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Autism Spectrum Series – Theory of Mind

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Welcome to this week’s In Therapy post.

In this week’s Autism Spectrum series, I want to discuss theory of mind, as it is an important aspect of social communication, and a big part of the difficulties that someone on the Spectrum might experience.


1I find it amazing how people on the Spectrum, particularly Aspergers, find ways to figure out how to navigate the sea of social communication that we take for granted as neurotypicals.

It is amazing but also, to them, to be expected as it is a skill and a tool for survival and for living in a mainly mainstream world.


In brief, theory of mind explains how people understand someone else’s point of view, including what they know, what they believe, their emotions and intentions. This understanding in turn helps to navigate the sea of social communication and situations we discussed last week.

It is similar to empathy, only differing in that empathy allows the person to feel what the other is feeling, whereas theory of mind stops at the understanding that someone might have different feelings to themselves.

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Sometimes people might struggle with social interactions because they might believe that everyone believes and thinks exactly the same way as they do.


In neurotypical children, theory of mind – knowing that others might have different beliefs, knowledge or emotions about things – starts to develop at the age of 3-5 years, while in those on the Autism Spectrum it might begin to develop between the ages of 5-13, but it might not develop to the same level of the neurotypical children.

This is a good predictor or aspect important in diagnosing Autism or Aspergers.


The opposite of theory of mind is mind-blindness.


3Knowing that theory of mind is an area to be worked on, and following from what I said last week about challenging the individual’s learned view of a particular situation (remember the folding of the arms scenario), providing skills to develop social skills in understanding others’ reactions and beliefs is an important aspect of the therapy or coaching process.

For example, in the folding of the arms scenario, the individual with Autism trying to figure out what the folded arms mean, might react aggressively because they might believe the person is angry with them and they are trying to defend themselves from this anger.

If we analyse this scenario with the individual, and explore other reason for the other person having their arms folded, we might see their behaviours change – if the person is just feeling cold, the individual might offer them a jumper or try to get them a hot drink to warm up.

4In therapy, I use this technique with my mainstream clients, in a similar way but possibly in a more cognitive way, in more abstract terms; whereas with someone with Autism it might need to be discussed in a more objective, tangible, behavioural way.

That is not to say that I wouldn’t or haven’t used both ways of working with my clients on the Spectrum.

It’s just about finding the right words and ways to make things easy to grasp, to get that “aha” moment that effects change in therapy.

Same idea, different process.


Theory of mind is one aspect of social communication and interaction, but it goes even further than just preventing someone from understanding another person’s beliefs, emotions and intentions.

As a consequence of the difficulty in figuring these out, the following areas of social interactions are also affected: having meaningful conversations, resolving problems, having intimate relationships, to name a few.

5This can be highly frustrating, leading to “meltdowns” or broken relationships if not picked up soon enough.


Having said that, most humans have broken relationships – so it is important to normalise that these broken relationships aren’t privy to people on the Spectrum. We all fail at communicating well what we think or feel, especially to those closest to us.

Becoming aware of this and learning from our mistakes is going to make the difference in our next relationships.


Understanding how this area of functioning is affected, will provide great insight into the mind of someone on the Spectrum, and therefore allow us to better understand their behaviours and communications, whether verbal or otherwise…

6…they will also allow us to find better ways to teach social interaction skills and ways to guess what the other person is thinking and feeling, and therefore increasing the chance of close relationships, meaningful conversations and increased ability for problem solving.


I trust in the process and I trust in my clients’ capacity to develop all these things, and more!


I have been working with clients on the Spectrum from a cognitive standpoint, in the here-and-now, but also understanding – psycho-dynamically – that some issues that they might be experiencing might stem from childhood experiences or other experiences from the past.

I work in this way with everyone, but pay special attention to the social communication aspects when working with people on the Spectrum.

In my place of work with young people with Autism and other disabilities, we us social stories to help them understand what is happening now, what is going to happen next, where we are going, when we are eating or having a snack, and when we are getting back to the care home after an outing.

7This works very well as it gives them information and therefore lowers anxiety during transitions.


There is a lot of scope to help mainstream individuals understand how people on the Spectrum function and how they have learned to navigate the complex world of social interactions, which in turn will help us show the person on the Spectrum how others think, creating a better environment for everyone.


Understanding is key…


 

 

I welcome your questions and comments below.

Next week I will write more about Intense World Theory.


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Autism Spectrum Series – Navigating the sea of social communication

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Welcome to this week’s In Therapy installment of my Autism Series.

If you haven’t read last week’s post, click here to read it. I spoke about life milestones and how these affect both neurotypicals and people on the Spectrum. I also highlighted the effects in another post (read it here).


1In this week’s post, I want to tackle a big topic: social communication and how this is worked out by people on the spectrum. This is a very big topic, and therefore I don’t expect to talk about everything in just one post.

If you have any suggestions about what I can add, any questions, or you want to guest post about this topic, do leave me a message.


The first thing to remember is that people on the Spectrum are like all of us in most respects.

We all need to eat, drink, shower, have meaningful activities and relationships. We all have needs, wants, preferences, favourite people and activities. We all have hormones – (((this is a whole other topic for another day, but an important one at that as it has been difficult to get people to understand that sexual needs are for everyone not just neurotypicals or those without disabilities of any kind. Why?)))

In spite of those similarities, there are some marked differences, one of them being social interaction and communication.

Their perception of the world is different to neurotypical ways of perceiving the world, and therefore the way they interact with the world is going to need to be different.


2Let me get a bit philosophical, authors such as Locke, talk about realism and how our perceptions are only mental representations of the actual object we are observing.

In this way, every single one of us has a different mental representation of the same object, which might be slightly different but in the end we all know we are talking about the same object, right?


Sometimes those on the Spectrum might get confused – are we both talking about the same object? What is it about this conversation about this object that is confusing me? Am I missing something that is being communicated – sarcasm, facial expression, tone of voice?

This might lead to what we often call “challenging behaviours”.

I would rather call them communications and coping mechanisms to what turns out to be a difficult situation for the person.

Trying to figure out whether someone is using sarcasm, making a particular facial expression to match their verbal communication, or saying something in a particular tone can be exhausting.

3Many people with Aspergers will have set rules that they’ve figured out through the years, to identify what is going on in a social interaction: “when someone crosses their arms it means that they are angry with me”, for example.

This could be true in most occasions, but what happens when the assumption is wrong and the person is just holding their arms together because they are cold?


I am finding it important in my sessions to normalise what is Aspergers/Autism behaviour and what is “being human” behaviour.

Normalising and giving alternatives like the one above to different situations, without shaking up their well-designed system of interactions, helps develop new skills and add to already existing ones.

What is OK to do in a social interaction and what is not, is a very subjective thing indeed. And therein lies the difficulty.

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This includes being able to ask questions about particular behaviours someone might be unsure of – “I see you’ve crossed your arms, are you ok?”

There might need to be some practising to get there, and some energy investment in this, but it might help with their future interactions in similar situations.


Someone on the Spectrum might expect a conversation to go one way, but being unable to control what the other person is saying might mean they are surprised by the response and might need to invest some time and energy in figuring out what they mean – facial expression, tone, sarcasm or not – and what the best response is in this case.

Providing a space to develop communication skills and question the need for them is important. Acquiring new skills through therapy or coaching might help gain better understanding of why we do what we do, why do we respond like we respond, and why we hide when we hide – this applies to both neurotypicals and people on the spectrum.


With my less-verbal or fully non-verbal clients, I find it important to really “listen” to the body language.

Being attuned to the subtle communications is vital and it improves my relationship with the person, and in turn allows them to access more of what they need and find fulfilling activities and interactions.

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They might realise they can trust me more because I am watching closely and responding to their cues.

I can then verbally express what I think they want, and keep showing different objects, activities, pictures or symbols until we definitely get to what the person really is communicating they want.

Sometimes I will get it wrong, and I will apologise for doing so, or for taking too long to get it.

This also happens in neurotypical to neurotypical interactions, but it’s enhanced by the lack of verbal input and other ways of communication used by the individual.

A quick eye gaze towards a favourite object, a particular sound in response to me asking whether they want a drink (or something else), is so important. It is how they get their needs met.

(Verbal) Neurotypicals might just need to say, “can you pass me that drink please” and that’s it. Quick and simple. We get our drink!

But getting that drink when you are non-verbal, maybe have limited ways to communicate, interact and move, amongst other things that might need to be taken into account here, might take a bit longer…


There’s a lot of food for thought here…So I am going to leave it there for this week.

Next week I want to talk about theory of mind and intense world theory, which helps understand even more the social struggles someone on the Spectrum might experience.

I hope this has been helpful. If you find anything that might need rephrasing, rewording or amending altogether, do let me know.

Would you like to add anything? Send me a message and let me know.


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Autism Spectrum Series – Life Milestones and their consequences

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Welcome to this week’s In Therapy post.

So far, I have written about topics that I feel will be helpful and informative to everyone in society.

1For the next few months, I have decided to start a series on topics that might be helpful to people on the Autism Spectrum and those around them.


The topics will be around issues that “mainstream” folk might also struggle with, so this will still apply to everyone, but I will be putting the emphasis on the added different situations that might creep up for those on the Spectrum.


I might not be able to tackle every individual situation that might arise – with that I mean that each person on the Spectrum will experience the same situation in a different way and might need a different way of working through it.

For example, loud music might be a problem for one individual but not for the other. So, having a noisy neighbour who plays loud music all the time might be Ok for the first person but might be causing all sorts of problems for the other. One might need some support in dealing with anxiety and stress of the noise, whilst the other might be blissfully unaware of the noise that’s going on.

Do let me know if there’s any particular situation that you’d want me to talk about in the series, and I’ll be happy to include it.


2This week I want to talk about a topic that is a peeve of mine as a member of society.

I have spoken about this before (read my post on the should, must and have to’s), and it’s something that I am passionate about challenging.

It causes more harm than good, in my opinion.

Especially to those of us who do not meet the stereotypical or the average lives that are expected from us.

The stereotypical or average lives usually include something like this:

Be born

Go to school

Go to university

Get a job (possibly for life, even if miserable!)

Get married

Have children

Retire

Die

Ok it’s very general and there might be some more or less in that list according to your individual culture and society, but this should look familiar to everyone to a certain extent.


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What happens when we don’t fit into that stereotype?

When we do something different like go the entrepreneurial route rather than the employee route?

What if we decide to not have children?

What if we never buy a house and move around the world often?

The list goes on…

Well that’s usually met with judgement and tut tut’s from our loved ones and others we might cross paths with.

Or it might be met with acceptance, well done if you’ve found those open minded people in your life!

This is just what us “neurotypicals” have to deal with.


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People on the Spectrum might have to deal with that and the added bonus of having to deal with difficulties as the one I describe above about the noise issue.

I say difficulties, let me correct myself and say differences.

Yes it’s difference not difficulty.

We all learn to adjust and deal with circumstances with the tools and abilities we have been given.

This is no different in someone with Autism.

It in fact becomes more important and part of everyday life.

Maybe someone on the spectrum will not be able to have a job that their neurotypical counterpart might have, but that doesn’t mean they are not a valued member of society.

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Could they have skills and abilities that gives back to society in a way that doesn’t meet the stereotypical working style?

Yes!

We just need to allow the space to develop this and not judge what we don’t understand.


There are other aspects of life, other than work, that need reviewing for both neurotypicals and people with Autism.

For people on the Spectrum and those of us around them, it might be even more pressing to challenge these society imposed life milestones, and allow for more flexibility and creativity in how things are done and how lives are lived.


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Acceptance is one step…

Acquiring knowledge and understanding is another…

Living and letting live, whatever it looks like for whomever we are talking about – neurotypical or autistic – is, in my opinion, the greater step.


Have you got something to add to what I’ve said so far? Do let me know and I will make sure I add it to the next post.

Would you like to guest post in this series? Write to me and we can arrange it!


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