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5 minute read Autism autism diagnosis

Autistic traits: When self-care gets pathologised

In order to receive a clinical diagnosis of autism, a person must meet certain criteria. Aside from the damaging and negative language that describes our way of experiencing and responding to the world as deficits, these criteria don’t really tell us anything about “being” autistic. They are interpretations through the medical and neurotypical gaze of what autism looks like if you aren’t actually autistic yourself. (Not dissimilar to claiming the scientific “proof” that a coconut is in fact a mammal because it has brown hair and produces milk – it certainly meets some of the criteria for being a mammal!)

A clinician with absolutely no understanding of what it is like to be autistic could take these criteria and use them as a checklist against which to compare a person. We know Autistic people protect themselves by masking or camouflaging their autism (sometimes automatically and without choosing to), and we know that certain groups of people are less likely to receive a diagnosis of autism and are more likely to receive differential diagnoses that overshadow their autism. The road to correct diagnosis is a rocky one. But this blog is not about that. These are areas that desperately need further research and exploration, but I will stick to my theme of autistic traits indicating self-care rather than being the deficits so often described.

What do we mean by self-care?

A dictionary definition of self-care describes: “The practice of taking an active role in protecting one’s own well-being and happiness, in particular during periods of stress.”

In popular culture, self-care has become synonymous with bubble baths and herbal tea, but self-care can actually be an act of political warfare, or simply the stuff we need to do everyday to be at our best. Proactively regulating ourselves through increasing and decreasing sensory input can be part of our self-care.

For instance, we might wear noise-cancelling headphones in a shop, so we can reduce the sensory input from the speakers blaring out loud music and the background noise of extractor fans and chattering customers. This may make us better able to socially interact with the shop staff and complete our transaction less painfully.

What if we don’t have those noise-cancelling headphones to hand?

We might make a repetitive noise, repeat words out loud, or hum a note that blocks out all that background hubbub. This could have a number of effects, including:

a) our noise blocks out some of the background noise

b) it creates some predictability and therefore, feelings of safety in an otherwise stressful situation

c) it may provide regulating sensory input through the pleasant sensation of making the noise with our mouth

How might this look to an observer?

Observers might think various things about us making a repetitive noise – anything from a lack of understanding, “why if they don’t like noise are they making such a racket?!” to the more pathologising observation that the person is showing stereotyped and repetitive use of speech or hyper- or hypo-reactivity to sensory input. Both opinions offer up explanations from an “outsiders” point of view rather than understanding autism from the inside.

How many other traits of autism are in fact Autistic people practising self-care?

I have worked in the field of health and social care for 30 years and have met Autistic people who have severe learning disabilities and physical disabilities, Autistic people who are articulate in using speech, signing, actions and gestures, and other forms of communication. I have had Autistic colleagues and friends. All of whom meet those criteria for diagnosis set out in the DSM-5. Each Autistic person is unique, just as everyone else is unique – that is why we refer to the human race as neurodiverse – all minds are different.

My professional and personal experience tells me that Autistic people instinctively and intuitively do what we need “in protecting one’s own well-being and happiness, in particular during periods of stress.” And my goodness, it is stressful living as an Autistic person in the world. No wonder we have to find ways to protect our wellbeing.

What else could be going on?

I would love to hear your comments, reflections and thoughts. Here are a few of my own examples of how those “deficits” described in the diagnostic criteria may in fact be coping strategies and self-care activities used to help me exist in a world that is so frequently not set up for people like me:

  • My social challenges often come from being overwhelmed due to having too much sensory information to process. When I am better regulated and therefore not in a survival state of fight, flight or freeze I am more able to access what is referred to in polyvagal theory as my social engagement system. The things I need to do to be regulated may look different to those things non-autistic people do. This isn’t due to a deficit, but simply down to my experience of the world being different to theirs – seeing as my experiences are different, no wonder my responses look different too!
  • I use my body to self-regulate – how wonderful is that! When I have no equipment to hand I can still move my arms, bounce up and down, or make a favourite noise repeatedly. (referred to in DSM-5 as stereotyped use of movement)
  • My so-called special interests are not special in terms of topic – it is not my fault that other people seem to select from a somewhat restricted choice of interests. The abnormal intensity and focus following these interests (as described in the DSM-5) brings me a sense of calm, a sense of achievement in a world that frequently puts me down, and an opportunity to recharge. All great examples of self-care. In fact, some research of Porges described in one of his books about polyvagal theory and feeling safe, quotes: “a reduction in heart rate variability was a robust indicator of sustained attention and mental effort”
  • My sensory responses are only hypo- or hyper-responsive, or abnormal, if you are comparing them to your own and assuming yours are “normal”. In our neurodiverse human race where each of us has a wonderfully unique mind, how can we define normality anyway? When you understand that my sensory experiences are different to the majority of peoples, you may begin to understand that my responses are different too. Different, yes; AND proportional to my experience. A proportional response cannot surely also be a deficit?
  • My work as one of the directors of Autism Wellbeing CIC included co-authoring Sensory Trauma: Autism, sensory difference and the daily experience of fear where we generate a novel “Sensory Trauma” framework in which to (re)consider the lived experience of Autistic people. We explore the concept of affordances and how the same environment affords each of us a different sensory experience

Conclusion:

It is difficult to define autism. In my opinion, the DSM-5 criteria offers a highly restricted view of autism that is fixated on how autism is perceived by non-autistic people. It does not focus on the many strengths that autistic people have, including how we frequently incorporate self-care into our daily lives. I would like to reframe some of those deficits as instinctive ways Autistic people practice self-care.

But I do not believe that simply swapping a list of deficits in the diagnostic manual for a list of strengths, will improve things – the list of strengths is simply the other side of the same coin. But by flipping that coin over, we begin to consider autism from other angles – and that is important. I believe that autism research needs to move from an almost total focus on research topics concerning the biology, causes and treatment of autism, to topics that seek to understand the experience of “being” autistic. The times in my life that have been most positive for me, have come about through people accepting me, valuing me and seeking to better understand how it is to “be” me. Being able to quote diagnostic criteria or hypothesise over genetic factors that could have contributed to my autism have done nothing to improve things for me. I speak in more depth about autism research in another blog.

So, how can we reframe autistic deficits as self-care? Education and awareness raising are a good starting place and there are many fantastic individuals and organisations doing just that.

I made a personal change in how I use language. I stopped using the words hyper- and hypo- in relation to my sensory experiences after we wrote our Sensory Trauma position paper. Instead, I focus on the experience of “being” autistic. I choose to use phrases like “my tactile sense is heightened” or “my interoception, or awareness of body sensations like hunger and pain tend to be muted”. These expressions are finding their way into more mainstream usage with our National Autism Team here in Wales now referring to heightened and muted sensory experiences in their latest information. This is positive because it better helps people understand the experience of being Autistic. Autism is not a set of symptoms to be ticked off against a list.

For me, being autistic is about how my whole being – my body, sensory systems, brain, everything about me – interacts with the world. It is about the relationship I have with the world. A relationship that is affected by how I perceive the world through my different sensory, cognitive and social experiences. A relationship that is also affected by how the world perceives me. I cannot do much about being me, about being Autistic – and nor do I want to. But I can do something about how autism and Autistic people are perceived… we all can….

So lets do it!

Comments most definitely welcomed.

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Placing my pain – or how I’m learning to say “ouch” in all the right places!

In my previous blog Saying “Ouch” in all the Wrong Places, I describe our sense of interoception and how my sensory processing differences result in my brain receiving very muted signals about what I feel inside my body. The blog gives some examples of how this manifests for me and the challenges this creates when attempting to describe medical symptoms and access appropriate medical support.

Today I visited the dentist. Dental appointments would have been unthinkable when I wrote that earlier blog, but with support over the summer, I have had several visits to the dentist, requiring x-rays, a tooth extraction and follow up treatment for ‘dry socket’. I went back today because I was experiencing symptoms of severe pain.

Note that I state experiencing “symptoms” of severe pain and not “experiencing severe pain”. Whilst my muted interoceptive experiences have remained similar, my understanding and acceptance of what they mean for me has changed considerably.

Sensory processing:

Each of us experiences pain differently. It’s common knowledge, and we often attribute unhelpful value judgments to people’s experiences of pain. The way that our brain processes the signals that come from our body is unique for each of us. It is dependent on the context too, and can fluctuate. This is accurate for all people, but Autistic people and those who experience sensory processing differences for other reasons, may experience sensory information in different ways. Not just internal body signals; but noise, taste, touch, smell and visual information too. We may experience sensations intensely, or they may be muted. Sensory information could be distorted or fragmented, or take a long time to process.

My personal experience of pain tends towards not noticing it until the sensations are very strong. This is not because I am some brave superhero – it’s just how my sensory processing system works. My brain requires lots of interoceptive sensory information to register something is happening. Conversely, my tactile processing system needs only a tiny bit of sensory information to register with my brain and I can incorrectly appear to be oversensitive to labels in my clothes, or having wet hands for instance.

How I experience pain:

Just because I may not have a strong awareness of something in my body hurting, doesn’t mean I am not in pain. If a medic asked me to use a pain scale to rate the severity of my toothache this morning, they would have been met with a puzzled look and a “I’m not sure….It’s not too bad, I suppose” – I certainly could not have attributed a number between 1 and 10 to indicate how severe it was. In fact, the stress of trying to define what was wrong and where in my body that sense of something being wrong was located, could have pushed me into complete overwhelm. But I was in pain – only I didn’t feel it in the conventional way.

On Saturday I recognised a change in my mood that was not related to any circumstances or life events – in fact I was having a great day with lots of absorbing activities to occupy me. I found I could not regulate my sensory processing system – and as someone who is proactive in sensory regulation and incorporates it as part of my lifestyle, this concerned me. It was dramatic enough to make me realise that something potentially serious was going on; and because I have an awareness of how I experience pain and illness, I explored whether it could have been caused by pain.

I scanned through my whole body, inch by inch; noticing whether I could detect any sensations, or none at all.

I tried to put my “something is wrong” feeling into words but couldn’t. So I didn’t push myself.

I distracted my mind from disappearing into my black mood in search of why “I” am so wrong, and brought my awareness back to my body. This required a huge leap of faith on my part as I have experienced extensive negative feedback from professionals about my insights into my own needs. However, I know myself well and there is little to be gained by stressing over whether I will be believed or not – or whether I am making a fuss about nothing. My dysregulated sensory processing system and my distressed emotional state that could not be regulated by my typical everyday self-care, told me that I was most likely unwell or in pain.

I checked I did not have Covid-19 and my lateral flow test was negative. I tried to notice any symptoms, such as a runny nose or a cough, or limbs that were an unusual shape, but couldn’t detect anything of note.

I considered the type of negative thoughts I was having and rather than challenging them or getting drawn into them, I stood back and wondered what they were trying to tell me…

Noticing where my pain is:

Using my skills in logic and analysis, observations from years of supporting people who communicate without talking; and combined with past knowledge of myself, I considered I may have toothache. I had needed dental treatment in the summer, so this seemed a strong possibility.

I examined my mouth and face in more detail. I noticed that if I touched my jaw I felt slight pain. I looked in my mouth but saw nothing that indicated swelling or infection. As the day wore on, and into the next day I found that I noticed slight earache as well as the sensitivity when I touched my jaw. It was as if the overwhelming and widespread feeling of something being wrong was settling in one place. The sensation was certainly not pain that could be classed as severe, but I recalled how the abscess that had required a tooth extraction in August had created similar mood changes and sensory dysregulation in my body.

When I visited the dentist in the summer they tapped my teeth and explained that if there was a problem I would soon know! I did not react with a typical pain response but the x-ray showed what they referred to as a pathological cyst. When I viewed the x-ray back in the summer, it enabled me to place my pain in my body, and my mood symptoms lifted, I was more able to regulate myself and I began to notice my toothache and could treat it with painkillers.

I decided I would telephone the dentist on Monday morning. I pushed aside my anxiety about making a fuss and made a plan. I knew the dental receptionist would ask if this was urgent and would qualify that by asking if the pain was so severe it was keeping me awake. This line of questioning delayed my treatment in the summer because I answered honestly and said “no”. However, I realised back in the summer that I was incorrect with my response of no. The pain was preventing me sleeping because I was having nightmares, distressing thoughts, and panic attacks. These symptoms that are typically associated with mental illness are closely linked to physical illness in my case. My nights have been disturbed for some weeks and although I have not had a sensation located in my mouth that has kept me awake, the pain has kept me awake by manifesting in other ways.

The receptionist was accommodating and listened as I explained that my pain was as bad as it had been in the summer. Fortunately I could have an appointment later that morning with the dentist who knew me well. I have very specific support needs when visiting the dentist and was relieved to be seeing someone who knew me.

My appointment resulted in confirmation that my cyst was still there, in the same place and the same size. The extraction and weeks of antibiotics had not healed it. Further treatment is booked and I left feeling reassured.

Conclusion:

I am learning to trust my own knowledge of how my body works. This is no easy task when my life has been filled with invalidating comments, disbelief and failure to address my needs.

Some people work hard to identify sensations in their body and name them “correctly” and describe them so they fit mainstream expectations of how bodies work. I feel no need to do this. I prefer to develop my self-knowledge and accept this is how MY body and brain works. I would like more people to accept the way my body works is “normal for me”.

At times it may be helpful to frame my experiences in ways that clinicians accept and understand, in order to receive timely and responsive treatment, but I do this purely for that reason and I would love to be able to use my own language and lived examples, and be taken seriously. Sadly, if I explained I had mood symptoms and thought it was actually toothache, I would likely be seen as neurotic. I get better treatment by stating I am experiencing symptoms of severe pain. Those times when I am unwell or in pain are not the best time for changing attitudes!

Locating the pain reduces the risks that come from being so dysregulated. It also enables the pain to be treated.

It is interesting to note how once I have located where the pain is likely to be, I start to feel it slightly. When the location is confirmed by x-ray or other tests, it begins to hurt more. The overwhelming sense of not being ok that fills my body, condenses into its correct place. Clinicians can really make a difference to people like me by listening with interest and without judgment. Learning to explore your whole body and notice anything different can be useful too. I have used mindfulness for decades and find body scans help me. Pain scales are not a good indicator of severity of pain for some people – what is more useful is having trust in the person’s ability to notice that something is not right for them – and then support them to explore it.

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5 minute read

Taking things literally – there’s more to it than meets the eye!

‘Taking things literally’ is a trait or stereotype commonly associated with autism. The diagnostic manuals used by clinicians don’t include specific details on this – but many of the organisations that professionals and families consider to be an authority on autism detail it in their information:

“Autistic people can take things literally, and may not understand open-ended questions.” National Autistic Society UK

“Children and adults with autism have difficulty with verbal and non-verbal communication. For example, they may not understand or appropriately use: …expressions not meant to be taken literally” Autism Speaks USA

I’ve written this blog to share a little of how I experience the world and to offer an alternative perspective the reader may like to consider. It is all too easy for people to accept the “what’s” of autism. Endless organisations tell us the symptoms of autism, or what autism looks like to other people. I like to share the “why’s” and the “how’s”. Tell it from the inside. I have no more authority to speak for all Autistic people than the popular experts do, but I invite you to push aside what you have been told about autism for the next few minutes, and step into my mind….

Metaphors, idioms, and what happens inside my mind:

I can spot a figure of speech immediately. I have learned many of them off by heart. I automatically know that:

  • “Raining cats and dogs” means raining heavily
  • “Between a rock and a hard place” means having to decide between two equally difficult things
  • “They’re a walking encyclopaedia” means someone knows a lot of facts (but I start to giggle to myself at the imagery of a big book with arms and legs, walking down the road!)
  • Whereas someone who says they could “Eat a horse” horrifies me, even though I understand that they are more likely to eat a pile of toast than enact the picture I have in my mind of their face covered in blood, whilst discarded equine bones pile up underneath their dining table!

My mind works visually. When I am presented with information, I see an image of it inside my mind. Unsurprisingly, I can imagine objects more easily than abstract ideas. Ideas may have no boundaries or physical shape that my mind can hold on to. I want to know what a thing looks like and how it works.

Processing and understanding new information:

When I am presented with new information, my mind creates a visual image to help me process and understand it. I match that image to other things I know, which helps me understand the information in more depth.

Here is an example that you may recognise from a blog I wrote about masking. In it I describe how I frequently mask my need for clarity. The reason I mask my need for clarity is because I have consistently and repeatedly received negative feedback for asking the “wrong” questions.

I was sat in the board room in a very serious meeting and the person talking used the phrase “the elephant in the room”. Now, I absolutely knew this was not to be taken literally. An alarm went off in my brain that said “idiom/metaphor/figure of speech alert”. So I used my quick thinking brain to whiz through everything I knew about elephants to try and work out the meaning. Elephants are big – are they talking about something that is big? Elephants have big ears and a trunk – no it can’t be to do with that and stop it Emma, do not go off on a mental tangent about the different types of elephant and their respective physiology. Elephants never forget – aha, maybe it’s to do with memory or remembering something. What else do I know about elephants?….And then the question came: “Do you have any thoughts on that Emma?” And I realised that I hadn’t got a clue what was going on, or what the question was, and I couldn’t even grasp at an answer out of thin air. The conversation had moved on and I was lost in the world of Proboscidea. I was probably the only person in the room with the taxonomic knowledge to name the order that elephants, mammoths and mastodons sit in – and I was probably the only person in the room feeling stupid, anxious and lost! And all because I didn’t want to make myself look stupid for not understanding something. I challenge you to spend a day in your workplace or school considering how complex language is if your default setting is to take things literally.

https://undercoverautism.org/2020/05/31/masking/

As you can see, I understood this was an idiom – I certainly did not experience that lack of understanding so often assumed in information about autism.

But did I truly take the expression literally? I certainly stated in my earlier blog that my “default setting is to takes thing literally”. I assumed I did because that’s what autistic people supposedly do. These days, I am less certain that “taking things literally” is an accurate description of what is happening for me.

Had I sought clarity by asking for more information about the elephant, I would in all likelihood, have reinforced this idea of literal mindedness. My visual mind was desperately trying to match my elephant image with other elephant info stored in my brain. I wanted more information and it seemed natural to drill down deeper into the world of elephants to find what I needed.

Affordances:

Autism Wellbeing refers to affordances within our paper Sensory Trauma: Autism, sensory differences and the daily experience of fear. This useful infographic gives an example of some sensory experiences a slamming door may afford to two people in the same room. In its simplest form, each of us may perceive or pick up different affordances from the same environment, event or interaction.

So what is going on for me?

I described to my colleague Rorie, how difficult I find interpreting and understanding new ideas, particularly when they contain unfamiliar figures of speech . I need clear information up front – and enough of it to enable me to move forwards in the conversation, or the piece of reading.

The visual image created in my mind when confronted by the “elephant in the room” idiom, demanded my full attention. It was as all-encompassing and as distracting as someone expecting me to continue a conversation or read and understand a written article, but with a gong being beaten loudly next to my head!

I could not simply shift the image to one side and continue. I expressed that it was a “visual thing” and not a “taking things literally thing”.

Rorie and I reflected on affordances, and on the possibility that, when it comes to idioms, I preferentially pick up the visual affordance offered by the idiom rather than the semantic affordance. This feels right to me. My difficulties often arise from sensory processing differences rather than a lack of understanding.

As Rorie said to me, “That is a whole different way of thinking and talking about a dimension of autistic experience typically couched in terms of autistic people having ‘impaired understanding’, ‘taking things literally’ or being ‘oppositional'”

Conclusion:

There are many widely accepted mainstream ideas associated with autism that may be better understood from a sensory processing perspective rather than an “impaired understanding” perspective. I shall explore some of these ideas in future blogs.

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5 minute read Autism camouflaging masking social communication wellbeing

Snapshot: a typical day in the professional life of one Autistic woman…

The Covid-19 pandemic has led to a change in how we carry out our work for all of us – and for many of us that has meant working from home and reduced social contact.

My typical working week has gone from face-to-face meetings, visits, and home or office based work, to almost exclusively working from home with those face-to-face meetings replaced with video calls and most visits postponed. I wrote about zoom fatigue and the analogies it has with Autistic communication, last year.

Yesterday was different. Yesterday I stepped out into the “real” world and was required to drive to the nearest city and check out a potential location that may be suitable for delivering a service…..

And oh my goodness – did I really used to do this every day??!!!!!

Photo by David Marcu on Unsplash

The journey was great, I have always loved my time alone in the car listening to the radio or energising myself with a loud and uplifting tune. It gives me uninterrupted space to prepare my thoughts before appointments, and process them afterwards. In fact, this “thinking time” is something I miss in my working life.

Prior to leaving home I added the name and phone number of the person I was meeting to the notes app on the home screen of my phone. When I have lots to process, I can find it difficult to navigate my phone because I can’t find the right app or read numbers and letters easily. I was familiar with the area of the city I was visiting but used an online map to view the front of the building – this helps me hold an image in my mind of what I am looking for. Needing to look for something when I don’t know what it looks like is a non-starter for me. Potential business clients can help me (and lots of other people) by sending a photo of their building as part of any joining instructions – and if they send one of the person I’m meeting too, then I will be seriously impressed!

It was a frosty morning and I de-iced the car in plenty of time and dug out my warm wool coat from the back of my wardrobe. It has been some time since I wore it and it’s heavy weight and smart appearance was just what I needed to make me feel embodied, confident and business-like. Plus it has a pine cone in one pocket and a squidgy toy in the other, that I can hold and squish and feel without anyone noticing!

I was in the zone, so I got in the car and headed off.

I pulled up to the ticket machine at the multi-storey carpark entrance and wound down my window. I was offered a choice of pressing a button to talk to someone or pressing a big, flashing button with no instructions. I decided that the flashing button would be for the ticket, having reasoned that one doesn’t usually need to hold a conversation with another person in order to use a carpark. Correct! Pressing the button resulted in a ticket shooting out towards me and the barrier lifting up. I smiled to myself and noticed that already my racing mind was consciously thinking through everything – working out what was going on and why; and how I should respond. Those intuitive, “everybody knows how to do that…” activities that many people take for granted, often require considerable processing by myself and other Autistic people, and can result in me appearing slow, confused, stressed, overwhelmed or anxious.

Once parked up I needed to cross the road to the building I was visiting. The 4 lanes of traffic, including a bus lane, were in stark contrast to the country lane I live on, and I had not experienced such a volume, speed and noise of traffic in a long while. I stood at the kerbside, looking right then left, then right again but dared not cross. My brain could not process the speed of the vehicles; and the overwhelming noise meant my eyes couldn’t see properly and I could get no sense of how near or how fast the cars were by using my sense of vision or hearing. I gave my brain and body a few moments to settle and I instructed my feet how to move. Imagine a party game where you are instructing a blindfolded person around an obstacle course; “lift your left leg up a bit, no not that much, move it forward 30 cm, careful now” etc etc – that’s the level of instruction I need to give my body when coordinating movement in certain situations. I cautiously crossed the road once I was ready.

The building I had seen on google maps was right in front of me and I was pleased that I had looked up a photograph before leaving home. I even noticed the restaurant to one side and the shop to the other were exactly as pictured and I felt reassured by this tiny piece of familiarity and predictability. The doorway to the building had 3 panels of buttons for calling the various companies inside. Some had labels and some didn’t. There was a sign saying “Press doorbell for reception” and I looked all over the door from top to bottom but saw no bell and no switch that could be the bell. My eyes went back to the panels on the wall, and I tried to find one that had the name I was looking for amongst the moving mass of letters, numbers and sticky patches where labels had fallen off. I wondered if the sign requesting “Press doorbell…” was referring to one of these buttons on the wall? Perhaps what I think of as a doorbell – a single button on, or right next to a front door – means something different in an office environment? Maybe I could use the internet to search for “what is meant by office doorbell” or “how to find a doorbell amongst a load of buttons” – perhaps if I searched it up online and clicked “images”, I would get to see some examples of what this type of doorbell could look like that I could match to what was in front of me? But I decided against it. I needed to get my brain back on track so that I could attend my meeting.

I pulled out my phone and went to the note taking app on the front screen and called the phone number I had recorded there. No answer. I searched for the main company phone number, thinking that if the receptionist was going to meet me at 10.30am as planned, they would probably be at their reception desk and answer the phone….they didn’t.

I looked back at the panels of buttons and tried to work out the correct protocol for choosing which one to press. After much logical thought and a fair amount of trying to work out the potential impact of me pressing the “wrong” button, I decided to go for the panel that had numbers and one slightly larger button with a picture of a bell on it. I pressed it and waited. A voice came from the tiny speaker and I introduced myself, apologised for probably pressing the wrong button and enquired whether I could be directed to the company I was due to meet with.

All I could hear from the tiny speaker was a mumble of human noises against the backdrop of equally intense roaring traffic, seagulls, slamming doors, people shouting and talking, wind, car horns, bus engines revving, tyre noise against the road, brakes squealing, my breath, my heartbeat in my ears, the creak of windows being opened, the jangle of the door being opened on the shop next door, the delivery men unloading their van, the radio from the same van…..I picked out a few words from the mumble of human noise coming out of the speaker: “other door”, “Chinese”, “right”. I said thank you and walked away. I felt sad.

I considered going home and recalled how on one occasion I drove 150 miles to a meeting and had a similar experience, I left without even entering the building. I reflected on how difficult it is for me navigating a world that my brain processes as overwhelming. I ensured I regulated my senses because I recognised the overwhelm was spilling over from my senses and into my thoughts that were spiralling downwards into “why is it you are so rubbish”. I find it more effective to regulate my senses than challenge my thoughts at times like these. The issue is primarily one of sensory overload rather than anxiety. The anxiety stems from the sensory overload. I was grateful for my loss of smell and taste – the legacy of Covid-19 infection, as the diesel fumes, cigarette smoke and litter smells could have easily tipped me over into meltdown.

I put my hands in pockets and used my sensory items. I stepped back from the doorway and instructed my brain to pull away from tunnelling down into the finer detail and I got myself to look at the bigger picture. I searched for anything that could give me a clue. I walked down the side road, reminding myself that movement is regulating and good at times like this. I swung my arms a bit and made sure my fists weren’t clenched. I did not find the door. I went back to the main street and walked the other way and lo and behold there was a doorway with a sign on it for the company I was visiting.

At this point I stopped. I reminded myself that the people I was meeting did not need to be told about the online map showing the “wrong” door under the business entry for their company. They did not need to be told that I had tried phoning the receptionist just like the joining instructions detailed, but no-one answered. They certainly didn’t need to know about the traffic or the ticket machine buttons or any of the other ****ing buttons! They’d have no interest in my experience of crossing the road. If they asked me how my journey was – they would not be requesting any of this information – they wouldn’t actually be interested in my journey!

Now was the time to regulate myself and rehearse my “eye contact protocol”. Face coverings make this trickier as I tended to look at people’s mouths prior to masks becoming the norm. On video calls I make awesome eye contact because when you look at your laptop camera light it appears you are making eye contact with the person. You don’t even have to look at their face at all or even have it on your screen if you don’t want to!

So I gained entry into the lobby and BAM! the intensity of the lighting gave my brain too much information to process once again. Thankfully my already (fairly) regulated sensory processing system was able to cope and I prepared myself for meeting my host by repeating my mantra of “look directly at the person and say hello, then scan the environment whilst commenting on how nice it is, then make brief eye contact each time the person pauses”. I walked up the stairs, took a big breath through my nose not my mouth – mouth breathing in a mask feels extremely unpleasant, and in I went.

I am sharing this because it is my reality, and I recognised yesterday how far I have come in terms of understanding myself and managing all this. The world has got no easier, but I have become more able to meet my own needs. I no longer wonder why I am so rubbish at life – I’m brilliant at life – it’s just most people don’t have to go through the level of stuff I have to go through to get to a meeting, let alone to cope with the social, communication, sensory and other demands once inside.

This is a snapshot of me on a good day. To get a true picture of a good day I should add in the social anxiety about how I’ll come across in interactions and the anticipatory anxiety about what is going to happen. Plus the additional sensory input from perfume, aftershave and cleaning product smells; food that I need to eat or decline without causing offence; stairs and chairs to navigate without falling over; handshakes or physical contact; and remembering that I probably won’t recognise the signals in my body that tell me I need to drink or use the toilet until the last moment. I will be consciously repeating the protocols for dealing with small talk and making eye contact.

And if this is a good day – consider a bad day! Illness or stress make all the above far more challenging. No safety to regulate myself or seek clarity makes things worse. Masking autism for sustained periods is harmful, but is sadly necessary for me, in order to take part in the world as a professional person.

What will help?

There are some practical examples in this blog. Photos and clear information and joining instructions. Physical environments that are designed to be more accessible from a sensory processing perspective. Improved understanding of what it is like to be autistic –contact me via our website if you’d like to find out about bespoke training for your organisation or for yourself.

What helps me most is having a proactive approach to sensory regulation. I also use mindfulness – not as an exercise or technique that I plan into my day, but as a way of dealing with situations. I have learned to pause and notice and accept how I experience the world before reacting.

This short film is one of Aesop’s fables and I frequently reflect on what it means to me and how I treat myself in my thoughts and behaviour – perhaps you may take some positive meaning from it too? I recognised the need to follow the moral of the tale on my way home from the meeting yesterday – I was proud of myself for handling the run up to the meeting I described in this blog, plus everything that went on once inside – and I considered I could ‘quickly pop into the shops’ on my way home. Of course the additional demands this placed on my sensory processing system overloaded me instantly and I walked away considering I had done done enough brilliant stuff for one day and should give myself a break to recover and recuperate, and not push myself harder.

Categories
5 minute read Autism Coronavirus interoception Uncategorized

An Autistic experience of the impact of Covid-19 infection on sensory processing

Background:

I contracted Covid-19 for the first time in April 2020. This required a hospital visit which led to my interest in developing resources to support other Autistic people and their families as part of my professional work as a director of Autism Wellbeing CIC.

I received my two doses of the Covid vaccine during the summer of 2021 and was unfortunate to become infected with Covid-19 for a second time in October 2021. My symptoms of early illness did not present in the expected way.

My most recent Covid-19 infection initially resulted in the common symptom of complete loss of my sense of taste and smell. I have regained about 5% of my olfactory and gustatory processing ability six weeks on from infection.

My professional career has been within social care – developing and delivering services to people who are labelled as having complex needs. My own experience of Covid-19 enabled me to reflect upon some of the potential impacts this could have on other Autistic people, and in particular those who use non-verbal communication or are considered to have “challenging behaviour”.

Interoception – knowing I am ill:

Prior to both infections with Covid-19 I noticed a complete change in my demeanour. I did not feel ill. I did not feel hot or cold – although a thermometer indicated I had a fever. I experienced the sudden onset of severe depression-like symptoms. Fortunately, I am aware of how my interoceptive processing experiences manifest. Interoception is the sense we use to process internal body signals such as pain, hunger, or needing the toilet – and to notice our emotions and the changes they are creating in our bodies (racing heart could mean excitement or anger for instance).

The severity of the depression-like symptoms frequently overshadows my attempts to seek medical help for my physical illness. When I seek medical intervention at these times, my physical illness is typically overlooked, and my mental health is scrutinised – despite me articulately and accurately informing medics that I believe I am coming down with a physical illness. This overshadowing of my physical illness due to putting greater emphasis on the risk management or identification of my depression-like symptoms may prolong my illness as my physical health problems are not treated.  It invalidates my experiences and may even create barriers to me seeking support or communicating with medics.

When I consider people I have supported professionally, that are labelled as having “challenging behaviour”, I recognise occasions where perhaps they too may have experienced a sudden change in mood due to a physical illness. Within my work I have observed people exhibiting behaviours such as shouting; biting themselves or others; or running away. These behaviours were considered to be caused by the person trying to communicate that something was wrong and as practitioners we would consider whether this could be something external such as too much noise or the person not wanting an activity to end, for example; or something internal such as toothache or illness.

At times, “challenging behaviour” was interpreted by some practitioners as having an element of intent or wilfulness on the part of the Autistic person. It was sometimes considered that the person didn’t know how to communicate “properly” using speech or sign language or had poor social skills – and therefore chose to demonstrate their pain/distress/urge to leave, by “acting out” and using their behaviour in a planned or possibly even manipulative way to communicate with others.

Where no cause or trigger was obvious to the (usually non-autistic) observer, it was common for the observer to conclude that the person was over-reacting or hyper-responding in some way, and subsequently needed to learn more appropriate coping strategies. My own symptoms of sudden severe depression could look like emotional instability to an observer, and they may well consider me unable to cope with being ill. They may misconstrue that my mood symptoms are a response to my physical illness and not the way that illness manifests for me.

Sensory Processing:

Thank you to my colleague Kate for the drawings http://www.autismwellbeing.org.uk

Sensory processing is the process by which the nervous system receives, organises, and understands sensory information. All of us experience the world through our senses and our brains process this information.

Autistic people frequently process sensory information differently to non-autistic people. Our sense receptors (eyes, ears, taste buds and so on) may work perfectly well but there may be differences in the way our brain processes the sensory information.  This may include struggling to process too much sensory information or filter out unnecessary information; experiencing heightened, muted, or distorted sensory signals; delays in processing; or perception in one or more senses shutting down, resulting in an incomplete picture of what is happening within the body.

Each of us has a unique sensory profile. But sensory processing does not happen in isolation. Our sensory experiences change and can appear inconsistent to others who do not recognise the dynamic and context specific nature of sensory processing.

Our senses play an essential role in keeping us safe. For example, if food smells rancid, we know not to eat it, and if we feel unstable on a structure, we climb down from it. Sensory information tells us how to act in and adapt to the environment. Sensory processing also plays a role in regulation, activating us to evade a threat or calming us so that we feel safe.

Positive and negative aspects of my loss of taste and smell:

  • My overall amount of sensory processing was dramatically reduced. This had a calming and regulating effect upon me and reduced distress in some situations. e.g. the lack of diesel fumes and burger van smells made visits to my local town more bearable.
  • Food never tasted “off”. This reduced the anxiety I typically experience when food tastes different to usual. I used the best before date to identify whether something was safe to eat.
  • Food tasted of nothing – so texture became more intense. I realised that I could never eat broccoli without the “reward” of the taste of it to compensate for the texture!
  • I have practiced mindfulness for decades and found that eating mindfully was the best way to cope with my sudden loss of taste. I would put the food on my tongue and notice it without judgment. At first, the only food I could identify in my mouth was mango, due to the distinctive fizz. I am now aware of spices, bitterness, and the saltiness of marmite.
  • I recognised how I rely on my sense of smell when cooking. It lets me know when to check if the toast needs turning over under the grill and if food is getting close to being cooked. Without the ability to smell my food cooking, I had to focus on following safe cooking procedures and use a timer or else risk burning food.
  • Smell keeps you safe – I no longer felt disgust at cleaning up pet poo, even if I accidentally got some on me! I didn’t automatically recoil from mess or take extra care using bleach or filling the car with petrol as there was no aroma from it and it could have been water as far as I was concerned.
  • I can no longer smell the weather and therefore cannot easily identify whether I should wear a jumper or coat. My sense of smell is more effective than my awareness of temperature when processing the environment.
  • I use my sense of smell to recognise people. Their sudden lack of aroma made them as difficult to recognise as a radical new haircut or significant weight change would. This created a sense of unease within me.
  • I am concerned that I may smell bad, or my home may smell bad.
  • I am aware that I would not smell burning so have become extra vigilant about checking things are switched off at night. I recognise that this vigilance could become anxiety, perseveration, and obsession, so I have adopted a sensible routine to manage my safety concerns without escalating them.

Conclusions:

My sensory experiences following Covid-19 infection have reminded me how our senses work together and not individually.

The role of our senses in keeping us safe is significant. Risk taking may not always be due to recklessness, impulsivity, or lack of understanding of risks – it could occur due to sensory differences.

Autistic people may experience the world in a disorganised or chaotic way because our senses work so differently. My typical need for routine and structure reflects this. Since Covid-19 infection, I am aware that I am relying even more than usual on timers, reminders, and routines in order to compensate for my loss of certain senses. To an observer, Covid-19 may appear to have made me “more” Autistic. It hasn’t; but my “normal for me” world has changed, and I am needing to find security, certainty, and predictability in this new world of minimal smell and taste.

If I was supporting an Autistic person who was not able to articulate their experiences, and they had recently tested positive for Covid-19, I would consider how their sensory processing may have been affected. It would not surprise me if some Autistic people needed to increasingly rely on their other senses to make sense of the world if their sense of smell and taste reduced. They may touch things more to identify them using their tactile sense. They may stim more in order to get extra vestibular and proprioceptive input. I’d expect to see more tasting and smelling of items and people; and possibly increased frustration at not being able to recognise them by these methods.

I would also expect to see an increase in repetitive questioning by some Autistic people. I too have a felt a need to check and recheck information in order to seek out familiarity and predictability. I have found satisfaction in the predictable to-and-fro of scripted or familiar conversations and exchanges. Those reliable quotes from films and songs that stay the same each time you hear them! Similarly, I would not be surprised to see people stuck in a loop of thinking, or stimming, or behaving in a particular way – these tendencies are often exacerbated by change and unpredictability and can provide predictability and a self-soothing function.

Moving forwards, I have prepared myself for a potential return of my sense of taste and smell. I am aware that just like the effects of the various lockdowns ending; a sudden increase of sensory information may be too much for my brain to process and result in survival responses of fight, flight or freeze. I plan to stick with my mindful approach to noticing what my senses are picking up, with no judgment and a curiosity that will hopefully enable me to reflect and share my insights.

I encourage practitioners to consider sensory processing experiences when supporting Autistic people whose behaviour suddenly changes from what is usual for them, and perhaps check whether Covid-19 infection and symptoms related to loss of smell and taste may be the cause.

Categories
5 minute read Autism autism diagnosis Research

Autism research: Looking for answers in all the wrong places

In recent weeks, the largest ever UK autism research project, Spectrum 10k, was paused and an apology given to Autistic people, their families and charities that support them. The ubiquitous Simon Baron-Cohen, endorsed by several celebrities had declared how this research would investigate genetic and environmental factors that contribute to the wellbeing of autistic individuals and their families. Questionnaires and saliva DNA samples were to be used to learn how different genes are associated with autism and co-occurring health conditions.

Who wouldn’t support research that has the potential to reduce some of the health and wellbeing inequalities faced by Autistic people which, after all, are numerous and considerable?

Well…. A large proportion of the Autistic community don’t support the Spectrum 10K research in fact!  A Twitter poll #AskingAutistics  posed the question “What’s your view on Spectrum 10k?” The 582 respondents voted:

Fantastic 1%

Not Sure 17%

Awful 82%

Social media pages came alive with comments, questions, anger, fear, and objections about the way that so many autism research projects are undertaken. However, Autistic voices were repeatedly “shushed” and valid concerns about eugenics were mislabelled as conspiracy theories.  

Autism Research:

It may be helpful to understand a little about autism, about autism research, and about how autism is perceived.

Autism is a neurological variation, a naturally occurring expression of human neurodiversity. Autism is lifelong, and Autistic people can be of any gender or race and have a wide range of cognitive abilities. Autistic people almost always experience sensory information differently to non-autistic people. This means they process the world very differently to non-autistic people and subsequently have a different way of being in the world. I have spent 25 years working in the field of social care, and I am currently a director of Autism Wellbeing, a small non-profit organisation. I am undertaking PhD research about perceptions of autism, and my previous postgraduate research was about the effectiveness of mental health outcomes monitoring tools.

A review of autism research funding in the UK was carried out in 2016 by Autistica – the UK’s national autism research charity. The most common research areas were about the biology of autism; its causes; and autism treatments. Spending on autism research had trebled between 2013 and 2016.

Yet despite all this research, autistic people experience poor outcomes compared to their non-autistic peers in a range of life domains. Knowing about autism doesn’t necessarily improve outcomes for autistic people. When it comes to mental health, autistic people are more likely to die by suicide, are more likely to self-harm, and are more likely to experience mental illness than non-autistic people. Autistic people face barriers to seeking psychiatric treatment and as I discovered in my own experience as an Autistic person, misdiagnosis can often occur, and autism can be missed – with devastating effects.

Key findings of a report into UK autism research highlighted that academics perceive themselves to be engaged with the broader autism community, but this perception is not shared by other stakeholders, most notably autistic people and their families. Autistic people see the challenges of autism as societal and attitudinal and not about ‘curing autism’.

Autistica led a James Lind Alliance Priority Setting Partnership, that asked over 1,000 people for their top questions for autism research. These were then ranked in a final workshop attended by autistic people, parents, and professionals. The number one priority was about mental health and autism. Nowhere within the top ten was any mention of understanding the genetics or biology of autism.

The need for a different approach to autism research:

Very few studies have been completed about perceptions of autism, or attitudes towards autistic people. Research seems centred on fixing autistic people rather than improving society. Like many other Autistic people, the challenges I face are better explained by the social model of disability than the medical model. I do not feel that a better understanding of my genetics will reduce the barriers I face every day as an Autistic person.

My PhD research sits within the field of social science and my presentation recently won the WISERD PhD poster competition: “I feel like a square peg in a round hole: How is autism perceived and does it matter? – An exploratory case study into perceptions of autism within a Community Mental Health Team”.

In academic literature there is a disconnect between autism as a condition and being autistic as an experience. Autism is seen as a medical disorder and so attracts a disproportionate amount of research interest and funding – you could even say it is a research topic that keeps on giving. As an essentially narrative condition diagnosed on the subjective opinion of clinicians, autism is susceptible to ceaseless and sustained interpretation and reinterpretation. According to the prevailing science based, medical, cognitive interpretation of autism as involving a lack of theory of mind, autistic experience itself is a “black box” and hence not susceptible to investigation, let alone interpretation. Perhaps this relieves researchers of any felt obligation to interrogate either their own perceptions of autism/autistic experience or anybody else’s.

My PhD research question took a while to materialise. I considered a number of research topics, all related to autism; and time and time again, I kept coming back to the same concept. No matter how much we know “about” autism – Autistic people still experience poor outcomes. Perhaps the issue is not about something that is “wrong” with Autistic people, but something that is wrong with the way Autistic people are perceived and consequently treated. As my research question materialised, I realised that what was missing from the research was not “what is autism?” or “which gene causes autism?” but “how is autism perceived?” I believe that by exploring this area of research, outcomes for autistic people may be improved.

I believe it is time for researchers to collaborate with Autistic people and together take a look outside of the bodies and brains of Autistic people and into society, to see how improvements can be made.

Categories
2 minute read Autism

Autistic people – you are valuable as your whole Autistic self

Spectrum 10k research – there is a link at the end of this short blog. This blog is entirely my personal opinion.

I have needed time to process this research and what it means to me. My initial thoughts were complex – I felt conflicted and confused.

I totally stand by the researchers wanting to improve outcomes and wellbeing for autistic people.

I totally stand alongside every other parent who sees the struggles their autistic child faces every single day – and would give anything to improve that.

I don’t have an understanding of how DNA and uncovering which genes cause autism will improve autistic people’s lives. I look at other genetic conditions that we understand better; like Down’s Syndrome and compare the options…I am not filled with confidence. I would like to understand more.

I appreciate the fear of eugenics. The reality of whether genetic tests will be used to eliminate Autistic people – or simply the bits of Autism people don’t like – or even the co-occurring conditions only – is something we are unlikely to get a truthful and long-term answer to. The reality of eugenics may be cloudy – but the fear Autistic people are expressing, is tangible and totally real. Yet Autistic people’s concerns are being minimised, invalidated, and spoken over time and time again. Autistic people are being tone policed for their communication-style differences, not listened to, not taken seriously, nor respected.

My need for self-care has meant that I have chosen not to get involved in dissecting the methodology, ethics, and motivation of this research at the moment. But a quick background search on the institutions, funders and past research topics has rung alarm bells for me.

What concerns me most with the launch of this research is the way that it was done:

The lack of awareness of how Autistic people may feel about it.

The lack of compassion and empathy.

The lack of foresight.

The missed opportunities to collaborate meaningfully and take people with them.

This irresponsibility has been divisive and enhanced mistrust.

Some Autistic people are quite rightly distressed by this research, yet this does not seem to have been factored into the research – support was not set up alongside the research, to help manage the inevitable and very real concerns people would have. Yes, the researchers have answered questions – but have they even considered the emotional fall-out – and how that may be experienced by Autistic people (who process information, sensory input, including emotions – differently to non-autistic people). Do we feel cared for, nurtured, and looked out for by these researchers?

My initial thoughts were complex – my current thoughts have moved on but are equally complex. I see research with stated good intentions, that also reminds me that given the choice, some people would prefer it, or think it for the best if Autistic people, like me, did not exist. I am significantly deficient enough that they should be offered the choice about which parts of me are useful enough to be allowed and which bits to get rid of.

My genetics and neurology make me – they make me different to the majority, but I am me, and equally valid. I have a right to be here warts and all. Let’s fix society first.

Autistic people are more likely to experience mental health issues – and most will tell you that this is down to how we are treated and the barriers we face – not our inherent so-called deficiencies.

Many autistic people feel ashamed of our differences – we are more likely to experience abuse, be out of work, struggle with education. We frequently mask our autism – not because we want to fit in – but just so that we are allowed to take part. We may struggle with our identity and feel ashamed.

But it is not for us to be ashamed. Every single human has a right to be here. No one – I repeat – no one person has zero physical, mental, emotional, learning, social or other issues. I have struggled with my own sense of worth throughout my life – and I want to say to other Autistic people.

You are welcome as you are. You don’t need to feel ashamed.

Shame on those who say otherwise.

UK research has predominantly focused on the biology, causes, and treatment of autism. Key findings of a report into UK autism research highlighted that academics perceive themselves to be engaged with the broader autism community, but this perception is not shared by other stakeholders, most notably autistic people and their families. Autistic people see the challenges of autism as societal and attitudinal and not about ‘curing autism’.

CRAE, 2013. A future made together: shaping autism research in the UK, London: University of London.

Non-autistic allies – please take a moment to let the Autistic people you know – and those you don’t too, if you feel inclined – that they are valuable as their whole self. This is a message rarely heard by Autistic people.

Thank you for reading.

https://www.crowdfunder.co.uk/crowdfunding-to-help-autism-wellbeing-bounce-back

Categories
2 minute read Autism camouflaging identity masking

Autistic masking – let’s see it for what it is

Time and time again I read and hear how autistic people camouflage their autism so that they are more able to fit in. This makes a huge – and rather arrogant assumption – that we want to fit in – that we don’t want to be autistic.

I can only speak for myself but would like it on record that this is certainly not the case for me! The photo above is of a Speckled Wood butterfly, camouflaged against the woodland floor. This butterfly does not wish to “become” the woodland floor, nor does it want to stop being its authentic butterfly self. It has one reason for camouflaging and one reason only – to avoid predation.

Autistic people mask or camouflage their autism for many reasons; and frequently report the devastating impact of this on their mental health and wellbeing. Autistic masking is more than the reputation management and social niceties most people use every day. It is not simply about fitting in – often it is about avoiding bullying, discrimination, reduced opportunities or downright harm – predation even!

The framing of autistic camouflaging as a means to fit in, invalidates the lived experience of many autistic people. It fails to take responsibility for the discrimination and abuse directed towards autistic people. Until society accepts responsibility for the way autistic people are treated and changes this to become more positive, autistic people will need to protect themselves by masking their autism.

We may wish to take part – but this is not the same as “fitting in”. We may even be invited to join in – but frequently this is tokenistic. Inviting me to a place that I cannot enter because of my needs, but refusing to change it so I can enter or take part, is not inclusion.

I’d like to reframe the idea and commonly accepted use of language about autistic people camouflaging in order to “fit in” – and suggest we use the words to “take part” instead. It is a subtle change of language but the former suggests that those “others” want to become the same as the majority. Whereas “taking part” allows people to retain their identity whilst still belonging to the whole group.

Disabled people should not have to pretend we are not disabled. I would never expect my colleague who uses a wheelchair to put his chair to one side all day at work, because after all he can walk a few steps when he needs to. I would never tell him that I saw him walking a short distance the other day and he looked like he was doing it really well so why can’t he go without his wheelchair all the time? I certainly wouldn’t suggest that we all have to put up with things we don’t like and if we let him use a wheelchair, everyone will want one!

I will no longer be referring to autistic camouflaging or masking as a strategy used to better “fit in”. I shall tell it like it is. There are no excuses. Until society accommodates autistic people and stops the discrimination, mistreatment and abuse so that I can “be” autistic without needing to hide, I shall remind people that they play an important part in my need for masking; and they need to stop!

Categories
5 minute read Autism identity social communication

Authentically Autistic

This brief piece was prompted by a number of discussions I’ve had with people about autistic masking, being authentic and true to your autistic self.

You may like to check out my writing about autistic masking via the menu.

What makes me different?

I’m autistic, so experience the world differently to non-autistic people. My senses work differently – my personal range of sensory experiences is broader than most non-autistic peoples’. I experience some things more intensely (e.g. sound and smell) and others less intensely (e.g. body sensations and balance)

I have less need to form hierarchies than many of my peers – I still love to organise things and compartmentalise them, but we use different systems.

I think about things differently. I tend to consciously think through things that many others find intuitive – and intuitively know things that others have to think about!

So what is the problem?

I am in a minority. A seriously misunderstood minority. This means I often have to hide things like the extent of my sensory overload or my need for clarification.

My logical and literal mindedness puzzles people. My drive for clarity and need for honesty perplexes them.

And often it is NOT a problem. I have integrity, I cannot tolerate inequality. I stand up for what is right regardless of the personal consequences.

So, when is it a problem?

It becomes a problem when I remain dysregulated because I cannot do what I need to do to be in a state where I can learn and thrive. None of us can. But for me, the sensory aspects of the environment – and inside my body (noise, smells, lighting, my emotions) tend to effect me more because my sensory processing works differently.

Being dysregulated always makes thinking, communicating, and looking after myself and others needs, more difficult. That’s the same for all of us.

Humans are social animals. I don’t particularly enjoy socialising and I certainly find humans difficult to understand, but I recognise my social responsibilities. I may not want to hang out with other people for fun – but I choose to have unconditional positive regard for them….. and in fact, some of them are actually quite nice!

When I was younger I would be blunt, straight to the point and say exactly what I thought. I knew I was right. I certainly didn’t aim to be rude. In fact, I thought I was doing people a favour by leaving the bullshit out and getting straight to the point! I saw no need for small talk. I empathised by finding common ground that demonstrated my understanding of the other person’s situation and shared this with them. I used my incredible capacity for problem solving to offer advice, find solutions and share them with others. I wanted to be helpful. My heart was very definitely in the right place.

How was this perceived?

I sometimes came across as rude, self-centred and insensitive.

I am not.

Reflecting on this, it is important to consider that other people don’t necessarily operate in the same way as me. Those sensory and cognitive experiences I listed earlier may be different.

When I appreciate this, I realise how invalidating my responses to others may be. Lets take empathy as an example – a subject I have written about in my personal blogs and for Neuroclastic.

My natural, authentically autistic response to someone telling me something distressing about their own experience is to trawl through my memory for something comparable.

I don’t feel a lot when people share their experiences with me. Other autistic people may be somewhere else in this broad range of sensory experiences and physically feel other peoples pain to such an extent it hurts them too. If I responded with a “yeah well, whatever” to someone’s loss, and my autistic friend with the intense emotional sensations responded with a “omg, that is so awful – look I’m crying too” – neither of us would be much use to the person who was choosing to share their experience with us.

So I developed a technique that uses my very natural abilities of logic and reasoning. I would find something comparable from my own life and tell them about it so they realise that I truly understand.

Except they don’t!

Of course, these genuinely autistic responses can be seen as invalidating for others. And it’s not just issues around empathy where this happens.

If I was to tell someone that they looked dreadful in their new dress when they asked me for my honest opinion, they’d likely be hurt.

I hate lying and I find the games people play where I am meant to know the hidden meanings behind questions, frustrating and disappointing. I am lucky to live in a family where we can be open and honest and not dress things up in untruths.

How can I stay true to myself without hurting others?

As I have matured, I have found ways of remaining authentically me, whilst recognising that other people may be running on a different operating system to the one I’m running on. Expecting other people to appreciate my straight talking just because I’d like them to do that for me, is a non-starter.

I could simply say “I am autistic, I have every right to be autistic and this is how I do things” and expect them to accept this. But they won’t! People don’t. Maybe one day when people understand autism better they will accept our way of being a bit more. In the meantime, I do have people that I can be more blunt with, or skip the small talk. It’s great and is a very small step on a long journey to equality.

Or I could mask my differences and pretend that I am like them too. That I enjoy small talk, that I like to beat around the bush rather than get to the point. That I am happy to lie! But that sucks, and messes with my mental health. I sometimes need to mask my distress and dysregulation in order to feel safer and to blend in – and we all need to behave differently in different situations in order to act appropriately. But long term masking erodes your wellbeing and identity.

How do I find a balance?

The most important consideration goes back to my thoughts on how I treat others – and myself. Unconditional positive regard. Not being an asshole to others or to myself! Recognising our differences and accepting them. Using my desire to find common ground, but not in a way that invalidates other people’s experiences or takes from them and puts the focus on me instead. Not needing to change people, instead accepting them as they are.

I recognise that I am in a neurological minority. The majority of people tend to assume I am like them, because my differences are not usually visible upon first impressions. They should accept me for being me and for being autistic, but they usually don’t.

I want them to treat me in the way that I treat them.

When I am talking with someone that has a different way of being in the world to me, I try and understand how it is for them. Many autistic people do this – it is what makes us so great at masking and camouflaging our autism.

I still use my particular way of empathising to consider that the other person may get an unbearable sensation if I tell them honestly that their dress looks awful on them. Just like I sometimes get an unbearable sensation when I have to make small talk. I consider that they may find our surroundings drab and insignificant and easy to filter out – whereas I am annoyed by the background noise and distracted by their perfume. I hold on to the fact that we are operating on different systems. But I don’t necessarily say all this out loud.

I cannot get them to understand my way of being by forcing it upon them, just like they cannot get me to become less autistic by forcing me to enjoy soap operas and small talk! Nor can I bully them into changing their attitude by blaming or shaming them for simply being born different to me. Nor should they try and bully or “normalise” me or my autistic peers by making us keep still instead of stimming; or keep quiet instead of asking for the clarity we need.

Photo by Pixabay on Pexels.com

We need to do this together…

I would love non-autistic people to put the same amount of effort into understanding autistic people that autistic people often put into understanding them.

If I am going to accept that I need to be diplomatic when telling you about your dress, so that we maintain our positive relationship and you don’t feel hurt; then I’d like you to reduce the amount of effort you unknowingly make me use when trying to understand your true intentions and desires when we are chatting.

We both need to recognise each others intentions – and we may need to get to know each other and see beyond the stereotypes in order to do that.

Autistic people often communicate really well with other autistic people – we clearly don’t have deficits.

When you know me, you will value my honesty. Don’t write people off because they say or do things that seem odd to your way of thinking. If I accidentally upset you, remember that my intentions may not have been the same as your intentions in the same circumstances – and I’ll try and do that for you too.

I will not compromise my values, but I’m happy to adapt my communication style to accommodate you – in fact I do this most of the time already! Please do the same for autistic people.

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A Brief Christmas Message…

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