Paul Isaacs' Blog

Autism from the inside


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A Tall Tail Of Somotisation Disorder

The Beginning

I started getting symptoms of this in late infancy around 11 years old this was related to mitigating factors both to do with neurological processing such as aphasia, alexithymia and visual agnosias, environmental factors bullying and emotional triggering.

Psycho-Somatic Trauma Based Response to Negative Environment Experiences?

I would get sensations of my body “melting”, headaches, stomachaches, tingling in limbs, face and lips and by the time secondary school came and chronic bullying persisted in the first two weeks the pain would start again as stated above.

In particular, the pattern of shrinking was observed in two parts of the brain called the putamen and the caudate, a change oddly reminiscent of adults who have experienced early life stress, such as childhood maltreatment.

These sensations would cause me to have intestinal discomfort ranging from chronic constipation to nausea.

I would go to the school reception during lunch break sometimes on a almost daily basis saying either about a stomachache and/or headache. I would sit in floods of tears wanting to go home this went on for approximately 18 months as my nervous system was also being pushed as panic attacks usually followed before and/or after an episode of pain.

This meant that obsessive-compulsive disorder manifested in persistent hand-washing, counting, checking and reassurance around illness and disease began which last from the ages of 12 to 15.

Psychological Pain Presenting as Physical Pain?

What is Somatic Symptom Disorder

People with somatic symptom disorder experience real physical symptoms — they are not imagined. These symptoms can vary in intensity from mild to severe and often include breathlessness, exhaustion, or weakness, though pain is the most commonly reported symptom. Doctors may be unable to pinpoint a medical reason, or there may be a clear and diagnosable medical cause. However, people with somatic symptom disorder are likely to experience the symptoms of their illness more severely than is common.

 

Fast forward to this year and very recently I woke up in tremendous pain it started with an “itching” sensation in my lower arms and legs, then they felt like they were on fire, I got up and moved my legs persistently for 40 mins trying to “release” the sensation

I went to the GP this week who confirmed somatisation disorder secondary to an anxiety disorder, PTSD, depression and hypercondriasis which makes sense.

Pain would be triggered by talking about illness in any context,so for example people on the bus sat behind me and in the GP waiting room for example the described pain would migrate and move from my lower back, to my upper back from upper limbs to my lower limbs my body would begin to shake and adrenaline fired through my body, my stomach muscles would cramp up and it would gurgle.

I went for a walk two nights ago and my feet went “numb” this caused great distress and panic as I walked home however bursting into tears was a great release for me.

Conclusion

Now most of pain has subsided but what does psycho-somatic pain represent? For me I feel it is unprocessed emotions, recent environmental distress and need for my body and brain to calm down.

Paul Isaacs 2019


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Elderly Paraphrenia and Atypical Grief

Nan and I 1990s

My Nan has been diagnosed with Paraphrenia a form of late onset schizophrenia that effects 0.1 percent of the elderly. This is secondary to an atypical form of grief.

She has had auditory hallucinations for 2 years along with complex visual hallucinations the most recent episode was in the morning seeing flames all around her. Others she has experienced are of people, animals and objects. This is related to urinary tract infections.

 

She has experienced psychosis and delusional thinking it is clear from my views of this states that she is very scared, confused during the lead to these events and afterwards she quite rightly views them as ego-dystonic (separate and in conflict with “self”).

Paul Isaacs 2019

 


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Dealing With Passive Aggressive Behaviour

I feel sorry for passive aggressive person’s over amplified and converted contact with sly control over a person’s life.

Like sucking the heavenly sap from a beautiful and fruitful tree it will slowly dry and not bear ideas anew.

I have since realised that childlike adults that produced airs of controlled silence, defiance, user of situations and emotional strife are indeed unhappy souls.

Who take away the shine of others dulled down do not let them take the shine of you away for they only want but never truly have.

Paul Isaacs 2019


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The Problem with Somatisation Disorder

Image result for Somatization disorder

Note this is from a personal perspective

Certain personality types (such as mercurial/borderline) are more akin to having somatisation type disorders in which person feels they are becoming increasingly ill and/or have serious and multiple symptoms that indicated a serious illness and/disease.

“The main features are multiple, recurrent and frequently changing physical symptoms of at least two years duration. Most patients have a long and complicated history of contact with both primary and specialist medical care services, during which many negative investigations or fruitless exploratory operations may have been carried out. Symptoms may be referred to any part or system of the body. The course of the disorder is chronic and fluctuating, and is often associated with disruption of social, interpersonal, and family behaviour.”

Awareness of Emotional States and Somatic Pain

The persistence is the pain and the feeling that invokes, having alexithymia means that I have problems identifying what my inner states are leading to often painful and chronic psychosomatic symptoms which in my life time have included as follows

  • Nausea
  • Tension Headaches
  • Toothaches
  • Jaw aches
  • Lower back Pain
  • Arm and Shoulder Pain
  • Pins and Needles in Legs and Feet

The recent bout is having a pulsating tinnitus in my left ear which is anxiety/stress related and is not due cardiovascular disorder and or stroke related symptoms but never the less is persistent at the moment. Age and awareness in my case have helped with these areas of anxiety and “getting on with it” as means to move on and look towards the psychological/developmental aspects they have on me in terms and working from there.

Paul Isaacs 2018

 


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Autism, Alexithymia, Body Disconnection, Mental Health & Loss

Tulips

 

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.

Remembering

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


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Autism, Emotions, Attachment and Borderline Personality Disorder

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Borderline Personality Disorder can be a difficult condition to live you may struggle to be “in your own skin”, have issues with “identity” and purpose in life, with other people and may flip-flop between different aspects of what you perceive your identity to be. Your emotional input-output may well disruptive and hindered.

Borderline personality disorder (BPD) can cause a wide range of symptoms, which can be broadly grouped into four main areas.

The four areas are:

  • emotional instability – the psychological term for this is ‘affective dysregulation’
  • disturbed patterns of thinking or perception – ‘cognitive distortions’ or ‘perceptual distortions’
  • impulsive behaviour
  • intense but unstable relationships with others

Emotional Dysregulation

These four main areas may well vary from person to person and emotional instability and modulation may make you vulnerable to teasing and bullying in your early years as the reactions may well be more extreme and unpredictable in nature, you may push people away without realising or cling on to friendships that aren’t there. This can lead to internal problems with modulating one’s own emotions.

Cognitive Distortions, Dissociation & Psychosis

Cognitive distortions can come in many forms and affect how you deal with in particular negative emotions you may “lock them away”, project them through self-harming, other aspects that can distort reasoning are episodes of psychosis and a breakdown of internal and external reality this may be accompanied by episodes of dissociation.

Impulsivity & Challenges In Friendships & Relationships

The person may want these aspects of life but maintenance for both you and the person you are friends with could be hindered by the symptoms above the changing winds of emotions, a lack of grounded identity and purpose, disruptive and sometimes paranoid thinking and firm and often “black and white” sense of what relationships and friends “should and shouldn’t be”, fear and loss and may have issues with attachment with people around them.

Coming Out The Other End?

I have documented my mental health issues over the years which includes having Borderline Personality Disorder and how that interacts with the overall package within my “autism” and this is how of have dealt with these negative and sometimes behaviours.

  • People have their own thoughts, feelings and identities and one must respect a person’s autonomy.
  • Grounded sense of “self” I am a whole person with the ability to change.
  • Emotions are human and therefore not “abnormal” and are part of the human existence and managing them is crucial for healthy relationships.
  • All friendships and relationships are unique in their creation some last a lifetime others don’t and one must accept this.
  • I can help and empower people but not overbear them or smother them.
  • Seeking balance has a positive impact in your overall life and existence.

Darth Vader shows the key features of BPD

  • He fears loss of people he is closest too. The Death of his Mother and not having a Father figure
  • He has intense and unstable relationships with the people he loves. His love for Padme and his and Father-figure friend Obi-Wan
  • He suffers from emotional dysregulation and has feelings of intense fear, rage, sadness and sorrow. “I Hate You!”, “Where is Padme? Is she safe is she alright?”
  • He displays impulsivity and cognitive distortions through manipulation of Chancellor Palpatine. “In your Anger you Killed her (Padme)”
  • He has problems with self identity switching from “Anakin” to “Vader”.

Conclusion

I have documented that when dealing with autism you must look at the rounded view that personality types and thus personality disorders can be a part of the package and if this is the case maybe we should looking a little deeper into what that means when managing a person on the autism spectrum who is in emotional crisis and the services that can be provided in the future.

Paul Isaacs 2017


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The Importance of Recognising Personality Types In Autism

Note this is from a personal perspective

Personality types are just as relevant to in which a person behaviours and responds to the environment around them, this includes interaction, communication, lifestyle choices, interpersonal choices etc.

Personality Types A Mix & Match

We can break down these personality types into their basic forms. In example I will use three different personality variants (people can have to 4 to 6) however this will simplify the point in question.

Personality Types in Autism 2017 Image

Personality Types Are Valid

People on the autism spectrum will have personality types within their “autism fruit salad” like all other human beings people have overlapping personality types which can be fluid or concrete, complex or refined, narrow or lengthy which will be dictated by genetics and the environment they are in. They can also spill over into “disordered” extremes.

Is “Autism” All Of A Person?

I think that the main factor that gets missed in the overall ensemble when looking at ASD is personality traits/types. To define one’s whole neurology as one’s “self” ego-syntonic were as I see my neurology in terms of autism as part of “self” not the overall picture “ego-dystonic”.

This would surely help professionals, parents, guardians and people on the autism spectrum? To know that part of being a human is to do with the development of these aspects to?

“Autism” It Is Apart Of The Mix Not The Defining Factor

To put in honestly that fact that I am face-blind isn’t “me” it is just how I processing faces, the fact that have simultagnosia as see in pieces isn’t “me” but is how I process visual information, the fact that I am aphasic and meaning deaf and struggle at times process the words being spoken to me isn’t “me” but is how I deal with receptive language they are part of the package, the fact that I struggle to do simultaneous “self and other” isn’t “me” but it means I need time to gauge and internalise information is again part of the package .

They come along for the ride and my personality types will dictate how I cope, manage and productively find an outcome for these different processing issues I have. If someone isn’t seen as person first then what are they?

Paul Isaacs 2017