Sunday, February 24, 2013
Adults on the Spectrum: These are your Feet on Asperger's
When I first started working with adults on the spectrum there was no literature to refer to, and certainly no treatment guidelines. It was a brand new frontier, and so exciting. I haven’t lost that sense – that there’s an ever-expanding landscape of discovery when it comes to working with adults on the spectrum. Part of the constant novelty lies in the complexity of the mind; our personalities and coping mechanisms emerge through a complicated interplay between environment and genetics. Of course we all know this. But most of us consider autism to be a strictly neurological disorder, with observable behavior manifestations. After working with hundreds of adults, I’m beginning to have my doubts.
What emerges after working with so many adults on the spectrum are patterns. These patterns reveal common threads between everything from client histories, to their private philosophical musings, to their choice of partners, to their sexuality, to the way they sit. I’m not talking about anything near 100% consistency, of course. But I am talking about unmistakable trends, the likes of which I’ve not seen in other populations. I’ll be writing more about these trends in posts to come.
But for this short post I’d like to focus on one rather endearing trend: what adult clients do with their feet. After seeing lots and lots of adults on the spectrum I couldn’t help but notice how they tend to sit.
Not all of them, mind you, just many more than I had ever seen when working with varied populations.
Since sitting in this manner is not socially sanctioned for adults (yes, even our sitting postures are guided many unwritten social mandates), it’s unusual to see adults, both men and women, sitting in this position. Some of them let me take pictures of their feet. I've got almost fifty of them! All the same position. It’s not a groundbreaking clinical observation, just a fun one, and one example of how people on the spectrum can transcend social expectations and teach us about ourselves. Apparently sitting with your feet like this is really comfortable. I’ve tried it now, and it made me remember how many comfortable things we give up when we enter the world of adulthood and social referencing. The ability to be disconnected from social norms can cause problems - we hear lots about that - but it can also preserve behaviors that are timeless in their comfort and charm.
See our this post referenced on The Atlantic: http://www.theatlantic.com/health/
Friday, November 9, 2012
ASPERGER'S AND PARTNERS: THE 98 PERCENTER
- Often extroverted, or a socially extroverted introvert
- Can be emotionally labile – shifting and reactive moods
- Socially adept – can fit in with many different kinds of people
- Highly communicative of emotional states
- Can seem very angry one minute, then pick up the ringing phone and seem cheery
- Knows how to make people feel good
- Often skilled with remembering details about people’s lives
- Highly sensitive to others’ perceptions and judgments
- Quick to anger
- Prone to anxiety and/or depression
- Excellent at chit chat (though s/he may not like it)
- Often interested in social justice (animal rights, etc)
Monday, July 30, 2012
Adults with Asperger's and Building Self-Concept
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.
Tuesday, July 17, 2012
Adults with Asperger's: Why Freezing Strawberries Can Be Hard
But gathering information from the Aspie partner goes a little differently. Many folks with Asperger's have a difficult time recognizing and naming their emotional states. Most of my clients know if they're comfortable or not comfortable, but distinguishing between emotions like guilt and sadness, or happiness and excitement, is trickier. Funny that many of these adults enter into relationships with partners who are so highly empathic; I've heard couples report that the non-Aspie partner will know her partner is anxious before he does!
This difficulty naming emotions wouldn't seem like too much of a disability, except that we rely on our ability to notice and name our internal states constantly - throughout interactions with everyone from the mail carrier to our spouse. Think of the lack of control that can come from not being able to name your emotion - how then can you modify your environment or the behavior of others to meet your emotional needs? Here's an example of the kind of interaction that can emerge:
#1: I'm so angry with you for forgetting to freeze those strawberries!
#2: I didn't forget.
#1: Yes you did. You always do. I told you to freeze them, and there they sit on the counter!
#2: That's because I haven't gotten to it yet.
#1: Well when did you think I wanted them frozen? After they've gone moldy?
#2: They're not moldy.
#1: That's not the point! I asked you to do me a simple favor and you just won't do it! I really do have
to do everything myself. Can 't you understand how that hurts me?
#2: (silence)...beginning to shut down
#1: Is that a "YES"?
#2: (silence)....shut down
In this example (as you may have guessed) Partner #2 is the partner with Asperger's. As tension rises during the conversation, he is unable to identify his emotional state - things are moving too quickly, and she's waiting for a response. There's no time to slow down and ask himself what he's feeling - to do so might even further escalate the situation. Because accessing emotion takes time - more time than is socially sanctioned - he may focus on the information coming his way - because frankly, he can process information with lightning speed. Once she's offered a statement that's untrue ("I really do have to do everything myself"), the conversation is largely over. He cannot correct her statement without furthering their journey down the rabbit hole. He cannot acquiesce, because the statement is not correct. With no option, he shuts down.
In an effort to justify feelings, many of us exaggerate information. Without doing so, it seems, we are not taken seriously. But doing so invites debate. Were the strawberries really in danger of going moldy? Perhaps not. Because she has expressed her feelings in terms of information, the validity (or lack thereof) of the information is relevant. This debating of information is often a major way these conversations get derailed.
But there's an exciting twist to this story. Healthy communication requires sharing perspective using reality-based language. It requires resisting the temptation to read into behaviors, to assume motives. Yet most of us are socialized to infuse our communication with emotional intensity when we feel unheard. Of course this will not work in an Aspie relationship. Nothing will close down a conversation more quickly. Healthy communication is literally the only thing that will work.
If folks with Asperger's tend to miss emotional cues unless the cues are potent and unmistakable, it's natural for partners to want to amp up the intensity in an effort to be heard. It's painful when this backfires for both partners. Developing a system that helps you and your partner navigate conversations - and communicate intense emotions in non-threatening ways - is crucial. Without systems to manage these moments, partners will feel both bullied and unheard.
While freezing strawberries may seem to be an inconsequential issue, it's often these everyday rough spots that couples address in sessions. When simple interactions can veer so far south, the couple is at risk for chronic hypervigilance and reactivity.
More on these systems to come.
Wednesday, June 13, 2012
The Hidden Autistics IV: Relationship Counseling
I know, you think I am exaggerating. Really, though, people do think this.
Consider a client I'll call Eloise, who came to see me in a "last ditch effort" (her words) to save her relationship. Having already visited two couples therapists for help in understanding how to relate to her Aspie husband, she was in the process of resigning herself to the "truth" they had shared with her: her relationship could never meet her emotional needs. Her best bet would be to reframe her relationship as a platonic partnership, and to get her emotional needs met elsewhere. The ideas of knitting clubs and online forums had been proposed, and Eloise was in a state of panic.
After offering this brief history, Eloise stated her purpose in seeing me. She wanted help in moving through the grieving process. She needed to mourn, she said, mourn the normal relationship she would never have. She wanted to know if I could help her with this grief work, so she could move towards acceptance of this stunted marriage. She couldn't leave, she explained, because her husband was a wonderful person, though sadly therapists (and books!) had revealed that he was incapable of connecting to her emotionally.
In responding to Eloise, my first task was to breathe through my outrage. The two therapists who had offered Eloise this glimpse of her marital destiny had not even met her husband. Both had "comforted" her by explaining that his withdrawal and disconnectedness had nothing to do with her - rather this was his neurological disorder at work, and nothing could fix it. Beyond the irresponsibility of this crystal ball therapy, their predictions made little sense given recent research on brain plasticity. (See this great TED talk on the subject at http://www.ted.com/talks/michael_merzenich_on_the_elastic_brain.html for a brief introduction.)
The truth is that Asperger's, and its impact on relationships with self and others, is poorly understood, especially by many clinicians. And certainly no clinician should ever give a prediction for an individual's lifelong functioning, especially if that person has never been evaluated. Aspie couples come to therapy looking for tools and answers, and are often instead given prescriptions for hopelessness. It's one thing to talk conservatively about treatment goals; it's another thing to throw out goals altogether.
Therapists often tell clients married to ASD adults that their partner cannot feel empathy and cannot truly love. Perhaps the reason I take such exception to this kind of dangerous feedback is that it's simply not true. All of my clients feel empathy, and all are capable of love. In fact many times my Aspie clients are shocked to find that their partner's faith in their love and loyalty can be compromised by a forgotten good-bye or missed eye-contact. One Aspie partner remarked: "How can our whole relationship hang by a thread? It makes me afraid to open my mouth for fear I'll accidentally destroy my marriage." Of course this anxiety furthers ASD clients' reluctance to establish connection, which furthers their partners' feelings of being ignored or neglected.
Partners with Asperger's have often spent a lifetime making unpredictable relationship mistakes that carry real repercussions. When the probability is high that your efforts to connect will be met with rejection, it's awfully hard to justify the logic of continuing to try. Successful relationship therapy involves identifying triggers so that both partners can work towards feeling safe together. This is the foundation of building connection.
Clinicians are trained to use good communication to build safety, rather than building safety to facilitate good communication. I'm proposing the notion of working together to establish safety first. This is crucial for creating a context in which people with Asperger's can experiment with being vulnerable, and non-Aspie partners can experiment with interpreting behaviors in brand new ways.
Saturday, June 9, 2012
The Hidden Autistics III: You Don't HAVE to Look Them in the Eye
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.
Thursday, June 7, 2012
The Hidden Autistics II: Asperger's in Adults and Empathy
An oxymoron, you say? I don't think so. In fact, this happens so often during sessions that I've begun to think of Asperger's as a disorder often characterized by too much empathy, not a lack thereof.
Before I get started on this idea - one I expect will be viewed with skepticism, at best - let me describe what happened during one such session, one that illustrates my point.
My client - let's call him "Giles" - and I were discussing the use of gaming as a self-soothing tool, one that may solve for otherwise overwhelming emotional states. Giles used few tools of escape, and we both agreed that his immersion in the world of online gaming came with a price.
At some point we compared his gaming to other self-soothing tools, and I mentioned my tool of choice: doughnuts. In response, Giles began to make a case for the harmlessness of doughnut overuse. After a couple of minutes straight of his explaining why I should not feel guilty about my doughnut habit, I realized he was concerned I might have grown embarrassed.
I stopped him. Could this be right? Indeed, it was. Giles, this adult with Asperger's, had sensed I was embarrassed, and was doing his best to make me comfortable. There was no other way to explain it: this was empathy.
In fact, many clients have demonstrated the same level of empathy in myriad ways during sessions. I see it when they tear-up describing their pet's pain. I see it in their silent withdrawal when a parent is unfairly raging. I see it in their pull towards social justice. I see it in Asperger's men's groups, during which they are gentle and supportive of each other in ways that violate male social norms.
In fact I often wonder if the withdrawal adults on the spectrum resort to is emotionally necessary. If they feel others' pain acutely, and on top of that often lack the social skills to offer "appropriate" comfort, what are they to do? Withdrawal and distancing become more than relating styles: they become necessary tools for self-preservation.
Picture the plight of the teenager on the spectrum who comes home after school to find parents who are quietly angry at each other. Because he is sensitive, he knows something is wrong. His body is on alert, and he wants to help. Because he is empathic, he would like to offer comfort. However, because he is bright and learns from patterns, he knows that historically he has said the "wrong" thing in these situations, which has made things worse. He determines, quite logically, that the best thing he can do is go to his room and put on an audiobook. Both parents notice this, and note how little he appears to care about anyone but himself.
Adults on the spectrum often over-empathize. To feel deeply, and fail miserably when they try to offer comfort, causes more injury than can be tolerated. Retreating offers solace. And confirms their image as non-empathic.
"Autistic empathy" is a powerful experience, and leaves the adult with no way to manage the strong emotions of others, which resonate so deeply in him. Our job in relating to them is to look past the veneer of calm or indifference with quiet curiosity, to resist the outrage we feel when someone displays so little outward reaction. Partners who do this are met with a rich world of sensitivity and attachment, the world they sense but cannot readily see.
Saturday, May 26, 2012
The Hidden Autistics - Asperger's in Adults
It took a few sessions to realize this fine gentleman suffered mightly with the symtoms of Asperger Syndrome, which he kept well managed and thoroughly hidden. Contrary to the stereotyoes of adults on the spectrum, my patient displayed no "meltdown" behavior, was keenly (TOO keenly) aware of people's reactions to him and exhibited no bizarre special interests or encyclopedic knowledge of vaccuum models.
In fact, "Joe", as we'll call him, socialized quite well. He seemed quietly confident and wry, intelligent and perceptive. People responded well to him, really liked him, though probably none of them would describe him as a close friend. No one realized - in fact he often went without realizing - that his baseline anxiety approached panic on a regular basis. As soon as he was out of bed, existential angst was his constant companion. His difficulty managing his thoughts made rudimentary conversations minefields to be navigated. And navigate he did, dodging social errors with the same fright and determination one might actually dodge mines. After even minor social interactions he routinely found himself exhausted, and would retreat to soothing, isolated activity: sculpture, writing, woodworking. Not conversation with his wife.
Diagnosing this man was problematic. He truly did not fit the criteria for Asperger Syndrome. In fact, the only person to suspect he was on the spectrum was his wife, who puzzled endlessly about this curious man. He seems so sensitive and kind, she would say. Yet he ignores my birthday and hangs up before saying goodbye. He's so charming with others, yet so silent at home. He never misses a deadline at work, yet cannot remember to give our dog his heart medication.
Partners of people on the spectrum are drawn to what they can sense is inside their partner. Yet they feel shut out, left pining for connection with this special person who remains unreachable. It can be a confusing relationship, and one that can easily lead to resentment.
So what was the problem I ran into with the collaborating therapist? She found it hilarious - outrageous! - that Joe had been diagnosed with Asperger's. When Joe would make an insightful comment during group session, this group therapist and members would share a hearty laugh, rolling their eyes that this sensitive man had been diagnosed as autistic. When Joe would tear up recounting his wife's rage and disappointment, he'd hear "So Mr. Autistic is shaking because his wife got angry! Ha ha! Shouldn't you be indifferent and focusing on dinosaurs?" (I'm sorry to say this is a direct quote.) The general public, even many clinicians, cannot believe someone like Joe can be autistic. His social deficits are so well hidden that he has convinced the world his autism does not exist. And he has perhaps convinced himself.
One person remains unconvinced. His wife. After a long day of running what he terms his "social program", feigning natural banter and hiding anxiety, he is exhausted. His wife comes home to a man who has retreated to isolation as a desperate attempt to find peace and rest.
I'd like to write more about this "hidden autistic" phenomena. Someone must. Adults on the spectrum are often too good at convincing others they are fine, have no emotions, are robotic. This is never the case, and the illusion can be dangerous to long-term mental health for autistics and their partners alike.
Sunday, March 18, 2012
NEW THERAPIST AT TERRA THERAPY P.C.
I'd like to welcome our new therapist, Kimm Klassen. Kimm earned her master's in social work at Eastern Washington University, and currently works as a therapist in the Bellevue Washington school district developing and implementing programs for kids and families with special needs.
Saturday, November 26, 2011
Loving Your Introverted Husband with Asperger's
My husband zones out if too much is going on!
STRAYING FROM THE MID-LINE - ADULTS WITH ASPERGER'S AND THEIR PARTNERS
Through working with many Aspie couples I've come to notice an interesting phenomenon. The apparent lack of emotionality of the Aspie partner seems superficial. After gentle questioning it becomes apparent that many adults with AS are quite emotional - sometimes even overly sensitive - and many of them are suffering in silence.
Sunday, May 8, 2011
Can Aspies Write Science Fiction? Ask Katie Bridges.
Sunday, March 20, 2011
The Badger and The Mole
When one partner in a couple has Asperger's, things can be....challenging. I often hear from partners of adults with AS statements like:
Thursday, December 2, 2010
MRI Scans and Asperger's - New Research
The online journal Autism Research published a new study today on how MRI scans of brain circuitry might help us understand how the brains of people with HFA differ from the brains of people without spectrum disorders.
Researchers were able to measure six physical differences of microscopic fibers in the brains of 30 males with confirmed high-functioning autism and 30 males without autism. How these findings might relate to adults with Asperger's is unknown. The scans helped researchers identify adults in the study with HFA with over 90% accuracy. While the study was small, the progress is promising, as researchers are increasingly in search of definitive evidence of brain differences related to autism. Identifying such differences may serve to clarify diagnosis, which is a largely subjective process at present.
While the study authors find the results promising, MRI scanning for diagnostic purposes is a long way from becoming a widely used tool.
Using the MRI, the study authors measured how the water in the brain flows along the axons or nerve fibers in the parts of the brain that control language, social and emotional functioning. The scans revealed that the wiring of the brains of those with autism was disorganized compared with the brains of a typical person without autism.
Such results are important for adults with Asperger's to consider, and important for their partners to consider. The communication difficulties which can cause immense frustration for the partner of an adults with AS are understood today, with increasing clarity, to result from neurological brain differences.
Currently there is no biologic test for autism; clinicians working with adults must gather information about current and past functioning to piece together a clinical picture. This process can be tricky, as adults have often adapted to social rules and settings, making what might be more easily identifiable "Aspie" behaviors difficult to see. Often family members are the true observers of these behaviors, but are left without a framework with which to understand them.
Saturday, August 28, 2010
Adults with Asperger's - The Eyes Have It
Researchers in 1997 (Baren-Cohen) found that adults with Asperger’s have difficulty reading mental states by looking at a person’s eyes – not only the expressions of the eyes, but the location of their gaze. These findings were expanded upon in 2002 (Rutherford), when researchers found that adults with AS have difficulty extrapolating people’s mental states from their vocalizations.
Take just a minute to imagine some of the implications.
- You might miss the message of a potential friend who uses vocal inflection to communicate her irritation with your long story; her social rejection results
- You might not see that the person gazing past you is no longer interested in your words; when he abruptly walks away, you’re left confused and mid-sentence
- You might not notice the heavy-lidded, far-away gaze of your partner, which implies her deep thought; when you interrupt her, her anger seems “out of the blue”
- You might not see the knowing glance between party goers when you introduce a boring topic; when you proceed to elaborate, group members leave
- You might miss the sarcasm of a coworker when he shares that a secret is “common knowledge”; when you mention it to a coworker the next day, you’ve unwittingly committed a serious social blunder
We constantly use our flexible and dynamic ability to read and react to myriad social cues to avoid social disasters. Adults with AS who may not have this luxury are left trying to navigate the social landscape with no real map. The negative reactions, indifference and subtle (or not-so-subtle) rejection they deal with can lead to social anxiety, confusion, avoidance, isolation, even depression.
You can cut some slack for those who struggle to keep up with an ever-changing social context by resisting the urge to expel them from the group. You can resist the urge to mock or embarrass. If you have social gifts, you can share them. Remember, adults with AS are often developing the computer programs you work with and performing the neurosurgery you may benefit from.
Tuesday, August 10, 2010
Art and Asperger's
McNall Mason is the mom of a great 7 year old kid with AS. They are working on an amazing art collaboration, and their work will be featured in the DubSea Coffee Shop in West Seattle. The opening is on September 18.
Their ultimate goal is to open an art studio and gallery space for aspie kids in the Olympia area. A portion of their sales will go this end.
Take a look at their work. Whimsical, fun - a sample of the great aspie mind at work!
Adults with Asperger's and Their Rules
Adults with AS often utilize an elaborate system of these beliefs, or rules, to organize their experiences, especially when they find themselves unable to understand what is going on around them in the social realm. Of course this is not a new concept – all of us utilize unwritten rules to help guide decisions and behaviors. Adults with AS might find themselves leaning heavily on rules – which are often inflexible – in an effort to understand social dynamics. Setting rules can be quite adaptive – being held in slavery to them is another story.
Becoming aware of his “rule” was very helpful to this man. Learning to become aware of, articulate and evaluate these rules can be central to understanding a huge source of self-judgment and self-criticism. This man began to systematically challenge this rule: did he really believe work defines manhood? Did he know of any “real” men who did not work? How could he lower his anxiety when engaging in leisure activities?
This scenario may not ring a bell for you, but you may find that you do adhere to other rigid rules – and you may find you become upset when your rules are broken. Rules can make the world feel safer – they can add structure to a seemingly chaotic and unpredictable reality. When rules stop working for you – and you start working for them – you’ll know it. You’ll find yourself becoming angry and frustrated. Others might complain of your bad attitude or rudeness. Your anxiety may climb.
Becoming aware of your automatic thoughts, or rules, is often the first step in replacing maladaptive rules with healthier rules that reflect your true values. We all have internal rules that help us navigate the social world, and being conscious of them can help you feel more relaxed and be kinder to yourself and others.
Saturday, June 12, 2010
The Hidden Social Curriculum
In a very interesting book published in 2004, authors Myles, Trautman and Schelvan propose that some individuals may lack social intuition. The Hidden Curriculum is a brief survey of commonly missed "rules" that can help inform people who struggle to understand social norms.
The authors explain that social intuition, the skill of automatically understanding social rules, "is the lifeline that saves most of us on a daily basis from an array of potentially disastrous social situations."
It seems that neurotypical people, in contrast to those with AS, constantly, instantly and seamlessly survey the unwritten rules in social environments to make decisions about how to proceed successfully within a given context.
Great. For them.
As most readers know, socializing is not so simple for most people with Asperger's. While many people with AS can accomplish this constant surveying, assessing and decision making, it might use up nearly all his or her energy. With no assurance of success! After an exhausting evening of trying to keep up with conversations, mimic others' behavior, and stay off topics like Star Trek, it's no wonder many people with AS end up avoiding the social settings they crave.
According to the authors, and according to most clinicians, social skills are just that - skills. They can be taught, learned, practiced and mastered. Where to start? Let's start with the category of friendship.
Here is some loose paraphrasing of some of the "rules" the authors list. Some of them may sound amusingly obvious; others give the reader pause. See what you think:
- Friendship takes a lot of time to develop. Just because someone has been nice to you once does not mean he or she wants to be your friend.
- You should not have to pay someone to be your friend.
- If someone asks you to hang out, it's probably not a good idea to ask him or her to hang out every day.
- When someone does not want to hang out, don't pressure him or her to hang out - accept the answer and move on.
- Just because someone is very popular, it does not mean that he/she is nice or a good person.
- When you're first getting to know someone, consider doing a structured activity together first, like going to the movies or playing miniature golf. This way, there's a starting and stopping point, and you don't have a lot of time to talk.
- Friends say nice things to each other, not nasty comments like "You are such a loser."
- It's ok to feel mad at your friend sometimes. You can work out your differences and tell your friend why you felt mad.
- Friends forgive each other for mistakes they accidentally make.
- When you have a friend over, follow these steps:
2. Offer him a drink.
3. Ask him what he feels like doing. Have two activities in mind
(like video games or a movie)
- Consider following your hobbies to find friends - many adults find friends in book clubs, chess clubs, athletic groups, etc. These groups may be independent of work or school.
- If you're at a friend's house to eat and don't like what's being served, say "Just a little bit, please. I'm not very hungry' instead of "I don't want any - I don't like it
- When hugging a relative of the opposite sex, keep yourself a little separate, and don't hug for too long.
- Spend some time talking about what your friend is interested in. This way, you won't dominate the conversation with your own interests, and your friend will feel included.
If you find yourself faltering, please know you're not alone. And remember that you can master these skills so that people want to be around you. Don't lose hope.
Thursday, April 8, 2010
Asperger's and Pinnochio - Wooden Conversations
And what bad news for those of us who make little use of paralinguistics - the gesturing, facial expressions, tone modulations and postures which help communicate our message's meaning.
Signs that you may not be infusing your communications with the oopmh! that keeps people interested: when you're speaking people may act bored, look distracted, talk over you, ignore you, or cut the conversation short so they can move on to other, more engaging conversation.
If you notice people reacting to you in these ways, take heart. You can modify how you communicate in ways that change how others perceive you. You can also become aware of signals you give out that can confuse others and cause them to disengage. So start troubleshooting now to avoid conversation that is stiff and wooden. After all, the only one who can get away with wooden conversation is Pinnochio.
How Gestures are Used
Gestures are generally used to either supplement language or to replace language. For instance, if I put my fingers to my lips because I want silence while I finish my phone call, I'm replacing language ("please be quiet") with a gesture. However, if I tell my teammate, "Great game!", and then slap my open, up-facing palm with his (also known as a "high-five"), I've used a gesture to add oomph! to my verbal message.
People use countless gestures to add meaning to their verbal messages in all kinds of settings. Think of the boss who asks where that report is, but pairs the question with a definitive frown: she's just let you know that she's not happy about something - and it probably has to do with the report.
Understanding how gestures play into communication takes practice. If you're speaking to a coworker, who begins tapping his feet and looking around, you'd be wise to understand that he's feeling impatient. Depending on the context, you may want to wrap it up, ask if another time to talk would work better, or remember that he may want a turn in the conversation. This "conversational multitasking" takes cognitive flexibility - and just like stiff muscles, flexibility increases with time and practice.
Posture is an important feature of communication. Many adults with AS struggle with core strength - feeling like Pinnochio with no strings can make it awfully difficult to sit or stand erect. However, slouching can communicate fatigue, boredom and disinterest....often the last messages one wants to send.
Eye contact is another form of communication which falls by the wayside for many with AS. Yet lack of eye contact can communicate disinterest, even disrespect! If you'd like your conversation partner to get the message that you value him or her, are listening and care, the importance of sporadic eye contact cannot be overstated.
Did you know that hygiene also can be considered a form of communication? We actually communicate a great deal to others via our daily cleaning and grooming habits. Ineffective or inconsistent hygiene says much to others about your self-esteem, confidence and intelligence. Hygiene can be considered the foundation for good communication - if it's not there, it's unlikely that the best repertoire of jokes and gestures will get you anywhere.
Avoiding the Wooden Conversation with Improved Paralinguistics
How can one go about increasing the effectiveness of his or her paralinguistics?
Start with the basics. The first thing others notice about us is usually our grooming. Daily showering and teeth brushing, deodorant use and clean, wrinkle-free clothing can do wonders for the impression we send to others. Of course this sounds pretty basic, but it's not for many adults with AS. Why? Often it comes down to sensory overload: the sensitive system can be overloaded by the cold blast of shower water or the pungent taste of peppermint toothpaste. There are so many products on the market to help the individual with sensory issues manage daily tasks which can produce overload: from soft, tagless washcloths to mild, bland toothpastes - why not invest in making hygiene as comfortable as possible? This is the time for action, not shame.
As discussed above, posture says a lot. Remember that posture often communicates mood, intent or attitude. Taking the time to practice and perfect this small aspect of communication is well worth the effort and time. You may catch yourself sagging against walls or shifting and slouching down in your seat. When you do, straighten up. Exercises designed to increase core strength can help immensely. For examples, see the Mayo Clinic's site:http://www.mayoclinic.com/health/core-strength/SM00047
If you struggle making eye contact, try looking at the small space between the eyes of the person you're speaking with. Intersperse this with real eye contact - it will lessen the burden on you while preserving the message that you want to send - that you are actively engaged in the conversation and want to connect with the person you are speaking with. Constant eye contact is not necessary...but intermittent eye contact really is. As with most things, practice helps the behavior become more natural, comfortable and automatic.
Lastly, the smile. So many adults with AS have a standing face that feels neutral to them - but looks angry or bored to others! Don't fall into the habit of the wooden, expressionless face. Smiling briefly takes practice but lets others know you're not just a puppet. People generally respond very well to being smiled at, and smiling can communicate friendliness and openness, which fosters connection.
You can change the way you communicate without changing what you say. Adults with AS often have vastly impressive stores of knowledge and incredibly unique perspectives to share. Don't let a Pinnochio-like presentation prevent friends and coworkers from benefiting from all the richness of what you have to say.