because “you can’t just answer questions online and be told you have ADHD.”
Before we had our session, I had sent her a message:
Looking forward to talking with you. I recently was diagnosed with ADHD and Autism and would like to talk about what next steps I should consider. My primary care doctor seemed to suggest pushing me towards ADHD meds, but also suggested talking with a psychiatrist in more detail.
… But she didn’t ask to read the report. In the session, she asked to see it, but didn’t have a way for me to share my screen or to share the document with her. She literally just asked me to hold the report up to the screen — as if she didn’t believe it existed at all.
What she didn’t ask — what led me to seek an evaluation. Or how the diagnosis had impacted me. Or what I hoped to get out of the session.
The irony wasn’t lost on me: in a 60-minute session with a mental health professional, the only person doing any real talking was me — and even that was only for the first 10 minutes or so. The call became less of a consultation and more of a lecture, one that ignored all context, dismissed my lived experience, and ultimately made me feel like I had to defend my diagnosis rather than explore or look at it.
The Problem With Systems That Don’t Listen
What struck me most was not just the skepticism, but the way it was delivered: without any attempt to gather evidence. No invitation to send the documentation ahead of time. No “I’d like to review your materials before we continue.” Just a flat rejection of the premise: that someone could be accurately diagnosed without ever setting foot in a doctor’s office.
We were 15 minutes into a 60-minute session when the air went out of the room. The provider had made up her mind. Without having seen a single page of the diagnostic report, she told me there was nothing more she could do. If I wanted to move forward, I’d need to be evaluated again — this time by someone “in person.” In her words, “That’s how I do my practice.”
She said that a lot. “That’s how I do my practice.” As if that explained everything.
But here’s the thing: I’m not in your practice. I’m in my life. And in my life, I finally have answers to questions that have lingered for decades. In my life, I’m navigating the complexities of being a newly diagnosed autistic adult who’s also grappling with ADHD — and trying to figure out how best to support myself in a world that was never designed for brains like mine.
Instead of helping me move forward, this session tried to drag me back to square one.
The Cost of Being Dismissed
This wasn’t just a waste of an appointment. It was emotionally costly.
When you’ve spent years doubting your own internal experience — wondering why you struggle with things other people find easy, why socializing exhausts you, why your brain seems to go a hundred directions at once — finally getting a diagnosis can be life-changing. It reframes everything. It gives you language, tools, and, most importantly, hope.
So to then be told, flatly and without any real investigation, that your experience doesn’t count unless you jump through even more hoops? That doesn’t just invalidate the diagnosis — it invalidates you.
It tells you that even after all the right steps, all the right paperwork, and all the self-advocacy in the world, someone can still look at you and say: “No. I don’t believe you.”
What I Wish Had Happened
If I could re-write the session, here’s what it would look like:
- The provider asks me to upload or email the diagnostic report in advance.
- We begin the call with a simple, open-ended question: “Tell me a little more about your diagnosis and how you’re feeling about it.”
- Based on the report and my needs, she offers options: medication possibilities, lifestyle support, referrals, or even a recommendation for an in-person consult if necessary.
- We spend the session collaborating — not contradicting — so that I leave feeling supported, not silenced.
Instead, I left the session feeling like I’d wasted both my time and my vulnerability.
Why This Matters
I’m not sharing this story to shame the provider (in fact I won’t even name her). I’m sharing it because this happens to autistic people all the time. Especially those in the ‘lost generation’ — those of us diagnosed in adulthood. We work so hard to understand ourselves better, and when we reach out for help, the system shrugs. Or worse, it gaslights.
Telehealth has opened doors for many of us who would otherwise go undiagnosed. It is valid, and there are many excellent providers out there who recognize that. But the old-school mindset that nothing “counts” unless it happens in person? That gatekeeping has no place in modern mental health care — especially when it masquerades as expertise.
At the very least, if you’re a provider, ask to see the documentation before you dismiss it.
Autistic people deserve better. I deserve better. And if you’re reading this and nodding along, you do too.
