Autistic Spectrum

I work with older adolescents and adults on the autistim spectrum. I utilize DIR (Developmental, Individual based, relational) therapy, as well as Mentalization Based Treatment, and other treatments for autism.  The following is some of the basis for my work.  

We are wired for intersubjective experiences, and we are also wired to be investigative, to seek patterns, and to be curious.  Some infants are more attuned to the intersubjective, and some more interested in objects, and most are in the middle. The ones who aren’t in the middle, who might be far more interested in objects, tend to have more difficulty with coordinating the sensory motor with affects and cognitions, making it hard to communicate.  More recent research indicates that autistic people aren’t dis-interested in the social but develop neurodivergent ways to express social interest.  We might have been looking at neurologically divergent people with a neurotypical frame.  And, more and more, autistic people have contributed tremendously to this discussion.

INTERSUBJECTIVITY

Intersubjective experiences are so important because they allow us to make sense of the world through shared understanding. Shared understanding is generated between individuals before speech through a language of body movement and non-verbal vocalization, expression of feeling and interest made in gestures of movement and voice. It seems to be a pre-wired, built in function of the cortical motor system, and is sometimes referred to as motor resonance. “Intersubjectivity is what renders experience meaningful and allows us to feel alive and real”.  Intersubjective experiences mutually influence the parent/child, therapist/child.  Without more experiences with others, an autistic child can feel un-involved, and isolated.  

PART OF THE PROBLEM

For autistic people, the coordination of the sensory motor, affective and cognitive states are disrupted – different than non-autistic people. There are differences in sensitivity; difficulties with the timing, coordination, and integration of movement and perception, differences in the painfulness of certain stimuli, muscle tone differences, differences in posture(rigid), differences in attention, and differences in bodily coordination during social interactions.

These difficulties lead to an infant who has a hard time taking reaching out, and a marked difficulty engaging and anticipating others. Communicating is difficult. But that doesn’t mean that the infant lacks interest. 

Autistic people often report being fascinated by objects/phenomena as a child.  They could spend hours in rapt attention to, say, weather patterns, construction sites, tractors on a farm.  Intense fascination could also include activities such as speed cubing, or wheel spinning.  And they can be lonely. 

Is it possible that autistic people suffer because less interaction with others leads to loneliness?  Or might they feel overwhelmed by the difference between themselves and others? Or, for some, who’ve been in ill-fitting behavioral treatments feel that they are just performing, and not themselves. 

When I ask autistic people how they see autism in themselves, it is nearly always negative – I’m too picky, I don’t make eye contact. I don’t have any friends.  They don’t see themselves as just different.  They don’t verbalize “I have a deep aesthetic appreciation for things”.  Or “my love of learning is really important”, or” I’m really good at seeing patterns” or I’m good at researching things.  The negative feelings about themselves leave them even less interested willing to engage with others. 

People on the autism spectrum can be helped with high sensitivity and emotions, especially when they can begin to understand what they are feeling and why; then break downs are less likely.  That’s important because too many breakdowns lead to even less engagement.  They can also be helped when the parent or therapist find ways to really engage with the person.  (Autistic children often struggle with a feeling that no one is interested or interesting.)  A parent’s/therapist’s surprising interactions can also help the child feel interested.  Parents and therapists also work with helping the person take more initiative, figure things out more on their own (with support).