Saturday, June 9, 2012

The Hidden Autistics III: You Don't HAVE to Look Them in the Eye

Early in my practice in California my very first client - smart, sweet and sensitive - came in wanting some help with his relationship.  Our dialogue seemed to flow pretty smoothly, but he spent most of our hours together staring - intently and without break - directly into my eyes.  I had no idea what to make of it.  He couldn't have had autism, of course - he not only made eye contact, he never stopped!

After a while I realized I wasn't going to find the answer in the DSM, as this client fit neatly into no diagnostic category.  I knew I'd have to find a new therapeutic approach if I were going to help him at all.  I could tell the approach was going to have to be more collaborative than is allowed in traditional therapy.

After we'd established a good and safe relationship, I asked him about his constant eye contact.  "Oh yes," he replied. "I hate doing it, but in college I was accused of stealing, because I was broke and never looked people in the eye.  It made people uncomfortable. So now I always do, constantly, so people are comfortable and know I am honest."

Aha!  This client's efforts to guide communication according to objective rules had backfired, and his staring came off as unnerving.  And he had no idea.  My job as his therapist was to share how I experienced him, and so I did, gently.

He was shocked, of course.  But we had a laugh and got to work, with a new problem to solve.  How could he make more eye contact, but do it appropriately?  We explored some techniques he could use to master his natural inclination to avoid looking into people's eyes.  The solutions we came up with, however, addressed not just the comfort of his conversation partners, but his OWN comfort.  This was a new concept for him.  Having spent his life struggling to meet the demands of typical communication styles, he had long since stopped paying attention to how miserable he was trying to do so.

So he learned to gaze at the area between people's eyes, to make intermittent eye contact, to offer disclosures ("sorry if I look away a lot, it helps me think") and to pay attention to his own need to take breaks.  You know what happened?  He mastered a bit of effective communication. But more importantly, he learned that he can change his communication habits while providing for his own emotional wellbeing.

In my mind, this second lesson is vastly more important.  Unfortunately, it is one often ignored by social skills programs and couples communication therapists.  "Ignore your discomfort," they seem to advise, "and with time you'll learn to talk our way."  Shake hands, make conversation, buy flowers, ask questions.  Make eye contact, mimic others' posture, smile, look relaxed.

Learning to communicate in ways people understand is an obvious necessity for getting along in relationships and at work.  But can adults with Asperger's modify their communication habits while respecting their own different styles of relating?

My answer: they must!  And they can, though the work is less structured and cannot be found in a book.  It requires careful investigation of the client's feelings and reactions, many of them unpleasant.  It requires some humor and some experimentation, a lot of patience.  And it works!

That first client of mine?  He grew to make eye contact pretty comfortably in sessions.  It's still hard for him when he's trying to glean a lot of new information from the person he's talking to, or if he's feeling threatened in any way.  But he no longer ignores his own comfort for the sake of mimicking the style of others.  Rather he meets people halfway - and thereby invites others to meet him halfway, too.


Anonymous said...

Excellent post and insight. My son does well with social skills but still gets very anxious for conversation with anyone. He knows the rules but does not want to play the game! No one addresses the underside of social skills. Good post thank you. Look forward to the next one. You are on to something!

Anonymous said...

This is a great piece. I feel like a bear dancing on a ball balancing spinning plates when I'm talking to anyone and I can see they are relaxed. I would like to put down a plate or two but people don't understand. This is a great concept for people without autism to read about. Jake

Anonymous said...

I try to make eye contact but it is so distracting! Thank you for talking about this.

Loco Geologo said...

Really good explanation of what my wife calls my cow eye.

'Enjoying The Hi-5s of Autism - A Family Experience' said...

Maintaining eye contact us challenging but important as a method of 'acceptable' communication. One-on-one conversations conducted in-person usually involve prolonged and intermittent, if not casual glances at one another.
Keep trying. Split second practices have worked for our son.
Thanks for the topic.

ischemgeek said...

I have a trick that I learned as a kid because my parents wouldn't believe anything I said if I didn't make eye contact, but if I was telling them something important, I was nervous and eye contact was harder.

I don't look at the eyes, I look at the nose, mouth, or forehead.

If the other person is further than arm's length away, it makes them think you're making eye contact and saves you from the discomfort of actually meeting someone's eyes.

It works for me and a lot of autistic adults I know - most of the autistic people I know online use this trick once they figure it out or are told about it because it's a great compromise - you feel like I'm meeting your eyes, I don't have to feel like I'm rubbing my eyes with sandpaper.

Anonymous said...

Oh wow, I think I've been doing this for years, after reading a lot of self-help books about communication skills.
Looking back now, there were even times when I mentally criticised people for failing to maintain eye-contact trough all of the conversation. Whoops.

Anonymous said...

I have self tested as having Aspergers and high Empathy. I received no support. I was too sensitive, codepenant, a genius who was faulted at work because people did not understand how I made decisions. I could appear to be empathic with technical instruments because I remembered previous malfuntions.
I worked in healthcare for 40 years. At only age 23 a patient who had been declared deceased and was later admitted for breathing but declared brain dead, began to speak to my when I touched her. Another patient who was brain dead always rapidly increased his respirations when I entered the room. Family asked why I talked to him. I told them we were told to always talk to unconsious patients and that his breathing changed. I assumed he was aware of much that went on and suggested that they speak directly to him. Both of these patients survived and became concious.
We need empathics in healthcare because they add so much value. I worked with many UW medical residents who seemed to value what happened between patients and myself.