Anxiety

some things can be a real drain on energy, and sometimes we don't even notice. for example, avoid spending more than 2 or 3 hours a day in front of a tv or computer screen, avoid sexual gratification for 7 days in a row, avoid overeating, avoid eating anything with much saturated fat for a few days, avoid arguing, avoid spending much time doing boring mental tasks, etc.

it's an aweful translation but i can't find a complete better one, so see this link to chapter 10 of the dao de jing which summarises the concept of "deep love" ("dark Te"?!?): http://home.pages.at/onkellotus/TTK/English_Addis_TTK.html#Kap10

Thanks everyone for comments. I shall take a peak at your blog, Zoe.

Melly

Dan said:

there's a lot of threads in different parts of this small forum which cover pretty much the same topic... it's a very common issue that i used to have myself, the solution for me wasn't so hard after all, but working to find it took forever...

So Dan, if you don't mind me asking - what worked for you?

Melly

Hello again Longman

Re how is this intervention being explained to parents - its an intervention that is not really very well known in this country, unfortunately.  If a parent is interested in learning about it, they can get in touch with someone who is trained to support the family to use the intervention.  There is a list of trained Consultants here:

http://www.rdiconnect.com/pages/Find-a-Consultant.aspx

One of the reasons I am writing my blog is to try to explain it to parents and professionals who are interested in it - I include video footage and a written analysis of the clips in the hope that this helps to explain the intervention more fully, as well as discussing some of the theory in other blog posts.

Episodic memories (EM) can be generated in people with autism in the same way that they are generated in typical development in the early years.  Lets say I am supporting a parent to develop EM in their child who has autism.  First of all, I would work with the parent to re-establish whats called the 'guided participation relationship' with their child.  This is the crucible of child development and is common to every culture across the world.  Children with autism are unable to participate in this relationship because the autism takes them on a different developmental pathway.  I've also written about this on my blog.

Once the GPR is in place, I would support the parent to give the child experiences where s/he achieves some form of success (competently resolving a challenge or a breakdown in an activity) and increase the odds of an EM being captured by spotlighting the child's success with subtle non-verbal actions such as altering voice tone and volume of vocalisation (such as "Oooooohh").

You can actually check whether an EM has been encoded afterwards by revisiting the activity ie talking about it and waiting to see if there is a recognition of the crucial moment (the moment of competence/success).  Usually the child will smile once you get to the point where you talk about their competence and/or they will start taking over the description of the event themselves.

So - there is a means of realising the objective but it is part of a much wider developmental approach and it is not something that is a quick fix, or something that can be 'taught'.  Basically it entails going back, establishing the guided participation relationship (which can be done with adults with autism too, not just children with autism) and re-doing the developmental steps that were missed first time round.

I made the point at the NW launch of the 'You Need to Know' campaign last week that campaigning for better mental health services for people with autism is just one side of the coin - we also need to be promoting and lobbying for interventions that seek to develop resilience in people with autism because resilience has been shown in research to be key to good emotional health.

Zoe

At the risk of responding too often, I wanted to add a further thought on this. Confidence building may be a way of reducing anxiety. Spiralling anxiety undermines self-confidence and self esteem. The idea of underlying episodes in memory that NTs acquire to offset the uncertainties that underpin anxieties seems to me a very productive theme to explore.

One of the striking effects of university or college courses for people on the spectrum is that the regime contains less of the peer criticism and bullying that can exist in school environments. It is reassuring to watch people come in to university with rigid rouitines and senstivities, which seem to resolve themselves with the different atmosphere, but also because of the opportunities for confidence building successes and adventures. While these hopes can still be dashed, I've seen a number of people on the spectrum acquiring confidence and self respect and growing with it.

Certainly my own anxiety problems were very destructive and consumed vast amounts of time going over and over sequences of highly improbable outcomes, reinforcing negative feelings. I've gradually pulled out of this, over years of experimentation, by building up self-confidence. Looking at this I am acquiring reference points to offset the anxieties.

So there may be possibilities here in giving children opportunities to shine as much as possible to offset the neagtives which otherwise fuel anxiety.

I'm afraid I relied on my interpretation of the blog and your posting, so I agree in retrospect that you did not mention counselling, and apologise for attributing words not used.

Perhaps you could elucidate though. By what mechanism is this intervention to support being explained to parents? I'm not clear about how these episodic memories are to be supported in development, as an alternative to working around the difficulties, and the blog is a review of an event that perhaps explains this in depth.

If there was something to improve confidence and resilience in children on the spectrum it would be invaluable in avoiding the problems encountered in teens and early adulthood, but there has to be a means of realising this objective.

Hello Longman

Its the development of resilience rather than confidence that is the main focus of my post.

I'm not recommending any form of counselling - there was no reference to counselling anywhere in my post.  Neither did I attribute all autistic behaviours to one cause.  Autistic behaviour, just like non-autistic behaviour, can be attributable to any number of causes or triggers.

I dont really follow your argument about anxiety being caused by a need to analyse all possible outcomes......this wouldnt work as a generalisation - for example, people with autism who also have learning difficulties may well not be able to analyse all possible outcomes, so that wouldnt explain their anxiety. However, the occurance of unpredictability and uncertainty would explain some of their anxiety.  Sensory problems may also explain anxiety.

The need for constancy to me is a way of coping with the challenge of uncertainty - remove the uncertainty by developing static, rigid routines that are predictable.

Finally, I dont understand how artificial episodic memories of competence could be generated.  An episodic memory is laid down via a natural organic process - it cant be created synthetically, so what you are suggesting be generated (possible outcomes) may be some kind of reference point but it isnt an episodic memory (and therefore wouldnt contribute to the development of resilience - which is my key point).

The research shows that people with autism have impairments in episodic memory, so I'm not sure how you think people with autism would be able to create their own episodic memories.

Hope was writing about phobias.  I think phobia is in another league to the kind of anxiety I am talking about.  I do know something about anxiety but wouldnt claim to know anything about phobias - I think experts are needed to help with them.

Zoe

I understand Zoe's argument because confidence is crucial to reducing anxiety and having reliable reference points is common to both confidence and anxiety.

I'm not so sure that explains anxiety amongst people on the spectrum, and Hope has just introduced some more imponderables that are not just answered by confidence.

I have a theory of my own, but it is only a theory and untested as yet, bar my own limited efforts to observe.

The need to analyse situations, such as a social situation or a conversation makes people on the spectrum much more inclined to persevere with speculations and working out possible outcomes to compensate for not having the instincts or acquired processes manifested by neurotypicals. That need to analyse all possible outcomes of a situation may be crucial to special interests. It also may explain the need  for constancy or routine to provide a reference point in a sea of possible outcomes. Hence I think autistic spectrum anxiety is driven by more than just lack of reference points but by a need to cover all outcomes. Hence spiralling anxiety and negative reinforcement may be observed, which is more than just reference points.

I cannot comment on Zoe's research into a method of counselling as she has done the work and generated evidence; I've no points of reference from which to comment. However Autistic behaviours seem to me complex in origin and not simply attributable to one cause. I hope Zoe's idea is productive but I'd also like to hear other people's reactions to whether our anxiety behaviour is just down to not having enough episodic memories of competence situations as reliable reference points, or being able to substitute these artificially.

This is an important topic and needs more debate I think.

I have constant anxiety. Basically, I have had phobias since I was around three years old: dogs, thunderstorms, fire-works, contamination, illness, health anxiety, death, cars, accidents........The one thing I am not scared of is public speaking and being on stage!.

I have co-existing OCD which means that I wash my hands too much, wash cutlery over and over, and I do not like other people touching my cutlery or moving it about.

I also have generalised and constant tension along with the physical symptoms of anxiety: sweaty hands, lump in throat,  shaking and sleeplessness occur about once every few days, whenever I get really worked up. I have had these problems for as far back as I can remember. I am constantly on edge. I have received psychological therapy but it did not really help. My best therapy has been having a support worker going places with me. My support worker has suggested that I try hypnosis, but I am sceptical. However, it may be worth a try

Anxiety is caused by uncertainty - whether someone is on the spectrum or not, the trigger is the same for all of us and our basic response mechanism is flight, fight or freeze.

As babies, toddlers and children we spend thousands of hours with our parents learning about the world - and much of this learning is about how to manage uncertainty.  Our parents help us to resolve challenges or make repairs within interactions or activities.  This leads to us forming what's called 'episodic memories' of our own competence - special memories that help to build resilience.

Resilience is what enables people without autism to overcome anxiety.  We've got lots and lots of special episodic memories of being competent at different things.  When we are presented with a new challenge, our brain goes 'oh, this is new and scary' and then a nanosecond later, our brain also goes '...but hang on, I've done something similar to this before and maybe I can use some of what I did then to help me now'

Children with autism go down a different developmental pathway because of the autism.  The result is that they are unable to take part in the special relationship with their parents that enables them to lay down the episodic memories of competence......so they dont develop resilience to the same extent as people without autism.

In my blog, I am writing about using an autism intervention that helps parents to support their children to lay down these special episodic memories of competence - this increases resilience and decreases anxiety.

http://notnigellanotjamie.blogspot.com

Its no quick fix......but it does work specifically on the impairments in episodic memory that are a key factor in autism, rather than working round the difficulties, which is what most other interventions and strategies seem to do.

Zoe

From an educational perspective NT teenagers' anxiety seems to have a lot to do with relative time and the speed of growing up - the consequences of what causes anxiety seems too immediate and too cataclysmic to form a perspective. So it is a common enough experience for tutors supporting NT students with anxiety to have to try to unravel the threads according to priority, offer solutions to the solvable worries (especially if that's making course or assignment adjustments - things tutors can sort), and reassuring students that their anxieties are not as unique or insolvable as they might suppose.

Translating this to students on the autistic spectrum is vastly harder. The bottleneck effect is much more severe. The predisposition to try to work out responses to numerous unlikely outcomes is hard to stop. The spiralling process of negative reinforcement - calculating worse and worse scenarios is very hard to break (what if, then what if, then what if). However I cannot find enough information around on how to ease the load. It is an area where we could do with research on making life easier. Tutors can still address course matters quickly, and access help with non-academic problems that can be easily resolved, which can reduce the pressure temporarily. But I have never felt comfortable giving autistic spectrum students the advice I would readily give NT students, because the capacity to self-help is less clear, and there are dangers.

One is to develop a way of interrupting the worry loops. I've my own system now of telling myself arresting phrases such as "I've had enough of this!" and "no its not that bad", but it took years to make these work. Some psychologists advocate substitute pain to distract, like wearing a thick rubber band on your wrist and snapping it against the inside of your wrist to stop unwelcome thoughts (trouble is many people know about this and assume you are seeing a psychiastrist - or they ask embarrassingly why do you have elastic bands round your wrist?).

Another remedy is to carry a notebook and write everything in it - thoughts, worries, reminders. Thjis gets things down on paper where you can find them again, that might otherwise be going round in your head.

By writing out worries and what you can do about them you can prioritise or categorise them, and do something to resolve those readily addressed, so as to reduce the number of worries coming through the bottleneck.

I note Communication magazine (spring 2011) p30-31 has other suggestions for writing down such as worry symptoms and solutions, which is similar.

However the anxiety spirals facing young people with aspergers/autism are particularly bad, and I feel research is needed to establish reliable and meaningful solutions rather than just "maybe that might work" offerings.  Having good anxiety reduction strategies could be a breakthrough for many.

there's a lot of threads in different parts of this small forum which cover pretty much the same topic... it's a very common issue that i used to have myself, the solution for me wasn't so hard after all, but working to find it took forever...

Thank you, UK aspie and Alyd.

We have tried different relaxation techniques - breathing, yoga, stress balls etc but haven't yet found one that consistently works. Need to keep trying. S is very scared of dogs, so that technique wouldn't work for us.

That is great that breathing works for you UK aspie and that your dog has made such a difference to your son, Alyd.

Melly

Hello, I remember when my son was in his early teens, he had extreme anxiety attacks. through our Gp he was referred to a play therapist and counsellor who taught him some relaxation techniques. we also got a rescue dog, and although it sounds silly, we never looked back ! i shared the dog walking with my son as i was working full time, he met people out and about and gradually built up his confidence. he began to look up and not at the ground any longer and he did start to enjoy his time walking with our dog. There were times of course when he met people he didn`t want to be near- that used to bully him, but again, gradually he conquered those demons- literally. The more he faced them by walking the dog past , the less his anxiety affected him. before this my son wouldn`t go out of the house, sat in a dark room, on his computer. If there is something you can think of, to do with your teenager, anything is worth a try. before this I tried to get my son to do all kinds of stuff but nothing worked. the other thing that really helped was an elderly neighbour- I would send my son over the road with some baking or scones for the elderly man and my son would talk away to him. After a few times, he would ask if i had anything for the man across the road- and he stared to enjoy going to visit him. Its a matter of trying anything you can and maybe a combination of things will help.

i hope this is useful, allyd.