Saturday, December 26, 2009

Feeling Alive

“I am eight years old. When I get scared I go into the bathroom. I take off all my clothes and lay on the bathroom floor. Does anyone see me? Can you feel me? I fantasize that I am alive, and being touched all over. I close my eyes and touch myself all over as if someone else is doing it. I feel alive when I do this. I wish someone else would do this. Consume me and make me feel alive. I want to be examined from head to foot. Examined as if I am important.”

What is this autistic boy telling us? It seems that he does not feel alive. It is hard to know exactly what he means by being alive. By speculating, it seems he feels he can make himself feel alive if he actually does what he wants someone else to do – touch him. He seems to be acting out his need to be touched and seen. He seems to be telling us that he wants to be known and that he wants every orifice to be touched and seen.

Every human being needs to be seen, recognized and ultimately touched by another human being. This child has missed out on this opportunity and is thus acting out his need for this psychological touching. It may seem strange that a young child would go to great lengths by acting out his needs through his behaviors. For autistic children this is the norm and must be understood for what it is and what he means through his behavior.

Most typical children can use words to express their needs. Autistic children cannot use words and thus must rely on their bodies to express their needs. We can also say that typical children have had an attachment. It is through an attachment that the child learns how to regulate himself through the mutual regulation process between caregiver/s and infant. During the attachment process we also come to understand ourselves by how our caregivers’ understand, accept, validate and recognize us. The caregivers help the child to symbolize his experiences. Unfortunately, the autistic child has not had the benefit of an attachment to a caregiver and thus is waiting for the attachment process to be completed. It can be said that he has an Incomplete Attachment.

It is also important to note, that all typically developing as well as autistic children have varying degrees of what I call self-agency. Self-agency is the ability to use oneself in relationship to others. In the lowest functioning autistic child he has no self-agency and thus has no words or is echolalic. The higher functioning the child (typical or autistic) the more self-agency he has. The autistic child will always use his body as a substitute for his lack of self-agency. Thus what he tells us through his body is very important for us to understand.

One more key idea is important to cite here. Autistic children when communicating with their bodies are talking about their psychological needs and not necessarily their daily needs. The typically developing child will express the desire to have a cookie, drink some milk, etc. Of course the autistic child has those needs as well, but he uses his body to express much deeper psychological needs such as our autistic boy in this blog. Through his body (unconsciously) and what may seem strange to some, he is telling us he has a deep need to be touched and seen. We can assume that these needs have not yet been met.

Friday, December 18, 2009

A Nonexistent World

"I live in a world where I do not exist. I know I have hands, arms, legs and a brain, but my place in this world is very tenuous. If I leave a room and come back, will the people in the room remember me? I live in constant fear that others will not remember me. Do they have the ability to keep me in their minds? I am never sure if they do or will. I wonder to myself that if I use a loud voice will I be remembered? If I make sure that I am a good boy, will people remember me? The fear of being remembered is coupled with my inability to remember myself. I constantly forget who I am. I have to frequently remind myself, 'You can talk and initiate conversations.' This does not come easily for me especially when I am in relationship with others. At those times, I feel very anxious and forget what I want to talk about and who I am."

What is this autistic boy telling us? It seems he can see himself physically, but not psychologically. He seems to live in a world consumed by fear and the inability to feel recognized by others and by himself. There are two key points that he seems to be telling us: 1) he exists not knowing if others can hold him in their minds and 2) he cannot hold himself in his own mind. He loses his ability to exist in the minds of others as well as within himself.

It is important to make sense of this experience by reviewing what we know about an “Incomplete Attachment.” In the attachment process, the child learns about himself through the eyes and behaviors of his caregivers. He learns how to regulate himself and his emotional states through the mutual regulation that takes place between the caregivers and himself. He learns that it is safe to exist because he feels seen and validated by others. Unfortunately this autistic child has not gained the benefit of what other’s receive within the attachment process – a sense of self, a sense of security, a sense that there is continuity of being, a sense of wholeness, a sense of a personality, a sense of calmness and a sense of a meaningful existence. It can be said that because he has had an incomplete attachment his psychological development is at a standstill and delayed. He is thus left waiting for the attachment process to be completed.

Stern (1985) unintentionally captured very vividly the experience as an autistic person when he described his reason for placing the sense of self in infancy at center stage of developmental inquiry. Taking Stern (1985)* into consideration, I am going to try to sum up what I perceive the autistic experience to be. It can best be described as a state of psychic paralysis, with no ownership of action or will, extreme fragmentation and disassociation and with a deep sense of loneliness and depression. It is a complete state of futility, hopelessness that feels scary and absolute. It feels like a state of never-ending hell analogous to living in a “black hole” with no exit. Life feels meaningless and is filled with ever-present despair. It is a continuous experience of thinking, but with no language to give shape to those thoughts. It is a continuous state of anxiety without the ability to identify the anxiety or stop it. It is a continuous state of confusion without the ability to ask for help or seek clarity. It is an experience of having no way to use the self in relationship to others. It is as if one is living in a “ deep vacuum” with no bottom, top or sides. It is a state of existence without boundaries. It is a state of existence with no continuity of being. It feels as if you exist without a personality. You are a nonexistent being within a shell that looks like a person.

* Stern, D. (1985) The Interpersonal World of the Infant. New York: Basic Books.

Thursday, December 10, 2009

“My Fantasy Family, My Existence”

“I go to sleep every night and visit my fantasy family. They save me from the nothingness of everyday existence. I do not feel alone with my fantasy family. They protect me and make me feel alive. I do not want to have a fantasy family, but sadly there is no other answer. So once again I crawl into my bed and cover my face and dream of being real.”

What is this autistic boy telling us? He seems to find comfort in his fantasy family versus his real family. He creates a family that seems to give him something he cannot find in his relationships with his own family. He seems to depend on this fantasy to exist. This fantasy allows him the control over his existence, which he does not feel he actually has. This fantasy family seems to be a substitute for what he cannot find in his own family relationships. This made-up family can help him survive and give him the psychological ‘strokes’ and validation he may be missing.

He also talks about his life feeling like a ‘nothingness existence.’ He seems to be saying that he cannot be a ‘real’ participant in everyday life and thus his life feels like a state of nothingness. He also seems doomed to this fantasy existence. It does not seem like he wants to live in a fantasy world, but feels there is no other alternative. Finally, he dreams of being real, which tells us that he may not feel in touch with his genuine self.

Let’s make sense out of this boy’s experience with his made-up fantasy family, his nonexistent life and not feeling ‘real’. It seems that this autistic boy is very creative. He knows there are things he is not receiving from his family and so creatively makes up a family that can provide what he feels he is missing. This fantasy helps to sustain the child even if only in a very fragile manner.

He is also telling us that he does not feel ‘real.” I believe ‘realness’ comes out of feeling in touch with one’s genuine self versus living as a made-up or false self. A false self is created when the child complies with the needs of the caregiver at the expense of his own needs. This is done unconsciously between the child and caregiver. When things go as expected during the attachment process, the child gains the needed validation of his affective experience (feelings and emotions) so he can in turn feel a sense of being 'real' in the world. In this child’s experience, he never fully developed this validation so he is left to feel ‘unreal’ and as I also have previously described as having an “Incomplete Attachment.”

Thursday, December 3, 2009

“I am too Smart to be Seen as Defective”

“I can't let anyone know how smart I am. I know I am and that is my secret. It has to be a secret because I do not have a personality or self-esteem, but when I get a personality and have self-esteem then people will know that I am smart and that I figured it all out by myself. I figured out all my problems by myself. It is not safe to have anyone help me because they will think that I must have done something wrong. I do not want to be seen as wrong and defective because I am smart. When you are smart you keep your mouth shut. When you talk others can misunderstand what you say or twist what you have to say and make you feel stupid. Because I am not stupid, I will keep my mouth shut and let everyone else put their feet in their mouths. I am too smart to do that.”

What is this autistic boy telling us? I will try to interpret his message. He is telling us he knows he is smart, but cannot let others know his secret. He is afraid that if people find out he is smart he will be expected to do ‘things’ that he knows he cannot do. Furthermore, he does not feel he has a personality or self-esteem, but knows he can potentially have both. He seems to be obsessed with being misunderstood and seen as not smart. By relying on others he feels he could be made to feel stupid. Finally he observes that people tend to put their ‘feet in their mouths’, which he feels he is too smart to do.

Let’s make sense out of this boy’s experience. Within the autism community, I believe the intelligence of people with autism is misunderstood. Autism is not about academic intelligence, but instead about emotional intelligence. This boy recognizes he is academically bright and that his ‘autistic behaviors’ mislead people to think that he is not intelligent. He grasps the problem, but cannot do anything about it. Many people feel that at least some autistic people have limited intelligence. They contribute ‘brightness’ to those that are high functioning or have Asperger’s. Unfortunately for the rest of those with autism they are labeled as less intelligent.

From my perspective, this matter regarding autistic intelligence needs to be reexamined. I believe as mentioned previously that the person with autism does not have a problem regarding his academic intelligence, but instead it is his emotional intelligence that has been delayed. It has been delayed because he has not benefited from a completed attachment. Without a complete attachment, the child, teen or adult displays behaviors that seem to be bizarre, but actually are methods used by the person to cope with his predicament. Unfortunately because an autistic person does not speak or is echolalic, flaps his hands, resists change and does not relate to people, he may be labeled inappropriately as mentally limited. I believe all people with autism are highly academically intelligent. Our emphasis with people on the spectrum should not only be with their academic development, but more so on their emotional intelligence.