Friday, June 22, 2007

Introversion and autism

Here's an e-mail I just sent to the author of a book I read:

"In your book The Hidden Gifts of the Introverted Child, you describe autistic people (I use that term broadly, including Asperger Syndrome and PDDNOS) in a way that is, in my opinion, damaging and discriminatory.

I am autistic. I am also introverted. I don't think I have heard of a single autistic who isn't introverted. Introversion is a near-universal characteristic of autistic, though of course not all introverts are autistic. Autistic people also have a number of other traits, which are not any better or worse than normal, just different.

You describe autistics in the following manner:

"Autism and Asperger's Disorders. These syndromes reflect a cluster of symptoms that include problems in communication and relating to others, and the display of repetitive behaviors. In the film Rain Man, Dustin Hoffman portrayed a character with severe autism. Autistic children lack age-appropriate friendships, empathy, and an interest in sharing and communicating with others. However, they may have great gifts in specific areas, such as in sequencing numbers and visual processing. Asperger's Disorder is diagnosed when the child is at a higher level of functioning. Studies indicate various brain areas that are affected, but as yet there is little certain about the causes or the cure for these conditions. Because an introverted child may seem disinclined to socialize, parents may suspect autism... But introversion and autism are very different issues. Introverted children have normal social relationships and form close attachments with parents and with peers. Introverts do not exhibit the repetitive behavior, such as rocking or head banging, that characterizes autism. Nor do innies display the uncanny 'savant' quality of, say, being able to recall random lists of numbers that sometimes signals these conditions."

Firstly, it seems like you are echoing medical terminology. I don't think in a single instance you described introverts as 'displaying' some kind of distinctive behavior.

Empathy is used by autism 'experts' in a very distinctive, and in my opinion inaccurate, manner. Autistic people care about other people, it's just that other people don't make sense to us. At one point in your book, you say:

"Right-brained innies may have a high emotional quotient, or 'EQ.' They can imagine themselves in another child's shoes. This is called having empathy."

That kind of 'empathy' is based on the assumption that others think like you. I used to think other people thought like me, and as a result most people were completely incomprehisible to me. It was only when I realized that I'm autistic, that my mind is actually different from others, that I began to get some real understanding of others. I'm surprised that a person with a minority temperament would actually think this kind of empathy is really useful. No doubt you've had extroverts acting like since they don't like being alone, you must be dying for company as well. That is 'empathy' as you describe it. It is only effective if you are interacting with someone who is very similar to you - even so, because no one is exactly the same, this kind of 'empathy' will cause misunderstandings.

Also, I'd like to point out that autistics don't have some kind of deficit in social skills. We are simply different. I've found that non-autistic people have, if anything, more difficulty understanding autistics than we do them. This is not because of some kind of deficit, simply less practice. Only about 1 out of a 100 people are autistic. That means that non-autistics only rarely meet autistic people, while autistics are constantly meeting nonautistic people. In addition, nonautistics hold the power in society. The oppressed group generally understands the oppressors better than the oppressors understand them.

I do not have the need for interaction that most people do. In fact, I find interaction tiring. Is this really different from introversion? I have read that introverts find interaction tiring and need alone time. Decreased interest in interaction seems therefore to be a typical trait of introverts, though more extreme in autistics. Also, decreased interest in interaction is not synonymous with not caring about others. I care very intensely about other people. I love my parents and younger brother very deeply, as well as my pets and my autistic friend. I also care, on a more abstract level, about all the children who are suffering because they are being told that who they are is not lovable and they must become someone else. You describe that problem regarding forcing extroverted behavior on an introvert. Autistic also experience this, often more pervasively.

One thing I'd like to mention is that since many autistics have an on/off tendency in various areas, they may not be recognized as introverts. Rather than being quiet until they warm up and then becoming interactive, an autistic person may jump into interaction, chattering away eagerly until the interaction is over. Conversely, their rest time is longer. This is just because autistics focus intensely and are slow to shift focus. I may interact happily in a party, only to need to spend the next day at home interacting only with my pets. (You say introverts do well with pets. So do autistics, especially with cats. In many ways, autistic people are like cats. I find it much easier to understand my cats than many people.)

Many traits you describe in introverts are also autistic traits. Autistics have similar patterns in memory as you describe - my memory is highly associative, and if the question doesn't bring up the right associations I don't remember the answer. Autistics are picky eaters for some of the same reasons you describe in introverts - increased sensitivity to taste and smell, not noticing hunger, etc.

You describe introverts becoming rigid under stress. Autistics who are under constant, intense pressure (as are many, by well-meaning parents and others who want them to function) become very rigid and black/white in their thinking, this is then taken as an inherent part of autism. If they are given less stress, their thinking 'magically' becomes more flexible.

I have seen many books, like yours, which advocate acceptance for a certain mild difference while fervently distancing that difference from other related traits which they consider 'disorders'. It's an awful thing to push down others in order to get acceptance for yourself. I try to accept all kinds of people, you should too.


PS: Yesterday I turned 18. Today, I will have my party, and for the first time in about 4 years will have a friend at my party - the 10 year old autistic boy I've mentioned (I think) on this blog before who I really connected with. I was terrified about inviting him, but his mother was really happy about it.

Tuesday, June 19, 2007

My Autism Test

I just made an online unofficial test for autism. Here it is:

You scored 2 language, 4 social, 6 interests, and 5 sensory/motor!

Description 1

Link: The Autistic Test written by Ettina on OkCupid Free Online Dating, home of the The Dating Persona Test

By the way, the sole reason I joined that dating site was to write online tests on it.

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Friday, June 08, 2007

Sociability and Behavioral Diversity

I just found an interesting introduction to a section on cat behavior in the book Treatment of Behavior Problems in Dogs and Cats which states that cats appear to have greater diversity in behavioral patterns than dogs. I don't know if this is true, but it's an interesting idea.
I've also noticed that autistics are very diverse in behavior patterns. Obviously, this is most likely for somewhat different reasons, but I wonder if decreased sociability may cause greater behavioral diversity? Here are some suggestions as to how:
  • Firstly, decreased sociability may have a direct effect of reducing imitation. Many autistics are less sensitive to peer pressure. Cats also seem to mimic other cats less than dogs do - for example, dogs often react to another dog barking by barking themselves, whereas cats only seem to mimic other cat's sounds if they are exposed to the same kind of eliciting factor, such as an unfamiliar cat. And this is often not imitative, because they're likely to growl just as much at a silent opponent. Another example is cats meowing in fear in the car - several cats doing the same thing, but each would make that same sound if they were alone in the car ride or the other cat was silent.
  • Secondly, even if they are quite imitative, spending more time alone reduces opportunities to observe the behavior of others. Also, their environments are likely to be more variable, for example all the kids in a class experience the same lighting while someone in another room is under different lights.
  • Thirdly, on an evolutionary basis, populations that are more socially cohesive, especially those with a lot of cooperative behavior, need fairly effective communication between different individuals. Therefore, the behavioral outliers may be selected against because they have more difficulty understanding and being understood by the others. In support of this theory, the areas where cats act most similar are in interactions with unfamiliar cats, such as mating and fighting. Their everyday behavior is more variable, because it's less important to be easily understood (of course, hunting is pretty similar too, but that's because they hunt the same sorts of creatures). As a side note, social outcasts may ally themselves with other social outcasts, even if they are quite different from each other. If this leads to reproduction, the resulting children are likely to be quite variable behaviorally.

On another topic, my pet rat Anja has some kind of stomach flu. She's been acting listless and not eating or drinking very well, her fur is ruffled and dull-looking, she's been shivering a lot and she has diarrhea. Currently, the vets are giving her fluids and cultivating her poop to figure out what's wrong. She'll most likely be sent home tonight with antibiotics and we'll get the results tomorrow. My other rat, Karana, is fine, but I brought her in as well in case she gets it as well, and to keep Anja company (rats are social creatures and don't like being alone).

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Wednesday, June 06, 2007

Why Coming Out Doesn't Apply as Well to Autism

Often, parallels are drawn between autistic rights and gay rights. I agree with many of these parallels (I'm currently reading On Being Gay and seeing many problems described which are also present among autistics, such as the difference between gay community and other minorities who are more genetically and familially distinct) but there's one aspect which is different, which I want to explore. That is coming out.
The first important difference is that autism is more obvious than gayness. It's relatively common for an autistic person to be identified as such by someone else before they even know they're different. And many autistics can't hide it in some or most situations no matter how hard they try. For example, if you watch Amanda Baggs's videos of herself on YouTube, it's hard not to realize she's disabled. Even my father, who seems pretty NT, was recognized as autistic by an educational psychologist because when he quoted Temple Grandin, he quoted her Texas accent as well as her words.
So it's more common for autistics than gays to be given no choice about whether to come out or not, because autism is more obvious. In fact, it's probably much more common for autistics, especially of the younger generations, to be diagnosed by someone else instead of self-identifying. And then it's on record that they're autistic.
Secondly, if an autistic isn't diagnosed, very often they don't know what autistic is. Most people know the defining characteristic of gayness - being sexually attracted to the same gender instead of the opposite gender. There is no such defining characteristic of autism, or if there is, it's not known. Instead, it's defined by a cluster of traits that are not easy to define or determine. The self-identification of autism basically is 'I feel my mind works similarly to people I know of who are considered autistic' which is certainly not well-defined. And since autism is both less common and harder to define than gayness, most laypeople have a much poorer understanding of how to tell if someone is autistic. So an autistic may know they're different, but have no idea there is a word for how they're different. How do you come out if you don't know what you are?
The normal is less clear too. Most gay people are certainly aware that the norm is to be sexually attracted to the opposite gender. But many autistics think various aspects of their differences are normal. I thought everyone thought the way I did, but for some inexplicable reason were better at handling the world than me. I knew that I was gifted, but thought that just meant having a good memory and thinking fast (and because I didn't remember everything perfectly and sometimes processed more slowly, I doubted I was really gifted).
In addition, gayness primarly affects personal relationships, whereas autism also affects performance in school/work and self-care and things like that. (I know gay people have been fired for being gay, but I'm talking about effects directly as a result of interaction between one's mind and the work environment.) Diagnosed autistics may need to reveal their difference in order to get things like extra time on exams, natural lighting, etc in work or school or else they will have trouble performing. And they may need assistance caring for themselves on a daily basis, such as getting regular meals, although they're less likely to actually get it. In this area, a better parallel are other disabled people.

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Saturday, June 02, 2007

Disrespecting Patients

I've read about the ways that 'patients' are disempowered by caregivers, but I don't think I've been on the receiving end of it until recently.
A couple days ago, I had a second asthma attack bad enough for the emergency ward. (I sure hope this doesn't keep on happening.) Anyway, while in the emergency ward I experienced two different kinds of disrespectful treatment, one from a nurse and the other from a doctor.
Firstly, the nurse came up and asked how I was doing. I gasped out 'not very well' and he replied 'nonsense! You're fine!' I tried to explain that I was most definately not OK, but he just continued saying similar things. I understood that he was trying to calm me down, but I found it really disrespectful and patronising to be contradicted about my experience, and it left me feeling really scared that I might not get proper treatment because they might think I was faking it.
After he left, I overheard an interaction between him and another patient which made me realize that rather than just being hypersensitive, I was reacting to a real problem in this man's behavior. He was talking to someone who'd just had a stroke. First he cajoled them to 'give him a smile', and then said 'I knew it was hiding in there somewhere'. Later he said 'come on, big strong girl like you, you can push against my hand'. I found it really offensive how he was treating this other patient, and I would not be surprised if that patient found it demeaning as well.
Awhile later the doctor came. We told him about how I had another asthma attack about a week or two ago and had taken three days of prednisone and been using Symbicort 2-8 times a day (at least 2, more if I had trouble breathing). He first said 'why did you only take three days of prednisone?' in an accusing manner, and later lectured me about overusing the Symbicort, saying I should only take 2 a day. In both cases, I'd been following the doctor's orders - the emergency ward had given me the prednisone and arranged for my regular doctor to see me just as I finished it to decide on a more permanent treatment, and my regular doctor had told me to take the Symbicort at least twice a day and more if needed, but not more than 8 a day. I thought we'd made that pretty clear, but he seemed to think I'd done something wrong.
When he told me what to do (take Symbicort twice a day and use a regular symptomatic as needed), he said I should do as I was told so I wouldn't end up there again, which is pretty ridiculous since I did what the doctors had told me and still ended up in the emergency ward.

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