On Consent

There have been several times where I have noticed that children with high-functioning autism have a difficult time stopping what they are doing when someone withdraws their consent.

Let’s say that an autistic child is playing around with another child. Let’s say they are wrestling around, and the autistic child is on top of the other child, and the other child is yelling for him to get off. I have noticed that it usually requires a third party to get the autistic child to stop what they are doing, or for the other child to actually resort to physically pushing him off or even hitting him to get him to stop.

After noticing it in other autistic children, I noticed it in my own son. Daniel doesn’t know when to take “No” for an answer, that when people tell him to stop doing something, he should stop doing it. He doesn’t seem to hear the person refusing or withdrawing their consent. As a consequence, I have been making  a particular effort to help him understand that you always need the other person’s consent if you’re going to do something with them. This may include something as simple as having a conversation, but it may involve play as well. And, when he gets much older, it will definitely have to include sex, to say the least. The last thing anyone wants is for their child to make that mistake.

The good news is that after only two weeks of talking to Daniel about consent and not continuing to do things after he was asked to stop doing them, this morning on the drive to school his sister asked him to stop making some noise he was making, and he actually stopped, saying, “OK. I’ll stop.” I immediately thanked him for doing so.

When I was a child, my mother would often accuse me of being “argumentative and aggravative.” I think to a great extent those two tendencies–which I have found to be not uncommon among autistics–are part of that issue of consent. Someone who is aggravating another is continuing to do what they are doing beyond the point where the person has asked the person to stop. The one doing the aggravating may not stop because they are trying to annoy the other on purpose, or they may not stop because the request just isn’t registering properly. If it’s the latter case, you can teach the person that when people ask you to stop, the rule is that you stop.

There are perhaps few lessons as important as this one to teach, whether your child is autistic or not.

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Is ADHD Really Anxiety?

There are a few traits that are almost completely co-morbid with autism: chronic anxiety and ADD/ADHD. If you have autism, you have anxiety and attention problems.

Autism, though, isn’t the only thing where anxiety and attention problems are co-morbid. The same is true of post-traumatic stress disorder (PTSD). When you have PTSD, you are in a state of constant anxiety and constant hyper-vigilance. Hyper-vigilance means you are constantly actively keeping close tabs on the environment. Your attention is drawn to every little thing, to anything you catch out of the corner of your eye.

This hyper-vigilance sounds an awful lot like ADD/ADHD. Hyper-vigilance is actually how I would describe my ADD. It’s not that I have a hard time paying attention–rather, I have a hard time not paying attention to literally everything around me. To the person I’m directly in front of, it’s going to appear that I am having a hard time paying them attention, though.

If we understand ADD/ADHD as hyper-vigilance, this could then easily explain why many with ADD/ADHD can pay close attention to video games, for example. After all, many video games simulate conditions in which hyper-vigilance is needed to succeed.

Obsessive focus on an area of interest could also be understood as hyper-vigilance. Hyper-vigilance will also require hyper-focus if and when the “danger” is located. When there is no actual danger, that hyper-focus could manifest itself in a variety of other ways, including obsessive interests.

Hyper-vigilance comes out of anxiety, and we autistics are full of anxiety. In our case, the anxiety stems from our constantly being bombarded by sensory input. We’re overstimulated, and oftentimes that stimulation doesn’t get integrated well. It should not be surprising if an intense environment should result in hyper-vigilance within that environment. Anxiety is the intermediary.

While I myself do not use any kind of medication, and we do not use medication on our son, I do understand why some might want to medicate themselves or their children. The typical medication is for ADD/ADHD–things like Ritalin–because that’s the most problematic behavior. However, if my suspicions are correct, we are very much treating the symptoms of anxiety rather than dealing with the deeper cause–the anxiety itself.

Since we cannot rewire the brain, we cannot treat the ultimate cause (and we with autism probably wouldn’t want to do that, anyway, since that wiring is part of who we are as human beings), but anti-anxiety medications may go a long way toward eliminating at least the co-morbidity of ADD/ADHD. They would also likely alleviate some of our social issues, which stem from that anxiety.

The general rise in ADD/ADHD and the high prevalence of it in the U.S. can, I believe, based on this thesis, be traced to the fact that our school system is making our children far more anxious than ever before. But that’s a whole other set of issues. I will say, though, that rather than putting more children on Ritalin and related drugs or anti-anxiety medications, perhaps if our schools treated students as ends in themselves rather than as means to achieve testing outcomes to make administrators look good and justify their 6-digit salaries, there wouldn’t be nearly as many children with ADD/ADHD.

Autistic Masking

A recent trend I have seen on Twitter among autistics there involved opposition to “autistic masking.” Not all autistics can mask, but many if not most can. And that creates a number of problems for us.

I’m honestly a little torn on this issue, because on the one hand, I realize that literally everyone “masks”–you are a spouse, a parent, a friend, a child, an employee or employer, and there may be remarkably little overlap among those personas you present–and on the other hand, autistics both have to mask a lot more (like stimming), and masking is much more exhausting for us than it is for neurotypicals.

Over time, though, a lot of masking just becomes second nature. Sometimes you mask without even realizing it. For example, recently Daniel started engaging in palilalia. It was only recently that I realized palilalia was something I also did–only, I did it silently, in my head. I don’t see any particular benefit to my “unmasking” my palilalia. I’m still doing it–silently, in my head–and all it would do would be to cause unnecessary stress on others for me to do it out loud.

There are a lot of things people keep to themselves. People self-censor all the time. It’s called being polite. It’s called having good manners. You learn good manners. It’s not something anyone is born with. It’s a form of masking, and it’s a form of masking that makes you a better person over time.

However, the last century has seen a rise in what I would call the “cult of authenticity.” Everyone seems to think–or at least say they think–that people ought to be more “authentic,” that they need to be their “authentic selves.” I say that’s nonsense. I don’t want people to be their authentic selves. I want them to be better, nicer, kinder, more generous than their authentic selves–even if their authentic selves are good, nice, kind, and generous. The cult of authenticity has ruined art, poetry, relationships, and general civility. Rather than expecting everyone to rise up to greater heights, we want everyone to wallow in the shallows of their “authentic” selves.

At the same time, I can understand why many autistics are truly tired of masking. Masking is, for us, a great effort and, even when well-performed, prone to breaking down. Masking for neurotypicals is easy and relatively effortless. Masks can change in less than a moment. This is hardly the case for autistics. We have to always think about what it is that the person in front of us wants to see from us. And heaven help us if the situation changes and the mask has to change. Worse, we have to mask things that others don’t have to mask. Neurotypicals are sincerely interested in other people and stories about others people, while very often we autistics aren’t. But we know it’s important to others to talk about those thing, so we feign interest. Also, if we are allowing a lot of back-and-forth in conversation, you may rest assured that it’s only because we are artificially cutting ourselves off despite having so much more to say. This, too, is a form of masking.

I suppose the real problem with masking is that while presumably neurotypicals do get times when they can be their “authentic selves” around certain people, we too often feel like we can never be ourselves–even around friends and family. When can I stim without feeling self-conscious about it? (Of course, I also rarely stim when I’m fully comfortable, so I suppose wanting both is contradictory in nature, at least for me.) When can I just talk and talk and talk about what interests me? I pretty much never get that opportunity, and I find myself less and less able to have conversations about my interests that go on for as long as I want them to go on (ah, the beauty of grad school in allowing such conversations!).

I often put up with people touching my wrists (which makes me want to crawl out of my skin), and I have to wear suits and long-sleeve shirts (remember my wrists?) in certain situations. I’ve had to get over being interrupted when I work so that I’m not biting people’s heads off. Even then, I really haven’t “gotten over” the intense irritation I get at being interrupted when I’m working on something, especially my writing. Rather, I mask it, taking a moment to calmly move out of the zone and into a space where I can converse. But let me ask you: should I have just kept biting people’s heads off, or should I have masked that reaction? I think we should probably all agree on the answer to that.

Living in the world means masking. This is true for all people. However, it’s harder for us autistics. And we’re rarely if ever given the opportunity to truly be ourselves. Which only makes it harder. Which is no doubt why there is this movement against masking. We have been pressured into always-masking (and always doing so poorly), and many have gotten sick and tired of it. The answer, for them, is to demand from everyone that we be allowed to never mask anymore. I think there are rhetorical benefits to that approach insofar as it draws attention to what we have to do to get along (and even then, not enough)–especially if it can draw attention to the fact that masking, because it’s so hard for us, actually harms us not only through mental exhaustion, but from people reacting so poorly to when the mask starts to crack. We need people to realize what we’re doing and how it can harm us. But, truth be told, we’ll never be able to stop masking. It’s simply part of being human.

Oxytocin and Autism II

Oxytocin is an important neurotransmitter, and one which has been implicated in autistic behaviors. Known as the “love hormone,” there’s a lot more to it than that. According to Psychology Today,

It regulates social interaction and sexual reproduction, playing a role in behaviors from maternal-infant bonding and milk release to empathy, generosity, and orgasm. When we hug or kiss a loved one, oxytocin levels increase; hence, oxytocin is often called “the love hormone.” In fact, the hormone plays a huge role in all pair bonding. The hormone is greatly stimulated during sex, birth, and breastfeeding. Oxytocin is the hormone that underlies trust. It is also an antidote to depressive feelings.

As I have noted before, oxytocin has a dark side, meaning low levels of oxytocin not only reduce one’s desires for social interaction, but also reduces the tendency to engage in “groupthink,” the worst versions of which are racism and sexism. To the extent that autistics don’t engage in in-group/out-group thinking, we have a general tendency to not engage in racism and sexism.

However, do note many of the behaviors noted above. I suspect that it’s not just any empathy that’s affected by lower levels of oxytocin, but the specific kind autistics have problems with. Coincidentally, the kind of empathy we autistics have problems with is the same empathy that actually makes people favor their in-groups over out-groups and thus can make people behave in racist and less moral ways.

Also note that oxytocin is as much the sex molecule as the love molecule. I have read that many autistics have little to no interest in sex. While that’s certainly not universal (I’m sure other hormones, etc. are involved and affect sex drive as well), it seems to be much more common among autistics than neurotypicals. Low levels of oxytocin would explain this phenomenon. Ironically, since having sex increases oxytocin levels, those who lack interest in sex due to low oxytocin levels are behaving in such a way as to maintain low oxytocin levels.

The connection to trust is a bit odd to me, as I find autistics to be generally quite trusting. However, it may make sense if trust is tied to in-group members, and distrust to out-group members. Without that distinction, it may be that we are simply more trusting of out-group members, and thus we seem more trusting overall.

Here is an interesting overview of the research to day on the connection between oxytocin and autism. I have also written about the connection between touch and increasing oxytocin levels in a post titled Hugs Help.

The Mesolimbic Reward Pathway

The mesolimbic reward pathway is a neural system that helps people be more social. The larger it is, the most social a person is. Perhaps not surprisingly, it’s smaller in people with autism.

What this pathway seems to do is make social interactions pleasurable. Again, the larger it is, the more pleasurable one’s social interactions are going to be. That is, you get rewarded for being social. While it’s likely social interactions aren’t actually made painful by having a smaller pathway, social interactions simply aren’t as pleasurable. If you’re not being rewarded for something, how likely are you to do it?

The authors point out that they haven’t untangled cause and effect quite yet on this. Do more social interactions cause the mesolimbic reward pathway to increase, or does its size increase social interactions?

This makes me wonder, though, why it is that many of us on the spectrum find pleasure in certain things–more so, it seems, than do others? For example, my clipboard gives me pleasure. I use it to do most of my writing. My books give me pleasure. I’m very happy just looking at them in my library. Is there a pathway in the brain for object-pleasure? Or does the mesolimbic reward pathway make social interactions so much more pleasurable that neuroptyicals prefer social interactions over the pleasure things give them?

Autistics Helping Autistics

Medical Express has a piece on an autistic man, Kyle Barton, who lives in the Plano area and who attended UTD who has had a hard time finding a job. The title of the piece is Man with Autism Helps Design Virtual World to Make Life Better for Adults like Him. The entire thing is well worth reading, and I don’t want to summarize it. The article not only discusses his project, but goes into the struggles he’s had finding a job.

I certainly understand that struggle. Barton certainly should not be unemployed. He is a graduate of UT-Dallas and, very obviously, very intelligent. And yet, he’s struggled to find work. I have a Ph.D. from UT-Dallas, and yet the only work I’ve managed to get have been adjunct professor jobs, and temporary and part time work. I’m incredibly thankful I now have a full time job, but it’s as a paraprofessional (don’t get me wrong, I love the work I’ll be doing, but I should be making far more given my education and abilities).

While I do hope that Barton’s work will help many autistics navigate the world better and, hopefully, find and keep work, there’s a certain absurdity to someone like him or me having trouble finding employment. We seem to mostly be guilty of being socially awkward, spending too much time working at work, being too creative, and treating too many people as equals. The fact is that most people are completely intolerant of any real differences in thinking and behavior and only tolerate superficial differences.

 

Autistics vs. Socipaths

I want to make a bold proposition: the polar opposite of the autistic is the sociopath.

The autistic is internally chaotic and thus attempts to order the world–we seek order and seek to create order. That’s why young autistics in particular love to line things up (or make lists, as I did, which is really the same thing). It’s why we love structure in our lives and prefer for things to be predictable. Chaos added to chaos is just too much.

The sociopath is internally overly-ordered and thus attempts to bring chaos to the world–they seek chaos and seek to create chaos. They are extreme risk-takers and thrill-seekers. In its healthiest forms, they may climb mountains; in its unhealthiest forms, they may be serial killers. (Of course, not all thrill-seekers are sociopaths, though we do know that thrill-seekers do need more stimulation than does the average person.)

Each is seeking to balance order and disorder, as all of nature, from the level of quantum physics up through living things, human psychology, and human societies, does. When the internal world isn’t both ordered and disordered simultaneously, but is imbalanced in one direction or the other, balance in the external world is sought.

We do not have the sociopathic equivalent of the severe autistic because while too much chaos can make one unresponsive, too much order won’t have the same effect.

If my thesis is true, the sociopathic brain should be dominated by negative feedback (too much glutamine, too few synapses, etc.) and thus need stimulation (challenges). Challenges require strategies, so we should expect sociopathic people to be more strategic. We would also expect them to be more “social” and more outgoing and charming as a result. As a result, sociopaths both tend to be attracted to positions of power, and people tend to reward them by giving them power. You will find an extremely high percentage of politicians and CEOs to be sociopaths (though sociopathic CEOs also tend to be the least effective because of their tendency to take risks and not actually care about anyone else).

The autistic brain seems to be dominated by positive feedback (too much glutamate, too many synapses, etc.) and thus need a more calming atmosphere (which is why challenges can frustrate autistics). Autistics don’t seem to be particularly good at strategy, but tend to be creative problem solvers (mostly to try to order everything). They would then also be more likely to be introverts and anti-social, though this primarily comes about because we’re perceived as “socially awkward” by neurotypicals.