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Autism from the inside

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Autism, Shy Bladder Syndrome and Body Agnosias

Image result for shy bladder


Parcopresis, also termed psychogenic fecal retention, is the inability to defecate without a certain level of privacy. The level of privacy involved varies from sufferer to sufferer. The condition has also been termed shy bowel. This is to be distinguished from the embarrassment that many people experience with defecation in that it produces a physical inability, albeit of psychological origin.


Environmental Origins and Processing Event

When I was eight years old and was going to the toilet at primary school in came two students were playing out side the toilets and preceded to kick the door in unison until it forced opened they looked upon me a laughed it took me a long to the process the event due to visual perceptual and language processing disorders.

Reactionary PTSD

This has has a dramatic impact albeit subconsciously on going to the toilet in public forums I cannot defecate until I am in places of familiarity leaving a level of bodily tension.

Body Disconnection & Delayed Perception/Processing

Visual analysis of faces and nonfacial body stimuli brings about neural activity in different cortical areas. Moreover, processing body form and body action relies on distinct neural substrates. Although brain lesion studies show specific face processing deficits, neuropsychological evidence for defective recognition of nonfacial body parts is lacking. By combining psychophysics studies with lesion-mapping techniques, we found that lesions of ventromedial, occipitotemporal areas induce face and body recognition deficits while lesions involving extrastriate body area seem causatively associated with impaired recognition of body but not of face and object stimuli. We also found that body form and body action recognition deficits can be double dissociated and are causatively associated with lesions to extrastriate body area and ventral premotor cortex, respectively. Our study reports two category-specific visual deficits, called body form and body action agnosia, and highlights their neural underpinnings.

Dipartimento di Psicologia e Antropologia Culturale, Università di Verona, Verona, Ital

I have had a level of body agnosia and pain agnosia in my life which have caused, social emotional disconnect, alexithymia, language processing disorder and so forth. This can also cause problems with understanding and perceiving “pain”, “discomfort” and my case “being full”. Staying over a friends house made me realise the problems that still resonate eating food and then forcing your bowels not to move then caused an unfamiliar “sensation” which I was able to then realise was “nausea” in the pub.

The second the delayed response was in the home when my body moving without understanding why or where climbing up the stairs I projected vomit but had no understanding of what, why or how. A wave of exposure anxiety came over me I had to stop myself from self-harming wanting to hit my head and arms. I said sorry repeatedly for the mess which was made however they were very understanding and caring.


I luckily have a sense of humour and hold these things with a level of comedic reality and I was lucky to have like minded people in my company. 😉

Paul Isaacs 2017




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Asperger’s Syndrome & Classic Autism? Or Left Brain, Right Brain Autism “Fruit Salads”?

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The late Polly Samuel’s (Donna Williams) through her career had pointed out that firstly autism was adjective a describer of an experience rather than a definer of a person, she also pointed out through her books and blogs that “autism” is different for each person a clustering and multifaceted condition made of different conditions in both neurology  and biology  and contributing psycho-social factors, identity, mental health and environmental factors

Asperger’s Syndrome – Left Brain Autism


When noting and observing people with Asperger’s Syndrome the part of the brain which is being used to compensate for a disconnect right is the left, people with Asperger’s Syndrome have a condition called social emotional agnosia this means that the person cannot perceive facial expression, body language and tone of voice. Even thought sensory issues may present themselves it would to do with modulation and integration rather than sensory perceptual issues that effect different areas of the brain, faceblindness (prosopagnosia) has a high co-morbidity as well as dyspraxia, alexithymia and literal perception of language. So other words people with AS have to intellectualise in order to compensate for the disconnect in the right.

Characteristics of Right Hemisphere Syndrome: 

– Left visual neglect – an individual may neglect words on the left side of the page or not realize that there are objects on the left side 
– Difficulty with facial recognition 
– Poor awareness of deficits 
– Poor self-monitoring 
– Impulsive behavior
– Poor initiation and motivation 
– Disorientation 
– Impaired attention/memory 
– Difficulty with organization and reasoning/problem – solving 
– Difficulty with social aspects of language (e.g., poor turn taking skills, providing too much information) 
– Difficulty understanding humor 
– Difficulty with word retrieval 

© By Beata Klarowska, M.S. CCC-SLP Monday, July 25, 2011

Classic Autism – Right Brain Autism

When looking at “classic” autism one makes the impression that the person has (and wrongly) a “lower functioning” variant of AS, this could not be further from the truth people with classic  autism tend to to have receptive and expressive aphasia, verbal agnosia, speech/oral apraxia, and a higher rate of visual perceptual disorders such as simultagnosia and semantic agnosia. However introspection is in tact and just look at the poetry and art.

What if my brain injury or stroke is on the LEFT SIDE of my brain?

Injury to the left side of the brain may result in right-sided weakness and the following communication problems:

  • Receptive Language: Problems with understanding spoken or written language (listening and reading)
  • Expressive Language: Problems with expressing spoken or written language
  • Apraxia of Speech: Problems with programming and coordinating the motor movements for speaking
  • Dysarthria: Aspects of the speech system is impacted, which may result in slurred speech or a change in how your voice sounds
  • Computation: Problems with number and math skills
  • Analyzing: Problems with solving complex problems



Right Brain Left Brain Autism Fruit Salads Image 2017

Differences between Aspergers and Autism ‘fruit salads’?

 In one of my books, The Jumbled Jigsaw, I presented a range of conditions commonly collectively occurring in those with autism and Aspergers. I was asked about the differences between an Aspergers (AS) ‘fruit salad’ and an Autism ‘fruit salad’As an autism consultant since 1996 and having worked with over 1000 people diagnosed on the autism spectrum there are areas that overlap, areas where similar can easily be mistaken for same, and areas that are commonly quite different. Some with AS can present far more autistically in childhood but function very successfully in adulthood. Some with Autism can have abilities and tendencies commonly found in Aspies and some will grow up to function far more successfully than they could in childhood but, nevertheless, when together with adults with Aspergers they each notice that the differences may commonly outweigh the similarities. Generally the more common differences are:

originally called ‘Autistic Psychopathy‘(now outdated)
commonly not diagnosed until mid, even late childhood.
lesser degrees of gut, immune, metabolic disorders, epilepsy and genetic anomalies impacting health systems
mood, anxiety, compulsive disorders commonly onset from late childhood/teens/early adulthood as a result of bullying, secondary to social skills problems, secondary to progressive self isolation and lack of interpersonal challenge/involvement/occupation.
scotopic sensitivity/light sensitivity more than simultagnosia
most have social emotional agnosia & around 30% have faceblindness but usually not due to simultagnosia
literal but not meaning deaf
social communication impairments, sometimes selective mutism secondary to Avoidant Personality Disorder (AvPD)
sensory hypersensitivities more than sensory perceptual disorders
higher IQ scores due to less impaired visual-verbal processing
tendency toward Obsessive Compulsive Personality Disorder (OCPD), Schizoid rather than Schizotypal Personality Disorder and commonly Dependent Personality Disorder to some level.
higher tendency to AvPD rather than Exposure Anxiety
Alexithymia is common
ADHD common co-occurance but may be less marked than in those with autism.

Once known as Childhood Psychosis (now outdated)
generally there is always some diagnosis before age 3 (those born before 1980 were still usually diagnosed before age 3, although commonly with now outdated terms like ‘psychotic children’, ‘disturbed’, ‘mentally retarded’, ‘brain damaged’.
higher degrees and severity of gut, immune, metabolic disorders, epilepsy and genetic anomalies impacting health systems
mood, anxiety, compulsive disorders commonly observed since infancy
commonly amazing balance but commonly hypotonia
simultagnosia/meaning blindness rather than just scotopic sensitivity
verbal agnosia/meaning deafness
verbal communication impairments (aphasia, oral dyspraxia, verbal agnosia and associated echolalia and commonly secondary Selective Mutism)
lower IQ scores associated with higher severity of LD/Dyslexia/agnosias
tendency toward OCD/Tourettes, also higher rate of Schizotypal PD, DPD is common and tends to be more severe
higher tendency to Exposure Anxiety more than AvPD
higher tendency toward dissociative states (dissociation, derealisation, depersonalisation)
poetry by those with autism as opposed to AS commonly indicates those with autism can have high levels of introspection, insight
ADHD extremely common co-occurrence

Donna Williams, BA Hons, Dip Ed.
Author, artist, singer-songwriter, screenwriter.
Autism consultant and public speaker.

Reflective Conclusion

It is simple people need to start looking at the functioning of the brain and how these different systems work for different people. This will in turn create advocacy which is not only meaningful and beneficial but character building and the correct information will give a broader foundation and palette to work from. I have autism (as opposed to AS) not because I am just “saying it” but because of what part of my brain effected.

What I am not saying (and never will say) is that I am speaking for all that would be disservice to many peoples realities. I am fully aware that this may challenge people me saying there are differences however looking at the neurology behind it and Polly’s observations I think there is room for healthy discussion.

Paul Isaacs 2017

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Autism and Asperger’s Different Trajectories and Different Presentations?


Today I was doing autism training and in the team was lovely and inquisitive man with Asperger’s Syndrome as the session went on he shared some of his experiences from not picking up verbal cues, being literal and having sensory integration disorder as well as issues with emotional regulation and possible alexithymia.

It amazes me still that people think that “Autism” and “Asperger’s Syndrome” are still considered to some to be the “same thing” when is clear that even if on the surface some of the issues may be similar many of underlying components are very different. If I use both the gentlemen in question and myself as examples so here goes.


  • The gentleman seemed to display a level of Social Emotional Agnosia which meant he struggles with non-verbal cues, tone of voice and facial expression he acknowledged that he use past experiences to build up a format of how to understand someone
  • He didn’t have Prosopagnosia (30% of people with social emotional agnosia do so)
  • He was literal in processing of verbal language and seemed to have less impaired visual-verbal processing
  • Possible Alexithymia which is “knowingness of your own emotional states”
  • Seemed to mentalise in a more logical, literal and pragmatic manner which suggests the use of the “left brain” person.

With Myself


  • I have a mixture of Simultagnosia (Object Blindness) and Semantic Agnosia (Meaning Blindness) which means my visual field is fragmented, distorted and incoming visual information does not have any meaning, context or reasoning
  • I have Prosopagnosia (Faceblindness) as an extending of the already existing issues around visual perception meaning I “recognise people” primarily by patterns of movement and voice
  • I have a level of Receptive and Expressive Aphasia (Meaning Deafness) which even in its current residual form means I “lose” the ability to keep up with interpretive verbal information and struggle with visual-verbal processing
  • I have less literal, logical and pragmatic style of thinking or organised thoughts  I am very much a “right brain” person.



I was asked what I thought the main different feature was between Autism and Asperger’s. I think you’ll maybe find in reading through the site on brain hemisphere specialisation that there are many Aspies who may be better at left brain stuff and many Auties who may be more right brain but not nearly recognised for the abilities they do have as much as they are recognised for the left-brain abilities they don’t have. Whilst most people have a balance of both abilities, being extremely one side or the other clearly means the abilities of that other side are far less practiced. Processing incoming information in a non-Autie manner usually involves using a good balance of the two. So feel free to try the test yourself.

Donna Williams

Related image


Different Trajectories 

Maybe its is because I spent large part of my infanthood exploring through my senses and/or through patterning, theming and feeling struggling to get a sense of what “interpretive information” is and what it means? To be around such information and how to connect all the dots within in my mind. However I appreciated and acknowledged the validity of it in my previous blog post.

I flourish in areas of typing, writing poetry and creativity I love wordplay, sounds,  pitches and the seemingly infinite kaleidoscope colours, shapes, textures and shines they “talk to me” as much as next person.

Things Foundly Remembered

I saw your face with my hands

A voice a distant echo but foundly acknowledged

The smell of the wise tree in the garden the leaves did dance

A new place everywhere to be eagerly explored upwards and onwards

Flomping along the globblyness unstuck and unshackled my hands are free

Looking at the gloaming and silvering shape what plotunes and envelopes my soul

I thank you old friends you are me and I am likewise swashing around in the ink clouds


Paul Isaacs 2017


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Autism, Alexithymia, Body Disconnection, Mental Health & Loss



Note – This is from a personal perspective

In short space of time two people dear to me had sadly passed away my Gramp Gilbert Harpwood and my friend Donna Williams (Polly Samuel).

I knew that because of alexithymia I would find this process lag and that I wouldn’t be “emotionally connected” straight away this led me to going day to day with no sort of emotional context at all despite showing on the surface seemingly “connective” emotions they were not connecting with me on the inside.

Alexithymia /ˌlɛksəˈθmiə/ is a personality construct characterized by the subclinical inability to identify and describe emotions in the self.[1] The core characteristics of alexithymia are marked dysfunction in emotional awareness, social attachment, and interpersonal relating.[2

Expression Of Grief

After the month and half since my Gramp’s loss and not long after Polly’s I started getting pains in my arm, stabbing and throbbing like a vice was clamped on my left arm. I quickly ruled out tetanus (which is serious bacterial infection) this then progressed into neuropathic – like  pain which was shooting from my neck, jaw, arms, legs, feet and groin “settling” in places for minutes and hours with a “warm”, “tingling” feeling as it moved.

I know this based on having a family history of mood, compulsive and anxiety disorders many things came into place as well as somatisation disorder which is a pseudo pain diversion.

Anxiety and Somatic Disorder

Somatic symptom disorder occurs when a person feels extreme anxiety about physical symptoms such as pain or fatigue. The person has intense thoughts, feelings, and behaviors related to the symptoms that interfere with daily life.

Anxiety Neuropathic-like Symptoms

Anxiety doesn’t actually create peripheral neuropathy. While anxiety and stress have been thrown around as possible issues that lead to neuropathy, peripheral neuropathy is about nerve damage, not nerve symptoms, and since anxiety is unlikely to cause nerve damage, it can’t technically be peripheral neuropathy.

Dermatillomania (skin picking disorder)

Dermatillomania may be a reflection of a mental health problem. Psychological and behavioural theories suggest that skin picking may be a way of relieving stress or anxiety.

A Dolly Mixture Of Mental Health Conditions

I  know that I have mixture of differing overlapping co-conditions going with my mood disorder being an understandable and normal reaction to grief, skin picking and impulse control disorder which has resulted in my hair being riddled with scabs which is my sub-concious at work, to having excess adrenaline  that is being “stuck” in my body from time to time.

Externalising To Process My Own Emotional States

The alexithymia and associated problems that go with such as body disconnectivty (body agnosias and hemiplegia)  leaving me detached from my own emotional states leaves me also waiting for the emotions to come at a frantic, unprocessed rate leaving me to pick up the pieces of the jigsaw puzzle. I have created my own strategies such as writing, poetry and art which help me externalise and thus connect with my own emotional states, thoughts and feelings.

Visual Perceptual Disorders and Mentalising

Another aspect is the visual perceptual disorders which includes simultagnosia (object blindness) assoicated with prosopagnosia (face blindness) and semantic agnosia (meaning blindness) which I have that means my memory isn’t “visual-assoicative ” and I have no “pictures” of “emotional association” so my “meta-reality” (which all people have) has to be externalised.


I know that with the slow realisation of my internal states will aid me in the this journey which is a normal journey for human beings, remembering people fondly, the good times, the laughs, the smiles and interactions.

Paul Isaacs 2017


Diagnosis – Looking At What “Autism Is” Is That The Future?

I have been is the autism “world” as a speaker, trainer and consultant for well over seven years, I do not pretend to know all the answers nor I do project or promote that I have them all I can only speak from first hand experience of myself and the others that have been involved in professional capacity.

A 3D Diagnosis For The Future?

I what would like to offer a foundation of empowerment not because I know best but to give people the opportunity to find out about their “autism” what is made up of and the “mechanics” that go with it.

I have wrote and documented my autism the fact that is made of being brain injured at birth, speech and language delays, sensory agnosias, aphasia, apraxia the fact that I have dealt with mood, impulsive and anxiety disorders also.

Information processing such as

  • Sensory Agnosias (being Faceblind, Object Blind and/or Meaning Blind)
  • Attention deficits (ADD, ADHD)
  • Learning Disabilities
  • Apraxias (Oral Apraxia, Fine and Gross Motor Apraxia and Dyspraxia)
  • Aphasia (Receptive, Expressive and Mixed)
  • Gut, Immune and Metabolic Disorders
  • Tissue Connectivity Disorders
  • Seizure Disorders
  • Mild Brain Injury (Affecting Developmental Pathways and Trajectories)
  • Sleep Disorders


  • Development (Gender, Sexuality, Self Perception, Environment, Viewing yourself and as a “child”, “teenager” or “adult” regardless of chronological age)
  • Adjustment (Family and.or Personal Environment)
  • Disorder Extremes (Personality Types/Traits that are not balanced causing problems with overall functioning)

Psychiatric Co-Morbids

  • Mood Disorders (Emotional Dysregulation
  • Anxiety Disorders (OCD, Social Anxiety, Generalised Anxiety)
  • Psychosis
  • Impulse Control
  • Attachment Disorder
  • Dissociative Disorders


  • Dietary/Nutrition Disabilities
  • Morning the Child
  • Isolation/Alienation
  • Learned Helplessness (Dependency Personality Disorder/Co-dependency)
  • Presuming  Incompetence
  • “Cat” People vs. “Dog” People (Exposure Anxiety. PDA, ODD RAD)
  • Eating Toothpaste (Gut Disorder and Fluoride Toxicity)

Human Variants of Learning

  • Visual
  • Verbal
  • Logical
  • Physical
  • Aural
  • Solitary
  • Social
  • Mixed

The fact that being borderline made me emotionally unstable, struggled with boundaries and also being schizotypal made me odd, aloof and detached from people and at times society. These “elements” are all about of my “mix” and words not only for these “pieces” empower not only the person in question but the services they come into contact with also family and friends.


Fruit Salad 2017


Looking Deeper, Looking Forward, Education & Empowerment

I went through my autism “fruit salad” at an event recently and asked if the diagnosis had pointed out the specific pieces how would they have felt? Also would this model benefit them I came to the conclusion yes because understanding  that the word “autism” isn’t  one thing but understanding the pieces of their children’s autism was felt to be very important, helpful, empowering and overall was a beneficiary to the services that they would come in contact with. Giving them not just the word “autism” but what it meant for them specifically.

My Autism Fruit Salad 1 Updated 2017

Autism Fruit Salad 2 2017

Autism Fruit Salad 3 2017

Autism as “Fruit Salad” Video by Donna Williams



“Autism” is not “one thing” it is specific to each person also people do not have an “autistic personality” exclusively although personality types like solitary, idiosyncratic and conscientious would look more “autistic” but are smaller elements in the overall mix.

I do not believe that a person’s autism is everything about them because human beings are made up much  more than one element/label/word.

You can get  “non-autistic” personality types the people that challenge the stereotypes who could be equally adventurous and mercurial in their ways. For 2017 lets look at this from a broader perspective and empower people with knowledge that is worthy of making a difference.

I am not negative about autism but I am realistic and grounded about what the word means. By finding out the mechanics of what is going that is a positive approach to leading a more fuller, healthier more balanced life.

Paul Isaacs 2017

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Autism: A Very Sensory Christmas



Note: This is from a personal perspective

One of the amusing observations from my parents was my indifference to Christmas in the my early infant years, this would be noted as they would wait eagerly excited on the day while I would still be fast asleep in my bedroom coming down later in the day.


Another observation was my facial indifference to the event at hand the lack of excitement as each present was opened. My Mum can remember one year they bought me a bike which was perched on the fireplace (not lit of course) she seemed bemused that I didn’t go to the biggest first opening the presents scattered around the tree, when it came to the bike being opened she can remember me staring indifferently at the bike with no seemingly no acknowledgement of what it was or the significance of what it meant.

Looking a back at these two observations I can see many different aspects of what was going on from the inside and how observationally they caused confusion with my parents.


One of the conditions I have noted about is simultagnosia and seeing things in bits along side aphasia and language processing issues these hidden blockages no doubt would have an impact on how I physically expressed my emotions to the outside world, be it in this case contextually joy, excitement and love.

All these things I feel and felt but because of visual perceptual issues, language processing, alexithymia and information processing delays these were not seen by my parents however other aspects of Christmas did excite me such as the colourful wrapping paper, glittered tree decorations and the twinkling lights but it was much more instant for me to access how I felt about a present would take longer so time would be needed. As the years progressed so did my level of understanding of what was going on.

I was happy at Christmas. 🙂

Paul Isaacs 2016

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Autism, Faceblindness & Social Media



Note this is from a personal perspective

I got a good question from a Dean Beadle a international speaker on the autism spectrum with regards to faceblindness and the use of social media.


The way in which I recognise people I have documented in various other blogs with regards to “seeing” faces or rather not and that is through patterns of movement (the way in which the person moves their body around the enviroment) and the person’s voices. Context helps through understanding (their full full name, significance of were I know them from).#



When it comes to social media it is best for people to message to help me remember where they came from. I do look for full names (that is a good start) and other contextual and associative information, although at times I have gotten it wrong in terms of sending the friend request to the wrong person it is a matter of trial and error for me. 🙂

Paul Isaacs 2016