Klipper in en relevant text från ledande forskaren Tony Attwood.
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Compensatory and Adjustment Strategies to being Different.The author has identified four compensatory or adjustment strategies developed by young children with Asperger’s syndrome to the realisation that they are different from other children. The strategy used will depend on the child’s personality, experiences and circumstances. Those children who tend to internalise thoughts and feelings may develop signs of self-blame and depression, or alternatively use imagination and a fantasy life to create another world in which they are more successful. Those children who tend to externalise thoughts and feelings can either become arrogant and blame others for their difficulties, or view others not as the cause but the solution to their problems. Thus some psychological reactions can be constructive while others can lead to significant psychological problems. These are the four reactions that have been observed by the author.
A Reactive DepressionSocial ability and friendship skills are highly valued by peers and adults and not being successful in these areas can lead some children with Asperger’s syndrome to internalise their thoughts and feelings by being overly apologetic, self-critical and increasingly socially withdrawn. The child, sometimes as young as six or seven years old, may develop a clinical depression as result of insight into being different and perceiving him- or herself as socially defective. Intellectually, the child has the ability to recognise his or her social isolation, but lacks social skills in comparison to intellectual and age peers, and does not know intuitively what to do to achieve social success. Brave attempts by the child to improve social integration with other children may be ridiculed and the child deliberately shunned. Teachers and parents may not be providing the necessary level of guidance and especially encouragement. The child desperately wants to be included and to have friends but does not know what to do.
There can be increased social withdrawal due to a lack of social competence that decreases the opportunities to develop social maturity and ability. The depression can also affect motivation and energy for other previously enjoyable activities in the classroom and at home. There can be changes in sleep patterns and appetite, and a negative attitude that pervades all aspects of life and, in extreme cases, talk of suicide, or impulsive or planned suicide attempts.
Escape into Imagination A more constructive internalisation of thoughts and feelings of being socially defective can be to escape into imagination. These children develop vivid and complex imaginary worlds, sometimes with make-believe friends. In their imaginary worlds with imaginary people, these children are successful, socially and academically. Searching for an alternative world can lead some children to develop an interest in another country, culture, period of history or the world of animals, as described in the following passage by an adult with Asperger’s syndrome.
When I was about seven, I probably saw something in a book, which fascinated me and still does. Because it was like nothing I had ever seen before and totally unrelated and far removed from our world and our culture. That was Scandinavia and it’s people. Because of it’s foreignness it was totally alien and opposite to any one and any thing known to me. That was my escape, a dream world where nothing would remind me of daily life and all it had to throw at me. The people from this wonderful place look totally unlike any people in the “real world”. Looking at these faces, I could not be reminded of anyone who might have humiliated, frightened or rebuked me. The bottom line is I was turning my back on real life and it’s ability to hurt, and escaping.
The interest in other cultures and worlds can explain the development of a special interest in geography, astronomy and science fiction, where a place or planet may be ‘discovered’, a place where the knowledge and abilities of the child with Asperger’s syndrome are recognised and valued. Sometimes the degree of imaginative thought can lead to an interest in fiction, both as a reader and author. Some children, especially girls, with Asperger’s syndrome can develop the ability to use imaginary friends, characters and worlds to write quite remarkable fiction. This could lead to success as an author of fiction, or as a travel journalist.
The escape into imagination can be a psychologically constructive adaptation, but there are risks of other people misinterpreting the child’s intentions or state of mind. Hans Asperger wrote, with regard to one of the four children who became the basis of his thesis on autistic personality disorder, that:
He was said to be an inveterate ‘liar’. He did not lie in order to get out of something that he had done – this was certainly not his problem, as he always told the truth very brazenly – but he told long, fantastic stories, his confabulations becoming ever more strange and incoherent. He liked to tell fantastic stories, in which he always appearedas the hero. He would tell his mother how he was praised by the teacher in front of the class, and other similar tales. (Asperger 1944, p.51).
Under conditions of extreme stress the propensity to escape into an imaginary world can lead to an internal fantasy becoming a ‘reality’ for the person with Asperger’s syndrome. The person may be considered as developing delusions and being out of touch with reality. This may result in a referral for a diagnostic assessment for schizophrenia, as occurred in the biography of Ben by Barbara LaSalle (2003).
Denial and Arrogance An alternative to internalising negative thoughts and feelings is to externalise the cause and solution to feeling different. The child can develop a form of overcompensation for feeling defective in social situations by denying that there is any problem, and by developing a sense of arrogance such that the ‘fault’ or problem is in other people. The child or adult goes into what the author describes as ‘God Mode’, an omnipotent person who never makes a mistake, cannot be wrong and whose intelligence must be worshipped. Such children can deny that they have any difficulties making friends, or reading social situations or someone’s thoughts and intentions. They consider they do not need any special programs or to be treated differently from other children. They vehemently do not want to be referred to a psychologist or psychiatrist, and are convinced that they are not mad or stupid.
Nevertheless, the child does know, but will not publicly acknowledge, that he or she has limited social competence and is desperate to conceal any difficulties in order not to appear stupid. One strategy is to develop an attitude of denial and arrogance that can be of great concern to parents, teachers and psychologists. A lack of ability in social play with peers and in interactions with adults can result in the development of behaviours to achieve dominance and control in a social context; these include the use of intimidation, and an arrogant and inflexible attitude. Other children and parents are likely to capitulate to avoid yet another confrontation. The child can become ‘intoxicated’ by such power and dominance, which may lead to conduct problems.
When such children are confused as to the intentions of others or what to do in a social situation, or have made a conspicuous error, the resulting ‘negative’ emotion can lead to the misperception that the other person’s actions were deliberately malicious. The response is to inflict equal discomfort, sometimes by physical retaliation: ‘He hurt my feelings so I will hurt him’. Such children and some adults may ruminate for many years over past slights and injustices and seek resolution and revenge (Tantam 2000).
The compensatory mechanism of arrogance can also affect other aspects of social interaction. The child may have difficulty admitting being wrong and be notorious for arguing. Hans Asperger advised that:
There is a great danger of getting involved in endless arguments with these children, be it in order to prove that they are wrong or to bring them towards some insight. This is especially true for parents, who frequently find themselves trapped in endless discussion. (Asperger 1944, p.48).
There can be a remarkably accurate recall of what was said or done to prove a point, and no concession or acceptance of a compromise or a different perspective. Parents may consider that this characteristic could lead to a successful career as a defence lawyer in an adversarial court. Certainly the child has had a great deal of practice arguing his or her point.
Imitation An intelligent and constructive compensatory mechanism is to observe and absorb the persona of those who are socially successful. Such children initially remain on the periphery of social play, watching and noting what to do. They may then re-enact the activities that they have observed in their own solitary play, using dolls, figures or imaginary friends at home. They are rehearsing, practising the script and their role, to achieve fluency and confidence before attempting to be included in real social situations. Some children can be remarkably astute in their observation abilities, copying gestures, tone of voice and mannerisms; they are developing the ability to be a natural actor. For example, in her autobiography, Liane Holliday Willey (1999) describes her technique.
I could take part in the world as an observer. I was an avid observer. I was enthralled with the nuances of people’s actions. In fact, I often found it desirable to become the other person. Not that I consciously set out to do that, rather it came as something I simply did. As if I had no choice in the matter. My mother tells me I was very good at capturing the essence and persona of people. (p.22)
Becoming an expert mimic can have other advantages. The child may become popular for imitating the voice and persona of a teacher or character from television. The adolescent with Asperger’s syndrome may apply knowledge acquired in drama classes to every day situations, determining who would be successful in this situation and adopting the persona of that person. The child or adult may remember the words and body postures of someone in a similar situation in real life or in a television program or film. The person then re-enacts the scene using ‘borrowed’ dialogue and body language. There is a veneer of social success but on closer examination, the apparent social competence is not spontaneous or original but artificial and contrived. However, practice and success may improve the person’s acting abilities such that acting becomes a possible career option.
There are two possible disadvantages. The first is observing and imitating popular but notorious models, for example, the school ‘bad guys’. This group may accept the adolescent with Asperger’s syndrome, who wears the group’s ‘uniform’, speaks their language and knows their gestures and moral code; but this in turn may alienate the adolescent from more appropriate models. The group will probably recognise that the person with Asperger’s syndrome is a fake, or ‘try hard’, who is probably not aware that he or she is being covertly ridiculed and ‘set up’. The other disadvantage is that some psychologists and psychiatrists may consider that the person has signs of multiple personality disorder, and fail to recognise that this is a constructive adaptation to having Asperger’s syndrome."
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