Stress, Anxiety, and the Aspie Woman, Part III: What Do You Believe?

…You were
looking for the X somewhere off the map where
underneath is buried treasure, a skin that you could
trade your own for and put on so that they would
find a way to love you again. Fifteen years later, you are still
looking. You don’t know that you are
stuck with yourself, and that no such treasure
ever existed.
(from my poem, “Scapegoat”)

If you’ve been following along for the last couple of weeks, you know that I’ve been talking about stress and anxiety, and how they affect individuals with Asperger Syndrome. I’ve discussed some of the reasons that we have more difficulty handling stress and anxiety, as well as some helpful coping strategies. This week, I’ll be throwing cognitive behavioral therapy and mindfulness into the mix as two more things that can help Aspies overcome anxiety and effectively deal with stress.

The text I’ve been working from is Asperger Syndrome and Anxiety: A Successful Guide to Stress Management by Dr. Nick Dubin. While slowly reading this book, I’ve been processing the material intellectually and using it as a lens through which to reexamine both my past and my present. What really hit home was when I read his discussion of EMSs and how they impact people with Asperger’s.

What Are EMSs?

Okay, I’m not talking about emergency medical services. What Dubin is referring to are early maladaptive schemas. I’ll explain this concept by breaking it down into its components.

First, let’s deal with the word schema. Schemas, as defined by developmental psychologist Jean Piaget, are sets of core beliefs that you hold about the world, yourself, others, and this reality in general. You interact with the world, experience emotions, and make choices based on the schemas that you form, carry, and use inside your mind.

To better help you conceptualize this, think of schemas as files inside your brain. Those files contain information, definitions, categories, etc. that help you understand the world and act accordingly. For example, I have a schema in my mind concerning the purple spectrum of colors. I’ll show you one example of that schema below:

Shades of Purple, from Wikipedia

And so I base my judgment of what is “purple” and what is “not-purple” based on my own mental schema. So say I encounter this color:

Look at the color inside this DIV.

Is it purple or not? It’s a color called “fandango”, which Wikipedia classifies as shade of fuchsia (which is a synonym for magenta). Fuchsia and magenta themselves are considered a reddish- or pinkish-purple shade. So, maybe it’s purple? Do I include it in my purple schema? If not, do I form a separate schema, or file in my mind for magenta/fuchsia and their related colors? Does a top of that color match a skirt with a black and purple print? These are examples of ways in which schemas affect our everyday thinking and decision-making.

Now let’s pick apart the world maladaptive. The American Heritage Dictionary, Fourth edition defines the word as follows:

maladaptive. adj. 1. Marked by faulty or inadequate adaptation. 2. Not assisting or promoting adaptation.

In other words, if something is maladaptive, it means that it does not allow you to accommodate, or adapt to, your reality in a positive way. In the case of a maladaptive schema, it gets in the way of you making the best decisions or interacting with your environment in the best way possible. Also, you may end up with negative thoughts and emotions that don’t serve you well and cause you to engage in self-defeating behaviors. But more on that later.

Now let’s talk about the word early. I’ll cast it in the light of cognitive behavioral therapy – or more specifically, schema therapy. According to Dubin, Jeffery Young developed schema therapy on the premise that most of one’s negative core beliefs are formed early in one’s life – during childhood or the teen years. He also posits that to affect any sort of change for the positive, one has to identify and then correct these negative core beliefs.

What Kinds of EMSs Are There?

Dr. Dubin presents five distinct domains of early maladaptive schemas that are specific to Asperger’s syndrome. These five domains contain eighteen negative core beliefs commonly formed in childhood that are self-defeating and commonly cause us stress and anxiety. I won’t discuss all of them, but there are three domains in particular in which I held my own negative core beliefs.

1. Disconnection and rejection. This domain includes negative core beliefs that cause the person holding them to not trust the world – or more specifically, the people in it. This kind of belief can take many forms, such as: fear of abandonment; a general mistrust of people (and a belief that people will hurt them purposely or are “out to get them”); a belief that others are unable or unwilling to meet their emotional needs; an idea that they don’t fit in or are “freaks”; or a fear that they are failures in comparison with others.
2. Impaired autonomy and performance. Beliefs in this domain cause the person to conclude that they cannot adequately function in the world. Basically, if we hold these beliefs, it means that we think that we can’t make it in this world or that we can’t “hack it”. Either we don’t feel that we can take care of ourselves or handle the responsibilities of being an adult, or that we are excessively vulnerable to harm or disaster, or we may lack a basic sense of self due a lack of self-acceptance.
3. Over-vigilance and inhibition. Beliefs in this domain cause people to conclude that they are out of control and that something could go wrong at any time. They believe that the world is a scary and unsafe place. Even more specifically, they may believe that an inappropriate expression of emotion will get them into trouble or cause other negative consequences.

I have an example from my own life of how I formed negative core beliefs in each of these three domains. I contracted Lyme disease in 1986, when I was ten years old. I spent a good part of my fifth grade year in and out of hospitals. This was a very scary time in my life: because I was first misdiagnosed with juvenile rheumatoid arthritis, I endured treatments which did nothing to help and tests that brought no new answers as to how to help my condition. When I was finally diagnosed correctly in January of 1987, I’d not only been poked and prodded quite a bit but I’d accumulated a growing sense of loneliness from staying in the first hospital; now here I was in another one. For a short span of time (to this day I’m not sure how long) my mother was staying overnight with me some nights, and my father was coming sometimes to visit. One night in particular, I felt scared, empty, and lonely, so I called home and asked if Mom could come back to the hospital. My father, who’d answered the phone, refused and then told me I would have to learn how to be strong and be alone.

To this day, I don’t know if he was trying to help, or trying to get me to understand that Mom needed to sleep at home overnight, or if he had selfish motives for his answer, or what. Mom told me later that he did not tell her that I’d called. I’ll let you the reader draw the conclusion as to why and what, but I ended up forming two key negative core beliefs as a result of this incident – fear of abandonment and a belief that I could not trust others with my emotional needs.

Now, I’ll fast-forward to my teen years and highlight how I formed another core belief. Over the six years during which my mother and I were staying with my aunt, my aunt would frequently yell at me, hit me, or worse things for my inability to understand some of what she termed were “common sense” things: small things, like my inability to raise and lower Venetian blinds correctly (I’d never lived in a house with them before then), or larger things, like my inability to tell that a boy or a man wanted to get into my pants. The phrase she kept repeating to me was that I was “smart in books, but dumb in life”. So what happened? I ended up feeling as if a) I was more vulnerable to disaster or harm (as if I had a “take advantage of me sign” around my neck) and that b) I was really clueless about life and that I’d better watch out or I was really going to screw up.

And on top of this, I ended up forming a negative core belief in the third domain: over-vigilance and inhibition. As I’ve said both earlier and in previous posts, I was abused physically, emotionally, and sexually. During the episodes of physical abuse from my aunt, I had to take what was dished to me, but I was never allowed to react: my retorting was considered “backtalk” and I was then punished further. If I blurted out anything like “I hate you” or “I wish I weren’t here”, I’d get slapped across the face and sometimes whipped harder. One incident in question, which in retrospect was an Aspie outburst, landed me in the juvenile mental wing of our local hospital when I was twelve. And when I tried to reach out to others who could help me, word eventually reached my aunt and she lectured me about “airing family secrets” to outsiders. As a result, I became very careful about how I behaved, especially in public, to the point of where I was stiff, anxious, and could not relax – and I was careful about what I told others. Eventually, there were fissure cracks in my soul from all the strain, and I did let loose and explode – but more on that another time.

As a result of all of this, I did a few things that in retrospect were not healthy at all. First of all, I formed a “tough girl” persona in which I insisted on independence to the point of where I had myself completely convinced that I needed no other people or outside help – while deep down inside, I ached for love, being able to trust others, and an ability to be interdependent with others in a healthy way. Secondly, I would alternate between desperately wanting to trust others to the point of being gullible (which adds to the natural gullibility that we with Asperger’s tend to have) and getting screwed over, and becoming overly paranoid and suspicious of everyone and everything. Thirdly, I added a veneer, a facade if you will, to the “tough girl” persona – emotions in the background, perfect behavior, and never letting anyone see me react or sweat. It was like having a constant “poker face” for a good percentage of my adult life in which I denied that there was anything really wrong inside. And fourthly, I’d known that I was “different” from everyone else because of what I now understand to be my Aspie traits – the trouble with socializing and my inability to understand certain social cues – and I was convinced that people could see through me and really know how much of a “freak” I was. And those who didn’t see it, I told myself, only liked me because they couldn’t see it – and if they knew what I really was, they’d run the other way screaming. As of this wrapped up together made me feel lonely, isolated, alienated, and like a huge fraud.

How to Combat EMSs

Thankfully, there is a way to deal with one’s early maladaptive schemas: Dr. Dubin outlines a concept called “mindfulness”. Basically, what this means is to observe one’s thoughts and identify when a thought or an emotion is the result of a negative core belief – in short, you must catch yourself “in the act”.

Now, how do we do this? I’ll refer back to Dubin’s citation of appraisal theory, which says that we evaluate situations through a primary appraisal process (in which we determine if something is a threat to our well-being and if so, whether we deal with the threat or flee), and then a secondary appraisal process in which we consciously reevaluate the situation and make some decisions and determinations about it. During secondary appraisal, we are likely to assess the situation through our lenses of early maladaptive schemas and the negative core beliefs under which they fall. Thus, it is at this very time in which we must recognize that we are doing this, stop ourselves in our tracks, and reevaluate the situation through a more objective lens.

Dubin points out two aspects of mindfulness – 1) understanding our emotional triggers (i.e. what situations cause us to feel anxiety, and how those situations relate to our negative core beliefs, and 2) Eckhart Tolle’s idea of “present moment awareness”: that is, focusing on whatever it is you are doing right at that exact moment. Both of these can help us observe what causes us to become anxious or engage in self-defeating behaviors: we can’t catch the fly if we don’t see it, and this mindfulness, or “seeing” is the first step.

And once we’ve caught what’s causing the problem, we need a solution. My therapist put it this way – once we identify the negative, we must replace it with something positive or closer to the truth. This involves an honest assessment of the situation, which we can perform during the secondary appraisal process; once we’ve come to the truth, we then have something to replace the negative core belief with.

How might this play out in real life? I’ll give you a practical example. When I write a poem, I must engage in present moment awareness by focusing only on my writing – the act of creation through which I allow the images in my mind to come forth and then translating them into words. I do not need to think about the poem last week which was not up to my standards, or what sort of poem I will write tomorrow. And if that flow of creation momentarily ceases, I must observe if I have any negative thoughts or anxiety about this and then replace them with objective truth. Now that I’ve thought about it, I know that in the past these negative thoughts and emotions (such as “I can’t do this: who am I kidding?”, or “I really suck as a poet – I can’t even complete a poem!”) resulted from a negative core belief that I am not a good poet – which I formed subconsciously as teenager when the same aunt discouraged me from pursuing writing as a profession, saying that the arts “won’t pay the bills”. This, in addition to other negative comments from her (“get your head out of the clouds”, for example) and in combination with my own tendencies towards perfectionism and inner self-doubts about my creative capabilities might paralyze me – but only if I let them. If I replace these negative thoughts with something closer to reality (“I am a good poet – I’m just having a little difficulty right now” or “The flow stopped – but it happens to everyone. I will get over it.”), then I can clear my cognitive and emotional obstructions and reduce my own anxiety. In addition, I will be building my self-esteem and with each completed poem further confidence in my abilities as a poet.

Conclusion

I hope that this week’s post has provided my readers with more tools to help reduce stress and anxiety. As I’ve outlined above, mindfulness and the understanding of the negative core beliefs that one holds can help immensely in overcoming both of these. In addition, cognitive behavioral therapy and its techniques might be helpful to those with Asperger’s, especially those carrying around emotional wounds and negative coping behaviors

I am grateful to Dr. Dubin for this book, as it has much wonderful information and resources to help combat both stress and anxiety. I would highly recommend either purchasing the book or getting it from your local library – he goes into much further detail than I could possibly devote here to the subject. And besides, he’s an Aspie – someone from the inside who has been where many of us have.

Thank you for sticking with me through this (very long) installment today! And thank you for reading as I get both informational and personal on this blog. Please tune in next week, when I am going to deal with stressors specific to Aspie women. And in the meantime, please talk back to me. What have been your experiences with stress and anxiety? If you’ve done cognitive behavioral therapy, how did it work for you? I’ll see you next week here on WWA.

‘Til Next Time,

Nicole