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Is autism really a superpower or a curse?

Superman can fly, Spiderman can climb up buildings, the Hulk is incredibly strong, so what’s my superpower? Well….., I’m relatively useful in a quiz. So, once a week I could go down to the local boozer and help a quiz team do a little better…..maybe. Wow, that’s an headline grabber, I’m not sure Marvel will be making a movie about my crazy superpower any time soon. Yes ladies and gentlemen, over the years I have accumulated many a puzzled look from inebriated geniuses in pubs, as I win their beloved weekly quiz, only to fade into the mist never to be seen again.

The Phoenix quiz dream team

In a world of positive psychology, autism or traits associated with it are often described as superpowers, but at times they can be more akin to a curse. If I had dig deep to find anything that could vaguely be presented as a so called superpower, then accumulating disparate trinkets of knowledge is the closest I can get. Learning and retaining facts from a sizeable collection of atlas’s, encyclopaedia’s and general knowledge books from as far back as I can remember is what I did and do, albeit electronically these days. By the age of 10 I strangely, knew every capital city in the world, among many other ‘niche’ facts that sparked my bizarre brain.

But let’s be clear, this not a superpower, my thirst for knowledge is simply a special interest. I’ve never been a fan of fiction, but over the years my interest in tangible reality and my detachment from the fiction has strengthened. In total, I’ve probably watched less than a dozen films all the way through in the last 10 years, while barely making it past the first couple of episodes of any recent TV show. In contrast, I’ve perhaps viewed 100’s if not 1000’s of documentaries over the same time frame and read countless books on all sorts of odd topics. My weirdest to date being, The Soviet Afghan War. How a Superpower Fought and Lost. Which is fine for military historians, but it’s maybe a little too much for bed time reading.

Of course, this doesn’t make me smarter, or better than anybody else. It simply means I have a knack and an interest for remembering lots of useless information, that most people don’t care about. Yet, I couldn’t remember which cupboard the saucepan goes in, after years of living in the same place. So if pushed to name my superhero character, it would be less Superman and more Mildly Good at Pub Quizes Man. Which somehow doesn’t possess the same sense of aura as the former moniker, nor does it neatly fit on a tee shirt. But who knows, it may well catch on.

Even my superpower, as ‘impressive’ as it is, can have a downside, generating constant thoughts about subjects from all corners of the knowledgesphere. Inevitably, this leads to bleeding my wife’s ear about the latest thing on my mind, because as we know, autistic folk like to talk about our special interests (and talk and talk). Which is fine, but sometimes it would be nice for my mind to just chill out, but it never does. Hence why I do blogs, writing constantly about politics for about 6 years, before I sort of got it out my system. Now I use my own experiences to explore topics related to autism, thus still providing a valid outlet for discovery and learning.

To be honest, I have other dubious strengths, that often feel like millstones around my neck. It was once described to me that autistic people don’t just notice the forest or all the trees, but every leaf, insect, flower and moss on each tree. This is primarily, because autistic people process a greater amount of sensory information than neurotypicals. Regularly, I detect details, patterns and inconsistencies where others may not. Even this can be a nightmare, as I recognise imperfections everywhere, making it difficult to enjoy certain things, even my new house at times.

Many of my other traits could be labelled cognitive strengths, but they are not without significant drawbacks. One such trait is the ability to make rational decisions more easily than non-autistic people, primarily because I don’t get influenced by “gut instinct”. In fact, although intellectually I know what this phrase is supposed to mean, I’m not sure if I’ve ever experienced it. The distinct lack of emotional sway in my deductive and reasoning skills is largely to do with Alexithymia, which I undoubtedly have. Broadly, this is defined as emotional processing problems, which is not entirely helpful, nor is it as exciting as say, being invisible.

I do, however, have an incredible talent for losing my keys, wallet, ATM card or my phone, sometimes in the short term, but it’s not inconceivable to lose things for days on end. This is due to the ‘superpower’ of executive dysfunction, where I have notebooks for my notebooks, plus a whiteboard in my office. Despite these secretarial accessories, I’m still not remotely close to being organised, but my notebook collection is a thing of beauty, so I guess there is an upside.

Sure, I can power through an academic assignment in a couple of days, where it may take others 2 weeks or so, but that’s a pretty specific skill and not wholly practical most of the time. It means during these periods, I get totally consumed by what I’m doing, while not particularly receptive to anything else going on. I can easily lose track of time and can get grumpy when prevented from pursuing what I feel I need to do. Again, I don’t expect the big Hollywood studios will be knocking on my door anytime soon proposing “Hyperfocus Man, coming to cinema near you”.

But hang on, why do we need to wrap everything in such grandiose terms, to make us feel windswept and interesting. We are all extraordinary, just by our very existence. Isn’t that not good enough? Sure, I’m going lose my wallet within the next week, leave my money in the ATM and walk away, forget my phone that’s on top of the car, stay up until 4am watching documentaries and get back to learning Polish. Why Polish? Because I find it cool, in a weird autistic way. Just as I find baseball stats, geopolitics and moral reasoning fascinating. But I know I’m not alone in having quirky interests and traits, we all have our unique autistic blueprints to offer and that’s the amazing bit, not some contrived superpower that may or may not exist.

The weird world of gut feeling, intuition and moral reasoning

Phrases such as, “well what’s you’re gut telling you” or “I’m getting a funny feeling about this”, are used all the time. But what if you don’t get any feelings in your gut or anywhere else for that matter and intuition just simply sounds like an excuse to explain guesswork or a coincidence? Well I’m one of those people. Of course I can intellectualise what people mean by this, despite never experiencing it. However, I can’t ever remember any kind of emotional intuition based epiphany that has shaped my decision making. On my favourite quiz show The Chase, often the host will say to contestants “go with your gut”, well, all my gut ever tells me is if I’m hungry or not.

So what is intuition? Linguistically, a 15th century definition describes it as, “insight, direct or immediate cognition, spiritual perception,” this was originally a theological term, from Late Latin intuitionem. Although, In practical terms, an example of this could be a feeling or a voice inside your head telling you not to go down a certain street. On the whole, intuition is a thought to stop you from doing dumb things and can also be known as a sixth sense. Decisions using this sense are not reliant on reason, or are they always logical but they can still lead you to the right answer……apparently.

Generally, it is thought that everyone possesses this special power, but I would be inclined to dispute this assertion and if I do indeed have intuition, I would argue mine is infinitesimal, to the point of being redundant, a bit like the appendix. Intuition could be said to be deployed when you hear people claim they have negative vibes about others. Personally, I have no idea what this concept even means. Many times I have been duped by people who I thought were friendly, only for them to turn out to be devious and at times abusive. In addition, I always use logic to decide whether for example somewhere is safe to walk, checking lighting, if people are hanging around, historical reports of violence, location and knowledge of the area among other sources of input.

So let us dig a little deeper into the concept of intuition. Firstly, it appears to have been largely immune to scientific inquiry, plus it is exceptionally difficult to measure, therefore, it resides in the realm of philosophy. Most studies have been of a qualitative nature, with many quantitative studies adding precious little to our understanding of this construct. The best that researchers can do at this stage is to split it into two broad categories. One of which would be to view intuition as an experience based phenomenon relying on implicit knowledge, accumulated through experience and recalled through pattern recognition. Other studies indicate that it relies on sensory and affective components during the intuitive process.

Researchers generally agree there are 3 commonalities;

  1. Intuitive events originate beyond consciousness.
  2. Information is processed holistically.
  3. Intuitive perceptions are frequently accompanied by emotion.

In summary, the concept of intuition could be explained as a non-conscious, quick pattern recognition and synthesis of past professional experience and expertise. Therefore, experienced decision-makers circumvent analysis in favor of holistic scanning of memory for similar events or situations.

To take this one step further, in psychology, cognitive experiential self-theory (CEST) was developed, which offers that humans process information using 2 systems; a rational system and one that is experiential. Not dissimilar to this idea, Nobel Prize winning Daniel Kahneman proposes the idea of fast and slow thinking, this also known as Dual Processing Theory and is thought to be the procedure used when making decisions. This mechanism is divided into two, system 1 (thinking fast), a “gut reaction” intuitive way of thinking and system 2 (thinking slow) which is analytical, often called critical thinking.

Kahneman postulates that as humans, we wrongly think we are rational, spending the majority of our existence in system 2 thinking, when in reality most of the time we are accessing the intuition based fast thinking method (system 1). He asserts that it is only when we encounter something unexpected or when we make a conscious effort do we use slow thinking. Kahneman explains that system 1 is automatic, constantly generating suggestions of, intentions, impressions, intuitions and feelings for system 2. If these are approved by system 2, they then become beliefs and voluntary actions.

Although fast thinking is often accurate, periodically it can produce errors of bias, answering easier questions than those asked, without knowledge of logic and statistics. Fast thinking is narrative driven, quickly creating plausible stories, relying, on associations, memories, assumptions and pattern matching. This can lead to defaulting to a seemingly conceivable story, even if this originates from incorrect information, thus leading the individual to jump to conclusions.

So, where does autism fit into all this? In 2016, a paper was written to investigate Dual Process Theory, which is basically fast and slow thinking, in relation to autism. With regards to decision making, it was surmised that autistic individuals found three core features that made this particularly difficult. Those being, decisions that involved talking to people, a change in routine or if the decision was required to be made quickly. While it is recognised that the first two are core diagnostic features of ASC, the third is not.

Delving deeper, it has been identified that people with ASC or those with high autistic traits display a combination of lower intuitive and greater deliberative reasoning styles, compared to both individuals with low autistic traits or without a diagnosis of ASC. Intuitive and emotional reasoning according to this study features less in an autistic person than deliberative, logic based critical thinking, leading to enhanced logical consistency. Potentially, unearthing a valid reason as to why autistic people are reported to dislike making decisions quickly.

As much as this sheds light on autistic thinking processes, personally, I consider there are other things at play that lead autistic people to rely more on deliberative reasoning, that being alexithymia. It is estimated that between 45-80% of the autistic community have alexithymia, as mentioned in my previous articles and is a condition that’s characterised by emotion processing discrepancies, possessing these 7 traits;

  • Difficulty in identifying feelings
  • Difficulty distinguishing between feelings and bodily sensations
  • Difficulty describing feelings to others
  • Difficulty identifying facial expressions
  • Difficulty identifying / remembering faces
  • Constricted imaginal processes, evidenced by the scarcity of fantasies
  • A stimulus bound, externally orientated cognitive process

With this in mind, I propose that someone possessing some if not all of the listed traits of alexithymia will have extreme difficulty accessing intuition and emotion led reasoning (fast thinking) effectively. For autistic individuals with alexithymia, this type of deliberative thinking has been suggested to have an effect on the moral reasoning of an individual. This is a relatively convoluted idea, but I think it’s worth sticking with it, for the metaphorical pot of gold at the end. But first, I need to introduce you to the trolley problem which has been used extensively to investigate moral reasoning.

So what would you choose? Personally, I would drop kick the man off the bridge, but I know I’m in the minority (again). So why do other people like me think this way? One academic that has studied trollyology extensively is Professor Joshua Greene from Harvard University. Greene suggests that this goes back to the dual process thinking model, what Kahneman termed fast & slow thinking. Greene states that if we were faced with such a dilemma, we would experience a strong negative emotional response, activated by the thought of harming someone physically.

Intense feelings surrounding such an event would be due to empathic concern for the victim’s pain, causing personal stress for the decision maker. Furthermore, performing the action itself, challenges our developmental and historical conditioning with regards to harm aversion. If these emotions are not countered by deliberative reasoning processes, then a deontological (Kantian ethics) response would prevail, deeming it always wrong to sacrifice 1 to save 5. Conversely if the emotional response is not strong enough to counter slow thinking (deliberative reasoning), a utilitarian solution would be found. Interestingly, Jeremy Bentham the founder of utilitarianism is thought to have had autism.

As previously noted, alexithymia is a reduced capacity to experience, reflect and identify ones own emotions. In addition, there is a difficulty identifying feelings and bodily sensations associated with emotional arousal, plus an inability to describe these emotions adequately to others. Therefore, this creates an obvious problem for the alexithymic person regarding empathy.

Empathy consist of two parts;

  1. Cognitive empathy – involves understanding the emotional state of others by forming abstract mental representations of these states while maintaining self-other distinction.
  2. Affective empathy – revolves around experiencing these emotional states indirectly, for example “I suffer, because you suffer”.

Social neuroscience, indicates that the brain regions that are involved in mapping our physiological states that inform us of our subjective feelings are also involved when predicting the feelings of others. We basically use our own feelings as a guide to understand the emotional states of others, in order to experience these vicariously. Therein lies the problem. If some individuals have trouble pinpointing their own emotions, how can they indirectly experience the feelings of others? Unsurprisingly, this will give rise to an impairment regarding the expression of empathy and thus an increased propensity towards a utilitarian model of moral reasoning.

In summary,

(1) Higher levels of trait alexithymia relates to reduced empathic concern and increased acceptance of utilitarian choices when faced with moral dilemmas.

(2) Reduced empathic concern predicts a higher acceptability of utilitarian options when challenged with moral problems.

Of course, this by no way means that people with alexithymia, with or without autism do not care. We simply need to use a different route to neurotypicals in order to obtain the best possible outcome. I know I cannot rely on intuition or emotional reasoning, because I have no real concept of it. What I do have is, good deductive reasoning, meaning, I may at times have to ask more question than a neutotypical, but simply being aware of this is exceptionally useful. Further to this, although my thought processes are more deliberative and less intuitive, in certain settings I may gain an advantage. For example, in acute stressful situations regarding others, I rarely get emotionally wedded to the situation, allowing me to make clear logical decisions.

These thoughts have been ruminating in my mind for a while and it has taken a reasonable amount of work in order to piece them together, as they are tricky concepts. I first started thinking about my distinct lack of intuitive skills a while ago. I would often stare blankly at people who ask, “what’s you’re gut feeling”? Having no real insight as to what they were referring to and consequently at a loss when trying to provide an adequate reply. These ideas graduated towards wanting to explore how this might affect my moral decision making, as I knew from previous studies that utilitarian philosophy made a great deal of sense to me, but often not to others. Hopefully, this article may help non-autistics and autistics alike in gaining some insight into moral reasoning and why our core morals may differ quite substantially.

Can you feel it? Tactile processing difficulties and autism.

I’m sure it will come as no surprise that sensory issues are a predominant factor regarding people with autism. After all, it’s part of the DSM V diagnostic criteria, therefore, almost everyone who is autistic has difficulties with sensory processing in some form or another. In a 2013 study it was reported that over or under sensory responsiveness existed across all domains examined; visual, olfactory, tactile, auditory, vestibular, gustatory and proprioception. A later 2019 paper confirmed these findings, adding that 95% of those on the autistic spectrum expressed sensory abnormalities.

Comparatively speaking, touch appears to attract rather less attention regarding research, despite approximately 60% of us showing altered tactile sensitivity. This can manifest in a variety of ways from actions that can cause injury such as; head banging, skin picking and self biting to hyper or hyposensitvity towards certain stimuli. Personally, I find hugging an interesting topic, primarily because many people on the spectrum shy away from such an activity. However, this may not be solely related to any social component, but a combination of this and hypersensitivity of the peripheral neurons, leading to avoidance or conversely, hyposensitivity causing some people to be indifferent to touch.

Looking broadly at touch, it is viewed as an essential component in which to explore our environment. Further to this, it is important when forming social interactions and developing relationships. Social touch early in our development can produce long term positive effects. This type of physical contact between mothers and their babies can improve mood and reduce cortisol reactivity, while gently rocking the child produces a calming effect. It is suggested that abnormal responses to sensory stimulation reduces the substantial contribution of touch involved in the normal parental relationships in early life. This is thought to add to any social impairments, while being closely linked not only to social but emotional distress early on in a child’s life.

One could argue that hugging encapsulates many of these interconnections. In all honesty, it has never been my favourite sport, I like my personal spatial perimeter to be approximately 3 kilometres if possible. Joking aside, I think I’ve hugged probably less than ten people in my lifetime. It’s an awkward activity, primarily from a social perspective, also, I’m never sure when it’s the appropriate time to do it, on which side or even for how long.

To complicate matters further, I grew up in stoic, stern and unemotional 1970’s Britain, where you hugged your grandma and possibly your mother, but never other males. A firm handshake was more than adequate when meeting someone, this would include family members. To this day, I have never hugged my Dad, nor do I feel any less of a human for not doing so. Now, however, I live in the substantially more ‘huggy’ New Zealand and I find it all a bit of a tactile fueled minefield.

Although I have had some auditory sensory issues over the years, and to a lesser extent problems with visual stimuli, it’s appears that tactile sensations have been my Kryptonite for as far back as I can remember. As a kid, I frequently produced many strange and wacky responses to what would on the surface appear innocuous encounters for most people. One such reaction relates to stickers, yep, those ‘things’ that are often handed out as rewards for younger children. I could cope with them being in an album (where they obviously belong), such as my 1977 Panini football sticker album, but they don’t and never will belong on me, be it my jumper, coat or shirt. Just in case charity “tin rattlers” are reading this, I don’t need a sticker. But alas, my tactile inspired weirdness doesn’t stop there.

As a young child, I remember hating having sand on my feet, in particular in between my toes. My mother used to try and remove it with a towel that felt more like sandpaper, unsurprisingly making matters worse. Later my Dad learnt to simply carry a bottle of water with him, using it to wash off the offending sand, once we’d left the beach. Of course, good old clothes labels were always a problem as a kid, slightly less so now, however, it’s those pesky seams that irritate me more as I get older. Even now, some materials and the particular fit of clothes can make it difficult to wear certain items and this can change day to day.

On the whole, I find creams and lotions hugely constricting, especially if it’s required all over the body. Unfortunately, possessing typical Celtic skin (freckles), applying sun lotion is a must, unless I want to look like a lobster over the summer and increase the chances of skin cancer (which I don’t). So invariably, when I return home from the beach, where sand is now no longer a problem for me, I have to shower the sun cream off my body almost immediately. One further issue, which is also a deeply disturbing habit Kiwis possess predominantly at sporting events, is the wearing of face paint. Just for the record, if anyone ever approaches me with any weird ideas of applying paint to my skin, I will not be responsible for my actions. Just saying.

There is one potential area of tactile processing sensitivities that is persistent and disruptive, occurring almost every night. I say “potential” because I’m not sure if this would be classified as a tactile response or an interoception issue. Just to clarify, interoception is the process in which we interpret internal sensations of the body, such as, recognising when we are hungry. My issue is this, I routinely have sensations all over my body at night, ranging from tickles, feelings of itchiness, through to relatively intense sensations of pressure from the covers particularly on my feet or even my limbs resting on each other. I have witnessed some of this during the day, but it is more noticeable at night, often keeping me awake, contributing to an already poor sleeping pattern. Does this sound familiar to anybody?

Now obviously this could be anything and not necessarily related to autism, but there is an interesting gene called contactin associated protein 2 (CNTNAP2), linked to autistic individuals which has been found to play some role in the itch response. What the function of CNTNAP2 is, regarding the neural transmission of itch is currently unknown, but this discovery does suggest a connection between autism and itching. This gene is found throughout the Dorsal Root Ganglia (DRG), which is a superhighway containing sensory cells. The DRG is responsible for transmitting sensations of itch and pain from the skin via the spinal cord through to the brain.

I’d be curious if other people with autism experience a similar kind of skin sensitivity, as it is difficult to find much information about this among the academic literature. Research in this area is still very new, with this paper on the CNTNAP 2 gene being published in 2021. Please let me know in the comments, plus you’re welcome to add any ideas that may help relieve this. So far, I’ve tried antihistamines and mindfulness and other common sleep hygiene tactics. As always, I hope this blog has highlighted an area of autism that is of interest to individuals on the spectrum and those who are not. Take care.

Fantasy land! Imagination and autism.

When I was 9, my teacher at the time Ms Craigie suggested I had no imagination. How dare she! Well, okay she was right. Alternatively, she could have said, that the scope of my imagination did not extend too much further than the bounds of reality. As a young child, I don’t ever remember playing pretend, nor did I want to, often much happier kicking a ball around, on my own. It’s also certainly possible that my narrow range of imagination is as much due to nurture than it is nature. Interestingly, I have absolutely no recollection of my parents ever reading stories to me before bedtime when I was young. So, as I grew older, everything I perused was grounded in reality, encyclopedias, maps and anything else in between was marinated in facts.

By about 9 I knew every capital city in the world, admittedly, not entirely useful, but I guess it kept me quiet, while providing a source of intrigue for my primary school teachers. Rather than reading fantastical stories that didn’t make any sense to me, I collected, stamps, foreign currencies and studied the football tables on a Saturday night, after the match results had come in. This was infinitely more preferable to something that didn’t actually exist and this is still largely true today. Although old ideas of autistic people not possessing any imagination is now considered inaccurate, there is a group of us who do have a limited imagination, but this is only indirectly related to autism.

It is thought that one reason for a dulled imagination could be Alexithymia. In a nutshell, it’s described as a condition that’s charactersised by emotion processing discrepancies, with between 45%-80% of spectrum dwellers possessing this trait. In short, aspects of Alexithymia present as;

  1. Difficulty in identifying feelings
  2. Difficulty distinguishing between feelings and bodily sensations
  3. Difficulty describing feelings to others
  4. Difficulty identifying facial expressions
  5. Difficulty identifying / remembering faces
  6. Constricted imaginal processes, evidenced by the scarcity of fantasies
  7. A stimulus bound, externally orientated cognitive process

As mentioned in previous articles, Alexithymia comes in 2 main flavours, cognitive which is what many autistic people experience, encompassing numbers 1-5 and affective alexithymia where examples 6 & 7 live. Having completed the OAQ-G2 Alexithymia test, scoring a lofty 157/185, it can be determined reasonably confidently that I have high alexithymic traits in all 7 domains, hence my ‘blunted’ (relatively absent) imagination.

As an adult, this manifests in a number of ways; although I can now actually enjoy reading fiction at times, it must still contain a strong link to reality to retain my attention, such as crime or spy novels. Therefore, reading any book that has little connection to the real world is still considered an utterly pointless exercise. Some will argue that fiction is a great form of escapism, this may well be true, but to me it is more like being held captive on a fairy infested Alcatraz inspired prison island.

Film and TV is another area where I mercilessly apply my ‘reality filter’. Only once have I ever watched something that would resemble a superhero movie, that being the very first Batman film made in 1989. Furthermore, I am proud to say that Potter in all his bespectacled wizardry has never crossed the threshold into my life, in either medium, film or book. Neither have I read or seen one installment of Game of Thrones, because lets be honest people, dragons don’t exist. Further to this, my irritation towards the nonsensical even extends to adverts, such as this one.

For crying out loud AA, unicorns are not real and dinosaurs haven’t been around for millions of years, so why would they been in the same living room fighting? Stuff like this drives me nuts! Of course I’m probably in the minority and I’m acutely aware I’ve become less tolerant as I’ve got older. For example, as a child I could sort of cope with Star Wars or Battle Star Galactica, because I could depict the narrative as a battle between good and evil. But Dr ‘bloody’ Who, on the other hand, was a step too far. A plethora of monsters, a disappearing police box and the incomprehensible fact that it was cavernous inside, despite being externally tiny looking, blew my mind.

Even family games don’t escape my authenticity check. Balderdash is probably my least favourite game of all time. Why? You may ask. Because the object of the exercise is to make crap up about non-words or provide false definitions about real words convincingly, in order to win. In my exceptionally irrational view of the world, this is what you play when you’re crap at quizzes, but want to still appear outwardly superior to morons like me. Am I projecting a little too much? Probably. But to my annoyance, I was once caught up in this trap of tedious bullshittery, thinly disguised as an enjoyable game. Yes, this may have been 15 years ago, but the scars run deep

So what have we learnt today? Well, we are all wonderfully different. Some autistic people may not have much of an imagination (me and I suspect a few others). Although, this may not be directly linked to autism, but a condition called Alexithymia, more accurately Affective Alexithymia, which can restrict the imagination, while limiting many cognitive processes to those of us that are externally orientated. As always, I hope readers can obtain something relatively interesting from this article and even have a go at the Alexithymia test, maybe let me know how you get on in the comments. Finally, please don’t take my irrational ramblings too seriously, I was predominantly pretending…….or was I.

Boo!!! Autism and the calming smell of fear

One thing I’ve noticed during my 50 years on this planet, at times where the majority of people are relaxed and calm, I’m often on edge, for example chatting with friends in a group. Conversely, instances that many would state as anxiety or fear inducing, I feel strangely relaxed. Whenever I’ve been among potentially stressful environments that are not directly concerning myself, I’m usually calm and logical. Now some of this could possibly be that I had the skills both innate and practiced to deal with such events, but there might just be another contributory factor.

When people are afraid they emit chemicals that are detected by others, inducing a contagion effect. Although, the spread of fear throughout the group appears to bypass those who have autism. Not only do autistic people have trouble deciphering facial expressions, the same can be said for odours. Humans release chemicals, announcing a range of emotions including happiness, aggression and fear. For neurotypicals the detection of the fear chemical can lead to a physiological response such as, raising the heart rate. In contrast, those who are autistic can have a very different response to NT’s.

In a 2017 study, 2 groups one autistic and the other non-autistic, were exposed to sweat odour from 2 distinct groups. One who had been skydiving, while the other group possessed non fear induced sweat from exercise. When the non-autistic group smelt the fear induced sweat group, it initiated a fear response within their own bodies. In contrast the non fear-induced sweat failed to evoke any anxiety responses within the same group. For the autistic group there was a polar opposite response, as the autistic group displayed heightened levels of anxiety towards the non-fear inducing chemical in sweat.

Expanding on the first experiment, both groups spoke to robotic mannequins that emitted different odours from their nostrils, while giving the participant tasks to complete. The autistic group showed greater trust in the mannequins that expelled fear inducing chemicals, rather than mannequins that smelled calmer. Conversely, the non-autistic group trusted the ‘calm’ mannequins more readily. Finally, a third experiment was conducted to ascertain the response to the calming chemical in sweat (hexadecanal), which was released into a room along with a loud unexpected noise. The autonomic fear response was analysed using the blink response. While those without autism showed decreased blinking, the autistic group displayed more anxiety with a noticeable increase in blink response.

A 2017 meta analysis on autism, odour detection and identification using 11 studies discovered some fascinating correlations. Those with IQ’s above 113 were hypersensitive, while individuals with IQ’s less than 113 were hyposensitive to odour detection. Furthermore, those over 30 were found to be hypersensitive, with under 30’s deemed to be hyposensitive to odour detection. Obviously, as with practically everything, correlation does not necessarily mean causation, but these results certainly provides interesting food for thought.

Maybe all of this information can offer some insight as to why I avoid so called joyful, fun, calming activities such as social gatherings like the plague. My wife quite rightly states that I am terrible in everyday situations, but great in a crisis. During my time in the navy, within health professions and even during day to day events, I certainly feel eerily comfortable the more serious things become. Over my half century, I have been involved in ship engine fires, helicopter flight emergencies, quite serious personal physical attacks and medical emergencies. However, on the whole, feel less stressed dealing with such events, than sat in a loud crowded pub on a Saturday night.

As with many things it’s always difficult to untangle the contributions of nature versus nature, but we autistic folk are undoubtedly different (proudly so). So I think this particular subject adds further intrigue and complexity as to why this is the case. As always, I hope autistic and non-autistic people alike find this interesting and possibly enlightening in some small way.

Executive dysfunction and autism: The eternal quest for an organised life.

People talk about multi tasking, but honestly, I’m just amazed I can walk, breathe and speak at the same time. Just getting my stuff together prior to work is a military operation. It involves transporting items I need to the door and then checking each one carefully, while mentally working through what I’ll require during the course of the day. Inevitably, there will always be something that I will have lost, but that’s just the way life is for me. Even getting out of the car to go into the house with several items in my hands, requires conscious careful preparation in order for them not to end up crashing to the ground.

Common skills required to perform many tasks can be found (unlike my phone) under the term Executive Functioning or simply EF and is something many autistic people regularly struggle with. To others, I could be viewed as scatty, unorgansised, forgetful, rigid in my processes and maybe easily distracted, but my sub optimal executive functioning skills is my excuse and I’m sticking to it. But don’t just take my word for it.

Executive Functioning is considered essential for goal orientated behaviour, closely linked to cognitive processes such as memory and attention. It is an umbrella term that can encompass functions that include; working memory, impulse control, planning and cognitive flexibility, generally referred to as domains. Although EF is not explicitly stated in DSM V as part of the diagnostic criteria, difficulties with Executive Functioning have been expressed by autistic people in numerous studies. However, the relationship between autism and executive dysfunction appears to be a complex one.

Johnson et al. (2019) noted in their study that executive dysfunction was reported more by the ASD group than the control group and was considered distinct from any autistic characteristics. This suggests that autistic individuals can have clinically significant Executive Functioning difficulties which substantially disrupts everyday life, as well as any challenges that present with autism. These conclusions concur with an earlier paper by Hill and Bird (2006) who observed an association between ASD symptomatology and executive dysfunction. Furthermore, brain imaging studies also support the idea of EF as a fundamental aspect of ASD, displaying functional and structural differences within the pre frontal cortex.

Although there are regular findings of EF dysfunction across autistic children, adolescents and adults, the domains affected are less obvious. A meta analysis carried out by Demetriou et al (2018), found that autistic individuals performed worse when EF skills are tested compared to neurotypical controls. Despite this, particular domains of deficit were not identified, moreover, moderate differences were highlighted in all the EF sub domains utilised; fluency, concept formation, planning, mental flexibility, response inhibition and working memory. This is congruent with the current broad idea that autistic individuals have a global impairment of executive functioning due to either an under or over connectivity between brain networks as opposed to distinct anatomical deficits.

The bottom line is, autistic people have an array of problems with executive functioning, most probably because our brains are wired differently. As a mind break, here’s a nice colour piccie to recap what makes up executive functioning, just in case your brain is about to explode.

From a personal perspective, executive dysfunction is probably my most prevalent dilemma I deal with on a daily basis, due to my weirdly connected brain. I have, however, over the years developed varying ways of combating this (some better than others), enabling me to function relatively well in the world. Current literature also confirms that the differential in EF performance between those who are autistic and neurotypicals decreases with age. These changes are largely thought to be connected to two things; mental maturity developing naturally as we age and an increased use of compensatory mechanisms that have been honed over the years. Despite all this, in my experience these strategies are still tiring, plus not always reliable, thus requiring constant modifications and tweaks.

It is noticeable that my executive functioning often deteriorates when I need it the most, when there is pressure to perform. In my job as a Registered Nurse, this is primarily a result of the amount of tasks or information that is held in your head, plus the time-frame required for these tasks to be completed. Without doubt, this can be demanding for the vast majority of people at the best of times, but if you have executive functioning problems, it can be truly arduous to say the least. Due to the nature of the work, I quickly had to find systems that worked for me, usually involving lots of writing and re-writing of plans. Although this significantly adds to my workload, these strategies ensure that I am the safest most competent nurse I can possibly be. As a positive, because I can’t rely on my executive functioning skills, I am forced to reflect, evaluate and update any processes regularly. Which of course, is not a bad habit to get in to.

This conscious planning, encompassing writing lists in notebooks, on the phone or on whiteboards isn’t exclusive to nursing or even work for that matter, it’s been a recurring theme throughout my life. I have notebooks for my notebooks, lists for my lists and a whiteboard in my office, all in an effort to maintain a reasonably organised life. Keeping work on track is relatively easy in a way, because it’s contained withing certain hours, a geographical location and a discrete role. The rest of my life, however, often feels utterly chaotic. Anything added to my daily routine that is out of ordinary has a pretty good chance of being initially forgotten. Luckily my wife is often on hand to gently remind me what needs to be done, such as taking a mask with me every time I go out during these times of COVID.

University or college courses have always proved to be difficult periods and leave me prone to executive malfunctions. Broadly speaking the purely academic aspects of studying have rarely been an issue, but remembering deadlines, equipment for labs or exam dates have caused major problems in the past. In fact during my last degree (nursing), my good friend Fern practically became by personal assistant, reminding me about exam dates, assignment deadlines, what I needed to bring or do for certain lectures or activities and even suggestions about when to start studying. We actually joked about her impromptu, unofficial administrative role, but without her help, the course would have been infinitely more challenging for me.

If I actually got to the exam on the right day, or handed my assignment in correctly, that for me was often the hard bit done. There was, however, one occasion when I didn’t realise I had an exam until an hour before, luckily, I still managed to pass, albeit with a poorer grade. Below is a list of similar dilemmas that may plague others with executive functioning issues. See how many you can recognise.

Roughly, only 20% of people in the English speaking world that reside within the autistic community have full time employment. Among a myriad of other reasons, I suspect that problems with executive functioning is a significant barrier to obtaining and maintaining a full time job. Furthermore, many autistic people have fairly stripped down lives, such as; having no partner or kids, not driving, having few friends and an adhesion to fairly rigid routines. Of course, not all of this will be in response to diminished EF skills, but from my own experience, I know it certainly doesn’t help when life is complicated. The world suddenly becomes messy, confusing and tough to organise without these innate skills to draw upon.

Coordinating varying components of life can be exceptionally exhausting and things often feel out of control. So, with this in mind, if you are autistic, please don’t be so hard on yourself, consider the perpetual pursuit for an organised life as a journey and not a destination. It’s important you find your own distinct way to navigate the murky waters of executive dysfunction towards a more peaceful you. As always, I hope touching on this subject may help in some small way, for both autistic and non-autistic people alike.

No answer: Why many autistic people hate phone conversations.

This is a short but apt article, especially as I lost my phone earlier this week, focusing on the recurring theme of autistic adults and their hatred of phone conversations. Of course, I could have written about my less than optimal “executive functioning” abilities leading to the loss of the aforementioned communication device, but I’ll leave that for another day. In a study by Sedgewick and Howard 2021, the general consensus was that among our community the phone was considered ‘evil’. Regardless of whether we are phoning out or receiving a call, the phone is commonly thought of by autistic people as a terrible way to communicate.

So why is it, that this symbol of modern communication is so despised by us? One word that seems to appear consistently around the idea of phone calls is anxiety. Participants in this paper stated difficulties with deciphering social context, finding it challenging to interpret the caller’s tone or intonation. From personal experience this is hard enough when someone is standing in front of me, let alone when I am speaking on the phone. Without facial expressions or body language to give me a fighting chance, often I am left guessing with regards to any nuance that may be hidden beyond the actual words.

Furthermore, many of us like to incorporate routines and some predictability into our lives, so receiving a phone call, especially whilst in the midst of concentrating on something else can be particularly unnerving. There is of course a major drawback to this phone allergy, that being, the vast majority of jobs include telephone calls at some time or another. It’s difficult, if not impossible to escape (not through a lack of trying on my part) that at some point you will have to talk on the phone. For me, receiving phone calls is on the whole worse than making them. Surprises that start with an annoying ringtone, followed by someone blathering on, while I attempt to understand what they are trying to convey, at the same time placing it into some form of social context is not my favourite way to spend the day.

At least if I am going to make a phone call, I can rehearse what I want to say and pace it accordingly. Often, I will even use a script to keep me on track, however, this can fall over into a big snotty heap if the person decides to veer off piste, or asks questions I hadn’t prepared for. Regularly, this results in a period of elongated silence, followed by querying what they just said, in order to buy myself sometime to figure out what they are actually talking about. What is also mildly to moderately irritating is when somebody else answers the phone, then says “oh it’s for you”, without any warning, preparation or even a clue as to who it is. This mainly occurs at work, so in fairness, it wouldn’t be hugely professional for me to hang up on them, as tempting as this option may appear.

So what form of communication do autistic people actually prefer, I hear you ask. Well according to several studies, it turns out we like the written form, texts, emails, snail mail, online messaging, it really doesn’t matter, as long it’s not the damn phone. There are several explanations thought to be behind this, one of which is thinking time. On the whole autistic people are planners, we like to gather and organise our thoughts for maximum clarity and effect. The written form is inherently slower, providing time for us to process the information and present an appropriate response thus reducing the possibility of anxiety or simply being misunderstood.

Another reason to gravitate to this mode of communication is, structure, using the written word, autistics are given time to research or to find the optimal response, which may even extend to ‘borrowing’ phrases. This is something I have definitely done over the years, frequently stealing phrases from people who I considered role models, even from the TV or books. I’ve utilised this for both face to face communication and during times on the phone. Over the years, I’ve collected phrases that seem to have had the best effect (by others). All the while, intently observing and studying social interactions, in order to pass as a ‘normie’. These are what I call my ‘presets’, but over a period of time (50 years) they are now more ingrained, fluid and practiced, therefore, fooling many people I meet into thinking I am a neurotypical. This can be used as an example of camouflaging, deployed in an effort to fit in with society, but alas, it comes at a cost to ones mental health.

A further issue, common with autistic folk is a multitude of sensory issues associated with conversing with another on the phone. Many of us will have problems blocking out background noise, making it increasingly difficult to figure out what is being uttered, exacerbating any existing anxiety. Beyond auditory issues, from personal experience I can be distracted by just about anything, but generally it manifests visually. However, a combination of sounds, movements and even temperature can easily overwhelm my senses, making it difficult to focus on the conservation, resulting in asking the caller to repeat the sentence. One further issue that applies more so on the phone, is knowing when to speak. It would seem that I spend most conversations speaking over someone, as I fail to work out when it is my turn to talk.

So, how do we get around this aversion to phones for many autistic adults. Well, personally I would prefer it if people didn’t phone me at all. Maybe, leave an answer phone message, or a text, possibly an email, how about write me a letter that I’ll receive in a decade or so, or scribe to me on an ornate scroll with your finest quill. Whatever method you choose, just please please please don’t use the bloody phone.

I’d be interested to know what methods of communication any autistic folk out there love and hate, in the comments. Does the current research regarding phone calls fit with your experiences, or do you love a good chin wag on the “dog and bone”. Anyway thanks for reading everyone.

Suicidality: Why is it so prevalent in the autistic world?

A large body of evidence strongly suggests the prevalence of suicide ideation within the autistic community is significantly higher than that of the general population. In 2014, research noted that within a population of 374 autistic adults, 31% self reported depression, 66% disclosed suicidal ideation, while a staggering 35% recounted plans and attempts of suicide. Further to this, a 2018 review went on to suggest 72% of autistic people experienced suicidal ideation over a lifetime.

Undoubtedly, one of the potential causes of suicidal ideation is depression. In their 2016 book “Exploring Depression and Beating the Blues”, psychologists Tony Attwood & Michelle Garnett highlighted a number of reasons why people on spectrum become depressed, including:

  • Feelings of isolation and loneliness
  • Feeling rejected and not respected by peers
  • Finding socialising mentally exhausting
  • Internalising and believing peer criticism
  • Focusing on errors and what could go wrong
  • Possessing an aversion to change or believing it is unattainable
  • Being unable to cope with specific sensory experiences
  • Being diagnosed with Autistic Spectrum Condition
  • Having a family history of depression

Clearly, there must be more to it than just depression, especially when acknowledging the considerable disparity between reports of depression (31%) and feelings of suicide (66%). One plausible conclusion is something called alexithymia. This term encapsulates variations an individual may have regarding the processing of emotions, in particular relating to identifying and describing emotions within the self. Here’s a list of obstacles that people with alexithymia may encounter.

  • Identifying feelings
  • Distinguishing between feelings and bodily sensations
  • Describing emotions to others
  • Identifying facial expressions
  • Identifying or remembering faces
  • Fantasizing
  • Developing a thinking style using inner experiences (often thinking styles for those with alexithymia are based on external events)

Although, not all will experience each one of these, many of those with alexithymia will witness a number of these challenges to varying degrees. So why is this important regarding suicide? The simple answer is, it is estimated that between 40-65% of autistic people have alexithymia and the gap between reports of depression and suicide ideation is largely thought to be due to alexithymia and not autism per se. It is widely considered that this condition initially develops as a defence mechanism to protect oneself against highly emotional events and presents in 2 broad flavours.

  1. Cognitive alexithymia – relating to the difficulties with identifying, analysing and verbalising emotions
  2. Affective alexithymia – corresponds to the disparities with imagination and emotional arousal.

It’s proposed that cognitive alexithymia is more common among people with autism, but experiencing both types is not unusual. It is postulated that the condition can develop in 3 different ways.

Primary – thought to be caused by genetics and family relations, in particular childhood trauma or negative interaction with the primary caregiver.

Secondary – resulting from psychological stress, chronic disease or organic processes such as brain trauma.

Organic – a sub category of secondary caused by trauma, vascular or other brain damage.

If we return to suicidality, several primary drivers have been unearthed when relating these thoughts to autism. First of which is loneliness, conversely, social support is deemed as a protective factor against this. However, as autistic people tend to have less social supports on average than neurotypicals this can exacerbate feelings of loneliness. One extra layer to add is, alexithymia itself is deemed to contribute towards loneliness. Meaning, the greater the severity of alexithymia, the less social interactions a person is likely to have. Areas such as; intimacy, sociability, submissiveness, assertiveness, responsibility and controlling behaviours are all negatively affected by this condition, thus compounding social isolation.

Without doubt, anxiety is a huge issue among the autistic community with 63% reporting a lifetime history. It is, therefore, reasonably common for people with autism to become overwhelmed by the pressures of life or the amount of hurdles that need to be overcome, giving rise to anxiety and drastic coping mechanisms. Additionally, autistic folk may be stuck in distressing, depressive and suicidal thought patterns. This can be due to rigid behaviours, a lack of cognitive flexibility and the feeling that a particular disturbing state will never end, thereby, allowing thoughts of more permanent solutions to these temporary problems to flourish.

Another term frequently used in the autistic community and contributory factor is camouflaging. This can be described as the process of concealing one’s authentic identity in order to fit in with society and is used extensively particularly by autistic females. Camouflaging can broadly split this into 3 sub-types.

  1. Compensation – employed in difficult social situations, such as, copying body language, facial expression and social cues.
  2. Masking – used to hide autistic characteristics or to present as non-autistic.
  3. Assimilation – adopted with a view to fit in with others in social settings. This can be done by putting on a act, avoiding or forcing social encounters.

A major problem with camouflaging is that it can be mentally and physically exhausting. Individuals report that it can evoke further stress and anxiety after the event. Autistic people who camouflage also highlight increased symptoms of depression and ultimately convey feeling less accepted by others. Although camouflaging appears to have detrimental effects on our mental health, it is usually felt necessary because the consequences of not doing so are thought to be, social exclusion and rejection.

It is worthy to note that all of the above factors are common in autistic people, each one contributing to an increased susceptibility of suicidal ideation and possibly suicide itself.

How does this fit with my experiences?

I was diagnosed with autism at the age of 50, however, I have had suicide ideation since the age of roughly 13. To complicate matters further, since going on this recent diagnostic journey, I am also fairly certain I have alexithymia. In fact, I completed a recent test regarding alexithymia and scored 159 out of 185, strongly indicating I may have the condition. In contrast, my wife who I would offer is in touch with her and the emotions of others, while also being good at reading people scored 54/185. In effect, Bev acted as a control group, allowing me put my results into perspective. If you are keen to have a go, press on the link. Be aware, this is not a diagnostic tool, but may provide some direction regarding this condition.

In addition to this, I also have been diagnosed with anxiety based depression and double depression during varying periods of my life, another key component when considering suicidal thoughts. I suspect it would be difficult to ascertain if the depression runs concurrently with ASC (autistic spectrum condition) or if it is simply because of it. Either way, I think it’s safe to say I have a relatively strong element of depression in some form or another.

Furthermore, during the assessment process with regards to the autism diagnosis, I scored very high on the Camouflaging Autistic Traits Questionnaire (CAT-Q). The report stated that all aspects; compensation, masking and assimilation were being practiced to an “exceptional extent”. As mentioned earlier, camouflaging can have deleterious effects on the mental health of a person, thus adding further complexity when trying to unravel the reasons for my long term suicidal thoughts.

Having had these unhelpful thoughts for about 4 decades, I have given the possible mechanisms some thought and think I have 3 distinct suicidal thought processes. The first one relative to the other two is reasonably benign. When situations aren’t going well (on a milder level) or I have too much time to think (often at night) or it appears there are too many things going on at the same time, I quite often think “stuff it, I’ll just kill myself”. It’s much more habitual in nature and probably offers some form of a ‘get out clause’ when things seem difficult. Autism expert Tony Attwood offers, that “when autistic people get anxious they push the panic button and when they get depressed they press the suicide button”. I think my ‘chronic’ suicidal ideation mode is a reasonable example of this.

My second mode related to suicidal thoughts, is linked to an area that has been looked at by multiple professionals and researchers, often described as a “depression attack”. The ‘attack’ is usually short lived lasting no more than an hour, it feels exceptionally intense and is predominantly brought on by stress. For me, this could mean a change of routine, particularly if it is unexpected, maybe new things that are suddenly forced upon me, perhaps an environment that is busy or loud, but generally it’s a combination of multiple factors. When the stress builds, I cease to function logically, at which point like many people with Autism there’s primarily two ways to go, either into a meltdown or a shutdown. All of which can occur very quickly and can be perplexing for those around us, plus frightening for the person involved.

Whichever path is taken, at this juncture we are neither rational or reasonable. Personally, I am more likely to shutdown, which is an apt description of how it feels. My thoughts seem like they are out of control, then all of a sudden my mind seizes up and basic functions or thought processes suddenly appear impossible. For those 30-60 minutes, conversation with me is futile, therefore, I can’t explain what is occurring to anyone. During this period my mind has been overstimulated and I need to put the brakes on quick, so I shutdown. Dependent on where this occurs, it can be incredibly embarrassing, for me often leading to thoughts of suicide, due to feelings of shame and guilt. The only way out of this, at the acute stage is to remove myself from the stressors immediately.

My final process leading to suicidal ideation builds up over a much longer period of time and is strongly linked to the causes mentioned earlier:

  • Anxiety
  • Loneliness
  • Distress
  • Camouflaging
  • Social exclusion

Arguably, this is most dangerous of the 3 modes of suicidal ideation and has been the path that has led to my 2 previous attempts at suicide. This particular process is generally proceeded by a long period of depression, which can progress towards more concrete thoughts regarding killing myself and mental rehearsals of the plan. Due to the length of build up, it should in theory, be the easiest to pick up on, thus providing a suitable intervention from either people who are close or mental health professionals. However, because Autistic people are not good at explaining emotions, it often gets misinterpreted as something less serious than it really is.

Personally, I tend to intellectualise the situation, thus obscuring the ‘red flags’ which would often be recognised by therapists. It’s fairly obvious that signs were clearly missed by health professionals regarding my last attempt while in Auckland, most probably due the unique presentation of suicidal tendencies that emanate from those who are autistic. Manifestations of suicidal intent among those with ASC appear different in my estimation from neurotypicals and thus urgently requires further research in order to curtail future catastrophic outcomes for autistic people.

Just to be clear, in no way have I written this article to shock or scare people regarding suicide and autism. On the contrary, I want to provide some factual information alongside my personal experiences, in order to offer people further insight in this area. If others who are autistic feel they can relate to any of the content in some way, or it gives loved ones an ‘insiders’ perspective, or simply provides a greater understanding, it will have been more than worth the time spent writing it. Thanks for reading.

A 50 year journey of discovery (part 3): A decade long roller-coaster ride.

When we left Manchester the temperature was -7 celsius on route to the airport, but here we sat, outside of Whangarei Airport at a little after 10am and it was already pushing 28 degrees. We were hot, disoriented and thousands of miles away from the place we still referred to as home. We may have left the cold, icy weather behind, but my GP in the UK would be proved correct, my ‘problems’ were not going to simply disappear. However, now I was on the other side of the world, without many of the protective systems that I had cultivated throughout the years. Luckily for me, Bev would be ever present, as many of my demons would return to haunt me with a vengeance.

We had been accepted to live in New Zealand on a residents visa prior to arriving, on the back of Bev’s job. But with no work for myself, this allowed me way too much time to think, rarely a good thing. After roughly 10 months of looking for work, I found employment at the Accident Compensation Corporation’s (ACC) local branch. For the uninitiated, this is a crown entity providing people within New Zealand financial compensation and support for those who have suffered personal injuries. I was employed as a case administrator, but it became apparent early on that this job was largely unsuitable for me and my mind.

Firstly, it was office work, not the optimal place for me to flourish. The job also consisted of numerous phone calls, both inbound and outgoing calls. As somebody who hates talking on the phone at the best of times, this was somewhat of an issue. Rarely do I answer my own calls, unless I know exactly who it is and preferably what the conversation will entail. Furthermore, the corporation was obsessed with mind numbing meetings, where I attempted (but failed) to look semi interested. Staring at a screen, interminable meetings and talking on the phone made up about 90% of the working week. Sprinkle in, some corporate team building or personal development training and I was ready to jump off the nearest metaphorical bridge, albeit with very few options in Whangarei.

It was probably no shock to anyone who knew me, in even the most fleeting sense, that after one whole year I was looking for the exit door or even an ejector seat. In fairness, ACC served its purpose, providing much needed money, even funding a short break to Aussie. But it was becoming patently obvious that it was time to find something more fulfilling. Although, what I did next still ranks as one of the most perplexing life choices I have ever made. Using my previous qualification in podiatry I secured a place on a pharmacy degree course in Auckland. This was full-time and would whisk me away from my primary support system, that being Bev. At the time, however, we really didn’t think this would be an insurmountable obstacle. So in early 2013 I shipped out to Auckland to begin a phase of my life that would prove to be the darkest period thus far.

At around about this time, our house that we had recently bought, while heeding all the advice regarding building checks and balances was found to be leaky. A combination of moving to Auckland and what would be a long running saga regarding our porous home, no doubt put untold stress on my wife, which we’ll return to in due course. But for now, I was a 42 year old man, with no chemistry background whatsoever who was about to embark on a pharmacy degree. Observing this with the luxury of hindsight, this was inevitably doomed to fail, and it did, spectacularly.

On arrival, what became immediately evident was, I had very little in common with the majority of people on the course. Although, without doubt there were a few people who appeared as chinks of light within this period of darkness. In sum, I was a working class, middle aged bloke, who spent nearly a decade in the navy, who to a large extent had discovered life and already had a myriad of strong, largely cynical opinions about it. So whenever I felt the odd urge to partake in activities, such as touch rugby or karaoke, which incidentally expended a years supply of social energy, I was left with an even greater feeling of solitude. If ever there was an example highlighting the disparities between being on your own and being alone, this would be exhibit A.

On many occasions, I found myself caught between two stools, one bunch often looked at me as if I was old enough to occupy my own casket (students), while the lecturers were guilty of treating me like a child who was incapable of wiping my own arse. This whole episode was destined to end badly and true to form it did. Using my x-ray autistic specs to reflect on this, things now make more sense. My routine prior to the course had been decimated, admittedly by choice, but I had no idea the damage this would cause. Living conditions were far too ‘peopley’ for this weirdo. Cooking facilities were in communal spaces and TV rooms were inhabited by boisterous students, who were compelled to investigate the concept of independence for the first time.

Further to this, my choice of friends in a desperate attempt to connect with people proved more detrimental to my health than the endless days of loneliness. Since then, I have now identified that as part of my autism I do not possess a psychopath detector, generally taking individuals purely on face value. This ensures I can be ripe for the picking for any narcissist or sociopath who gains joy from destroying another person’s life. Months of life as an older student led to, severe depression, anxiety, self harm, suicidal ideation and an eventual suicide attempt. During these times my phone was practically on speed dial to every mental health helpline I could find and yet nothing really alleviated how I felt.

Merely existing was proving increasingly difficult, while my attendance at lectures and labs were becoming a distinctly rare occurrence. Many times, I would be banging my head on the wall of my room for extended periods, which gave me some strange form of relief. I ate less and less, losing about 10kg’s, while barely sleeping most nights. To compound matters, the university counseling services were next to useless. Not helped by the fact I couldn’t explain what was going on and they didn’t seem equipped to deal with complex matters that were over 4 decades in the making. Eventually, I was referred to the crisis team in Auckland for the majority of the 2nd year. Care simply centered around checking if I was still alive, with the team contacting me in the morning by phone, followed by a physical visit in the evening.

As my mental health deteriorated, I was checked into a respite house in the suburbs. Here, I had no responsibilities, food was prepared, medication was kept safe by the staff, there was a spare guitar to play, a dog to stroke, plus bedrooms were spacious, I scored it 4.5/5 on Trivago…….not really. During this bleak time my wife arrived from Whangarei, at which point I was allowed to leave the house. We would walk for miles and just talk, trying to make sense of our strange predicament. Spending a week in respite certainly provided some restorative properties, but this wasn’t to last. Nothing deep seated had ultimately changed and with Bev back up north, I declined into further despair.

Auckland’s ‘high speed trains’. I think it would have stung a little.

My thoughts were starting to become darker, plans of suicide more concrete and rehearsed in my mind. It was a close run thing between hanging myself and getting run over by a train. This was a particularly bizarre decision, especially if you know anything about trains in Auckland. Firstly they’re electric, and crucially, they are not very fast. Undeterred by the lack of a high speed rail network, I calculated where the fastest point would be for the train to travel. For this, I looked at the distance between stations, straight sections of track and a lack of signals.

Needless to say, I was in a dark place when I chose to ‘execute’ (no pun intended) my locomotive inspired plan. In Auckland there is a large park called the Domain, the idea was to traverse across this to get to my destination. Parnell is known as a rather posh area of Auckland, but on this occasion it was chosen for the distance between stations, not the cafe scene. Before I left, I hastily wrote an incoherent suicide note almost out of the perceived expectations of others and began to trudge across the park. I distinctly recall feeling emotionally exhausted, with a myriad of incomprehensible thoughts washing over me. I remember purposely ignoring a phone call from the crisis centre, for a date with destiny, or more accurately, an electric light rail vehicle traveling from the suburbs of Auckland at a less than convincing top speed.

By this time, unsurprisingly my cognitive reasoning was less than optimal, I was depleted of energy, I’d also lost my bearings in the park, worse still (at the time), I couldn’t locate the train tracks. I was psychologically drained, confused and physically tired and subsequently fell asleep under a tree. I returned to the flat exhausted, to find members of the crisis team awaiting me. They offered that the best course of action would be to admit me under the mental health act. Finding all this too much to comprehend, I went along with their advice. After going through the necessary questions and procedures, I suddenly found myself in the mental health wing of Auckland Hospital, bewildered, lost, alone and utterly bereft of energy.

On accessing my room, the first job was to reinstall a ripped down curtain rail, especially if I had any intention of getting some sleep. Initially I found the hospital a scary environment, I didn’t know any of staff or clients nor the layout. Suddenly life seemed extremely unpredictable. I needed to develop a routine that provided a feeling of security and safety quickly. On my very first night, there was a fight between residents but luckily this was speedily resolved. Furthermore, in the morning, while making my way to the shower I had to watch my step, as faeces had been smeared all the way down the corridor by some disgruntled camper. My new temporary abode was going to require some adjusting to, but first impressions weren’t favourable 1.5/5 stars.

Unsurprisingly, privileges were given on a trust basis, as I was new I had none. This meant I couldn’t leave the facility initially at all, with or without supervision. As a matter of survival, I rarely spoke to anyone for the first 2 or 3 days, apart from when the nurses approached me. Implementing a routine and even a modicum of control in some way felt hugely important. This began by discovering the ‘library’ which was a quiet corner of the ward and an old classical guitar to play. At least now I had something that would pass a few hours alongside reading. Later in the week I found a lady on another ward who provided a very decent game of table tennis. We never actually spoke to each other throughout our hours of playing, but we both appreciated the benefits of good low serve and a topspin smash.

After a painfully long week I was released, Bev picked me up, we met a good friend who had been brilliantly supportive throughout this trying time and I had the first decent meal in days. Following my escape from Alcatraz, I ceased studying for the rest of the year and headed back north to Whangarei, mentally bruised but still alive. By this point our leaky home had become akin to a demolition site, with buckets strewn everywhere, plus missing bits of wall and ceiling throughout the house. Adding to my list of poor decisions, in my wisdom I decided to go back to finish my studying. What did that famous fella Einstein say about insanity? Suffice to say things never got any better, although this time I didn’t attempt suicide. Which was a win.

Over this same period, my wife understandably became exceptionally stressed having to live with the holey house on a daily basis, while also trying to support me with my regular trials and tribulations. One day at work Bev shockingly suffered a heart attack, with stress and crap genetics most probably being the main contributory factors. To this day it still rightly irks her, as she hardly drinks, never smoked and has always made an effort to keep healthy. Following this terrible event, Bev was consequently rushed to Auckland hospital for triple heart bypass surgery, across the road from the very university where I was studying pharmacy.

Her surgery largely went well, but not without complications. However, it quickly became apparent that I needed and wanted to leave Auckland for good. While Bev was recovering, it was obvious that I had to rethink my future, this is when I came up with the idea of nursing. This was partly inspired by the nursing care Bev received in Auckland Hospital, additionally, it was something I could study locally, while using credits from the pharmacy course in order to make life easier once enrolled. Northtec provided many things that were immediately more favourable compared to Auckland. Smaller class sizes, easier accessibility to lecturers, no condescending staff members and it was exceptionally near to where I lived.

The college may not have the storied reputation of the University of Auckland, but personally I found it a largely positive experience. Students were on the whole friendlier, staff were helpful, plus the campus was small and manageable. Despite this improved learning environment, most of my previous issues still lingered. Academically I found it relatively plain sailing, however, practical components of the course and group work were as difficult as ever. It was during these trying times that I started to think maybe it was more than depression and anxiety that persisted in making life so challenging.

Exams and solo presentations were perfectly fine, as I was in control of how I wanted to study or present the material. In stark contrast, working in groups was horrendous. The noise levels, people speaking over each over, the random distribution of work, group members going off on tangents, plus the reliance on other group members to do the work, then present it accurately was all quite stressful. Further to this the methods of delivery were often not what I would gravitate towards, with a lot of groups using ‘skits’ to convey the required information. In no way is this a criticism of the people on the course, rather it further highlighted the differences between me and most people.

Later on, I found ways to navigate these ‘challenging’ moments. Generally, it consisted of agreeing to do much of the behind the scenes information gathering and reporting back to the group once completed. These times were chiefly spent in the library where it was quiet and conducive to learning. One of my biggest issues is I am very easily distracted, this could be due to noise, the temperature of the room, comfort of a chair, the irritation of my clothes or even vibrations on for example an adjoining desk. On the flip side, if conditions are optimal I can hyper-focus, resulting in the production of large volumes of work in a short period of time. This is probably the nearest I’ll ever get to a super power, but it can come in handy at times.

Towards the end of the course I started to seriously consider the possibility of being autistic. Firstly, I did an Autism Quotient test, designed by Professor Simon Baron Cohen. Although this is not a diagnostic tool, it is considered useful for people who are investigating the prospect of being on the spectrum. It was somewhat of a surprise to find I’d scored 43/50, suggesting I was highly likely to be on the spectrum. This early exploration into autism led to further tests, all of which seemed to point to the same conclusion. It was around this time when Bev revealed that she had been thinking that I may have been autistic for years and that when we first met, she couldn’t work out by my facial expressions if I even liked her.

So after reading the DSM V regarding the diagnostic criteria, plus other books and journals on the subject, I decided to see if I was actually autistic. It would appear it was so obvious to the psychologist that she was left musing why it had never been picked up previously. Which brings us full circle to the beginning of part one. So, following the diagnosis, my hope is that it will help to make sense of many difficulties I’ve encountered over the years, thus allowing me to implement suitable strategies so I can live a more fruitful life both at home and at work. It’s still early days, but so far I will say that my acknowledgment of autism somehow allows me to be more compassionate towards myself (most of the time). All I want is to be is the best husband, nurse and human being I can, hopefully, this period of self discovery will help me achieve such a modest request.

In the next blog I will discuss depression and suicide ideation in relation to autism, both from a research and personal perspective, in an attempt to bring these issues to the forefront of people’s minds.

Featured photograph – Whale Bay, Northland, New Zealand.