Appointments, doctor’s appointments in particular, can be very stressful for those on the spectrum, due to the intense social anxiety they can trigger. So this week I thought I’d share some of the strategies that have worked for me and my family, that can help make appointments, including those over the phone, run more smoothly.
The first thing to note is that a lot of the anxiety around doctor’s appointments is less about the actual appointment, and more about all of the little things that come before the doctor’s appointment, most of which are to do with the existence of other people. For example, I personally get stressed about:
- booking in at reception (what if there’s been a mix up and I’m here on the wrong day? What if the receptionist tries to be friendly and chat to me?);
- finding a seat in the waiting room (what will I do if there are no seats?);
- sitting in a waiting room with other people (what if somebody approaches me and I don’t know how to respond? Or say they start trying to initiate small talk and I don’t understand? What if somebody is being loud and it hurts my ears?);
- missing the call when it’s my time (what if I’m late to the appointment? Or the appointment starts fifteen minutes late?);
- Finding the room (what if I can’t find the room and/or forget which doctor I’m supposed to see?).
You see, to an aspie mind, there are far many more variables to consider than just a simple doctor’s appointment, and all of these what-ifs have the potential to trigger feelings of anxiety.
As I’ve already mentioned, one way to overcome the fear of these variables is having someone you trust — and, crucially, who you feel is competent at handling in social situations — accompany you. This way, they can help you deal with any situations that arise. In my case, I know my mum can handle any situation that might arise for me – she can handle booking in if there’s a mix-up, and can help me make decisions if needs be. She will be with me to make sure I find a seat and will be able to respond to strangers appropriately if they try to talk to me. If the appointment is late, my mum can advise me on how long we wait, and she can catch any errors I make. A lot of ASD-caused anxiety is related to low self-confidence, so having someone with you for support who you know can be relied upon can be useful to give you the confidence to go through with an appointment.
Another thing that I like to do is have a plan. This applies much more generally than just appointments. Before I leave the house, my mum will run through what’s going to happen, especially if it’s in a new place. Obviously not everything can be planned for, unpredictable variables are always going to arise, but it helps to have a sense that I know what’s going to occur. Once we’ve gone through something (like an appointment) several times, there is less need to go through the plan again, but it helps.
Now, in the actual appointment…
The system we have devised is that Mum will tell the doctor at the start of the appointment that I have Asperger’s and explain the situation. Then she will start by doing most of the talking, and I can chip in when I feel comfortable. If and when I feel ready, then I can take over the discussion of things and speak for myself. This usually happens pretty quickly, but having my mum start the introductions is useful because it means that she is able to navigate for me what I think of as the ‘introductions’ or ‘small-talk stage’, because even if there is very little actual small-talk, there is this intricate process happening of going into the new room, establishing the environment, finding where you’re supposed to sit, saying hello to the doctor, sitting down, all of which may seem perfectly navigable to a neurotypical, but which takes me a certain level of time to process. When I walk into the room with a new person, there is a lot of stimulation to take in, whilst also trying to behave appropriately in front of a doctor and answer their questions of ‘how have you been? what brings you here today?’ etc. I usually just need a minute to ground myself and establish the tone of the conversation before it becomes easier to start talking.
What about phone calls, then?
Oh, the dreaded phone call appointment — which unfortunately COVID has made much more frequent. Honestly, phone calls aren’t that bad, but I prefer to avoid them in all places I can.
First, let’s answer the question – why are phone calls difficult for people on the spectrum?
The main thing is: they’re tiring. Don’t get me wrong, real life conversations are tiring too, because when I’m doing so I am still often masking my autistic traits, which even though I do it subconsciously, it’s still using up my internal batteries. However, on a phone call it feels like that masking instinct is turned up to 100 — even more so if I am talking with a stranger, which makes phone calls feel quite draining.
Another issue is that they are unpredictable. Even with my ASD meaning that I can’t pick up on body language and facial expressions, in real life conversations there are still little signs I can recognise which help me to navigate the conversation. But with a phone call, there are none of those cues. Thus, there’s an element of unpredictability with a phone call which means that it can be quite anxiety-inducing, especially initially when you first answer the phone when you hear an unfamiliar voice.
The other significant factor in a phone call is the fact that my ASD brain processes conversation just a little bit slower than the average neurotypical, and without those aforementioned social cues, I have to concentrate intensely on what’s being said in order to keep up. I am paranoid about mis-hearing information when listening to someone on the phone; accents can also be difficult for me to decipher because as I mentioned, my processing speed is slightly slower.
In addition, it can often simply just be difficult for me to keep my attention focused on the phone call, because it requires so much focus to decipher. Add to that the pressure to give spontaneous and socially appropriate responses, which might not always come naturally to aspies, and phone calls can become very stressful.
I often lament that a lot of the difficulty of phone calls could all be avoided if they could only be text messages instead. Ah well, we must still deal with them now and again. Honestly, though, they are manageable, with the right tricks. So here’s the strategy I use for those essential phone calls.
Usually, my mum will answer the phone for me, establish who is calling, and then she will put it on speaker, so we can both sit and listen to the call. Just like in real life appointments, she does most of the talking until I feel comfortable enough in speaking for myself. This takes the pressure off of me to respond initially, so I can focus on just processing the information, and getting used to the caller’s voice and accent. Then, like in real appointments, I can chip in and eventually take over entirely. It also helps because my mum can help me to take notes about information, and I don’t have to worry about remembering it all in one go. Having a pen and paper handy is always a good tip, as is making sure you’re ready for the call at the designated time, if there is one.
And that’s it! Those are the ways I manage appointments. If you know of any other useful tips, leave a comment or like and share this post if you think it would be helpful to others. Thanks for reading!