If you need to do an extended monologue to explain your situation/condition and you do this from memory, that is a big cognitive load. I suggest you write things down so you can follow your list in a less cognitively stressful way.

I struggle to understand why the therapist needs wait so long before responding. It would be helpful to break this conversation into smaller segments.

If the therapist responds and is long winded, tell the therapist to break the conversation into smaller points.

For me, my response will be "Hold on/slow down, I can only process one issue at a time."

I have lived with this limitation for more than 13 years. I need to take control and slow the pace and intensity of the conversation. Otherwise, the time is a total waste.

If there are multiple people talking and they tend to talk over each other, I need to either get them to speak one at a time or I need to walk away.

Many people are more focused on hearing themselves speak that truly being heard.

Learning skills to slow down and organize a conversation can be helpful, especially when the goal is understanding and improvement in your condition.