Last I checked,
I wasn’t born with apologies – though some would demand
that I wear them for the apocalypses in my DNA.
(From my poem, “Dear Earthling”)
After a bit of a hiatus, I am coming back to you with a post about something that has profoundly affected me for a long time, although I didn’t realize it until earlier this year. To put it another way, I live at the intersection of AS and PTSD.
Now, what do I mean when I say this? For those of you who have been following my blog, you know that I’ve spoken of my childhood and teenage years, which included physical, emotional, mental, and sexual abuse, as well as neglect – most of which happened between ages twelve and eighteen.
At some point I’ll chronicle everything that happened to me during this time period: but right now, I’ll give you an overview. I’ve already mentioned physical abuse – I recall being slapped, backhanded, having my hair pulled, and being hit so hard that I landed on the floor and against walls. There is a small indentation near the small of my back, above my buttocks, which is a hard patch of thick skin from where I was hit once with a belt buckle. I was yelled at, insulted (mostly “stupid” or “retard” but sometimes “slut” or “whore”), had my privacy invaded (my diary was read, so I resorted to hiding a journal under my rug between ages thirteen and fifteen), was criticized heavily for my mannerisms (the way I walked, talked, moved or held my hands, etc.), and being denied or discouraged from things I really wanted to do (e.g. I was told to “get my head out of the clouds” and was actively discouraged from pursuing writing).
Now, let me expand all of these generals for you and give you some specifics. Imagine not knowing how the environment in your home is going to be from one day to the next – or sometimes seeing it change from safe to dangerous within hours, even minutes. Imagine being slapped awake in the middle of the night for not properly cleaning the bathroom…or a few years later being forced to sit naked in front of others as punishment for the same thing. Imagine being forced to sneak around in order to write/draw/paint/sculpt/do whatever else it is that you love because you are afraid that someone will try to take this – one way of keeping your sanity – away from you. Imagine being criticized for the way you walk…or talk…or sit…and then later being told that you’re too tense and that you need to “relax”.
You would certainly say that treatment like this is a recipe for trauma, and for PTSD, would you not?
And I live with – and am trying to heal from – all of this, as well as the after effects. What are those after effects? I’ll put it to you this way: I once told my fiancé once that it was like, to use the cliché, living in a war zone – but for me, the enemies would spring forth from behind corners, walls, bushes, doors. And they were wearing the same uniforms that I was. Mostly it was my aunt, who was responsible for everything but the sexual abuse – the majority of the fear, mistrust, hatred, and bitterness I experience now is a direct result of things she did to me. To this day, I experience triggers, which are sights, sounds, and situations that remind me of what happened to me years ago. For example, I used to feel my insides knot, tighten, and twist up into a green jungle of fear whenever I saw a hand raised: I’d immediately flash back to being hit as a teenager. Now, the jungle still forms, but it is smaller, less dense, less tangled.
You can imagine what this is like for someone who is neurologically normal. Now, add Asperger’s into the mix, and it intensifies everything. How does this happen? That’s what I will discuss next.
The Basic Workings of PTSD
To begin with, I will give you a basic working idea of what PTSD is, with the help of material from The Post-Traumatic Stress Disorder Sourcebook: A Guide to Healing, Recovery, and Growth by Glenn R. Schiraldi, Ph.D.
PTSD stands for Post-Traumatic Stress Disorder and is usually caused by a single incident of severe trauma or several incidents of trauma in one’s life. In the past, soldiers returning from wars were seen exhibiting symptoms, which included nightmares, headaches, profound sadness, guilt, grief, anxiety, and emotional “numbing”; later, other individuals who experienced traumatic events such as floods, earthquakes, physical assault, sexual assault, car accidents, bombings, and so forth were observed displaying the same kinds of symptoms.
PTSD can be caused by: intentional human causes (assault, war, terrorism); unintentional human causes (car accidents, industrial accidents, fires); and acts of nature (floods, earthquakes, volcanic eruptions). Thus, our understanding of what kinds of events can cause PTSD has expanded to also include childhood abuse and trauma.
What Happens in the Mind of Someone With PTSD?
As I mentioned before, the development of PTSD begins with a person being exposed to a traumatic event. While this is happening, the person responds to the event with intense fear, helplessness, or horror. After the event, the symptoms begin to manifest themselves in three distinct ways:
The event is re-experienced. This happens through intrusive recollections of the event which invade one’s awareness. In simple language, you keep remembering the event – parts of or the entire episode – repeatedly, and at sometimes unexpected times. This is because of, as Dr. Schiraldi explains it, dissociation – mentally “escaping” during the traumatic event. Thus our mind “walls off” the memories of the event away from the rest of our conscious – this is its way of trying to help us. The problem is, as Schiraldi says, the wall around those traumatic memories is like a “leaky dam” – memories keep seeping through, and on top of that the memories are highly emotionally charged.
What causes these memories to leak through and thus the event being re-experienced? Something called a “trigger” – which is a sensory, emotional, or other “thing” that we come to associate with the original trauma. For example I mentioned earlier that seeing a raised hand makes me nervous, and used to remind me of being hit as a teenager. For someone else, the smell of burning wood might bring back the memory being trapped inside a burning building. Hearing yelling might remind another person of witnessing heated arguments and abusive episodes between their parents. An “anniversary date” of when a traumatic event ocurred might bring about feelings of anxiety and emotional pain.
And how is the trauma re-experienced? This can range from emotional reactions alone (anxiety, fear) to full-blown “flashbacks” (i.e. vivid recollections of the traumatic event with partial or full sensory detail) to a combination of the two. In my example mentioned above, I experienced anxiety and fear while seeing in my own mind my aunt’s hand raised to hit me.
Arousal. This can include hypervigilance, feeling vulnerable, startling easy, difficulty with sleep, and irritability, as well as physical responses such as increased heart rate, sweaty palms, elevated blood pressure, or hyperventilating.
Avoidance. A person with PTSD will try to avoid reminders of the trauma, which inevitably results in emotional numbing – it is impossible to block out the negative feelings without sacrificing positive feelings as well. Avoidance can also include blocking out literal memories of the event and experiencing a “doomsday orientation”, as Dr. Schiraldi put it – in short, the person does not look forward to a happy positive future and may even begin to believe that no matter how good life may seem, trouble will come.
How Asperger’s Complicates Things
According to Dr. Schiraldi, PTSD is considered an anxiety disorder. If you remember from some of my posts earlier this summer, people with Asperger Syndrome have challenges in dealing with anxiety to begin with. So if you put the two together – excessive stress and anxiety plus a person who is less equipped to deal with anxiety – you certainly have someone in a difficult situation.First of all, low frustration tolerance, if not dealt with, can make a bad situation worse. Remember our discussion earlier of “triggers”? The intense fear and anxiety that might recur during a flashback can become even more painful and scary for someone with Asperger’s due to the inherent sensitivities in our nervous systems. If the person is unable to calm down and release the anxiety flooding his/her system, then a re-experience or a flashback could easily turn into a panic attack, and in turn a panic attack can turn into an outburst, a meltdown, or a violent episode.
Secondly, unpredictability can play a large part in exacerbating the effects of PTSD in someone with Asperger’s. First of all, the lack of predictability in life can be scary – as is the very nature of most traumatic events, which come along unexpectedly. Secondly, if traumatic memories are “triggered” without warning, this can create more anxiety and fear. I, and many people with Asperger’s, crave stability – and the nature of both life as a whole and PTSD tend to work against our efforts to create that stability in our lives. Thus the scariness of life is made even scarier by these unwanted memories, thoughts, and emotions flooding our conscious – and can make it seem like we are living in a proverbial war zone.
Thirdly, sensory issues can play a part in an Aspie’s inherent challenges in dealing with PTSD. As I mentioned, sensory data may trigger unwanted remembrances of the traumatic event – and if we have trouble tolerating those kinds of stimuli, we may end up feeling more anxious or fearful. In some cases, the stimuli may even be painful. I know I have a hard time tolerating hearing yelling, especially the harsh and angry kind of yelling, even if it’s not directed at me – this is because 1) sometimes loud noises jar my nerves, and 2) excessive yelling is a trigger due to the emotional abuse I suffered as a teenager.
What Can We Do About It?
If you are an adult suffering with PTSD and on the autism spectrum, then I can certainly understand your struggles and your pain. The best thing I can do is pass on some things that are helping me. I find that right now, the two greatest helps are 1) having a support system of caring individuals and 2) a good counselor or therapist.
I am also striving to understand myself as much as possible. I have been recasting a lot of my life through both the lenses of AS and PTSD to understand why I act and react in the ways that I do. You see, as I grew up, I came to blame myself for a lot of things, framing them as personal shortcomings in my mind. For example, I blamed myself for my difficulty in social situations, thinking of myself as “stupid” or a “weirdo” for being unable to act and interact as other kids did. Because of the deep down shame I developed at what I now understand as Aspie traits, I began to try to hide these things and developed a façade – a face I put out in an attempt to seem normal. Remember how I said in a previous post that I watched and imitated? That was part of the reason why. But now, I understand that none of this what my fault. It is the way my brain is wired. And I’ve concluded that I did not deserve the treatment I was given and it doesn’t matter truthfully I am an Aspie or not.
In addition, I am attempting to change my thinking and to understand that what I went through as a teenager does not dictate how my adult life will become. I’ve already talked about early maladaptive schemas (EMSs), which are discussed by Dr. Nick Dubin in his book Asperger Syndrome and Anxiety: A Guide to Successful Stress Management. EMSs formed in childhood can certainly complicate things by not allowing positive ways to cope with the emotional pain – and by themselves they can create more emotional pain after the fact. We may have a tougher time untangling ourselves out of the web we create based on these negative EMS’s and negative core beliefs – we follow “rules” that ultimately harm us. For example, if the idea that “we don’t talk about family secrets” was instilled to us when we were younger (as it was in my case), we may refuse to seek help to recover from any abuse we’ve suffered…which of course precludes us from seeking professional mental help or confiding in friends or loved ones about our pain. In short, we can stand in the way of our own healing. But we must make an effort to correct the thinking that limits us and causes us pain – and I believe CBT (cognitive behavioral therapy) is a good tool to help us examine and correct that thinking.
Thank you for sticking with me through this somewhat lengthy (and graphic) post. I will continue to explore issues that are relevant to people with Asperger’s, especially women. Please talk back to me and let me know what your experiences have been. I welcome your input.
Until Next Time,
Asperger Syndrome and Anxiety: A Guide to Successful Stress Management by Nick Dubin.
The Post-Traumatic Stress Disorder Sourcebook: A Guide to Healing, Recovery, and Growth by Glenn R. Schiraldi, Ph.D