Coach for Asperger's

Social Skills for Adults

Frequently, kids on the autism spectrum attend social skills classes. There, kids are taught the basics of getting along with others, things like making good eye contact, respecting others' personal space, the rules of give and take in conversation. Usually, after a few months or sometimes a couple of years of these sessions, the members move on to other activities and social skills training formally ends. (When I talk with adults with ASDs, they often complain bitterly about how much they hated these classes and how they didn’t learn what they needed from them.)

But we all, kid or adult, need good social skills to get along with others, and everyone needs to have supportive relationships. That requires a lot more than the basics taught in children’s social skills classes. So how can adults on the spectrum improve their social skills?

Sometimes, adults are lucky enough to find a support group where they can interact with others who might be willing to practice some skills, give honest feedback, or even just be patient with those whose social skills might be a bit off. If you’re lucky enough to live near one of these groups they can be a great source of both support and a learning environment. Other adults find a partner or close family member who can help with interpreting the more precise situations. For many adults on the spectrum, a parent, sibling, or partner really functions as a social skills coach. (For an example of this, read Mozart and the Whale, reviewed in a previous post, where a married couple, both with Asperger’s, demonstrate how they use their relationship to improve their skills. Each learns to pay attention to the other’s signals, manage their tempers and respect each other’s boundaries throughout the course of their relationship.)

For people without the advantages of close relationships, there are still ways to learn these skills. One option is to hire a coach or therapist. These professional relationships are specifically designed to provide that detailed feedback in a safe setting. It can be very different from interacting in a give and take two way friendship. But not everyone is comfortable about working with a professional, and that’s where books can help.

Michael Yapko’s Depression Is Contagious: How the Most Common Mood Disorder Is Spreading Around the World and How to Stop It is all about how social relationships are crucial in preventing depression. Yapko argues that our modern culture is failing us with its emphasis on instant gratification, personal fulfillment, technology and acquisition, all at the expense of good relationships with others. Throughout the book, Yapko presents the skills he finds most important in establishing and maintaining good relationships, things like setting good personal boundaries, analyzing character before starting relationships, and how to manage conflict. The book has little self help exercises throughout, called “Learn by Doing” and “Pause and Reflect” where the reader can actually work on these skills individually. Although it’s not referred to as such, this book is really the closest thing I’ve read that could be considered a “Social Skills Book for Adults”. If you’re looking for a way to improve your relationships, get along better with others, and manage both personal and professional interactions, check out a copy of Depression Is Contagious.

Book Review: Mozart and the Whale: An Asperger’s Love Story

Mozart and the Whale: An Asperger’s Love Story, by Jerry and Mary Newport, with Johnny Dodd, is a sometimes hilarious, often heartbreaking, but ultimately inspiring story of a couple who never really fit in, until they met each other. Jerry Newport is the author of several earlier books, and he’s been quite active in the Asperger community, even starting the support group where he met his future wife.

Both Jerry and Mary Newport relate the stories of their own difficult childhoods, growing into adults who struggle with relationships, underemployment, and social isolation. Jerry’s portrayal is engrossing for many reasons, not the least of which is his unique way of viewing the world through numbers. In spite of his mathematical genius, Jerry struggles to find a career that uses his skills in any way, and frequently has to make a living through less challenging jobs, and admits to having no concept of how to relate to women.

Mary’s story is less typical, and often truly tragic. So often, Asperger’s is thought of as a male diagnosis, and women on the spectrum are overlooked. Mary Newport, as so often happens with Asperger’s women, does manage to have relationships, although they fall into the realm of dysfunctional, often abusive, and sometimes bizarre.

The framework of the book, and the real soul that makes the story so is compelling, is the couple’s relationship, their struggles to connect and understand each other, and their commitment to support each other and grow. They often don’t fit the norms society may expect, but Mozart and the Whale is inspirational.

Married to Someone with Asperger’s?

A lot of people, usually women, call me because they suspect or wonder if their partner or spouse might have Asperger’s or autism. They might be looking for a way to understand, a solution to a specific problem, or a way to “fix” their partner. (If you’re wondering, no I can’t fix your partner, that would be like trying to fix my left-handedness. Asperger’s is a neurological and behavioral difference, not something to be fixed -  which doesn’t mean that all couples can’t learn to communicate and relate to each other in a healthier way.)

There are many reasons a person would choose to be involved in a romantic relationship with an individual on the autism spectrum. Often the autistic partner is more reliable, honest and steady, there’s usually a relief since there’s so much less game playing. A lot of men with Asperger’s seem to really see the woman for who she is, not being drawn in to the cultural limitations that women must fit a certain mold. And of course, the intellectual depth can be very appealing.

At the same time, autism and Asperger’s really do involve a different way of seeing the world and dealing with it, especially socially, in the context of relationships. This fact can mean real difficulties within marriages. All marriage counselors quickly see that the very things that draw a couple together in the first place are the same things that really bother them later on. The strength of Asperger’s that draw a couple together can also pull them apart.

For those neurotypical spouses and partners looking for support, GRASP has an new online group. GRASP, The Global and Regional Asperger Syndrome Partnership, has a number of local support groups, primarily on the East Coast, as well as online support groups for various Asperger’s related issues. One of the great strengths of GRASP is its strong support of adults on the spectrum, as well as the focus on having autistic individuals running the organization. If you’re a neurotypical partner of an individual on the spectrum, why don’t you check out this new group?

Repetitive Thinking and 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?

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

Depression and 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

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.

Mirror Neurons and Autism Spectrum Disorders

Mirror neurons, structures in the brain that fire not just when performing an activity, but also when watching another perform that same activity, are being researched by neuroscientists around the world. What is of interest here regarding mirror neurons is the theory that differences in the mirror neuron system may account for some of the symptoms seen in Asperger’s and autism.

Many of my clients on the autism spectrum are very interested in learning about the technical and medical issues surrounding their diagnosis. I’m always excited when I find good, straightforward information on these topics. Rather than attempt to re-explain what the researchers already have explained in clear and understandable terms, I’m going to just direct interested readers to these links.

For a basic discussion of mirror neurons, go to TED, and listen to VS Ramachandran’s The neurons that shaped civilization.  Ramachandran doesn’t discuss autism in this brief talk, but his 2006 article in Scientific American, Broken Mirrors: a theory of autism with LM Oberman. discusses autism in depth. Finally, if you’re still looking for more, Nova has a presentation online about how mirror neurons work.

Asperger’s, Sex and Sensory Issues

Asperger’s and sex is the phrase most frequently searched for on this blog. I’ve written a bit on the topic of Asperger's, autism and sex, as well as posted an interview with a Bay Area sex therapist. But I suspect there’s a large group of current and potential readers looking for more information. I think a lot of readers want dating information, but even more are interested in help specifically about sexual relationships. Unfortunately, there’s not a lot published on the topic.

One issue of concern to many adults with Asperger’s and autism is Sensory Processing Disorder, also called Sensory Integration Dysfunction or sensory or tactile defensiveness. And of course, sensory problems could easily impact sexual matters.

Recently, I posted a blog review of the book Too Loud, Too Bright, Too Fast, Too Tight: What to Do If You Are Sensory Defensive in an Overstimulating World, by Sharon Heller, Ph.D. (2002, Harper-Collins). The book covers many topics, but it also has some information specifically on the impact of sensory defensiveness on sex.

Sensory integration is not an area where I have any training, but if you’re interested in learning more on this topic, check out the book for some specifics, or talk to an Licensed Occupational Therapist who works with adults.

Book Review: Too Loud, Too Bright, Too Fast, Too Tight, by Sharon Heller, Ph.D.

For adults on the autism spectrum, including those with Asperger’s, sensory issues can be a major problem. Clothing textures are irritating, foods taste and feel unpleasant, lights may be glaring and noises and odors overwhelming. These issues can be a major contributor to problems with social interactions and managing work environments.

Often, children diagnosed with autism spectrum disorders (ASDs) like Asperger’s, autism, or PDD-NOS, as well as those with ADHD are under the care of a medical doctor who recommends Occupational Therapy as a part of treatment. OT can be invaluable in helping these children manage sensory problems. Unfortunately, many adults on the autism spectrum were not diagnosed as children, and only figure out their issues when they self diagnose as adults. Learning about autism and Asperger’s can help many adults adapt to their own deficits and start to utilize their strengths more effectively. Frequently, looking at sensory integration and sensory defensiveness can add immeasurably to the quality of life for adults with ASDs as well.

There are several good books on sensory integration and sensory processing, but generally they concentrate on children’s issues. Too Loud, Too Bright, Too Fast, Too Tight: What to Do If You Are Sensory Defensive in an Overstimulating World, by Sharon Heller, Ph.D. (2002, Harper-Collins) is an excellent guide that's written more for adults.The beginning of the book explains sensory processing and details the many ways that sensory defensiveness can manifest itself in different individuals. Heller focuses on the different senses and how each sense can individually vary for different people. While some people are tormented by tactile sensations, others struggle with smells and tastes. The most useful section of the book called “Your Sensory Diet” lists dozens of activities and lifestyle changes that individuals can make to improve their sensory experiences. Appendix B lists the many ways in which different individuals may react to sensory issues. I think a lot of people, both on the spectrum and neurotypical, will recognize themselves in some of these areas.

While many adults may (and should) decide to see a specialist, such as an Occupational Therapist, to get treatment for sensory issues, this book is both a useful introduction to sensory processing, and a reference book packed with ideas to get the problem under control.