William is thirty years old and has just been diagnosed with Asperger syndrome. He is articulate, literate and lives independently. William’s diagnosis came about as a result of him reading a book on autism and recognising his own difficulties in the descriptions given. William sought advice from the local autistic charity and made an appointment with his G.P. to seek a psychiatric referral. However, six months later, a follow-up call from the charity revealed that William had failed to get a referral and was now in a very anxious state.

A long face-to-face discussion with William revealed that, although he was able to make and attend the appointment with his G.P., the anxiety he felt in the meeting prevented him from communicating why he was there. The panic he felt in this situation overtook his usually good communication skills. To cope with the anxiety, his strategy was to sit passively and agree to everything suggested by the G.P.

William suffers from an arthritic condition, for which he receives regular medical attention. In six months he had made three appointments to discuss his suspected Asperger syndrome, but each time, his G.P. had treated his physical condition, unaware that this was not the reason for the appointment. Despite his abilities, William felt incapable of raising this subject with his G.P., such was the anxiety it caused him, and so it was agreed that an advocate would attend the next appointment with him and speak on his behalf. William’s G.P. found this perplexing, since she had known him some years and seen him regularly in that time, but was glad to help him with the referral, which did result in a formal diagnosis for William.