Paul Isaacs' Blog

Autism from the inside


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A Lesson in Time – Mental Health Assessment Pre-Diagnosis

Paul 7 Years Old

Family Assessment

Tuesday 11th February 1997

Presenting Problems

Mr. Isaacs was unable to attend today as he is a shift worker and since accordingly this date he has been changed to day work. My initial impression of Paul was of a much younger lad (he is eleven in May) physically and psychologically.

Paul was eager to explain his concerns to me and at times was very insistent on not letting his mother give a more comprehensible explanation of the situations that had occurred.

Paul’s major sense of unhappiness and the reason for his referral is that he feels he is verbally bullied at school. he gave examples of being taunted primarily about 1.) The way walks. 2.) Shuffling his feet. 3.) He wears glasses – and he has been called “four eyes”. However, he feels that the teaching staff are against him . In year 4 he had an unhappy relationship with his form teacher. It does seem one particular occasion he was humiliated – but to the infants so they could show him how to behave.

Mrs Isaacs also incited another incident which seemed to have upset her more than Paul. It became apparent that when Paul was explaining his situation at school his explanations tented to be repetitions of his parents points of view.

Paul after became muddled and it seemed there gaps in connecting and associating. It was also significant that when Paul referred to “she!”- his pronunciation was really that of “he” – I did check several times, but it appears that both Paul and his mother were unaware of this – which was marked. (receptive hearing problem? speech difficulties?).

Mrs Isaacs pointed out that Paul always had difficulties “concentrating” and settling down to work – she remembers this as steaming as far back as three year of age – When he attended play-group. she also recalls at this age and ever since that has had problems with “interacting with others” (her words). Paul has not many friends and it was brought to Mrs Isaacs’ attention by the teaching staff that he was a “solitary figure” in the playground. His mother also pointed out that they lived close of approx ten houses and that there were other children of Paul’s age, but he tended to say in.

Her explanation for this was that he felt safe and secure behind closed doors. Paul did mention some of his friends, but found it hard to articulate what he felt about his friendships with them. He did admit to hitting out at people at times is was significant that he mentioned his father hit him when he was angry. Mrs Isaacs denied this. Paul’s response was “I suppose Mum must embarrassed that I said that.”

Paul’s self-perception is that his “fairly sensible” , however he admits to being influenced by others into “being silly”, but he feels other children are being “sillier” the than him – “going over the top”. He feels he doesn’t go over “the top”. Paul has recently had to go back to the very basics in Maths with one other pupil. Mrs Isaacs conveyed concern and irritation that the teaching staff had not picked up on Paul’s severe difficulties with Maths; especially in view of him starting upper school at Lord Williams East in the new academic year (Sept 1997). Paul’s reading age is estimated as that of a nine year old. it appears the only positive subject that could of was Paul’ art. Mrs Isaacs believes and feels the teaching staff convey negative messages surround Paul’s overall performance. Mrs Isaacs explained that Paul gets very “worked up” over homework assignments, Paul also stated that he cries very easily hence his vulnerability at school in being bullied. It appears Paul suffers from anticipatory anxiety and expressed his fear of commencing upper school as he has heard he will get “beaten up”. Is is of significance that Mrs Isaacs was unhappy at ‘Long Crendon Primary School’ and suffered “bullying” at ‘Lord Williams’ East’. Mr Isaacs is also being scapegoated at work – he is being ‘verbally bullied’ (Mrs Isaacs’ words) and harassed and feels under a lot of pressure.

Family History

When referring to the history of the pregnancy Mrs Isaacs requested to speak separately – she explained she told no one of the pregnancy – only her partner (whom she is married to). She had been rushed into the JR as Paul “was distressed” – he was a month premature and was in SBCU post birth. She was unable to breast -feed Paul remarking they had said “she was too big”. Transition to weening had been unproblematic. Had been slow in walking – 18 months? He was sleepy baby and had to be woken up for feeds – He had been a “good baby”. However Mrs Isaacs had fond toddlerhood difficult – his “boisterousness”. Paul has had three operations 1.) Circumcision at 2 years 2.) Grommets 3.) Adenoidectomy at 4 years – at the JR and Radcliffe. Tonsillitis – query – Tonsillectomy otherwise healthy. Mother with Paul for all operations – no significant complications

Paul would like help with “the teasing” – he said it although it had been easier recently he wants to be able to cope with it better if it worsens again. He also says he is very sensitive and works himself into a state easily. There is also much anticipatory anxiety regarding this move to Lord Williams’ East in the Autumn. In ascertaining his mood he expresses no helplessness or hopeless feeling and denies suicidal ideation or such thoughts. He does covey and sense of confusion and bewilderment over the treating of staff’s “rude words” (his words) about his self-presentation. (percistanty anxiety).

  1. Assessment from Psychologist (educational?) to check ot cognitive abilities and overall school performance.

  2. Social skills group at “The Park Hospital for Children”. (mother drives) for interaction with class.

  3. Possible Family Therapy – concerns regarding Paul;s parents and levels of depression. Re-enactment of mother’s unhappy school experience and father’s “bullying” at his workplace, especially regarding “authority figures”

Cognitive Abilities , Cognitive Impairment & “Mental Retardation”

“It became noticeable he had very slow speech”

There was a massive transition in 1993/1994 prior to this interaction before this I was echolalic, meaning deaf to large degree and unable to speak in a fluid manner. Having visual agnosias, oral apraxia and challenges around receptive language meant that getting an interpretive and expressive framework was slow, stilted and lengthy. I went through bouts of selective mutism hating my “connected” voice which then in turn triggered exposure anxiety.

there appeared to be a gap in connecting and association.

Still have complex visual and verbal blockages meant that my “cognitive abilities” were hidden and therefore not “seen” I have no doubt that the lady in question had her own frame of reference on how I was processing the information so thinking I was “retarded” was just the tip of the processing iceberg.

‘Bursting into tears quickly’ – Alexithymia, Body Agnosias and Trauma

There are many overlapping reasons why this was happening at this point – the reason in which I was at this assessment was the persistent verbal bullying from a senior member of staff at the primary school I attended. Having body agnosias meant that I couldn’t gauge or manage my own emotional states this would be related to alexithymia the inability to “know” your own states of emotion, the ability to “internalise” them and mentalise them on a “conscious” level however manner years later when I wrote my first book I came to realise that on a “unconscious” all my experiences were unlocked through typing.

(receptive hearing problem? speech difficulties?)

I was traumed from an early age by expressive language (but at times would be intermittently intrigued) due to a language processing disorder (aphasia), I was triggered by exposure anxiety, dissociated easily and would struggle to get incoming information with “meaning” living in the world of the system of “sensing” before awareness mind and the ability to make interpretive connections.

Battling Books & Formulas & Artism

He has severe difficulties in maths.

His reading age has been estimated at an average age of nine.

Not being able to mentalise in a visual – verbal way meant that I had challenges around comprehension and getting meaning from books, written words and maths. (dyslexia, dyscalculia and visual-verbal agnosias) found the process of writing very difficult the way in which I held the pencil, the ability to concentrate on letter and sentence formation. The same goes for maths.

My solace for extraction and distraction was art which was were my mind was freed and felt “at home” I started from a very young around 5 smearing paint on to a piece of paper and I was hooked from that point on then transitioning to drawing by route during this period of my development.

Prematurity & Height

“There is some evidence that babies who were born premature tend to be shorter in childhood, but they usually catch up with those born at term in late adolescence. But our study shows that women who were born very preterm fail to reach the stature you’d expect based on their parents’ and siblings’ heights.”12 Dec 2016

She noted that developmentally and that I seemed “younger” than my age from a psychological and psychical perspective there is a link between having a short stature and prematurity currently I am only about 5’8′ I do not think I will be growing vertically anytime soon.

Did I Have An Attachment Disorder?

I can assure you I was lucky that my parents gave me love, support and grounding even though they didn’t know that I was on the autism spectrum. Did they both have difficult childhoods and upbrings? Yes they did for many different reasons.

My Father had parents his whom were his primary caregivers who didn’t not show him love, affection, boundaries or a sense of meaningful inclusion both of the parents were cold and aloof and didn’t seem to understand (be it wanting or otherwise) the serious practicalities of what parenthood meant for a child’s development and emotional wellbeing.

My Mother was seen as a disappointment to her Mother who was constantly comparing my Mum to other people explaining that she needed to be more like other people as opposed to building up her own sense of self and identity, self-worth and autonomy.

The truth is I am and try to be a objective judge of character when it’s presented to me and the answer is no I did not have a attachment disorder and my parents were not to blame for anything.

My Mother fits the solitary, serious and self-sacrificing personality types she is giving, emotionally connective and generous.

My Dad fits the conscientious, mercurial and adventurous personality types he is assertive, pragmatic and forthright.

I love and value them as human beings because despite their own “shit” they didn’t fling it consciously or otherwise on to me.

Paul Isaacs 2019


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Androgyny & Male Feminity

Gender conforms nothing to me since my teens I knew I was effeminate and what sort of bigitory around chasms of narrow passed down thoughts that being “feminine” is some how the negative “ying” to the positive “yang” of being “a man” in the context of denying your own weeping tear ducts and inner feeling states.

I am probably more happy now that I can have a matured head on my shoulders that I can take the assured nature of experience and use it now.

Paul Isaacs 2019


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My World- Autism, Ethos & Humanity

I am pleased an eagerly proud to be working for a small autism organisation called My World and day centre for people on the autism spectrum. This summer it shall be four years of service to which I have contributed my consultancy work.

With people who have a narrow, conceited and reductive view of what autism “is” and how one is supposed to “act” and “behave” noting that it has “one look” so therefore “one approach and intervention” is wrong and that doesn’t happen here.

At My World all the caring and empathic staff are valued, open-minded and willing to learn this means that what is taken is a person-centred approach, looking at the person’s mental health, learning styles, information processing challenges and ultimately sees them as people or equal worth and value going about their day and purcuits.

Our success is our ethos, open-mind natures, ability to learn new things and approaches and empathy which encourages people in the end to be the best version of themselves.

Paul Isaacs 2019


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What Are “You”?

I often teeter on the wonderance of what it means to be a brain with a nervous system?

Why I am here? Why I am attuned and attached to an aging body? Why do I think, act, behave and react the way I do?

People are sometimes scared of their own minds and thought processes seeing them as a darkly moulded appendage that is seperate from one’s self an inner coil of contradictory truths.

As I know at this point I couldn’t be more happier being my own best friend, ally and comfort in times of earthly solace to do the right things. I hold in to truths even metaphorical ones and friends of friends a like flow into our pathly existences once again.

Paul Isaacs 2019


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“Neurotypical”, Reverse-Bigotry & The Warped Lense Of Equality

 

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Not this is from personal experiences

“Neurotypical” Is Inaccurate & Misleading? 

The word Neurotypical is used to describe people who are “non-autistic” but what if we have got that all wrong? What if the barriers are being created by the assumptions of what “autism” is that then thrusting one’s own presumptions of what it is like to be “non-autistic”?  I think that there really is no such thing.

Bigotry Is Still Bigotry 

Reverse bigotry is still that bigotry and if someone is using the words “NT” or “Neurotypical” to dehumanise, belittle or bully someone then surely that very generalised assumption if wrong? How does that become validated? Is it a sense of one’s own self importance, ego, group think and conformation bias, upbringing and/or past experiences? What gives someone the right to say these things and not take social emotional impact it has on the people in question?

“Autistic Identity”

This has worryingly been created through a “narrow” bandwidth of what autism “is” and “isn’t” but also what being “non-autistic” “is” and “isn’t”. The truth is there are far more similarities between people than not so why over invest in stereotypes? Which in the long run give people  a generic tick list of “traits”?

More Voices? More Perspectives? 

If we created so many degrees of separation do we strive to lose our objectivity? Being grounded means looking at things from the angle of non-bias. I have seen too much militancy that means that some people’s experiences have been silenced because they have not fitted the status quo that means there is rhetoric and that is unhealthy. Equality is for everybody.

No one “owns” autism it is not a thing to be bought or sold, no one should be able to cherry pick what autism “should look like” because guess what? It doesn’t have a “look” and more you give it one ironically the more voices will be lost.

Paul Isaacs 2018


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Is Stereotyping & Glamorising Autism A Dangerous Path to Tread? Balance Is The Way Forward

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I think of Polly a lot and as it is coming near to a year since she has passed and autism awareness month. I think of the valuable and human lessons she taught me and other advocates who keenly listened and understood not only her perspective on the matter but her overall out look and ethos.

Paul 1995 - 1

Autistic Person? Or Person With Autism?

I think when I was born and all that was around me that I wasn’t fully aware of yet, the people, trees, the buildings, the modern world, the natural world. I think of cladding and chosen identities and when comes to defining a person by one aspect of themselves. I often wonder and worry about what that means. If we see everything as the “autism” from the moment one gets up to the moment one goes to bed what is left?

Cannot we see the other aspects the mould a person such as the environment they live in? The personality types they have? The mental health conditions? Their sense of identity? (other than being “autistic”) And their learning styles?

If we are addressing “autism” surely we should be looking at the bigger picture rather than tired and easily digested rhetoric such as “all autistic’s are logical, literal thinkers” or “all autistic’s have special interests” not taking into account the broader perspective on neurological and biological aspects, the social emotional aspects and very specific wants and needs of that person themselves and/or their families and loved ones.

An “Autistic Mind”? Or a “Human Mind? 

Last time I checked there is no such thing as a mind cannot have be clear cut as “autistic” and “non-autistic” many aspects to do with information processing can have an impact on presentation. Such as a person with social-emotional agnosia not being able to read body language, facial expression and/or tone of voice, aphasia and being able to express and/or retrieve words and apraxia with living in a body that doesn’t obey its commands of the “owner”.

Personality types in human beings regardless of autism effect the presentation of the person such as being solitary and a preference for being alone, idiosyncratic and not confirming to the cultural and social expectations and conscientious and wanting logic, linear thought and perfection to name but a few.

Balance

If we ditch the rhetoric, the cash-cows, the money makers, the politics and get to what is “real” then that is the greatest and most honest foundation of them all. True empowerment is knowing what something is and working from there not making things up to suit the make-shift package you want to “sell” to people.  I think there is nothing wrong with showing the example of just “getting on with one’s life” as the greatest one.

I am not famous, “special” or “unique” words like that scare me. It puts me on some invisible pedestal that quite rightly I don’t deserve nor want to be on. 😉

Paul Isaacs 2018


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The “Autistic Identity” Phenomena

When I was diagnosed was autism in 2010 – I wasn’t aware of such an “identity” because to honest I was never in that “world” at all. I often wonder that despite the obvious difficulties I had during my development and environment the one thing that I had going for me was the simple “human-hood” which was conveyed by the my parents as a way of connecting with me.

I don’t consider this perception from my parents to be “unique”, “specialised” or “autistic-specific” in its intentions nor in its thinking at the time (although it could have well be seen as that on reflection).

I wasn’t born with a “label”

In many of my blogs I have spoken about the balance of being seen as “human”, “person” and “being” first and as I have been in this “world” for over five years. I have seen the firm importance of seeing people as “people”, by not defining their whole “soul”, “identity”, “being” by their label (or labels) nor having it being overtly defined for them so there is nothing else left.

“Labels” are an adjective not an overall definition

If everybody was to be defined by solely by a “label” wouldn’t it be restrictive, suffocating and narrowing your bandwidth of experiences, perceptions, thoughts and feelings?

Not towing line meant I could see “myself”

I am glad that I haven’t towed the line into the realms of stereotypes, group think, confirmation bias and all the militancy that goes with it. I am glad that my parents after I was diagnosed said that I am still “Paul” regardless. I am glad that I see the importance of seeing somone as a person first. I am glad that I have other interests that take up my time productively such as drawing, poetry, walks in the countryside and meeting up with friends.

People are people regardless

I am free to think and feel and have a more refined outlook that I am firstly and thankfully not being the centre of the universe, not the big answer all  to the questions, not speaking for “all” (because no one can) and have a egalitarian view that all people are of equal worth in this world no more and certainly no less.

Paul Isaacs 2016