Pain from other's talking

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I have been working with an 18 year old who has PDD-NOS for about 6 months. His mom hired me to help give him more social exposure and find positive ways to manage stress.

The way he acts is very unusual for someone with PDD-NOS. He is extremely social and wants to say hello and give high fives to everybody he sees. The biggest challenge we all face is that he seems to suffer from extreme mental pain and possibly even physical pain when other people are talking around him. With strangers talking it is not an issue, but when people he has a close relationship with are talking, he cannot stand it.

For example, I was with him and his mother and when his mother would say something to me or I would say something to her, he would start holding a lot of tension in his body and begin to make sounds like he was being punched or something.

He tends to hold onto this tension well after the moment has passed. Basically until he goes to bed, he has a permanent scowl, regardless of when this happened. He has described it to me like the conversations are stuck in his head. The school counselor thinks we should ignore the behaviors and just carry on, but I don't think they realize the extent to which it goes. It's very difficult to ignore the sounds of someone in distress.

We're trying a lot of different approaches. I recommended that to his mom that he starts talking to a specialized behavioral therapist.

Just wondering has heard about anything like this and could shed some light on it for me. Thanks in advance!

Could it be that his thinking is limited to himself-centric or everyone else.
And when you go into a grey area he can't handle that. He can't handle someone close to him not talking about him. That sort of talk doesn't fit into his world view. This may be some sort of variant of black white thinking that commonly affects people on the spectrum.

Yes! I think that's exactly it.

I've talked to him about this a lot, and am trying to get him to arrive at this understanding. I am unsure of what I can do to help him get there and what we can do after he gets to this understanding.

Hi and welcome. When you and his mother are talking (as mentioned in your inital post) when this happens, is he the topic of conversation? If so, I would have a very similar, but, perhaps, less extreme response/symptoms, as it can make me quite uncomfortable when people speak about me, or in the 3rd person, in my presence (whether positive or negative), for some reason. If it is in fact, due to the conversation being about him, it could effect him so profoundly, that he might ruminate on it, continuously (the conversation becomes stuck in his head).

This is just my personal experience, thus, what he is experiencing could be something entirely, different, but, I thought I'd mention it, in case it could help in some way.

Thanks for the reply!

It doesn't matter what the topic of conversation is about. I could be talking to an employee at a restaurant asking about the food and it will cause the same reaction. His parents could be talking about plans for the day or whats for dinner and he'll react the same way.

It is only if people he knows are talking to anyone else besides him, it will cause this negative reaction. I could talk to him about anything and he'll be fine.

You're welcome! What BTDT mentioned, seems likely, then. I hope things go well/get sorted out. You may be quite a bit, more knowledgable than me, so, forgive me if I sound like Im teach you, or similar, as it's not my intension. : )) in case it is helpful to know, if it's a personality related matter, your idea to suggest a certain type of therapy for his difficulties seems reasonable, as the brain develops, well into a person''s early to mid 20's. Thus, there is hope to relieve at least, some of his discomfort/dis-ease, no matter where/what it stems from, exactly. I agree with you, that some of his behaviours are unusual for PDD-NOS, although, not impossible. I wish him/all of you, a most successful outcome. He is fortunate to have you in his life, as it is apparent you care about him/ his well-being.

Thank you for the well wishes! May 2018 be a joyous year for you

Thank you, MeditativeMind! May 2018 be a joyous year for you, as well!