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Autism from the inside


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Doing It Your Way – A Long Road to Autism & Self Care Skills

IMAG1230

Haha love this blog about autism and splinter skills and were one skill set can baffle and be up for contradiction in another.

Bathing, Temperature & No Sense of Time or Body 

It took me until sixteen onwards to understand the concept of bathing as a tool to wash your body in prior to this I would urinate in the bath, smear bubble bath liquid  on the tiles along with shaving foam.

A lot of times bathing the water would be too hot, too deep and would cause me to get light headed. I would sometimes lay in the bath for hours (until the water was cold), get lost dissociate, disconnect and focus on a fixed point and/or using the bath products.

The Art Of Toothbrushing

Tooth brushing I have yet to master, I have bouts of mild gingivitis, and a recent salivary gland infection which has “switched off” my left salivary gland. (I lose the patterns of how to brush my teeth for how long, the amount of pressure etc.) Dentists kindly remind me each time of how to do it.

The Delicacy of Shaving

Shaving my face I find odd too most of the hair density is below my jaw line, as such I am still so disconnected from body (so again losing patterns, strategies, movement and motion.) Leaving me with a blotchy and blood ridden skin at times.

Toilet Trouble 

Toileting is a lot about were my body is in relation to the toilet and pan, knowing the internal reasonings, feelings and sensations that go with it. This is secondary to shy bladder and bowel syndrome.

Mop Maintenance 

Hair brushing is a trial I have long thick curly hair and I have days and moments in which struggle  to obtain and use right brushes and the stratagems to untangle.

Learning, Context & Conclusion 

Context and meaning blindness, the inability to visually mentalise, visual perception, motion perception and body agnosias mean I rely on placement, position and associated contexts.

I suppose I did it my way.😉👍

Paul Isaacs 2020


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Autism, Alexithymia, Dissociative Disorders & Trauma

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Note – This is from a personal perspective

Overview

In secondary school their was an isolated incident of sexual abuse which I was subjected to, this happened in the changing rooms and I have documented about how I had to get closure on this incident myself.

Alexithymia and dissociative reactions are two strategies that have been put forward as coping mechanisms to alleviate painful emotions. Adult studies reveal an association between alexithymia and dissociation. In line with the coping hypothesis, it was predicted that the relationship between alexithymia and dissociative tendencies would be partly mediated by current levels of stress and past traumatic experiences. Dissociation may also be related to enhanced fantasizing, although alexithymia has traditionally been associated with an incapacity to fantasize

Jennifer G. Schnellmann PhD, ELS 2005

Alexithymia has a common overlap with some people on the autism spectrum, in which the person has problems identifying, wording and extracting inner emotional states, having a language processing disorder no doubt hindered my ability to express (word finding and word losing), visual agnosias of varying kinds and degrees which hindered my to get gestalt perception and mentalise and thus extract the information and process it accordingly.

But imagine that as an autie you get tolerated in a mainstream school of bullying, exclusion etc…. so you try your butt off to pass as ‘non autistic’ or at least mirror others…. but on your own out comes your autie self… and over YEARS the ‘acting normal’ self becomes an ‘alter’ and has its own abilities, its preferences, its dislikes, the things its invested in, the things its disinterested in (like all the ‘autistic’ stuff… because it would attract more bullying, exclusion, etc)….

Donna Williams 2012

Dissociation Disorder & Repressed Memories

Coming to terms with my dissociation is to understand where it came from so here is the a list of events that interacted and caused dissociation and dissociative personas which then in tern effect the association of the “core self” which then in turn had an impact on my psychological and emotional development.

  • I was traumatised by children and teachers using functional speech and language at primary school because I could not keep up with it on an interpretive level (this wasn’t done on purpose nor was this anyone’s fault or intention).
  • I was put into adult situations at primary school with no advocate or caregiver present (teachers arranging meetings about “negative” behaviour prior and after functional speech so dissociation, personas and exposure anxiety were triggered).
  • Having body and pain agnosias meant without clothes on and/or pressure points meant I could detach and dissociate quicker.
  • Having prosopagnosia secondary to simultagnosia meant I bonded with the “person in the mirror” in toilets and washrooms.
  • Secondary school involved the use of three personas all with splintering personality types, learning and communication styles and “tasks” both motivational and/or otherwise to “protect” on a subconscious level the “core self”.
  • Only became self aware of being “different” at 16 and later was using word “autism/autistic” at 18, however lacked a self-awareness of my challenges to others and didn’t consciously change and/or suffer from avoidant and/or social anxiety/phobia.
  • PTSD in adulthood and repressed memories of sexual abuse came in later adulthood through nightmares and flashbacks in a distorted and fragmented fashion due to visual perceptual and language processing disorders.
  • Outlets for Alexithymia and emotional regulation came up more prominently in adulthood through art, poetry and creative writing and aided my ability to mentalise.
  • Being Mercurial and Idiosyncratic meant I could create novel, inventive and “odd” ways of distancing myself from emotional difficulties and pain.
  • Being in the “system of sensing” for far longer and still retaining aspects of it meant I valued the world and would sense the energies around me beyond their set interpretive “meaning”.

Accepting What “Brought me to the Dance”

I have no doubt that I have been coloured by my experiences, they mold people, influence, guide them, help them and sadly sometimes destroy them.

I have come to realise the value in experiences regardless of these being positive or negative I still learn from them.

They’re my teachers my reflectors and I refuse to live a half life in which my destiny is to be defined by things that were out of my control and contextual to the knowledge (or lack of) at the time.

Paul Isaacs 2020


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Donna Williams’ Autism Fruit Salad – Bridging the Medical and Social Model of Disability

When Donna published “Autism: The Inside Out Approach” in 1996 it was the beginning of a trail-blazing analogy which would look at autism from the factual, compassionate and directional angle.

Looking Outside The Box

It would ditch rhetoric, confirmation bias and group think it would challenge people views (rightly or wrongly) about autism as a singular condition but look at it through the lens as a multi-faceted condition in which the person has their own unique “pieces” which would present differently from person to person.

Setting A Fluid Framework

She quite rightly humanised medical conditions that present themselves as apart of someones autism such as visual perceptual disorders such as faceblindness, simultagnosia and semantic agnosia and expand on the themes of context blindness in pragmatic but emotionally binding way.

Breaking The “Status Quo”

She would advocate for people who had severe apraxia and aphasia as a part of their autism and would need facilitated communication and assisted communication tools. She would advocate for people who struggled with ABA programs which triggered exposure anxiety.

She would challenge the status quo of “all people with autism think in pictures” or “all people with autism are logical literal thinkers”. She would advocate for people with health conditions as a part of their autism.

Equalism

She would quite rightfully not tolerate internalised bigotry within the autism world and would promote a heart warming and expanding message of egalitarianism in which means equality for all which is not just said but put into practice in a person’s daily life.

Let her videos, blogs and books inform you and empower you for in the end what she wanted out of you was to the be the best version of yourself.

Paul Isaacs 2019


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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 he 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 stemming 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. (persistent anxiety).

  1. Assessment from Psychologist (educational?) to check on 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 around 80 to 90 percent 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 and hating my “connected” voice which then in turn triggered exposure anxiety.

there appeared to be a gap in connecting and association.

Still having 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 and verbal bullying from a senior member of staff at the primary school which 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 many years later when I wrote my first book I came to realise that on a “unconscious level” all my experiences were unlocked through typing.

(receptive hearing problem? speech difficulties?)

I was traumatised 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). I found the process of writing very difficult the way in which I held the pencil, the ability to concentrate on each 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 upbringings? 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 his parents were cold and aloof and didn’t seem to understand (be it wanting or otherwise) the serious practicalities of what parenthood meant for in a child’s development and emotional well-being.

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 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 an 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 Father 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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Autism, Mentalising & Gestalt Perception

Note this is from person perspective

Gestalt perception can account for both strengths and weaknesses of autistic perception. On the one hand, they seem to perceive more accurate information and a greater amount of it. On the other hand, this amount of unselected information cannot be processed simultaneously and may lead to information overload. Autistic people may experience gestalt perception in any sensory modality.

Olga Bogdashina 2014

About a month ago I was a friend of mine who is a speech and language therapist who works with people with autism, brain injuries (associated with language processing) other other neurological conditions.

Visual Perception & Memory

She asked me about how I mentalise the world around despite having challenges with visual-verbal connections and the ability to “marry” words and images together. This made me think about how I piece my “world” together and what tools I have used to do so. So she suggested about a simple memory comparison which was to see in the mind’s eye a generic church figure which she could.

Sensory Associative Memory

I said that when I think of a church I think of the feel and texture of the grass, the feel of the aged stone walls, the loud squeak of the wooden door, the musky smell of the aged church. She said can you bring all the those senses (experiences) together. I said I cannot as I think of them one sense at a time.

There appear to be multiple pathophysiological mechanisms that result in apperceptive visual agnosia. These may be related to the misperception of shapes due to defects in representing the elementary properties of curvature, surface and volume149 or failure to integrate multiple elements into a perceptual whole.150 Patients with severe apperceptive agnosia usually have extensive and diffuse occipital lesions and tend to have residual field defects.151

D. Tranel, A.R. Damasio, in International Encyclopedia of the Social & Behavioral Sciences, 2001

Conclusion

It’s clear that I have documented about having faceblindness, object blindness and meaning blindness which of course leads to “blindisms” in visual surroundings in which one has “context blindness” in which objects, faces and places lose their significance and visual-verbal meaning.

However it is clear from this conversation that the way in which I store memories through fragmented pieces of information bring about and evoke an emotional connection with what I am talking about.

Paul Isaacs 2019


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Asperger’s Syndrome & “Classic” Autism – Left Brain Autism & Right Brain Autism “Fruit Salads”

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

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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

© 2016 CONSTANT THERAPY

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:

ASPERGERS
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
dyspraxia
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.

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.
http://www.donnawilliams.net

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 affected.

What I am not saying (and never will say) is that I am speaking for all that would be disservice to many people’s 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 2019


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Asperger’s Syndrome and Autism? – Doing vs. Being?

When we some people look at Asperger’s Syndrome and Autism it can be used interchangeably as the “same thing” but a “different presentation” between the two. If we look a little (or a lot) deeper you can actually find that the differences lie in brain hemisphere dominance and neglect and all that comes with it.

Autistic’

Reliant on the mapping of pattern/theme/feel known as ’Sensing’, with intermittent use
of interpretative processing at the level of the literal
Mono tracked processing with moderate to severe information processing delay.
Indirectly Confrontational, self in relation to self

The struggle here is the use of switching between “being” and “doing” states this means that the person is going from a “sensing” state to an interpretive state.

Asperger’s’

Interpretative processing at the level of the literal intermittent processing
beyond the literal to the ’significant’,
Generally Mono tracked processing with mild information processing delay

Those with Exposure Anxiety are indirectly-confrontational and self in relation to
self. Others are able to manage directly confrontational other-initiated social
interaction but generally lack a simultaneous sense of self and other

The struggle here is the opposite the use switching between “doing” and “being” this means that although the person gets a level of “significance” they may get “stuck” in a state of over thinking.

Exposure Anxiety is one of the three faces of “Autism”
Notes from a presentation by Donna Williams
At Flinders University, Friday Jan 16th 2004

Autism Doesn’t Run On”One” System

There is not one “system” in autism and that is part of the larger issue, by promoting tired stereotypes and linear 2D presentations of “collective autism” in which the person is assumed to think, act, react and behave in the same manner is rather passe and potentially dangerous.

Looking deeper, being objective and opened minded to the varying presentations that both “Autism” and “Asperger” fruit salads supply as an adjective and a description can lead down to meaningful roads of empowerment.

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Paul Isaacs 2019


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Left Hemisphere, Right Hemisphere & The “Mechanics” Of Autism “Fruit Salads”

Autism and Aspergers Hemishpere Image

When looking at autism “fruit salads” and function of both brain hemispheres it is interesting look at the difficulties in each area.

Looking at Donna Williams’ work on the subject of the differences between “Aspie” and “Autie” fruit salads was to do with hemisphere dominance and neglect a trade off between on or the other with “Aspinauts” being the “grey area” of in-between.

On a personal note I always thought she was on to something and looking at this simple table backs it up, consultancy observations, personal experiences and tireless effort to give people a better understanding of both DISablity and disABILITY with autism.

http://brain.web-us.com/brain/LRBrain.html

Left Right Brain Functions Aspergers Autism Image 2018

Right Hemisphere (Asperger’s) “Fruit Salad”

Extralinguistic Deficits

Again, RHD patients are unlikely to display the kinds of phonological, syntactic or semantic problems associated with aphasia. However, although they do not typically have many specific language problems, they definitely have difficulty communicating. This impairment seems to follow from an inability to integrate information; RHD patients apparently do not make adequate use of context in their interpretations of linguistic or nonlinguistic messages. They have difficulty distinguishing significant from unimportant information. For example a patient of mine when asked to describe the “Cookie Theft” picture card from the Boston focused on irrelevant features without describing the overall picture. Some aphasics with typical left hemisphere lesions present with executive function disturbance similar to right hemisphere syndrome.

Literal Interpretations

RHD patients may be able to comprehend only the literal meaning of language. Thus, they will often fail to understand many jokes, metaphors, irony, sarcasm, and common sayings that include figurative language. For example, if an RHD patient hears someone say that they are about to “hit the ceiling,” he might assume that the person is really about to begin striking the ceiling. Such a patient may also have trouble understanding indirect requests. For example, if he is asked if he “could open the window,” he may fail to identify this as a polite request and simply answer “yes” rather than opening the window.

These problems with figurative language may be viewed as one manifestation of the inability to base interpretations on context.

Difficulty identifying relevant information

When listening to a conversation or reading, an RHD patient may fail to abstract the main point contained in the information being shared. This happens in spite of the fact that, unlike an aphasic, the patient can understand all the individual words and grammatical structures used. For RHD patients, it appears that their comprehension of everyday language is impaired by a failure to distinguish important information from irrelevant detail and also by an inability to integrate According to Blake 2007, RH patients have difficulty comprehending non-literal language, humor, and multiple interpretations Furthermore, Blake says that their difficulty with language production includes: impulsivity, inefficiency, and egocentricity. She also says that the same problems are seen in traumatic brain injury.

Inability to interpret body language and facial expressions

In a conversation, RHD may miss out on important cues that should tell them about the emotional state and true intention of the person with whom they are interacting. This inability to interpret body language and facial expression may be related to an overall failure to use context in the interpretation of individual pieces of information. Problems with the interpretation of facial expression may also be due to the fact that RHD patients often fail to maintain eye contact with their conversation partners.

Flat affect

RHD patients may fail to display a wide range of facial expressions themselves. Also their speech is frequently aprosodic, or lacking variations in pitch and stress. Some patients will sound “robot-like,” and thus be unable to express emotion or changes in meaning via changes in intonation. These patients will no longer be able to vary pitch to signal the difference between a question and a statement or use word stress changes within a sentence to signal a difference in meaning.

Problems with Conversational Rules

RHD patients may fail to follow conversational rules, including those governing turn-taking, the initiation and closure of a conversation. RHD patients may tend to dominate conversations, as they are frequently verbose. They may also fail to properly estimate levels of shared knowledge, failing to give the listener enough background information to understand their statements. According to Myers and Mackisack (1990), RHD patients appear to not care about the needs of the listener. They, like children in an early developmental phase, may assume too much knowledge on the part of the listener; or not enough. They appear to answer without adequate search for the right answer. They also may fail to pick up on non verbal cues that signal listener’s reactions.

Impulsivity

RHD patients may exhibit poor judgment and problem solving abilities. They may require constant supervision due to a tendency to attempt tasks of which they are no longer physically capable. This may be related to anosognosia. They may also exhibit impulsivity in the sense of failing to censor the statements they make to other people.

Confabulation

RHD patients may make untrue statements. These do not usually seem to be deliberate lies. According to Brownwell et al. (1995), this may be the patient’s way of responding to his own confusion rather than attempts to mislead the listener

The Neuroscience on the Web Series:
CMSD 636 Neuropathologies of Language and Cognition
CSU, Chico, Patrick McCaffrey, Ph.D.

Conclusion Asperger’s- Fruit Salads

There tends to be a lower level of visual-verbal processing difficulties in this profile, social emotional agnosia, alexithymia, issues around a shared “sense” of social, self and other. Internal mentalising (to gain meaning) would make sense.

Left Hemisphere (Autism) “Fruit Salad”
  • Sensory disturbances, weakness or paralysis on the right side of the body. Read more.
  • Impaired vision on the right hand side of both eyes. (hemianopia)
  • Speech and language problems (aphasia).
  • Difficulties in recognizing objects (agnosia).
  • Problems with daily activities, routines that used to go well (apraxia).
  • Reduced memory for verbal (spoken) matters.
  • Decrease in analytical skills.
  • Problems with chronology (in order of time, cause and effect)
  • Reduced timing and speed of skills
  • Confusing left and right
  • Difficulty in dealing with numbers, understand numbers and dealing with money
  • Become slow
  • Exhibit insecure, anxious and withdrawn behavior
  • Risk of depression
  • Chance of changing moods, easily overwhelmed by emotions

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Conclusion Autism- Fruit Salads

There seems to be a higher level of visual-verbal processing difficulties, language processing disorders, sensory perceptual agnosias, problems with a sense of “self” and other. External mentalising (to gain meaning) would make sense.

Paul Isaacs 2018


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The Cognitive Aspects of Autism

Image result for Donna Williams autism

I used to think I was stupid and there are many things which are a struggle. It’s hard for me to tell a garlic crusher from a can opener. I sometimes can’t visually recognise my own husband. I lose the meaning of things I’m not physically using so cooking and running water can be a problem. There is often no left or right in my world and up and down sometimes tumble too. I use objects to track my thought externally or have to type it out to experience it after it hits the screen. I often can’t tell if I like something, whether I’m hungry or whether I had a good day. But I can do so many things that people really struggle to understand how extremely uneven abilities can occur in the one person. But in fact, that is the cognitive definition of autism.

Donna Williams 2009

Cognition vs. Expression

I don’t know on a conscious level what I am always doing, thinking or feeling which means in responses that on the surface seem very “limited” or “surface” an action creates a response but not always a “connected” one.

I can however type long reams of introspective and emotional material on a unconscious level which seems paradoxically detached from what I can say verbally at times. My inner world is far more richer than at times what I can get out verbally. This lends to personality types which are more attuned to empathy I show this through art and poetry.

“Sensing” vs. Intellectual Processing

I can see that this is to do with the residual aspects of being meaning deaf, context and meaning blind, information processing delays and language processing issues. I have found over the years “pathways” of extraction such as art and poetic writings. I “be” and the puzzle seems to all come together with an “unknown knowingness” that I cannot do when I am in a more conscious state as contradictory as it sounds one gets less out of me.

Paul Isaacs 2019


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A Journey With Exposure Anxiety

 

Exposure Anxiety comes in 3 levels:

  • Specific: Targets only specific environments, activities and interaction with particular individuals.
  • Generalized and other-directed: Effects all areas of life which directly involves others.
  • Generalized and both self and other directed: Effects all areas of life which directly involves others but is also present when alone.

Copyright Donna Williams 1991, 2003, 2008

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Residual “Exposure Anxiety?

If we think about exposure in a residual (non syndromic sense) those moments of embarrassment, aware of being aware, aware of your own self-awareness of the situation meant that you froze clammed up or even ran away meant that this “feeling” you wanted to escape, remove, and disappear.

 A Personal Look at Exposure Anxiety And Me

If you turned the “volume-up” on this condition you may find that it fits in the realms of being called “Exposure Anxiety” a feeling on a chronic level that falls into the three subtypes above. I would say that in my early years I had the 3rd one throughout my child and teenage hood as I grew into my twenties and was at the tail end of being employment in my mid teens I was thrust into a world of expectation from a social perspective that in many ways never let up. I never the less “kept going” and now at the age of thirty two I can say that the claws of this condition have shortened, nails smoothed and hands made smaller.

I would say it has an impact on me in specific areas so that is going from 80% to now at a more comfortable 30% and below I can show more of “myself”, be, share and talk in a more “connected manner” than I did even 10 years ago. Other things have changed to my environment, my purpose, life is but a rolling journey and that is the joy we can all celebrate and question at different stages in our lifetime.

My information processing being meaning deaf and meaning blind have changed, the tints have aided in those areas of visual perceptual challenges, and my meaning deafness is around 30% so I can keep a better track on conversation around me. My emotional processing and perception are still delayed that is a work in progress and I seek not to compare but to be the closest version of “me” I can be.

When we look at other people’s autism “fruit salads”, we begin to wonder what is the “driver” to what I am seeing? Is it sensory perceptual? Is it dietary disabilities? Is it seizure related? Is it emotional perception? Is it language processing? Etc. By looking at the person’s “systems” you are dealing into those areas of honest and humble questioning, what will you find and how will you adapt?

Common Threads Of Humanity?

Do people with autism have much more in common with those without? My answer is yes they do the only difference is the areas of that person’s “autism” that is challenging some to smaller more residual degrees others to more severe and/or profound degrees it is not the matter of it being a linear spectrum from “classic” autism to “asperger’s syndrome” but the also the palette of grey and what is specific to that person is what matters. All human beings have “system” it may be just that I have taken the time (which anybody could choose to do in my circumstance) and work out “what that is”.

Looking At People As People?

If one ignores the poison of the autism militancy which is political and unhelpful in its projection and reasoning one must look at the person and what “autism” is for them and means for them.

Paul Isaacs 2019