“I am five years old. Terror is my bosom buddy. It never leaves me. It follows me like night follows day. I cannot move. I feel petrified like “petrified wood.” Every movement, every gesture is scary, beyond scary - frightening beyond belief. Words will not come out of my mouth. They stay in there like immovable objects. Words are frightening. They are enemies. Sentences seem fragmented. When I talk, I feel like one word is on my left and the next on my right. I feel like it will be damaging for me to talk. Every word I say will hurt me. I must not talk. My words are too threatening.”
What is this autistic boy telling us? From my perspective he is saying his fear/terror/anxiety is so big that he cannot manage himself. He is so scared he becomes ‘immobile’ and unable to function as a human being. He has turned to stone like a piece of petrified wood. Some might say he is scared out of his mind. This can also be called a type of hysteria. He is telling us that not only does he feel like ‘stone,’ but also that it feels like his words are stuck within him and are too frightening to use. We can say that words are not easily used if at all by him. Words seem all over the place for this autistic boy. Finally, probably because of his frightening experience with words he has decided that his spoken words are too threatening for others to hear. Thus he decides that he will keep to himself out of fear of hurting others as well as himself.
Let’s make sense out of this boy’s experience with anxiety and his frightening experience with words. From the perspective of an “Incomplete Attachment” we can make sense out of what is occurring here. During the attachment process, a child gains the ability to self-regulate through the experience of mutual regulation with the primary caregivers. Because the autistic child has not had a completed attachment he has not benefited from this regulation process. The child is left ‘waiting’ for the attachment process to resume. Within this state of ‘waiting’ the child is coping with an existence that is very different than for those with a completed attachment. An observation of any autistic child will give us a glimpse into how hard it is to exist without a completed attachment. Each child will have different methods of how he will cope with this unusual state of existence. That is why each autistic child seems so different from another child, but also at the same time can have similar behaviors. Without the ability to self-regulate which comes with a completed attachment the child is left in an extreme state of anxiety. Everything he does is filled with anxiety – moving his body, talking, walking and bodily functions to name only a few.
Therefore, working with those with autism and extreme states of anxiety, we need to 1) recognize that anxiety is a part of the autistic experience, 2) anxiety is the result of an “Incomplete Attachment”, 3) the key to working with the autistic child is to help him have a completed attachment, so the child can learn to self-regulate, and 4) in order for the child to have a completed attachment he needs a caregiver/therapist who can help in the process of mutual regulation.
Showing posts with label anxiety. Show all posts
Showing posts with label anxiety. Show all posts
Thursday, November 26, 2009
Thursday, October 8, 2009
Without Words
“I cannot ‘come back’ and defend myself. I cannot respond to others. This is scary, beyond scary. It is terrifying. Sometimes the words seem to be accessible, but as I open my mouth they disappear. In the presence of another, I instantly forget what I was going to say. This happens over and over. I want to talk, but I forget what to talk about. It feels like I am a blank slate. It petrifies me. People on the ‘outside’ expect me to talk. What am I going to do? Sometimes I watch real carefully to see what would be a good answer and give them back what they want. I am pretty good at this. I feel this is the only way to survive. Survival is becoming my middle name. Who would ever understand that I am a blank slate? When I am alone I am not blank, but in the presence of others I am. I am a blank slate walking around in a person's body. Please help me. This is too much for me to know. Who will listen to my burden?”
Let’s make sense out of this autistic child’s experience. We can only deduce what is going on within him. He seems to be telling us he has no ability to respond to others and this scares him very much. He says he wants to talk, but in the presence of others he goes blank. By himself he is not blank and can form ideas and probably has feelings. Finally he feels burdened by this experience and there is a sense of hopelessness and desperation in his writing. In my previous blog, we understood his experience to be a feeling of lack of freewill and control over his environment.
This child is describing the experience of not being able to express himself as he sees others do. It is a tortuous experience, which he seems to lack the ability to change on his own. I believe it is important to note that this phenomenon is probably going on with others with Autism Spectrum Disorders as well. He is describing how relationships cause him tremendous anxiety and cause him to collapse. He is not ‘falling apart’ because he wants to, but because of the anxiety.
How can we help this child who seems to collapse in relationship to people? Some steps that may be helpful for the child and yourself are 1) recognize that he has the potential to communicate, but the presence of another makes him feel too anxious and he ‘goes blank’ or forgets what is on his mind, 2) he is not going blank because he is willful or difficult, 3) help him to understand that you understand his predicament, 4) help him to become more comfortable with others including you. Until his anxiety is under control he will continue to go blank and finally 5) give him the time and space to talk. Create opportunities for dialogue with you.
Anxiety is something that people on the spectrum are always trying to manage. We need to put ourselves in their shoes. If they lack self-agency and dissociate in the presence of others, which creates an inability to communicate their needs than their daily existence will be one of coping and anxiety. People in general remain anxious when they do not have a way to self-regulate. 'Typical' people talk about their problems with others and hopefully find new solutions to manage a given situation or their anxiety in general. Because autistics do not have the ability to communicate their feelings we have to find other methods to help them to self-regulate.
What can we specifically do to help the autistic who is anxious? There is not an easy answer, but some thoughts to consider: 1) Talking about anxiety in general may be helpful. If the child is nonverbal, speak about how he might be anxious doing the specific thing he is doing. If he does have words either ask him how he is feeling or interpret what his anxiety might be like. Let him respond to you. It is important to not expect that he will be able to speak about his anxiety, but at least allow for this to be part of the discussion between the two of you. By doing this he is acknowledged for how he is feeling and hopefully in turn feels understood, 2) make room for the discussion of anxiety as part of the dialogue, 3) let him have the time he needs to warm up to new situations and not be pressured to comply to others' time frames and 4) work on developing a relationship with him that allows for mutuality, dialogue and direct expression of feelings.
Let’s make sense out of this autistic child’s experience. We can only deduce what is going on within him. He seems to be telling us he has no ability to respond to others and this scares him very much. He says he wants to talk, but in the presence of others he goes blank. By himself he is not blank and can form ideas and probably has feelings. Finally he feels burdened by this experience and there is a sense of hopelessness and desperation in his writing. In my previous blog, we understood his experience to be a feeling of lack of freewill and control over his environment.
This child is describing the experience of not being able to express himself as he sees others do. It is a tortuous experience, which he seems to lack the ability to change on his own. I believe it is important to note that this phenomenon is probably going on with others with Autism Spectrum Disorders as well. He is describing how relationships cause him tremendous anxiety and cause him to collapse. He is not ‘falling apart’ because he wants to, but because of the anxiety.
How can we help this child who seems to collapse in relationship to people? Some steps that may be helpful for the child and yourself are 1) recognize that he has the potential to communicate, but the presence of another makes him feel too anxious and he ‘goes blank’ or forgets what is on his mind, 2) he is not going blank because he is willful or difficult, 3) help him to understand that you understand his predicament, 4) help him to become more comfortable with others including you. Until his anxiety is under control he will continue to go blank and finally 5) give him the time and space to talk. Create opportunities for dialogue with you.
Anxiety is something that people on the spectrum are always trying to manage. We need to put ourselves in their shoes. If they lack self-agency and dissociate in the presence of others, which creates an inability to communicate their needs than their daily existence will be one of coping and anxiety. People in general remain anxious when they do not have a way to self-regulate. 'Typical' people talk about their problems with others and hopefully find new solutions to manage a given situation or their anxiety in general. Because autistics do not have the ability to communicate their feelings we have to find other methods to help them to self-regulate.
What can we specifically do to help the autistic who is anxious? There is not an easy answer, but some thoughts to consider: 1) Talking about anxiety in general may be helpful. If the child is nonverbal, speak about how he might be anxious doing the specific thing he is doing. If he does have words either ask him how he is feeling or interpret what his anxiety might be like. Let him respond to you. It is important to not expect that he will be able to speak about his anxiety, but at least allow for this to be part of the discussion between the two of you. By doing this he is acknowledged for how he is feeling and hopefully in turn feels understood, 2) make room for the discussion of anxiety as part of the dialogue, 3) let him have the time he needs to warm up to new situations and not be pressured to comply to others' time frames and 4) work on developing a relationship with him that allows for mutuality, dialogue and direct expression of feelings.
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