Coach for Asperger's

Repetitive Thinking and the Autism Spectrum

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.

One of the most troublesome aspects of autism and Asperger’s can be the tendency toward repetitive thoughts, also referred to as stuck thoughts or ruminations. While this trait is probably tied to the ability toward extreme focus that can be such a strength for those on the spectrum, it’s a problem when individuals can’t shift away from thinking about things that are not of their choosing. Often, individuals get caught up in worries, dwelling on past slights from others or their own mistakes or have problems letting go of past traumas.

Frequently, people will refer to this issue with the term “obsession”, but I don’t like to use obsession in this case. Technically, “obsession” as used in the mental health sense refers to stuck images, thoughts or ideas that are a part of Obsessive Compulsive Disorder. Although some individuals with ASDs also have OCD, that’s not always the case.The content of thoughts in OCD also tend to be different than those found with ASDs. (For an excellent article on this, see McDougle, C. J., Kresch, L. E., Goodman, W. K., et al (1995) A case-controlled study of repetitive thoughts and behaviour in adults with autistic disorder and obsessive-compulsive disorder. American Journal of Psychiatry, 152, 772 -777)

An excellent book for self treatment of OCD is Brain Lock: Free Yourself from Obsessive Compulsive Disorder, by Jeffrey M. Schwartz, M. D. Schwartz presents a four step program involving learning to recognize obsessive thoughts, labelling them as a part of OCD, focusing on something else for at least a brief while, and then finally “revaluing” these obsessive thoughts. You can find a clear explanation of these four steps on the website for the Westwood Institute for Anxiety Disorders, Inc.

Neither the book nor the website talk specifically about the autism spectrum and repetitive thoughts, but Brain Lock does have an interesting chapter on the Four Steps and Other Disorders, and states that they can be applied to “almost any behavior you genuinely want to change.” (p. 187) The ideas in this book are certainly worth considering for those on the autism spectrum dealing with this troublesome issue.

Is it Autism or Asperger’s, Part 2?

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.

There’s a great deal of discussion about the proposed changes to the upcoming DSM-V and their characterization of autism and Asperger’s. There's a good chance that Asperger's will be rolled into the general category of Autism Spectrum Disorders. I think for many readers of this post, as well as adult clients I work with, formal diagnosis has never taken place, so the differentiation between the two disorders  is really a moot point, aside from how individuals define their own issues.

Lisa Jo Rudy, on About.com has written a number of articles commenting on how this proposed change is more vague than the existing criteria and merges a very broad spectrum of symptoms and behaviors into one even less specific category. I agree with her points about the range of skills and abilities throughout the spectrum, but I think the reality is that we just don’t have enough understanding of the spectrum variations to warrant a precise and meaningful differentiation between what in reality is probably many different forms of an overall autism diagnosis.

For an excellent discussion of the details of this issue, check out the latest Child-Psych blog, where Nestor L. Lopez-Duran, PhD discusses a range of practical and theoretical issues related to this topic. Of particular interest was his discussion of the Yale University Child Study Center criteria differentiating autism from Asperger’s, including differences in speech as well as differing desires for social interaction..

Depression and the Autism Spectrum

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.

Depression and antidepressants are big news this week with Newsweek’s February 9, 2010 story by Sharon Begley, “The Depressing News About Antidepressants: Studies suggest that the popular drugs are no more effective than a placebo. In fact, they may be worse.” (Sharon Begley also wrote the book Train Your Mind, Change Your Brain, which I discussed in an earlier post.)The article goes on to explain the placebo effect, and what analysis of numerous studies on antidepressants, both those published and not published are showing about the effect of the drugs, and the often superior results of psychotherapy.

Depression is a concern for many on the Autism Spectrum, with almost a third of individuals with autism and Asperger’s also dealing with depression. (Mohammad Ghaziuddin’s Mental Health Aspects of Autism and Asperger Syndrome has a good review on this topic if you’re looking for details.) Social isolation, difficulty managing relationships, chronic stress from sensory issues, and practical matters like underemployment can all be contributing factors. For more info, you can find an earlier article I wrote on "Depression with Asperger's Syndrome and Autism".

Dr. Michael Yapko, a Clinical Psychologist and MFT, has published and spoken extensively on the ideas that depression is the result of many lifestyle  and social choices and curing depression does not come from a pill. He is the author of Depression Is Contagious, which I haven’t yet read, but it’s in my stack of books. You can hear an interview of Dr. Yapko, where he discusses his book and theories on the importance of social connections and good problem solving skills in managing depression.

Please note: If you’re currently taking antidepressants and these articles are concerning to you, don’t just stop taking them. Please talk to your prescribing physician. It can be very dangerous to stop taking any prescribed medication, or to alter the dose, and any changes to medications should be made under a doctor’s supervision.

Temple Grandin Movie Premiers This Saturday on HBO

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.

Don't forget, the Temple Grandin movie is premiering on February 6, 2010 on HBO! Most of my readers are familiar with Temple Grandin, PhD, perhaps the most well known autistic person in America, as well as the designer of almost half the cattle handling equipment in North America. Dr. Grandin is inspiring because of her clear presentation and writing style, as well as the way she’s learned to adapt the strengths of her diagnosis to accomplish things she probably wouldn’t have been able to if she weren’t autistic. Dr. Grandin remains a free thinker, an individual who lives a life that is meaningful for her, and expands our own vision (whether autistic or neurotypical) of what a successful life can be.

Our society so frequently presents one way of succeeding in the world, with a fixed idea on success, relationships and how we should behave. Dr. Grandin is an example to all of us on how success can really be defined by the individual. Although she writes about learning social skills and has adapted to a neurotypical world in some ways, at the same time she remains true to herself, defining her own needs and wishes with regard to career and relationship. I always enjoy Dr. Grandin's writing, and I'm looking forward to this movie.