mental health from an autism perspective
I’m skeptical of new year’s resolutions, as a concept. There’s some cultural pressure around making them, and around what they should be (specific sorts of self-improvement). But I also like the concept of reflecting on my life and making some priorities, and at this particular time, my mental health and autism are things I’m reflecting on quite a bit. To be specific, my resolution is to “focus on improving my mental health using the lens of autism.”
the missing piece
Mental health has been a major topic for me over the past several years. I’ve been in talk therapy, taking anti-depressants, seriously introspecting on my anxieties, working on communicating my needs, and changing my environment as needed. In 2022, I made a lot of progress on the environmental/logistical factors of my life; I got my permanent German residency, I reduced my work schedule to four days a week, I started a new job, and I switched therapists.
But I felt, as I have before, that there was something left to solve, something missing. Some reason I’m still anxious when meeting new people, afraid people I trust will walk away from me, and driven to need to act perfectly in every situation. Every time I dug into one of those feelings with a therapist, I felt unable to articulate what event or trauma installed those anxieties in me. But when I put the autism lens on, I can make much more sense of these issues.
For example, meeting new people. I am pretty fascinated by people and strongly value community bulding. But. I am also face-blind, and so worry I won’t recognize someone and be thought rude. I also have trouble reading generalized social cues - instead I develop a social cue index for each person. So I’m actively working on interpreting that person’s cues when we first meet, and worry I’ll mess up before I know them better. Additionally, I am quite blunt when unfiltered, and need to calibrate the opacity of my filter and how open I’m comfortable being with that new person. Do I need to focus on tact? Should I be careful about how long I talk about my special interests? Have I asked them enough questions?
Maybe it sounds like I’m overthinking social interactions, but because of the way my brain handles socializing and communication, I do need to do at least some of this work or I will be unable to communicate with the majority of people. And some of it helps put people at ease, which I am really happy to do when I can. But when I look back at my life, I see a lot of rejection in my teenage years because I had not yet learned any of these social skills. So even though I have a pretty good track record of meeting new people and having positive interactions in recent years, the old fear still lingers. I also know that the set of behaviors isn’t my instinct - it’s a mask.
the autism lens
I’m slowly recasting parts of my emotional history in terms of things my own autistic experience. And part of that is naming and researching typical differences, using a combination of fellow autistics, my therapist, and the internet. From an internal perspective these are include at least some degree of:
alexithymia: Inability to identify and explain emotions felt my oneself. There are a range of experiences with it; mine is that it takes me extra time, thought, and detective work to find my feelings - even if they are rather strong. For example, I’ll notice my mouth hurting before I identify happiness, or a headache before I feel sad. This happens a lot when the emotions are in response to an ongoing situation, or the pileup of little events, in contrast to…
emotional dysregulation: Inability to control or regulate emotional responses to provocative stimuli. This has a rather broad definition, but I use it mostly to describe the experience of having a strong emotional overreaction to some events. And by overreaction, I mean as defined by myself compared to how I feel about things after the passage of time and the processing of my thoughts.
sensory hypersensitivity: Being more sensitive than average to sensory input. I feel this to some degree with most of my senses. I get headaches from squinting if I forget my sunglasses and I need noise-cancelling headphones to ride the train. I have very strong reactions to taste and texture of foods (picky eater, especially when my energy is low) and to the texture and feel of clothes.
poor interoception: Inability to detect and attend to internal bodily sensations. It takes me a while to realize if I am hot or cold, have a headache, am hungry, am tired, etc.
intolerance of uncertainty: Difficulty dealing with situations that have uncertain outcomes. Sometimes this is phrased as “having negative beliefs about uncertainty” which I feel describes me well. Dealing with uncertainty stresses me out and drains me.
From a relational perspective, the list is less clear - in part because this is where I’ve put in the most work to intellectually bridge the gap between the amount of intuitive social perception and what society expects of me. I know I can’t recognize faces (propagnosia) and likely also have trouble intuitively reading facial expressions. I probably lack an intuitive sense of the ebb and flow of conversation (whose turn it is to talk in groups). I get very nervous around situations where there are unwritten social rules (restaurants having different ideas about where and when you order and pay, for example) and I find myself being hyper-observant so I don’t make a mistake.
From one perspective, this list can feel really other-ing. Gosh, how many ways am I different than a neurotypical! For the most part, it instead helps me feel more normal. For the first couple decades of my life, I was interacting with people under the vague assumption that everyone else felt and reacted like I did. At the same time, I could never quite fit in, despite trying very hard to learn how to be like others. I then entered a phase where I realized I was somewhat different, and then each individual quirk felt like an additional weight. I would say “I can’t hear well in loud bars” and “I’m not good at eye contact” and “I have trouble with lies, even small innocuous ones” and “I’d find a surprise party unsettling” and “I feel best in a routine” and more.
Now I’ve taken what had become a rather long list of quirks and put most of them in the category “autistic” and I feel so much less alone. There is a documented and studied set of differences in how my brain functions, and there are a bunch of people who I can talk to about it. It also helps to know I am different. For example, I spent so long coping with face blindness that it wasn’t until the age of 32 or so when a combination of online dating (more than usual experience with meeting people I’d seen pictures of) and reading Oliver Sacks to realize others could recognize people by just their faces.
Naming my issues and inserting them into a category has helped me forgive myself when they cause tension or conflict with others. I’ve been able to view my mistakes with more compassion - strong sudden bursts of emotion followed by detective work to figure out how I truly feel (dysregulation and alexithymia) doesn’t always lead to great communication. I used to be really mean to myself about how I needed to fix the way I experience emotions, but now I know the real goal is to take responsibility and soften its impact on myself and others.
Now I will circle back to my resolution, which is “focus on improving my mental health using the lens of autism.” My experience with autism is that it reaches into nearly every corner of my life, so there’s a lot of ground there. You know I love a list, so:
sensory self-care: Checking in with myself about light levels, wearing headphones and earplugs as needed, making sure I have soft clothes, allowing myself to be a pickier eater when my energy is low, and other things to be kind to my senses.
being mindful of uncertainty: Uncertainty can be really draining for me, and I can work on establishing more routines in my everyday life to cut down some of it. But I can’t - and wouldn’t want to - cut down on the types of uncertainty that make it possible to interact with people and have adventures, so I can also work on mitigating its impact on me and just resting more when things are uncertain.
being mindful of change: Pretty much the same as I said for uncertainty, really.
self-acceptance: I’ve been really hard on myself in the past for issues caused by my emotional and social differences. I would like to be much more accepting and forgiving of myself when this happens, even if I am working just as hard to learn how to positively interact with others.
autistic trauma: With the help of my therapist, I’m delving into the small repeated traumas that came from not interacting well with others, not reading social cues, being rejected without knowing why, etc. Taken together, these have resulted in some strong fears about being left, which we can perhaps attack at their root.
making active choices about masking: My carefully constructed set of neurotypical social behaviors can be quite tiring. Some are completely un-necessary, and others may only be useful in certain situations. I’d like to make more conscious choices about what parts of my mask I wear with reference to my own energy level rather than the perceived needs of others.
Like any other lens, it will help me learn some things and then will gradually fade into another aspect of how I see the world (this happened with my feminist theory lens). But I do think this one is rather fundamental to understanding why I’m so overwhelmed and tired just when I’ve finally felt content and secure in many areas of my life.
a note on making this public
I do feel a bit anxious about putting this online - and inviting such a mixed audience to read it! I still have some strong instincts about wanting to be normal and blend in with everyone, and my anxieties do like to tell me that I risk rejection by doing anything but faking neurotypical. But I have benefitted so much from reading what others write about their experiences with autism that I’d like to model such open-ness myself, especially because I have the privilege to do so.