Coach for Asperger's

Asperger’s and Sex: A Conversation

Noted added 4/11/10. This blog has moved! I'll be leaving this older blog up for a while, but updated posts will be on my new blog. For more info on sex and relationships, as well as lots of book reviews, professional and personal resources for individuals of all ages with Asperger's, autism, ADHD and ASDs, please check my new blog, Thrive on the Autism Spectrum. 

In an effort to keep this blog fresh and informative, I’m starting a new feature today. Periodically, I’ll be posting a “conversation” with other individuals who I think may be of interest to adults with Asperger’s and autism. If you’d like to contribute to a future conversation, please email me at patricia@patriciarobinsonmft.com. Maybe I can interview you on this blog next!

Sex is a topic that isn't frequently discussed in connection to Asperger's Syndrome. There are a few books and several websites, but in general, I think sex is often an issue that gets overlooked. In the book Asperger’s From the Inside Out, author Michael John Carley discusses how issues around sex can be difficult for many adults with Asperger’s. (p. 110) Sensory issues, inadequate sex education, and difficulties with social skills can all contribute to problems in establishing and maintaining a healthy adult sex life. Therefore, I thought this topic would be a good place to turn to an expert.

Today I’m conversing with Isadora Alman, a Board certified sexologist and a California licensed psychotherapist and counselor. She’s the author of "Ask Isadora," a syndicated advice column on sex and relationships, which appears in newsweeklies nationwide, as well as the Sexuality Forum website.

Patricia Robinson: For starters, can you please explain exactly what a Board certified sexologist is, and how they work with clients?

Isadora Alman: As you know, the state of California licenses people helpers of several sorts: psychologists, social workers, and marriage and family therapists.  All have their areas of expertise in people helping.  There is no licensing for those who make sexuality their specialty so there are several professional organizations such as the American Association of Sex Educators, Counselors and Therapists and The American Board of Sexology who review the professional experience and expertise of those who do specialize and give them certification.

A sex therapist or a sexologist (one who studies sexuality) will be knowledgeable in relationships and in sexuality because one generally takes place within the context of the other.  I might work with clients who have little or no sexual knowledge or experience, making referrals and offering resources to gain know-how and confidence.  If a client's sexual expression is not as satisfying as it might be, I will work with him or her in making suggestions to improve knowledge and skill.  And, since communication is a very important part of finding a partner and enjoying sexual expression, I will also help with that.

Patricia Robinson: I think lack of sexual experience and lack of confidence can be common issues for adults on the autism spectrum, maybe those who didn't get to experience dating and relationships when they were younger. How would you help a client who feels less experienced than peers?

Isadora Alman: For social skills I don't think there's anything better than a mixed (men and women) support or therapy group.  There's is almost always one nearby anywhere in the Bay Area.  There one can get information, support and feedback from others without going on an actual "date" until s/he is ready.

In matters of sexuality I strongly recommend educational explicit films put out by folks like the Sinclair Institute that show and teach all manner of sexual expression.  I recommend a massage course to learn how to touch and be touched.  I recommend weekend workshops such as the Human Awareness Institute's "Love, Sex & Intimacy".  If a client would like, I can also make a referral to a sexual surrogate partner of either sex to learn hands on skills.

Patricia Robinson: There is so much information on sex on the Internet, and there are many different types of people to work with. (Therapists, medical doctors, sexologists, surrogate partners.) How can my readers be sure that they're getting good, educational and ethical information and help, and not just wandering into a misleading or exploitive situation?

Isadora Alman: The Internet is full of misinformation, it's true. Anyone can post anything. Unfortunately, there also exist people with degrees who may act unethically or have their own agendas, but usually membership in an accredited institution such as the American Medical Association or the American Association of Sex Educators, Counselors and Therapists is a fairly reliable endorsement.  The very best endorsement is a referral from someone you know and trust who has used that person's services before.  Ask around.  Ask other professionals you trust to recommend someone. Sometimes the same name comes up as a resource from several sources.  That's a good indication that this person is respected in his or her field.

Patricia Robinson: Isadora, thanks so much for talking to me on this topic. I’m sure this is an article that will be useful to many of my readers.

 

Book Review: Life and Love: Positive Strategies for Autistic Adults, by Zosia Zaks

Zosia Zaks has written a number of insightful and informative pieces on the topics of autism and Asperger’s, and you can find some of her work on the GRASP website, as well as in Autism Asperger’s Digest magazine. Recently, I wrote about her essay on empathy in my blog Social Skills for Kids, which I write to parents of children on the autism spectrum. Her most comprehensive work to date is the book Life and Love: Positive Strategies for Autistic Adults (2006, Autism Asperger Publishing Co.).

Life and Love: Positive Strategies for Autistic Adults is an insider’s guide to many aspects of life on the autism spectrum. Zosia Zaks has a master’s degree in Technical Journalism, and, like many adults with Asperger’s Syndrome, was not diagnosed with Asperger’s until the age of 31. In the first half of the book, entitled, "Life", Zaks takes on concrete and straightforward topics such as the practicalities of managing sensory issues, household chores, shopping, travel and healthcare. From her insider perspective, the author gives step by step instructions and detailed tips for a number of situations, like putting together a sensory emergency kit of items such as sunglasses and headphones, or sample schedules for managing clutter and organizing the home. This is the kind of practical, step-by-step information that will be useful for those who are struggling with the details of daily life. There’s also some brief but concrete and specific advice for attaining career success, including choosing an appropriate job and managing social issues at the office.

The second half of the book, entitled, "Love", is where Zaks shows her full range as a writer and the book really comes to life. The "Love" section of the book focuses on relationships, from friendship, to dating, to committed partnerships. Zaks skillfully shifts back and forth from abstract concepts, such as falling in love, to concrete tools like defining acceptable and unacceptable behaviors. The author continues to write in a practical and useful manner, but she discusses more emotional topics, like dealing with conflict, social isolation and the very real differences of life for males and females on the autistic spectrum.

There are also sections on internet dating, relationships with non-spectrum partners, and the different levels of friendships. This section also includes extensive materials on how individuals can keep safe while interacting with others, and a discussion of the pros and cons of disclosing an autism diagnosis.

I recommend this book to those on the autism spectrum and to those who care about someone on the spectrum. The first half of the book can function as an ongoing, practical reference, almost like an instruction book for adult living. The second half is much more, something to read and consider, and a way to deepen your understanding of relationships, whether you’re on or off the autism spectrum.

Getting a Diagnosis as an Adult with Asperger’s

Note: Added 11/3/10. This blog has moved! I'll be leaving the old blog up for a while, but updated posts will be on my new blog. For more info on this topic, as well as lots of book reviews, professional and personal resources for individuals of all ages with Asperger's, autism, ADHD and ASDs, please check my new blog, Thrive on the Autism Spectrum.

Is it worthwhile undergoing diagnostic testing if you’re an adult and you suspect that you have Asperger’s? That’s a question that seems to come up frequently. There are pros and cons and no answer is right for everyone. But, it can be helpful to look at the experiences of others.

Last month (September-October 2008), Autism Asperger’s Digest Magazine published an article entitled "Better Late Than Never", by Douglas Hogetvedt. The author was diagnosed with Asperger’s at the age of 49, and he writes about his experience with later life diagnosis. Some of the points he raises are that with the diagnosis his life “finally made sense.” He discusses how his diagnosis helps him understand his past, and makes him feel energized about his future. Hogetvedt did a lot of his own research through books and online before getting a formal diagnosis from a psychologist. He also talks about how difficult it was to find a professional who works with adults on the autism spectrum.

In the memoir Look Me In the Eye: My Life With Asperger’s, author John Elder Robison, discusses his own diagnosis at the age of 40. Like Douglas Hogetvedt, Robison first considered his own condition after learning about Asperger’s from a friend. Robison was given the book Asperger’s Syndrome, by Tony Attwood. He describes reading the book and experiencing relief that there were others like him. “All my life, I had felt like I didn’t fit in. I had always felt like a fraud or, even worse, a sociopath waiting to be found out.” (p. 238) Robison questions how his life might have been different if he’d had the knowledge earlier, and how he missed opportunities for relationships and education. He discusses how the diagnosis helps him feel that his knowledge and abilities are both rare and legitimate.

The other interesting point is how Robison used his knowledge of Asperger’s to understand the neurotypical world, and how he started making some conscious efforts to behave differently. He states that those changes resulted in getting different reactions from those around him. He defines this as moving from “being weird to being eccentric” (p. 240)  and that the confidence his diagnosis gave him helped him to make friends. Robison also makes the point that he’s not defective, and that his Asperger’s traits contribute to his strengths.

The Complete Guide to Asperger’s Syndrome, by Tony Attwood (p. 29) has a long discussion of the pros and cons of diagnosis for both children and adults. It’s too lengthy to summarize here, but certainly worth checking out. Attwood gives mostly positives of diagnosis, but has a few cautions as well.

So how do you get a diagnosis if you want one? The ideal is to find a psychologist who specializes in autism and Asperger’s and who works with adults. Some medical doctors are very familiar with the diagnosis, others don’t have much experience in testing or with Asperger’s. There is no blood test or simple, universal method to test for Asperger's, so the experience of the professional is important. If you’re just looking to get some understanding of yourself, and you don’t want a formal evaluation, you can start with the scales published by Simon Baron-Cohen. The Essential Difference: Male and Female Brains and the Truth About Autism (2003) has a range of self tests in the appendix that you can take before seeking professional advice.

(As a final point, I’ll end by stating that I am not giving medical advice. Please seek professional advice if you have concerns about medical issues.)

Strengths of Asperger’s: Genius and Intellectual Gifts

Check out the latest autism article in the UK’s TimesOnline: Autism genes can add up to genius: Intellectual gifts and certain brain disorders are closely related, by Jonathan Leake. Leake discusses a Cambridge University study by Simon Baron-Cohen which studied mathematicians and their siblings and found a much higher rate of autism among them than in the rest of the population.  Baron-Cohen stated,  “It seems clear that genes play a significant role in the causes of autism and that those genes are also linked to certain intellectual skills.” This new study seems to agree with some of Baron-Cohen’s earlier work, where he found, “Separate studies have shown that the fathers and grandfathers of children with autism are twice as likely to work in engineering. Science students also have more relatives with autism than those in the humanities.”

In the article, Leake also discusses a study by Patricia Howlin, of the Institute of Psychiatry at King’s College London, which found 39 of 137 people with autism possessed an “exceptional mental skills, such as memory.”

Thanks to the Autism Hub blog LeftBrainRightBrain for pointing me in the direction of this article.

More Tips for Managing Small Talk in the Office

Last week I talked about tip 1 if you want to play the small talk game: You Can Keep It Short, But Say Something. This week I’m moving on to my next tip:

2. Dealing With “How Are You?”

“How are you?” is an example of a social script that neurotypicals use all the time. Typically, it’s followed by, “Fine, thank you. And you?” That’s answered with “Fine, thanks.” Most of the time, there’s very little variation to this script, other than the slight modifications involving “great” “pretty good” “hangin’ in there” or for the particularly upbeat “fabulous!”

I think most people learn to follow this script at a young age, although it’s rarely used by kids to each other. But the question is, when do you follow the script, and when are you expected to actually answer the question?

Nonverbal cues give the answer. The problem is that the question can be either a greeting or a true request for information. As a greeting, it’s essentially the same as saying, “Hello.” The person who starts the script will often be walking toward you, and they won’t really slow much, or will even continue talking after asking the question. If you’re getting these signals that the answer is not of much interest, then it’s fine to just follow the script. If you don’t know the person other than to say thanks when they hand you the bag of groceries, the scripted answer is expected.

What are the signs that the questioner really cares about the answer? Well, he or she will often do one of these things:

• Attempt steady eye contact.
• State the question with more emphasis.
• State the question more slowly.
• Stop walking or slow down.
• Continue to sit silently after asking.

These are just some of the cues that a real answer is expected. Circumstances make a difference too. If you’re hobbling around on new crutches, just got back from a family funeral, or just won the lottery, the questioner may know that and be asking for greater detail.

In any case, you’re probably safe keeping the initial answer fairly short and positive. If your listener interrupts, looks away or over your shoulder, or even starts to walk again, these are signs the conversation has gone on long enough. And of course, your closer friends will want longer and more honest answers.

As I read blog posts and have conversations with people on the autism spectrum, I continually hear the question, “Why don’t neurotypicals just say what they mean?” It’s true, we don’t and I think I’ll feel embarrassingly shallow next time I ask, “How are you?”

Adults with Asperger’s: How to Manage Eye Contact

Please check out my new article Adults With Asperger's: How To Manage Eye Contact. It can be found on ezinearticles.com. I've also got a number of other articles on that site on related topics, many written to the parents of kids with Asperger's, autism and ADHD. (On ezinearticles.com I'm Patricia J. Robinson, the Patricia Robinson writing about botox is not me!)