Truth be told, I am Autistic …
At age 56 and 20 years of clinical practice, I was inspired by a client’s courage to engage in a full battery of Psychological Testing (at my request) to get a broader and more evidenced-based perspective on their unique set of diagnoses. This particular client’s clinical documentation declared: BiPolar, manic; BPD; Schizophrenic; ADHD; Substance Use Disorder. Yet every time we met for a session the puzzle pieces provided did not match up with the individual before me week after week.
Knowing the value of Psychological Testing I sold them on the idea. When we read the report we both cried, High Functioning Asperger’s. No wonder some of his medications never worked, the self-medication with substances, the repeated self-harm (since age 3), the exacerbation of ADHD to a manic frenzied binge. We cried some more. We re-wrote the Treatment Plan to accurately reflect triggers for anxiety, depression, daily suicide ideation, self-harm, substance use, intense bouts of emotional dysregulation. We made a lot of phone calls. We got the medication adjusted. We engaged in a higher level of care via a community-based program. In my mind, I heard me say, this looks all too familiar, this profile looks a lot like me. So, I went and got tested myself.
Yes, I am part of the “lost generation” who did not get the support, understanding, accommodations that are available today. I was bullied. It was violent. And yet, like many of the “high functioning Asperger’s” tribe finished graduate school, have a full-time job, relationship issues per usual for ASD adults, car payments. Our reality, our daily life is a mixed bag of exhilarated by our passions for computers, arts n crafts, animals, human rights, the environment and bouts of debilitating anxiety, perhaps OCD, bouts of debilitating depression, perhaps PTSD and/or grief reflecting many types of loss over our lifetime. History has shown that we are some of the most amazing people and as Temple Grandin put it “we’d still be in caves.”
I enjoy working with “my peeps”. I utilize a variety of clinical and social media resources to structure our work together. Most ASD adults already have a few good life “hacks”. My task is often to tweak those and add a few more to the toolbox. My go too, more often than not, is Nonviolent Communication.
What is NVC? A communication process developed by Dr. Marshall Rosenberg Ph.D. beginning in the 1960s as “A Way to Focus Attention”. Dr. Rosenberg studio with Carl Young, who crafted Person-Centered Therapy. Dr. Rosenberg was also well versed in Cognitive Behavioral Therapy. NVC is a technique for more clear, empathic, non-judgmental communications proceeding through four areas of focus: observations, feelings, needs, and requests. NVC is taught as a process of communication to improve compassionate connection – to speak and hear what is alive in the other and within ourselves = self-empathy.
You might ask why is NVC relevant to our ASD community:
- NVC provides a “black n white” sequence, to facilitate real connections with practice;
- ASD folk – you and me – find ease, connect more easily, “black n white”, clear exchanges create ease request and receive something we need while living out our lives and ways to consider meeting the expressed needs of each other. It keeps our community safe and satisfying. The practice allows us to increase our capacity for compassion and then share this through wholehearted living.
- Facilitates setting boundaries so that we can live in our integrity “B.I.G. What boundaries do I need to put in place so I can work from a place of integrity and extend the most generous interpretations of the intentions, words, and actions of others” Dr. B. Brown, LCSW, Ph.D.
- “In traffic” how to stay in my lane – empathy to drive in different traffic patterns
- ASD folk often have difficulty understanding the behavior of others – their motivation seems odd or unclear, leaving us feeling … odd, weird, an outsider …
- This tool (questions for self and other person in conversation) can help us identify what emotions are engaged based on data … what need(s) are being met or not met.
The “treatment plan” might look like this:
–Increase personal autonomy – as evidenced by (AEB) increase the ability to “own” message; make observations without making inferences; recognize and verbally report feelings; identify the reason for feelings in terms of “because wants”; express wants in actions terms; ground thoughts and anecdotes in present feelings and wants.
-Increase awareness of Interdependence: impact AEB “ability to receive wants as wants and not as demands, obligations, or duties”; “ability to receive feelings and wants as feelings and wants and not as personal praise or criticism”; and “ability to receive feelings and wants without evaluating the accuracy, morality or competence of the speaker”
-Increase competency regarding conflict resolution “through generating want-oriented alternatives” AEB – increasing “ability to generate alternatives in time, person, place and action dimensions” and “ability to differentiate protective and educational force from the punitive force”
-Increase personal sense of self-empathy and empathy for others –AEB learns and practices Nonviolent Communication Model – “observation”, “feelings”, “needs” and “request” as formulated in Nonviolent Communication: A language for Life by Dr. Marshall Rosenberg PsyD.
Other resources to consider:
Dr. Stephen Porges’ work with our Polyvagal Nervous System;
Holly Bridges’ Reframe Your Thinking Around Autism (“cliff notes” of Dr. Porges’ work)
Dr. Charlotte Kasl’s work 16-Steps to Empowerment;