"Where is my Personality?"

"Why doesn't anyone recognize that I do not have a personality? I know that I do not. The other day I realized that I could sneak out some words and that nobody knew that I was sneaking. Are people so stupid that they cannot tell when someone does not have a personality, when someone cannot cry, when someone is sneaking? I guess if they cannot tell, I will sneak out and practice being a person. The pain of not being is scary and all consuming. I have to work real hard so to get to the other side where happiness lives."

What is this autistic boy telling us? He knows he does not have a personality and is not a person. He is very aware that other people are different. He seems envious of their ability to exist and to be a person. He seems determined to get a personality by what he calls sneaking out words. He also notices that others do not know the difference when he does this. He seems very lonely, in a lot of psychic pain and desperately wants to be like others.

What does it mean to have a personality? This autistic boy is opening up an important issue. I would like to delve into this subject briefly. The definition of personality from Webster's Dictionary (1989)*: "the visible aspect of, one's character, the sum total of the physical mental, emotional and social characteristics of an individual and the quality of being a person; existence as a self-conscious human being. Some might also think about personality as what we call our self.

According to Adams (1954, cited in Schultz & Schultz, 1994) * personality is 'I'. Adams suggests that when an individual uses 'I' he is expressing his personality, which describes who he is. Thus we are always describing ourselves and showing our personalities when we use the word 'I'. Furthermore, "The word I is what defined you as an individual, as a person separate from all others." (Schultz & Schultz, 1994, p.8)

This is important based on what we know about autism from an incomplete attachment. It is my belief that the child with autism does not have access to his 'I' because he does not have access to the different parts of himself because those parts are dissociated. He also does not have what I call self-agency which allows him to use those parts of himself in relationship to others. Thus we can now make sense of what this autistic boy means when he says he "wants a personality." He wants to have access to those dissoicated parts of himself and more importantly he wants to talk about himself using 'I'. As we know some people with autism refer to themselves using 'you' or echolalia. It is not until an individual has a completed attachment will he be able to use 'I' in relationship to others. It is also important to note, that individuals with autism do want relationships. A lack of self-agency and dissociation make this difficult to accomplish.

Most 'typical' individuals do not have to think about what it means to have a personality or to talk from the 'I' position (see my blog on communication and autism). The person with autism struggles with these ideas on a daily basis.


*Webster's Encyclopedic Unabridged Dictionary of the english language (1989), The dictionary entries are based on the first edition of the Random House Dictionary of the English Language (1983). New York/New Jersey: Gramercy Books.

*Schultz, D., & Schultz, S.E. (1994). Theories of Personality (5th ed.), Pacific Grove, CA: Brooks/Cole.

Feeling Sick: Communication, Obsession and Autism

"I like being sick with the flu. It's not that I really like being sick, but I like the attention I get when I am sick. My mother is the perfect mother when I am sick. I even feel that I can talk when I am sick. Usually I don't like to sleep with the light off at night and the door shut, but when I am sick I just do not care about those things. The pain of sickness seems to create a situation where I feel more normal than I usually do. This is something I have thought about a lot. I have figured out that when I am sick it is my one chance to talk about the pain that I feel inside. So when I talk about the pain due to fever, I am really also talking about the pain inside. It is not socially acceptable to talk about my inside pain and besides I don't believe others including my parents would understand my inside pain. The pain inside is my secret and I must handle it by myself. That is one of my rules. When I am sick it is an opportunity to talk indirectly without revealing myself too much."

What is this autistic boy telling us? He seems to feel more 'normal' when he is sick with the flu. He can do things during this time that he feels he cannot do otherwise. He also realizes that he can use his flu symptoms as a vehicle to talk about his deep internal feelings. He knows he cannot talk because he does not have the ability to use himself with others. This is what I call a lack of self-agency. He also knows that by using something that is really happening he can in some sense talk out of two sides of his mouth. On the one hand, he is talking about how he feels with the flu, but more importantly he is also talking about his deep psychic pain and feelings.

This is a common phenomenon for those with autism. They cannot talk about themselves or represent themselves to others, but they can talk (if they have words) about what they see outside of themselves. Thus some people with autism can be seen to talk on two different levels. The obvious level (in this case about his flu) and the less obvious which is a much deeper feeling state.

Another example may be helpful to explain this phenomenon. As we know children with autism are known to have obsessions. These obsessions seem to be unique to each child. It is my belief that if we take any one obsession, we can understand it from two different levels. For example, a child may be preoccupied with cars, trains and other modes of transportation. One level of understanding is the obvious. Typically, one would say, "he is obsessed with cars and trains." On a deeper level, I believe is is also saying, "I cannot move and I am trying to figure out how things move and I need you to help me move."

Why does the child with autism use this very indirect way of talking about what his needs are? It is important to remember that people with autism have anywhere from none to very little self-agency. Self-agency is what gives us the ability to represent ourselves in relationship to others. Thus, these children do not have a way to represent themselves with others, but their bodies still need to communicate. Thus the child with autism communicates through his body in a way that most people are unfamiliar with. Once the child feels his obsession is understood and recognized, he can let go of that particular obsession. Thus the obsession serves as a vehicle to communicate ideas and feelings that the child cannot otherwise communicate.

Eye ‘I’ Contact and Autism

“Sometimes I practice looking at someone directly to see what it feels like. If I practice long enough maybe it will feel okay to do. I notice that this is important, but it goes against my rules. If somebody made me look at him in the eye, I would probably do it, but you better believe that I would hate him. I will look someone in the eye when I am ready and do it in my own time and space. If someone is trying to fix himself that part is just not ready yet. Have you figured out that I am very stubborn? It's not that I like being stubborn, but I need to protect myself.”

Let’s make sense out of this autistic child’s experience. We can only infer what is going on within him. He seems to be telling us that eye contact does not come naturally to him. He also might be saying, “leave me alone and do not force me to use eye contact.” If he is forced, he is saying he will resent that person’s interference. Finally he is telling us he is trying to fix his situation and does not want to be intruded upon by others.

What do we do about this child’s lack of eye contact? This is a quandary for us because as ‘typical’ people we know that when good communication is taking place eye contact is direct and focused on the other person. With the person with Autism Spectrum Disorder (ASD), this is not the case. In fact it appears to be just the opposite. The urgency is to want the person with ASD to be in the world and be like us. This may cause us to force or demand the child to use eye contact. I believe this is putting the ‘cart before the horse.’

As we know people with ASD struggle with communication and relationships with others. Eye contact stands out as a nonverbal gesture that feels troublesome for those who work with or have children with autism. I believe that the child will start to use eye contact when he is ready. Thus we need to be patient and let it happen in the normal course of the child’s development.

Some thoughts to think about regarding eye contact: 1) the child is not deliberately being difficult by not using eye contact, 2) his body will not let him use eye contact or let him use his bodily gestures as we might be familiar with, 3) this does not mean that the lack of eye contact cannot change over time, 4) as the child develops his ability to communicate verbally, his use of direct eye contact will develop as well, 5) in fact it might be the last nonverbal gesture he will be able to conquer. This will vary from child to child, 6) eye contact is a nonverbal (gesture) communication from the unconscious of a person, 7) when communication is good we say that the person is congruent. Their verbal communication is complimented by their nonverbal gestures (eye contact being only one of many nonverbal gestures). This means that the person will use direct eye contact when he feels more comfortable with his verbal communication and his relationships with others. Eye contact demonstrates the individual’s confidence and self-esteem, and finally 8) a way to think about eye contact is that the child will use ‘eye’ contact when he can use ‘I’ contact.

Goal III - Development of a Repertoire of Practical Techniques - Part I

This blog is a continuation of the goals of Relational Therapy. In this discussion I will emphasize how the caregiver or therapist can set out to develop a repertoire of practical techniques while utilizing Relational Therapy with individuals with Autism Spectrum Disorders. Part II of this blog will be a continuation of a discussion of practical techniques that one might use in working with those with autism.

Goal III: The development of a repertoire of practical techniques (Techniques to be used when working with a person who does not have access to use herself in relationship to an other – lacks self-agency)

A. Do not try to extinguish the “behaviors” that the child uses to communicate. This is their only means of communication. This is important for the following reasons: 1) Without the use of oneself, the child exists at the mercy of the other, 2) Without the use of oneself, the child’s body responds to the ‘other’ as if the other controls them, 3) The child is inseparable from the ‘other’ – if the mother says something, the child feels they now have been given permission to exist. This is a very fleeting experience. The child does not have a mind to use with the other. The only thing the child can do is exist as the other. 4) If you do not have any use of yourself in relationship to others, you forget yourself when you are in relationship with an ‘other’. The other ‘other’ becomes like the boss of ‘you’. You cannot make a move unless the other moves first. Your body will not let you move on your own. You are at the will of the other. This is a very good example of being in the waiting position – waiting to attach. 5) Everybody on the outside becomes that “hoped for person” to attach to. Your body acts as if this is the person to attach to and 6) It is important to understand that the child does not have any control over these behaviors or their bodies.

B. Do not force eye contact. As the child can use “I”, the child will use “eye” contact.

C. Interpret the behaviors the best you can back to the child. In doing this, you are letting the child know that you understand what is going on.

D. Understand that the “autistic behaviors” are communications of an unconscious child who uses his body as a means of communication.

E. This type of communication is not nonsensical. It just needs to be understood as one might understand a dream. Also the child talks in metaphor that is like a mystery that needs to be understood

F. It is your job to make meaning of the communication by using words that symbolize the autistic child’s/adolescent’s behavior and or communication. The child does not have the ability to symbolize words and use them as a typical child might. Thus we need to be the intermediary in helping to put words to their actions.

G. All the behaviors of an autistic child are important and need to be understood by the therapist or caregiver so the child can feel understood and recognized.

H. In whatever way you can, let the client know that you see and understand him.

I. The child may or may not let you know that they feel understood.

Next week we will continue this discussion which will include more techniques you can use when working with your autistic child.

Autism and Communication

Getting one’s needs met and to exist happily in one’s family, community and beyond is dependent on the ability to communicate. As non-autistic individuals we can use ourselves to communicate our needs and express our feelings. The autistic individual depending on their functioning level, has anywhere from extremely limited (nonexistent in some) to some ability to ask for their needs to be met. Some people with autism seem to communicate by perseverating on a topic that seems to not relate at all to whatever the topic might be. For example, one child may become fixated on televisions and only be able to talk about this subject, no matter what else is being discussed. It is not unusual for autistic individuals to seem to come out of "left field" with what they might say. For example, the topic may be "going to the grocery store and what will be bought at the store." The child may say, “you are pretty.”

There are also individuals who are nonverbal, those who use echolalia and still others that can only express their needs by reversing their pronouns. When they want a cookie to eat, instead of saying “I want a cookie,” the child may say, “you want a cookie.”

Let’s make sense of what is going on. If as I am suggesting the child has not had the benefit of an attachment, lacks the ability to use him/herself in relationship to others and is also in a state of dissociation with varying degrees of consciousness then I would continue to propose that the child’s ability to communicate is going to be compromised. Let me explain how these different elements contribute to not only problems in communicating, but also relating to others.

It is important to remember that the autistic individual wants to communicate and in fact is always communicating about himself even though he may be nonverbal, echolalic or reversing pronouns. He is like any human being in that he has a need to communicate. Unfortunately, because he has had an incomplete attachment, he cannot identify his feelings, which are dissociated, and therefore cannot use those feelings to express his needs. In other words, he has not developed to a level where he has self-agency. This means he literally cannot ask for anything for his own benefit. This is not a physical problem, but instead a “developmental problem” that can change over time.

It is my opinion, that what one sees with the nonverbal autistic child is the reverse of what one sees with a “typical” child. I call this phenomenon “Inside out, upside down.” In other words, the unconscious part of the child is on the outside and the conscious part is in the inside. That is why some nonverbal autistic children seem out of control and low functioning, but with the use of a computer can communicate beautifully in writing. This is a very good example of the split or dissociation of the self. Most people are unfamiliar with seeing the ‘unconscious.’ Because most people are unfamiliar with the workings of the unconscious, autistic individuals are constantly misunderstood.

The phenomenon of echolalia is also something that can be understood. One first needs to remember that the autistic child has minimal and varying (depending on their functioning level) ability to use oneself in relationship to others. Also it is important to remember that a lack of attachment precludes one from being able to use one’s self. Thus echolalia is the result of not being able to use one’s self. The child only has access to what they hear. They may hear “do you want a cookie?” Developmentally all the child can do is mimic the other person. There is no awareness and ability to use the self in response to the other. Thus the end result is a repetition of what the child heard.

The child who reverses his pronouns and uses ‘you’ to mean ‘I’ is beginning to use his self with others. The child uses ‘you’ because it is safer than ‘me or I.’ The autistic child does not feel safe in the world. Everything is confusing, awkward and anxiety producing. The use of ‘you’ as it refers to the self is another example of dissociation. As I mentioned before the child is split. As the child develops and he becomes less split and gains more agency, he will then move to using the pronoun ‘me’ and finally as he has more and more access to himself, he will be able to use ‘I.’ There seems to be a direct correlation to the use of ‘I’ and ability to know and access feelings and use them in relationship to others.

Now lets look at why the communication of autistic individuals appears inappropriate. First of all, I believe that an autistic individual is always communicating his state of existence. Unfortunately, most perceive these communications from their own experience, which includes having completed the attachment process. In working with autistic individuals, many try to extinguish the “odd” behaviors of the child. In doing so, we are not understanding the message the child is trying to communicate through his strange behaviors. We in a sense are helping them feel misunderstood versus understood and not seen versus seen. Instead these communications need to be understood within the context of a child who has never attached and cannot use the self to communicate. Every behavior that the child uses can be understood and must be understood so that the child can gain understanding and recognition, which are precursors to being able to attach. Our work with the autistic person is to understand, validate, accept and recognize the autistic person. If the caregiver or professional can recognize and see the child, then the child can start to see him or herself.

Examples may help you to understand what I am communicating. I visited a three-year-old nonverbal boy, who had never seemed to play appropriately with his toys. In observing him, I noticed he was picking his lips. Instead of telling him not to pick his lips, I said, “you are telling me that something is going on around your lips and your inability to talk.” He looked at me and then played appropriately with a toy. Another example will help to highlight this point. I worked with another boy who liked to watch videos. He had certain ones he wanted to make sure I saw. One day, he showed me a video, which explained a complicated family dynamic. I interpreted the dynamic as it related to his family. As I was able to do that, he could begin to talk about his own personal experience. These are examples of how one interprets and uses projection with autistic individuals to gain access to their feelings (I will discuss how this is done in another blog).

In concluding this blog, I want to restate that the perseverations, the out of context communications, the use of pronoun reversal, echolalia, nonverbal communication, to name only a few, can be understood through the lens of an “Incomplete Attachment” which leaves the individual in a state waiting for the completed attachment and without access to self or what I call self-agency.