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Autism from the inside


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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 & Personality Types – They Do Exist

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Personality Types & Autism 

When we look at “autism” looking at personality types is just as important as any other factors. We could look at these aspects of a human being they are very much the “soul” of the person they pepper one’s temperament, personal outlook, emotional regulation, friendships, relationships and aspects of social and emotional interaction.

Identity Crisis

For people who are on the autism spectrum not all their “being” is dictated by the diagnosis that they have. This of course will vary from person to person depending on what part of their “fruit salad” are impacting and how they view their personhood within that. Is it hidden by language processing disorder? Is it being tempered and challenged by health issues? Or are there underlying mental health issues that are being called “the autism” when they are not?

Autism Isn’t a “Collective” 

Some people see their autism as “ego-syntonic” that is all their person and they feel it all of the time, others like myself see their autism as part of their “being” this means that other factors come into it such as environmental factors, mental health, identity and learning style all human being are made of up these things . For me it seems to over simplified and reductive to suggest that people on the spectrum share common goals, values and outlooks as a collective experience.

The “Sameness” Machine

“We” do not all come from the same place, we do not have a carbon copy autism “fruit salad” that is  shared from person to person. That means that one should be seen as an individual not just a sausage machine of traits. People are born with no labels what so ever and no one person is defined by “one word”.

Paul Isaacs 2018

 

 


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Autism “Specialism”, Personality Profiles, Reverse Bigotry & Being Human

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Many times people often focus on the person’s autism as all of “them” this means that the “autism” is the reason for all of their behaviours, reactions, actions and motivations. If you are on the autism spectrum you may well be aware of autism “stereotypes” such as an overtly logical, literal processor and extractor of information. If this is true in some cases it is far from the bigger picture and is far from the broader palette that is actually out there.

Let’s look at three examples of differing personality types

For the person with a Idiosyncratic personality type not fitting in a running along their own path maybe something that has brought them joy and/or isolation by “dancing to their own beat”, being naturally non-conformist, inventive and intuitive.

The Idiosyncratic Personality Type believe that your interests lie in (Oldham, pg. 252):

  • not being like anyone else
  • marching to your own beat
  • being unconventional
  • being original
  • standing out from the crowd

For the person with a Conscientious personality type they may be fixed on being productive, useful and striving for success the fear of failure and self loathing could hinder their development for continued perfectionism, however being pragmatic and ordered in nature along with highly motivational work ethic has its benefits.

The interests of the Conscientious Character Style include (Oldham, pg. 62):

  • having strong moral principles and being certain
  • not resting until the job is done and done right
  • being loyal to families, causes, and superiors
  • working hard to do well
  • achieving and accomplishing things
  • loving to work and be challenged

 

For the person with a Solitary personality type being focused on being alone, in a “inner world” and not be swayed by praise, acknowledgment or criticism this may come with a lack of social and emotional development however their comfortable observations of the world offer patience, tranquillity and healthily reserve.

The interests of the Solitary Personality Type include (Oldham, pg. 275):

  • not needing anyone but yourself
  • being unmoved by the crowd
  • being free of the need to impress and please
  • being free of emotions and involvements with others
  • having clarity of vision rather than sentiment and intimacy
  • discovering and recording the facts of existence

The Problem With “Specialism”

Nobody is better than anyone else and that accounts for people on the spectrum too. I strive for balance, objectivity, kindness, empathy and equality. If someone is going to be militant with the focus being that people off the autism spectrum are collectively “wrong” then reverse bigotry is still bigotry and doesn’t into the framework of empowerment it creates more divisions, voices, lost, realties not acknowledged that in not progress but quite the opposite.

Personality types and the richness of them are for all people to share I have noted that mine are idiosyncratic, serious, mercurial and self-sacrificing by narrowing your bandwidth and not acknowledging that personality types have much to about development as the neurological and biological challenges means you are missing the fundamental part of “humanness.”

Promoting equality in difference and diversity, is what I believe in and I’ll strive for the opportunity to do that, wherever I find it.

Any derogatory or dismissive stance relating to non-autistic people as a group is no less a form of prejudice as any in history.

Polly Samuel

Autism, Personhood, Personality Types and Identity

Theses aspects of a person/human being  are different for all but at the same time very real so if someone’s “autism” is just seen as “collective autism” in other words all the “traits” are “autistic” then that reductive way of perceiving will mean that the personhood and associated traits may well be ignored. This will have an impact of self-identity, self-worth and could potentially push these personality types into “disordered extremes” impacting on functioning further.

Looking at the full package of autism that does include personality types and disordered extremes and the inter-relation that have on the person’s perceptions, mental health, identity and reactions to environment.

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


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Colour Me With A Personality – Autism, Personality Types and “Disordered Extremes”

Malice Mizer Bara No Seidou 20004All human beings have personality types they are part of what makes “soul” along with are senses, information processing, reactions, life experiences, our friends, family members and cherished ones.

Many  a disagreement has been  made about me bringing up about personality types in the context of autism people have quite rightfully misunderstood my intentions or misunderstood the point of points I was trying to make so  lets look at this a bit more.

Of the 16 common personality traits identified by Oldham, all of us will have around 4-6 of these which tend to be our main personality traits, what collectively presents to others as ‘who we are’, our ‘self’, ‘personhood’, ‘identity’, ‘soul’. When these are not overdeveloped, they present merely as ‘traits’.  However, a particular personality trait or traits can become overdeveloped or stay at such a ‘volume’ that the person is functioning and presenting in the personality disorder range for that trait.  If they don’t break free of this they will progressively so identity with their own personality disorder they will take it as their ‘normal’.  Donna Williams (Polly Samuel)

NOT EVERYTHING IS THE “AUTISM” 

It is not restrictive or silly to point out that personality types do exist within human beings and in context of this segment with people with autism. Human being not only have 4 – 6 main personality types (no we are not machines we “encoding”) and you can also have what is called “secondaries” (mine I would say are conscientious and adventurous) that come along for the ride and they may well clash “internally” with the main traits themselves.

This is fluid and normal there is of course genetic factor to these traits maybe you can see “yourself” in another family member certain behaviours you can relate to and/or acknowledge, just like you can have personality clashes at work because you cannot relate to how some operates this is normal.

Some of the most common personality disorders in people in the autism spectrum include Obsessive-Compulsive, Schizoid and Schizotypal personality disorders and Avoidant and Dependent personality disorders.  Those with dissociative disorders may more commonly experience AvoidantSelf Defeating, Schizotypal, Borderline or Passive-Aggressive personality disorders.  Some personality disorders are commonly misdiagnosed as mood or anxiety disorders but unlike mood or anxiety disorders, personality disorders generally fail to respond significantly to medication.  Donna Williams (Polly Samuel) 

EGO- SYNTONIC & SEEING THE PERSONALITY DISORDER AS “THE AUTISM”

Ego- Syntonic Meaning Consistent with one’s sense of self, as opposed to ego-alien or dystonic (foreign to one’s sense of self). Ego-syntonic traits typify patients with personality disorders.

If a person or people around the person “sees” their “autism” as everything about them (including dictating their personality) then hypothetically if they acquired a personality disorder would they see it just apart of of their autism? Not needing to be changed? Or modified?

What if it is having an impact on the person but they just can not unpick or see that it is an issue and it is having an overall impact on their functioning? Their judgements? Their reactions? Their interpersonal skills? Their daily living skills? What then? This is food for thought from both a practical sense and how specialists can diagnose and treat those with personality disorders on the autism spectrum.

MY FOUR MAIN PERSONALITY TYPES WITH THE DISORDER VARIANTS

As you can see on the left I have my personality types and on the right I have the “disordered” variants of those types the explained in the middle is clear these “stresses” can cause the “normal” personality types to expand and “grow” the person themselves may well be observed by others as being “different” quick to temper, quick to cry for example their reactions are heightened to an extreme.

For more info on personality types look at www.ptypes.com

2007 PERSONALITY DISORDERS A PERSONAL PERSPECTIVE

In 2007 I suffered a nervous breakdown my parents had noticed a change in “me” looking through my medical records two words sprung out at me “borderline” and “schziotypal”.

 These had an effect on these five main areas of functioning

  • Personal Judgement
  • Interpersonal Skills
  • Personal Skills
  • Professional Skills
  • Daily Living Skills

Borderline Personality Disorder

It is characterized as:

A pervasive pattern of instability of interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
  1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-injuring behavior covered in Criterion 5
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
  4. Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse,reckless driving). Note: Do not include suicidal or self-injuring behavior covered in Criterion 5
  5. Recurrent suicidal behavior, gestures, threats or self-injuring behavior such as cutting, interfering with the healing of scars (excoriation) or picking at oneself.
  6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).
  7. Chronic feelings of emptiness
  8. Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  9. Transient, stress-related paranoid ideation, delusions or severe dissociative symptoms

Schizotypal Personality Disorder

It is characterized as:

A disorder characterized by eccentric behaviour and anomalies of thinking and affect which resemble those seen in schizophrenia, though no definite and characteristic schizophrenic anomalies have occurred at any stage. There is no dominant or typical disturbance, but any of the following may be present:
  • Inappropriate or constricted affect (the individual appears cold and aloof);
  • Behaviour or appearance that is odd, eccentric, or peculiar;
  • Poor rapport with others and a tendency to social withdrawal;
  • Odd beliefs or magical thinking, influencing behaviour and inconsistent with subcultural norms;
  • Suspiciousness or paranoid ideas;
  • Obsessive ruminations without inner resistance, often with dysmorphophobic, sexual or aggressive contents;
  • Unusual perceptual experiences including somatosensory (bodily) or other illusions, depersonalization or derealization;
  • Vague, circumstantial, metaphorical, overelaborate, or stereotyped thinking, manifested by odd speech or in other ways, without gross incoherence;
  • Occasional transient quasi-psychotic episodes with intense illusions, auditory or other hallucinations, and delusion-like ideas, usually occurring without external provocation.

PEOPLE WITH AUTISM DO HAVE PERSONALITIES

These had a great impact on my overall functioning and it took over two years to bring the “volume” down on these aspects of my personality to levels of “normality”.

The first issue I want to address is within the autism community? I want to healthily challenge people who do not think (or acknowledged) that firstly personality types exist with people on the spectrum and secondly if they do what are they? And thirdly do you think you have ever had any personality disorders either yourself? Or in a loved on? If so what helped?

COLOUR MY PERSONALITY 

To acknowledge personality types is not constricting it is in fact the opposite the world is an can be a colourful place and differing personality types are part of the package for everybody.

Paul Isaacs 2016


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Autism & Personality Disorders – A Personal Perspective

Compasition Photos17Note: this is from a personal perspective and doesn’t represent all people on autism spectrum

Personality Disorders & Autism

Yes they can co-occur and yes it does happen, personality disorders and autism these are types/trait which are “extreme” and “disordered” versions of “normal” personality type this can happen for variety of different reasons an environmental trigger, isolation and alienation, victimisation or genetic predisposition to having such extremes but is idiopathic in nature. (these can happen to ANYONE).

I Have “Been There”

I am a person who has “been there” in terms of personality disorders and it was during my early 2os, at this time I was being bullied at my workplace and into between hanging on there and leaving (which I did soon enough) it was a mixture of additional mental health conditions, unipolar depression, mood disorder (low mood dysthoria), self harming and suicidal ideation.

1. Schizotypal Personality Disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association, 1994, pg. 645) describes Schizotypal Personality Disorder as a pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  • ideas of reference (excluding delusions of reference);
  • odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations);
  • unusual perceptual experiences, including bodily illusions;
  • odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped);
  • suspiciousness or paranoid ideation;
  • inappropriate or constricted affect;
  • behavior or appearance that is odd, eccentric, or peculiar;
  • lack of close friends or confidants other than first-degree relatives;
  • excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self.

2. Borderline Personality Disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association, 1994, pg. 654) describes Borderline Personality Disorder as a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  • frantic efforts to avoid real or imagined abandonment;
  • a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation;
  • identity disturbance: markedly and persistently unstable self-image or sense of self;
  • impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating);
  • recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior;
  • affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days);
  • chronic feelings of emptiness;
  • inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights);
  • transient, stress-related paranoid ideation or severe dissociative symptoms.

What Are YOUR Personality Types?

When you look at these two sets of personality disorders from a person perspective they at both ends of the spectrum with one being marked by non-conformity and the other a sub-conscious wanting  how did I get through this ? Firstly knowledge – understanding my autism “fruit salad” meant looking at the whole package and that included personality types of which I have 4 these two above in there “normal” variants are 1. idiosyncratic and 2. mercurial balanced and have bettered my functioning along with my tinted lenses for visual perceptual disorders for example.

It Can Be Apart Of The “Bigger Picture”

By picking these aspects of functioning I think is important when looking at an autism diagnosis could be that undiagnosed or unrecognised personality disorders could hinder functioning of a person but could be just be thought as “the autism”. For me dissociation, suicidal ideation, interpersonal issues (compacted by the pds), auditory hallucinations and psychosis were the tip of the iceberg not only in my “autism fruit” salad at the point but also the development of my identity and personality as a whole.

Trying Introspection

I have learnt over time to take control and autonomy of my emotions despite having problems with mentalising and alexithymia, I have learnt to not be too intense with people I like and if sense that I am back away and “turn the volume down”, I have learnt the importance of autonomy and not fearing aloneness chronically, I have learnt and accepted that dissociation and being “borderline” gives my problems with “self identity” along with other issues such as “self and other” processing, alexithymia, visual perception, I have learnt that being “odd” means that something is up and I need focus of getting grounded again. I have learnt that overall with all the interacting pieces I know of that balance is the place to be that is message of hope.

Last Question

I challenge politely people on autism spectrum who think that autism is “all of them” with so many interwoven personality types in human beings would it really make sense for autism to be “all of the person?” considering autism is made up of pre-existing conditions anyway? I wonder in the future will they diagnose or recognise personality types in people on the autism spectrum? I certainly think that would beneficial.

Paul Isaacs 2016


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Autism & When “Special Interests” Go Wrong

There are many inconclusive stereotypes around the autism spectrum and one of them is a the all people on the autism spectrum have an “intense special interest” I have been working in the field of autism for over six years and I have met many folks who do not have a “special interest” of acute intensity nor want to.

“Special Interests”

If one can conceive a special interest then may be we could be looking at accompanying personality traits and types that would make someone have such a hyper-focus. The first is Obsessive-Compulsive Personality Disorder in which the person  has a intense devotion to work, perfectionism and rigidity. They could be also have that as a secondary to Schizoid Personality disorder in which the person is apathetic, secretive and distant.

Personality Types & Differing Profiles

To deny that “disordered extremes” of personality types can co-exist and interact with an “autism” or “asperger’s” profile is not helpful, it firstly  doesn’t benefit the person in question and secondly the premise should not be that “oh that’s the autism”.

Therefore giving the interest a green light and thus scapegoating that such behaviour is acceptable to demonstrate and carry out with such an intensity that may well have a negative impact on themselves and other they come into contact with.

No It Isn’t Just The “Autism”

So when can their “special interests” go wrong from a personal experience I can tell you, when someone you once did trust downloads information to you about satanism, the occult and the disturbing rituals that go with for over an hour, and you have to process what you have just heard (which for me is a significant delay), when my emotional perception has reached its emotional peak years after the incident, when people dismissed and didn’t acknowledge my trauma, depression, nightmares and suicidal ideatation and saw the incident as just someone’s “autism” and I should “get over it”. Then I question this on a personal an professional level.

Paul Isaacs 2016