If a professional is required by law to make these reports, and makes you aware of these duties at the start of your care, then there is no valid ethics complaint and no violation of trust. The therapist must tell you in their informed consent about these limits to confidentiality and should have done so before any personal information was disclosed to them.

While there is a potential of some harm due to this disclosure, therapists are not in a position to investigate and determine if abuse / credible threats of violence occurred and are explicitly not supposed to do so. They are supposed to make a report and allow other state agencies to investigate. If OPs family ended up hurting someone and the therapist was drawn into legal proceedings, they could equally be sued for having this information and not following their duty to warn.

OP, these issues do belong in therapy and you should be able to get support for them.

While autistic people do have some struggles with perspective taking, the “theory of mind” concept is still hotly debated. Is it still a theory of mind issue if an autistic person does not engage in perspective taking automatically, but can do so with intentional attention and / or coaching? That symptom is neither necessary or sufficient for an autism dx.

And for your other comment, lying happens for so many reasons it’s not a useful symptom either. Neurodiverse people lie all the time to get neurotypical off their back or avoid explains why, for example, trying to converse over the rattle of the fridge motor makes them want to punch things.

I don’t think this will answer your question directly, but Misdiagnosis Mondays has a good series on differential diagnoses and is generally good information.

neurodivergentinsights.com/misdiagnosis-monday/?s…

Don’t forget to include base rates in your calculations. Autism estimates can be as high as ~1 in 20 or 30 (for AMAB) depending on how you measure it and Psycopathy is far lower even accounting for measurement challenges. Also, the HARE, even the updated one, is more than 40 years old. I would be very suspicious of people using that measure clinically.

Anecdotally, autistic people can be prone to overly concrete / dichotomous answers on some measures, which leads some to endorse actions or thoughts they have had, but occur extremely rarely, when the measure is asking about a prominent and repeated symptom.

It is possible to be both, but there are many things that distinguish the conditions. Also, if a person is autistic and has not had that understand or proper accommodations, then “antisocial” habits that develop out of self-protection may be misconstrued as pathological personality traits.

This is a deep and nuanced conversation and it would be worth deconstructing your answers on the HARE with a therapist or someone who knows you well to see if your perceptions of your symptoms match with other’s perceptions.

I’ve had plenty of men tell me they refuse a vasectomy because it would impact their testosterone production… which is just not true, not how the body works, and has been proven over and over. So despite the procedure being the better choice for their family planning etc, they make choices that are less safe, less effective, or offload the family planning to their partners because they’re unscientifically afraid their masculinity will be affected.

Oh absolutely, I do something very similar and while I do have to travel in a similar way, I certainly could never justify, nor would I want a vehicle like that.

I understand your larger point but many psychological assessments cannot be conducted virtually, though development in that area continues. Additionally, if assessment for social skills (such as ASD assessments) is the goal, that needs to be done in person.

I’ve been listening to a ton of Sleep Token. I don’t really follow the cult lore around them, but the music is fantastic.

It takes about 5 half lives to clear 95% of a substance from your system. A quick google says the half life varies from 5-21hrs, so even if you’re on the slower end, a week should do it.

If you’ve been on it for a very long time then your CNS may need more time to get back to baseline, but you probably don’t need a perfectly clean slate to assess if a new medication works for you. Plus, switching from a nonstim to a stimulant is a totally different class of drug and you should feel the effects of a stimulant fairly quickly.

Just make sure you time and dose correctly to avoid messing up your sleep.

I used to keep fish. I loved learning about the nitrogen cycle, setting up the co2 diffuser, balancing tank parameters, designing the filtration system, researching, purchasing, and acclimating exotic fish. Fascinating, colorful and compelling. But once the set up was done and I had a mature tank I was bored and dreaded basic maintenance. The fish didn’t deserve a subpar home so I did my best, but when we moved and sold the set up, I never went back.

Ouch! Well, if you’re up, may as well read:

www.ncbi.nlm.nih.gov/pmc/articles/PMC4195638/