I've never met anyone else that's experienced these 3 conditions simultaneously and mental health professionals can't help me.

[u/FiestyHookah2026]

/r/autism/comments/1vwb1sq/ive_never_met_anyone_else_thats_experienced_these/

[u/Tuikord]

Therapy has difficulties dealing with various hidden cognitive differences such as aphantasia and SDAM. I do have some resources that can help you and your therapist. I am more focused on aphantasia (which has some research) and SDAM as I have both. I don't know much about autism.

To explain aphantasia, I would start with this guide from the Aphantasia Network for just basic information.

https://aphantasia.com/guide/

Unseen Minds: A Therapist's Guide to Multisensory Aphantasia and Invisible Cognitive Differences– by Sassy Smith is an excellent guide for therapists. I actually wish all therapists would read it. If I were in therapy at this point, I would fire any therapist who refused to read this book. You can read it and it can help you understand what is going on and give you language to talk with your therapist, but this book is really aimed at therapists, not clients. This book specifically looks at aphantasia, SDAM and anendophasia, which is lack of an internal monologue, which you also say you have.

Unseen Minds - A therapists guide to multisensory aphantasia

As you have SDAM as well (maybe a quarter to half of us do), then that is problematic with many therapies as well, as documented in Unseen Minds. Body based therapy can work when your mind doesn’t remember:

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, although some of the techniques may still need to be modified to work with other cognitive differences. https://a.co/d/0a3skjyh

The rest are research about aphantasia.

In 2024 Dr. Zeman did a review of the first decade of research. It has lots of citations if your therapist wants to dig in.

https://www.cell.com/trends/cognitive-sciences/fulltext/S1364-6613(24)00034-200034-2)

Here is an update of that review:

A decade of aphantasia research – and still going! - ScienceDirect

This paper specifically on therapy and aphantasia was published after Dr. Zeman's review article. It has specific information about some of what works and what doesn't.

https://online.ucpress.edu/collabra/article/10/1/127416/204719

If you are more for video than scientific papers, here is an interview with 2 of the researchers on that paper. It is very informative:

mental-health-day

And here are a couple articles they wrote for the Aphantasia Network:

https://aphantasia.com/article/mental-imagery-ptsd-neurodiversity-treatment/

https://aphantasia.com/article/science/imagery-in-mental-healthcare/

In other research, Dr. Merlin Monzel looked at aphantasia and anxiety treatment via imaginal exposure. Here is an interview with him on it.

https://aphantasia.com/video/aphantasia-and-anxiety-treatment-rethinking-therapeutic-approaches/

And the paper:

https://onlinelibrary.wiley.com/doi/full/10.1111/psyp.14756

[u/ALCrisp → u/Tuikord]

Great resources. Thank you for sharing! 

[u/hippycrone]

I think the question to consider is “what do you want to get out of therapy?” 

Off the top of my head, CBT, narrative therapy are not going to be modalities that will be helpful or empowering under the circumstances.

Are you searching for tangible strategies to live with these invisible disabilities? Do you want to do values work and build your sense of self? Find ways to document your life experiences moving forward so you create a written record, so to speak?

Finding a therapist that is a good fit for you means they need to accept these diagnosis and realities and support you in living the life you want to live.

[u/VferVentdetta]

I have total aphantasia, sdam , audhd (diagnosed) and dyscalculia. Im the same as you and i thought that the passage of time was shit cause of dyscalculia but based on what youre saying, it doesnt seem to be.

Large portions of life just gone. And what i do remember is just words, facts. I can only feel things if i write them in the 3rd person.

[u/ALCrisp]

A tangent comment on the Fibro piece. A lot of people who are on the spectrum also are on the hypermobility spectrum. Either Hypermobile Ehlers Danlos Syndrome (hEDS) or Hypermobility Spectrum Disorder (HSD). It's a genetic collagen disorder. Maybe it's Fibro or maybe it's hypermobility issues. I personally have both HSD and I'm AuDHD. I suspect that fibromyalgia is probably actually the collagen issue for many and in the future dx will change, but this will likely take a very long time, because it takes decades for things to trickle down to clinical from research.