I've been interested for awhile now in the potential relationship between autism and trauma, mostly positing that the various sensitivities peculiar to the autistic brain might make them more susceptible to what are just every day experiences for neurotypicals being recorded in a traumatic way.

This week, the BMJ published an editorial—“Neglected causes of post-traumatic stress disorder: Patients with psychosis, other delusional states, or autism are also at risk”—which at least tells me, once again, that I'm not the only one thinking about this.

Finally, people with autism spectrum disorder (ASD), a neurodevelopmental condition associated with atypical processing of the social and sensory world, often show intense threat responses to apparently harmless situations, such as changes in routine, social situations, or sensory stimuli. ASD may be associated with unique experiences and perceptions of trauma.

Reduced emotional coping skills place people with ASD at high risk of mood and anxiety disorders after exposure to stressors such as social misperceptions, prevention of repetitive or stereotyped behaviours, and aversive sensory experiences. Among people with ASD, in appears these atypical stressors may be associated with PTSD symptomatology as often as objectively traumatic events.

“Effective treatment of these neglected groups,” the editorial suggests, “requires the same trauma-focussed therapies that are recommended for PTSD after objectively traumatic events.”

(There's been some pushback on the issue of subjective trauma versus objective trauma. There's a semantic thing here that I'm not convinced somehow is underplaying autistic trauma or overplaying other kinds of trauma. Rather, I think it's fine to just pass it off as a sort of normative baseline that says, e.g., serving a tour of duty in a war zone is “objectively” traumatic in a way that difficulties with, say, socially performative communication is not. As in, both traumas are “real”; it's just that one is going to be more naturally traumatic for a wider range of people.)

What's important here is the argument (in my formulation anyway) that the autistic brain might be registering stimuli via methods or channels analogous to those by which so-called objective trauma is registered by neurotypical brains, and due to the autistic brain's hypersensitivity to certain forms of stimuli, this happens at a lower threshold than typical.

I've talked before about how this has implications for the psychotherapeutic process for autistics.

To wit: if our hypersensitivity to stimuli such as socially performative communication is resulting in such experiences being registered in our brains as trauma, how must therapy—a socially performative endeavor—be adapted or altered in order to treat us, so that it is not simply adding to the trauma?

Note: Links to entires on my previous blog will up updated to entries here on Write House once WriteFreely has WordPress imports.

#Autism #Psychotherapy #Trauma #June2019