Monday, July 30, 2012

Adults with Asperger's and Building Self-Concept

How do adults on the spectrum build their self-image?

I've been thinking recently about this: how my clients have built and maintain self-concept. Most of us use relationships to some extent to gather information about ourselves and build self-image.  Ongoing relationships help maintain and develop self-image.  This is a healthy process (to the extent the relationships are healthy), and a normal part of development.

Development teaches us that the reciprocity of early relationships is the first step in building identity.  It is crucial to bonding and attachment - that seems obvious.  If an infant has an "attuned" caregiver, s/he learns basic trust; that is, if needs are expressed, they are largely met.  This starts immediately after birth: the infant cries, expressing distress.  The infant is then cared for appropriately (whether that means being fed, changed, rocked, etc).  Over time, these reciprocal experiences teach the infant, then toddler, then child, then adolescent, that relationships with people are sources of safety and nurturing.  We learn, as a by-product, that we are worth this safety and nurturing.

What happens, then, when the infant on the spectrum attempts to enter into this exchange? I can think of lots of ways the system may get disrupted.  For instance, many parents recall that their babies (later diagnosed with a spectrum disorder) were inconsolable - obviously physically uncomfortbale, but only able to be soothed sporadically and unpredictably.  Other parents recall babies who didn't cry at all - who seemed to lack the interest in communcation.  Rather than express the need for caregiving, many of these young ones turn to self-soothing.  In some ways they seem almost autonomous from the start - instead of wanting to be rocked to sleep, they rock themselves; instead of playing peek-a-boo with a parent, they flap their hands alone.

If a child is uncomfortable  in a way that cannot be interpreted or soothed by a caregiver, the consequences for attachment can be serious.  I'm not sure many of my clients have found relationships soothing, though they do crave them.  Many Aspie adults I see seem to have given up on bringing their distress to others for relief.  Of course this contributes to self-sufficiency, but also to loneliness, especially when life or feelings are overwhelming.  Their strategy, then, is to keep life and feelings from becoming overwhelming in the first place....leaving their partners wondering why they don't jump in to participate in stressful conversations or share emotional space with people they find unpredictable.

But think about it - what if you couldn't lean on others when the going gets tough?  What if you couldn't make your needs understood in order to get what you need?  What if, instead, you were scolded, mocked or rejected? This may sound dramatic, but think of the engineer who truly does not know how to clean a bathroom, or the programmer who always seems to say the wrong thing.  Over time these experiences teach the opposite of emotional reciprocity.  Rather, they teach that interactions and relationships are often sources of pain.

The first step for healing for adults on the spectrum, then, is often establishing a reciprocal relationship - with self.  I know this sounds corny, but it's true.  If I cannot establish a compassionate and attuned relationship with myself, I'm going to have a very difficult time communicating my needs to a partner.  And partners are often desperate to be of help.  When interdependency does not develop, they are left feeling ineffective, or worse, inadequate.  This contributes to the desperation and rage I see in sessions, where each partner feels shut out, but for very different reasons.

Back to reciprocal relationship with self.  We all must become "attuned caregivers" to our selves.  If we have missed this opportunity in childhood, for whatever the reason, we must develop this skill in adulthood.  The first step of self-care is noticing our internal states, so that we can begin to establish a routine of awareness of self.  For adults on the spectrum this is often new.

If you or your partner has difficulty finding solace in relationships, you're not alone.  You can learn to tune into your own emotional states and find healthy ways to meet your needs.  You can learn to articulate what you feel and ask for what you need.  Relationships with other human beings can become sources of support and love.  I think it's never too late to establish new ways of attaching to others.