Autism in the Adult

Talking About Autism: Characteristics in Others

Join Dr. Regan for the final episode of the series "Talking About Autism." This episode focuses on how talk to others when you see autistic characteristics in them. 
New Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life
New Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website
Resources for Clinicians
 
Read the transcript:
00:00:02,540 --> 00:00:06,380Hello everyone.
300:00:06,390 --> 00:00:13,200This is Dr Theresa Regan and you are joining me for this episode of autism in the adult podcast.
400:00:13,210 --> 00:00:15,620I am a neuropsychologist,
500:00:15,630 --> 00:00:23,730the parent of a teen on the spectrum and I'm the director of a diagnostic autism clinic for adolescents,
600:00:23,730 --> 00:00:26,960adults and aging adults in central Illinois.
700:00:27,540 --> 00:00:33,220And we are in the third uh segment here of the series that we're calling,
800:00:33,220 --> 00:00:34,890talking about autism,
900:00:34,900 --> 00:00:43,350which has been a listener requested series and a really great topic to review together and discuss.
1000:00:43,930 --> 00:00:54,260The first episode was about personal journeys towards getting a diagnosis or receiving a diagnosis and how to communicate with others about that.
1100:00:54,740 --> 00:01:01,570The second episode was about navigating emotional atmospheres when talking about autism.
1200:01:01,570 --> 00:01:02,950For some reason,
1300:01:02,970 --> 00:01:21,150the topic can be very emotionally charged and it can be unexpected at times and intense and thinking about how to navigate all those emotions can help if you're wanting to talk more about the topic with other people.
1400:01:22,040 --> 00:01:30,930Uh and this episode is about talking about autism to others when its characteristics in them that you identify,
1500:01:30,930 --> 00:01:41,060that you wonder if they might be on the spectrum and you're wanting to bring up the topic and just kind of um suggest that to them or see if they've thought about it.
1600:01:43,640 --> 00:01:55,060What I'm going to do first is a segment where I'm going to lay the foundation for how I explain autism to other people.
1700:01:55,540 --> 00:02:02,610I think this Foundation may at times be something that you need a way of verbalizing.
1800:02:02,610 --> 00:02:04,960If you're going to bring up the topic to others.
1900:02:05,250 --> 00:02:06,650This may help some of you.
2000:02:06,650 --> 00:02:09,100It may be old hat for some of you.
2100:02:09,540 --> 00:02:16,530Um But it'll be after we review that foundational kind of information that I talk about.
2200:02:16,530 --> 00:02:24,360Some ways to approach people and ways to talk about the topic or introduced the topic.
2300:02:26,640 --> 00:02:30,060So when we talk about autism,
2400:02:30,640 --> 00:02:53,660you may be talking to someone who has less knowledge than you do about what it is and at some point in the conversation you may be wanting to clarify what it is so that they can consider the information um in a really accurate way.
2500:02:55,840 --> 00:03:03,850What autism is is a neuro behavioral developmental condition that's neurologic.
2600:03:04,340 --> 00:03:09,800Uh So what it means is that the brain,
2700:03:09,810 --> 00:03:17,060because it's in charge of our thinking skills are academic skills are motor coordination,
2800:03:17,070 --> 00:03:18,980our emotions,
2900:03:18,980 --> 00:03:21,110our personality structure,
3000:03:21,120 --> 00:03:22,950our behavioral patterns.
3100:03:23,340 --> 00:03:40,450Um Sometimes the brain has kind of an atypical wiring from birth that whereas one individual may be born with some atypical bone structure or an atypical heart valve.
3200:03:40,460 --> 00:03:48,150Um Others are born with an unusual pattern of neurological wiring and that's what this is.
3300:03:48,430 --> 00:03:57,710So it's a physical state and research at this point shows us that it's largely driven by the genetic code,
3400:03:57,710 --> 00:04:20,750which is not surprising in the sense that we now know it's not the result of poor parenting or um other things that decades ago people were talking about but that it's really um kind of this condition of how the code was revealed during development and how the body developed.
3500:04:22,440 --> 00:04:27,360Sometimes for the individuals with developmental differences,
3600:04:27,370 --> 00:04:32,280They have a few um atypical areas in their body.
3700:04:32,280 --> 00:04:37,530So one person might have a heart valve problem from birth.
3800:04:37,530 --> 00:04:41,610That's a congenital difference and may have autism.
3900:04:41,610 --> 00:04:54,890And in fact That is um true in the research that I think it's about 30% or so of kids with certain cardiac differences that are congenital,
4000:04:54,890 --> 00:04:58,500they're born with them are also on the autism spectrum.
4100:04:58,500 --> 00:05:11,660And the reason for that is just that this is a reflection of biology of how the person developed and came together before birth,
4200:05:13,190 --> 00:05:31,090neuro behavioral refers to the fact that the diagnosis only describes behavioral patterns and in that as a neuropsychologist behavior is interpreted perhaps more widely than than you might interpret it.
4300:05:31,090 --> 00:05:31,740So for me,
4400:05:31,740 --> 00:05:44,530behavior has to do with communication and the establishment of relationships and repetitious behavioral patterns and um reacting to the sensory environment.
4500:05:44,530 --> 00:05:48,260So all of those are neuro behavioral characteristics.
4600:05:49,640 --> 00:06:04,170One thing to understand that might make it easier to think about autism or to explain it to other people is that the brain is an organ that is organized.
4700:06:04,180 --> 00:06:11,330It's really organized by pattern and pathway and nuclei and location where,
4800:06:11,340 --> 00:06:11,780you know,
4900:06:11,780 --> 00:06:22,620you probably know that there are some things that the left side of the brain typically does and some things that the right side is in charge of and the same for the inside versus the outside.
5000:06:22,630 --> 00:06:41,660And there are some general patterns about how the brain is organized when a neurologist does a checkup for someone in the emergency room because they've had vision changes and they have weakness on part of their body.
5100:06:41,670 --> 00:06:46,190They will check all these kinds of things that the brain is in charge of.
5200:06:46,190 --> 00:06:48,500So they'll check the person's vision,
5300:06:48,500 --> 00:06:50,750they'll check the person's speech,
5400:06:50,950 --> 00:06:53,630their ability to find words that they want to say.
5500:06:53,630 --> 00:06:56,750They'll check the person's comprehension of speech.
5600:06:57,140 --> 00:06:59,130They'll watch the person walk,
5700:06:59,140 --> 00:07:01,680they'll check their strength and their reflexes.
5800:07:01,750 --> 00:07:11,060And the reason they do this is that it tells them something about what part of the brain might be struggling.
5900:07:11,440 --> 00:07:13,920Because we know for example,
6000:07:14,040 --> 00:07:17,540that in general the right side of the body is,
6100:07:17,550 --> 00:07:21,780is controlled uh in strength,
6200:07:21,790 --> 00:07:23,410in that muscle strength,
6300:07:23,420 --> 00:07:26,010by the left side of the brain.
6400:07:26,020 --> 00:07:31,380And so if the person's presenting with right sided weakness,
6500:07:31,410 --> 00:07:34,150there may be a left side of the brain issue,
6600:07:34,160 --> 00:07:39,860But it gives you this sense that when we see clinical signs,
6700:07:40,440 --> 00:07:46,080we can make conclusions about pathways and locations in the brain.
6800:07:47,330 --> 00:07:52,420The same is true when we look at neuro behavioral patterns.
6900:07:53,110 --> 00:08:00,700The reason I bring this up is that I think it gives meaning and cohesion to this concept of autism.
7000:08:00,700 --> 00:08:22,910That the reason these characteristics hang together in the same person is that they tend to hang together in certain pathways and connections in the brain and that to me gives this a kind of meaningful picture that oh there,
7100:08:22,920 --> 00:08:36,160there are particular freeways in the brain and stops along the way that hang out together anatomically and the expression of differences in that wiring hangs together behaviorally.
7200:08:37,340 --> 00:08:41,450So that concept of the anatomy,
7300:08:41,840 --> 00:08:49,600the wiring being reflected in the cohesion of these behavioral differences.
7400:08:49,610 --> 00:08:50,220To me,
7500:08:50,220 --> 00:08:51,560that adds meaning to it.
7600:08:53,440 --> 00:09:19,030The next part of neurology that I want to explain is that we realized as a scientific community that these kind of characteristics hang together In about 2% of the population and that they're really important to pay attention to like these have implications and there are things we should understand.
7700:09:19,040 --> 00:09:30,000So let's have a name for this so that we can communicate in an efficient way about these pathways that seem to be wired differently.
7800:09:30,640 --> 00:09:47,350So we currently use the words autism spectrum and that helps us communicate and study something and learn about it and kind of take a snapshot of someone's needs or how they might process the world.
7900:09:49,630 --> 00:09:55,850Now this gets to be complex because we then have to say,
8000:09:55,850 --> 00:09:56,400well,
8100:09:56,400 --> 00:09:59,360when are we going to call it autism?
8200:10:00,240 --> 00:10:10,330Because there will be these um characteristics here and there um that are noticeable.
8300:10:10,340 --> 00:10:13,560But when do we actually give it that whole name?
8400:10:14,540 --> 00:10:20,560So this is the same process that the scientific community goes through with?
8500:10:20,570 --> 00:10:22,960When do we call something dyslexia?
8600:10:23,840 --> 00:10:26,450Or when do we call something dementia?
8700:10:27,140 --> 00:10:29,150When do we call this?
8800:10:29,160 --> 00:10:32,400Alzheimer's dementia versus Lewy body dementia.
8900:10:32,420 --> 00:10:39,380So there are these distinctions that we're trying to make that are difficult to say,
9000:10:39,390 --> 00:10:39,700oh,
9100:10:39,700 --> 00:10:39,900well,
9200:10:39,900 --> 00:10:46,620let's say there have to be two characteristics in this area and three characteristics in this area.
9300:10:46,630 --> 00:10:48,460And then we're gonna call it this.
9400:10:49,540 --> 00:10:50,160Well,
9500:10:50,540 --> 00:10:59,950that's helpful in the sense that we add definition to the concept of autism or dementia or whatever we're talking about.
9600:10:59,960 --> 00:11:03,580But it is somewhat arbitrary.
9700:11:03,580 --> 00:11:05,760Like at some point you have to,
9800:11:06,440 --> 00:11:08,580if you're going about this process,
9900:11:08,750 --> 00:11:11,750you have to make some type of demarcation.
10000:11:12,240 --> 00:11:12,900You know,
10100:11:12,940 --> 00:11:15,330this is when we're going to call it this.
10200:11:16,340 --> 00:11:20,360An analogy might be um you know,
10300:11:21,340 --> 00:11:22,800if we're going to say,
10400:11:22,800 --> 00:11:24,990when do we call something purple?
10500:11:25,940 --> 00:11:26,540Well,
10600:11:26,540 --> 00:11:30,210there are colors that we would all agree are purple.
10700:11:30,220 --> 00:11:31,110There are colors,
10800:11:31,110 --> 00:11:33,190we would all agree aren't purple.
10900:11:33,200 --> 00:11:35,620And then there's kind of this,
11000:11:35,630 --> 00:11:36,210you know,
11100:11:36,210 --> 00:11:40,370middle progression of Hughes where somebody might say,
11200:11:40,370 --> 00:11:41,050well,
11300:11:41,060 --> 00:11:44,360I'd call that more red than purple and someone else would say.
11400:11:44,940 --> 00:11:45,690Uh well,
11500:11:45,700 --> 00:11:48,060I I think it's more purple than red.
11600:11:48,540 --> 00:12:00,550Um So there is this area of Hugh that is not captured in the way the diagnosis is currently defined.
11700:12:00,560 --> 00:12:01,650In addition,
11800:12:01,660 --> 00:12:09,620there are many associated characteristics of autism that are not part of the diagnostic criteria,
11900:12:09,810 --> 00:12:16,010but research has shown that they they very frequently occur.
12000:12:16,640 --> 00:12:17,200So,
12100:12:17,210 --> 00:12:18,510for example,
12200:12:18,520 --> 00:12:26,330it's very common for people on the autism spectrum to have sleep disturbance that's not part of the diagnostic criteria,
12300:12:26,340 --> 00:12:35,160but it is a very common co occurring um brain characteristic because the brain is in charge of sleep.
12400:12:36,240 --> 00:12:47,010Um Also there are people that feel like um atypical motor coordination should be part of the diagnosis because many,
12500:12:47,010 --> 00:12:53,620many people on the spectrum have a history of having some difficulty with motor coordination,
12600:12:53,620 --> 00:12:54,850not everybody.
12700:12:54,860 --> 00:13:03,460But it's common enough that some people feel like it should be one of the diagnostic features that can present.
12800:13:05,640 --> 00:13:07,600So in talking about this,
12900:13:07,690 --> 00:13:12,450I hope you get the picture that neurology is complicated.
13000:13:12,940 --> 00:13:21,960And when we're trying to realize that certain things hang together in a person and are valuable enough that we should be talking about them,
13100:13:22,740 --> 00:13:28,330we have to go about some process of defining what we call what.
13200:13:28,390 --> 00:13:30,200And the same is true as I said,
13300:13:30,200 --> 00:13:31,120for dyslexia.
13400:13:31,120 --> 00:13:34,560Like what do we call a reading problem?
13500:13:34,570 --> 00:13:37,060Is that when there's a phonetic problem,
13600:13:37,070 --> 00:13:38,760a sight reading problem,
13700:13:38,770 --> 00:13:45,830a reading comprehension for paragraphs problem and then how how big does the problem have to be like,
13800:13:45,840 --> 00:13:48,090is it that they're one grade behind?
13900:13:48,100 --> 00:13:48,470You know,
14000:13:48,470 --> 00:13:57,390So they're just gets to be this um discussion in scientific communities about what do we call it?
14100:13:57,390 --> 00:13:58,250And when do we call it?
14200:13:58,250 --> 00:14:04,260That that is true for this diagnostic process?
14300:14:06,160 --> 00:14:27,250Some people will end up having what we call sub threshold autism characteristics and that can still be good to understand in the sense that there's a point at which understanding that a behavioral pattern or a reaction to the environment has a neurologic base that can still be helpful,
14400:14:27,640 --> 00:14:31,670even if there's not the full picture there,
14500:14:31,680 --> 00:14:43,150it may help us understand the person or help the person understand themselves to know that there's kind of this neurologic foundation there for that particular characteristic.
14600:14:45,040 --> 00:14:48,120And this happens in families as well.
14700:14:48,120 --> 00:14:56,630We talked about the genetic contribution and what may happen in families is that certain people have no characteristics,
14800:14:56,640 --> 00:15:11,060certain people have some characteristics and perhaps a few people in the family meet threshold for a full diagnosis as we talked about,
14900:15:11,070 --> 00:15:14,440because the diagnosis is neuro behavioral,
15000:15:14,450 --> 00:15:21,960it's really important that people understand that thinking skills does not come into this picture at all.
15100:15:22,440 --> 00:15:27,010There is no diagnostic criteria for autism that has to do with intellect,
15200:15:27,020 --> 00:15:30,280which is good because it doesn't have to do with intellect.
15300:15:30,290 --> 00:15:33,920It can co occur with intellectual difficulty,
15400:15:33,920 --> 00:15:41,060it can co occur with average thinking skills and it can co occur for those who have giftedness.
15500:15:41,340 --> 00:15:47,100So there's no implication when we have this diagnosis,
15600:15:47,940 --> 00:15:48,500um,
15700:15:48,510 --> 00:15:54,690that intellect will look a certain way or that the future of the individual will look a certain way.
15800:15:54,700 --> 00:15:59,890We're just talking about an unusual neurologic level of,
15900:15:59,900 --> 00:16:07,160of connection within a certain pathway and these kinds of characteristics tend to hang together in certain people.
16000:16:09,440 --> 00:16:14,080So let's switch gears now that we have kind of a foundation about neurology,
16100:16:14,090 --> 00:16:15,280what it looks like,
16200:16:15,280 --> 00:16:17,360how the diagnosis is created.
16300:16:18,640 --> 00:16:32,760Let's go to this topic about how might you approach someone if you want to share with them that you think maybe they're on the spectrum or they have some characteristics that are neurologic or autistic.
16400:16:33,140 --> 00:16:48,270Um I'm gonna start by just saying at the beginning that as you may um realize I talked to a lot of people about this topic and sometimes I am invited to talk about it and that gives me permission to talk about it.
16500:16:48,640 --> 00:16:51,560Um Other times I bring it up out of the blue,
16600:16:51,560 --> 00:16:53,770like we're kind of talking about today,
16700:16:54,140 --> 00:16:57,540some of that may be out of the blue in a professional context,
16800:16:57,540 --> 00:17:11,660some of it may be uh with people in my general environment and I want you to know that I do not talk to everyone about my thoughts,
16900:17:12,340 --> 00:17:13,170um,
17000:17:14,640 --> 00:17:21,870indiscriminately so I am not of the opinion that if we notice this pattern and someone else,
17100:17:21,880 --> 00:17:26,560we automatically are obliged to talk to them.
17200:17:27,730 --> 00:17:28,450Now,
17300:17:29,440 --> 00:17:49,170that is because there are some people that I can think of in my life and in my experience in my communities that I know that they have autistic characteristics or I suspect that they would be on the spectrum if they had an assessment,
17400:17:49,540 --> 00:17:59,960but I do not have the type of relationship with them where it would be okay for me to bring that up,
17500:18:01,130 --> 00:18:02,740for example.
17600:18:02,750 --> 00:18:04,350Um you know,
17700:18:04,350 --> 00:18:09,540this may be a person that I've had really tough interactions within the past,
17800:18:09,550 --> 00:18:18,060or we've had a really difficult relationship and we just don't have the kind of relationship where I have permission to speak into their life.
17900:18:18,740 --> 00:18:19,270Um,
18000:18:19,280 --> 00:18:23,450I may hope that other people get the opportunity to talk to them about it.
18100:18:24,140 --> 00:18:24,500Um,
18200:18:24,510 --> 00:18:37,570but I may conclude that anything that I say is probably going to be filtered through this tough relationship that we've had and might even make things worse that now.
18300:18:37,570 --> 00:18:44,660I'm less inclined to think about it because I really don't like you talking into my life.
18400:18:46,140 --> 00:18:46,590Um,
18500:18:46,600 --> 00:18:55,950there may also be contexts in which I think it would be inappropriate to raise it at that place and at that time,
18600:18:56,440 --> 00:19:00,010so I'm unlikely to raise it at a funeral.
18700:19:00,010 --> 00:19:01,060I may not,
18800:19:01,540 --> 00:19:02,420you know,
18900:19:02,430 --> 00:19:03,170um,
19000:19:03,180 --> 00:19:10,580I feel like I'm going to bring that up to a superior of mine at a professional convention or something like that.
19100:19:10,580 --> 00:19:11,050So,
19200:19:11,440 --> 00:19:11,860um,
19300:19:11,870 --> 00:19:20,770I do pick and choose when I think it would be wise to approach someone and say something.
19400:19:20,960 --> 00:19:23,140Now there are exceptions to that.
19500:19:23,140 --> 00:19:32,380So let's say this person that I've had kind of a tough relationship with in my life is really in a dire spot,
19600:19:32,390 --> 00:19:36,720like they are struggling significantly and they can't figure out why.
19700:19:36,730 --> 00:19:46,960And really I believe it's related to things that would be eased if they knew this conceptualization of autism.
19800:19:48,140 --> 00:19:48,530Um,
19900:19:48,540 --> 00:19:49,530in that situation,
20000:19:49,530 --> 00:19:55,750I probably would decide to go ahead and approach them because of their high level of need.
20100:19:55,760 --> 00:19:58,130So in that situation,
20200:19:58,140 --> 00:20:04,760the context would override the relationship concerns that I have.
20300:20:05,240 --> 00:20:10,850So I always kind of make that judgment based on the relationship I have with the person,
20400:20:11,340 --> 00:20:15,060the context that we're in and and maybe the time,
20500:20:15,070 --> 00:20:16,950like is this the time to do it?
20600:20:18,040 --> 00:20:27,100And then I would make exceptions based on just what I think would be wise at that time based on their need based on where they're at.
20700:20:27,110 --> 00:20:27,490Um,
20800:20:27,490 --> 00:20:33,470and based on what I could contribute in cases where we do decide,
20900:20:33,720 --> 00:20:33,990you know,
21000:20:33,990 --> 00:20:36,260I think I'm going to at least bring it up.
21100:20:36,740 --> 00:20:57,860One thing that I find helpful is to think about this image of putting our toe in the water that we don't have to bring up the topic in all its glory and detail and kind of get down to the nitty gritty and convince someone that this is correct.
21200:20:57,870 --> 00:21:02,290We can kind of test the waters so to speak.
21300:21:02,290 --> 00:21:11,230So we could bring it up something gently or bring up something in a non direct way.
21400:21:11,240 --> 00:21:11,920Um,
21500:21:11,920 --> 00:21:14,330and kind of test the waters to see,
21600:21:14,340 --> 00:21:20,040does this person have a strong negative reaction to the topic,
21700:21:20,050 --> 00:21:24,040do they jump on board and seem really interested to talk about it?
21800:21:24,050 --> 00:21:26,670Do you think there's an opening to go deeper?
21900:21:27,040 --> 00:21:31,640So if there's some opening and you feel like there's some receptiveness,
22000:21:31,640 --> 00:21:35,430you can always share more or provide more information.
22100:21:35,440 --> 00:21:38,150So that's one thing that I keep in mind too,
22200:21:38,150 --> 00:21:40,840like putting feelers out,
22300:21:40,850 --> 00:21:47,060how how comfortable is this person with introducing this new topic,
22400:21:47,070 --> 00:21:57,420How open might they be when you decide you are going to share something or bring up the topic,
22500:21:57,430 --> 00:22:00,040you could do this in a variety of ways.
22600:22:00,050 --> 00:22:14,730So one way might be to share a personal story that kind of gives us an in in the sense that um I have a reason for bringing this up because I've experienced it and this is my experience.
22700:22:14,730 --> 00:22:25,540So if you're a person who's been diagnosed and you found that helpful or if you're a parent of a child or young adult who's been diagnosed,
22800:22:25,550 --> 00:22:28,670sometimes that just gives you,
22900:22:29,340 --> 00:22:36,830um it creates a context for the person to hear your wisdom based on your experience.
23000:22:36,840 --> 00:22:37,600So,
23100:22:37,610 --> 00:22:38,040oh,
23200:22:38,040 --> 00:22:40,400you've had this personal experience,
23300:22:40,410 --> 00:22:43,350I would like to hear what you have to say.
23400:22:44,140 --> 00:22:52,770So sometimes approaching it in that way I'm bringing it up because what you're experiencing reminds me of myself.
23500:22:55,640 --> 00:23:00,900Sometimes you can bring it up in the context of new learning that you've had.
23600:23:00,910 --> 00:23:05,430So maybe you're not a person who has experienced that yourself,
23700:23:05,440 --> 00:23:19,120but maybe you have recently heard a lecture or read a book or listen to a podcast and the light bulb just went off about various things maybe about yourself and about,
23800:23:19,130 --> 00:23:19,720you know,
23900:23:19,720 --> 00:23:22,660how neurology impacts people in general,
24000:23:22,670 --> 00:23:32,350like this has opened up a curiosity in you and you've really been thinking about that for yourself and you're thinking about it for this other person.
24100:23:34,240 --> 00:23:35,600And in that context,
24200:23:35,600 --> 00:23:50,260if you do lead with I learned about this and I've been thinking about it regarding myself and I realized that I tend to do this and this is really neurologically based.
24300:23:50,260 --> 00:23:51,780It's so interesting to me,
24400:23:51,780 --> 00:23:57,460it's helped me so much when we do lead with a personal experience.
24500:23:57,470 --> 00:23:59,670Even if it's not a diagnosis,
24600:23:59,690 --> 00:24:00,340you know,
24700:24:00,340 --> 00:24:13,950I have this personal experience where I've learned this about myself and then introducing the other person to think about themselves may be just a nice flow to the conversation.
24800:24:16,940 --> 00:24:17,270Mm hmm.
24900:24:17,840 --> 00:24:23,980Another way to approach it is to have a wondering or a curious tone.
25000:24:23,990 --> 00:24:38,080I think what we want to avoid is to have any kind of lecturing tone or that we are going to argue our point and that they must agree with us by the end of the conversation.
25100:24:38,080 --> 00:24:47,380I think what's likely to happen in that sense is that they can feel backed into a corner and they can push back really just to have more space.
25200:24:47,840 --> 00:24:52,010And so if we approach it more as a wondering,
25300:24:52,540 --> 00:24:53,110you know,
25400:24:53,110 --> 00:24:54,250I've been wondering,
25500:24:54,250 --> 00:25:04,400I've noticed this or that and I've been wondering if autism would be a way to understand what's been happening and kind of open up possibilities.
25600:25:04,410 --> 00:25:08,360What do you think or what's your thought about that?
25700:25:10,050 --> 00:25:17,050That gives the person's space to react and to think and they don't feel rushed or pushed.
25800:25:17,640 --> 00:25:18,450Um,
25900:25:18,940 --> 00:25:22,360and that freedom to explore the thought,
26000:25:22,840 --> 00:25:23,340um,
26100:25:23,340 --> 00:25:27,570with you or on their own can really bring about some fruit,
26200:25:27,580 --> 00:25:28,270I think,
26300:25:28,740 --> 00:25:29,690um,
26400:25:29,700 --> 00:25:41,560that can encourage people to learn more and give people space to get their in their own time now as a professional.
26500:25:41,740 --> 00:25:57,190I also have contexts where I am with a patient and I'm talking to them about this kind of based on my own clinical expertise and they've come in as a patient and I use the word patient because I work in a hospital,
26600:25:57,200 --> 00:26:01,490but you could say client or whatever kind of fits the situation.
26700:26:01,490 --> 00:26:03,190If you work in a school,
26800:26:03,200 --> 00:26:04,560there would be students,
26900:26:04,560 --> 00:26:05,260et cetera,
27000:26:05,940 --> 00:26:08,360and they have come in for some reason.
27100:26:08,360 --> 00:26:13,900And sometimes it has to do with an autism diagnosis and sometimes it does not.
27200:26:13,910 --> 00:26:17,120I work with patients who have all kinds of different backgrounds,
27300:26:17,120 --> 00:26:25,670someone may have had a head injury and be coming in for that or a stroke or an assessment for dementia.
27400:26:26,040 --> 00:26:29,780And I just realized in the midst of that,
27500:26:29,790 --> 00:26:32,860that there's an undiagnosed autism spectrum.
27600:26:32,870 --> 00:26:35,800So sometimes I'm bringing it up cold,
27700:26:35,810 --> 00:26:36,310um,
27800:26:36,310 --> 00:26:38,910where there's no context and they're not expecting it.
27900:26:38,920 --> 00:26:42,860And other times I'm bringing it up or they are expecting it.
28000:26:44,640 --> 00:26:45,360Um,
28100:26:46,140 --> 00:26:48,880I think it's pretty straightforward when they're expecting it.
28200:26:48,880 --> 00:26:50,630So I'm not going to cover that.
28300:26:50,630 --> 00:26:53,880I think what I said at the beginning of the episode,
28400:26:53,890 --> 00:26:58,460does summarize how I how I explain autism to people,
28500:26:58,840 --> 00:27:00,800but if they're not expecting it,
28600:27:00,810 --> 00:27:08,170what I find helpful is to summarize to them what they have said to me,
28700:27:08,640 --> 00:27:12,060so that I make sure I understood it correctly.
28800:27:12,940 --> 00:27:15,660But I'll take that summary and I'll say,
28900:27:15,780 --> 00:27:16,090you know,
29000:27:16,090 --> 00:27:20,050it sounds like you're a person who uh,
29100:27:20,060 --> 00:27:23,440really gets revived by alone time.
29200:27:23,440 --> 00:27:32,870And sometimes the drama of female relationships just actually feels overwhelming that you would be more content with your,
29300:27:32,880 --> 00:27:34,660your cat in a good book.
29400:27:34,660 --> 00:27:39,380And sometimes people at work seem to think you're standoffish or whatever.
29500:27:39,380 --> 00:27:48,750And so I go through the social part and then I'll say it also seems like when you're interested in something you are all in,
29600:27:48,750 --> 00:27:49,100like,
29700:27:49,110 --> 00:27:50,950you love that thing.
29800:27:51,340 --> 00:27:51,780Uh,
29900:27:51,790 --> 00:27:56,770and so I'll go through each of the criteria just saying that.
30000:27:57,540 --> 00:28:00,090So I'm not bringing up the word autism,
30100:28:00,280 --> 00:28:06,010I'm just showing them that I've heard their description of themselves.
30200:28:07,640 --> 00:28:10,400And I in my own mind,
30300:28:11,340 --> 00:28:18,360I'm saying it back because I know that these things represent some of those criteria,
30400:28:20,940 --> 00:28:22,910then I will say,
30500:28:22,920 --> 00:28:23,630you know,
30600:28:23,640 --> 00:28:31,010when these kinds of things happen and they're expressed in the same person.
30700:28:31,440 --> 00:28:34,000One of the things I think about is neurology,
30800:28:34,000 --> 00:28:37,000because these patterns of neurology,
30900:28:37,000 --> 00:28:39,500these freeways or highways in the brain,
31000:28:40,470 --> 00:28:40,840you know,
31100:28:40,840 --> 00:28:46,500there are patterns that contain these characteristics and when they happen together,
31200:28:46,500 --> 00:28:49,520often it's because of a neurologic,
31300:28:49,530 --> 00:28:50,660um,
31400:28:50,670 --> 00:28:59,540space in there that has some different kinds of wiring that people are noticing and when we see that in the same person,
31500:28:59,550 --> 00:29:03,850we have a name for that and what we call that is autism.
31600:29:05,040 --> 00:29:10,060And then I'll just kind of let them process or react.
31700:29:10,640 --> 00:29:12,770Now I have to say that I am,
31800:29:13,140 --> 00:29:17,050I am very surprised um,
31900:29:17,060 --> 00:29:20,070at how many times somebody in the room,
32000:29:20,070 --> 00:29:24,600whether it's a family member or themselves will say I thought so,
32100:29:24,610 --> 00:29:29,030but I didn't want to bring it up and maybe there's a group of three of them,
32200:29:29,030 --> 00:29:29,360right?
32300:29:29,360 --> 00:29:31,360Like the client and family members,
32400:29:31,360 --> 00:29:33,970but they've never talked to each other about it.
32500:29:33,980 --> 00:29:35,520They've just been wondering,
32600:29:35,520 --> 00:29:38,910but they don't feel like it's okay to bring the topic up.
32700:29:38,920 --> 00:29:40,960Kind of like we talked about before.
32800:29:40,980 --> 00:29:42,990Like is this okay to mention,
32900:29:43,000 --> 00:29:44,450is this okay to think about?
33000:29:44,840 --> 00:29:46,890And so we'll go from there.
33100:29:49,220 --> 00:29:59,080Sometimes this is something that they have never considered and they are surprised and kind of pause and have to take that in.
33200:29:59,090 --> 00:30:01,950And I might kind of ask them,
33300:30:01,950 --> 00:30:03,560what are your thoughts about that.
33400:30:04,340 --> 00:30:05,170Um,
33500:30:06,340 --> 00:30:08,110if there is,
33600:30:08,120 --> 00:30:09,190uh,
33700:30:09,200 --> 00:30:14,790a misunderstanding or they just don't know much about autism or they're thinking of it in a different way.
33800:30:14,800 --> 00:30:17,350I just try to give that education,
33900:30:18,440 --> 00:30:24,530if the person seems to be stressed by that or to be upset,
34000:30:24,540 --> 00:30:27,670I just try to figure out what the barrier is.
34100:30:28,140 --> 00:30:33,680So if it's not an information gap that I fill in with education,
34200:30:33,680 --> 00:30:38,550it may be an emotional reaction like we talked about last time,
34300:30:40,540 --> 00:30:45,640um I may say it sounds like maybe you feel like this is a criticism,
34400:30:45,650 --> 00:30:46,090you know,
34500:30:46,090 --> 00:30:48,410this isn't a criticism to me,
34600:30:48,420 --> 00:31:01,210it's really just the self revelation that can help you so much understand yourself and what you need and um really just feel better in your own skin.
34700:31:01,210 --> 00:31:03,360There are lots of things we can recommend.
34800:31:05,640 --> 00:31:19,960One of the things I try to do if the person is not really feeling open to the diagnosis or the discussion at that time is just to try to leave the door open.
34900:31:20,540 --> 00:31:22,600So I might say,
35000:31:22,610 --> 00:31:23,170well,
35100:31:23,170 --> 00:31:27,150if you ever want to talk more about that topic,
35200:31:27,160 --> 00:31:29,960let me know because I'd be happy to do that.
35300:31:30,540 --> 00:31:32,640Um but in my mind,
35400:31:32,640 --> 00:31:34,620I also know that I just,
35500:31:34,690 --> 00:31:40,210I may just want to plant the seed and let them go and not push the topic,
35600:31:40,250 --> 00:31:42,460but now that I've introduced it,
35700:31:42,840 --> 00:31:45,440they may process that over time.
35800:31:45,460 --> 00:31:48,460Someone else may bring it up to them in the future.
35900:31:48,470 --> 00:31:51,180It may all fall together to them,
36000:31:51,180 --> 00:31:52,660but at a different time.
36100:31:52,670 --> 00:31:55,950So planting a seed is okay as well.
36200:31:58,400 --> 00:31:59,590I may also say,
36300:31:59,590 --> 00:32:00,060you know,
36400:32:00,710 --> 00:32:04,960at some point it doesn't matter if we call it that,
36500:32:04,970 --> 00:32:10,190but I do think there's some neurology behind it and because of that,
36600:32:10,190 --> 00:32:13,270I have some things that I think would really be helpful for you.
36700:32:13,740 --> 00:32:18,920So sometimes the person may be able to consider that there is some neurology there,
36800:32:18,940 --> 00:32:21,770but not wanting to call it a particular thing?
36900:32:22,140 --> 00:32:23,510Uh and other times,
37000:32:23,520 --> 00:32:23,880you know,
37100:32:23,880 --> 00:32:31,950I just try to focus on what I think would be helpful regardless of whether the person wants to call it a specific thing.
37200:32:34,340 --> 00:32:39,580Other times I just let it be,
37300:32:39,580 --> 00:32:46,680I don't bring up the topic or maybe I have and it's been shut down and I just,
37400:32:46,740 --> 00:32:53,130in my own mind think of the person through that lens when it's helpful.
37500:32:53,130 --> 00:32:59,770So maybe there is a behavior or a communication that otherwise I would feel a bit perplexed about.
37600:33:00,440 --> 00:33:11,950Um but because I can remind myself that there neurology maybe um autistic in nature that that can help me understand.
37700:33:11,960 --> 00:33:17,310So it could help me um when I interact with the individual,
37800:33:17,320 --> 00:33:23,760even if we're not kind of overtly calling ah the characteristics by any particular name.
37900:33:25,440 --> 00:33:33,410Those are a summary of my thoughts when it comes to describing autism and autistic characteristics to others,
38000:33:33,420 --> 00:33:44,560introducing that topic kind of feeling out how they think about it and planting a seed for someone to process that information over time.
38100:33:45,840 --> 00:33:49,760I'm really glad you joined me for this last episode of the series,
38200:33:49,760 --> 00:34:02,960talking about autism and next time we are going to begin a new series that has to do with the experience and expression of autistic characteristics across the lifespan.
38300:34:03,840 --> 00:34:08,850I'm going to be talking about topics such as the developing nervous system.
38400:34:08,850 --> 00:34:13,420So the brain doesn't fully develop until about 21 years of age.
38500:34:13,420 --> 00:34:21,260So how can that impact the evolution of autistic characteristics through childhood and adolescence?
38600:34:21,440 --> 00:34:27,600We're going to talk about hormonal shifts and how that can impact these things puberty,
38700:34:27,600 --> 00:34:28,630menstrual cycles,
38800:34:28,630 --> 00:34:29,540pregnancy,
38900:34:29,550 --> 00:34:31,100menopause aging,
39000:34:31,740 --> 00:34:38,620and we're also going to talk about other things related to aging on the autism spectrum,
39100:34:38,630 --> 00:34:46,260such as the experience of shifts and how the characteristics our felt or expressed.
39200:34:47,440 --> 00:34:48,460Until then,
39300:34:48,570 --> 00:34:51,690I hope you have good talks about autism with each other.
 

Talking About Autism: Navigating Emotional Atmospheres

Join Dr. Regan for the second episode of the series "Talking About Autism." This episode focuses on how the thoughtful navigation of emotions during conversations about autism can create space and freedom for more discussions.
New Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life
New Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website
Resources for Clinicians
 
Read the transcript:
00:00:05,740 --> 00:00:06,480Hello,300:00:06,490 --> 00:00:12,460This is Dr Theresa Regan. Thank you for joining me for this episode of Autism in the Adult.400:00:13,140 --> 00:00:19,260I am happy that you're joining us for this series called Talking about Autism.500:00:19,270 --> 00:00:37,150This is the second episode, and I had originally predicted it was going to be about talking to others when you see autistic characteristics in them and you wonder if a diagnostic evaluation would be helpful for them?600:00:38,740 --> 00:00:44,170What happened is that, as I'm mulling around the topics for the series,700:00:44,180 --> 00:00:49,560I really couldn't get my mind off what was going to be the 3rd episode --800:00:50,140 --> 00:00:56,260which I'm going to call "navigating emotional atmospheres"... when we're talking about autism.900:00:57,040 --> 00:01:13,790And I've come to the conclusion that I'm going to cover that topic here in the second episode because I feel like it's really important to consider before we talk to other people about autistic characteristics.1000:01:13,790 --> 00:01:20,860How would we navigate the emotions that are sometimes present around the topic itself?1100:01:21,640 --> 00:01:39,160Last episode we talked about Talking About Autism when you are on a journey toward evaluation yourself ... when you're considering that, or when you have a new diagnosis and you might want to talk to people about your diagnosis and about autism.1200:01:40,640 --> 00:01:40,960So,1300:01:40,960 --> 00:01:50,260this episode is going to be focused a little bit more on navigating the complexity of people's emotional responses.1400:01:50,740 --> 00:01:54,850And as we talked about in the first episode,1500:01:54,850 --> 00:02:03,690it really is an emotionally charged topic and in some ways that's a bit mystifying to me.1600:02:03,700 --> 00:02:12,650... the amount of emotion people have about a topic that sometimes they're not even really impacted by on a personal level,1800:02:15,840 --> 00:02:22,160but talking about autism often does involve navigating emotional atmospheres.1900:02:22,780 --> 00:02:23,000Um,2000:02:23,000 --> 00:02:27,760and it's hard to predict what the atmosphere is going to look like or how complex it is.2100:02:29,040 --> 00:02:38,010Sometimes the atmosphere may be charged because we would like to talk to someone about the topic and how it impacts,2200:02:38,010 --> 00:02:38,690let's say,2300:02:38,690 --> 00:02:40,110our own family,2400:02:40,120 --> 00:02:44,600or how it impacts someone in the family or how it impacts you.2500:02:44,610 --> 00:02:51,730And there can just be this unusual response of2600:02:51,740 --> 00:02:53,630a lot of emotional charge.2700:02:53,640 --> 00:03:04,360I spoke with a young woman recently who was saying that she was shocked at how angry people in her family were when she brought the topic up.2800:03:04,940 --> 00:03:10,160And that is not an unusual thing for someone to share, that2900:03:10,170 --> 00:03:12,310it can really charge people up.3000:03:12,320 --> 00:03:13,660And um,3100:03:14,350 --> 00:03:17,440sometimes you're not just bringing up a topic,3200:03:17,450 --> 00:03:22,560you're bringing up all this emotional processing and content.3300:03:24,240 --> 00:03:25,270Other times,3400:03:25,270 --> 00:03:30,560people on this journey toward an autism diagnosis or self awareness,3500:03:30,940 --> 00:03:33,150they may feel other emotions too.3600:03:33,150 --> 00:03:39,460They might feel relief that they finally understand how they're wired.3700:03:39,940 --> 00:03:40,330Um,3800:03:40,330 --> 00:03:51,550they might share that this is such a meaningful and important thing to them that they really have a lot of emotion about the value of the diagnosis.3900:03:52,140 --> 00:03:55,130Other people may really be in a different spot.4000:03:55,130 --> 00:03:59,150They might be in this spot where they're processing.4100:03:59,160 --> 00:03:59,740Um,4200:03:59,750 --> 00:04:01,040just surprise.4300:04:01,040 --> 00:04:05,950Like they were not expecting it, processing maybe grief or fear.4400:04:05,960 --> 00:04:06,730Um,4500:04:06,740 --> 00:04:24,830a lot of emotions can come with this diagnosis or this discussion. And for people who have been in the autistic community for a while and they have this deep passion to advocate for,4600:04:24,840 --> 00:04:25,670um,4700:04:25,680 --> 00:04:27,930anyone who um,4800:04:27,940 --> 00:04:37,810has diversity in their neurology ... and many times that passion comes with a lot of emotional charge as well.4900:04:38,080 --> 00:04:55,940And so we may have people who are so passionate about what language is used or how we should interact with others or support others or whether we should have interventions for autism or not.5000:04:55,950 --> 00:05:09,050So there can also be this passionate approach to what is right or wrong to say or do for the autistic individual or within the community.5100:05:11,240 --> 00:05:22,150What can happen is that the presence of this emotion can shut down the discussion before it's really launched.5200:05:22,540 --> 00:05:31,980So we have something come up and it's responded to with strong emotion and it's very common,5300:05:31,980 --> 00:05:39,190I think for that strong emotion to overtake the topic itself and then people in the room realize,5400:05:39,200 --> 00:05:40,000oh,5500:05:40,010 --> 00:05:40,570okay,5600:05:40,570 --> 00:05:42,960this is not okay to talk about.5700:05:42,970 --> 00:05:45,830This was a really strong,5800:05:45,840 --> 00:05:47,050passionate,5900:05:47,580 --> 00:05:54,850intense reaction and I feel like I'm getting the emotional message that this is not okay.6000:05:56,140 --> 00:05:56,830In fact,6100:05:56,840 --> 00:05:58,530I think to myself,6200:05:58,540 --> 00:06:06,830if I wanted to make sure that it was not okay to talk about some particular topic and that everyone around me knew it,6300:06:06,840 --> 00:06:13,160I probably would be very quick to have emotional responses.6400:06:13,170 --> 00:06:20,350I'd probably be ready with criticism or judgment or correction or logical arguments.6500:06:20,740 --> 00:06:21,440Um,6600:06:21,450 --> 00:06:27,850maybe even just joking at someone's expense or whatever I could do to make6700:06:28,740 --> 00:06:35,360the discussion so intense that people realize that needs to be shut down.6800:06:35,740 --> 00:06:43,170So when I am approaching this topic of how do we say autism is okay to talk about?6900:06:43,170 --> 00:06:44,830Let's bring it to the table.7000:06:44,830 --> 00:06:46,160It's always okay.7100:06:46,160 --> 00:06:48,100How do we create that atmosphere?7200:06:48,110 --> 00:06:54,350I think one of the things we focus on is protecting the emotional atmosphere.7300:06:54,840 --> 00:06:55,610Um,7400:06:55,620 --> 00:07:10,600and being aware that the emotions that we are filtering into the conversation may actually really detract from someone's comfort level of bringing it up.7500:07:10,670 --> 00:07:14,860It may detract from people's ability to process the topic itself.7600:07:15,240 --> 00:07:21,230And so I'm just really conscious of trying to attend to that.7700:07:21,240 --> 00:07:24,060Whenever I speak with someone about the topic,7800:07:28,340 --> 00:07:31,780there's a lot of emotion about what to call things.7900:07:31,790 --> 00:07:34,310So what language are we using?8000:07:34,320 --> 00:07:46,700Some people really strongly want the language of "the autistic individual" or "the autistic" because they really self identify with that neurology.8100:07:46,700 --> 00:07:47,620It's who they are.8200:07:47,620 --> 00:07:49,000It's how they're knit together.8300:07:49,340 --> 00:07:51,650They welcome that identification.8400:07:52,040 --> 00:07:57,090Other people do not want to be known as an autistic individual.8500:07:57,090 --> 00:08:07,660They feel more comfortable saying they are an individual on the spectrum or they have autism, and other people have strong emotions against that.8600:08:07,940 --> 00:08:18,120So we even have this really emotional response to what words are okay to use and that can really um,8700:08:18,130 --> 00:08:20,360come into the discussion as well.8800:08:21,740 --> 00:08:29,510People may have very charged reactions about the,8900:08:29,790 --> 00:08:33,420the peaks and valleys of anyone's journey and by that,9000:08:33,420 --> 00:08:37,460I mean that in our culture,9100:08:37,470 --> 00:08:51,060if someone is struggling with something and oftentimes people on a journey toward diagnosis have come to that journey because they've hit some season of struggle.9200:08:51,440 --> 00:08:52,550Um,9300:08:52,940 --> 00:08:54,130in our culture,9400:08:54,130 --> 00:09:07,990we're very focused on fixing these struggles and sometimes that in itself can shut down discussions about complex things,9500:09:07,990 --> 00:09:10,660about things that are not easily fixed.9600:09:12,540 --> 00:09:21,670People on a journey probably get a lot of advice before they get to this journey of assessment for autism.9700:09:21,740 --> 00:09:24,560They've probably gotten a lot of advice like,9800:09:25,040 --> 00:09:25,370uh,9900:09:25,380 --> 00:09:30,900"that wouldn't happen in my house" or "this is how we did it and it fixed it completely,"10000:09:30,910 --> 00:09:32,540or um,10100:09:32,550 --> 00:09:38,510"these are the seven steps to being free from anxiety and if you do these,10200:09:38,520 --> 00:09:40,660then you shouldn't have a problem."10300:09:43,040 --> 00:09:43,400Um,10400:09:43,410 --> 00:09:45,270in my own personal journey,10500:09:45,270 --> 00:09:47,540I really experienced that a lot.10600:09:47,550 --> 00:09:48,300Um,10700:09:48,310 --> 00:09:51,940as a parent, and I know this podcast is about adults,10800:09:51,940 --> 00:09:56,750but the topic of emotional processing um,10900:09:56,760 --> 00:10:00,460is just a very human topic across the lifespan.11000:10:01,140 --> 00:10:01,500Now,11100:10:01,500 --> 00:10:05,210one of the things that my son on the spectrum struggled with,11200:10:05,220 --> 00:10:05,750um,11300:10:05,760 --> 00:10:09,090so much was sleep and also as an infant,11400:10:09,090 --> 00:10:12,310he was just very colicky and upset.11500:10:12,310 --> 00:10:12,500He,11600:10:12,500 --> 00:10:14,960he had a difficulty calming.11700:10:15,340 --> 00:10:16,110Um,11800:10:16,120 --> 00:10:18,550and a lot of things went into that,11900:10:18,550 --> 00:10:20,050but um,12000:10:20,050 --> 00:10:23,880we were really struggling with a sleep issue.12100:10:23,880 --> 00:10:30,260And in fact he didn't End up sleeping through the night on a consistent basis until he was eight years old.12200:10:30,740 --> 00:10:34,020And that was really difficult on him.12300:10:34,030 --> 00:10:48,410It made all the other features more difficult for him to manage and it impacted our resilience to and our ability to um really sustain wellness as a household.12400:10:48,410 --> 00:10:50,550So I remember um,12500:10:50,560 --> 00:10:52,260getting this,12600:10:52,270 --> 00:11:07,050he was in daycare twice a week and I went to pick him up one day when he was 10 months old and the nursery leader who had had him in her,12700:11:07,060 --> 00:11:10,360they call it class in her class for um,12800:11:10,370 --> 00:11:13,020from the beginning of when we started going,12900:11:13,530 --> 00:11:21,880she left me a note and it said "his crying is disruptive to the class.13000:11:22,440 --> 00:11:25,050Please have him better by tomorrow."13100:11:26,030 --> 00:11:31,570And that is kind of an example of this,13200:11:33,740 --> 00:11:46,730this mindset that things can be fixed if only you're good enough parent or if only you're committed enough to be um,13300:11:46,740 --> 00:11:52,960a calm person or if only you're committed enough to be a good spouse,13400:11:53,040 --> 00:11:53,410you know,13500:11:53,410 --> 00:11:54,750whatever that looks like.13600:11:55,590 --> 00:12:00,270And not only was I a struggling mom,13700:12:00,290 --> 00:12:05,210but now I had been told that I should have this fixed.13800:12:05,220 --> 00:12:08,260I should be able to fix it.13900:12:09,010 --> 00:12:14,770And also another example when he was 14000:12:14,780 --> 00:12:16,200a couple of years old,14100:12:16,200 --> 00:12:17,470two or three years old.14200:12:17,480 --> 00:12:22,840I was looking into Melatonin to assist with sleep.14300:12:22,850 --> 00:12:49,260And I read the reviews online for different products and a mother on their wrote this scathing comment that um using Melatonin for children is child abuse because um any good parents should know how to get their kids down for bed and that would never happen in her house.14400:12:49,640 --> 00:12:52,450So it was long... long, 14500:12:52,450 --> 00:12:54,130that's the gist of it though.14600:12:54,140 --> 00:12:55,850Um and so,14700:12:55,860 --> 00:12:56,420you know,14800:12:56,420 --> 00:13:05,290these messages that are so emotionally intense and not only does it bring about this shame and blame and hopelessness,14900:13:05,300 --> 00:13:09,780but it also creates this atmosphere where it's clear15000:13:09,780 --> 00:13:12,310it is not okay to say that you're struggling.15100:13:12,640 --> 00:13:24,460Um it's not okay to bring up um that you've tried everything and you don't know what's going on um because not only are you struggling,15200:13:24,460 --> 00:13:34,460but apparently it's also something that you could very well fix um, and you should fix and therefore the struggle is also your fault.15300:13:34,940 --> 00:13:39,680So these emotional um... these emotional charges,15400:13:39,690 --> 00:13:48,370I think really dampen our ability to give people the freedom to talk about all the ups and downs of their life,15500:13:48,370 --> 00:13:53,590like life is messy and good and hard and you know,15600:13:53,590 --> 00:14:00,860I feel like I can bring up any topic um and realize that it's okay to share that.15700:14:01,340 --> 00:14:02,320Instead.15800:14:02,320 --> 00:14:10,550I think we have a lot of emotional overtones to what's okay to bring up and what's okay to talk about.15900:14:12,640 --> 00:14:19,860I remember um being struck too uh when my son was about a year old,16000:14:20,440 --> 00:14:23,870one of my colleagues had an infant,16100:14:23,870 --> 00:14:25,170this was her first child,16200:14:25,180 --> 00:14:29,840and after I think five days after she was born,16300:14:29,850 --> 00:14:39,100um my colleague brought her in and she was just this bundle of pink, cute as can be, slept the whole time.16400:14:39,600 --> 00:14:41,610And you know,16500:14:41,610 --> 00:14:45,860that was so different than what was happening in my home.16600:14:46,340 --> 00:14:47,890And she said,16700:14:47,890 --> 00:14:48,360gosh,16800:14:48,360 --> 00:14:52,560I'm really a little um nervous and watchful,16900:14:52,560 --> 00:14:56,110because I have to wake her up in the middle of the night for her to eat.17000:14:56,120 --> 00:14:56,660You know,17100:14:56,660 --> 00:15:00,210she's already sleeping through and I'm a little nervous about,17200:15:00,220 --> 00:15:00,550you know,17300:15:00,550 --> 00:15:02,780her nutrition, and, of course,17400:15:02,790 --> 00:15:06,760here I am not sleeping for a year.17500:15:07,240 --> 00:15:11,010And another colleague said to her,17600:15:11,250 --> 00:15:11,690"oh,17700:15:11,690 --> 00:15:13,810what a good baby you have."17800:15:14,440 --> 00:15:21,250And usually I'm very measured in my speech and I think about what I say ahead of time,17900:15:21,250 --> 00:15:33,860but I felt this surge going from my toes up to my ... my voice and I blurted out, "all babies are good."18000:15:35,140 --> 00:15:36,560And she said,18100:15:36,560 --> 00:15:37,340"well,18200:15:37,360 --> 00:15:37,950yeah,18300:15:37,950 --> 00:15:39,360but you know what I mean?"18400:15:39,840 --> 00:15:48,370And I realized that we attach goodness to a baby,18500:15:48,370 --> 00:15:49,860that's easy.18600:15:50,590 --> 00:15:51,130I said,18700:15:51,130 --> 00:15:51,520"you mean,18800:15:51,520 --> 00:15:53,950she's easy and that's good."18900:15:55,040 --> 00:15:57,020But all babies are good.19000:15:57,030 --> 00:16:08,250So I think we have to watch our emotional tone so that we make sure everyone knows that every infant has value.19100:16:08,260 --> 00:16:11,660Every individual is important.19200:16:12,120 --> 00:16:13,060There aren't,19300:16:13,070 --> 00:16:13,960you know,19400:16:14,640 --> 00:16:16,990good babies and bad babies.19500:16:17,440 --> 00:16:26,460There are struggling babies and babies that are not struggling and so forth across the whole lifespan,19600:16:26,840 --> 00:16:35,150that our emotional charge can sometimes make people feel less than good, less than valued.19700:16:36,060 --> 00:17:00,150And so I think that really became apparent to me and I'm much more aware of protecting the emotional atmosphere when I'm speaking to someone to really protect that they understand that they are important and that we're having this tough discussion because their well being is important.19800:17:01,840 --> 00:17:12,020What I started to think about is that even though I want people to be have the freedom and the space to be where they're at,19900:17:12,020 --> 00:17:13,920whether they're celebrating this,20000:17:13,930 --> 00:17:15,600whether they're relieved,20100:17:15,600 --> 00:17:16,960whether they're struggling,20200:17:17,540 --> 00:17:23,120whether they're upset about the diagnosis or the concept,20300:17:23,130 --> 00:17:25,450I want to give people space,20400:17:25,630 --> 00:17:35,460they don't have to react in a certain way in order to be good or in order to please me just because I'm in a different place.20500:17:36,840 --> 00:17:38,220On the other hand,20600:17:38,230 --> 00:17:48,060I really want to balance that freedom to feel with my own awareness of protecting the emotional atmosphere.20700:17:49,140 --> 00:18:09,170There are some emotions that I really um try to protect people from during our conversations and The Big one I would say that I never feel is helpful in the conversation is shame.20800:18:10,240 --> 00:18:15,780Um I just feel like that is so easy.20900:18:16,940 --> 00:18:29,670Mhm uh emotionally to bring into conversations when someone is struggling that I really try to be very careful to protect what's going on from any shame.21000:18:30,140 --> 00:18:36,760Um and I would also say emotions like hopelessness,21100:18:36,760 --> 00:18:37,620helplessness,21200:18:37,620 --> 00:18:42,780worthlessness, and it's okay for people to feel fear...21300:18:42,780 --> 00:18:48,380But I do try to protect from that just global fear that doesn't leave,21400:18:48,390 --> 00:18:48,680you know,21500:18:48,680 --> 00:18:50,360this is not a season of fear.21600:18:50,360 --> 00:18:56,230This is "I am afraid of a diagnosis in general."21700:18:56,640 --> 00:19:01,100And so I try to have some protection for that.21800:19:02,740 --> 00:19:04,010By protection.21900:19:04,020 --> 00:19:07,640I mean that I try to really monitor my own language.22000:19:07,650 --> 00:19:10,300I try to acknowledge what people are saying,22100:19:10,300 --> 00:19:11,770but I do point out,22200:19:12,340 --> 00:19:13,110um,22300:19:13,120 --> 00:19:18,270when I feel like an emotion is really just working against their wellness,22400:19:18,640 --> 00:19:19,080you know,22500:19:19,080 --> 00:19:23,950it sounds like this is about shame and there is no criticism here.22600:19:24,440 --> 00:19:26,460This is not a criticism.22700:19:26,920 --> 00:19:38,230This is to increase your power to understand yourself to be able to get centered when you're just feeling off center.22800:19:39,010 --> 00:19:40,860This is not a criticism.22900:19:41,740 --> 00:19:46,170So I may say things like that to protect the atmosphere.23000:19:51,740 --> 00:20:00,630I also try to explain to people if they are in a point of struggle about the topic,23100:20:00,640 --> 00:20:02,360let's say I've brought it up.23200:20:03,440 --> 00:20:05,360They're struggling with the topic.23300:20:06,950 --> 00:20:22,850I try to explain why I bring up what feels like a difficult topic to them and my memory goes back to when my son was in preschool.23400:20:23,440 --> 00:20:23,770Uh,23500:20:23,780 --> 00:20:33,270it was an early intervention preschool and he had started showing at the age of three some additional um,23600:20:35,340 --> 00:20:37,860characteristics that,23700:20:38,360 --> 00:20:38,660you know,23800:20:38,660 --> 00:20:45,520we later realized were part of the autism and I in a parent teacher meeting.23900:20:45,520 --> 00:20:48,360There were two teachers in me and I said,24000:20:48,360 --> 00:20:51,470have you started seeing these kinds of things for him?24100:20:51,470 --> 00:20:52,860Because we're seeing that a lot.24200:20:53,330 --> 00:20:58,020And I remember vividly that they both looked at each other,24300:20:58,020 --> 00:21:03,700both teachers and didn't say anything and then looked at me and said,24400:21:03,700 --> 00:21:07,050well we'll just start to work on that... they hadn't seen it.24500:21:07,940 --> 00:21:27,030And I knew darrn well that they knew something that I didn't and that it didn't feel to them like it was okay to bring up and then I felt too afraid to push it because I'm like,24600:21:27,040 --> 00:21:27,530oh,24700:21:27,800 --> 00:21:29,810if this is not okay to talk about,24800:21:29,810 --> 00:21:31,350do I really want to know?24900:21:31,840 --> 00:21:33,180But to be honest,25000:21:33,190 --> 00:21:36,850I needed to know I needed that information.25100:21:37,240 --> 00:21:46,050It didn't help me to be in the dark for two more years about what we could have been really understanding better.25200:21:46,940 --> 00:21:51,350Um So when I'm talking to someone in that position,25300:21:52,730 --> 00:21:54,560I may say something like,25400:21:54,940 --> 00:21:55,680you know,25500:21:55,680 --> 00:22:06,460it's because your well being is so important that I will always bring up topics that impact your well being,25600:22:06,460 --> 00:22:20,270even if they're ... they feel tough because you are important and it's important to talk about these things and I'm a person that will do that with you.25700:22:21,540 --> 00:22:30,390Um So I also try to bring it to the table when it's about to be shut down again,25800:22:30,390 --> 00:22:34,360tying it to their their well being,25900:22:34,360 --> 00:22:36,780their worth and my value for them.26000:22:38,350 --> 00:22:41,730I've also I started to think,26100:22:43,340 --> 00:22:44,110you know,26200:22:44,120 --> 00:22:52,020what do I want people to leave a conversation with me with?26300:22:52,020 --> 00:22:53,640What do I want him to leave with?26400:22:53,700 --> 00:22:54,040Well,26500:22:54,050 --> 00:22:57,080I'd like them of course to leave with some information.26600:22:57,080 --> 00:23:09,860But even more so I realize that what is most impactful is I want them to leave knowing that they are valued.26700:23:10,440 --> 00:23:12,990I want them to leave without fear.26800:23:13,540 --> 00:23:18,360I want them to feel empowered and courageous and supported.26900:23:19,540 --> 00:23:24,670So when I am interacting with them about the topic,27000:23:25,240 --> 00:23:28,770am I providing data and information of course,27100:23:30,040 --> 00:23:54,770but I'm very watchful that ultimately my goal is to have them sit with me in this experience and to be able to leave with a sense of freedom and being supported and for them to leave and say,27200:23:55,940 --> 00:24:03,450I feel like I was seen because that's really important.27300:24:05,540 --> 00:24:09,610I want to share a personal experience,27400:24:10,160 --> 00:24:15,950just two to round out this episode.27500:24:17,040 --> 00:24:19,050And um,27600:24:21,540 --> 00:24:35,850I got to the point where I did want to process this with my son's pediatrician When he was about four.27700:24:36,340 --> 00:24:44,050And I came to that on my own by research and watching him.27800:24:44,050 --> 00:24:47,680And um I decided,27900:24:47,830 --> 00:24:48,290you know,28000:24:48,290 --> 00:24:50,250it's time to talk about this.28100:24:50,570 --> 00:25:11,550And my reluctance to talk about it with him was because I know that even physicians get emotionally charged about the topic and I did not want to get into any kind of push or pull and I did not know his opinion.28200:25:11,560 --> 00:25:19,450He was our third pediatrician to be honest and I just did not know him that well.28300:25:20,330 --> 00:25:30,670And because I knew it might be a topic that might get shut down or there might be an emotional charge.28400:25:32,340 --> 00:25:35,220I practiced what I was going to say ahead of time.28500:25:35,230 --> 00:25:36,780Like a lot.28600:25:36,790 --> 00:25:39,510You know how you feel like I'm going in.28700:25:39,520 --> 00:25:41,550I have this one appointment.28800:25:41,560 --> 00:25:43,110I don't know this person,28900:25:43,120 --> 00:25:47,760but I need to make sure I'm thinking clearly enough to get these things across.29000:25:48,640 --> 00:25:54,580So I practiced and I wrote things down and the appointment got rescheduled three times.29100:25:54,590 --> 00:25:57,360So it's one of those things and you're waiting.29200:25:57,740 --> 00:26:02,610And I went to the appointment.29300:26:02,610 --> 00:26:04,760So I was kind of armed with,29400:26:05,540 --> 00:26:08,580you know what I wanted to say?29500:26:08,580 --> 00:26:13,340But I was very watchful about how this would go.29600:26:14,120 --> 00:26:24,600And I also had received so much advice for so long without really getting assistance.29700:26:24,610 --> 00:26:28,540And I didn't want that to be the case either.29800:26:28,790 --> 00:26:32,460I really wanted to talk.29900:26:32,470 --> 00:26:41,860I wanted someone to talk with me about a difficult thing and a complex thing and I wanted um something substantive to do next.30000:26:43,040 --> 00:26:46,370So we discussed a lot of things.30100:26:46,380 --> 00:26:52,850Um He referred us to the autism diagnostic clinic at our local easter seals.30200:26:53,340 --> 00:26:55,990Uh and then that wait list started of course.30300:26:56,540 --> 00:26:59,520Um So did he give me information?30400:26:59,520 --> 00:27:00,310Yes.30500:27:00,320 --> 00:27:01,960Did he give me a plan?30600:27:01,960 --> 00:27:02,940Absolutely.30700:27:02,950 --> 00:27:05,960But when I left that office,30800:27:06,640 --> 00:27:11,210what was life changing for me ... was mostly something else.30900:27:12,440 --> 00:27:20,800And what it was was that at the end of our talk... and I still get emotional about this.31000:27:20,850 --> 00:27:22,390At the end of our talk,31100:27:22,390 --> 00:27:24,110he looked at me and he said,31200:27:24,110 --> 00:27:24,590"I hope,31300:27:24,590 --> 00:27:33,710you know you're a good mom"... and I had practiced what to say in this session.31400:27:33,710 --> 00:27:35,160But I,31500:27:35,300 --> 00:27:36,600my mouth hung open.31600:27:36,600 --> 00:27:57,550I was literally speechless and I realized in that moment that nobody had ever said that to me and I knew darn well that if I asked my friends or my family,31700:27:57,550 --> 00:27:58,800do you think I'm a good mom?31800:27:58,800 --> 00:27:59,320They would say,31900:27:59,320 --> 00:28:01,300well of course you are.32000:28:01,330 --> 00:28:02,860That goes without saying.32100:28:04,440 --> 00:28:06,350But I realized it doesn't,32200:28:06,590 --> 00:28:19,200it doesn't go without saying because we get all these messages that we're doing something wrong or our struggle would be gone if we knew what we were doing.32300:28:21,540 --> 00:28:23,550Nobody had ever said,32400:28:24,740 --> 00:28:25,190I hope,32500:28:25,190 --> 00:28:25,450you know,32600:28:25,450 --> 00:28:36,770you're a good mom that has never left me.32700:28:37,240 --> 00:28:43,700It took no skill to say he didn't have to be an autism expert and he was not.32800:28:44,840 --> 00:28:54,790But when I left the emotional atmosphere had been protected and I left feeling seen and heard and valued.32900:28:55,840 --> 00:29:07,160And that gave me the courage to keep going to talk about something that is complex and emotionally charged.33000:29:07,840 --> 00:29:26,480And sometimes what we need to make people understand is that we see the heart that they have for their kids or we see all the detective work they've done to try to figure themselves out that we see their value.33100:29:26,480 --> 00:29:27,560We see them.33200:29:28,640 --> 00:29:29,660We honor them.33300:29:29,660 --> 00:29:31,060We respect them.33400:29:32,440 --> 00:29:32,970Um,33500:29:32,980 --> 00:29:35,600and that's something we think goes without saying,33600:29:35,600 --> 00:29:36,890but it really doesn't.33700:29:36,900 --> 00:29:45,910And so that's what I mean by navigating emotional atmospheres and protecting emotional atmospheres.33800:29:46,600 --> 00:30:00,420That sometimes the one thing we can do to open up a discussion where people feel free and safe enough to talk about something complex is to say,33900:30:00,420 --> 00:30:05,270I see you and you're important and I'm glad you're here.34000:30:05,460 --> 00:30:06,560And let's talk about it.34100:30:10,240 --> 00:30:15,330I hope you'll join me next time for our final episode in the series,34200:30:15,340 --> 00:30:22,510which is about talking about autism to others when you see autistic characteristics in them.34300:30:22,510 --> 00:30:25,240But but they're not expecting this discussion.34400:30:25,240 --> 00:30:25,860This is,
34500:30:26,040 --> 00:30:26,380you know,34600:30:26,380 --> 00:30:27,720something you want to bring up.34700:30:27,730 --> 00:30:30,660But should I bring it up and how could I bring it up?34800:30:30,940 --> 00:30:40,860Um That will be our next discussion and I will see you then.

Talking About Autism: Personal Journeys

Join Dr. Regan for this first episode of the new series "Talking About Autism." This episode focuses on talking about autism when you are on a journey toward diagnosis and after you have received a diagnosis. 
New Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life
New Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website
Resources for Clinicians
Read the transcript: 
100:00:03,540 --> 00:00:07,840Hello and welcome to this episode of Autism in the Adult.200:00:07,880 --> 00:00:09,020I am your host,300:00:09,020 --> 00:00:10,510Dr Theresa Regan.400:00:10,520 --> 00:00:12,600I'm a neuropsychologist.500:00:12,620 --> 00:00:15,060I am a certified autism specialist,600:00:15,440 --> 00:00:23,750the director of an autism diagnostic clinic for adults in central Illinois, and the mother of a teen and the spectrum.700:00:24,550 --> 00:00:27,630I am starting a new series of episodes today.800:00:28,040 --> 00:00:33,040I think this may end up being a 3-4 part series.900:00:33,040 --> 00:00:34,330We'll see how it goes.1000:00:34,340 --> 00:00:40,060Um and basically the series is going to be called "Talking About Autism."1100:00:40,440 --> 00:00:50,490And this was a listener request... from multiple listeners that have emailed about "How do I talk about this to other people,1200:00:50,490 --> 00:00:52,570whether that's my own diagnosis,1300:00:52,570 --> 00:00:56,720whether that's talking to people that I think may be on the spectrum,1400:00:56,720 --> 00:01:07,320but they haven't been thinking in that direction... and how do I navigate all the emotion that sometimes comes with these kinds of discussions?"1500:01:07,320 --> 00:01:12,460So we're going to take some time to sort through some of those topics.1600:01:13,340 --> 00:01:22,680I believe that this topic is really important, and that's why I have set aside to do a series of episodes about the topic.1700:01:22,690 --> 00:01:31,780I also feel like this is probably one of the most challenging episodes that I've put my mind to here.1800:01:31,790 --> 00:01:59,210And that is because in some ways it's a lot easier to present some research and a list of facts and definitions of terms than to talk about these concepts and experiences and to wrap words around things that are perhaps more personal or experiential is a little more challenging, but worth it I think...1900:01:59,210 --> 00:02:00,260but challenging.2000:02:00,270 --> 00:02:05,960And one of the challenges is probably to make some organization of it.2200:02:06,750 --> 00:02:11,650... So there's some cohesion in what we're talking about in each episode.2300:02:12,140 --> 00:02:13,810So in this first episode,2400:02:13,810 --> 00:02:22,700I'm going to cover the topic of talking about your own autism diagnosis to other people,2500:02:22,700 --> 00:02:25,060and I'm going to cover two things.2600:02:25,060 --> 00:02:37,560One is if you're an individual who's thinking about starting a journey toward evaluation, and you're talking to people about your desire to do this,2700:02:37,940 --> 00:02:38,340um,2800:02:38,340 --> 00:02:45,270some of what we review will have to do with this kind of process ... this starting of that journey.2900:02:45,280 --> 00:02:46,590And also,3000:02:46,590 --> 00:02:50,800then we'll finish by talking about once you have a diagnosis,3100:02:50,810 --> 00:02:51,930um,3200:02:51,940 --> 00:02:54,270who do you talk to about it?3300:02:54,280 --> 00:02:55,960How do you bring it up?3400:02:56,340 --> 00:02:56,890Um,3500:02:56,900 --> 00:03:00,750how does that go after you have a diagnosis?3600:03:01,140 --> 00:03:01,660Um,3700:03:01,660 --> 00:03:13,960so we're going to jump in first with that process that perhaps you're someone who's been thinking about yourself or been thinking about,3800:03:13,970 --> 00:03:14,870um,3900:03:14,880 --> 00:03:16,890perhaps your loved one,4000:03:16,890 --> 00:03:28,020Maybe your partner has been thinking about this and wants you to join them in this journey or you have a child or adolescent that you think may be on the spectrum.4100:03:28,020 --> 00:03:28,360And,4200:03:28,370 --> 00:03:35,550and this is just the beginning of a quest to figure out more information.4300:03:36,840 --> 00:03:43,910One of the really unusual things I think about autism as a diagnosis is that for some reason,4400:03:43,910 --> 00:04:00,060and I don't really understand why, everyone really seems to have an opinion about this topic as far as whether you actually are or are not on the spectrum.4500:04:01,140 --> 00:04:03,120And it's,4600:04:03,130 --> 00:04:03,780again,4700:04:03,780 --> 00:04:09,280mystifying to me because it doesn't seem to be based on any professional qualifications.4800:04:09,740 --> 00:04:10,330Um,4900:04:10,340 --> 00:04:10,770you know,5000:04:10,770 --> 00:04:17,750I think someone that you see at the grocery store seems just as adamant about that as your grandmother,5100:04:17,750 --> 00:04:19,390who's just as adamant,5200:04:19,400 --> 00:04:21,860um as your therapist and so forth.5300:04:22,540 --> 00:04:33,460Um it's mystifying in the sense that if someone told me they had a cardiac uh difference that was causing some arrhythmia or whatever,5400:04:33,840 --> 00:04:36,020I would never think to say no,5500:04:36,020 --> 00:04:37,180you don't.5600:04:37,320 --> 00:04:39,490I'm not a cardiologist.5700:04:39,500 --> 00:04:42,360I don't know if you do or not,5800:04:42,940 --> 00:04:44,640and um,5900:04:44,650 --> 00:04:50,840that just doesn't carry over to this neuro behavioral developmental condition.6000:04:50,840 --> 00:04:51,260So,6100:04:52,340 --> 00:05:06,610autism is a physical, neurologic state where the genetic code and the process of development of the brain has produced this less than typical neurology.6200:05:06,610 --> 00:05:10,610So 2% of people 6300:05:10,620 --> 00:05:17,250in our population, and that is a percentage that's pretty stable across age groups,6400:05:17,250 --> 00:05:18,250across country,6500:05:18,250 --> 00:05:24,220across research study ... that 2% of people will present with this neurology.6600:05:24,220 --> 00:05:26,650And so it's not very common.6700:05:27,340 --> 00:05:28,230Um,6800:05:28,240 --> 00:05:34,130and yet everyone seems to feel like they could recognize it... and I'm not,6900:05:34,140 --> 00:05:35,770I'm not sure where that comes from,7000:05:35,770 --> 00:05:48,970but that will probably be something you encounter if you say "I've been wondering if I'm on the autism spectrum" or "I've been wondering if my child is on the autism spectrum."7100:05:48,970 --> 00:05:55,830And you'll probably get some immediate responses from people that that is not the case.7200:05:55,830 --> 00:05:57,950And that could range from,7300:05:58,340 --> 00:05:58,790you know,7400:05:58,790 --> 00:06:00,860the physician that you see.7500:06:00,860 --> 00:06:02,910It could be a therapist.7600:06:02,910 --> 00:06:07,250It could be any range of people.7700:06:09,040 --> 00:06:20,860The reason that I bring up this type of encounter is that I think it's often not very helpful because it's non specific.7800:06:21,440 --> 00:06:27,290Um there's often not a reason given and it's not really based in data,7900:06:27,290 --> 00:06:38,160it's kind of based on this general gut feeling or what people expect autism to look like in their neighborhood or their family or their classroom or whatever.8000:06:38,640 --> 00:06:39,110Um,8100:06:39,120 --> 00:06:42,260but it's not really based on substance.8200:06:42,840 --> 00:06:54,860And one of the ways that I have found to kind of defuse that or at least ask for some substance is to say in response to that,8300:06:55,440 --> 00:06:55,860"Oh,8400:06:55,860 --> 00:06:56,390okay.8500:06:56,390 --> 00:06:59,410What criteria don't you think I meet?"8600:07:01,040 --> 00:07:04,320And whenever I've said that,8700:07:04,320 --> 00:07:13,660I've never had anyone who knew the criteria that actually were responding to that or giving this input that autism is incorrect.8800:07:14,140 --> 00:07:15,760Um so again,8900:07:16,440 --> 00:07:20,790unusual that people feel that strongly about it,9000:07:21,240 --> 00:07:22,160um,9100:07:22,540 --> 00:07:25,140and will produce that,9200:07:25,150 --> 00:07:25,800um,9300:07:26,040 --> 00:07:27,360that opinion.9400:07:27,740 --> 00:07:33,900But you can kind of diffuse that if you ask them for more specific data,9500:07:33,910 --> 00:07:35,770more specific information,9600:07:35,780 --> 00:07:36,500um,9700:07:36,500 --> 00:07:39,680you can kind of point out ... and sometimes it's been interesting.9800:07:39,680 --> 00:07:40,290So,9900:07:40,300 --> 00:07:41,150you know,10000:07:41,150 --> 00:07:45,240one person might say to me well I'm a counselor and I'll say,10100:07:45,240 --> 00:07:45,480yeah,10200:07:45,480 --> 00:07:47,940I know... a lot of people don't know the criteria though.10300:07:47,940 --> 00:07:51,190So what criteria don't you think this person meets?10400:07:51,640 --> 00:07:52,920And then she said,10500:07:52,920 --> 00:07:53,070well,10600:07:53,070 --> 00:07:55,060I guess I don't really know the criteria.10700:07:55,840 --> 00:07:58,060So it just helps diffuse that.10800:07:58,070 --> 00:07:59,760And I wouldn't recommend,10900:08:00,340 --> 00:08:00,820you know,11000:08:00,820 --> 00:08:03,580going in guns blazing or anything,11100:08:03,660 --> 00:08:05,680but just in a very matter of fact,11200:08:05,690 --> 00:08:10,990calm way that you'd like their input if it's based in the data,11300:08:10,990 --> 00:08:15,550what kind of observations are they using to say that,11400:08:17,440 --> 00:08:17,880you know,11500:08:17,880 --> 00:08:31,410Another comment that I find non specific and I find this comment to be kind of dismissing11600:08:31,410 --> 00:08:44,410I guess of someone's journey that they're taking toward an evaluation and what can happen unfortunately is the person will say,11700:08:44,410 --> 00:08:44,630"Well,11800:08:44,630 --> 00:08:46,120why do you think that?"11900:08:46,130 --> 00:08:55,960And you'll start to share some of your thoughts and experiences and then you're a bit trapped because they may say,12000:08:56,340 --> 00:08:56,780"Oh yeah,12100:08:56,780 --> 00:08:57,760but I do that too.12200:08:57,760 --> 00:08:59,170And I'm not autistic,12300:08:59,180 --> 00:09:00,560everybody does that."12400:09:01,240 --> 00:09:10,350Um and it just doesn't leave you in any better place than you were.12500:09:10,360 --> 00:09:10,680Again,12600:09:10,680 --> 00:09:12,760it doesn't add anything of substance.12700:09:12,760 --> 00:09:14,350It doesn't clear anything up.12800:09:14,840 --> 00:09:23,260Um And so one thing I find helpful to mention in this kind of dynamic would be to say,12900:09:23,840 --> 00:09:24,610"Well,13000:09:24,620 --> 00:09:42,960that would be like saying that because we all forget things that Alzheimer's dementia isn't really impactful to people, and something may be impactful to an individual because of how frequently it happens or how much distress it causes.13100:09:43,340 --> 00:09:44,370Um So,13200:09:44,380 --> 00:09:52,200so that's the thought process I'm using about my own experiences in the end.13300:09:52,200 --> 00:09:56,560I would never have your goal be ah,13400:09:56,940 --> 00:10:00,390to convince everyone that you come in contact with,13500:10:00,390 --> 00:10:02,690that the journey is relevant.13600:10:02,700 --> 00:10:18,650I think that autism is just such a misunderstood concept that you're going to have people who just are not in the same place that you are, and to go back and forth feeling like your role is to convince people,13700:10:18,660 --> 00:10:19,460um,13800:10:19,460 --> 00:10:21,060is probably not,13900:10:21,640 --> 00:10:22,270um,14000:10:22,280 --> 00:10:24,660not a role that really brings fruit.14100:10:25,220 --> 00:10:33,800And so I would consider letting go that agenda if that's your goal,14200:10:33,860 --> 00:10:36,260that you'll be able to convince everybody.14300:10:39,440 --> 00:10:40,950And interestingly,14400:10:40,950 --> 00:10:44,680as with other complex life situations,14500:10:44,680 --> 00:10:53,100what I find personally is that sometimes the people I expect to be there for me in this situation,14600:10:53,110 --> 00:10:57,740whether that's a celebration or whether I'm grieving about something,14700:10:57,750 --> 00:10:58,690um,14800:10:58,700 --> 00:10:59,770a wedding,14900:10:59,770 --> 00:11:00,900a funeral,15000:11:00,910 --> 00:11:01,640uh,15100:11:01,650 --> 00:11:02,630a promotion,15200:11:02,630 --> 00:11:06,240a move ... sometimes I expect,15300:11:06,250 --> 00:11:06,930you know,15400:11:06,930 --> 00:11:17,150these closest people to be really with me and a lot of times that's not necessarily the case and we may like it to be that way,15500:11:17,540 --> 00:11:23,440but in life I just find that there will always be people that step up that surprise you.15600:11:23,450 --> 00:11:23,690Like,15700:11:23,690 --> 00:11:24,150wow,15800:11:24,150 --> 00:11:26,500I wouldn't have expected you to be the one,15900:11:26,510 --> 00:11:27,320you know,16000:11:27,320 --> 00:11:30,190to kind of step up and meet me in this place.16100:11:30,200 --> 00:11:36,860But I did expect this other person to be able to support me and they're really not able to do that.16200:11:37,140 --> 00:11:47,570So sometimes the journey does involve letting go of some expectations and giving other people the freedom to be in a different place,16300:11:47,580 --> 00:11:56,350allowing yourself to grieve that you're not on the same journey that everyone else is ... that other people don't appreciate that part of your journey.16400:11:57,040 --> 00:12:05,960Um but not getting into the trap of trying to convince people who just aren't really there.16500:12:08,640 --> 00:12:23,850Another comment that I feel is dismissive and very general and non substantive is a comment people make ... I suppose to be um supportive,16600:12:24,340 --> 00:12:29,330but it dismisses some of the complexity of the journey,16700:12:29,340 --> 00:12:30,250I think.16800:12:30,260 --> 00:12:32,400And that is the comment I hear a lot,16900:12:32,400 --> 00:12:32,980which is,17000:12:32,980 --> 00:12:33,410"Well,17100:12:33,420 --> 00:12:36,160I guess everyone's a little autistic these days.17200:12:37,040 --> 00:12:39,250Apparently we're all autistic."17300:12:39,260 --> 00:12:39,580You know,17400:12:39,580 --> 00:12:41,260that kind of comment.17500:12:41,940 --> 00:12:49,050Um actually 2% of individuals meet full criteria for the autism spectrum.17600:12:49,440 --> 00:12:50,100Um,17700:12:50,110 --> 00:12:57,360so it's not this popular fad that everyone's getting diagnosed with.17800:12:57,840 --> 00:13:06,360Um I think there's a lot of emphasis on diagnosis now because we're realizing how many people have been missed or misdiagnosed.17900:13:06,840 --> 00:13:07,280Um,18000:13:07,290 --> 00:13:09,490but everyone's not autistic.18100:13:09,500 --> 00:13:13,130Uh this is an unusual neurologic pattern.18200:13:13,140 --> 00:13:14,490It's unique.18300:13:14,500 --> 00:13:21,230Uh it's not that common and it's really worth paying attention to and realizing,18400:13:21,240 --> 00:13:21,770you know,18500:13:21,770 --> 00:13:23,250when that's present.18600:13:26,000 --> 00:13:38,960Some people will advise that you don't pursue the journey of evaluation based on their premise that the diagnosis won't make a difference anyway.18700:13:39,440 --> 00:13:42,810And I've heard that from physicians,18800:13:42,810 --> 00:13:45,760from psychologists. psychiatrists, teachers,18900:13:46,240 --> 00:13:46,770um,19000:13:46,780 --> 00:13:49,930all kinds of people.19100:13:49,930 --> 00:13:56,050So I don't think it's really specific to any group of people or generation,19200:13:56,050 --> 00:14:11,160but I think it's just a revelation that in our culture... in our communities... we're really not to the point where people understand what a difference it does make and what a difference it should make.19300:14:11,540 --> 00:14:15,350So um if someone says that ... that probably,19400:14:15,740 --> 00:14:26,030well I would say it does reveal that they don't understand the neurology of autism well enough that they can really comment on your situation.19500:14:26,040 --> 00:14:35,960And again it may be your psychiatrist who doesn't or ... and it's not um a criticism of any one person.19600:14:36,040 --> 00:14:44,630I'm just commenting I think on the state of our community as far as our awareness of what the neurology looks like,19700:14:44,630 --> 00:14:54,150what impact it has on you or people around you and all the things that do make a difference about knowing that.19800:14:54,640 --> 00:14:59,080Um So it should direct our expectations,19900:14:59,080 --> 00:14:59,860our goals,20000:14:59,860 --> 00:15:03,100our understanding of the why of behavioral patterns,20100:15:03,110 --> 00:15:05,020how to get the best outcomes,20200:15:05,020 --> 00:15:06,600how to support each other.20300:15:06,610 --> 00:15:16,310Um because at a very basic level when you're going on a journey to um have an evaluation for autism,  20400:15:16,310 --> 00:15:29,450you're trying to figure out if your behavioral patterns in certain areas reflect neurology or whether they reflect more traditional mental health issues.20500:15:29,450 --> 00:15:39,460And I know that those two categories are not clean cut categories but for the purpose of this basic discussion,20600:15:39,470 --> 00:15:44,340I'm going to point out those 2 categories.20700:15:44,340 --> 00:15:55,380So I'm going to give an analogy that I hope will demonstrate why it does make a difference to understand if parts of a behavioral pattern have a neurologic base.20800:15:55,390 --> 00:16:03,410So let's consider that a psychologist has two clients coming in that day and they both have the same concern.20900:16:03,440 --> 00:16:08,830They both have a memory concern, and the psychologist could think,21000:16:08,830 --> 00:16:11,040"Well it's the same concern.21100:16:11,040 --> 00:16:22,460So I'm just going to use the same treatment for both patients since we're really just wanting to improve memory regardless of the reason for the memory difficulty."21200:16:23,340 --> 00:16:23,980Well,21300:16:23,990 --> 00:16:24,480let's say,21400:16:24,480 --> 00:16:27,400another psychologist has the same thing.21500:16:27,400 --> 00:16:29,920They have to people coming in but they decide,21600:16:29,930 --> 00:16:30,470you know,21700:16:30,480 --> 00:16:33,700it really does matter what the reason is.21800:16:33,710 --> 00:16:39,640And so I'm going to do an assessment to see -- why are these people having memory difficulties?21900:16:39,650 --> 00:16:42,010And the first client of the day,22000:16:42,010 --> 00:16:50,570the psychologist does the assessment and they see a cognitive pattern that's very classic for an alzheimer's dementia,22100:16:51,140 --> 00:16:54,390which means that the hippocampus is not functioning well,22200:16:54,400 --> 00:16:56,670there's a disease process here.22300:16:56,680 --> 00:17:03,650It really looks like it's going to be degenerative, and the memory loss is very based in neurology.22400:17:05,340 --> 00:17:07,900And the second client who comes in,22500:17:07,910 --> 00:17:22,860the psychologist does the assessment and realizes after the evaluation that their memory loss is due to traumatic experiences... that they've had so much trauma in their life that they're dissociating,22600:17:23,140 --> 00:17:41,960that they are shutting down their awareness in order to just go on autopilot and that's why they're losing chunks of their day and they forget parts of their childhood and their mind is just not online all of the time because it's trying to protect itself from all these strong emotions.22700:17:44,240 --> 00:18:03,720So at a basic level the treatment needs to be different ... the conceptualization needs to be different, and the support that we offer people needs to be different - based on whether there's been this more mental health path to these symptoms or whether there is some neurologic base.22800:18:04,140 --> 00:18:17,040So I'm not going to recommend that the Alzheimer's patient come into psychodynamic therapy every day to work on trauma work so that their memory will improve.22900:18:17,050 --> 00:18:21,970I need to understand what the base of the concern is.23000:18:21,970 --> 00:18:25,160So I understand what's likely to be helpful,23100:18:25,540 --> 00:18:31,620but I very well may recommend that the second client engage in trauma work,23200:18:31,620 --> 00:18:32,860whatever that looks like.23300:18:33,340 --> 00:18:48,390Uh and that should help this pattern of dissociating and help her be more aware and present psychologically in the moment and cut down on that loss of memory. Now,23400:18:48,390 --> 00:18:51,240certainly Alzheimer's and autism are not the same,23500:18:51,240 --> 00:18:51,710right?23600:18:51,720 --> 00:18:57,160Autism is developmental and Alzheimer's is acquired.23700:18:57,840 --> 00:19:00,080Alzheimer's is degenerative,23800:19:00,090 --> 00:19:01,220it gets worse.23900:19:01,230 --> 00:19:07,370Um and autism is based on how the brain was wired during development.24000:19:07,370 --> 00:19:10,770It's not a degenerative process,24100:19:11,640 --> 00:19:35,460but you can see this general concept of figuring out if there's a part of something going on that's neurologic versus more traditional mental health issue, and so I feel ... I feel like that in itself can be a really important part of the journey toward figuring out if autism is present.24200:19:35,940 --> 00:19:41,840So let me offer one additional example in this ... ,24300:19:41,840 --> 00:20:04,170I'm going to take little Johnny who's in kindergarten, and mother comes to talk with the teacher and gets to hear that "Unfortunately, Johnny is really struggling with his color recognition, and all of his peers are really taking off on recognizing colors and naming them and organizing them into hues and patterns.24400:20:04,170 --> 00:20:09,200And boy, little Johnny is not up to speed in that area.24500:20:09,210 --> 00:20:15,720And so what the teacher recommends is that she's going to repeat, for Johnny,24600:20:15,720 --> 00:20:24,760why it's important to work hard to learn his colors because it does impact various parts of his life.24700:20:25,140 --> 00:20:29,990So explaining ... a lot of explanation of why this is important.24800:20:30,000 --> 00:20:31,950She's gonna ask Johnny if ...24900:20:31,960 --> 00:20:42,450if he agrees that this is an important thing, and he says yes. And so she's going to add extra homework, extra tutoring about color recognition.25000:20:42,540 --> 00:20:54,290She's going to ask the parents to give extra work and help him at home and maybe set up um a prize versus consequences kind of thing.25100:20:54,290 --> 00:20:59,370Like if you can advance in this area up to your peers,25200:20:59,380 --> 00:21:01,600you can get this extra present.25300:21:01,600 --> 00:21:08,060But if you can't, then you can't go on the trip at the end of the year with your class.25400:21:08,740 --> 00:21:12,060So they've set this whole thing up, and every year,25500:21:12,060 --> 00:21:13,590the same thing is repeated.25600:21:13,590 --> 00:21:19,670Boy, Johnny needs to work harder on his color recognition. By middle school,25700:21:19,670 --> 00:21:23,120Johnny has this learned hopelessness...25800:21:23,120 --> 00:21:25,980That no matter how hard he tries,25900:21:25,990 --> 00:21:30,890he's always falling short of people's expectations in this area.26000:21:30,890 --> 00:21:36,260And instead of being shamed and embarrassed about it anymore,26100:21:36,260 --> 00:21:37,330he starts to say,26200:21:37,330 --> 00:21:38,110"You know what?26300:21:38,120 --> 00:21:40,400It's because I don't even care about colors,26400:21:40,480 --> 00:21:42,170I don't care about this."26500:21:42,540 --> 00:21:50,720And there starts to be this really difficult dynamic now between Johnny and his parents and his teachers,26600:21:50,730 --> 00:21:52,050a lot of strain,26700:21:52,050 --> 00:21:56,290some acting out. And all of a sudden, in middle school,26800:21:56,290 --> 00:22:02,030someone thinks to see if Johnny is colorblind. Lo and behold,26900:22:02,040 --> 00:22:08,760he has color blindness, and all this time we've been telling him to work harder.27000:22:10,440 --> 00:22:15,030We've been lecturing him about why it's important to do better.27100:22:15,140 --> 00:22:18,060We've been asking him if he agrees that it's important.27200:22:18,740 --> 00:22:19,240Um,27300:22:19,240 --> 00:22:31,960We've been tutoring him, all to no avail, and here we were asking him to do something he's not capable of doing at the same level as his peers.27400:22:32,540 --> 00:22:37,930And that is a difficulty because we've really uh,27500:22:37,940 --> 00:22:39,870set up this expectation.27600:22:39,870 --> 00:22:44,950He has this learned hopelessness that he just can't meet people's expectations.27700:22:44,960 --> 00:23:01,570The relationship between him and the teachers and the parents has become very strained and it could have been avoided if we understood that there's really a physical limitation that his eyes just can't process that information.27800:23:01,570 --> 00:23:07,190So asking him to work harder is not going to be something that is helpful.27900:23:07,190 --> 00:23:09,350It's not going to bring about a better outcome.28000:23:09,620 --> 00:23:11,800In fact it's making things worse.28100:23:12,640 --> 00:23:18,700So now let's say you have gone on this journey and you do have a diagnosis.28200:23:19,740 --> 00:23:23,360Um One of the questions that people then ask is well,28300:23:25,140 --> 00:23:25,740you know,28400:23:25,740 --> 00:23:29,150I don't ... I don't know who I want to talk to about this.28500:23:29,150 --> 00:23:30,860Do I have to tell everybody?28600:23:31,240 --> 00:23:40,670Um In fact some people may say I don't even want to go on that journey toward evaluation ... because my partner wouldn't understand that diagnosis.28700:23:40,680 --> 00:23:48,190And in reality... this is part of your medical record,28800:23:48,190 --> 00:23:59,370part of your um diagnostic history that you do not have to share with people outside of your medical care.28900:23:59,370 --> 00:24:02,350So if you have a partner,29000:24:02,740 --> 00:24:05,770you do not have to reveal that to them.29100:24:06,340 --> 00:24:09,400If you don't want to tell your family,29200:24:09,400 --> 00:24:12,100if you don't want to tell your teachers,29300:24:12,110 --> 00:24:17,690you have discretion about who you reveal too.29400:24:17,700 --> 00:24:23,560And I am speaking to you about the interpersonal aspects of revealing.29500:24:24,040 --> 00:24:34,810Um I'm not giving any legal or policy advice on anything about revealing in certain situations.29600:24:34,820 --> 00:24:36,990But interpersonally,29700:24:37,000 --> 00:24:43,060you don't have to reveal everything about yourself to every person in your life.29800:24:44,640 --> 00:24:52,460There may be reasons that you may decide to discuss your diagnosis with someone or some group of people.29900:24:52,940 --> 00:25:07,260And one of the reasons may be that you may want to explain who you are and how you're wired and what your needs are to other people and that may make life just easier with them.30000:25:08,280 --> 00:25:15,540And you can make the explanation nonspecific or specific.30100:25:15,540 --> 00:25:20,390And what I mean by that is you can use the word autism or not use the word autism,30200:25:20,940 --> 00:25:23,620but in some instances you might want to say,30300:25:23,620 --> 00:25:23,920you know,30400:25:23,920 --> 00:25:27,390I've really learned that my system needs X,30500:25:27,390 --> 00:25:29,900y and Z to feel calm.30600:25:29,900 --> 00:25:32,720So I'm gonna go take a break now,30700:25:32,720 --> 00:25:34,060if that's okay with you,30800:25:34,540 --> 00:25:36,660or you might want to say,30900:25:36,670 --> 00:25:37,380you know,31000:25:37,380 --> 00:25:41,770I've learned that I kind of miss sometimes what my friends need.31100:25:41,770 --> 00:25:42,730And so,31200:25:42,740 --> 00:25:43,250you know,31300:25:43,250 --> 00:25:45,700if you said something and it's just gone over my head,31400:25:45,700 --> 00:25:47,370please tell me again,31500:25:47,370 --> 00:25:50,170I really don't want to miss what your needs are.31600:25:50,540 --> 00:25:51,020Um,31700:25:51,030 --> 00:25:58,070so that's kind of a nonspecific way without using the word autism,31800:25:58,070 --> 00:26:05,760that you can share what you've learned about yourself in that context and that could make your relationships,31900:26:06,340 --> 00:26:07,120um,32000:26:07,130 --> 00:26:08,860really run more smoothly.32100:26:10,640 --> 00:26:21,380Another reason that someone may want to discuss their diagnosis may be that they might want to be someone that advocates for people on the spectrum,32200:26:21,380 --> 00:26:32,310that they might want to be part of creating an atmosphere that normalizes discussions about autism and that supports autistic individuals.32300:26:32,320 --> 00:26:37,670So they may decide that part of their own journey as personal to them,32400:26:38,540 --> 00:26:41,840that that may be part of how they approach things,32500:26:41,840 --> 00:26:43,960at least during a season of their life.32600:26:44,640 --> 00:26:45,160Um,32700:26:45,160 --> 00:26:45,640so,32800:26:45,640 --> 00:26:52,670in an effort to create an atmosphere of discussion and inviting discussion and advocating,32900:26:53,040 --> 00:26:57,290they may give this personal kind of,33000:26:57,300 --> 00:26:57,860um,33100:26:58,240 --> 00:27:01,180revelation to people about their own experience,33200:27:01,190 --> 00:27:02,480what they've learned,33300:27:02,480 --> 00:27:05,560how they can help support individuals on the spectrum.33400:27:07,440 --> 00:27:11,550I had a situation come up like that in my own life,33500:27:12,340 --> 00:27:23,950after my son had been diagnosed at the age of five at our local easter seals and I was at a Children's event and my son was out there,33600:27:23,960 --> 00:27:24,650um,33700:27:24,660 --> 00:27:36,860taking a certain kind of lesson in a group and another mother was sitting next to me and I had seen her son there a few times before and in watching his behavior33800:27:36,860 --> 00:27:38,770I did think to myself,33900:27:38,780 --> 00:27:42,310I wonder if his parents know he's on the spectrum.34000:27:42,310 --> 00:27:44,980It was pretty clear to me,34100:27:45,540 --> 00:27:46,030um,34200:27:46,030 --> 00:27:51,720for a variety of reasons... and one day she just happened to be sitting next to me.34300:27:51,720 --> 00:27:56,290We hadn't sat next to each other before and she,34400:27:56,300 --> 00:27:58,450I actually just said to her,34500:27:58,450 --> 00:27:58,830how,34600:27:58,840 --> 00:28:01,060how's your son enjoying this?34700:28:01,540 --> 00:28:07,720I asked about how he likes school and my intention was not to bring up the,34800:28:07,730 --> 00:28:09,350the diagnostic issue.34900:28:09,360 --> 00:28:11,700My intention was just to be polite.35000:28:11,710 --> 00:28:13,880So how does your son like school?35100:28:13,880 --> 00:28:14,980What is he like best?35200:28:14,980 --> 00:28:16,080How you know?35300:28:16,090 --> 00:28:16,880Um,35400:28:16,890 --> 00:28:18,930and in that process,35500:28:18,930 --> 00:28:19,650she said,35600:28:19,660 --> 00:28:20,060oh,35700:28:20,060 --> 00:28:21,550he's doing really well,35800:28:21,640 --> 00:28:24,340he's a little behind with some social things,35900:28:24,340 --> 00:28:26,970but I'm sure that will mature quickly.36000:28:27,540 --> 00:28:28,010Um,36100:28:28,010 --> 00:28:31,470and then she said a really,36200:28:31,480 --> 00:28:37,890there was a really pivotal moment for me and I was caught off guard and she said,36300:28:38,440 --> 00:28:39,160actually,36400:28:39,160 --> 00:28:45,260his teachers had the gall to suggest he's on the autism spectrum.36500:28:46,340 --> 00:28:54,110And I had that kind of moment where you feel like everything sits still and things are moving in slow motion.36600:28:54,110 --> 00:28:54,740But you know,36700:28:54,740 --> 00:28:56,670you have to respond or,36800:28:56,680 --> 00:28:59,360or your mind is trying to think of something to say.36900:29:00,740 --> 00:29:02,930And I thought to myself,37000:29:02,940 --> 00:29:14,860I know I don't have to talk about our experience with her, and I'm not feeling very generous in this moment,37100:29:15,440 --> 00:29:17,300but I said,37200:29:17,300 --> 00:29:17,610you know,37300:29:17,610 --> 00:29:19,280if I don't say anything,37400:29:20,430 --> 00:29:25,350I feel like I'm going to be agreeing that this is not something we can talk about.37500:29:26,340 --> 00:29:29,440And that's not what I believe and that's not the atmosphere37600:29:29,440 --> 00:29:35,280I want to create ... that if I don't reveal our experience,37700:29:36,140 --> 00:29:40,760I am agreeing that it takes gall to suggest that.37800:29:41,940 --> 00:29:44,160And I also didn't want to shame her.37900:29:44,740 --> 00:29:47,430I know what it's like to be a struggling mom.38000:29:48,140 --> 00:29:48,770I don't,38100:29:49,540 --> 00:29:50,110I'm not,38200:29:50,120 --> 00:29:52,990I wasn't in the same place that she is,38300:29:53,540 --> 00:29:57,100but I did not want to wound her or shame her.38400:29:57,330 --> 00:30:03,060And so I ended up saying in a very matter of fact tone,38500:30:03,070 --> 00:30:03,390"Oh,38600:30:03,390 --> 00:30:05,120my son's on the spectrum.38700:30:05,130 --> 00:30:08,580We got diagnosed at easter seals and you know,38800:30:08,580 --> 00:30:10,670that was one of the best things we ever did.38900:30:10,680 --> 00:30:14,650His therapies were so helpful and you know,39000:30:14,650 --> 00:30:17,800that was really something that was good for us."39100:30:19,040 --> 00:30:21,120And then I just said to her,39200:30:21,130 --> 00:30:21,640"You know,39300:30:21,640 --> 00:30:26,910whatever your son needs to be doing well and uh,39400:30:26,920 --> 00:30:28,660feeling good and connecting with people,39500:30:28,660 --> 00:30:31,060I just hope he gets that ... whatever that is."39600:30:33,540 --> 00:30:39,960So sometimes we make decisions about revelation based on what kind of atmosphere we want to promote.39700:30:43,690 --> 00:30:49,760Sometimes we might want to discuss our diagnosis to formalize something in a record,39800:30:50,140 --> 00:30:58,650like a medical record or a school or work record where we're asking for specific accommodations or we're asking,39900:30:58,660 --> 00:30:59,350um,40000:30:59,740 --> 00:31:00,530for,40100:31:00,540 --> 00:31:01,390uh,40200:31:01,400 --> 00:31:03,000an intervention like,40300:31:03,010 --> 00:31:03,580um,40400:31:03,590 --> 00:31:08,250occupational therapy or something that's going to be directed towards that need.40500:31:08,250 --> 00:31:10,420So sometimes we'll um,40600:31:10,430 --> 00:31:17,170discuss that with a team of people working on giving us specific interventions or accommodations.40700:31:19,140 --> 00:31:23,410And we also may wish to help someone specific.40800:31:23,420 --> 00:31:25,470So maybe we've,40900:31:25,480 --> 00:31:26,070you know,41000:31:26,080 --> 00:31:29,990we've revealed the diagnosis to some people close to us,41100:31:29,990 --> 00:31:38,270but most people don't know, and you run across someone that's really struggling, and you really think you get it.41200:31:38,340 --> 00:31:39,020You know,41300:31:39,030 --> 00:31:47,170you think I know what that is and I was so helped by this that maybe my experience might help them.41400:31:47,540 --> 00:31:57,850So you may choose in that moment or with that person to kind of talk about your own experience of diagnosis and why that made a difference for you.41500:31:57,850 --> 00:32:00,800And you might say something like,41600:32:00,810 --> 00:32:01,220you know,41700:32:01,220 --> 00:32:03,330"I don't know if that's anything you've considered,41800:32:03,330 --> 00:32:05,160but it may be something to think about."41900:32:08,140 --> 00:32:17,360And the last reason I'm going to put out there is just that sometimes when you are in an increasingly close relationship,42000:32:17,370 --> 00:32:20,450whether it's a friendship or um,42100:32:20,460 --> 00:32:22,040a partnership,42200:32:22,050 --> 00:32:23,560a romantic partnership,42300:32:24,540 --> 00:32:26,100part of growing closer,42400:32:26,100 --> 00:32:27,180over time,42500:32:28,140 --> 00:32:28,670you know,42600:32:28,670 --> 00:32:31,400maybe you've connected over favorite interests,42700:32:31,400 --> 00:32:33,470maybe you've connected in a group,42800:32:33,480 --> 00:32:39,260maybe it's been a year and you're getting closer and (the time frame isn't important,42900:32:39,260 --> 00:32:53,170I'm just trying to emphasize that there's been this growth together) ... And part of encouraging even more intimacy and closeness is self revelation.43000:32:53,640 --> 00:33:03,440So you start to reveal over time things that have really impacted you or things that you've been through and what your journey has been like.43100:33:03,450 --> 00:33:09,350So someone might share with their increasingly close friend what it was like when their mom died.43200:33:09,840 --> 00:33:15,060Or someone might share their diagnostic journey towards an autism diagnosis.43300:33:15,440 --> 00:33:23,280So sometimes it's part of this growing intimacy that self revelation brings whatever that revelation is.43400:33:23,290 --> 00:33:27,770And in this case it could have to do with the diagnosis of autism.43500:33:30,140 --> 00:33:34,760Those are my scattered thoughts um,43600:33:34,770 --> 00:33:42,800about talking about a journey toward diagnosis or an existing diagnosis with other people.43700:33:42,810 --> 00:33:48,300And I hope that these have provided some food for thought.43800:33:48,310 --> 00:33:48,930Um,43900:33:48,930 --> 00:34:07,440some examples of things that you might say or might avoid or might consider. The next episode is going to focus on bringing up the conversation or the topic with people that you think may be on the spectrum that you'd like to help,44000:34:07,450 --> 00:34:10,520but they really don't see this coming.44100:34:10,530 --> 00:34:12,660You don't ... you're not sure how they're gonna react,44200:34:12,660 --> 00:34:13,850You don't know what to say.44300:34:14,240 --> 00:34:19,260So that will be this next episode and the final episode,44400:34:19,270 --> 00:34:25,260I envision being about dealing with strong emotions um,44500:34:25,270 --> 00:34:28,280in conversation about autism.44600:34:28,280 --> 00:34:34,110So one of the things I've really experienced and learned is that people have strong,44700:34:34,110 --> 00:34:39,540strong emotions for a variety of very legitimate reasons.44800:34:39,550 --> 00:34:42,310And sometimes dealing with the emotions44900:34:42,310 --> 00:34:48,550in the conversation can be even more difficult than figuring out the words to say.45000:34:48,940 --> 00:34:49,560Um,45100:34:49,560 --> 00:34:54,410and sometimes you never know what kind of emotion is going to come on the scene.45200:34:54,420 --> 00:34:55,260Um,45300:34:55,270 --> 00:35:03,890and so I'm going to kind of focus on this emotional exchange during the third episode of this series,45400:35:03,890 --> 00:35:05,860Talking About Autism.

Recognizing Attempts at Regulation on the Autism Spectrum

Join Dr. Regan for the final episode of a four part series on regulation and dysregulation on the autism spectrum. This episode focuses on recognizing when an individual is attempting to regulate and using this information to partner toward the best outcome.
New Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life
New Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website
Resources for Clinicians
Transcript of Episode
100:00:00,340 --> 00:00:03,370This is Dr Theresa Regan.
200:00:03,380 --> 00:00:10,830I'm a neuropsychologist and I specialize in understanding the way that the brain is related to emotions,
300:00:10,830 --> 00:00:13,000behavior, cognition --
400:00:13,000 --> 00:00:16,430thinking skills -- and also personality.
500:00:16,440 --> 00:00:18,910I'm a certified autism specialist.
600:00:18,920 --> 00:00:24,060I'm the director of an autism diagnostic clinic for adults in Illinois.
700:00:24,070 --> 00:00:26,650And I'm the mother of a teen on the spectrum.
800:00:27,740 --> 00:00:35,960This is our final episode of a four point series on regulation and dysegulation on the autism spectrum.
900:00:36,440 --> 00:00:37,640In the first episode,
1000:00:37,640 --> 00:00:39,800we talked about what those words mean.
1100:00:39,800 --> 00:00:49,130So regulation has to do with the nervous system's ability to help us stay centered with alertness...
1200:00:49,140 --> 00:01:02,480whether we are able to wake up quickly and efficiently in the morning and are able to wind down to sleep in the evening ... that has to do with regulation of our alertness,
1300:01:02,490 --> 00:01:04,900Also regulation of attention...
1400:01:04,900 --> 00:01:14,000so sometimes we may feel spacey and inattentive and other times we may have too much hyper focus,
1500:01:14,000 --> 00:01:19,350too attentive to details that aren't really helping our situation.
1600:01:19,360 --> 00:01:21,530And also third,
1700:01:21,530 --> 00:01:24,370the regulation of emotions and behavior.
1800:01:24,370 --> 00:01:35,970And so this would be what we typically call fight, flight, or freeze modes when someone's overwhelmed and they may revert to an outburst or a meltdown,
1900:01:35,980 --> 00:01:39,230they may be an individual who has quieter struggle...
2000:01:39,230 --> 00:01:41,930So they may have flight reactions --
2100:01:41,930 --> 00:01:43,590like I'm leaving school,
2200:01:43,590 --> 00:01:46,580I can't come out of my room,
2300:01:46,580 --> 00:01:48,340I'm withdrawing.
2400:01:48,350 --> 00:01:52,880I'm hiding ... psychologically or physically.
2500:01:53,740 --> 00:01:57,440And some people have freeze reactions that ... I'm physically present,
2600:01:57,440 --> 00:01:59,430but I'm really shut down.
2700:01:59,430 --> 00:02:07,660I'm not psychologically present ... and it may even take the form of a dissociative episode like this person is shut down...
2800:02:07,670 --> 00:02:10,520They don't remember this conversation later.
2900:02:10,520 --> 00:02:14,360They're really just not able to be fully present.
3000:02:15,440 --> 00:02:18,590Another form of freeze reaction
3100:02:18,590 --> 00:02:25,130could be this expression of psychological stress through the physical body.
3200:02:25,140 --> 00:02:29,330So a person who's having what we call nonepileptic seizures.
3300:02:29,340 --> 00:02:39,150Those are seizures that are expressions of psychological struggle rather than based in electrical changes in the brain.
3400:02:39,160 --> 00:02:42,420That would be in this category.
3500:02:42,420 --> 00:02:49,150People who have feelings of physical pain in the context of emotional pain.
3600:02:49,540 --> 00:02:52,750People who have headaches or stomachaches etcetera.
3700:02:55,540 --> 00:03:02,510So we talked about ways to prevent dysregulation in the second episode.
3800:03:02,510 --> 00:03:06,960How to reduce those episodes of feeling uncentered.
3900:03:08,240 --> 00:03:09,490In the third episode,
4000:03:09,490 --> 00:03:26,260we talked about how to recover once dysregulation occurs, because it will ... it does for every human and there are just times in our life when we have more difficulties slipping into these dysregulated states.
4100:03:26,270 --> 00:03:27,850And then once that happens,
4200:03:27,850 --> 00:03:30,760we need to have strategies to recover.
4300:03:30,770 --> 00:03:33,360And that was our third topic.
4400:03:34,040 --> 00:03:52,950This is our fourth and final topic, and it's about how to recognize when the person you are with ... or how to recognize in yourself ... when you are attempting to regulate, because a lot of what we do as humans is say to ourselves,
4500:03:52,950 --> 00:03:53,310"Gosh,
4600:03:53,310 --> 00:03:55,540why is this person behaving that way?
4700:03:55,550 --> 00:03:57,150What does it mean?
4800:03:57,640 --> 00:03:59,980Why is my kid doing this?
4900:04:00,050 --> 00:04:01,770What's their intention?
5000:04:01,770 --> 00:04:02,820What does that mean?
5100:04:02,830 --> 00:04:06,790Or why did my spouse say this or didn't say this?
5200:04:06,790 --> 00:04:08,460What is the meaning behind that?"
5300:04:09,040 --> 00:04:15,620And it's really important if someone has a behavior and an attempt to regulate, that
5400:04:15,620 --> 00:04:19,740we understand that's what this behavior means.
5500:04:19,740 --> 00:04:24,760It's stemming, not from any personal issue between me and this person,
5600:04:24,770 --> 00:04:48,260It's stemming from an attempt to regulate and it's a sign ...it's revelation to the person and to those around him or her, that this is a person who's not feeling centered, and they're trying to get there and we all really want to support each individual's attempt to get to the center.
5700:04:48,740 --> 00:05:04,560And the first step is recognizing when someone is trying to do that and not interfering with their attempt to regulate unless we can offer them a better option for regulation and we'll talk about that in a little bit.
5800:05:06,140 --> 00:05:18,160One of the strategies that we talked about in previous episodes for regulating, whether that is alertness or attention or emotional calm,
5900:05:19,240 --> 00:05:34,590can have to do with the sensory system. The sensory inputs that people often use for adjusting that regulation state often has to do with pressure...
6000:05:34,600 --> 00:05:40,460So getting sensations of pressure, and that can be in the muscles or the joints.
6100:05:40,940 --> 00:05:44,560That's when we get what we call proprioceptive input.
6200:05:44,940 --> 00:06:02,550And that is why weighted blankets are calming for some people, that you have this pressure in the muscles and the nervous system gets these signals that it can kind of recenter, refocus, and get grounded.
6300:06:02,840 --> 00:06:09,760That's why yoga often is something that people gravitate toward for calming and centering,
6400:06:09,940 --> 00:06:19,520you often have these poses that you hold for a significant amount of time... enough that that pressure in the joint really gets settled in there.
6500:06:19,530 --> 00:06:35,590But there are a lot of other ways that people get pressure as well and we'll talk more about how to recognize that ... A lot of times the things people gravitate toward without really realizing why do I do this...
6600:06:35,600 --> 00:06:42,930There could be some sensory input part to it besides pressure...
6700:06:42,930 --> 00:06:45,740we're also going to be looking at movement.
6800:06:45,750 --> 00:06:50,360So that's when our brain receives vestibular input.
6900:06:50,840 --> 00:07:00,690So if person is riding their bike down through hills and down through neighborhoods,
7000:07:00,700 --> 00:07:04,950that person is getting vestibular input into their brain.
7100:07:05,340 --> 00:07:18,240And this kind of input is only present if the person is moving through space in the sense that they were in position one and now they're in position two... like they're down the street,
7200:07:18,250 --> 00:07:23,660that means the fluid in their ears starts to move and the brain gets this type of input...
7300:07:24,440 --> 00:07:32,360What doesn't give the brain vestibular movement input would be if the person is riding a stationary bike,
7400:07:32,740 --> 00:07:37,920they're moving their arms and legs and guess what ... they are getting proprioceptive input....
7500:07:37,920 --> 00:07:40,980that pressure in their muscles and their joints...
7600:07:41,020 --> 00:07:45,670but they're not moving through the neighborhood, down the hill,
7700:07:45,720 --> 00:07:53,560they're not getting that sense of movement into the brain, and that can be why a lot of people -- and you know who you are --
7800:07:53,640 --> 00:07:56,650will say, "I love running through the neighborhood,
7900:07:56,650 --> 00:07:58,590but I'm not going to run on a treadmill."
8000:07:58,600 --> 00:07:59,580You know,
8100:07:59,590 --> 00:08:04,670that is a clue that you are someone that needs that vestibular component,
8200:08:04,680 --> 00:08:07,950otherwise it just doesn't meet your sensory needs.
8300:08:09,740 --> 00:08:25,450Let me give some more examples of sensory strategies so that we recognize when someone around us may be using a sensory strategy. When kids or adults chew on things...
8400:08:25,840 --> 00:08:27,110pencils,
8500:08:27,120 --> 00:08:28,170shirts,
8600:08:28,180 --> 00:08:29,910chewing on gum,
8700:08:29,920 --> 00:08:34,280chewing on the tops or tabs of things.
8800:08:34,280 --> 00:08:39,010People put all kinds of things... like straws or tabs in their mouth.
8900:08:39,020 --> 00:08:42,710So our approach to correcting that is to say,
9000:08:42,710 --> 00:08:42,900"Hey,
9100:08:42,900 --> 00:08:44,330don't chew on your shirt,
9200:08:44,330 --> 00:08:45,460that's disgusting"...
9300:08:45,740 --> 00:08:48,410or don't chew on the pencil,
9400:08:48,410 --> 00:08:49,850it's not for chewing.
9500:08:50,140 --> 00:08:54,580Um but that kind of instruction doesn't really help.
9600:08:54,590 --> 00:09:06,710And the reason that in the long term the person kind of reverts back to that is it's probable that they actually are needing some pressure input through their jaw,
9700:09:06,720 --> 00:09:09,680through their uh the teeth into the jaw.
9800:09:09,690 --> 00:09:19,950And when you chew you get a lot of oral input and a lot of pressure input and that kind of input may be centering for that person.
9900:09:20,440 --> 00:09:30,240We even now ...at least in the United States, when there's an individualized educational plan for a student with attention problems or other difficulties in school,
10000:09:30,250 --> 00:09:47,750it may be written in their program that they're allowed to chew gum during class because it can help with focus and concentration and centering to have some pressure through the jaw and through the the teeth into the jaw.
10100:09:49,240 --> 00:10:09,850Another way that you might see people trying to get proprioceptive input would be that kid that is rolling on the ground, is crashing into people or things, and seems to like that.... um impact of hitting something or tackling in football,
10200:10:10,240 --> 00:10:16,260that kind of thing is going to give them pressure in their muscles and joints.
10300:10:16,940 --> 00:10:34,400Kds who like to run and jump into someone's lap or jump into a bear hug might really be wanting to get that pressure input ... for people who like to work on a laptop or on a project while they're laying on their stomach,
10400:10:34,400 --> 00:10:38,360you're getting a lot of pressure throughout your...
10500:10:38,740 --> 00:10:56,460the length of your body. When people are sitting and they're um kind of swinging their legs and they're hitting their ankles onto the the leg of the chair.
10600:10:56,940 --> 00:11:00,960Uh that gives pressure into the ankle joint there.
10700:11:01,440 --> 00:11:04,360People who like to go barefoot,
10800:11:04,370 --> 00:11:22,550you get a lot more proprioceptive input from the floor that way... by going barefoot rather than having a shoe on. Other people shuffle or drag their feet and they might be corrected by a parent and saying pick up your feet...
10900:11:23,440 --> 00:11:34,020the individual who sleeps with a ton of blankets or stuffed animals or really likes to be swaddled into something to sleep
11000:11:34,030 --> 00:11:39,250might be seeking pressure input. For people seeking vestibular input,
11100:11:39,640 --> 00:11:45,970you get that movement input ... and it may be riding the bike as I had talked about,
11200:11:45,980 --> 00:11:54,330It could be jumping on a trampoline (that also gives you pressure in your joints or when you flop on the bed of the trampoline).
11300:11:54,340 --> 00:11:55,010So you,
11400:11:55,020 --> 00:12:00,260you might be seeing that the person is getting both of those ...
11500:12:02,240 --> 00:12:06,720people who love roller coasters, who like to ride a motorcycle,
11600:12:07,140 --> 00:12:07,910Um,
11700:12:07,920 --> 00:12:20,790even just we can see that some people like to go for a ride in the car, and that clears their mind and it may be that there's some component of quiet that they find there,
11800:12:20,790 --> 00:12:27,260but they're also maybe just this predictable linear movement that might be calming.
11900:12:28,440 --> 00:12:30,980I want to tell you a story in particular.
12000:12:30,990 --> 00:12:35,480I saw a mother and her...
12100:12:35,490 --> 00:12:52,510I would say the son was probably about 10 years old, and it was one of those situations where unfortunately we were all in line to sign up for something that was related to a kids activity.
12200:12:52,520 --> 00:12:57,890And so there were parents in this long line and um,
12300:12:57,900 --> 00:13:01,930some parents had their kids with them and the line,
12400:13:01,940 --> 00:13:07,550I think it was raining outside and the interior of the office...
12500:13:07,740 --> 00:13:23,220it was just very winding and it was like you could fit one person in this little hallway and then it it just um meandered like a snake around this whole building and so you didn't see any windows and you were kind of...
12600:13:23,230 --> 00:13:25,900it really was loud and claustrophobic,
12700:13:25,900 --> 00:13:29,460it was very difficult for me to wait in that line.
12800:13:30,340 --> 00:13:33,720And the boy who was next to me,
12900:13:33,730 --> 00:14:07,460I could hear his mom talking to another mom in line ...and she was talking about how her boys loved to ride down this a really, really steep hill by their house, and she she just worries about them a bit because it's so steep and they do things like you know riding on their handlebars and ...they just are so driven to go down this hill that she hasn't been able to figure out a way to keep them from doing that.
13000:14:08,540 --> 00:14:14,270And in my mind I'm thinking "oh those are kids that need a lot of vestibular input,
13100:14:14,270 --> 00:14:20,750they need that ... they're trying to regulate and that's the way that they found that really serves that purpose.
13200:14:21,340 --> 00:14:35,820And interestingly, the next thing that happened was the boy next to me started shaking his head back, back, back, back, back, back, back and forth... vigorously and then he'd stop and then he'd shake,
13300:14:35,820 --> 00:14:36,060shake,
13400:14:36,060 --> 00:14:36,290shake,
13500:14:36,290 --> 00:14:36,510shake,
13600:14:36,510 --> 00:14:36,780shake,
13700:14:36,780 --> 00:14:37,010shake,
13800:14:37,010 --> 00:14:50,930shake his head and then he'd stop... and in my head, I thought "oh that's a great way for this kid to try to regulate in a hallway, because there's no way he's riding his bike down this hallway,"
13900:14:50,940 --> 00:14:52,730but by shaking his head,
14000:14:52,730 --> 00:14:54,150he's standing still,
14100:14:54,150 --> 00:15:02,300he's not making any noise and he's getting vestibular input because his head is shaking and that fluid in the ears is moving.
14200:15:02,540 --> 00:15:03,230And I thought,
14300:15:03,230 --> 00:15:03,490wow,
14400:15:03,490 --> 00:15:05,660that's a really great strategy for him.
14500:15:06,240 --> 00:15:08,180And the mom though,
14600:15:08,190 --> 00:15:17,060didn't realize what was happening, and she saw that as bad behavior and she said "stop that."
14700:15:18,240 --> 00:15:23,480And that's really the purpose of this episode... that if we don't understand,
14800:15:23,520 --> 00:15:24,180you know,
14900:15:24,180 --> 00:15:32,630here is someone who is struggling to stand still in a winding hallway,
15000:15:32,630 --> 00:15:34,040that's not moving,
15100:15:34,050 --> 00:15:35,740the line's not moving,
15200:15:35,750 --> 00:15:37,290people are talking,
15300:15:37,290 --> 00:15:39,160it's a very close space.
15400:15:39,640 --> 00:15:42,360Um and he's not able to move at all.
15500:15:43,040 --> 00:15:47,060So here he comes up with this great strategy,
15600:15:47,060 --> 00:15:48,570I'm sure unconsciously,
15700:15:48,570 --> 00:15:49,550it's not like he thought,
15800:15:49,550 --> 00:15:51,060how can I get movement input?
15900:15:51,070 --> 00:15:54,120But his body helped him out by saying,
16000:15:54,120 --> 00:15:54,350hey,
16100:15:54,350 --> 00:15:55,210do this.
16200:15:55,740 --> 00:15:57,670And mom said no,
16300:15:57,680 --> 00:16:02,770and so what we can really do, if we recognize what is this behavior...
16400:16:02,770 --> 00:16:03,920we could say,
16500:16:03,930 --> 00:16:06,450"oh that's a great strategy,
16600:16:07,030 --> 00:16:15,000Does that feel good to move your head like that" -- and we can help the person identifying themselves,
16700:16:15,000 --> 00:16:17,160what feels calming and what they need.
16800:16:17,840 --> 00:16:18,470Now,
16900:16:18,480 --> 00:16:25,930if she felt like that was too disruptive or if he were somehow banging his head into people,
17000:16:25,940 --> 00:16:28,400she very well could say something like,
17100:16:28,410 --> 00:16:31,510oh I really see that your body has that itch
17200:16:31,520 --> 00:16:32,250to move,
17300:16:32,250 --> 00:16:33,940it really needs to move,
17400:16:33,950 --> 00:16:36,190That's kind of hard to do in here.
17500:16:36,190 --> 00:16:42,160But would you like to go to the indoor pool after we're done?
17600:16:42,160 --> 00:16:53,240So you can get some of that movement that you really need... so that she's offering an alternative, and she's acknowledging that that actually serves a very important need for him,
17700:16:53,250 --> 00:17:08,950that he needs a lot of movement throughout the day and offering him more opportunity to do that again in a way that is safe and healthy and doesn't disrupt other people is a much better strategy than saying "don't do that."
17800:17:09,140 --> 00:17:11,620So once she understands that,
17900:17:11,630 --> 00:17:18,080they'll get along well with it, once we have a detective's hat on and we can say,
18000:17:18,080 --> 00:17:18,520wow,
18100:17:18,520 --> 00:17:21,240I wonder if X,
18200:17:21,240 --> 00:17:22,480y and Z.
18300:17:22,490 --> 00:17:22,890You know,
18400:17:22,890 --> 00:17:28,960I wonder if this behavior that you're showing really serves a function for you that's important.
18500:17:29,440 --> 00:17:40,060Then our solution can be to help the person realize what's happening, to support their attempts to regulate, and to create more opportunities for good regulation.
18600:17:42,540 --> 00:17:50,170It also breaks up this adversarial stance between people where if I'm correcting this person and saying,
18700:17:50,180 --> 00:17:50,960um,
18800:17:50,970 --> 00:17:51,440you know,
18900:17:51,440 --> 00:17:52,380pick your feet up,
19000:17:52,380 --> 00:17:55,740don't drag your feet, and don't shake your head, and don't talk.
19100:17:55,750 --> 00:18:18,890It gets into this very constant kind of adversarial situation where I've established a relationship with the person where I'm making sure they fit into a very small space, and they feel like their needs aren't getting met ... and she's asking, let's take the son who likes to move or needs movement,
19200:18:18,900 --> 00:18:22,030She's asking him to be still and be quiet.
19300:18:22,030 --> 00:18:25,830So she's asking him to regulate in the hallway.
19400:18:25,840 --> 00:18:29,560But she's asking him not to use regulation strategies.
19500:18:29,570 --> 00:18:31,560So that's where the problem is.
19600:18:31,560 --> 00:18:43,910He can either stay in the line and tolerate it by moving his head -- or he might then become more disruptive.
19700:18:43,910 --> 00:18:48,450Like then "I just can't stay in the line if I can't use the movement."
19800:18:50,640 --> 00:19:11,790I want to give you another example I witnessed of someone who is using vestibular input to regulate, and that was a preschooler who I observed the class was walking in their single file line behind the teacher. One of the students that had a lot of difficulty regulating 
19900:19:11,790 --> 00:19:15,480-- I already knew from past observations --
20000:19:15,490 --> 00:19:21,740He was spinning while walking down in line.
20100:19:21,750 --> 00:19:23,940This kind of took a lot of coordination,
20200:19:23,940 --> 00:19:27,150but he was spinning in his own personal space,
20300:19:27,150 --> 00:19:31,260but while moving in a single file... line and again,
20400:19:31,260 --> 00:19:34,520that was something that he got reprimanded for.
20500:19:34,530 --> 00:19:36,050But it's a big revelation.
20600:19:36,050 --> 00:19:37,050It's a big clue.
20700:19:37,340 --> 00:19:38,410And if we can say,
20800:19:38,410 --> 00:19:38,890wow,
20900:19:38,890 --> 00:19:40,350that's a clue,
21000:19:40,360 --> 00:19:46,240maybe I should put this kid on a swing and and let him go before we go back into the classroom,
21100:19:46,250 --> 00:19:48,770then we can use that information.
21200:19:51,140 --> 00:19:54,130The person who wants to chew on everything.
21300:19:54,140 --> 00:19:59,030Maybe they can chew gum instead of chewing on pencils or ruining their shirts.
21400:19:59,040 --> 00:20:06,770Um maybe they can chew on a pencil topper ... so they make different things you can chew on that you could put on top of a pencil.
21500:20:07,040 --> 00:20:17,890Another strategy that sometimes works for kids to kind of give them another source of regulation is to have them do their homework or um you know,
21600:20:17,890 --> 00:20:23,940for an adult to do their projects, while sitting on an exercise ball because when you're doing that,
21700:20:23,940 --> 00:20:30,350you're getting more pressure into your seat and you have the opportunity to move and get that vestibular input as well.
21800:20:30,350 --> 00:20:39,660And sometimes that reduces the need for chewing because you're actually getting some pressure and movement and feel more centered.
21900:20:43,840 --> 00:20:48,020Another way that people tend to seek regulations...
22000:20:48,020 --> 00:20:58,150so we've talked about sensory inputs... and another way that people seek regulation is when they want to engage in their pleasurable activities.
22100:20:58,160 --> 00:21:00,640So for the individual on the spectrum,
22200:21:00,640 --> 00:21:07,010this might include something like sorting or patterning objects in their collections.
22300:21:07,340 --> 00:21:11,590So they may take time to sort and organize their colored pencils,
22400:21:11,590 --> 00:21:13,060they're playing cards,
22500:21:13,070 --> 00:21:16,140they may take out items to look at that
22600:21:16,150 --> 00:21:24,350... they have that are figurines that are ornaments, that are books in a collection with special covers signed by the author.
22700:21:25,940 --> 00:21:31,930It may be that this person is wanting to read their favorite book,
22800:21:31,930 --> 00:21:33,830watch their favorite tv show,
22900:21:33,840 --> 00:21:38,970eat their favorite meal ... and this is their attempt to regulate.
23000:21:38,970 --> 00:21:42,500So they're gonna like ... their pleasurable,
23100:21:42,500 --> 00:22:02,420go-to activities ... and they're also going to tend to like things that are familiar. And one of the biggest problems I encounter for families is when they misinterpret why the person is trying to grasp at these familiar and pleasurable things.
23200:22:02,430 --> 00:22:12,260So let's take the example of a teenage girl who comes home from school and she is exhausted,
23300:22:12,640 --> 00:22:14,910it's loud at school,
23400:22:14,920 --> 00:22:17,520she was previously homeschooled,
23500:22:17,520 --> 00:22:21,340so the high school environment is a big difference.
23600:22:21,350 --> 00:22:24,860And after school she gets off the bus,
23700:22:24,860 --> 00:22:34,600she comes in and she breaks the family rule about using mom's iPad.
23800:22:34,600 --> 00:22:41,910So she is allowed to use mom's ipad for a certain number of minutes a day,
23900:22:42,440 --> 00:22:47,770and it is not until she has done her homework that she's able to start with it.
24000:22:48,240 --> 00:23:05,170But she goes right in to get the iPad, and she goes to her closet and she sits in the dark with the iPad, um with the closet door closed and mom finds her in there and ... really,
24100:23:05,170 --> 00:23:08,550really gets upset! Like this...
24200:23:08,560 --> 00:23:10,870these kind of things have happened before.
24300:23:10,880 --> 00:23:16,900And mom really views her as being very defiant,
24400:23:16,910 --> 00:23:29,670even though she intellectually knows the rules. She interprets her sitting in the closet in the dark with the ipad as "I know I'm not supposed to be doing this and I'm doing it anyway"
24500:23:29,670 --> 00:23:36,200and that feels very, very intentionally willful and defiant to mom.
24600:23:36,200 --> 00:23:40,450And so she um takes a very hard stance about it...
24700:23:40,450 --> 00:23:43,960she starts to yell and get upset,
24800:23:43,960 --> 00:23:50,320she grabs the ipad and physically takes it out of her daughter's hands.
24900:23:50,840 --> 00:23:53,110the daughter loses it,
25000:23:53,190 --> 00:23:55,160she starts screaming,
25100:23:55,540 --> 00:23:58,540she slams doors,
25200:23:58,540 --> 00:24:03,560she takes one of the doors ... not completely off the hinge,
25300:24:03,560 --> 00:24:19,380but kind of breaks and bends one of the hinges, and it just turned into a very loud screaming and property breaking kind of episode.
25400:24:19,380 --> 00:24:29,700And so this was unfortunate because I think mom's interpretation of what was going on was inaccurate.
25500:24:29,720 --> 00:24:34,060In my working with this teen,
25600:24:34,540 --> 00:24:38,460this is a teen with straight A's in school,
25700:24:38,840 --> 00:24:43,760she is very rule-oriented in school,
25800:24:43,760 --> 00:24:47,860which makes her mom feel very upset that she breaks the rules at home ...
25900:24:48,640 --> 00:24:52,390but she's just exhausted by the time she gets home,
26000:24:52,400 --> 00:24:59,970it's a complex academic, sensory, and social environment ...and she has not been used to it,
26100:24:59,980 --> 00:25:05,320she's back in a public school environment, and even the bus drive there and the bus drive home,
26200:25:05,320 --> 00:25:06,570that adds another,
26300:25:06,580 --> 00:25:07,340you know,
26400:25:07,340 --> 00:25:15,330hour to the day of being around all these people ...and it's very overwhelming to her. When she gets overwhelmed,
26500:25:17,840 --> 00:25:32,000what she wants to do is look at pictures of animals, and she wants to look up animal facts and topics and charts, and she wants to learn about a new animal and see pictures of the animal.
26600:25:32,010 --> 00:25:54,060And so all she's doing on the ipad is looking up animal facts and pictures and this is soothing to her. I do get where mom's coming from, that there are some households where the rule is you get to do fun things after you do your homework,
26700:25:54,940 --> 00:26:04,740but this person's nervous system really needs the opportunity to regroup before doing something again.
26800:26:04,750 --> 00:26:05,550That's hard.
26900:26:06,340 --> 00:26:18,300So she is at a breaking point when she comes home and it's actually her attempt to regulate that has her take this thing ... and I know she's hiding with it.
27000:26:18,300 --> 00:26:26,360But I also think that being in a dark, quiet space is also something she's trying to do to regulate as well.
27100:26:29,140 --> 00:26:41,150I think the misunderstanding is that mom feels that the daughter on the spectrum could easily comply and behave in a different way.
27200:26:41,160 --> 00:26:51,480And my view is that she's leaning toward trying to get her neurologic needs met and it breaks the household rule
27300:26:51,480 --> 00:26:54,540which puts everybody in a very tough position.
27400:26:54,550 --> 00:27:00,810So mom is essentially saying "I want you to regulate without doing your pleasant activities."
27500:27:00,820 --> 00:27:06,970And she is saying "I can't regulate if that's taken away from me."
27600:27:06,980 --> 00:27:14,580So mom's um kind of coming in and barging into the the bedroom area and the closet area,
27700:27:14,580 --> 00:27:17,860turning the lights on, physically taking away the
27800:27:18,540 --> 00:27:30,270ipad and raising her voice ... really added to this very overwhelming situation for her ... and then when she couldn't use flight... 
27900:27:31,040 --> 00:27:33,760here she had come home and used flight right?...
28000:27:33,760 --> 00:27:35,560I'm going to go to the closet.
28100:27:36,240 --> 00:27:36,440Um,
28200:27:36,440 --> 00:27:41,860and her favorite activity to prevent a meltdown.
28300:27:42,240 --> 00:27:44,310Once that was taken away from her,
28400:27:44,310 --> 00:27:48,350then she did have a meltdown, and it wasn't in defiance...
28500:27:48,360 --> 00:27:52,050it was just that what she was using to regulate was taken away.
28600:27:53,040 --> 00:27:58,300I think there would have been a much better outcome if the parent had seen her in the closet and thought,
28700:27:58,300 --> 00:27:58,720wow,
28800:27:58,730 --> 00:28:01,170it looks like you had a really rough day.
28900:28:01,740 --> 00:28:07,260Does it feel good to be in a dark cozy space and looking at your animals?
29000:28:07,740 --> 00:28:14,850And this could have started a real dialogue about what her system needs and what she notices.
29100:28:15,330 --> 00:28:23,200And it can introduce this concept that we can partner together to make sure that you're safe and healthy,
29200:28:23,200 --> 00:28:29,960but that your needs also get met because you are important and how you're doing is important.
29300:28:30,640 --> 00:28:30,990Um,
29400:28:30,990 --> 00:28:34,060and it sets up this collaboration and this partnership.
29500:28:35,740 --> 00:28:46,070Maybe there could be flexibility in the iPad rule and maybe they discussed that mom really does want her to feel centered after a hard day at work.
29600:28:46,080 --> 00:28:55,060And one option might be that mom and daughter could sit in a dark room together after school and look at animal facts for 30 minutes.
29700:28:55,540 --> 00:29:10,140If the reason that mom is restricting the ipad is that she thinks that she must be in the closet because she's looking at unapproved sites ... or maybe they could decide that having animal books from the library
29800:29:10,150 --> 00:29:10,880
29900:29:10,880 --> 00:29:19,170and the daughter could choose those books and go into an enclosed dark space and look at the books...
30000:29:19,180 --> 00:29:25,270if the reason for the rule is that mom doesn't want electronics all day in front of the daughter.
30100:29:26,540 --> 00:29:34,310Perhaps they could even have a tradition where after her alone time looking at animal facts and books,
30200:29:34,310 --> 00:29:37,810she could come out and tell mom some animal information.
30300:29:37,920 --> 00:29:42,660What was the most interesting that she learned... and this could also bring them together.
30400:29:43,140 --> 00:29:43,710
30500:29:43,710 --> 00:29:44,930once they have this,
30600:29:44,940 --> 00:29:49,510this better partnership and a tradition like 'this is how you unwind,
30700:29:49,520 --> 00:29:51,060this is how we connect'...
30800:29:53,350 --> 00:29:56,450And then once they figure out that that's helpful,
30900:29:56,940 --> 00:30:03,780they can talk about what else could we set up for you and give you access to that would help your system.
31000:30:03,790 --> 00:30:04,330You know,
31100:30:04,330 --> 00:30:22,270maybe this person needs a weighted blanket or a hammock or maybe laying in a bubble bath after school feels grounding, and they could come up with more ideas so that she has more access rather than less access to regulating activities.
31200:30:24,140 --> 00:30:28,080Consider an example of a husband who comes home from work
31300:30:28,090 --> 00:30:34,350to his wife and two preschool kids, and he walks straight to his home office,
31400:30:34,350 --> 00:30:35,570he shuts the door,
31500:30:35,580 --> 00:30:47,870he watches tv, plays games on his phone... and his kids had just thrown themselves at him when he came in the door only to be uh rejected and feel rejected.
31600:30:47,880 --> 00:30:54,320His wife is feeling like she's the one who needs to recharge because she's been with the kids all day.
31700:30:54,320 --> 00:30:59,760She hasn't seen another adult and she also feels ignored and rejected in her marriage.
31800:31:00,940 --> 00:31:03,360This again is a case of,
31900:31:03,940 --> 00:31:04,300um,
32000:31:04,300 --> 00:31:13,160an autistic adult who has given everything at work and comes in and actually does need some recentering time.
32100:31:13,640 --> 00:31:19,670And a discussion of this would probably be more fruitful
32200:31:20,100 --> 00:31:27,860than people talking about discontent with it, or telling him to do something different.
32300:31:28,440 --> 00:31:28,840Uh,
32400:31:28,850 --> 00:31:42,760it may be much more strategic to say "what do you need for these 30 or 40 minutes when you get home and then I'll tell you what I need and how can we get these things that we all need in the evening."
32500:31:45,040 --> 00:31:55,720Another strategy would be maybe he could start doing things at his office that would help him regulate during the day and then when he gets home,
32600:31:55,730 --> 00:31:58,800maybe he'd have a little bit more left.
32700:31:58,800 --> 00:32:00,880So maybe over a lunch break,
32800:32:00,890 --> 00:32:04,450he could eat his sandwich while he's walking around the block,
32900:32:04,830 --> 00:32:08,300Maybe he could listen to music when he's not in meetings.
33000:32:08,740 --> 00:32:18,850So this conscious working towards strategy helps us with the regulation piece.
33100:32:19,850 --> 00:32:21,320Then when he gets home,
33200:32:21,720 --> 00:32:26,330maybe he could go into his office and do some alone things for 30 minutes.
33300:32:26,740 --> 00:32:31,770And if wife needs alone time then or needs together time with him,
33400:32:32,140 --> 00:32:38,390they could pick maybe a restorative activity for the family... one that the kids never get to do.
33500:32:38,400 --> 00:32:53,170But they're going to pull this out in the evening because they really need something that's restorative and calm and so maybe they don't let let the kids watch movies or eat popcorn or eat anything in the living room.
33600:32:53,440 --> 00:33:05,000So maybe they could have a popcorn picnic or a pancake picnic in the living room while they put on a cartoon and they can turn off the lights.
33700:33:05,060 --> 00:33:07,540The kids might settle down in there,
33800:33:07,540 --> 00:33:15,490they can turn the volume down and then the parents could just cuddle on the couch and that level of activity
33900:33:15,490 --> 00:33:22,450may be something that he can regulate through and that actually is also restorative for them as a family.
34000:33:23,740 --> 00:33:35,700So once we recognize that the behavior is not intentionally defiant or manipulative at its core... and it doesn't represent a rejection of other people,
34100:33:35,700 --> 00:33:38,860we can problem solve and establish a partnership.
34200:33:39,240 --> 00:33:42,550And if you're the individual learning about yourself,
34300:33:42,550 --> 00:33:48,500you can say to the other person ... it looks like you have had a crazy day,
34400:33:48,510 --> 00:33:50,390I want to know what you need.
34500:33:50,400 --> 00:33:58,060Let me tell you what I think I need ... and so we can all grow in this self awareness and in these discussions about partnering.
34600:33:59,940 --> 00:34:07,230It's also important to note that flight can sometimes be an attempt to save regulation as well.
34700:34:07,240 --> 00:34:09,320And we talked about this a little bit.
34800:34:09,320 --> 00:34:31,190I just want to emphasize it before we end today ... that if someone leaves the room or if they shut down or if they stop the conversation and they are just going to leave ... one danger to chasing after them physically or psychologically,
34900:34:32,040 --> 00:34:36,180is that that flight may be the only thing
35000:34:36,180 --> 00:34:39,720saving them from melting down,
35100:34:39,730 --> 00:34:41,350that might be their strategy...
35200:34:41,350 --> 00:34:43,160flight might be their strategy.
35300:34:43,170 --> 00:34:45,360And so if it is,
35400:34:46,440 --> 00:34:53,540it often doesn't help to chase after the person and prevent them from flight.
35500:34:53,550 --> 00:35:00,900That's not to say that we don't want to work toward a more sustained level of communication.
35600:35:01,340 --> 00:35:09,630It's just that what doesn't seem to work -- and even though it's understandable ---is to go kind of in chase mode,
35700:35:09,630 --> 00:35:11,770like "I'm not going to let this go,
35800:35:11,770 --> 00:35:12,600this is important,
35900:35:12,600 --> 00:35:13,860we need to do this."
36000:35:14,840 --> 00:35:16,080Again,
36100:35:16,080 --> 00:35:18,600there are lots of caveats to all these,
36200:35:18,600 --> 00:35:24,740these are kind of general principles that I found helpful,
36300:35:24,750 --> 00:35:30,960but there may be times that you do block an activity or escape because of safety reasons.
36400:35:31,340 --> 00:35:35,100Um but most of the time when I see it happening,
36500:35:35,100 --> 00:35:36,970it's in frustration.
36600:35:37,340 --> 00:35:42,170Uh that ... I'm not gonna let you leave or I'm not gonna let you be defiant.
36700:35:43,140 --> 00:35:48,360Another approach that may work better in the flight mode issue is saying,
36800:35:48,370 --> 00:35:51,750I know that having this conversation is really tough for you,
36900:35:52,240 --> 00:35:56,340but it's also really important to me to communicate about this.
37000:35:56,340 --> 00:36:01,250And what would help you feel more centered and still be able to communicate.
37100:36:02,130 --> 00:36:14,160So some people may do better communicating about a sensitive topic when you're sitting in the dark so that they don't have to be face to face with you and they don't have to have eye contact.
37200:36:14,630 --> 00:36:26,540Another person may want to email about things for the same reason... that anything you can do to reduce the intensity of the conversation might make it more successful.
37300:36:26,550 --> 00:36:29,390So if they're overwhelmed enough that they want to leave,
37400:36:29,400 --> 00:36:35,950how can you reduce the intensity without reducing the core of what you want to accomplish?
37500:36:36,230 --> 00:36:39,710So maybe you can reduce the eye contact.
37600:36:39,720 --> 00:36:49,960Maybe you can reduce um you know turn down the lights or go in a quieter spot or schedule a time instead of having it spontaneous.
37700:36:50,930 --> 00:37:05,450So the bottom line summary of today's episode on recognizing when someone is attempting to regulate is that the way that we interpret someone's behavior ...
37800:37:06,140 --> 00:37:07,850you know, "what does this mean?"
37900:37:08,430 --> 00:37:17,490... it ends up impacting a lot, and if we think the behavior means someone's being disrespectful,
38000:37:17,490 --> 00:37:36,300manipulative, defiant, rejecting us ... then we are often going to respond in a way that's less effective than if we recognize that "oh this is a person who is dysregulated and trying to regulate.
38100:37:36,300 --> 00:37:37,950They're trying to get back.
38200:37:37,960 --> 00:37:47,010... this is a person who's overwhelmed ... then we can make better choices about how to respond in that situation to get the better outcome,
38300:37:47,020 --> 00:37:55,580the best outcome ... and that may include "wow it looks like you've had a rough day" or "it's really noisy in here isn't it?"
38400:37:55,590 --> 00:38:01,670Or "it seems like your system might need to move"... and really problem solving together.
38500:38:03,130 --> 00:38:07,440I hope this four part series on regulation has been helpful to you.
38600:38:08,330 --> 00:38:15,550It's certainly a topic that people often contact our clinic for ... for advice and education.
38700:38:17,430 --> 00:38:22,840Next time you join me it will be for the beginning of our next series, and I'm going to call it,
38800:38:22,840 --> 00:38:24,450Talking About Autism.
38900:38:24,830 --> 00:38:28,140This is a listener request, and I think it's a great one.
39000:38:28,140 --> 00:38:30,140It was sent in by several people,
39100:38:30,150 --> 00:38:36,950all wanting to really hear my input about how to talk about autism with each other.
39200:38:37,630 --> 00:38:39,110Hope you can join me then.
 

Recovering from Dysregulation on the Autism Spectrum

Join Dr. Regan for the third episode of a four part series on regulation and dysregulation on the autism spectrum. This episode focuses on strategies for recovering from dysregulated states. 
 
As referenced in the podcast: 
Exhaustion in Autism: Balancing Momentum for Daily Activities
Gaining Momentum for Activities: Shifting from Sluggish to Active
Keeping Momentum for Activities on the Autism Spectrum
 
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website
Resources for Clinicians
 
Transcript of Episode
100:00:03,540 --> 00:00:07,840Hello everyone and welcome to this episode of the podcast,
200:00:07,850 --> 00:00:09,680autism in the adult,
300:00:09,690 --> 00:00:10,910I am your host,
400:00:10,910 --> 00:00:12,450Dr Theresa Regan.
500:00:13,040 --> 00:00:14,870I am a neuropsychologist,
600:00:14,870 --> 00:00:20,640which means that I specialize in understanding how the brain impacts things like thinking,
700:00:20,640 --> 00:00:21,320skills,
800:00:21,330 --> 00:00:22,410emotions,
900:00:22,420 --> 00:00:24,560behavior and personality.
1000:00:25,160 --> 00:00:30,460I'm the founder and director of an adult diagnostic autism clinic in central Illinois.
1100:00:30,840 --> 00:00:40,560And today we have the third episode in a series of four on the topic of regulation and dysregulation on the autism spectrum.
1200:00:41,440 --> 00:00:42,960In the first episode,
1300:00:42,960 --> 00:00:51,080we defined these terms where regulation is feeling just right in the area of alertness,
1400:00:51,090 --> 00:01:03,630attention and calm, and dysegulation is feeling too high or too low in these areas and when someone is not feeling centered with their emotions,
1500:01:03,630 --> 00:01:11,960they might have a fight, flight, or freeze reaction, and the freeze reactions might include shutting down,
1600:01:12,410 --> 00:01:19,850they might include physical expressions of stress, or what we call dissociation.
1700:01:20,540 --> 00:01:31,760Dissociation could include things like forgetting periods of time or feeling disconnected from the body or feeling that things around us are not real.
1800:01:33,640 --> 00:01:34,800In the first episode,
1900:01:34,800 --> 00:01:38,030we also reviewed that within the autism spectrum,
2000:01:38,030 --> 00:01:43,360dysregulation is more common than for those with different neurology.
2100:01:44,540 --> 00:01:46,760In the second episode of this series,
2200:01:46,760 --> 00:02:08,760we talked about how to reduce the number and intensity of dysregulation episodes by taking care of the nervous system on a daily basis using things like sensory inputs and other strategies and also watching how intense a life schedule the person is diving into.
2300:02:10,520 --> 00:02:12,120For our third episode,
2400:02:12,120 --> 00:02:16,460our focus will be on what to do when dysregulation hits.
2500:02:16,940 --> 00:02:21,650We all have dysregulated states... for the person on the spectrum,
2600:02:21,650 --> 00:02:28,970they may be more likely to have these and, even when we do all that we can do to support the nervous system,
2700:02:29,440 --> 00:02:38,260we're going to have periods where we're really not just right with regard to alertness or attention or emotional status.
2800:02:38,840 --> 00:02:40,860So when someone is dysregulated,
2900:02:40,860 --> 00:02:47,170they might appear to be sluggish or have difficulty getting going or unmotivated.
3000:02:47,180 --> 00:02:53,360That would be when their motor is running too low in the area of alertness and activation.
3100:02:54,040 --> 00:03:04,330This type of dysregulation is covered in previous episodes about exhaustion and autism, and momentum within autism.
3200:03:04,330 --> 00:03:10,290And I will post the links to these episodes below today,
3300:03:10,290 --> 00:03:15,530We're going to focus on the dysregulation that looks like anxiety,
3400:03:15,540 --> 00:03:17,310upset, anger,
3500:03:17,310 --> 00:03:18,360restlessness.
3600:03:18,930 --> 00:03:24,570These things that may manifest in fight, flight, or freeze reactions.
3700:03:28,540 --> 00:03:37,480So once there's a dysregulated state, there are things that I would recommend not doing and things that I would recommend doing.
3800:03:37,480 --> 00:03:41,650So we're gonna start with this category of what not to do.
3900:03:42,040 --> 00:03:49,540Many of the things that we have an instinct for when someone is dysregulated actually may make things worse.
4000:03:49,550 --> 00:03:51,270So what do we tend to do?
4100:03:51,270 --> 00:03:51,470Well,
4200:03:51,470 --> 00:03:55,010we might ask the person to talk about how they're feeling,
4300:03:55,010 --> 00:03:56,760why they're feeling that way,
4400:03:56,760 --> 00:04:01,320what triggered this really strong emotional reaction.
4500:04:02,240 --> 00:04:08,560We may reason with them about why they should be feeling or reacting differently.
4600:04:08,940 --> 00:04:10,390We might say things like,
4700:04:10,390 --> 00:04:13,130"Well they didn't mean it" or "it's not a big deal,"
4800:04:13,130 --> 00:04:28,420"don't overreact", or "it's your own fault because you know you did this rule breaking activity and now you have a consequence." Or number three, we may tell them to regulate better.
4900:04:28,440 --> 00:04:31,000So we may say to them calm down,
5000:04:31,010 --> 00:04:32,180don't yell,
5100:04:32,190 --> 00:04:43,490look at me while I'm talking to you ... when someone is overwhelmed by what is happening around them or within their own system.
5200:04:43,500 --> 00:04:52,360It's really not likely to be helpful in that moment to add demands to this person who's already overwhelmed.
5300:04:54,040 --> 00:04:56,530For the person on the spectrum,
5400:04:56,530 --> 00:05:02,300it's already going to be effortful for them to figure out what their emotions are,
5500:05:02,310 --> 00:05:09,250what triggered them, and to talk about them face to face and eye to eye with another person.
5600:05:10,040 --> 00:05:18,350And we also see that it takes effort to reason in the moment, to talk ourselves down, to try to regulate ourselves.
5700:05:18,940 --> 00:05:26,280Um and so it's probably not only not realistic for them to be able to do that when overwhelmed,
5800:05:26,840 --> 00:05:33,750but talking to the individual who's overwhelmed also just adds stimulus,
5900:05:33,760 --> 00:05:35,150It adds demand,
6000:05:35,150 --> 00:05:36,860it adds noise.
6100:05:37,740 --> 00:05:45,750And so to the extent that talking is just adding stimulus to the situation,
6200:05:46,540 --> 00:05:50,490I really would recommend being calm,
6300:05:50,490 --> 00:05:51,840being quiet.
6400:05:52,340 --> 00:05:59,360Not necessarily engaging with the person in the moment that they are overwhelmed.
6500:06:00,540 --> 00:06:21,560So in general I find it helpful to reduce talking at that point of dysregulation unless there's a safety issue that you're trying to quickly address but otherwise um I really would not recommend a lot of talking and reasoning and explaining during that period of time
6600:06:24,440 --> 00:06:34,060Other things that I would recommend not doing would be ... I would not take away possessions from them at this time.
6700:06:34,540 --> 00:06:37,820So don't try to take something out of their hands.
6800:06:37,830 --> 00:06:43,810Don't try to take something away from their space or their room...
6900:06:43,820 --> 00:06:51,070the place where maybe they find comfort. Objects are often very important to the individual on the spectrum.
7000:06:51,070 --> 00:06:55,530And when someone's dysregulated and overwhelmed,
7100:06:55,530 --> 00:07:01,660it's often not a good time to try to separate them from something that's that important to them.
7200:07:03,640 --> 00:07:09,120Likewise touching them or wrestling with them ...kind of getting into their space.
7300:07:09,130 --> 00:07:16,060Um It's generally again going to add stimulus to what they're trying to process.
7400:07:16,070 --> 00:07:26,660So now I have touch-stimulus, and I have people in my space, and that is often likely to increase this dysregulated state.
7500:07:27,640 --> 00:07:35,830Again just kind of thinking how much information is coming at this individual who's already overwhelmed.
7600:07:35,830 --> 00:07:46,660So it's a lot of stimulus to come at them all at once, and to be in their space or to take away some of the possessions that are important to them...
7700:07:48,520 --> 00:07:50,970So during a period of dysregulation,
7800:07:50,970 --> 00:08:09,650the general concept to follow is that reducing stimuli and demand in that moment may help the individual become better regulated, but adding things that are stimuli to them that they have to process ...
7900:08:09,660 --> 00:08:12,090adding your speech, adding...
8000:08:12,090 --> 00:08:13,990being in in their space,
8100:08:14,000 --> 00:08:17,080taking away things that are comforting to them...
8200:08:17,080 --> 00:08:20,860that's likely to increase the dysregulated state.
8300:08:23,440 --> 00:08:36,660Another thing that you can do to help not increase this escalation of being overwhelmed is don't respond to the individual with heightened emotion.
8400:08:37,440 --> 00:08:45,220So emotional atmospheres can feel very intense and overwhelming to the individual on the spectrum.
8500:08:45,220 --> 00:09:06,420And when the person is already overwhelmed by their own emotions, it's really even more overwhelming if they have to react to and process your emotion that is coming toward them... it adds so much... this feeling of being overwhelmed.
8600:09:08,040 --> 00:09:14,760I would recommend staying very calm and even and predictable.
8700:09:17,240 --> 00:09:27,650I would make sure not to respond with reactivity, or unexpected statements or behaviors that they also have to react to and process.
8800:09:28,240 --> 00:09:31,670If you do approach the person with high reactivity,
8900:09:31,680 --> 00:09:43,970you're really asking them again to deal with a lot of new unique intense stimuli coming at them and to deal with your reaction as well as their own.
9000:09:43,980 --> 00:09:52,760And this is likely to increase this escalation of ... you know, feeling so upset or dysregulated.
9100:09:55,840 --> 00:10:08,350The goal that we've talked about so far is this goal of reducing what the person is having to process in that moment when they're already dysregulated.
9200:10:10,040 --> 00:10:26,190We'd like to take away some of the intensity of the situation to help them be able to recenter, to regroup, and in addition to reducing intense inputs around the individual.
9300:10:26,240 --> 00:10:38,930The focus should be on adding inputs that are regulating, that are calming, that are centering... these may be things like sensory inputs.
9400:10:38,940 --> 00:10:43,950And we talked about some of the strategies for this during the last episode.
9500:10:44,440 --> 00:10:53,160But, for example, an individual on the spectrum may really like pressure inputs or movement inputs.
9600:10:53,730 --> 00:11:06,880So an individual when dysregulated may be calm or help center themselves when they use a weighted blanket, or maybe they know that if they soak in a tub,
9700:11:06,890 --> 00:11:09,660they feel a lot more centered after that.
9800:11:10,240 --> 00:11:13,360Some people recenter by lifting weights,
9900:11:13,360 --> 00:11:14,330doing yoga,
10000:11:14,330 --> 00:11:26,460swinging ... these pressure inputs into the muscles and joints and the movement that the body has through space when it's doing things like swinging or bike riding.
10100:11:28,340 --> 00:11:30,830Those experiences may be calming,
10200:11:30,840 --> 00:11:38,750they may be centering for the individuals so if you can add calming and centering inputs without talking,
10300:11:39,440 --> 00:11:43,250this can really help getting back to a regulated state.
10400:11:44,140 --> 00:11:55,150And the second thing that can be centering for the individual is being able to do something that's soothing or filling for them.
10500:11:55,740 --> 00:11:58,480So thinking about this individual,
10600:11:58,480 --> 00:12:01,210what do they lean towards doing ... that
10700:12:01,210 --> 00:12:04,050they seem to find rejuvenating.
10800:12:05,240 --> 00:12:17,860Someone may really feel calmed and soothed when they are building a model of a boat or a car or when they're building something with legos,
10900:12:18,840 --> 00:12:28,460another person may love sorting through their collections or sorting through images on Pinterest,
11000:12:28,840 --> 00:12:36,510looking at various colors that are so ... they're just so compelled by these colors,
11100:12:36,520 --> 00:12:40,760they capture their attention and it's almost like they just fill,
11200:12:40,770 --> 00:12:45,290fill this person up ... and they feel so rejuvenated.
11300:12:46,240 --> 00:12:53,980A third person may love to listen to history podcasts or to watch a favorite movie,
11400:12:53,990 --> 00:12:57,870even one that they've watched 100 times,
11500:12:57,880 --> 00:13:04,560It may be their go-to movie when they want to regroup and settle back to the center.
11600:13:05,540 --> 00:13:10,020In these moments of being uncentered and wanting to recenter,
11700:13:10,030 --> 00:13:17,640it's very likely that familiar things will be more calming than new things.
11800:13:17,640 --> 00:13:24,650So um a lot of times if people watch what they're drawn to on a difficult day,
11900:13:24,740 --> 00:13:27,850it may give them this information.
12000:13:27,860 --> 00:13:38,590This when they're a detective about their own reactions, about what they go to when they do need to have a recentered moment.
12100:13:38,600 --> 00:14:05,300And one person may know that on difficult days they tend to watch the same particular movie or another person may know that on difficult days they tend to go for this same food pattern of eating that this is their go-to when they want to soothe and calm and recenter so far.
12200:14:05,300 --> 00:14:35,050We've talked about the importance of reducing stimuli and demand during a dysregulated episode and the impact of increasing familiar and soothing inputs during these episodes ... because the first goal that we want is for a recentering ... The final thing I would recommend is that the individual and those who are family or friends should try to work out ahead of time
12300:14:35,640 --> 00:14:37,320some type of game plan,
12400:14:37,350 --> 00:14:53,130a strategy for coping when the individual is dysregulated. Because during that episode, the brain is overwhelmed and it's not going to be great at thinking "What should I do?"
12500:14:53,270 --> 00:14:53,690You know,
12600:14:53,690 --> 00:14:56,800what should I do during this episode to feel better?
12700:14:57,340 --> 00:15:10,650So all this detective work ahead of time about what is calming and soothing and filling to me, and what is draining and overwhelming ... can be done ahead of time.
12800:15:11,240 --> 00:15:13,260People do it all different ways.
12900:15:13,260 --> 00:15:23,230Some of them make a list that they can look at when they are dysregulated ... of things that they can do to feel more centered.
13000:15:23,240 --> 00:15:24,200Oh yes,
13100:15:24,210 --> 00:15:24,590you know,
13200:15:24,590 --> 00:15:25,940I wouldn't have thought of this,
13300:15:25,940 --> 00:15:32,060but I can take a walk outside of the weather permits and I actually do feel better then.
13400:15:32,840 --> 00:15:41,890Sometimes people make a box ahead of time of items in it that are soothing.
13500:15:41,890 --> 00:15:46,070They might have a lava lamp in there that they can just watch,
13600:15:46,070 --> 00:15:47,960they might have a stress ball.
13700:15:48,440 --> 00:15:57,350Uh there might be slime or different scents like lavender or vanilla that are soothing or calming.
13800:15:59,140 --> 00:16:06,550So this detective work ahead of time can be really helpful and then adding cues to the person
13900:16:06,550 --> 00:16:09,000either from familiar people who can say,
14000:16:09,000 --> 00:16:09,280hey,
14100:16:09,280 --> 00:16:14,900I wonder if it would feel good for you to do this or to have it in the environment,
14200:16:14,900 --> 00:16:17,460like a list or a box of items...
14300:16:19,840 --> 00:16:27,240Ideally the individual will have a sense over time of when a dysegulated state is coming on.
14400:16:27,250 --> 00:16:28,660So for example,
14500:16:28,670 --> 00:16:37,060if they lean toward starting to shut down or disassociate during difficult times or difficult conversations,
14600:16:37,470 --> 00:16:43,520they may start to catch themselves when their mind starts to go blank and they're talking to somebody.
14700:16:44,540 --> 00:16:49,630They also may have a sense over time of when this happens at home,
14800:16:49,670 --> 00:16:55,320it often helps me to do these kinds of things-- and when it happens in public,
14900:16:55,330 --> 00:16:57,860I've learned to do these other kinds of things.
15000:16:59,140 --> 00:17:02,700Being able to recognize dysregulation, know
15100:17:02,700 --> 00:17:11,670what you can do to help recenter, and getting to the point where you can communicate briefly to other people around you about what's happening...
15200:17:11,680 --> 00:17:21,090that can really add another layer of growing into maturity with these strategies ...That, as we communicate with other people,
15300:17:21,100 --> 00:17:25,370we can really stabilize these situations and these relationships.
15400:17:25,380 --> 00:17:26,850So for example,
15500:17:26,850 --> 00:17:33,770if you are becoming dysregulated during a meeting at work, and you realize that you're headed for a meltdown,
15600:17:34,140 --> 00:17:40,530it's generally very acceptable and professional in most work settings to step out...
15700:17:40,540 --> 00:17:49,670if you offer some type of explanation...  walking out of the room without explanation would not be considered okay or professional,
15800:17:50,040 --> 00:17:55,250but someone may use a very generic explanation and just say,
15900:17:55,260 --> 00:17:55,870"You know,
16000:17:55,880 --> 00:17:58,340I'm starting to not feel very well,
16100:17:58,340 --> 00:18:13,360I just need to get some air" or the person may have the kind of relationship with their boss where they've discussed some things already that helped them in intense situations at work.
16200:18:14,940 --> 00:18:17,480So in that case the person might say,
16300:18:17,480 --> 00:18:17,840"You know,
16400:18:17,840 --> 00:18:21,450I can see that I'm really feeling passionate about this topic,
16500:18:21,840 --> 00:18:29,660but I also want to be able to hear what you have to say and ways in what your opinion is different from mine.
16600:18:29,670 --> 00:18:34,050And I think I just need to step out to regroup for a few minutes,"
16700:18:34,740 --> 00:18:45,960or if the strategy has to do with reducing the intensity of the conversation and a few minutes of stepping out is probably not going to be enough to regulate.
16800:18:46,440 --> 00:18:48,310They may say to their boss,
16900:18:48,320 --> 00:18:48,720"You know,
17000:18:48,720 --> 00:18:52,890I can feel myself getting really passionate about my own opinion,
17100:18:52,890 --> 00:18:55,920but I know that your perspective is important too,
17200:18:55,920 --> 00:19:08,140and I'm wondering if I could take time to gather my thoughts and to send them to an email so that I've kind of processed them and they're organized.
17300:19:08,260 --> 00:19:11,440I'd really love for you to hear them,
17400:19:11,440 --> 00:19:14,320but I also would like to read your thoughts.
17500:19:14,320 --> 00:19:15,960If you could send them to me.
17600:19:15,970 --> 00:19:32,670I find that a lot of times when I'm processing information that's really important to me having time to mull it over and having some time to get organized with my thoughts before a discussion with my colleagues really helps.
17700:19:33,940 --> 00:19:39,360Then I would like to come back and talk more about our opinions and talk them through."
17800:19:40,340 --> 00:19:51,640Sometimes the addition of time to process and removing this face to face intensity of the moment can help a person stay centered while still communicating about difficult things.
17900:19:51,650 --> 00:19:55,330So this could be a technique that's done in a workplace,
18000:19:55,340 --> 00:20:06,600in a school setting, or even just as part of a friendship or partnership when you're both having this intense conversation about something that you disagree on.
18100:20:06,600 --> 00:20:07,970But it's very important,
18200:20:07,970 --> 00:20:08,290you know,
18300:20:08,290 --> 00:20:17,670being able to have time and space to process before you come back together can help stabilize that interaction.
18400:20:20,940 --> 00:20:35,920It especially helps if you can let the other person know that the reason you're stepping back is because you do want to be able to process differing opinions and that their their opinion is important to you,
18500:20:35,920 --> 00:20:38,430even though you disagree with it.
18600:20:38,440 --> 00:20:46,530Um that it kind of helps show that you want there to be a good exchange.
18700:20:46,540 --> 00:20:48,000If you're walking out,
18800:20:48,000 --> 00:20:52,110sometimes people feel like they're not even committed to a good exchange.
18900:20:52,110 --> 00:20:54,950So what ... what good is this partnership?
19000:20:54,960 --> 00:21:09,600But if you can say it's because I really want to process things well, and I really want to hear your thoughts even though I can feel myself getting too passionate about the topic right now.
19100:21:09,610 --> 00:21:16,260Sometimes that puts in perspective that this is someone that does want to make this exchange of ideas work.
19200:21:18,540 --> 00:21:28,670That is a summary of someone who has gone on a long journey of figuring out what it feels like to them when they're dysregulated ...
19300:21:29,440 --> 00:22:07,960what kinds of things they can do to try to salvage that interaction and recenter in particular settings, and how they can communicate that to other people with experience and detective work and being mindful about kind of planning and sorting these things out the individual and those around him can develop communication about the strategies that work best and knowing these things and communicating about them can stabilize different interactions over time.
19400:22:08,640 --> 00:22:14,960So we've talked now about several ways to approach periods of dis regulation.
19500:22:15,340 --> 00:22:31,060One thing I will end up emphasizing here is that these are all general statement and of course there are also exceptions to every general principle and I can't address every type of situation,
19600:22:31,140 --> 00:22:38,260but all I can say certainly is that these are general things I've noticed that do help or don't help.
19700:22:40,120 --> 00:22:44,630Focus should also always be on the person's safety in that moment,
19800:22:44,630 --> 00:22:47,690if there's something unsafe that needs to be stopped,
19900:22:47,700 --> 00:22:52,260that's really something to immediately intervene with.
20000:22:53,340 --> 00:23:01,460But in general reducing stimuli and demand and increasing soothing inputs can be really helpful.
20100:23:03,840 --> 00:23:12,810I don't want to leave the impression that I don't think the autistic individuals should ever experience challenge in his or her life.
20200:23:12,810 --> 00:23:36,960So we all benefit from this appropriate level of challenge with support and that helps us grow, and the topic during this episode happens to relate to whether adding challenge and demand to the individual while they're dysregulated is generally fruitful ... and that's when I think it's just the wrong timing.
20300:23:37,440 --> 00:23:48,800So challenge should be added when the individual is fairly centered and regulated, and that's why working on regulation first can be beneficial --
20400:23:48,800 --> 00:23:54,860so that goals with some challenge can be added once regulation has improved.
20500:23:57,640 --> 00:24:05,670Now our next episode will be the final in our four episode series on regulation and dysregulation.
20600:24:07,140 --> 00:24:09,360In the 4th and final episode,
20700:24:09,360 --> 00:24:19,670we'll talk about how to recognize when someone is trying to regulate themselves, and what to do and not do in those situations.
20800:24:20,740 --> 00:24:28,060So thank you for joining me, and I hope to catch you next time for the final episode of the series on regulation.
 
 

Reducing Dysregulation on the Autism Spectrum

Join Dr. Regan for the second episode of a four part series on regulation and dysregulation on the autism spectrum. This episode focuses on three strategies to help reduce the frequency and intensity of dysregulation episodes for the autistic individual. 
 
Zur Institute webinar Feb 2022: ASD Interventions Across the Lifespan
 
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website
Resources for Clinicians
100:00:03,540 --> 00:00:07,840Hello everyone and welcome to this episode of the podcast,
200:00:07,850 --> 00:00:09,680autism in the adult,
300:00:09,690 --> 00:00:10,910I am your host,
400:00:10,910 --> 00:00:12,450Dr Theresa Regan.
500:00:13,040 --> 00:00:14,870I am a neuropsychologist,
600:00:14,870 --> 00:00:20,640which means that I specialize in understanding how the brain impacts things like thinking,
700:00:20,640 --> 00:00:21,320skills,
800:00:21,330 --> 00:00:22,410emotions,
900:00:22,420 --> 00:00:24,560behavior and personality.
1000:00:25,160 --> 00:00:30,460I'm the founder and director of an adult diagnostic autism clinic in central Illinois.
1100:00:30,840 --> 00:00:40,560And today we have the third episode in a series of four on the topic of regulation and dysregulation on the autism spectrum.
1200:00:41,440 --> 00:00:42,960In the first episode,
1300:00:42,960 --> 00:00:51,080we defined these terms where regulation is feeling just right in the area of alertness,
1400:00:51,090 --> 00:01:03,630attention and calm, and dysegulation is feeling too high or too low in these areas and when someone is not feeling centered with their emotions,
1500:01:03,630 --> 00:01:11,960they might have a fight, flight, or freeze reaction, and the freeze reactions might include shutting down,
1600:01:12,410 --> 00:01:19,850they might include physical expressions of stress, or what we call dissociation.
1700:01:20,540 --> 00:01:31,760Dissociation could include things like forgetting periods of time or feeling disconnected from the body or feeling that things around us are not real.
1800:01:33,640 --> 00:01:34,800In the first episode,
1900:01:34,800 --> 00:01:38,030we also reviewed that within the autism spectrum,
2000:01:38,030 --> 00:01:43,360dysregulation is more common than for those with different neurology.
2100:01:44,540 --> 00:01:46,760In the second episode of this series,
2200:01:46,760 --> 00:02:08,760we talked about how to reduce the number and intensity of dysregulation episodes by taking care of the nervous system on a daily basis using things like sensory inputs and other strategies and also watching how intense a life schedule the person is diving into.
2300:02:10,520 --> 00:02:12,120For our third episode,
2400:02:12,120 --> 00:02:16,460our focus will be on what to do when dysregulation hits.
2500:02:16,940 --> 00:02:21,650We all have dysregulated states... for the person on the spectrum,
2600:02:21,650 --> 00:02:28,970they may be more likely to have these and, even when we do all that we can do to support the nervous system,
2700:02:29,440 --> 00:02:38,260we're going to have periods where we're really not just right with regard to alertness or attention or emotional status.
2800:02:38,840 --> 00:02:40,860So when someone is dysregulated,
2900:02:40,860 --> 00:02:47,170they might appear to be sluggish or have difficulty getting going or unmotivated.
3000:02:47,180 --> 00:02:53,360That would be when their motor is running too low in the area of alertness and activation.
3100:02:54,040 --> 00:03:04,330This type of dysregulation is covered in previous episodes about exhaustion and autism, and momentum within autism.
3200:03:04,330 --> 00:03:10,290And I will post the links to these episodes below today,
3300:03:10,290 --> 00:03:15,530We're going to focus on the dysregulation that looks like anxiety,
3400:03:15,540 --> 00:03:17,310upset, anger,
3500:03:17,310 --> 00:03:18,360restlessness.
3600:03:18,930 --> 00:03:24,570These things that may manifest in fight, flight, or freeze reactions.
3700:03:28,540 --> 00:03:37,480So once there's a dysregulated state, there are things that I would recommend not doing and things that I would recommend doing.
3800:03:37,480 --> 00:03:41,650So we're gonna start with this category of what not to do.
3900:03:42,040 --> 00:03:49,540Many of the things that we have an instinct for when someone is dysregulated actually may make things worse.
4000:03:49,550 --> 00:03:51,270So what do we tend to do?
4100:03:51,270 --> 00:03:51,470Well,
4200:03:51,470 --> 00:03:55,010we might ask the person to talk about how they're feeling,
4300:03:55,010 --> 00:03:56,760why they're feeling that way,
4400:03:56,760 --> 00:04:01,320what triggered this really strong emotional reaction.
4500:04:02,240 --> 00:04:08,560We may reason with them about why they should be feeling or reacting differently.
4600:04:08,940 --> 00:04:10,390We might say things like,
4700:04:10,390 --> 00:04:13,130"Well they didn't mean it" or "it's not a big deal,"
4800:04:13,130 --> 00:04:28,420"don't overreact", or "it's your own fault because you know you did this rule breaking activity and now you have a consequence." Or number three, we may tell them to regulate better.
4900:04:28,440 --> 00:04:31,000So we may say to them calm down,
5000:04:31,010 --> 00:04:32,180don't yell,
5100:04:32,190 --> 00:04:43,490look at me while I'm talking to you ... when someone is overwhelmed by what is happening around them or within their own system.
5200:04:43,500 --> 00:04:52,360It's really not likely to be helpful in that moment to add demands to this person who's already overwhelmed.
5300:04:54,040 --> 00:04:56,530For the person on the spectrum,
5400:04:56,530 --> 00:05:02,300it's already going to be effortful for them to figure out what their emotions are,
5500:05:02,310 --> 00:05:09,250what triggered them, and to talk about them face to face and eye to eye with another person.
5600:05:10,040 --> 00:05:18,350And we also see that it takes effort to reason in the moment, to talk ourselves down, to try to regulate ourselves.
5700:05:18,940 --> 00:05:26,280Um and so it's probably not only not realistic for them to be able to do that when overwhelmed,
5800:05:26,840 --> 00:05:33,750but talking to the individual who's overwhelmed also just adds stimulus,
5900:05:33,760 --> 00:05:35,150It adds demand,
6000:05:35,150 --> 00:05:36,860it adds noise.
6100:05:37,740 --> 00:05:45,750And so to the extent that talking is just adding stimulus to the situation,
6200:05:46,540 --> 00:05:50,490I really would recommend being calm,
6300:05:50,490 --> 00:05:51,840being quiet.
6400:05:52,340 --> 00:05:59,360Not necessarily engaging with the person in the moment that they are overwhelmed.
6500:06:00,540 --> 00:06:21,560So in general I find it helpful to reduce talking at that point of dysregulation unless there's a safety issue that you're trying to quickly address but otherwise um I really would not recommend a lot of talking and reasoning and explaining during that period of time
6600:06:24,440 --> 00:06:34,060Other things that I would recommend not doing would be ... I would not take away possessions from them at this time.
6700:06:34,540 --> 00:06:37,820So don't try to take something out of their hands.
6800:06:37,830 --> 00:06:43,810Don't try to take something away from their space or their room...
6900:06:43,820 --> 00:06:51,070the place where maybe they find comfort. Objects are often very important to the individual on the spectrum.
7000:06:51,070 --> 00:06:55,530And when someone's dysregulated and overwhelmed,
7100:06:55,530 --> 00:07:01,660it's often not a good time to try to separate them from something that's that important to them.
7200:07:03,640 --> 00:07:09,120Likewise touching them or wrestling with them ...kind of getting into their space.
7300:07:09,130 --> 00:07:16,060Um It's generally again going to add stimulus to what they're trying to process.
7400:07:16,070 --> 00:07:26,660So now I have touch-stimulus, and I have people in my space, and that is often likely to increase this dysregulated state.
7500:07:27,640 --> 00:07:35,830Again just kind of thinking how much information is coming at this individual who's already overwhelmed.
7600:07:35,830 --> 00:07:46,660So it's a lot of stimulus to come at them all at once, and to be in their space or to take away some of the possessions that are important to them...
7700:07:48,520 --> 00:07:50,970So during a period of dysregulation,
7800:07:50,970 --> 00:08:09,650the general concept to follow is that reducing stimuli and demand in that moment may help the individual become better regulated, but adding things that are stimuli to them that they have to process ...
7900:08:09,660 --> 00:08:12,090adding your speech, adding...
8000:08:12,090 --> 00:08:13,990being in in their space,
8100:08:14,000 --> 00:08:17,080taking away things that are comforting to them...
8200:08:17,080 --> 00:08:20,860that's likely to increase the dysregulated state.
8300:08:23,440 --> 00:08:36,660Another thing that you can do to help not increase this escalation of being overwhelmed is don't respond to the individual with heightened emotion.
8400:08:37,440 --> 00:08:45,220So emotional atmospheres can feel very intense and overwhelming to the individual on the spectrum.
8500:08:45,220 --> 00:09:06,420And when the person is already overwhelmed by their own emotions, it's really even more overwhelming if they have to react to and process your emotion that is coming toward them... it adds so much... this feeling of being overwhelmed.
8600:09:08,040 --> 00:09:14,760I would recommend staying very calm and even and predictable.
8700:09:17,240 --> 00:09:27,650I would make sure not to respond with reactivity, or unexpected statements or behaviors that they also have to react to and process.
8800:09:28,240 --> 00:09:31,670If you do approach the person with high reactivity,
8900:09:31,680 --> 00:09:43,970you're really asking them again to deal with a lot of new unique intense stimuli coming at them and to deal with your reaction as well as their own.
9000:09:43,980 --> 00:09:52,760And this is likely to increase this escalation of ... you know, feeling so upset or dysregulated.
9100:09:55,840 --> 00:10:08,350The goal that we've talked about so far is this goal of reducing what the person is having to process in that moment when they're already dysregulated.
9200:10:10,040 --> 00:10:26,190We'd like to take away some of the intensity of the situation to help them be able to recenter, to regroup, and in addition to reducing intense inputs around the individual.
9300:10:26,240 --> 00:10:38,930The focus should be on adding inputs that are regulating, that are calming, that are centering... these may be things like sensory inputs.
9400:10:38,940 --> 00:10:43,950And we talked about some of the strategies for this during the last episode.
9500:10:44,440 --> 00:10:53,160But, for example, an individual on the spectrum may really like pressure inputs or movement inputs.
9600:10:53,730 --> 00:11:06,880So an individual when dysregulated may be calm or help center themselves when they use a weighted blanket, or maybe they know that if they soak in a tub,
9700:11:06,890 --> 00:11:09,660they feel a lot more centered after that.
9800:11:10,240 --> 00:11:13,360Some people recenter by lifting weights,
9900:11:13,360 --> 00:11:14,330doing yoga,
10000:11:14,330 --> 00:11:26,460swinging ... these pressure inputs into the muscles and joints and the movement that the body has through space when it's doing things like swinging or bike riding.
10100:11:28,340 --> 00:11:30,830Those experiences may be calming,
10200:11:30,840 --> 00:11:38,750they may be centering for the individuals so if you can add calming and centering inputs without talking,
10300:11:39,440 --> 00:11:43,250this can really help getting back to a regulated state.
10400:11:44,140 --> 00:11:55,150And the second thing that can be centering for the individual is being able to do something that's soothing or filling for them.
10500:11:55,740 --> 00:11:58,480So thinking about this individual,
10600:11:58,480 --> 00:12:01,210what do they lean towards doing ... that
10700:12:01,210 --> 00:12:04,050they seem to find rejuvenating.
10800:12:05,240 --> 00:12:17,860Someone may really feel calmed and soothed when they are building a model of a boat or a car or when they're building something with legos,
10900:12:18,840 --> 00:12:28,460another person may love sorting through their collections or sorting through images on Pinterest,
11000:12:28,840 --> 00:12:36,510looking at various colors that are so ... they're just so compelled by these colors,
11100:12:36,520 --> 00:12:40,760they capture their attention and it's almost like they just fill,
11200:12:40,770 --> 00:12:45,290fill this person up ... and they feel so rejuvenated.
11300:12:46,240 --> 00:12:53,980A third person may love to listen to history podcasts or to watch a favorite movie,
11400:12:53,990 --> 00:12:57,870even one that they've watched 100 times,
11500:12:57,880 --> 00:13:04,560It may be their go-to movie when they want to regroup and settle back to the center.
11600:13:05,540 --> 00:13:10,020In these moments of being uncentered and wanting to recenter,
11700:13:10,030 --> 00:13:17,640it's very likely that familiar things will be more calming than new things.
11800:13:17,640 --> 00:13:24,650So um a lot of times if people watch what they're drawn to on a difficult day,
11900:13:24,740 --> 00:13:27,850it may give them this information.
12000:13:27,860 --> 00:13:38,590This when they're a detective about their own reactions, about what they go to when they do need to have a recentered moment.
12100:13:38,600 --> 00:14:05,300And one person may know that on difficult days they tend to watch the same particular movie or another person may know that on difficult days they tend to go for this same food pattern of eating that this is their go-to when they want to soothe and calm and recenter so far.
12200:14:05,300 --> 00:14:35,050We've talked about the importance of reducing stimuli and demand during a dysregulated episode and the impact of increasing familiar and soothing inputs during these episodes ... because the first goal that we want is for a recentering ... The final thing I would recommend is that the individual and those who are family or friends should try to work out ahead of time
12300:14:35,640 --> 00:14:37,320some type of game plan,
12400:14:37,350 --> 00:14:53,130a strategy for coping when the individual is dysregulated. Because during that episode, the brain is overwhelmed and it's not going to be great at thinking "What should I do?"
12500:14:53,270 --> 00:14:53,690You know,
12600:14:53,690 --> 00:14:56,800what should I do during this episode to feel better?
12700:14:57,340 --> 00:15:10,650So all this detective work ahead of time about what is calming and soothing and filling to me, and what is draining and overwhelming ... can be done ahead of time.
12800:15:11,240 --> 00:15:13,260People do it all different ways.
12900:15:13,260 --> 00:15:23,230Some of them make a list that they can look at when they are dysregulated ... of things that they can do to feel more centered.
13000:15:23,240 --> 00:15:24,200Oh yes,
13100:15:24,210 --> 00:15:24,590you know,
13200:15:24,590 --> 00:15:25,940I wouldn't have thought of this,
13300:15:25,940 --> 00:15:32,060but I can take a walk outside of the weather permits and I actually do feel better then.
13400:15:32,840 --> 00:15:41,890Sometimes people make a box ahead of time of items in it that are soothing.
13500:15:41,890 --> 00:15:46,070They might have a lava lamp in there that they can just watch,
13600:15:46,070 --> 00:15:47,960they might have a stress ball.
13700:15:48,440 --> 00:15:57,350Uh there might be slime or different scents like lavender or vanilla that are soothing or calming.
13800:15:59,140 --> 00:16:06,550So this detective work ahead of time can be really helpful and then adding cues to the person
13900:16:06,550 --> 00:16:09,000either from familiar people who can say,
14000:16:09,000 --> 00:16:09,280hey,
14100:16:09,280 --> 00:16:14,900I wonder if it would feel good for you to do this or to have it in the environment,
14200:16:14,900 --> 00:16:17,460like a list or a box of items...
14300:16:19,840 --> 00:16:27,240Ideally the individual will have a sense over time of when a dysegulated state is coming on.
14400:16:27,250 --> 00:16:28,660So for example,
14500:16:28,670 --> 00:16:37,060if they lean toward starting to shut down or disassociate during difficult times or difficult conversations,
14600:16:37,470 --> 00:16:43,520they may start to catch themselves when their mind starts to go blank and they're talking to somebody.
14700:16:44,540 --> 00:16:49,630They also may have a sense over time of when this happens at home,
14800:16:49,670 --> 00:16:55,320it often helps me to do these kinds of things-- and when it happens in public,
14900:16:55,330 --> 00:16:57,860I've learned to do these other kinds of things.
15000:16:59,140 --> 00:17:02,700Being able to recognize dysregulation, know
15100:17:02,700 --> 00:17:11,670what you can do to help recenter, and getting to the point where you can communicate briefly to other people around you about what's happening...
15200:17:11,680 --> 00:17:21,090that can really add another layer of growing into maturity with these strategies ...That, as we communicate with other people,
15300:17:21,100 --> 00:17:25,370we can really stabilize these situations and these relationships.
15400:17:25,380 --> 00:17:26,850So for example,
15500:17:26,850 --> 00:17:33,770if you are becoming dysregulated during a meeting at work, and you realize that you're headed for a meltdown,
15600:17:34,140 --> 00:17:40,530it's generally very acceptable and professional in most work settings to step out...
15700:17:40,540 --> 00:17:49,670if you offer some type of explanation...  walking out of the room without explanation would not be considered okay or professional,
15800:17:50,040 --> 00:17:55,250but someone may use a very generic explanation and just say,
15900:17:55,260 --> 00:17:55,870"You know,
16000:17:55,880 --> 00:17:58,340I'm starting to not feel very well,
16100:17:58,340 --> 00:18:13,360I just need to get some air" or the person may have the kind of relationship with their boss where they've discussed some things already that helped them in intense situations at work.
16200:18:14,940 --> 00:18:17,480So in that case the person might say,
16300:18:17,480 --> 00:18:17,840"You know,
16400:18:17,840 --> 00:18:21,450I can see that I'm really feeling passionate about this topic,
16500:18:21,840 --> 00:18:29,660but I also want to be able to hear what you have to say and ways in what your opinion is different from mine.
16600:18:29,670 --> 00:18:34,050And I think I just need to step out to regroup for a few minutes,"
16700:18:34,740 --> 00:18:45,960or if the strategy has to do with reducing the intensity of the conversation and a few minutes of stepping out is probably not going to be enough to regulate.
16800:18:46,440 --> 00:18:48,310They may say to their boss,
16900:18:48,320 --> 00:18:48,720"You know,
17000:18:48,720 --> 00:18:52,890I can feel myself getting really passionate about my own opinion,
17100:18:52,890 --> 00:18:55,920but I know that your perspective is important too,
17200:18:55,920 --> 00:19:08,140and I'm wondering if I could take time to gather my thoughts and to send them to an email so that I've kind of processed them and they're organized.
17300:19:08,260 --> 00:19:11,440I'd really love for you to hear them,
17400:19:11,440 --> 00:19:14,320but I also would like to read your thoughts.
17500:19:14,320 --> 00:19:15,960If you could send them to me.
17600:19:15,970 --> 00:19:32,670I find that a lot of times when I'm processing information that's really important to me having time to mull it over and having some time to get organized with my thoughts before a discussion with my colleagues really helps.
17700:19:33,940 --> 00:19:39,360Then I would like to come back and talk more about our opinions and talk them through."
17800:19:40,340 --> 00:19:51,640Sometimes the addition of time to process and removing this face to face intensity of the moment can help a person stay centered while still communicating about difficult things.
17900:19:51,650 --> 00:19:55,330So this could be a technique that's done in a workplace,
18000:19:55,340 --> 00:20:06,600in a school setting, or even just as part of a friendship or partnership when you're both having this intense conversation about something that you disagree on.
18100:20:06,600 --> 00:20:07,970But it's very important,
18200:20:07,970 --> 00:20:08,290you know,
18300:20:08,290 --> 00:20:17,670being able to have time and space to process before you come back together can help stabilize that interaction.
18400:20:20,940 --> 00:20:35,920It especially helps if you can let the other person know that the reason you're stepping back is because you do want to be able to process differing opinions and that their their opinion is important to you,
18500:20:35,920 --> 00:20:38,430even though you disagree with it.
18600:20:38,440 --> 00:20:46,530Um that it kind of helps show that you want there to be a good exchange.
18700:20:46,540 --> 00:20:48,000If you're walking out,
18800:20:48,000 --> 00:20:52,110sometimes people feel like they're not even committed to a good exchange.
18900:20:52,110 --> 00:20:54,950So what ... what good is this partnership?
19000:20:54,960 --> 00:21:09,600But if you can say it's because I really want to process things well, and I really want to hear your thoughts even though I can feel myself getting too passionate about the topic right now.
19100:21:09,610 --> 00:21:16,260Sometimes that puts in perspective that this is someone that does want to make this exchange of ideas work.
19200:21:18,540 --> 00:21:28,670That is a summary of someone who has gone on a long journey of figuring out what it feels like to them when they're dysregulated ...
19300:21:29,440 --> 00:22:07,960what kinds of things they can do to try to salvage that interaction and recenter in particular settings, and how they can communicate that to other people with experience and detective work and being mindful about kind of planning and sorting these things out the individual and those around him can develop communication about the strategies that work best and knowing these things and communicating about them can stabilize different interactions over time.
19400:22:08,640 --> 00:22:14,960So we've talked now about several ways to approach periods of dis regulation.
19500:22:15,340 --> 00:22:31,060One thing I will end up emphasizing here is that these are all general statement and of course there are also exceptions to every general principle and I can't address every type of situation,
19600:22:31,140 --> 00:22:38,260but all I can say certainly is that these are general things I've noticed that do help or don't help.
19700:22:40,120 --> 00:22:44,630Focus should also always be on the person's safety in that moment,
19800:22:44,630 --> 00:22:47,690if there's something unsafe that needs to be stopped,
19900:22:47,700 --> 00:22:52,260that's really something to immediately intervene with.
20000:22:53,340 --> 00:23:01,460But in general reducing stimuli and demand and increasing soothing inputs can be really helpful.
20100:23:03,840 --> 00:23:12,810I don't want to leave the impression that I don't think the autistic individuals should ever experience challenge in his or her life.
20200:23:12,810 --> 00:23:36,960So we all benefit from this appropriate level of challenge with support and that helps us grow, and the topic during this episode happens to relate to whether adding challenge and demand to the individual while they're dysregulated is generally fruitful ... and that's when I think it's just the wrong timing.
20300:23:37,440 --> 00:23:48,800So challenge should be added when the individual is fairly centered and regulated, and that's why working on regulation first can be beneficial --
20400:23:48,800 --> 00:23:54,860so that goals with some challenge can be added once regulation has improved.
20500:23:57,640 --> 00:24:05,670Now our next episode will be the final in our four episode series on regulation and dysregulation.
20600:24:07,140 --> 00:24:09,360In the 4th and final episode,
20700:24:09,360 --> 00:24:19,670we'll talk about how to recognize when someone is trying to regulate themselves, and what to do and not do in those situations.
20800:24:20,740 --> 00:24:28,060So thank you for joining me, and I hope to catch you next time for the final episode of the series on regulation.
 
 

Recognizing Dysregulation on the Autism Spectrum: Fight, Flight, Freeze

Individuals on the spectrum who are going through a season of struggle often describe episodes of dysregulation (not feeling centered in their alertness, attention, or emotions). Join Dr. Regan for this first episode in a 4 part series on dysregulation to learn how to recognize a dysregulated state and why these states are often misinterpreted or mishandled. 
 
The Alert Program: Your Best Self
The Testing Psychologist podcast: Best of 2021
Zur Institute webinar Feb 2022: ASD Interventions Across the Lifespan
 
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website
Resources for Clinicians
 
Episode Transcript
100:00:00,340 --> 00:00:17,760Welcome to autism in the adult podcast.
200:00:17,770 --> 00:00:18,750I'm your host,
300:00:18,760 --> 00:00:20,290Dr Theresa Regan,
400:00:20,300 --> 00:00:22,560an adult neuropsychologist.
500:00:22,640 --> 00:00:28,050I specialize in brain behavior relationships for those 14 and older.
600:00:28,540 --> 00:00:35,050I'm the parent of an amazing teen on the autism spectrum and a certified autism specialist.
700:00:35,740 --> 00:00:38,200I am deeply grateful to bring validation,
800:00:38,200 --> 00:00:42,850hope and purpose to individuals and their families living on the autism spectrum.
900:00:43,540 --> 00:00:45,430With this mission at its core,
1000:00:45,440 --> 00:00:52,580I founded and currently direct the OsF healthcare adult diagnostic autism center in central Illinois.
1100:00:52,590 --> 00:01:10,560My books include Understanding Autism in Adults and Aging Adults and Understanding Autistic Behaviors. For more information and to join my online community for free visit www.adultandgeriatricautism.com.
1200:01:11,440 --> 00:01:13,550Please join me in helping individuals,
1300:01:13,560 --> 00:01:18,550couples and families thrive while living life on the autism spectrum.
1400:01:20,540 --> 00:01:24,460Hello and welcome to this episode of Autism in the Adult.
1500:01:25,240 --> 00:01:29,460And I'm glad you joined me for this first episode of 2022.
1600:01:30,240 --> 00:01:35,050I just want to highlight a few things that have gone on recently.
1700:01:35,050 --> 00:01:44,680I was happy to be named in the episode Best Of for 2021 that The Testing Psychologist produces.
1800:01:44,680 --> 00:01:46,520This is a podcast by Dr.
1900:01:46,520 --> 00:01:47,550Jeremy Sharp
2000:01:47,940 --> 00:02:02,790talking about issues related to assessment in psychology, and my episode in august Identifying Adult Autism was the second downloaded episode of the season.
2100:02:02,800 --> 00:02:03,290So,
2200:02:03,290 --> 00:02:14,720I was so honored to be among many very accomplished people talking about important topics and assessment of Autism in the adult was right up there at # two.
2300:02:14,720 --> 00:02:14,990So,
2400:02:14,990 --> 00:02:16,900I was happy about that.
2500:02:16,900 --> 00:02:19,920I'll put the link below if you or someone you know
2600:02:19,920 --> 00:02:22,800would like to learn more about assessment.
2700:02:23,340 --> 00:02:29,160This episode of the testing psychologist was produced for clinicians.
2800:02:29,160 --> 00:02:36,450So people who are trying to understand how to assess and evaluate autistic characteristics in their clients.
2900:02:37,040 --> 00:02:44,660I also have an exciting opportunity for clinicians coming up in February on the 26th of 2022.
3000:02:45,100 --> 00:02:50,030This is a two hour live interactive webinar with Zur Institute.
3100:02:50,040 --> 00:02:50,480And again,
3200:02:50,480 --> 00:02:52,330I'll put the link below.
3300:02:52,840 --> 00:02:58,210This is entitled Autism Spectrum Disorder: Interventions Across the Lifespan.
3400:02:58,640 --> 00:03:05,150So not everyone on the spectrum will need support or intervention at all seasons of life.
3500:03:05,540 --> 00:03:26,890But for those who are clinicians, we have people come to us asking for assistance during a tough period or about a difficult thing that they're grappling with and to understand the neurology of the client is so important to drive the strategies that will be most helpful for them.
3600:03:27,140 --> 00:03:42,770So I'll be talking specifically about strategies that are likely to help the autistic client and ... things that we typically do in a counseling sessions, will highlight those that wouldn't be likely to be as helpful.
3700:03:42,770 --> 00:03:45,730So that's February 26,
3800:03:45,730 --> 00:03:46,3402022.
3900:03:46,350 --> 00:03:48,850And I'll go ahead and put that link below.
4000:03:51,540 --> 00:03:55,260Today's topic is dysregulation.
4100:03:55,840 --> 00:04:00,240I envision this to be the first episode in a four part series.
4200:04:00,250 --> 00:04:04,160And so today we're going to talk about what this regulation is and
4300:04:04,170 --> 00:04:06,060how to recognize it.
4400:04:06,840 --> 00:04:09,290In the next episode of the series,
4500:04:09,290 --> 00:04:15,880we're going to talk about how to reduce the amount of dysregulation that someone experiences.
4600:04:15,890 --> 00:04:20,550The third episode will be how to recover from dysregulation.
4700:04:21,040 --> 00:04:27,820The fourth will be how can you recognize when someone is trying to regulate.
4800:04:27,830 --> 00:04:31,350So someone around us maybe trying to regulate,
4900:04:31,360 --> 00:04:35,650and we may criticize them or ask them to stop it,
5000:04:35,660 --> 00:04:37,230but there would be other,
5100:04:37,230 --> 00:04:41,050more impactful ways to get a good outcome.
5200:04:41,940 --> 00:04:44,020You'll understand more about what I mean
5300:04:44,020 --> 00:04:48,750when we start to talk about this thing called regulation and dysregulation,
5400:04:50,440 --> 00:05:05,650Everyone's brain and nervous system are in charge of helping us to stay centered with various things and part of what we stay centered with has to do with alertness.
5500:05:05,660 --> 00:05:08,070Can we wake up in the morning?
5600:05:08,070 --> 00:05:11,690Can we calm down and fall asleep at night?
5700:05:11,700 --> 00:05:16,830That's kind of our ... the tone of our alertness,
5800:05:16,940 --> 00:05:18,760our brain helps us with that.
5900:05:19,440 --> 00:05:23,900We also have this attention regulation.
6000:05:23,900 --> 00:05:31,520So our brain is supposed to help us focus on what's most important and just release and let go
6100:05:31,520 --> 00:05:38,670things that are no longer important or uh you know... if the information in our environment has changed.
6200:05:38,680 --> 00:05:46,990So we need to switch gears and attend to something else... so our brain helps us regulate alertness and attention.
6300:05:47,740 --> 00:05:53,190So when we talk about these two aspects of regulation (alertness and attention),
6400:05:53,740 --> 00:06:05,050there is an analogy that is commonly used with the occupational therapists that often try to help people learn how to regulate better.
6500:06:05,540 --> 00:06:09,560And that analogy is "how is your motor running today?"
6600:06:10,340 --> 00:06:14,560So if your motor is running sluggish,
6700:06:15,340 --> 00:06:17,420you are tired,
6800:06:17,470 --> 00:06:20,370you may describe yourself as feeling lazy,
6900:06:20,370 --> 00:06:21,540unmotivated.
7000:06:21,540 --> 00:06:22,910I can't get going,
7100:06:22,910 --> 00:06:24,250I feel sleepy.
7200:06:24,730 --> 00:06:31,750I'm just a bump on a log ... that is when your motor is running too low.
7300:06:32,640 --> 00:06:35,620Your motor can also sometimes run too high.
7400:06:36,140 --> 00:06:41,260It's revved up and it's not in that just right state.
7500:06:41,640 --> 00:06:47,250And a motor that's too high will be someone who is hyper, restless,
7600:06:47,640 --> 00:06:48,290angry,
7700:06:48,300 --> 00:06:49,240agitated,
7800:06:49,250 --> 00:06:50,070anxious,
7900:06:50,070 --> 00:06:54,700that extra alertness that we just don't need all the time.
8000:06:54,800 --> 00:06:56,970This high level of alertness.
8100:06:57,440 --> 00:07:07,360Um that is the motor that is running too high, and we would like our motor to be running just right.
8200:07:09,240 --> 00:07:13,370The Alert Program is one program you might want to investigate.
8300:07:13,380 --> 00:07:19,830It's run by occupational therapists who are very experienced in regulation strategies.
8400:07:19,840 --> 00:07:23,160And I have a link to the alert program below.
8500:07:23,640 --> 00:07:23,960Now,
8600:07:23,960 --> 00:07:28,870they train occupational therapists in strategies to help others.
8700:07:28,870 --> 00:07:41,060But they also have a new online program called Your Best Self that people can investigate to figure out regulation strategies for themselves.
8800:07:43,040 --> 00:07:43,540Now,
8900:07:43,540 --> 00:07:46,450we've talked about alertness and attention.
9000:07:46,840 --> 00:07:51,280There's also this area of emotional regulation.
9100:07:51,290 --> 00:07:54,160So when we have a strong emotion,
9200:07:54,170 --> 00:07:58,700our brain should help us make sense of it.
9300:07:58,710 --> 00:08:06,810Our brain should help us center it and help it be present in our mind that we're aware of it,
9400:08:06,810 --> 00:08:08,400but it's not overwhelming,
9500:08:08,410 --> 00:08:10,070it doesn't hijack us,
9600:08:10,080 --> 00:08:11,770it doesn't take control of us,
9700:08:11,780 --> 00:08:13,550It doesn't hurt other people.
9800:08:13,560 --> 00:08:20,160And that would be regulation or dysregulation of emotional experiences.
9900:08:22,440 --> 00:08:28,060When we talk about a dysregulated state in the area of emotions,
10000:08:28,120 --> 00:08:31,560we can talk about a fight reaction,
10100:08:32,240 --> 00:08:36,950flight reactions or freeze reactions.
10200:08:38,040 --> 00:08:56,000So a fight reaction in the area of emotions is that this very strong emotional experience ... comes in and the person feels so overwhelmed that there is this externalized expression of distress.
10300:08:56,640 --> 00:09:01,950And what I mean by that is I would include meltdowns in this category.
10400:09:01,960 --> 00:09:04,170I would include outbursts,
10500:09:04,180 --> 00:09:05,320crying spells.
10600:09:05,320 --> 00:09:08,480I even include, even though it's not fight,
10700:09:08,490 --> 00:09:14,960but I'd like to capture all the externalized reactions in this category.
10800:09:15,440 --> 00:09:18,050That I am going to argue with you.
10900:09:18,050 --> 00:09:19,950I am going to explode.
11000:09:19,960 --> 00:09:23,230And you can picture this volcano,
11100:09:23,240 --> 00:09:23,820right?
11200:09:23,830 --> 00:09:29,480that is just to the point of being uncontained and out comes
11300:09:29,480 --> 00:09:41,650this spewing of tears or yelling or throwing things... so that is the externalized sign of a dysregulated state.
11400:09:41,920 --> 00:09:43,890In the area of emotions,
11500:09:46,040 --> 00:09:52,660flight is another reaction that someone could have when they are dysregulated.
11600:09:53,340 --> 00:09:58,650This could look like ... I'm going to walk away from you and quit this conversation.
11700:09:59,040 --> 00:10:04,460I'm going to spend all day in my room doing things I enjoy but not interacting with you.
11800:10:05,140 --> 00:10:08,760I'm going to quit school and do home schooling.
11900:10:08,760 --> 00:10:10,450I'm going to quit this job.
12000:10:10,940 --> 00:10:15,560I'm going to quit this relationship because it's so up and down.
12100:10:15,560 --> 00:10:17,000It's like a roller coaster.
12200:10:17,000 --> 00:10:18,650It's just too intense for me.
12300:10:18,650 --> 00:10:20,000It's too unpredictable.
12400:10:20,040 --> 00:10:21,620I have to quit this,
12500:10:21,630 --> 00:10:23,060I have to escape,
12600:10:23,440 --> 00:10:28,630I have to withdraw. Then there are freeze reactions.
12700:10:28,630 --> 00:10:32,150So this is the time when you're physically present,
12800:10:32,160 --> 00:10:34,980but you're not psychologically present,
12900:10:34,990 --> 00:10:36,710that your brain shuts down,
13000:10:36,720 --> 00:10:46,300Someone might say the veil just seemed to go over his eyes and I just knew he was there but not processing what was happening during that time,
13100:10:46,300 --> 00:10:47,720someone may say,
13200:10:47,730 --> 00:10:48,200you know,
13300:10:48,200 --> 00:10:49,320I hear what you're saying,
13400:10:49,320 --> 00:10:52,460but my mind is blank and I don't know what to respond.
13500:10:52,470 --> 00:10:54,140That's a freeze reaction.
13600:10:54,150 --> 00:10:59,010So it signals that the person is dysregulated.
13700:10:59,010 --> 00:11:04,260They're having difficulty being fully present in the midst of the strong emotion.
13800:11:05,940 --> 00:11:28,150Another part of the freeze reaction can be what we call a somatization response to stress and that just means that the stress is not able to come into the person's emotional awareness and kind of sit there and be recognized and felt.
13900:11:28,740 --> 00:11:30,300And so the body says,
14000:11:30,300 --> 00:11:30,910hey,
14100:11:30,910 --> 00:11:35,150I will help you escape from this really difficult emotion.
14200:11:35,160 --> 00:11:45,140I will process the stress for you so that you don't have to feel this deep fear or this deep pain or anguish or anger.
14300:11:45,150 --> 00:11:52,690I'll just process that stress right through the physical system in these cases,
14400:11:52,700 --> 00:11:56,390the symptom which could be a staring spell.
14500:11:56,400 --> 00:11:59,740It could be something that looks like an electrical seizure,
14600:11:59,740 --> 00:12:01,350but it's really not.
14700:12:02,040 --> 00:12:08,600It could be something like a loss of memory for chunks of time or days or weeks,
14800:12:09,040 --> 00:12:17,000it could be a weakness where the person feels like their limbs are weak or paralyzed.
14900:12:17,010 --> 00:12:19,860So it could be a variety of things like that.
15000:12:20,240 --> 00:12:24,340Physical systems also could include issues of pain,
15100:12:24,350 --> 00:12:27,600issues of stomach distress,
15200:12:27,600 --> 00:12:28,470headaches,
15300:12:28,480 --> 00:12:30,550so lots of different things.
15400:12:30,550 --> 00:12:35,960Lots of different physical systems can process stress for us.
15500:12:36,340 --> 00:12:39,570And these symptoms,
15600:12:39,570 --> 00:12:42,760these physical expressions are real.
15700:12:43,140 --> 00:12:46,580They are not produced by the individual,
15800:12:46,580 --> 00:12:47,850They're not feigned,
15900:12:47,860 --> 00:12:50,290they're not exaggerated,
16000:12:50,290 --> 00:12:51,760they're not used to manipulate,
16100:12:51,760 --> 00:12:56,250they are really experienced and they are distressing in themselves.
16200:12:56,840 --> 00:13:04,260But they do help the individual ... kind of shield the individual from having to process in their awareness
16300:13:04,260 --> 00:13:05,660such strong emotion.
16400:13:07,340 --> 00:13:11,560And it can also include what we call dissociation.
16500:13:11,940 --> 00:13:17,410So I feel like I'm not even in my own body right now,
16600:13:17,420 --> 00:13:22,620I don't feel like I even know who I am or what's reality and what's not reality.
16700:13:22,630 --> 00:13:25,550I don't remember parts of the day,
16800:13:25,550 --> 00:13:28,090I feel disconnected from myself.
16900:13:28,100 --> 00:13:34,790So this dissociation can also be this form of a freeze state,
17000:13:34,800 --> 00:13:36,550a dysregulated state.
17100:13:38,040 --> 00:13:39,200So in summary,
17200:13:39,200 --> 00:13:48,820I'm talking about regulation as being that centered state that the brain should help us maintain,
17300:13:48,840 --> 00:13:58,410its that state where you're just right with alertness, with attention, and with emotional centeredness,
17400:13:59,040 --> 00:14:03,080you're not too low and sluggish and out of it,
17500:14:03,540 --> 00:14:05,090you're not too high,
17600:14:05,090 --> 00:14:06,620being overwhelmed,
17700:14:06,620 --> 00:14:08,460restless or agitated,
17800:14:09,840 --> 00:14:13,420You're not in a fight, flight, or freeze mode,
17900:14:13,840 --> 00:14:17,010you're psychologically present,
18000:14:17,020 --> 00:14:23,520You're physically present and you can maintain some sense of centeredness,
18100:14:23,520 --> 00:14:25,060you're not overwhelmed.
18200:14:26,640 --> 00:14:27,040Now,
18300:14:27,050 --> 00:14:33,850every human who lives life has periods with where they are dysregulated.
18400:14:33,860 --> 00:14:35,750It's a very human thing,
18500:14:35,760 --> 00:14:36,320right?
18600:14:36,330 --> 00:14:52,450We're living in a life day to day that is sometimes very difficult to navigate and we'll have periods of times where we lose it or where we go in our room and shut the door or we just freeze.
18700:14:52,840 --> 00:14:58,170And that's just a very human thing. For individuals on the spectrum,
18800:14:58,180 --> 00:15:06,440that nervous system pathway through the center and the front of the brain is particularly involved for them
18900:15:06,440 --> 00:15:10,760and it also is particularly in charge of regulation.
19000:15:11,240 --> 00:15:26,240So everyone on the spectrum will have difficulty in some way with getting to a regulated state and they'll probably have seasons of life where that is much more achievable,
19100:15:26,250 --> 00:15:29,940but seasons where... if anything gives them trouble,
19200:15:29,950 --> 00:15:32,550it very well may be the issue of regulation.
19300:15:34,840 --> 00:15:40,860That is why we talk about regulation on this program for Autism in the Adult.
19400:15:41,240 --> 00:15:49,970Because oftentimes when people are seeking assistance or they are in pain or there's something that they're struggling with...
19500:15:49,980 --> 00:15:50,570Uh,
19600:15:50,580 --> 00:15:55,960it very well may be in the area of getting to a regulated state.
19700:15:58,230 --> 00:15:58,570Now,
19800:15:58,570 --> 00:16:06,930one thing to understand is that the type of dysregulation that the individual shows can be somewhat specific to them.
19900:16:06,930 --> 00:16:09,470We kind of have our,
20000:16:09,480 --> 00:16:12,950our general ways of handling things.
20100:16:12,960 --> 00:16:13,480Um,
20200:16:13,480 --> 00:16:20,970and so one thing I recommend is knowing what you as an individual, or this person that you love,
20300:16:20,980 --> 00:16:30,950what they lean toward when they're dysregulated, because one thing we want to do is recognize what dysregulation looks like in this person.
20400:16:32,840 --> 00:16:34,960So for example,
20500:16:35,640 --> 00:16:47,590the person who is exploding and ranting because their usual parking space at work is being used by someone else,
20600:16:47,600 --> 00:16:56,300and the person at the entryway to work gave them a hard time because they don't have their badge on, and on the way to work
20700:16:56,300 --> 00:16:59,660they couldn't get the gas that they typically like to get...
20800:17:00,040 --> 00:17:02,690So they're feeling very uncentered,
20900:17:02,690 --> 00:17:08,260They're feeling off, and for this particular person when they're uncentered,
21000:17:08,260 --> 00:17:11,270they tend to get elevated.
21100:17:12,140 --> 00:17:16,490Um and tend to externalize that stress.
21200:17:17,940 --> 00:17:19,860So for this person,
21300:17:20,240 --> 00:17:22,830this outburst that they may have,
21400:17:22,830 --> 00:17:26,560maybe they come in and they have an outburst toward their colleague or something.
21500:17:26,940 --> 00:17:32,220Well that is often nothing to do with the colleague in particular.
21600:17:32,220 --> 00:17:33,680It just may be that,
21700:17:33,690 --> 00:17:34,060wow,
21800:17:34,060 --> 00:17:36,050this is a sign,
21900:17:36,060 --> 00:17:37,810this is a clue.
22000:17:37,820 --> 00:17:40,860This person is really off center.
22100:17:40,870 --> 00:17:45,100They're struggling to feel in that just right state.
22200:17:45,110 --> 00:17:46,480And for this person,
22300:17:46,480 --> 00:17:48,190when they struggle to feel that way,
22400:17:48,190 --> 00:17:51,960it happens to be that it comes out as irritability.
22500:17:53,740 --> 00:17:58,560Another person may lean toward quieter reactions.
22600:17:59,140 --> 00:18:00,930So this person,
22700:18:00,940 --> 00:18:06,120let's say we have another individual who experiences the very same thing,
22800:18:06,130 --> 00:18:17,590but this person comes in quietly, walks to their office and shuts the door, and doesn't open their office door as typical.
22900:18:17,600 --> 00:18:24,080Uh maybe they're in there for three hours without opening it, when typically they would go get some coffee,
23000:18:24,080 --> 00:18:26,460maybe say good morning to their coworkers.
23100:18:26,840 --> 00:18:27,760So wow,
23200:18:27,760 --> 00:18:30,350they've really retreated and become quiet.
23300:18:31,840 --> 00:18:45,350Now the difference between the fight reaction and the flight reaction is that one is very noticeable and everyone around that first person is like,
23400:18:45,350 --> 00:18:45,780wow,
23500:18:45,780 --> 00:18:50,600stay away from Joe today because he got up on the wrong side of the bed.
23600:18:50,600 --> 00:18:51,390He's really,
23700:18:51,400 --> 00:18:52,860he's really irritable.
23800:18:53,540 --> 00:19:03,940Um Now they may misunderstand the reason for that and they may not like the fact that he is loud and irritable.
23900:19:03,950 --> 00:19:05,080So they may not say,
24000:19:05,090 --> 00:19:07,490oh he's really in a dysregulated state,
24100:19:07,490 --> 00:19:08,450that poor guy.
24200:19:08,940 --> 00:19:11,940Um but they do notice it.
24300:19:11,950 --> 00:19:16,310They notice he's off center. On the other hand,
24400:19:16,310 --> 00:19:21,500for the person who reacts with flight to being dysregulated,
24500:19:21,510 --> 00:19:23,580they are often missed,
24600:19:23,590 --> 00:19:24,250right?
24700:19:24,250 --> 00:19:32,550So they may spend all morning in their office and either nobody will notice or they might misinterpret it and say,
24800:19:33,420 --> 00:19:33,910you know,
24900:19:33,910 --> 00:19:35,350she's kind of stuck up.
25000:19:35,360 --> 00:19:37,130She's just in her own little world.
25100:19:37,130 --> 00:19:47,160She doesn't socialize ... when really both the first person and the second person are in a state of dysregulation,
25200:19:47,160 --> 00:19:49,160which means that they are struggling.
25300:19:50,240 --> 00:19:51,460They're not doing well,
25400:19:52,840 --> 00:19:58,660But the quieter one may not be noticed and the louder one may be misunderstood.
25500:20:02,140 --> 00:20:14,430Now we also have freeze, of course, and let's say that there's a third individual and they have the exact same thing happen and yet they're walking into work...
25600:20:14,450 --> 00:20:19,560and someone asked them a question about a recent project.
25700:20:19,940 --> 00:20:21,890They can't think of the details.
25800:20:21,890 --> 00:20:25,960They're really feeling shut down and kind of out of their own system.
25900:20:26,340 --> 00:20:36,770And they're also realizing that they ... their stomach doesn't feel that well and they are starting to get some chronic pain in their muscles that they're feeling.
26000:20:37,140 --> 00:20:41,060Uh they just really don't physically feel well.
26100:20:41,940 --> 00:20:49,760Um Now this may be their state of dysregulation... that I'm feeling disconnected.
26200:20:50,140 --> 00:20:56,160It's hard to think through things and they may even say it's probably because of my headache.
26300:20:56,170 --> 00:21:01,860I can't think clearly because of my headache or my stomach ache and then they may go home for the day.
26400:21:03,140 --> 00:21:03,760Again,
26500:21:03,760 --> 00:21:07,990this is actually... in this scenario I'm describing...
26600:21:07,990 --> 00:21:10,890this is the same thing.
26700:21:10,890 --> 00:21:12,500It's dysregulation.
26800:21:12,760 --> 00:21:24,860It looks different, but it's the state of having things happen in your day that threw you off center and you're really struggling to know how to get back to center.
26900:21:25,740 --> 00:21:31,050And so all three of these people may look very different,
27000:21:31,320 --> 00:21:33,860but they're all struggling with dysregulation.
27100:21:34,210 --> 00:21:43,050Now one of the interesting things can be... if these people were sent to get help for their dysregulation.
27200:21:43,740 --> 00:21:57,450The first one might be sent to anger management training and perhaps he'd be diagnosed with something like bipolar because he has these swings of mood and regulation...
27300:21:58,140 --> 00:22:13,490Perhaps the second person goes for help and they coach her on social skills with colleagues and they tell her that as part of her job
27400:22:13,490 --> 00:22:15,770she really needs to speak up more,
27500:22:15,840 --> 00:22:16,750be a leader,
27600:22:16,750 --> 00:22:20,340be more engaged in the social milieu of the office.
27700:22:20,540 --> 00:22:24,760And so she's being coached on getting out there and maybe she,
27800:22:24,770 --> 00:22:26,370she gets a diagnosis,
27900:22:26,370 --> 00:22:27,860if she goes to a clinician,
28000:22:27,870 --> 00:22:30,280maybe she gets a diagnosis of anxiety,
28100:22:30,280 --> 00:22:32,860generalized anxiety or social anxiety.28200:22:34,340 --> 00:22:45,200The third person goes to get help because they often leave work feeling cloudy in there thinking they have some staring spells,
28300:22:45,200 --> 00:22:46,320they feel disconnected,
28400:22:46,320 --> 00:22:47,770they feel physically ill.
28500:22:48,440 --> 00:22:52,860So they go to the doctor and they get diagnosed with chronic headaches,
28600:22:52,860 --> 00:22:54,470maybe fibromyalgia,
28700:22:54,480 --> 00:23:10,470maybe um some um digestive sensitivities... and I'm definitely not here to say that nobody has those diagnoses and physical issues and this person may as well...
28800:23:10,480 --> 00:23:15,270What I'm saying though is that for this hypothetical individual,
28900:23:15,280 --> 00:23:16,950it's just not that simple.
29000:23:16,960 --> 00:23:32,940We don't want to miss the internal struggle of it because... if we understood that those physical symptoms in that state of fogginess were at least worsened by some of this dysregulated state,
29100:23:32,950 --> 00:23:33,240you know,
29200:23:33,240 --> 00:23:34,170that trigger,
29300:23:34,540 --> 00:23:45,460we could help much more efficiently without adding medications that may make things worse or extra doctor's appointments or extra stress.
29400:23:45,940 --> 00:23:46,780Um,
29500:23:46,790 --> 00:23:47,600we could say,
29600:23:47,600 --> 00:23:47,900hey,
29700:23:47,900 --> 00:23:48,590you know what,
29800:23:48,590 --> 00:23:51,370when you are are off center,
29900:23:51,370 --> 00:23:53,970when you are stressed and things have gone wrong.
30000:23:53,980 --> 00:23:58,510I feel like your system responds in this way,
30100:23:58,520 --> 00:24:05,590you know that your stress is expressed through your system and that you feel disconnected.
30200:24:05,590 --> 00:24:13,860I'm wondering if we could hypothesize about that and see if there's a more efficient way to get you to feel more centered.
30300:24:14,840 --> 00:24:18,100And I bring this up for a couple of reasons.
30400:24:18,220 --> 00:24:22,160One is ... dysregulation is common on the spectrum.
30500:24:23,640 --> 00:24:24,860Two is,
30600:24:25,440 --> 00:24:31,870it can be misunderstood and depending on the type of dysregulation,
30700:24:31,880 --> 00:24:39,660it can add diagnoses to a person's list that aren't the most helpful diagnosis.
30800:24:40,540 --> 00:24:41,090Um,
30900:24:41,100 --> 00:24:43,360often autism isn't on there.
31000:24:43,940 --> 00:24:44,510Um,
31100:24:44,520 --> 00:24:52,080but there may be this gathering of diagnoses that fit the symptoms in the moment.
31200:24:52,080 --> 00:24:54,040Like they fit some characteristic in the moment,
31300:24:54,040 --> 00:24:58,060but they missed the big picture of why this person is dysregulated.
31400:24:58,840 --> 00:24:59,200You know,
31500:24:59,200 --> 00:25:03,070they're dysregulated because the rhythm of their day,
31600:25:03,070 --> 00:25:18,260the structure of their day that they depend on as an autistic individual... that that was disrupted and that triggered this dysregulated state and in them it happens to look like fight or flight or freeze.
31700:25:19,240 --> 00:25:25,660And so the topic of this podcast then is to introduce you to this concept of regulation.
31800:25:27,840 --> 00:25:33,620And when you see yourself or someone you love in a dysregulated state.
31900:25:33,630 --> 00:25:38,030And instead of telling them to get it together,
32000:25:38,040 --> 00:25:39,290calm down,
32100:25:39,290 --> 00:25:40,380get out there,
32200:25:40,380 --> 00:25:41,360get over it.
32300:25:41,740 --> 00:25:42,370Um,
32400:25:42,700 --> 00:25:45,060you can say to yourself,
32500:25:45,440 --> 00:25:46,110wow,
32600:25:46,110 --> 00:25:48,230this is dysregulation.
32700:25:48,630 --> 00:25:49,890I know what this is.
32800:25:51,040 --> 00:25:52,580For example,
32900:25:53,140 --> 00:26:02,730if my son, who's on the autism spectrum, comes home from school and drops his book bag on the floor and walks past me without saying hello,
33000:26:02,810 --> 00:26:07,060lays on the couch and puts a cover over his whole body... over his head.
33100:26:08,040 --> 00:26:09,220I could say,
33200:26:09,230 --> 00:26:10,050Hey,
33300:26:10,540 --> 00:26:12,010you didn't say hi to me.
33400:26:12,020 --> 00:26:13,630You threw your stuff on the ground,
33500:26:13,630 --> 00:26:14,140which you know,
33600:26:14,140 --> 00:26:15,300it doesn't go there!
33700:26:15,420 --> 00:26:16,740Come out here and make this
33800:26:16,740 --> 00:26:17,070right.
33900:26:17,080 --> 00:26:18,610This isn't a hotel for you.
34000:26:18,610 --> 00:26:20,350I'm not your maid.
34100:26:21,340 --> 00:26:24,230But, if I really wanted to get the best outcome,
34200:26:24,240 --> 00:26:25,320I would say,
34300:26:25,330 --> 00:26:26,110oh,
34400:26:26,120 --> 00:26:27,300I know what this is.
34500:26:27,300 --> 00:26:29,740This is a clue to me.
34600:26:29,750 --> 00:26:30,650This is data.
34700:26:30,650 --> 00:26:31,860This is information.
34800:26:32,240 --> 00:26:50,200This is telling me he is dysregulated ... so it's not going to help things for me to punish him for being dysregulated, and it's not going to help me to tell him to get better regulated because he already doesn't know how to do that.
34900:26:50,200 --> 00:26:51,460He's already overwhelmed.
35000:26:52,240 --> 00:26:55,020What would really help is if I said,
35100:26:55,640 --> 00:26:56,080wow,
35200:26:56,080 --> 00:26:58,500this is a flight reaction,
35300:26:58,500 --> 00:26:58,750right?
35400:26:58,750 --> 00:26:59,690He's hiding.
35500:26:59,700 --> 00:27:00,950He's withdrawing.
35600:27:01,340 --> 00:27:02,760He must have had a bad day.
35700:27:02,760 --> 00:27:04,590So then I can go in and say,
35800:27:04,590 --> 00:27:05,060hey,
35900:27:05,540 --> 00:27:07,270it looks like you had a rough day.
36000:27:08,040 --> 00:27:16,290I'm going to give you five minutes, and I'll be back and we can figure out what you need to get more centered.
36100:27:17,540 --> 00:27:18,800So number one,
36200:27:18,810 --> 00:27:20,330I'm recognizing it,
36300:27:20,340 --> 00:27:21,460which is important.
36400:27:22,240 --> 00:27:22,590You know,
36500:27:22,590 --> 00:27:23,850this isn't bad behavior.
36600:27:23,850 --> 00:27:25,270This is dysregulation.
36700:27:25,840 --> 00:27:33,170This is someone who is overwhelmed and uncentered and it's expressed as flight in this particular person.
36800:27:34,640 --> 00:27:43,610I'm also explaining to him what I see because ... you know when we're overwhelmed, we often don't know what we're feeling,
36900:27:43,620 --> 00:27:45,510we're just surviving,
37000:27:45,510 --> 00:27:46,060right?
37100:27:46,540 --> 00:27:48,360So I'm saying to him,
37200:27:48,940 --> 00:27:49,550wow,
37300:27:49,560 --> 00:27:56,460it looks like you've had a hard day and you probably need something to get centered.
37400:27:57,740 --> 00:28:05,150And then we're also introducing this topic that there are strategies that you could use to help yourself get centered.
37500:28:05,150 --> 00:28:11,570Let's figure out what those are and let me partner with you to get centered to get regulated.
37600:28:12,040 --> 00:28:19,450So in the future in this series we're going to talk about not only how to recognize it ... which we did today.
37700:28:20,340 --> 00:28:29,400We're going to talk about how to prevent episodes of dysregulation or you know lessen them as humans.
37800:28:29,400 --> 00:28:34,550We're going to have them but... not to have them so frequent that someone's not functioning well.
37900:28:35,240 --> 00:28:46,160How to recover from a dysregulated state, and how to recognize when someone around you is trying to regulate.
38000:28:46,740 --> 00:28:48,400Um for example,
38100:28:48,400 --> 00:28:50,270my son under the cover,
38200:28:51,140 --> 00:28:54,300his being under the cover is him trying to regulate.
38300:28:55,040 --> 00:28:57,210So I don't want to punish him for that.
38400:28:57,220 --> 00:28:59,250I don't want to chastise him for that.
38500:28:59,260 --> 00:29:20,330I want to recognize what that is and then help him have different strategies ...more effective strategies to regulate and to let him know that I come alongside him to do that with him because I also really commit that his well being is important and I'm on his side.
38600:29:20,490 --> 00:29:21,060You know,
38700:29:21,070 --> 00:29:24,360I want him to feel just right.
38800:29:26,540 --> 00:29:39,670I'm glad you joined me for this first episode of 2022 as we dive into this concept of regulation and dysregulation and the role that the nervous system has in helping us be centered.
38900:29:40,140 --> 00:29:43,900And I hope you'll check out the links below.
39000:29:43,900 --> 00:29:46,180I have the alert program link,
39100:29:46,190 --> 00:29:52,250I have the link to the Best Episode of the Testing Psychologist podcast in 2021.
39200:29:52,260 --> 00:30:04,460I'm happy, happy to be the number two episode... and I have a link to my upcoming webinar for clinicians about interventions for the autistic client,
39300:30:04,840 --> 00:30:05,390um,
39400:30:05,400 --> 00:30:07,100across the lifespan.
39500:30:07,120 --> 00:30:12,460So I will see you for next episode on how to prevent dysregulation.
 

Planning a Merry Holiday on the Autism Spectrum

Take a moment to listen again to this holiday episode originally published in 2020. Celebrations may be draining or overwhelming to the individual on the spectrum. A little advanced awareness and planning can make a big difference! Enjoy ~
 
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website
Resources for Clinicians
 

Autism and Eating Disorders

Autism is found at higher than expected rates in those with eating disorders or problematic eating patterns. Join Dr. Regan to hear about this link and why it is important to understand.
article: Autism Spectrum Disorders in Eating Disorder Populations. A Systematic Review
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website
Resources for Clinicians
 
article: Autism Spectrum Disorders in Eating Disorder Populations. A Systematic Review

Guilt and Worry in Relationships: Four Strategies Toward Freedom

In this episode, hear why repetitive fears about social interactions may chase the autistic individual and learn four strategies for escaping those worries. 
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website
Resources for Clinicians