Episode 29: Misdiagnosed and Misunderstood - The Harm of “Lazy Diagnosing” in Mental Health
In this special conference edition of the Autism Learning Lab podcast, recorded during the Autism Symposium in Georgia, host Chris Blankenship is joined by Tony Meiners and Trish Ruggles for a conversation about “lazy diagnosing,” autism misdiagnosis, and the long-term impact of mismatched mental health treatment—especially for autistic women and high-masking adults. Together, they discuss how autistic individuals are often misunderstood within traditional mental health systems, leading to misdiagnoses, burnout, masking, and medical trauma. The episode also explores the importance of neurodiversity-affirming care, adapting therapy to the individual, and rebuilding trust after harmful treatment experiences.
Links:
Autism Learning Lab: https://www.autismlearninglab.com/ [https://www.autismlearninglab.com/]
Email: chris@autismlearninglab.com [chris@autismlearninglab.com]
The Neurodivergent Collective [https://theneurodivergentcollective.com/introducing-the-neurodivergent-collective/?utm_source=chatgpt.com]
Dr. Tony Meiners [https://theneurodivergentcollective.com/dr-tony-meiners/?utm_source=chatgpt.com]
Pathfinder Consulting with Trish Ruggles [https://www.pathfinderconsults.com/?utm_source=chatgpt.com]
About Trish Ruggles [https://www.pathfinderconsults.com/about?utm_source=chatgpt.com]
Quotes:
[12:35 - 13:17] Trish: “Most of my clients that I work with are diagnosed late and a lot of the female clients I work with are diagnosed in their 20s or 30s, and that is so profoundly late, and they've usually encountered a lot of hardship of not being able to make and keep friends, not being able to hold jobs, or they're only able to hold lower level jobs, they're never able to get promotions, and if they do, they start to crumble, they start to become depressed, they start to become suicidal, they get involved in substances to fit in, they often end up in really abusive sexual relationships because they don't know or understand any better, and it's connection, and it looks normal.”
[13:59 - 14:25] Tony: “I think the issue is that we often ask clients to adapt to the therapy instead of adapt the therapy to the client, you know, and a lot of these gold standard modalities assume a singular processing style or the singular way of perceiving the world, and when you're trying to have a client use this therapy that has these assumptions, but the client perceives the world differently. It's not going to work.”
[25:17 - 25:45] Trish: “I think another chronic one [issue] that happens over a long period of time as well is mistrust of providers, right? Like, what are you going to do to me? What are you going to make me do? What are you going to tell my parents? And on the reverse, the parents are going to say, like, what kind of hope are you going to give me now? And then you're, you know, it's going to fail to produce. So I think it can be long term, like a lot of mistrust, a lot of resentment, loss of hope.”
[30:48 - 31:03] Tony: “One of my mottos is, you are not the problem, the problem is the problem, and that's kind of how I start these, these sessions or conversations with clients or families, is really decentering and depathologizing that the person in front of me as the issue.”