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Autism from the inside


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Autism, Anxiety & Resilience

It is difficult for autistic individuals to embrace failure or take risks. Instead, patients see themselves as confined in a drama dominated by shadow archetypes, mystery, and chaos. This engenders an unpleasant emotion; one caused in anticipation of danger. Indeed, anxiety is the biggest source of stress for those in the autism spectrum. For many, it is their constant companion. Anxiety thus establishes an intimate relationship with a person only to be interrupted by occasional bouts of intense fear or even panic.

Manuel Casanova 2021

I have written over the years about my own experiences with anxiety and mood disorders from a personal perspective

The dualism of having visual perception challenges (simultagnosia, semantic agnosia) rendering me object and meaning blind was both freeing, tangible, emotive and enriching in one sense but could be the opposite – coping strategies from an early age were dissociation, assigned characters and secondary to exposure anxiety.

My first memorable episode was being meaning deaf not able to decipher the interpretive frameworks of language in early infancy.

Strategies Built Over Time

I value the past, I was undiagnosed until my early twenties so I lived in a sink or swim environment, lacking concrete conscientiousness as a “primary option meant I was adaptive in art, fantasy and later creative writing.

This became a much more leisurely venture, however I still use it as a way of bridging my emotional world through my works

Conclusion

I wanted to know whyI was like I was” this included my attributes, my vices & my personhood (I refrain from lacking objectivity in autism making the condition akin to a “superpower” I would much rather look at reality and all that comes with it).

This I suppose is grounding as you can like people for social binding qualities.

Paul Isaacs 2022


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Autism & Anxiety? What Are The Correlations?

Often people may ask what is anxiety? People have different thresholds, strategies, internal somatic experiences, and interpretations of what words mean to them.

Some when breaking down the different types of anxiety we can explore the different potential experiences that are going on.

Social Phobia/Social Anxiety Disorder – in which a person may be avoidant of social activities and/or deeply analyse their perceived faults.

Obsessive Compulsive Disorder – in which a person repeats actions (movements, songs, checking) to “feel safe” this experience is usually temporary and short term.

Exposure Anxiety – in which person’s nervous system is triggered by awareness of self that leads to compulsive reactive retaliation responses.

Analysis Paralysis – in which a person may overthink multiple strands of information and not come to a decision and/or look at too many variables.

Phobias – in which a person through core beliefs, early childhood associated trauma, perception and associated patterns has specific conscious and/or unconscious phobias secondary to anxiety and other mental health conditions.

Trauma – in which the from context of autism sensory integration, sensory perception, social perception, alexithymia, language processing and other information processing challenges that are secondary to a person’s environment cause a negative pattern of nervous system responses.

Conclusion

So, when we look at autism and anxiety, we must take time understand what type of anxiety is present, what triggers the person’s nervous system and taking into account their information processing, language processing, mentalising and learning styles when supplying information to them.

Paul Isaacs 2022


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Exposure Anxiety – Working With Involuntary Compulsive Avoidance, Diversion & Retaliation Responses

Note this from a personal perspective of Autism & Exposure Anxiety

Viewing Exposure Anxiety As Ego-Dystonic In Adulthood

When I was younger I used view Exposure Anxiety as a part of selfhood in which it was both sanctuary and a cage, a place reside and to hide and place to regulate from the intensity of the nervous system response it would create.

Selfhood, Personality & Mental Health

My view of selfhood has progressed over the past decade with an understanding of personality types, attachment, sociability, core beliefs, outlooks, environmental adjustment and the disordered extremes which can a do entrench functioning.

Mercurial/Borderline, Solitary/Schizoid, Idiosyncratic/Schizotypal, Self-Sacrificing/Masochistic & Serious/Depressive.

I was diagnosed with Borderline & Schizotypal Personality Disorders in 2008 along with mental health conditions auditory hallucinations and psychosis.

Exposure Anxiety, Core Self & Perception

It has come to my attention through two friends also on the autism spectrum that Exposure Anxiety still has an impact on my ability to converse and interact. Impacting on friendships and a shared sense of social. I thank them for pointing this out as it clear on reflection it still is having an impact.

Here is how presentation EA presents currently (the reactions aren’t personal to the listener but a reaction to exposure the compulsive need to “get rid of” the feeling.)

  • Socially Distancing Dialogues & Observations
  • Stilted Telegraphic Language
  • Bouts of Temporary Mutism

How this relates to core self is for you to imagine if you wanted to want, wanted to be, wanted to connect but your nervous system response is blocking to protect the “core self” through a complex nervous system response it could dictate and take over the original contextual reasoning of the conversation.

Perception is multifaceted and also gaps in knowledge are perfectly acceptable, if my reactions are causing potential upset, sadness, frustration or even anger for that I am sorry because regardless of its underpinnings that is the reality for the people involved not myself.

From a personality perspective I am naturally solitary only letting a few people in to my world on a personal level.

Riding Along With Other Information Processing Challenges

Alexithymia means I do not always understand or verbalise my own emotional states in real time, then there is social perception which for me is a mixture of simultagnosia, semantic agnosia coupled with a language processing disorder meaning conscious thought and mentalising internal frameworks and word association can be slower.

Shared Sense Of Social

A reduced ability to get a shared social sense of self and other can be seen in the in Conscientious/Obsessive Compulsive & Solitary/Schizoid personality types/disordered variants. It can make people feel like they aren’t being listen back they aren’t receiving the “feedback” in real time.

It is also be seen in autism “fruit salads” to varying different degrees, presentations with varying components and this can have impact of connected responses and internalisation processes – all self and no other or all other and no self.

Failure Is My Friend

As odd and as counter intuitive as it sounds I am pleased to have met and embraced failure in this area, it keeps me balanced, humble, objective and understanding (at least from my own personal view) how brilliantly unimportant I am in the vastness of the universe.

Paul Isaacs 2022


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NAS Lambeth /A2ndVoice Workshop – Autism & Exposure Anxiety

This workshop was about the crossover between Autism and Exposure Anxiety. Presented and Hosted by Venessa Bobb.

Cross overs with Pathological Demand Avoidance, Oppositional Defiant Disorder, Reactive Attachment Disorder & Passive-aggressive Personality Disorder.

Additional Links

Autism & Exposure Anxiety By Donna Williams

PDA & EA Cross Over By Donna Williams

Paul Isaacs Personal Experience of Exposure Anxiety

Paul Isaacs 2020


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Autism Bucks – What is Autism? Workshop

What is Autism? – Autism Bucks & Paul Isaacs

This workshop is an an introduction and overview of autism using Donna William’s “fruit salad” analogy as the basis. I shall be adding links to expanding on some of the aspects which I spoke about.

Autism “Fruit Salad” Expanded

Autism and Personality Types

Autism and Personality Types? Why Aren’t They Looked Into?

Autism, Personality & Identity

Ptypes website

Autism and Visual Perception

Autism, Visual Agnosias And Making Connections

Agnosia, Sensory Perception & Autism

Autism and Exposure Anxiety

Exposure Anxiety & Autism

A Diagnostic Criteria For Exposure Anxiety?

Further Links

What is Autism?

Differences Between Aspergers & Autism “Fruit Salads?”

Paul Isaacs 2020


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Autism, Alexithymia, Dissociative Disorders & Trauma

img_20200114_113354_0606894045460517763458.jpg

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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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

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


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Exposure Anxiety & Autism

Exposure Anxiety Image 2018

Exposure Anxiety was first written about in Nobody Nowhere in 1991 as a syndrome of involuntary and compulsive avoidance, diversion and retaliation responses.  A large section of my first text book, Autism; An Inside Out Approach in 1996, was dedicated to setting out strategies for managing, even reversing Exposure Anxiety.  In 2003 I wrote the first full book on Exposure Anxiety.

Published in 2003, Exposure Anxiety; The Invisible Cage of Involuntary Self Protection Responses, is the first ever text book by a person diagnosed with autism specifically focusing on co-morbid anxiety and impulse control disorders effecting those on the autistic spectrum.  It offers an innovative new approach to working with some of the most challenged people on the autistic spectrum.

Drawing on an ‘Indirectly-Confrontational’ approach, this 336 page book gives case studies and a wealth of strategies to reduce and progressively overcome the compulsive and involuntary avoidance, diversion and retaliation responses of Exposure Anxiety.   Exposure Anxiety is an ‘Invisible Cage’ that challenges the person to either side with it and identify self with their own compulsive self protection responses.

There’s is considerable overlap between Exposure Anxiety and conditions such as Pathological Demand Avoidance (first diagnosed in 2008), Oppositional Defiance Disorder (first in the literature around 2002), Avoidant Personality Disorder and Dependent Personality Disorder.  With this book actually written from an Inside-Out Approach, by someone who actually lived their entire life with and ultimately managed then overcame the condition, those looking for strategies for managing and reducing these conditions may find this book extremely useful.

Donna Williams

Motivational Differences Between Pathological Demand Avoidance Syndrome & Exposure Anxiety

As someone who has lived with chronic EA all my life this certainly different to PDA who may tolerate an audience (in a social context) I do not while with PDA is triggered by DEMANDs. I am triggered by EXPOSURE which is completely different in terms of motivations.

Exposure Anxiety, Personality Types & “Triggers” 

People with EA have a lack of sense of “self” this it true people with EA may see their condition as the very barrier to showing other’s themselves. I like my own company so naturally being solitary that isn’t a problem, also a lack of sense of self can be seen in people who are mercurial and fear loneliness (real or otherwise) those personality types I have.

If you wanted to want, wanted to be, wanted to co-exist but your EA was crippling you from doing so because of being noticed, awareness of existing etc, that would mean you were in a hidden battle a battle happening when nbeing triggered by the co-existense of other people, with the WANT and the  EA being in polar opposites and it being seen as ego dystonic.

ego-dystonic [e″go-dis-ton´ik] denoting aspects of a person’s thoughts, impulses, attitudes, and behavior that are felt to be repugnant, distressing, unacceptable, or inconsistent with the rest of the personality. See also ego-syntonic.

In EA you can have chronic, diversion, retaliation responses which in my case were running away, freezing, selevtive mutism (once functional speech came) and shutting down when people were expectant of response, expectant of a reaction and expectant of one’s own existence. Did that mean I would hurt the people I liked? Yes of course and then feared loss through these actions.

A message of hope would to understand EA its mechanics and to get the best out of the person and who they want to be.

Paul Isaacs 2018

 


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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.

Conclusion

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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Book Review Autism Decoded: The Cracks in the Code: Volume 1 By Stella Waterhouse

 

This books is a must read for parents, professionals and people on the autism spectrum 

Stella Waterhouse has been a professional in the field of autism since the 1970’s with a whole wealth information that taps into the very soul with resonance and deep thought, she clear has a passion for getting the knowledge out there by presenting different aspects in chapters with detailed and accessible writing.

From detailed historical elements of autism, professionals and advocates on the autism spectrum  written with eager candor, emotion and objectivity to the multi-faceted nature of autism broken  down into accessible  pieces.

  • Sensory Perceptual Disorders
  • Sensory Processing
  • Theory of Mind
  • Context Blindness
  • Language Processing
  • Exposure Anxiety 
  • Alexithymia
  • Personality Types
  • OCD, ADHD and other co-conditions
  • Short/Long Term Memory
  • System of “Sensing”
  • Facilitated Communication 
  • Left-Right Brain Functions & Brain Development 
  • Autism and Asperger’s Syndrome 
  • Savantism

The running theme in book contextual to the information based on the specific chapter is to give a human element that touches the reader, makes them think, reflect, perspective take, feel emotion and more.(with first person account and historical accounts).Woven with relative and  factual elements (such as the brain and nervous system) that broaden the palette and overall sphere of information giving rounded, objective and fluidity the runs from page to page.

This is a refreshing book that achieves the very title it was given looking beyond the stale and liner 2D nature of autism and opening up a broadening 3D perspective that will no doubt help generations to come. Highly recommended.

Paul Isaacs 2017