Therapists who are ignorant about AS [rant]

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The other day I had to take a class for work, and one of the presenters (a therapist) made some really stupid remarks about people with aspergers. For example: "What would aspergers people do if there were no computer games? Hahaha" I tried to point out the obvious, but he didn't get it.

I have to take classes sometimes where we are supposed to "learn" about aspergers. Only my boss at work knows about me, and I keep it that way to prevent being sidelined, made fun of, or written off by my coworkers and other management.

Still it makes me REALLY uncomfortable to have to supposedly "learn" about myself when a good deal of the time the information offered us is stereotyped, shallow, demeaning, etc. I've known a lot of aspergians who've come a long way in their lives, learning to get along in the world. But I've never met someone who benefited from "therapy" or other "help" such as offered through the traditional therapy systems. Although in many ways it's better for younger aspergians that more people know they exist and can help if they have, for example, severe communication issues. But in general, I think younger aspergians have it harder than we "old" aspgerians did, because we didn't have to grow up learning the latest NT theories about ourselves and being hampered in finding what works for us.

In an ideal world, I wish I had grown up knowing of older aspergians in my life - people who know the drill from the inside out and could help me find my way through the NT minefield of high school, college, and work. But "therapy"? I'm glad I missed it.

Autism may represent the last great prejudice we, as a society, must overcome. History is riddled with examples of intolerance directed at the atypical. We can sometime fear that which diverges from the “norm”, and sometimes that fear leads us to frame those who are different as being in some way lesser beings than ourselves.

Autism is framed as a disability, with mainstream theories presenting autism via deficit models. Popular theory is often passed off as fact with no mention of the morphic nature of research and scientific process. Most mainstream theory is silent regarding autistic strengths and atypical ability; indeed, what is in print often presents a damning image of autism as an “epidemic”. Hurtful words such as risk, disease, disorder, impairment, deficit, pedantic, obsession are frequently utilised.

A common misconception around autism is that it is inextricably linked to intellectual disability. However, many of the world’s great thinkers and innovators displayed autistic characteristics. “Autism and intellectual disability often occur together in clinical settings, and this has made many researchers think that the conditions must share the same genetic causes. Our research challenges this assumption,” says Dr Rosa Hoekstra, lecturer in psychology at the Open University, who led a recent study which found that the genes for autism are distinct from those for learning disabilities. Autistic people exhibit a range of intellectual ability, including exceptional intellect. An obvious cause of this discrepancy is that very intellectually able people are less likely to be diagnosed. Furthermore, some diagnosticians actively withhold diagnoses in those deemed to be coping.

Autism is NOT a disorder

In the DSM-5, Autism is classified as a neurodevelopmental disorder. However, this notion is controversial and outdated. Many people who have been diagnosed with Autism do not consider their Autism a disorder and scientists are increasingly starting to join their ranks.

Because Autism comes with both extreme weaknesses (flaws) and extreme strengths (gifts), scientists are starting to support the notion that Autism is just a natural but extreme variation in functioning rather than a disorder to be cured. This means that Autism — although at the edges of what qualifies as normal human behavior — is a part of normal human biodiversity.

It is also argued that many (if not all) symptoms associated with Autism are not so much caused by Autism but rather by Autistic people being forced to conform to the mould of a society designed for “Neurotypical” people. That means that these symptoms can and should be alleviated by allowing Autistic people to be themselves instead of forcing them to behave in ways that are alien to them. One might even argue that in a hypothetical society run by Autistic people, it’s the “Neurotypical” who appears to be have some kind of “disorder”.

From this perspective, labeling Autism as a disorder is not just wrong but damaging for the Autistic community, because it creates a false perception that people with Autistic are intrinsically less productive members of society, whereas many people with Autism are not just equally productive but even more productive than “Neurotypicals” when fostering an environment that allows their strengths to compensate for their weaknesses.

Changes in the scientific perception of Autism

Eugen Bleuler, a Swiss psychiatrist, was the first person to use the term Autism in 1911, as a reference to one group of symptoms of schizophrenia. Bleuler defined Autism as a detachment from reality associated with rich fantasy life:

“The […] schizophrenics who have no more contact with the outside world live in a world of their own. They have encased themselves with their desires and wishes […]; they have cut themselves off as much as possible from any contact with the external world. This detachment from reality with the relative and absolute predominance of the inner life, we term Autism.”

Bleuler described a rich variety of clinical manifestations of Autism: poor ability to enter into contact with others, withdrawal and inaccessibility (in the extreme cases, negativism), indifference, rigid attitudes and behaviors, deranged hierarchy of values and goals, inappropriate behavior, idiosyncratic logic, and a propensity to delusional thinking. This enumeration demonstrates that Autism is resilient to a simple medical definition because none of these manifestations is sufficient or necessary to diagnose Autism.

In the 1940s, researchers in the United States began to use the term “Autism” to describe children with emotional or social problems. Leo Kanner, a doctor from Johns Hopkins University, used it to describe the withdrawn behavior of several children he studied. His 1943 paper described 11 children who shared high intelligence, a profound preference for being alone and an “obsessive insistence on the preservation of sameness.” Kanner considered Autism a form of “childhood Schizophrenia.”

Around the same time, in 1944, Hans Asperger — an Austrian pediatrician — described four children in his practice who had difficulty in integrating themselves socially. Asperger identified in four boys a pattern of behavior and abilities that included “a lack of empathy, little ability to form friendships, one-sided conversations, intense absorption in a special interest, and clumsy movements”.

In spite of his unfortunate usage of the term “psychopathy”, Asperger passionately defended the value of Autistic individuals, writing :

“We are convinced, then, that Autistic people have their place in the organism of the social community. They fulfill their role well, perhaps better than anyone else could, and we are talking of people who as children had the greatest difficulties and caused untold worries to their care-givers.”

Asperger called these children “little professors” because of their ability to talk about their favorite subject in great detail. Asperger noticed that many of the children he identified as being Autistic used their special talents in adulthood and had successful careers. One of them became a professor of astronomy and solved an error in Newton’s work he had originally noticed as a student. Another one of Asperger’s patients was the Austrian writer and Nobel Prize in Literature laureate, Elfriede Jelinek.

Nevertheless, Asperger’s paper was published during wartime and in German, so it was not widely read elsewhere. For several decades, Kanner’s notion of as a form of “childhood Schizophrenia” persisted in academic literature, and psychoanalysts typically blamed emotionally emotionally distant mothering (known as the “refrigerator mom” theory of Autism). This theory is considered debunked by (almost?) all experts today.

In his 1961 work The Myth of Mental Illness, Thomas Szasz famously argued that what is commonly qualified as mental illness is merely a deviation from societal norms. Szasz argued that mental illness is a metaphor and not a genuine disease, that it is merely a way of dealing with problematic people in society. “Psychiatry is conventionally defined as a medical specialty concerned with the diagnosis and treatment of mental diseases,” he wrote. “I submit that this definition, which is still widely accepted, places psychiatry in the company of alchemy and astrology and commits it to the category of pseudoscience. The reason for this is that there is no such thing as ‘mental illness.’” By the late 1960s, he was perhaps the most famous psychiatrist in America. However, he was also the most despised among peers. This, and his theories being rooted in the discredited field of psychoanalysis, resulted in his work usually being either ignored or vehemently attacked.

In 1971, Israel Kolvin conducted seminal research that highlighted the distinction between Autism and Schizophrenia, which influenced the decision to include Autism and Schizophrenia as two separate categories in in the DSM-III. Still, most of Kanner’s description of Autism wasn’t challenged until Asperger’s research was referenced in a 1981 paper, Asperger’s syndrome: a clinical account, by English researcher Lorna Wing.

Objective criteria for diagnosing Autism soon followed, as did a clear separation from childhood schizophrenia, although it was not until 1991 that an authoritative translation of Asperger’s work was made (by developmental psychologist Uta Frith), which officially introduced Asperger’s work to the English speaking world. Following this publication, the early 1990’s marked the beginning of a gradual change of the perception of Autism towards a very diverse spectrum condition.

In 1997, Professor of developmental psychopathology Simon Baron-Cohen (a cousin of actor and comedian Sacha Baron Cohen) developed the empathising–systemising theory, which suggests that people may be classified on the basis of their scores along two dimensions: empathizing (E) and systemizing (S). Baron-Cohen suggested that the typical male brain is has a stronger affinity with systemising and the typical female brain has a stronger affinity with empathising.

Baron-Cohen further suggested that people with Autism show stronger affinity with systemizing over empathizing compared with their “Neurotypical” peers (irrespective of sex). This led to the conceptualisation of Autism as an “extreme of the typical male brain”. Later, in their 2008 study, Bernard Crespi and Christopher Badcock expanded upon Baron-Cohen’s theory and conceptualized Psychosis as an “extreme of the typical female brain” and the diametrical opposite of Autism.

Note that Psychosis being the “diametrical opposite of Autism” doesn’t mean that Autism and Psychosis are mutually exclusive. It merely means is that they are distinct and radically different brain strategies that are associated with respectively extreme Masculinity and extreme Femininity. While some individuals can be considered as purely Autistic or purely Psychotic, others experience symptoms of both Autism and Psychosis. Schizophrenia, Bi-Polar Disorder and Borderline Personality Disorder are typical examples where Autistic and Psychotic symptoms co-occur. The exact differences and similarities between these different “conditions” nevertheless remain very poorly understood.

By the late 1990s, online groups of Autistic persons started publicly defending the notion that that Autism is but a variation on the neurological norm and should be recognized and respected as a social category on a par with gender, ethnicity or sexual orientation. Since the beginning of the 21st century, this concept is now increasingly picked up by scientists as well, although it’s still considered controversial and thus far from universally accepted.

With recent works like Paris Williams’s 2012 publication Rethinking Madness and Wouter Kusters’s 2014 Philosophy of Madness, a similar paradigm shift has begun involving Psychosis — the “opposite” of Autism. ADHD has also been mentioned in this context, and the term neurodiversity has been coined in reference to a more general application of this concept, roughly echoing the ideas of Szasz many decades after they were first voiced.

Meanwhile, Olga Bogdashina’s little known 2003 publication is one of the first scholarly works to accurately describe Autism in all its diversity and accurately correlate Autistic behavior with corresponding emotions and cognitive styles. This work is the first of several to provide an in depth analysis of the many subtleties and nuances found in the language and perception of Autistic people.

I Benifit from my therapist but when she is wrong I let her know about it.

What exactly is directed therapy?

After I notified work of my recent diagnosis, I was invited to attend a "What is ASD/Aspergers" session for managers because I was keen to learn how work viewed it. I ended up filing a complaint because of the sheer number of stereotypes:
- Aspies are into train timetables
- Aspies think it's raining cats and dogs when you say it
- Aspies can't be girls
- Aspies are annoying
- There is a chance ASD/Aspergers can suddenly disappear in an individual/be cured

I am not saying some of these points aren't true for individuals out there but after the session, my manager no longer believed my diagnosis because I didn't fit the official company-approved stereotype. It was very upsetting.