Saturday, February 13, 2010

"Others Actions Stop Me": Nonverbal Communication and Autism

“Have I ever told you how the actions of others stop me from talking? It is as if their hand movements, their eyes or their tone of voice stops me from talking. I find myself focusing on their behaviors and forgetting what I should say in response. It is as if their behaviors become more important than their words. For example, when my mother raises her eyebrows at the same time she raises her voice, I find I cannot move or talk. It feels like her behaviors are a sign for me to stop and I can't go beyond that. I see my sister yell back at my mother at times like that, but I can't. I see that my sister gets into trouble for responding back. Maybe my way isn't so bad, but I wonder what makes me stop and not have the ability to respond? I feel like my body just won't let me respond. At other times, when my mother is in a good mood, I see happy behaviors - her eyes twinkle, her tone of voice is mellow and soft. At times like this, I say to myself I need to capture this moment and try to fit in all my words. Don't they say ---it's all in the timing?"

What is this autistic boy telling us? He seems to be entrapped by others’ nonverbal gestures. He can see that this does not stop his sister from talking back to their mother. He wonders why it stops him. He also realizes that if his mother is in a good mood he has more of a chance in using words (if he has them).

Let’s take a moment to focus on this area of nonverbal communication. It seems that our autistic boy has no choice but to focus on the nonverbal gestures of others and in turn feels manipulated by their nonverbal gestures. The behaviors of others stop or propel him to talk. From the perspective of an Incomplete Attachment, we can possibly make sense of what is going on here.

Let’s take a step back and think about nonverbal communication and nonverbal gestures. From my point of view, the definition of nonverbal communication is the body’s way of unconsciously communicating feelings and emotions. Sometimes a typical person may not have access to his emotions so that person may not be consciously in touch with a specific feeling and thus cannot verbally express a particular feeling. Fortunately, our bodies always are in touch with our emotions and those feelings come out through our nonverbal gestures/communications. The person with autism does not have access to words, but his body retains the memory of his emotions. Thus the unconscious child with autism is tuned into nonverbal communication much more than he is tuned into verbal communication. That is why our autistic boy focuses on the nonverbal gestures of others. Typical individuals are simultaneously unconsciously and consciously aware of what others (this will depend on the individual and their level of consciousness of nonverbal gestures) are saying nonverbally. If we think of the individual with autism as unconscious, he would by definition be more attuned to nonverbal communication versus verbal communication.

Another point to remember here is that not only is our autistic boy more attuned to nonverbal communication as compared to the typical person, but he also has no way to access his feelings and subsequently communicate those feelings (lacks self-agency). Thus he is left to only focus on the nonverbal communication and feel manipulated by others’ gestures.

Finally, as this autistic boy develops, gains an attachment, has access to his feelings, develops self-agency and is less dissociated he will not only be able to read others nonverbal gestures, but also will be able to verbally express his feelings like all typical people do. Thus as the person with autism develops, we see a change in his ability to function in the world. Autism is seen on a continuum from low functioning to high functioning to Asperger’s. I think there is a good reason to look at autism in this way. The child does develop. The child can actually move off of this continuum and become as typical as others.

Friday, February 5, 2010

Checking and Keeping Things in Order

“I have to check everything before I leave the house. If I deviate from my specific process, I have to start all over again. If anyone interrupts me in the process of checking, I have to start all over again. I am afraid if I do not follow the checking rules something bad will happen. When I do not do things in order it feels like I am doing something wrong. I cannot deviate from what I think of as my order. Order makes me feel comfortable. It relaxes me. Also I am not equipped to explain myself if I am going out of order. I do not have a way to defend myself. Order is my way of knowing what to expect and to know what comes first, second, etc. I cannot use myself so how can I explain if things get out of order?”

What is this autistic boy telling us? He checks and keeps everything in order and cannot deviate from his process. This reminds me of another autistic boy who would line up letters of the alphabet. If I took a letter and put it in the wrong place he would immediately change it back to its proper place. Both these boys are telling us that keeping things in order and checking helps to keep them calm and relaxed. They are self-regulating. They are both very fearful if things are out of order and not in their proper place. This autistic boy is very aware that he does not know how to express his concerns about order. He is obsessed with this need for sameness and order.

Checking and order seem to provide, as this autistic boy told us, a way to calm himself down and to regulate himself. Infants learn to self-regulate through the mutual regulation that takes place between mother and child during the attachment process. The child with autism has an incomplete attachment so can only rely on himself for methods to self-regulate. Each child with autism will find his own methods to self-regulate. As the child completes the attachment process, he will learn other methods to self-regulate through the interaction with a caregiver or a therapist. As this occurs, he will start to feel less anxious and will be able to give up coping strategies that were developed to manage his anxiety and stress.

I also think that other things are going on that we might speculate about. From the perspective of an Incomplete Attachment this child is trying to keep things in order because 1) he feels no order from within. In other words, he lives with a chaotic internal world, which is dissociated and does not allow him to have access to his words (lacks self-agency), 2) if he had access to his words then he could live without fear and 3) be able to respond to spontaneous situations and allow things to be out of order. Spontaneity from this perspective comes out of being sure of oneself which comes out of the ability to have access to ones feelings and to express those feelings freely.

This autistic boy may be checking for multiple reasons: 1) it provides as mentioned previously a way to feel calm relaxed and self-regulated and 2) from the perspective of an Incomplete Attachment, the autistic child is dissociated and can never be sure of ‘what has just happened’. He is never sure that what he has just experienced has really happened. He has no way of ‘testing reality’ by asking questions especially if he is low functioning. Thus he is left to his own devices to try to figure out what is going on. In a dissociated state, nothing feels stable and the child cannot be sure of what is happening at any point in time. Thus the checking is his way of making sure that everything is stable and that what he really saw did actually happen.