Autism Therapy
Different, Not Less
Note On Language
Identity-first language is used here following the liberating shift from a pathology paradigm to a neurodiversity paradigm. For example, "autistic adult" is used instead of "adult with autism," "adult with ASD," or "adult on the spectrum." Identity-first language is also strongly preferred in the autistic community. However, your language preferences may differ, and that is perfectly fine.
This World Seems Cruel
Have you ever been chastised, shunned, or bullied at school, felt isolated and misunderstood at work, or dismissed or rejected by friends and family? Or perhaps you fit in just fine, but you never feel like yourself. You have been feeling drained from overstretching yourself and masking socially to adapt to neuronormativity.
Have you ever felt like an outsider, a burden, or an alien observer? Have you ever been wrongfully accused of being "lazy," "overly sensitive," "difficult," "rude," "picky," "childlike," or "too much?"
It's exhausting to try to fit into a neurotypical world. Some social rules or concepts appear too arbitrary or abstract. Have you ever wished for a social rule handbook in which the neurotypical codes are actually decipherable or logical?
Neurology of Autism in A Nutshell
Have you always felt off or different your whole life? Maybe you've been looking for an answer for a long time, but the process has been overwhelming or confusing.
Autism is a hereditary neurotype featured with divergent neuroplasticity. Neuroplasticity is the brain's ability to form new connections and pathways and change how its circuits are wired. Neuroscience research has identified over-connectivity in unimodal brain networks and under-connectivity in brain supramodal networks in autistic brains (e.g., Maximo & Kana, 2019). It means that the autistic brain is one of neuronal over wiring. Our brains have proliferated in creating ideas and synapsis, but an autistic brain does not prune over time like a neurotypical brain.
As a result, the autistic brain has many parts of the brain that are hyper-connected and some hypo-connected.
The difference between an autistic brain and a neurotypical brain is like walking through different forests.
An autistic brain is like a dense forest with lots of branches,
making going underneath and going through difficult.
In contrast, a neurotypical brain is more like a sparse forest where you might be able to see the clearing on the other side. The autistic brain needs more processing time and heads up when things change because it takes time to navigate through the dense forest for the information to land on the other side.
Diversity of Autism
Autism is identified by a collection of characteristics that are as variant in trait and degree as something can be while still comprising a category. These categories include sensory-motor traits, repetitive behaviors, cognitive/executive functioning, communication, emotional, and social traits. "If you've met one autistic person, you've met one autistic person." It speaks to the enormous variety of autistic presentations. Not every autistic person will display every trait. You may exhibit different characteristics to varying degrees in different situations.
Autism In Girls and Women
Autistic girls and women are frequently overlooked due to the stereotypical image of autism of a young White boy.
The male-to-female ratio for autism has traditionally been reported to be 4:1; however, a large meta-study discovered evidence of a diagnostic gender bias, with the unbiased ratio closer to 3:1 (Loomes, Hull, and Mandy, 2017). Furthermore, the most recent study, which used a clinical dataset of 1711 <18-year-old children, found that the actual male-to-female ratio appears to be 3:4 (McCrossin, 2022). What's more, at the age of 18, 80 percent of females are still undiagnosed.
Similarly, autistic people of color are also routinely missed due to bias and poor access to diagnosis and treatment.
Studies have also shown that females are less affected than males in restricted and repetitive behaviors (Supekar & Menon, 2015). This means autistic girls generally have fewer overt behaviors than boys, which may contribute to diagnostic bias and delays. Also, due to gender socialization, girls learn to camouflage at a young age. As a result, they are more likely to internalize their distress, such as anxiety and depression. Autistic girls also have better apparent language skills, at least at first, are better at masking during tests, and are disadvantaged by tests tailored for boys.
Autism Co-Occurrence
Many autistic people experience multiple physical challenges that develop over the years. These may include muscle and joint pain, sinus infection, ear infection, toothache, heartburn, constipation, gall bladder issues, fibromyalgia, myalgic encephalomyelitis (chronic fatigue), hypertension, migraines, gastrointestinal problems, epilepsy, restless leg syndrome, Ehlers-Danlos syndrome, hypermobility, autoimmune issues, and nervous system disorders.
Other mental health co-occurrences include ADHD, eating disorders (anorexia and avoidant restrictive food intake disorder), and sleep disorders. One example is Delayed Sleep Cycle Disorder. Sometimes people stay up until 3 a.m. gaming because they can't sleep and are most alert at night. Sleep apnea, allergies that cause breathing problems, and restless leg syndrome are all more common in autistic people, further disrupting sleep. Standard sleep studies usually fail because autistic people can't sleep long enough to collect enough data between the 9:30 p.m. and 6 p.m. structured time.
Neuroqueer
Do you feel like the concept of gender has very little intrinsic meaning? Do you find the assumption that everyone should neatly fit into categories of men and women quite bizarre? Or do you find the idea of gender having to match sex at birth absurd?
Because autistic people are less likely to internalize social norms than allistic (not autistic) people, a large proportion of the autistic community identifies as trans, genderqueer, non-binary, nonconforming, gender questioning, or genderless.
However, autistic transgender people are frequently subjected to greater scrutiny when seeking professional support for physical transitioning.
Autism & Trauma
Autistic people are frequently subjected to various types of trauma, including developmental and systemic trauma.
Autistic children are more likely to have adverse childhood experiences such as financial hardship, mental illness or substance abuse in the family, parent separation/divorce, and maltreatment.
A population-based study, for example, found that nearly 1 in 5 autistic children was subjected to maltreatment, such as abuse and neglect, three times more likely than neurotypical peers (McDonnell et al, 2018). According to another study, autistic children were 2.5 times more likely to be referred to child protective services (Fisher et al., 2018). However, only 62 percent of autistic children's cases were investigated, compared to 92 percent of neurotypical children's cases. Autistic girls were more likely than autistic boys to have substantiated maltreatment (13.6 percent vs. 1.9 percent, respectively).
Furthermore, a systemic review study discovered that 40 percent to 90 percent of autistic children are bullied, 3-4 times more frequently than their peers.
Moreover, autistic people are more likely to be subjected to trauma in the school and health care systems.
Living with daily sensory overload leads to a cycle of feeling unsafe. These feelings can result in shutdown/meltdown/burnout/masking when they are not validated or accommodated.
The lifetime experience of being othered is traumatizing itself.
Do you experience a lifetime of being misunderstood, and thus there is no such thing as a low state decision? Therefore, making decisions can be frightening, and the fear of being wrong/making the wrong decision can be overwhelming. A lifetime of social rejection and relationship disappointments can lead to a great deal of self-doubt. Typical trauma responses may manifest in the form of depression, anxiety, OCD, PTSD, and complex PTSD.
How Can Therapy Help?
An autism-informed and trauma-informed therapy is critical for your healing.
Many clients have had negative therapy experiences due to therapists' lack of understanding of autism and how it intersects with trauma. They used standard modalities that fail to tailor to autistic people's unique way of thinking, feeling, or being.
The overarching goal in therapy is to assist you in developing a healthy trauma-informed positive autistic identity and
reclaiming your inner power and dignity
by:
✔ Providing a safe space where you can be your authentic self
✔ Aspiring to communicate in a clear and precise manner
✔ Dispelling internalized shame, stereotypes, and judgment about autistic people
✔ Dismantle the toxic effect of damaging messages of shame and stigma that you with invisible differences have received and internalized during your lifetime
✔ Compassionately stepping into a place of greater self-understanding, passion, and celebration
✔ Identifying your executive functioning profile, and exploring what can be improved, worked around, and simply accepted
✔ Exploring how to meet your sensory needs and experience the sensory joy
✔ Processing interpersonal dynamics and challenges
✔ Advocating for health care needs and accommodations
✔ Processing daily living challenges and exploring external and internal coping strategies
✔ Embracing your special interests
✔ Processing your trauma at your own pace
✔ Developing a routine of self-care and automotive maintenance
✔ Deepen your relationship with your authentic self, and use your strengths and voice to create spaces and relationships that work for you
