"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.

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.

"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.

Anger and Rage

"I am very angry and filled with rage. I cannot express my anger, but I feel it. This anger permeates into every part of my being. It helps me to stay alive. It gives me energy to exist. It seems to be functioning to protect me. It is like a person standing over me and protecting me. It feels as if the rage has torn me apart and allows one part of myself to take care of the parts that cannot take care of themselves. My anger and rage are being put to work to function in a way that is helping me inside. This anger and rage is inside waiting to come out. It cannot come out now because it has an important job to do, but when it does it will fill a very large room."

What is this autistic boy telling us? We can break up his message into two parts: 1) the dissociation experienced by individuals with autism and 2) how emotions such as rage and anger function within the individual with autism.

He seems to be telling us that he can feel his anger and rage, but more importantly cannot express it. From his vantage point, these emotions seem to be functioning as an internal protective mode. They protect the weaker parts of himself that cannot protect themselves. It is like they are functioning as people to protect him.

In some regards this can make sense. The individual with autism has not had a completed attachment and thus is left in a dissociated unconscious state (lowest functioning child with autism). This changes as the child develops. Thus he can become more conscious and less dissociated and then we would call him high functioning or with Asperger's. Eventually he may not be identified as being on the autism spectrum at all.

It is important to note that from the perspective of an incomplete attachment the child is functioning in a normal state of dissociation. Parts of the self are not conscious to or available to the child to use in his communications with others. It is this state that the child with autism lives. Bromberg (1994)* believes all individuals begin life made up of multiple self-states. Our wholeness develops through a relationship with another person. Because the person with autism lacks an attachment, he remains in a non-whole state. Thus the individual has different parts of himself that have not been validated, remain unconscious and are also not integrated.

In this situation, this autistic boy not only is in a normal state of dissociation, but also as he lives in this state of dissociation and as he develops, he learns to adapt to the situation and parts of himself (in this case his rage and anger) become internal methods to handle and cope with his dilemma.

I believe that as he develops a significant relationship with a person who understands his predicament, together they can forge an attachment which will help him to become less dissociated. He will be able to communicate his rage and anger and other emotions as he becomes less dissociated. As this occurs, he will be able to communicate his feelings that up to this point have only been internalized.

It is important to note that some individuals with autism are filled with rage and anger and that as they do develop we see more of the explosive anger coming out. Some individuals seem to be filled with inordinate amounts of anger. I think of this from three perspectives: 1) the excessive anger might be due to his rage at not having had a direct outlet for these emotions. In other words, he had to live without access to his emotions so he is filled with anger that has never previously seen the light of day, 2) when anger is dissociated the child does not have control over this emotion. Until the angry feelings are understood, they will come out as intermittent explosive acts of rage and 3) he probably has lots of angry feelings towards others that may not have helped him to express his anger. This may not seem logical, but I would imagine the child with autism looks to the caregivers and others to know how to solve his dilemma and when this does not occur in a reasonable period of time, his anger may grow. When he finally has access to his emotions, there is what I think of as a lot of residual anger to deal with. Thus it would be important that when working with individuals with autism from a relational perspective, to expect this build up of anger to come forward. This will be a positive move for the individual with autism, but caregivers and others may not know how to manage their own feelings when they are bombarded with these angry emotions.

* For more information on dissociation see: Bromberg, P.M. (1994) "Speak! That I May See You" Some Reflections on Dissociation, Reality, and Psychoanalytic Listening. Psychoanalytic Dialogues, 4 (4): 517-547.

Relational Therapy and an Incomplete Attachment: A New Look at the Etiology and Treatment of Autism Spectrum Disorders - Glossary of Terms

In introducing a new theory of autism, it is important that everyone have a glossary of terms that can be referred to that explains the terminology I use in my writings. This glossary is a ‘work in progress’ that will be tweaked as I receive feedback about how helpful it is.

1. Incomplete Attachment (also referred to as a lack of attachment) - the belief that children on the spectrum have not had the advantage of a completed attachment. Thus during the attachment period of life (birth – three years old) the child has not attached to the caregivers. There are probably many reasons why this has not occurred. It is not the fault of anyone. It is my belief that what one sees when observing children on the spectrum is a child who is waiting for the attachment process to be completed. The child is doing the best he/she can to cope with this predicament. All the behaviors such as flapping arms, nonverbal communication, echolalia, lack of responsiveness to others or inability to communicate one’s needs are coping mechanisms that can make sense when taken from this perspective.
2. Sense of Self-Agency – is the ability of the self to take initiative, to regulate oneself and to be the source of one’s behavior. A sense of self-agency is developed within a relationship with another person. The autistic person has an incomplete attachment thus does not have the advantage of self-agency. The functioning levels of those with ASD correspond with the degree of self-agency the individual has. The lower functioning individual has very little self-agency and thus is nonverbal or can only use echolalia. As the individual gains more self-agency we start to see the use of words such as “me” and “I” as well as more interactive behaviors. Then we start to call the person high functioning.
3. Dissociation – Parts of the self are not conscious to or available to the person to use in their communications with others. It is the state that the ASD individual lives. Bromberg (1994) believes all individuals begin life made up of multiple self-states. Our wholeness develops through a relationship with another person. * Because the autistic person lacks an attachment, he remains in a non-whole state. Thus the individual has different parts of himself that have not integrated. What does dissociation look like: 1) the person who is talking about one thing and then switches to another topic very dramatically, 2) the person who cannot talk about feelings, but can talk about an obscure topic, 3) the person who has a special ability such as remembering dates, but cannot attend to the topic at hand.

* For more information see: Bromberg, P. M. (1994), “Speak! That I May See You” Some Reflections on Dissociation, Reality, and Psychoanalytic Listening. Psychoanalytic Dialogues, 4 (4): 517-547.

Core Four of Relational Therapy Continued

The previous blog introduced the Core Four of Relational Therapy. The emphasis of that blog was to discuss the beliefs that are necessary for a parent/caregiver to incorporate when working with Autistic Spectrum Disorders. This blog will address the final two of the Core Four – assumptions and goals of Relational Therapy.

Assumptions that are the basis of Relational Therapy:
A) Relational Therapy is based on the assumption that the autistic child has not had the advantage of an ‘emotional attachment’, B) The child cannot use herself in relationship to others. To expect the child to be able to use herself is like “putting the cart before the horse”, C) A pervasive lack of self-agency means one cannot literally use one’s body, voice, arms or legs – low functioning autism, D) Higher levels of autism can be equated with the ability to utilize dissociation as a mechanism for survival, E) The child is living within the unconscious and thus her behaviors can only make sense if you understand the behaviors as unconscious unvalidated communications, F) There is nothing physically wrong with the child although the child and others feel something is physically wrong, G) What is ‘wrong’ is the delay in psychological development, H) The problem one is working with when working with an autistic child is their psychological development not their physical development, I) We are working with the concept of “Theory of Mind” and not intellectual development, J) Accept the child’s present state of psychological development knowing that it will change. Hold on to the belief that the child will change through the relationship with you. You are trying to forge an attachment, K) It is through an attachment that one can speak when our actions are understood, validated and accepted by another. The ‘other’ through this process, helps the child symbolize their experience. At that point, the child starts to see herself in the eyes of the other, L) The child is in a dissociated state – their intellect is separate from their emotions, M) Savant abilities are an example of a dissociated state, N) Our job is to relate to their emotional states. When this is done the emotional as well as the intellectual part will develop, O) Because the child cannot use herself she will depend on you the professional/ parent to jump start the attachment process, P) The child has no control over her behaviors, Q) The child is ready to attach, but will resist the process (unconscious) because of an original experience of a ‘lack of attachment’, R) The child through the therapeutic process or with the parent needs to have an experience of attachment, S)You are extremely important to the child. The child feels that their life depends on you. From an unconscious perspective, they need you for their development. They do not need just anyone one. They need someone who will be consistent and understanding of their predicament. You become that all-important person to them. That is how important their development is to the child. If you do the wrong thing, then you stop their forward movement. You have to be perfect or at least they need to know that you are trying to do your best. The child will know through your tone of voice and actions how serious you are about their predicament. If they sense you are not serious, then they will not ‘really’ attach to you. That is why it is so important for you to take them seriously. Their development is actually dependent on YOU. They know this and you need to work with them in such a serious way that they believe that you also know this. Also that is why it is so important to understand their predicament. If you do not understand autism from a lack of attachment, then you cannot reflect back to the child that “our presence together is important and what we do together will help the developmental process”. It is the relationship between the two that heals the child and makes the therapist better for having had this experience. Your belief in the importance of your role, the relationship and the child is paramount for the child’s growth. At all times you need to take this seriously. Never let down in your belief in the seriousness of the situation, T) It is important to not take the message of an autistic child from a literal or as a concrete perspective. Autistic children are always communicating on two different levels. The outside communication and the inside communication. Many times, the outside communication appears disjointed or unrelated to what is occurring in the moment. Many of the perseverations of the children are examples of this type of communication. These communications appear confusing to the outside world, but when interpreted properly, in the moment the child feels a sense of understanding that slowly moves the child to forming an attachment with the therapist/parent, U) This attachment process will be slowed down and difficult at best because a basic level of trust needs to be developed with the child, V) The child cannot use themselves in relationship to others and thus you must not expect that they will be able to respond to your requests (lower functioning child), W) Accept that they are existing, but not in the manner you traditionally expect of children, X) You will need to change your frame of mind when working with autistic children – their ability to be conscious about themselves does not exist especially in relationship to others, Y) If they could use themselves they would and eventually will be able to, and Z) You need to hold on to the belief that they can change.

The following are goals to incorporate as you conduct Relational Therapy:

1) Develop a therapeutic frame
2) Develop a model of attachment and engagement
3) Development of a repertoire of practical techniques
4) Develop specific steps in deciding which techniques to use

Autism and Dissociation

Through the lens of an “Incomplete Attachment” I have described that the autistic child is experiencing dissociated states. What does this mean? From my perspective, the child has many parts of himself that have not become integrated as a whole. These aspects of the self have not been validated and recognized by “an other” so the child, in turn, cannot use and see himself. Thus the different parts of this child become dissociated and cannot work together to the benefit of the child. We can say that this child does not have the ability to go from one part of himself to another. The child also cannot go within himself to retrieve these dissociated parts.

How can I recognize dissociation in an autistic child? Dissociation is easy to recognize. We all have aspects of dissociation, but it is more profoundly seen in Autism Spectrum Disorders. The following are examples of dissociation: 1) reduced sense of pain – the child may burn himself, but not demonstrate any outward behaviors that say, “I am hurting.” The pain is there and he feels it, but he is split off from his ability to claim it and name the feeling, 2) Exceptional savant skills – such as extraordinary ability to remember days of the week of birthdays and dates associated with events, ability to do mathematical calculations that others can only do with the help of a calculator or great musical and artistic abilities. These abilities seem to coexist with what appears to be severe disabilities. Most people observing such a mixture of behaviors would be confused and conclude that there must be something “wrong” with a person who on the one hand has great musical ability or artistic ability, but cannot talk. I would say this is an example of dissociation in that the emotions are split off from the intellect of the person, 3) Cannot shift thinking from one subject to another – this is an example of not being able to go from one part of the self to another. The individual is demonstrating on the outside of himself what is occurring on the inside of him. In other words, his inability to go from one part of himself to another, and 4) the child can think through mathematical problems, but cannot think through and understand social interactions – the child has access to his intellect, but no access to the emotional parts of himself. The emotional side is harder to access if you have never had an attachment. It is through an attachment that one feels understood and seen and in turn can talk and have access to the emotional parts of one’s self.

These are only a few examples of what I think about when observing the autistic person through the lens of dissociation and an “Incomplete Attachment.” When one thinks about autism from this perspective than one can have hope that the child can develop into an integrated person. The work with the autistic person is to help them to become more conscious of the split off parts. This includes helping them to name their feelings along with the development of a trusting relationship with “an other.” As they become more conscious of themselves their dissociated parts will begin to work together.

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.

An Incomplete Attachment and Understanding Autistic Behaviors

What does an incomplete attachment look like? One only needs to look at any child, adolescent or adult on the autism spectrum continuum to answer this question. The behaviors one sees with such individuals seem to be confusing and do not make sense. No two individuals with autism seem similar or manifest the same behaviors. If one thinks about autism from the perspective of an incomplete attachment then the developmental delays and the children will make sense.

From this perspective, the child has not had the benefit of a completed attachment. As all infants, she is born into the unconscious ready to be brought out in relationship to the caregiver, but this does not happen. The child is in a waiting state. He or she is waiting for a completed attachment. Thus the behaviors that one sees in the autistic child are the result of not having had a completed attachment. The behaviors are what can be called “coping” and “state of existence” behaviors. Each child will cope differently to the circumstance and thus will have different behaviors as compared to another child. A key point to mention is that because of the incomplete attachment the child is left without the ability to use herself both in body (lacks self-agency) and mind (lacks theory of mind). The ability to use one’s self will vary from child to child. Some children will be more conscious of him/herself and thus have more access to use themselves in relationship to others. Thus we have a continuum of ability, which is typically known as the functioning level of the individual on the spectrum (low functioning, high functioning and Aspergers).

To explain it in a little more depth, the behaviors one sees in autistic individuals are unconscious behaviors that have been dissociated or separated within the child. It is like the child is of two minds, the conscious mind and the unconscious mind. This is true of all human beings. Within the autistic child they are more dissociated and split from their emotions than others who appear to develop “typically.” Dissociation does not give us the complete picture. From a broader perspective, one can say that the child on the autism continuum has a lack of a completed attachment, has a dissociated sense of self, has developed coping mechanisms to manage the situation, is unable to use one’s self in relationship to others, seems to lack the knowledge of their own emotions and is unable to access those dissociated emotions and finally uses indirect mechanisms to grow in relationship to others. The treatments that seem to help this population are actually helping the child to become more and more conscious and integrated as a human being. Below I have compared the developing autistic child to the developing “typical” child.

“Typical” Child
1. On a continuum – from partial sense of self to a well integrated sense of self
2. Attachment has occurred
3. Ability to use oneself to get needs met. The degree that the individual can do this will vary widely
4. Knowledge and ability to know one’s emotional feelings
5. On a continuum has access to use one’s emotions in response to the other
6. Transference occurs in the relationship in a way that is typically understood
7. Can use the relationship to grow

Autistic Child
1. Varying degrees of dissociated sense of self
2. Lack of a completed attachment
3. On a continuum - from no ability to use oneself in relationship to another to ability to use oneself on a limited basis
4. Lacks knowledge of one's emotional feelings
5. Does not have access or ability to use dissociated emotions
6. Transference expressed in ways unfamiliar to most (indirect). Transference is fragile
7. Does not directly use the relationship to grow (indirect usage)

In my next blog, I will take the behaviors of the individual on the autism spectrum and make sense of them.