Energy Budgeting

I have a fairly busy week coming up. There are things in my diary that I’ve agreed to do that involve other people and are therefore “fixed” and would cause stress to me and others to cancel or change. There are also jobs that I really do need to do this week because not doing them would cause consequences (paying bills, dealing with various messages, making decisions about what to commit to over the next few months so other folk can plan, and that sort of thing). So I’m a bit stressed, and a bit anxious about how I’m going to cope with it all.

Part of what has happened over the last few weeks is that my state of “wellness” has shifted slightly. I’m far from “well” or able to live anything approaching what might be thought of as a “normal” life, but I’m no longer so ill that it’s obvious my life can only consist of getting out of bed, staring at the telly for a few hours, and then going back to bed again, which was how it was a few months ago. I can now manage to leave the flat on my own from time to time, even though it exhausts me, and, consequently, I’m doing rather more than I have been for many months.

But this increase in activity comes at a price. Each time I increase what I’m doing, a bit of functionality drops off somewhere else or I end up, on the days I’m not out in the world, back to being so ill that I can barely get out of bed. I managed to get to the conference the other week, and then to write it up as fully as I could, but the result was that I then spent two full days barely able to do anything and retreated back under my blanket on the sofa, stimming almost constantly, and not really managing to eat properly. You might have noticed that, as I’ve been doing more I’ve been blogging less. I only have so much energy and cannot use it everywhere at once.

And so I need to budget my energy. If I’m going to have enough energy to do the things I want to do in life (or, at least, as many of them as possible – I’d really have liked a full-time job and a family and to have been able to have a hobby or so on top of that, but I’m realistic to know that, for me, those things simply aren’t possible), then I’m going to have to save my energy rather carefully and work out what things drain my energy and what things give me energy, and how I can balance the two.

Which is, of course, why, stupidly, I’m up and out of bed before 10 in the morning this morning, too much in my head to go back to sleep, and now sitting at the computer writing a blog post about it!!!

The irony is not lost on me that I’ve woken up this morning feeling not too bad and am struggling to rest in the way that I know I should be doing if I’m to get through the rest of the week without falling apart. I’m just hoping that I can get the important jobs like bill paying done today so that at least I can allow myself to crash out later in the week if I need to, and I can spend all available energy dealing with the inevitable anxiety that seeing people (some of them new) and going to places (at least one of them unfamiliar) later in the week will inevitably cause.

It’s also particularly difficult to budget my energy at the moment because I don’t actually know how much energy I have to start with. In terms of spoon theory, I’m currently being given a number of spoons at the start of each day but I don’t know how many there are (I’m sure others with variable conditions will relate strongly to this feeling). In terms of monetary budgeting, it’s like working with a bank account without a balance available – I might have enough in there to go on a spending spree and buy whatever I like today, or I might go out and try to buy essential food and not have enough to pay for it. I simply don’t know, so it all feels like a bit of a guessing game right now and all I can do is keep trying to find out where my limits are.

What I do now know is that the only way to manage these energy levels is to let them settle as I stabilise after burnout, to work out just how much functionality I have in what areas, and then to start to look at how I can optimise life in general to be as good as it can be. I’m still accepting that it’s never going to be the sort of life I anticipated it would be when I was in my late teens and early twenties, nor the life that many other people expected me to have at that time. I’m still trying to figure out what I can do and get to a point where there is some sort of stability in my life. Currently, it all feels rather unknown and rather challenging and rather uncertain.

I could, of course, decline the offers to meet people, to play music, and to go out to dinner. I could give up the idea of ever running in big races. I could abandon plans to continue studying and learning. And I could decide to spend the rest of my life watching daytime TV, scrolling through social media, and playing with the animals. It became evident years ago that I can’t hold down a life-sustaining job for any length of time and I am not able to live independently. It also became apparent some years ago that having a family wasn’t going to be in my list of options either.

However, I’m interested enough in things that I don’t want to abandon all my goals and I do want to get back out into the world as much as I can. But, unlike in the past, I now have knowledge that makes me experience almost everything in life very very differently. I feel like I almost went into hibernation back in September 2016, and I’ve spent months, mainly hidden away in the flat, exploring my real identity, finding autistic communities online, learning the language of the autistic world, discovering things about my past, learning to listen to my body, having hundreds of “lightbulb moments” where I suddenly realise that there’s something ELSE I have always done because I’m autistic, and also allowing myself time and space to come to terms with what has happened and to recover from the huge burnout that had been building for some time.

But getting back out into the world uses energy. It uses energy in unexpected ways. Every time somebody asks me the question “What do you do?” it saps my energy levels massively because I have no simple answer and have not yet developed a reliable script. Every time people expect me to have “normal” social skills, or to chat in a group, or to be able to process the sheer amount of speech in the world, I get exhausted. Every time I have to explain because I’m meeting people who don’t know me online and don’t read my blog, it’s knackering. Every time I hear someone using person first language or functioning labels and so on I want to scream at them, I want to make them understand, but that all uses energy – things that are taken for granted in autistic communities online are totally foreign to most people in the outside world and, as is so often the case, the only way to deal with it is self-advocacy (ironically, I have a communication disability but in order to get my needs met in the outside world I have to be able to communicate effectively in a way that is exhausting and difficult to me)!!!

None of this surprises me, of course. Some of it I’ve known for years, and some of it is very easy to deduce when I think back to a year ago when I’d never heard of “burnout”, “stimming”, “inertia” and so on (I promise I’ll write proper blog posts explaining terminology at some point – it’s something I really want to do, but I can only process all these things at a certain pace and I can’t do everything at once). I know that there’s no reason why most people would have the faintest clue of what it’s like to experience the world as I do (and, of course, it turns out that I don’t know what it’s like to experience the world as they do either) and I’m now having to work out the interface between me, now unmasked, totally public and “out” and determined to be as authentically autistic as possible, and the world outside that won’t always totally understand me.

And it all uses energy. Lots of energy. And I don’t know whether I even have that much energy much of the time. But, ten months after discovering it was very likely I was autistic, six months after the low point of the aftermath of the first assessment going so badly wrong, and nearly four months after diagnosis, I’m starting to gather just enough energy together to do a few “normal” things out in the world. And since I’m no longer masking, or pretending, I’m hoping that I’ll gain quite a lot of energy from that – enough to compensate for the energy I’ll use doing all the necessary explaining.

So energy budgeting is very much something I’m thinking about at the moment. I’m starting to gather resources, starting to think about how I could make a system that will work for me (much like my old “mood diary” did so effectively in managing my bipolar disorder) in monitoring things, and what some of my goals for the future are going to be. Since I now know I have quite substantial limitations on what I can do because my neurodivergent brain needs so much energy to process “ordinary” things, I’m going to have to choose my goals and activities quite carefully!

This still feels like very very early days. There is still a long way to go. But it’s a start!

Understands What?

“Until everyone understands” proclaimed the slogan on the front of the conference pack for the National Autistic Society’s one-day conference on Autism and Mental Health.

I sat, during the afternoon tea break of this conference, which I’ve already described in some detail in My Conference Day and Content Report, and pondered exactly who “everyone” was, and, perhaps more crucially, exactly WHAT everyone would, ideally, understand about autism and autistic people. My experience, at a conference supposedly designed specifically to promote understanding about autism and autistic people had indicated that understanding was still distinctly lacking!

First off, there were the practical arrangements at the conference itself as far as autistic people attending were concerned. The worries caused by the initial e-mail about the parking were just the start of a really stressful and difficult conference that seemed to have almost ignored the access needs of the very people it was supposedly advocating for. Being forced to sit in really close proximity to strangers who were wearing non sensory-friendly clothing was absolutely horrible for me, and my request for an end seat was given hardly a thought. Furthermore, no allowance was made for those of us who struggle to sit “normally” on chairs and cope by rocking or pressure stimming with our legs folded under us. There was also no area available for those of us who might happily have spent the day sitting on the floor. Another autistic blogger who was at the conference and blogged about it afterwards observed that some delegates were strongly perfumed – although my own sensory sensitivity to perfume is relatively low, some autistic people find strong scents absolutely unbearable.

I had already compensated for lighting and sound issues by wearing sunglasses and earplugs (the onus was entirely on me to take care of myself this way) and the impossibility of even knowing where the quiet room was without any sort of map or plan in the conference pack meant that I never even located it. Someone online said there was a sign in the foyer, but getting into the foyer any time after the start of the conference was, for me, impossible, owing to the sheer number of people crammed into such a small space. Similarly, the instructions for splitting into streams were only given in spoken instructions, which I struggle to keep in my head – I never did work out where Stream B took place, and had I been hoping to attend that stream would have been really grateful for a map showing where that session was located.

And, of course, it was the issue with the foyer that prevented me from accessing food, drink, or toilet for the whole day. In order to have accessed any of these I’d have needed a carer, but there was no provision for one to attend with me unless they also paid the conference fee. As an autistic adult (and, indeed as a person on low income) I was entitled to a “reduced” fee for the day (including, presumably, the cost of the food and drink I was unable to access), but it was still sufficiently high compared to my income that I thought long and hard before signing away what was, for me, a large amount of money (you can maybe gather by now that I really am keen to learn and to get information, as I spent a very large slice of my monthly income to spend a day in quite significant discomfort and you might well ask why I would do such a thing – I hope I’ll answer that question later). Furthermore, the displays of books that I would have liked to have browsed were also in the foyer and therefore inaccessible – it’s little wonder that I do most of my book shopping on Amazon these days!

I was, to an extent, prepared for many of the difficulties I encountered throughout the day. Although I have not been to large conferences for a long time (I believe I last wrote a conference report around 20 years ago), I know that the logistics of organizing a large conference are not straightforward (and even less so when the space booked for the conference was quite so tight as it turned out to be). I also knew that I was, to an extent, entering a world that would be alien for me. It was obvious that the registration form had not been designed with autistic people in mind – not only was the pricing structure unclear as far as autistic adults were concerned, but the drop-down box forced me to use “person first language” and describe myself as a “person with autism”. I have been part of the autistic community for considerably less than a year and in that time it has become abundantly clear that, like me, the majority of autistic people prefer to refer to themselves as “autistic” and not “with autism” (which somehow implies that autism is an add-on). I’ve heard “professionals” say that “person with autism” emphasizes that autistic people are people and is therefore, somehow “better”. To be brutally honest, if someone needs reminding that we autistics are people, then the problem lies with them!

However, there was a really bright moment in the day when Lorraine MacAlister was discussing the support programme Teen Life at the end of the lunch break. MacAlister explicitly stated that the language of the programme would refer to participants as autistic teens, having taken advice from autistic people themselves! That was the moment that made me say YES! to myself. Somebody in the NAS is listening. Somebody IS understanding and believing autistic people. This is progress! Yay!!!

It was also obvious from the list of delegates attached to the final conference instructions e-mail that as a mentally ill autistic adult I would be in the minority (at a conference about autism and mental health, yes, I know – the irony is not lost on me) and that most of the delegates had described themselves as teachers, carers, parents, and so on. I’d be interested to know how many autistic people attended (I knew there were several through my contacts on facebook, and I subsequently discovered on twitter that there others who’d been there), although I do absolutely recognize that educating those who are not autistic is a really important part of the NAS’s work – it’s just a shame this education cannot extend to showing non-autistic delegates how an autistic-friendly event could be run, and didn’t include education on, for example, not wearing strong perfumes!

And so we come to the speakers. Like with the logistics I was prepared to encounter tough material (if I’d been expecting fairy stories then I was in the wrong place), and I’d read and absorbed enough information about the keynote speaker to expect that there might be some challenging aspects to his presentation. However, I was here this time to see (and hear) for myself rather than to read the reports of others and I started out with as open a mind as I could.

From the outset it was obvious that Tony Attwood is supremely skilled in the art of rhetoric and is a slick and practised speaker. However, it also became obvious very early on that he was not addressing the entire audience. I very quickly realized that in this context I was a “they”, and there was no concession given to the fact that there were autistic delegates present. While the majority of the audience laughed at Attwood’s “jokes” (about robots, Oxford and Cambridge, the Antiques Roadshow, and whether or not autistic people were still virgins in their mid-20s), I started to become somewhat irritated by this “humour”, most of which seemed to be carefully calculated to get the non-autistic members of the audience on side. I also wondered, though, how funny the parents present would find the jokes about virginity when their own children reached their mid-20s and were struggling with relationships? The fact that autistic children grow up into autistic adults (rather quickly) seems to be perpetually forgotten or ignored by so many people who focus on children.

As someone who was a classroom teacher for 5 years, I’m absolutely aware that humour can be a great way to teach and to help an audience to remember points that are being made. BUT, and this is a really big BUT, when that humour is at the expense of a minority group, it crosses the line from being fun and educational to being downright offensive. Attwood’s references to having “learnt Aspergerese” as some sort of language came over as downright crass, and his pointing out of his own proof-reading mistake in one of his slides, followed up by the assertion that “some aspie would probably point it out to him” was horribly reinforcing of stereotypes that really should have been consigned to history by now. I wrote in my notes: “You do not need to be autistic to be able to proof-read a slide properly – I have loads of allistic friends who are superb proof readers!!!” Attwood also used the term “neurotypical” to refer to non-autistic people throughout, never explaining that he was doing so colloquially or addressing the fact that there exist non-autistic neurodivergent people, who he basically erased from the planet with his language. He is, sadly, not alone in this.

Throughout all of Attwood’s sessions I kept having to remind myself that the “they” and “them” he was talking about was actually me. It felt like, as far as he was concerned, I was not part of his audience but one of his “subjects”. The converse of the “humour” was the sad story – tales of family members and patients also elicited responses from the audience, although in this case, sympathetic muttering rather than polite laughter. Throughout the day I was determined to be my authentic autistic self and didn’t deliberately seek out other humans (I was overloaded by the sheer number of them in the room in any case), and nobody spoke to me or approached me. I wondered, when hearing these sympathetic mutterings what people were thinking about the obviously autistic person sitting in the corner gently rocking to myself and chewing on a necklace designed for the purpose (I’d already damaged my fingers by chewing the skin off – ironically during the session on self-harm)!!!

At the outset of the last plenary Attwood directly spoke to us (the audience) with the words “You, as the parent/carer…” which was an interesting experience for me since I am neither a parent nor a carer. Was I even supposed to be at this conference? Was this talk for me at all? I have heard the term “othering” used when describing Attwood’s style, and it seemed very much to apply in this case. He also used phrases such as “somebody must fall in love with an aspie or they’d have died out years ago”, implying that “falling in love with an aspie” was some sort of weird penance maybe? He also seemed to focus rather heavily on those autistic people who would, under the (now superseded) DSM-4 have received (and still do receive, in some places under the ICD-10) a diagnosis of Asperger’s Syndrome, and also used the terms “severe autism” and “classic autism”, neither of which is beloved of many autistic people. I didn’t get much of a sense that he respected the whole of the autistic community with all its richness and variety of experience.

There were other indicators that Attwood was not really up to date with current thinking in the neurodiverse community and had focused his work on the view from “outside” rather than listening to those of us who make up that community. I also believe I heard him misgender someone, though I’m not in a position to call him out on that without hearing from the person concerned and establishing what they are comfortable with. It was also an interesting conference to attend for me as my main experience at conferences thus far has been of academics presenting to academics and many of the questions are often challenges or additions to the work presented. The questions that were drawn from the floor in this case were predominantly of the “please can you tell me what to do about my child / children I teach” and so on. When asked about autistic children in school being bullied, Attwood suggested that some other kids could be “trained to speak Aspergerese” (that phrase again) and could then be issued with “jigsaw puzzle badges”. At the mention of puzzle pieces I nearly fell off my chair. Does Attwood really not know just how offensive the puzzle piece symbol is to many members of the autistic community? Should somebody tell him?

It was a really interesting experience actually hearing all this. And it was in contrast to Khalid Karim’s professionalism and Wenn Lawson’s inclusive friendliness. I’m not saying that Attwood’s work hasn’t been incredibly useful in many ways. His strategies for balancing energy and dealing with meltdowns and shutdowns are excellent, The Complete Guide to Asperger’s Syndrome is a mine of information, and I shall also willingly read the recent book on depression, and it was obvious from some of the questions that many of the people at the conference learnt a great deal from him – I totally appreciate that most of them probably don’t, as I do, have 45 years experience living as an autistic in a non-autistic world, many of them will not have self-harmed or attempted to take their own lives, nor will they have experienced meltdowns and shutdowns from the inside. Neither will most of them have spent the last 9 months intensively studying absolutely everything they possibly can about autism, as I have! In many ways that is my privilege. Although Attwood would probably just tell me I was being a “typical aspie” or some such!

I had read tales online of autistic people returning from Attwood’s talks upset and traumatized. Partly because I was prepared for it, and partly because I treated the whole experience as an academic exercise, that wasn’t the case for me (although my sensory system was so overloaded when I got home that I could barely run a bath because the noise of the water running was so painful to my ears). Half way down the penultimate page of my notes I wrote “I wonder whether I could organize a proper autistic friendly conference” and I remember thinking “Right, my goal is to be speaking at things like this in 5 years time and I’m going to remember this experience”. Going to the conference has, to an extent, started me thinking about what role I might have in the future – what place there might be for an autistic adult who has academic experience, teaching experience, a fierce desire to learn, and is happy to stand up and speak to an audience? Is there some small way in which I can improve the world for all autistic people? Can I facilitate understanding of all things autistic using both experience and knowledge? Only time will tell. I know that, for the time being I’m still learning and still recovering from a severe autistic burnout, but I am also starting to get ideas and little beginnings of things to think about for the future. I might have spent most of the day silent, stimming, unable to access food, and not putting on any sort “social mask” (simply not enough energy for such a course of action), but it didn’t mean my brain was switched off – in fact, allowing myself to stim and not to worry about pouring energy into trying to chat to people or behave “appropriately” was the exact strategy that allowed me to spend my energy absorbing the information and thinking about it in some depth!

The conference has also inspired me to return to serious study of autism. Since my diagnosis in February I’ve eased off a bit and lost the impetus slightly, but it’s now back and I have new things to think about. I sat at the end of the conference wondering how this phase of “understanding autism” will be viewed in the future. I pondered the connection between adult autistics and allistic autism researchers, and how the two might work together and respect each other. I thought about the organization of events, about what might be researched and written, about the lack of focus on adults, and about how the current “understanding” seems to be very much based on models created by non-autistic people.

I got the feeling that this whole area is still very new, and that genuine understanding of autism is still very much under construction. But I also wondered whether Attwood’s approach was beginning to become part of “the past” now and whether greater consultation with autistic adults might be the way of the future. I came away with a sense that if the National Autistic Society really are going to keep going “Until everyone understands” then they have a long job ahead of them, and even their conference organizers still have a lot of understanding to gain – I didn’t return the feedback form at the end of the day because I simply didn’t have the energy, but I shall tweet this blog post to the NAS, and maybe, just maybe, somebody there will read it.

And as for me, was it worth going? Absolutely it was. It took me two full days afterwards to stop feeling really quite ill (there’s a reason these blog posts are being published a week after the event), but the knowledge I gained (about many things) was huge. I’ve also made new contacts online, started generating ideas in my mind, added to my reading list, and gained insight about many things.

Perhaps even more than that though, I proved I could do it. It wasn’t easy, and it was the first time I’d been out of the flat all day, without a known ally to look after me, in over 9 months. It took an awful lot of energy. But I managed it, survived, didn’t fall to pieces, and even learnt quite a lot. It really did feel like something of an achievement!

Content Report

During my conference day I attended five presentations in all, three plenaries, and two from Stream A, which I had selected as the one I’d deemed most likely to have the least “child specific” content when the initial programme was published. I was, however, pleased to see that the slides for all streams had been included in the conference pack so I’d be able to look through them later.

At this point, I’d like to add a content warning. The titles of the talks I attended were: Exploring depression, Coping strategies for anxiety, Deliberate self-harm in children and adults with autism, Autism and psychosis, and, Catastrophising – why do we do it and how can we deal with it? As you can probably guess from those titles, this wasn’t exactly light-hearted subject matter, and suicide, suicidal ideation, and self-injury were discussed on several occasions. This whole blog carries, on the home page, a warning about such things, but this post might be a bit heavier on such content than usual, so might be one to save for later if you’re currently vulnerable. I should also say that I’m using language I wouldn’t usually use (for example “people with ASD”, and referring to autistic people as “they”) to reflect the way some of the speakers presented more accurately, even though such language is not preferable to most autistic people, and definitely not to me.

This blog post might also be one of the longest I’ve ever written, but I wanted to include the whole conference in one post rather than splitting it. I’m also aware that I’m simply reporting on the material presented and where I’ve commented on that material it has been entirely from personal experience. I have not, at this stage, made attempt to verify or refute any of the material from a scholarly or research perspective.

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Tony Attwood began with his talk on depression, which linked in with his recent book “Exploring Depression and Beating the Blues”. He outlined the proportions of those with ASD who had depression as being approximately one third each of continual depression, cyclic depression, and no depression. He discussed “depression attacks” as something that “they” go through, and described how, at those times suicide was possible simply because the person suffering the “depression attack” would be desperate for the pain to end. Certainly, my own experience when severely depressed has been that my primary motivation for the suicide attempts I’ve made, or the ones I have planned but not executed, has been a strong desire for the pain to stop.

Attwood went on to discuss the overt pessimism of people with ASD, their diminished vocabulary to describe their worries, difficulties with friends, sensitivities to sadness in others, how sadness and anxiety seems to “stick” in the brain more than happiness, and how they accept “I’m stupid” messages more readily than others. Intellectual performance anxiety was also discussed, as many people with ASD struggled with sport and socialising they relied heavily upon intellect for self esteem (this was certainly the case during my own teenage years).

“Special interests” and their role in combating depression were discussed. The old clichés were wheeled out – dinosaurs received a mention, and the description of a child who had stated they “wished to be a robot” raised a titter of laughter from the assembled delegates. It was asserted that people with ASD liked to describe themselves by “what they do”, and there was a brief discussion of teenage girls with ASD and how they were not bitchy, and were likely to be interested in opera at age 15, so might come across more like a 25 year old while being emotionally less mature. While I’d have challenged Attwood on the emotional maturity thing, I recognised myself as a teenager who wasn’t much interested in other teenagers – although in my case I was into string quartets, symphonies, piano concertos, tone poems, and oratorios – my love of opera didn’t really blossom until I was at College in my early 20s!

There was some slightly uncomfortable discussion of how “Britishness” corresponded to “Asperger’s Syndrome”, with mention of Oxford and Cambridge, and the Antiques Roadshow, which Attwood subtitled “Spot the Aspie”! Train spotting and people who were still virgins into their 20s were also mentioned, and the assembled audience once again laughed obligingly, succumbing to Attwood’s skilful rhetoric.

Attwood’s slides provided an interesting checklist (presumably taken from the book – I don’t yet have a copy of it) of signs of depression, and he also discussed strategies that might be deployed to help. I very much liked his concept of an “Energy Bank Account” (pretty much the same thing as I use when I talk about “spoons”, and which I’m currently working on for my own monitoring of my own energy/spoon levels). He discussed the need to treat depression before an ASD assessment can accurately be made, he discussed exhaustion, and also mentioned that if enthusiasm for a usual, big, special interest was gone then depression might have taken root very deeply. He talked about animals often being better than psychologists in some circumstances – that very strongly resonates with my own experience!!! Medication was also briefly mentioned, as were unhelpful tools (such as alcohol – my own “self medication” of choice), and possible strategies for staying safe during a “depression attack”.

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The second plenary was given by Wenn Lawson, who I’d been very keen to hear as I’m very much enjoying The Nine Degrees of Autism, which he co-wrote with Philip Wylie and Luke Beardon. Lawson, who, unlike Attwood, is actually autistic, was instantly relatable. He outlined how applause was painful, which is absolutely the case, and was keen to voice concerns that there might become an “us and them” situation with autistic and non-autistic people. He also mentioned the need to build resilience in autistic people.

Much of the first part of his talk was focused on the notion of object permanence, and how much the lack of object permanence in autistic people can generate anxiety. Object permanence is that knowledge that something is still there, even when you can’t see it. Lawson mentioned his need for a photograph, a visual reminder, of his partner. Lack of object permanence on my part is the reason that we don’t put food away in a cupboard in our flat – if it’s out of sight it simply isn’t there, so my husband leaves it as visible as possible to maximise the chances that I’ll eat!

Lawson also discussed how autistic people rely on being interested and how special interests can be something other than traditional “hobbies” – they could be connected to something to wear, something to eat, or similar. Of course, developing a rather strong interest in autism was the whole reason I was at the conference in the first place – so this made absolute sense to me!

Lawson also discussed how to develop resilience by giving options on plans, to make things less concrete to avoid anxiety when plans were forced to change. He used the example of a school timetable that was prone to change and suggested that actually writing extra options onto the timetable would, to an extent, prepare for possible change in advance, and also gave the example of a girl going to a restaurant who might have to cope with a different table or waitress, and how preparation in advance might be a useful strategy to help the girl cope with issues that might arise. This sort of resilience is a necessary life skill for an autistic person to learn and to practice on a regular basis. Getting outdoors and getting exercise was also discussed as a way of building resilience, and how doing so might usefully be linked to interests connected to technology, such as geocaching, bikes with computer chips (I thought of my own love of looking at the stats on my Garmin after I’ve been for a run), or, in other cases having an animal such as a dog.

The way that more able adults often worry about things more was mentioned and how insight doesn’t actually change the anxiety problems associated with change, but can make it worse, not better. However, it seems that autistic brains gain more plasticity with age (unlike neurotypical ones). Lawson then discussed the processing of information and mentioned his own synaesthesia, which associates colours with moods. He stated that the mood of the audience was predominantly yellow, although I can’t remember what mood yellow represented, partly because the person with the sharp jumper was asking their friend what synaesthesia meant and the friend was googling it on an ipad, and partly because for me, yellow is E major, so everything in my head instantly went into four sharps!!!

The need for different sorts of cues (visual, auditory, kinaesthetic) for different people was discussed, as was motivation. Clubs and social motivations are unlikely to appeal to AS people, so movement and response has to be initiated in other ways. Lawson, like me, fails to see the problem with using ipads and technology in the classroom or in other situations. He suggested that the sort of anxiety triggered by demands placed on the autistic brain might be ameliorated by, for example, sending a text message to an AS person rather than asking them with spoken words. He cited one of his own family members saying that strategies that make the AS person believe that they’ve thought of what to do themselves are often the most successful.

Learning to be independent is often possible, but learning to be interdependent can be difficult with high levels of anxiety. Lawson also discussed the difficulties that AS adults might have when unable to communicate effectively with neighbours and so on because answering the door or telephone provokes too much anxiety. Information that isn’t conveyed by e-mail / text will often be missed. He concluded by mentioning mindfulness and asserting that it is very underrated as a tool for coping with some of the difficulties caused by being autistic.

***

Khalid Karim and his colleague Sarah Baines wisely started with a caution about the material in their presentation, which was focused on self-harm. Karim was an engaging speaker, and started by explaining some of the terminology often used to describe self-harm, including self-injury, suicidal ideation and so on. The question of what suicidal ideation actually means was discussed, and whether suicide attempts were part of the same thing. It was also noted that in the research the material available is predominantly concerned with genetics and statistics, but that there is almost nothing written about what can be done about self-harm in people with ASD.

After a brief discussion of how self-injurious behaviour (SIB) can become stereotyped in ASD (as opposed to “impulsive” in psychiatric illness), Karim went on to say how critical it was to ask not WHAT a patient was doing to self-harm, but WHY they were doing it. He also mentioned the recently increasing incidence of suicide in the general population, but that ASD data were very difficult to find and that suicide attempts are very much underreported. Autistic people are, apparently, more likely in general to have suicidal ideation, but with co-occurring depression the likelihood increases dramatically. Many ASD adults have suicidal ideation and have made suicide attempts.

The importance of discovering, in a clinical setting, what a SIB was trying to communicate was emphasised – language skills are often reduced when anxiety is high. SIBs can also be used, consciously, as a coping mechanism, and it’s important to try to understand whether the stressor is internal or external. SIBs can also be comforting and a relief from anxiety, even though they are difficult for an outsider to watch. An outside observer might instinctively try to stop such behaviour, but that might, in fact, have the reverse effect or cause the “patient” to redirect their behaviour to something even more harmful.

Various types of SIB were discussed, some of which were familiar to me from personal experience, and possible causes of SIB in autistic people were listed – for example repetitive, sensory, self stimulatory, poor sleep, communicative, anxiety, and so on. The management and impact of SIBs was also discussed.

Attention then turned to suicidal ideation, which is, apparently, really common in people with ASD – this is also borne out by my personal experience. Suicidal ideation doesn’t, however, always translate into suicide attempts, and, obviously, not every suicide attempt will translate into a completed suicide. It would seem that suicidal ideation peaks in the 20s, and precipitating factors for actual attempts vary. For those still in the school system there seems to be a reduction in suicidal ideation during school vacations. Depression, severe anxiety, and psychosis exacerbate the risks, as can feelings of exclusion – an autistic child in a mainstream school can often be “included, but excluded” so although they are physically present, they sometimes don’t make the same friendship connections with other children, even if they’re not actively bullied.

Karim also noted that the media has a role to play in self-harm. He observed that every time there is a programme on self-harm on the television the incidence of self-harm increases. He also noted that conventional “anger management” is a waste of time in these situations, and that poverty has a really significant role in increasing self-harm. Dangerous behaviours can also increase if they produce a desired response – the example was given of a kid climbing up a high building in order to get the fire brigade called because they liked fire engines. It was noted that understanding autism and mental health issues is complex and really hard work. A further example was given of a neurotypical carer assuming that a child’s self-harm was the result of the child’s mother having recently died, when, in fact, the issue was not the death of the mother but simply that the child was being bullied at school.

The issue of whether the “patient” even WANTED to be treated for their SIB was also addressed, and whether they even thought it was a problem. Maybe someone hitting themselves is a valid coping strategy, however distressing it might seem to an outsider. The need for flexibility in dealing with patients was discussed – an example was given where Karim had interviewed a child who was happy to be interviewed while upside down. It was also noted that sometimes the best strategy was to treat, say, sleep problems first, and that suicidal ideation in kids under the age of around 10 was often a way of expressing distress rather than really showing an understanding of death.

***

For the second session in Stream A, on psychosis, Tony Attwood was back at the microphone. He started by exploring the connection between ASD, schizophrenia, and psychosis, and went on to observe that schizophrenia was a common misdiagnosis in teenagers and adults with an ASD as the psychiatrists were often uncertain of the interpretation of phrases such as “hearing voices” and that imaginary friends and catatonia were often confused with signs of schizophrenia. Attwood also asserted that people with ASD were great at logic but less good at emotions.

Attwood discussed the connection between imaginary friends, people with ASD talking out loud while thinking in order to clarify thoughts (this reminded me of my own “scripting” behaviour), and the late development of internal dialogue in people with ASD. He also returned to the concept (mentioned earlier in the day) of AS people assuming what he termed “god mode”, in other words, compensating for lack of sporting and social abilities by developing an intellectual arrogance, especially if they were smart. He called this “Sherlock syndrome”.

Misdiagnosis of schizophrenia was further discussed. Many patients on chronic mental health wards were given a diagnosis of schizophrenia and then locked up for decades, when, in fact, they had ASD and had then suffered a breakdown.

The psychological reactions that many people with ASD experience as a result of being different were also listed, and it was noted that depression often starts young in people with ASD, who can seriously question the value of life (this latter tallies absolutely with my own experience). There was also an assertion that effusively social places such as Italy might be worse places for people with ASD than places such as Japan. The mimicry, acting, and chameleon-like behaviour of women and girls with ASD was mentioned as was the fact that such behaviour can lead to dissociative personality disorders and, in adulthood, substance abuse. Furthermore, those who hide in their houses in adulthood and become reclusive can apparently suffer from psychotic issues owing to sensory deprivation. It was also noted that people with ASD have high levels of paranoia and jump to conclusions, leading to diagnosis of prodromal signs of schizophrenia.

Catatonia was then discussed at length, as was isolation, and the withdrawal of many ASD people from the world because life was simply too difficult. The slowness of movement and difficulty initiating actions in catatonia was noted, as was the dopamine hypothesis and possible link with Parkinsonism. Attwood also asserted that catatonia was regressive.

***

The final plenary was also given by Tony Attwood, who was talking about catastrophising, particularly in regard to meltdowns in people with ASD. He started by outlining the rapid acceleration in intensity of emotions in people with ASD, describing the autistic brain as having an “on/off” switch rather than a neurotypical “dimmer” switch. He gave a brief introduction to the neurology of an ASD brain, positing that ASD amygdalae are larger and more overactive than those of neurotypicals. He suggested that this might be an adaption to aversive sensory experiences. The role of the frontal lobe in controlling “fight or flight” behaviour was also discussed as was the fact that in people with ASD the frontal lobe doesn’t receive information before a meltdown, so conscious control of emotions is not possible at that point. A meltdown might have been building for a while before it actually happens.

Attwood went on to discuss the potential use of fitbits (and presumably any other device that measures heart rate) as a good external indicator of a person’s anxiety levels. He also noted that saying “just relax” to a person in a heightened state of anxiety does not work, but that focusing on breathing or similar might.

He went on to discuss the mind of a filing cabinet, full of cognitive and social skills and proposed that one of the problems with intense emotions was that they effectively “locked” the filing cabinet, cutting off those skills and strategies and that even with instruction, many coping tools would not be available and that the best strategy was to remove triggers and to aim for calmness. He suggested that those dealing with meltdowns should behave “like a satnav” calmly redirecting and avoiding all analysis of what happened. He also suggested that getting rid of all need for sociability would be a good idea, and, if possible to engage the mind in some sort of special interest related activity – he gave the example of a child who was keen on numbers being encouraged to focus on some sort of counting activity. As a person who has huge meltdowns myself I did find much of this advice sensible and I might draw on it when I’m putting together the “how to” guide I’m eventually hoping to produce for those who might encounter me at such times.

As had been the case during the first session of the day, “depression attacks” were discussed. The advice for dealing with these “depression attacks”, which I thought sounded rather like what I’d call some sort of shutdown, was basically good.

Other tools and strategies were also discussed, particularly physical activity and the notion of using physical activity specifically for emotional release, although stimming, one of the most powerful tools for regulating emotions, was not mentioned. I’m very familiar with such strategies, although I’d not previously thought of “smashing up the recycling after school” as a tool for controlling emotions. Special interests and the value of animals were also discussed, with examples being given of parents being advised to get pet snakes and horses for their children! The role of medication and examples of maladaptive and adaptive strategies were also discussed as the session concluded.

***

The four sessions I didn’t attend because they were in different streams were on jealousy, speech and language therapy, self-esteem, and mindfulness. I’ve glanced briefly through the slides for the first three of these and read the article on mindfulness that was given in the conference pack. I have used mindfulness to deal with my own mental health issues over the last few years, with considerable success and I was pleased to note that the author of the article emphasised the circumstances under which it was not advisable to begin a mindfulness training programme – namely when there is upheaval in life or suffering from acute psychiatric conditions. I’d have been interested to attend any of these sessions, particularly the ones on self-esteem and mindfulness.

Hand Flapping

I wrote the words below (in italics) around eight months ago – before diagnosis, before forms, before I had any interaction with autistic communities online, right back in the early days of the “autism hypothesis” as I was then calling it. At that time I’d only just contacted my mother to start to ask about my early childhood, I’d heard the word “stimming” but didn’t really understand it, and I had no knowledge of autistic burnout or realization that I was experiencing it and had done so before.

I was yet even to receive the forms from the triage service or do any autism “tests” beyond the online one that I mentioned in The Discovery. I was still only just acknowledging that I even WAS autistic, and at that point I was only talking to a very small number of people about it and really only had Google and a couple of books to help me.

At the time I wrote the words I remember being really freaked out by them, even though I’d felt the need to write them. The whole concept of “just letting stuff happen” was so alien to me, having spent my entire life fighting to be “in control” and I was right at the start of the process of discovery. I had only just, a few days earlier, typed the words “I am autistic” for the first time and they still felt very foreign and strange and the whole notion of me being autistic seemed seriously wild – I didn’t spend a few years wondering or suspecting that I might be, as some people do – I’d gone from completely clueless to almost certainly autistic in the space of only a few weeks and my head was still reeling from the experience.

I didn’t even initially discuss them with either my husband or the friend with whom I was most closely corresponding about the possibility that I was autistic. I remember sending a rather coy facebook message to that friend saying I’d discovered something, but, initially it seemed too radical to say what – I’ve come a long way from then to now and my perceptions and levels of confidence have changed so much that I’m now publishing the words, which I couldn’t even send to my friend back then, openly on the internet!!!

But right from the off I knew I wanted to investigate the whole thing thoroughly. I wanted to experiment, to find out just what was going on. It was already obvious that the jiggly leg and the constant sitting with my legs folded under me and the gentle rocking and so on were likely autistic things and so I deliberately set out to learn to listen to my body and to what it wanted to do and to allow myself to experiment to see what happened.

Had I grown up knowing I was autistic and been part of any autistic community, this stuff might have been so commonplace in my life that it wouldn’t even have featured as a “thing to discover” but to me it felt new and big and important. I remember, much later, reading an account from another late diagnosed person saying it took them 6 months from diagnosis to reach that particular point. It took me only a few days from the point that I started to accept that I was autistic!

But I was deliberately experimenting. I am also pretty lucky in that I’m not the sort of person who feels shame about lots of stuff – I don’t have a deeply ingrained sense of “this is wrong” because I’ve always lived a somewhat random life, rather a long way from the middle of the “bell curve”! I knew by my teens that I was never going to be one of the popular “normal” ones and there’s no doubt that as I’ve got older I’ve increasingly adopted an attitude of “if they don’t like me as I am then I’ll just move on and not bother about it”. I have plenty of folk who do seem to be amused or entertained by me enough to stick around and whom I find interesting to be with so it’s not a big problem.

But, internally, this was for me, a big milestone, a big thing for me consciously to rediscover. And I remember, having typed the words “my autistic body” (perhaps an odd thing to type but it was what it was) looking at them with a mix of utter “this is so freaky and odd and new and scary and but ME?” and total “this is so comforting and reassuring and exciting and wow can this really be true” all at the same time.

September 2016

So, I’m staying overnight at my friend’s. I wake. It is 4 in the morning. When I wake I am overwhelmed with anxiety. Understandable. I’m away from home. I had orchestra. People. I talked a lot about autism to my friend yesterday afternoon and evening. My life is in such a period of upheaval and learning and turmoil. The revelations about my 4 year old self are still shocking me and rebounding inside my head.

I feel sick. Really really sick. I have felt this way here before. I have usually put it down to a large meal in college or too much alcohol. Neither of those is true for last night. A fairly small supper (I have learnt to eat small when things are unfamiliar because I know being out of normal routine is often stressful and makes me feel anxious and sick, so less food offsets the feeling).

Usually at this point I would try to keep calm and lie still. Breathing exercises. Mindfulness. Sometimes it works. But often I cannot get calm. The sick feeling rises. As I am emetophobic I get into a feedback loop. Sometimes I manage to fend it off but spend the next hour or so lying there feeling shaky and drained. Sometimes the worst happens. I end up in the bathroom and return, tearful and traumatised, to bed, where I might then drift into a troubled sleep, but the experience stays with me unless I spend the next few days working on blocking it from my mind.

Since it became apparent that I am autistic (there, I said it again) I have been experimenting. I have never known why I sit on the sofa at home and gently rock, but I do. It is calming. Maybe there is more in me. Something else. More long-repressed behaviours. I know I always fiddle with things. My hair. Pens. Cords. But maybe there are other things that are part of me that I am yet to discover.

I lie in the bed and decide to try something. To stop trying any sort of control over my body and mind and see what happens. My body starts to move. Rhythmically rocking backwards and forwards. It feels right. Then the strangest thing happens. I want to flap my hands. Really really want to. My arms emerge from under the covers. My hands begin to flap, fast, furious. I don’t know for how long, but the nausea and sick feeling subsides. I calm. Tears run down my face. I know I am going to be OK now. I flap a bit more, just to check. But I am calmer. The anxiety is reduced. I finally lie still.

I have heard mention of hand flapping. Has that found its way into my mind. Am I “trying” to be autistic, to prove something to myself? Au contraire, I was actually not trying to do anything except what my body felt it wanted to do. It felt natural. Normal. Although massively at odds with everything I have learnt from society over the last 45 years.

I wonder if my particular flapping is an autistic thing. So I grab my phone and Google autism hand flapping. My phone knows how to spell autism these days. I find a video of a man demonstrating flapping behaviour. It looks right. I read on a website that autistic children flap their hands and adults may go back to the behaviour as a way of relieving stress and anxiety. I don’t know if I am going back because I don’t know if I ever did as a child. Maybe so, but if that was the case I was almost certainly told to stop. Suppress. Do not exhibit abnormal behaviour. Nobody would have known back then what it meant.

I am slightly creeped out by the experience. The sense of calm the flapping induced was profound and remarkably quick. It clearly stimulated something that stopped the sick feeling, stopped the acute anxiety and stress. I feel very strange about this. I know it is an odd behaviour. Not something I have done in this way before. It was what my body wanted to do. And it worked.

I wonder what will happen over the coming weeks. As I come to terms with my autism what else will be revealed? I find the term “stimming” strange and unfamiliar. It was not a term I knew until very recently. Again, I worry that I am making myself autistic to fit the model. But every time I return to the fact that I have been autistic all along. It is not that I fit the model. It is that the model fits me. That I have found myself. Discovered needs in myself that were hitherto hidden. Years of lying in unfamiliar beds at night feeling sick. And I didn’t have a way of dealing with it. Now I do. That was what my body wanted. So that’s what I did. My autistic body. My differently wired head. My new life. My new start.

I am 45 years old and I am at the very beginning of my journey of learning to live like me. I have had fleeting moments, over the past week, where I have thought “when will life return to normal”. I know that old normal will never return. Yes, there is a part of me that is deeply unnerved by this whole autistic world. It’s so new. It has all happened so fast. Where is my old familiar life?

The old life is gone. I would not want it back.

***

Two Days Later

I have become a hand flapper. It has become important to me. I also like to rock, and to do things with my fingers, waggle my feet, bash my legs against the sofa back, and, of course, allow my leg to jiggle, rather than making the effort to stop what is often involuntary movement.

I was flapping tonight. Not because I was feeling particularly bad, but just to keep myself calm and to explore further the effect it has on me. I flapped for slightly longer than before. I felt a feeling in my fingers that was familiar, and pleasurable, and special. And it triggered a memory from long ago, very long ago, of the same feeling and I realised:

I. Have. Done. This. Before.

The realisation hits me. I did this as a child. I wonder why I stopped. Did someone tell me to stop waving my arms around? Did I gain awareness that other people didn’t flap their hands and as I was learning how to live by copying and observing I stopped? Did some kid at school bully me for it?

I wonder when it was. But I know now that I flapped my hands as a child.

Mind continues to be blown by all this stuff.

Breathe for goodness sake, breathe!

It turned out that I hadn’t just been flapping my hands when I was younger. As soon as I started to relax about it and consciously allow myself flap in front of my husband he said “Oh, you’ve always done that – though not quite as obviously as now”. Things I’ve always done with fingers and wrists when trying to make decisions or when stressed turn out all to be part of the same thing, but just on a smaller scale. I’ve since discovered that there are all sorts of times when I flap my hands, and these days I often hardly notice. Sometimes it’s when I’m happy about something, sometimes it’s for anxiety relief. These days I generally just go with it!

And, like so many autistic things, it possibly looks a little unusual from the outside. My husband (who also flaps his hands from time to time) frequently tells me I look like a T-Rex (I’m totally cool with that – I was a mad dinosaur fan as a kid and am still somewhat interested in them), and I suspect that some folk might find it a bit odd, but from the inside it’s just a natural form of expression and something that’s now very much part of my life.

The only thing I do have to make myself consciously remember from time to time is not to flap my hands while I’m holding a drink – that doesn’t work out well!!!

Good, Bad, Random!

It’s as if my head is desperately trying to prove just how true the oscillation theory actually is. Thinking back over the last few days:

Saturday – was a fairly good day. I knew I was a bit on edge, but still managed to get out and about to visit my best friend then to meet my husband for coffee. I was tired, and very much in need of time in the dark under my weighted blanket, but I was OK.

Sunday – was a bad day. I felt distracted and ill-at-ease all day. I achieved very little aside from watching multiple episodes of Columbo, a James Bond film, and The Terminal. I spent a lot of time under my blanket on the sofa, stimming in one way or another almost constantly.

Monday – I wrote the post about the oscillations. I then went out for my first proper run in months, just a single kilometre, but such a massive achievement from where I was. I came home and updated my calendar and replied to a few e-mails and had a generally good and productive evening.

Tuesday – was a terrible day. The neighbours were doing some DIY in the next room (we live in a flat) and were banging and drilling and scraping all day. I tried earplugs, headphones, ear defenders, but the feeling of all of them touching my ears was worse than the noise. By 4 in the afternoon I was a mess, my sensory system totally overwhelmed by the noise and feeling of closeness of the neighbours, and my brain seeming to be doing somersaults inside my head. It wasn’t good.

And I reacted in one of my more maladaptive ways to feeling so terrible – having hardly eaten anything all day I decided to have an early glass of wine, which led, eventually, to, well, rather more glasses of wine, and then even more, stronger, cheaper, wine… (you get the picture). I probably made a total arse of myself on facebook, but I did survive some fairly dark thoughts, so for that we must be thankful I guess!

It was also one of those days where I couldn’t write coherently. I find those days incredibly frustrating – when my head is full of thoughts and I can’t turn them into any sort of useable form. I started 4 blog posts / poems. Only one of them makes even vague sense, and it’s not exactly fun stuff for parties. I have a small collection of the darker stuff that I’ll perhaps try to sort out when I have enough energy to do it, but I’ll have to be in the right frame of mind for that.

So, ironically, just as I posted the post about oscillating, the last few days have been a microcosm of my life over the last 9 months or so. Good – bad – good – bad, and now, we’re back to good!

Today I feel much better. My head is clearer, I’m making myself eat food and drink sensible things like water and milk and tea, and I’ve washed my hair and checked that I’m wearing trousers without holes in in anticipation of spending the early evening at a “poetry and mental health” event which my husband is organizing. Also, the neighbours are quiet today, which helps immensely.

There are still unfinished blog posts in my folder, and there are still things I’d really like to be doing from the jobs list, but at the moment I’m happy to take whatever progress I can get. On days like this, when I feel somewhat inadequate that I haven’t yet written something really helpful (this blog is such a strange mixture of articles, journal entries, personal accounts, memories, random poems and so on), I can remind myself that I’ve only been doing this for a few months and although I really want to produce helpful material and a beautifully crafted set of posts, I also started this blog as an outlet for my thoughts, since I have no therapist nor much else beyond an exceedingly tolerant husband, one or two real-life friends, and those with whom I’m connected on social media.

I’m also really still getting used to the idea that I am autistic, I’m still working out how to interact with people out in the world in a way that is both possible, so that I can do the things I want to do, but will not break me as badly as it has done in the past. This is the start of the process, a time of experimentation and working out how to live my new life as an openly autistic person. I keep expecting myself to have all the answers, but I forget that I’m still very much at the start of this whole thing and it will take time before I can be where I want to be, both as far as being any sort of autistic advocate or gaining as much knowledge about autism as I want to, and simply being able to live some sort of life that works for me and I can cope with.

And I’m trying to resume bits of my old life too – playing music, running, studying, maths and science, a bit more attention for the animals, participating in events, seeing friends, even sorting out the chaos that is our flat, and so on. But I know that I have to tame my natural instincts, which are to plunge headlong into absolutely everything the minute that I have the slightest bit of energy (though that taming really doesn’t come naturally).

And to round off this somewhat random and oscillatory blog post, I’ve just looked at the date on my clock and noticed that it is exactly five months ago today that I published The Discovery and announced publicly that I am autistic, having spent the preceding four months getting my own head round the idea and discussing it only with a very few people. It was an interesting day, and the reactions from people who knew me were interesting too.

I’ve come a very long way since then. Things that seemed really wild just a few months ago seem to be such an established part of my life now. Life really has changed a lot.

And, on balance, it’s changed for the better!

The Magic Spot

You know those hanging sculptures?

The ones in spacious modern art galleries?

They’re made of all sorts of bits and pieces, hanging from the ceiling.

When you walk in to the gallery

All you see is a load of stuff,

Suspended on a bunch of wires.

Nothing makes any sense

And you wonder what crazy person decided to hang all their junk up from the ceiling and call it art.

But you walk around the room.

And you can see that the stuff is actually somewhat organised

And forms a picture.

Of sorts.

You stand and look at it for a while and you are about to move away and leave the room, because the picture really isn’t that good.

It’s all out of focus. Bits randomly appearing where they shouldn’t be. Gaps where you might expect to see continuity.

Then somebody says something to you,

Points to the outline of a pair of feet on the floor, previously unseen.

You place your feet over the outlines.

And you look at the junk, hanging from the ceiling…

Except that it is no longer just junk.

It is no longer a picture out of focus.

It is clear.

And beautiful.

And it makes sense.

Each individual thing, contributing to the whole. Each tiny piece of junk is supposed to be there. Nothing is out of place any more.

Because you are viewing it from the correct spot.

And it’s a beautiful piece of art.

Now imagine that you have spent forty-five years in that room, looking at the stuff that forms your life and trying to make sense of it.

And then you stand on that magic spot.

And you finally see the picture in focus.

And your entire life makes sense.

And you get a little bit of hope that it might even, one day, be a tiny bit beautiful…

You need time for your feet to recover from standing in the gallery for so long. You are exhausted.

You need to get used to seeing the picture clearly because the detail is overwhelming, and seeing it like this for the first time is new and unfamiliar.

And you need to show everybody else how they should look at the picture.

Because they won’t all understand what you mean straight away.

And maybe some never will.

But now you understand.

Your life makes sense.

Now you know where you need to stand, you can safely move around the room again, examining each individual piece, hanging from its wire.

You can analyse how each item fits, and you can see why it is there.

You move your feet away from the marks on the floor.

And you see that they are no longer outlines of feet. They are now words.

You bend down to take a closer look.

And you read the words that are written on the magic spot, the words that give you the information you need to make sense of your life.

They simply say:

You are autistic.

Eight Weeks On

So, eight weeks on from my diagnosis, I’m once again pausing to observe the passage of that time, and, understandably, reflecting on how life has progressed since I sat in the room at the end of a five-hour interview and testing session and was told that I clearly fulfilled the criteria for a diagnosis of autism spectrum disorder.

Eight weeks ago today I was relieved and exhausted in almost equal measure, having been officially told the news that explained why my life had been so incredibly difficult and I had failed, consistently, to live up to the expectations and demands that that so many people (including myself) had for me. I had reached the end of the process of assessment, and the end of the “old life” and had, finally, got to a point where I could start to rebuild something new, gentler and more forgiving.

Because I’d already read so many other accounts of how things had been for other people, and because I’ve been around long enough to have experienced a lot of ups and downs, I was under no illusion that receiving my diagnosis would magically transform my life into some fairyland, or that I would miraculously be able to access beautiful support or that all the ghosts from my past would reappear and apologise for all the years they’d told me to work harder, do better, or whatever, or that they’d explain that they really didn’t know how difficult life had been and they wished they had. I was, of course, right to hang on to a healthy skepticism that things would miraculously “get better” – one advantage of being a bit old and a bit logical is that a belief in magic and sparkles and fairy dust is not on the agenda. This process of readjustment to my new knowledge and rebuilding my new life is not going to happen overnight, and nor is it going to happen at all without considerable effort from me.

There is also the burnout to consider, and my mental health in general. At my follow up appointment I was advised to book an appointment with my GP to discuss my mental health in general and where to go from here. I wonder whether there will be more referrals, more discussions, and to what extent maintaining any semblance of mental wellness is, for me, going to be a lifelong task. I suspect only time will tell, as I adjust to the knowledge that I am autistic, as I learn what works, and as I start to try to work out what I’m going to do with the rest of my life – that is currently a very big question on my mind, both in terms of what I am able to do, and what I might actually want to do.

But, at this juncture, I am trying to identify how things now are, eight weeks on. It’s almost in the spirit of keeping some sort of journal, perhaps to refer to later, to measure progress. I look back now to what I wrote in Tiny Glimmers, just over three months ago, and, although it might not feel like it sometimes, and although my life still appears to be rather poor quality in many ways, and terribly terribly limited, I can see that things are generally better, and that I’m achieving a little more. I also have the confidence of my diagnosis, the feelings of validation that it gave me, and just that tiny bit of support I’ve had (help with forms, a follow up appointment, reassurance that I’m correct on many things and not going crazy, and suggestions for what I might do next), which have made a massive difference.

Interestingly, when I wrote Tiny Glimmers, I’d been trying to organize my paperwork and sort out my jobs lists and just get things a little more organized. I did the same yesterday, so maybe this is part of the process of taking stock, moving on, and trying to consciously plan and be proactive in life rather than just reacting to crisis after crisis and just “coping” whatever way seems most possible at the time. I did mindfulness meditation for several years (and have not ruled out returning to it when I’m in a more suitable place for it – now is not the right time) and one exercise that I found useful and adapted was to “check in” with feelings and to notice how they were. I adopted a method, during silent practice sessions, of using some of the time to analyse how things were, both physically and mentally (I know the two are not entirely separate systems, but I found it useful to examine each separately because my physical and mental health are so wildly different in their presentation – my physical health and fitness is probably on the “better” side for someone my age in my circumstances, and my mental health is certainly substantially worse).

So, I’d sit and take note of all the various bits of my body, usually picking up on various niggles caused by 50K training runs and the like, trying to work out whether the hip-strengthening work I was doing was easing the ITB (iliotibial band) issues I had for a brief spell, establishing whether my breathing was getting better with the new inhaler, that sort of thing. Mental wellness was, of course, more complex and involved trying to work out exactly where I was on the mania-depression scale, whether I was sleeping, eating properly, levels of anxiety and suicidal ideation and so on. But the exercise was helpful, because it enabled me to decide either to alter my training schedule or do more targeted exercises (physical) or to turn down or cancel things to remove pressure (mental). I had, without knowing it, developed a very basic knowledge that I needed to conserve social and sensory spoons. The “checking in” process really helped with that, and was one of the positives that I drew from the mindfulness I learnt in an attempt to prevent me relapsing, once again, into severe depression.

And now I’m using the “checking in” technique over a longer timescale, and I observe that although my mood and functional abilities are still very wobbly, and still varying wildly from day to day, the good days are better than they were, and the number of really really bad days has lessened. Like the tiny glimmers I observed back in January, there are little fragments of a new life that are now starting to show themselves occasionally, little moments where I am interested in SOMETHING again, and feel that one day I might have the energy to rebuild life and actually make it a bit better, rather than just surviving day to day, and, sometimes, hour to hour. The person who wrote Tiny Glimmers would have looked at the person typing this now and seen a veritable superhero – out of the flat now twice a week on average, starting to think about the future because I’m starting to think that I might actually HAVE a future, and making very tentative plans for the new life.

I know that everybody’s circumstances are different, and that there are many external complicating factors (burnout, family circumstances, comorbid conditions, reactions from others, and so on) during the period following an autism diagnosis. And I know that what I write here also varies wildly as my mood fluctuates and as I try to come to terms with the past and plan for the future. I’ve read accounts and heard from other people that it will be a year or so before things are likely to improve significantly, as my autistic brain is using a massive amount of processing power just to adjust to my new identity and therefore I have less energy for other things. However, using the best powers of logical analysis that I can summon, and viewing the evidence in my own life and in past posts of this blog, I can say that things are a little better now than they were a few months ago. It’s not dramatic – it isn’t “Hey, here’s an autism diagnosis – problems all solved” (and, to be honest, if it was like that then I’d be a little concerned because it’s so unrealistic), but it has made a noticeable difference to my life in a generally positive way. It’s slight, and it’s an upward trend rather than a continuous ascent (there are still a lot of sad and angry bits to work through), but it is, nonetheless, an improvement.

Letting Go

Apologies for yet another of these “journal type” posts. I had hoped that this blog would be just a little bit more balanced than it has been recently, and I’d still like to explore particular aspects of autism and create something a bit more useful, but, as I said right at the start, it is also, for me, part of the process of dealing with life and of trying to work out where to go from here!

I have spent the last few days feeling utterly shattered. This is partly because I managed to leave the flat a bit more than usual at the end of last week, and partly because I am starting to absorb everything that has happened over the last few weeks and preceding few months. Furthermore, it has become obvious that trying to struggle through learning advanced mathematics and completing assignments and sitting an exam in a few months time is totally and utterly beyond me right now. No matter how much I “put my mind to it”, it just isn’t happening. There are some times in life where no amount of effort will make something possible, and this is one of them. I had the same experience when I abandoned my DPhil 20 years ago – I wanted it so much, I wanted desperately to complete it, but sometimes, no matter how hard you search, there isn’t any more energy there. At that point there is nothing to do but accept that you need to stop, to give up, and to recover as best you can and make a new plan.

The process of acceptance is something I’m finding a bit odd, and also rather confusing. On the one hand I feel a huge relief that I can stop, breathe, and take some of the pressure off myself, but on the other, I feel somewhat bereft and directionless and a bit lost and I’m wondering what I’m supposed to do now.

The basic answer to that last question is, of course, obvious. I have plenty of things that still need doing – there is laundry and admin and trying to remember to eat and take care of myself. I also have lots of books and DVDs and so on that should keep me amused for a while. To many people this might sound like a great holiday, some sort of lovely blissful time – I now have permission to lie around in bed at home, watching the telly, reading anything I want, eating as much chocolate as I like, while just making the occasional list and chucking a load of laundry into the machine from time to time.

Except that this isn’t a holiday. It isn’t a break from the tough stuff – it IS the tough stuff. It has now taken me over a week to get enough brain cells together to even think about making a list. I am struggling to eat anything at all during the day as it just makes me feel sick and I’m having to force myself to nibble small quantities of high calorie food just to maintain my weight. I can’t concentrate to read most days, and I often find the light and sound from the TV terribly overstimulating. Strangely, the laundry is probably the best bit of the whole lot, though the noise from the washing machine sometimes makes me want to beat my head against the wall!

The above paragraph makes it obvious that I’m still very much recovering from burnout, and explains why I’m so unable to do more than leave the flat from time to time and the very occasional thing. And, on one level, it does give me a set of goals to aim for – eating proper meals, reading a few pages of a book, sorting out the random papers on my desk. On a small scale I have goals.

But the larger scale is more problematic. And this is where the dichotomy between feeling relieved and feeling lost is pertinent.

Getting my autism diagnosis is a huge relief. Learning that the struggles I’ve experienced all my life are the result of my brain working differently from the majority of brains is hugely enlightening, liberating, and exonerating. I know now that I was never able to fit into the world in the way that most people can because I was different from the start and I always will be. I’ve always known I wasn’t like most other people, but never really thought much of it because it was the way the world was for me, but I continually failed at things in a way that shouldn’t have been the case given how much I was working for them. Acknowledging that difference is really really helpful – in the same way that when we were discovering we were unable to have children one of the most helpful things I read was a paragraph in a book that explained that one of the difficulties of being childless is that it immediately marks you out as “different” in society because so many people do have families (and spend a great deal of time talking about them) that you will inevitably be an outsider on many occasions. That paragraph made me realise something I hadn’t hitherto realised – I was already different (I knew that much before autism was even considered) and my failure to produce a family made me even more different, even more of an outsider in society.

Acknowledging that feeling of “otherness” was really important to me then, as it is now. I have changed from being “wrong normal” to “right different”, which is good, because it means I can finally relax (as much as that’ll ever be possible for me), be myself, and set myself more realistic targets that allow me enough time for rest and recuperation in between and take into account how much just being out in the world exhausts me and drains my energy.

Finally, breathe. Stop. The battle is over. I can pause. Phew.

But what now?

And here is where the lost feeling comes in. Because the problem with not discovering you’re autistic until you’re 45, and with having achieved good exam results at school, and with having spent your entire life striving for “success” of some description is that without that ambition and those goals and those life plans, you feel somewhat cast adrift – I’m free, yes, from the expectations that I will now ever “get better” and be a high-flying something or other, but I’m also, now, somewhat directionless – floating around in an ocean and I don’t know which way to swim. The training I received in my youth was all based on me getting a good career, living a “normal” successful life. All my assumptions about my life included a full-time job, a family, and a house – that was the life I was prepared for. I never learnt about the benefits system, or what to do if you can’t work, or how to relax, or how to ask for help and support – none of those things was on my radar. I’m having to learn them pretty much from the beginning, in my 40s. This is a big ask – a complete rethink on my life philosophy. I’m also going to have to work out what I can actually do with my life that will take me beyond simply staring at the TV all day every day, because, even with my changed reality, I hope to be able to do a little more than that at some point.

So I look around and try to ascertain what others do with their lives. How do people who have neither a job nor family fill their days? What is life then for?

It seems like a wonderful opportunity – I’m sure there are people tied to jobs and families who would love to spend time travelling or pursuing hobbies or whatever, but I’m not only decidedly short on finances for travelling and so on, but just being out in the world with people exhausts me so much that any hobby would need to be mainly solitary and done at home. I’m not really looking for answers here, just pondering, and I know in my brain that I need to wait until I’ve recovered further from burnout before I can start to see what level of functionality I actually have and what I’ll ultimately be able to do.

So, I am liberated, free from the need to “perform” any more, free from the need to act the confident high-powered strong woman who I pretended to be for so long. But I am also cast adrift, directionless, like a balloon released and left to its fate, and I believe that I just have to go with both of these things for the time being. The old “rules” are gone. My life has been redefined. And there is no point fighting it, no point trying to cling on to “the way things were before”, because no matter how much I wanted that life to work, it didn’t, and the only way to move forward is to let go, relinquish control, and trust that some way forward will eventually emerge.

The Background

02-2016-12-08-13-47-41At the beginning of August 2016 I was living a normal life. Maybe not “normal” in the sense that many would call normal, but normal for me. I’d just turned 45, my husband and I were about to celebrate our 14th wedding anniversary, and we’d still failed to unpack or sort the chaos in our small flat following a rushed move a couple of years earlier. I spent my days studying when I could, playing music, running, being with our animals, and forgetting to eat lunch. All as usual.

I had, however, started to feel unwell again during the previous year. I’ve struggled with my mental health for decades, and was diagnosed first with anxiety and depression, then later with bipolar disorder. But I’d been reasonably stable since around 2013, had started to play the viola in orchestras again, and had generally spent much more time out in the world, reconnecting with friends, trying to rebuild my life, in the hope that I might one day be able to work again and be back to some sort of genuine “normal”.

But my health had started to decline. I’d had to drop a concert and several chamber music sessions, withdraw from my Open University study yet again, pull out of some races I’d planned to run, and by July I’d been back to my GP and picked up a prescription for the medication I’d successfully come off in 2013. It seemed obvious that I was headed for another breakdown, another episode of depression.

However, looking back now, there were things that didn’t tally with the descent into breakdown. For many years, I assiduously kept a mood diary. Just a simple cross in a box each day, to indicate an elated or depressed mood. My mood was still reasonably stable. A little under, but nothing that would indicate a severe mood shift. On the same chart I had a box into which I’d write a “score” for anxiety each day. The anxiety measurement was consistently high, and rising. That anxiety perhaps explained why I spent so much time feeling sick, why I would suddenly panic and shake for no apparent reason. I needed to calm myself somehow.

I was also perpetually exhausted. Going out to rehearsals sapped my energy and left me worn out and needing to sleep for days. I couldn’t drag myself out of bed much before ten or eleven, even on the best mornings. I’d go shopping to the supermarket and buy a small trolley load of groceries then come home and need to sleep for a couple of hours before I could put them away. That would then be me finished for the day. Going out for lunch or dinner would entail a two day recovery period. I’d had times like this before, but things were getting noticeably worse – no matter how well I ate, or how much mindfulness I practised, or what CBT tools I used, I was bone-numbingly exhausted whenever I went out.

A few people suggested chronic fatigue syndrome, but I knew that wasn’t right. I was still running, and once I’d recovered from the exhaustion I could easily do a 50K training run. Although I was really struggling at races – at the Brighton Marathon expo I’d had to take my husband with me to collect my bib as I’d been hardly able to speak to tell them my name. When other runners chatted to me during marathons I felt my legs get weaker. I got to an aid station only 30K into an ultra (no distance for me) and was unable to get a cup of tea because I had a huge panic. I sat by the side of the trail, shaking and in tears, before eventually pulling out of the race, assuming I had the flu because I felt so ill.

But the summer was approaching. I knew things would be quieter and I’d be able to catch up on sleep and get some rest. I could also pause my training schedule, chill out a bit, and I’d planned to spend much of the summer playing orchestral and chamber music and catching up with friends. I knew it would be busy and I’d be camping, but I also knew it was something I enjoyed. I’d even bought a new tent!

And so I set off with my tent, but without any idea of what was going to happen. I didn’t know then that I was only days away from something that would start to trigger a chain of events that would change my life for ever. Neither was I aware that the next few weeks and months would be an emotional rollercoaster like nothing I’d ever experienced before, and that the biggest discovery of my life was about to occur.

Unable to Wait

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This wasn’t the original first post for this blog. I wrote another one, over a month ago, which was to have been posted after things were “properly sorted” and I had the confidence of a piece of paper to enable me to tell my story to the world.

However, “proper sorting” is taking too long. I was told that things would be sorted last week – they were not (more on that in the future) and the effect on me was so catastrophic that I became suicidal and spent 48 hours living one hour at a time, waking in the night screaming, constantly tearful, and hanging on hour by hour, minute by minute.

I’ve never been good at concealing things. I can keep other people’s secrets totally reliably, but all my natural instincts are to be open, straightforward, and plain-speaking about my own life. I have written candidly about my mental health in the past, and for me that is much much easier than concealing the difficulties I’ve experienced. This new facet of my life will be no different. After last week’s disaster I finally started to feel that life was maybe worth living again when I decided that I would proceed with the original plan (slightly modified) with or without the piece of paper. I also now know that getting that piece of paper might be difficult, and a battle, an uphill struggle – the person I saw last week told me that “intelligent women were a problem” and that I was “very complicated”. I became so distressed during the appointment that I ended up self-injuring. My husband and I will continue to fight on, but my new life and way of living has already started and I need to be open about it now because concealing it is destroying me from the inside.

I don’t expect most people reading this will grasp the full enormity of what has happened to me since the summer. I do know that other people have been through the same thing and will fully understand. Some who’ve known me a while and have a little knowledge of their own might not be surprised. Maybe some won’t believe me at all (hence part of the desire for the piece of paper). Some might not have the faintest clue what I’m even going on about and will reach for Google to try to make sense of it all. Or perhaps think I’m even more crackers than I always have been and will wander off for a cup of tea, scratching their heads as they go!!!

However, for me, this is huge. The biggest thing that has ever happened to me. No question. It dwarfs getting married, getting my degree, burying my relatives, even discovering I can’t have children (I’m not talking here about whether things are good or bad, just about their magnitude in my life). This is the biggest. Is it good or bad? The answer at the moment is probably both, to some degree, although the question is much more complicated than that – and a discussion for a future post. In general, though, I believe this new knowledge will transform my life – it already has in many ways.

It has caused me massive swings of emotion over the last few months, from deep depression to relief and excitement, from severe anxiety to calm beautiful acceptance, and has meant that I’ve had vast amounts of new information to process and absorb. It’s still taking lots of energy. I’ve read over 20 books, hundreds of blog posts (one reason I’ve chosen to blog is that others might feel less alone by reading what I will write here), and lurked quietly on groups and pages on facebook, learning as much as I can. I’m probably still going to make mistakes with new language, recently learnt, and I expect I’ll look back on these early posts in a year or so and laugh at myself or cringe, but this blog is now part of the process too. Please forgive any errors while I’m still learning.

And as I am still learning, I’m not really in a position to start answering lots of questions yet – I still have more questions myself than I have answers, and my ability to respond to comments and questions might be somewhat limited for some time to come. My brain is still massively overloaded with new information and I absolutely need to learn everything at my pace, doing my own research, in my own way. That is really really important to me. I have now reached the stage where I can present the initial research and give my paper to conference, but taking questions from the floor will have to wait a while.

I have entered a world that, paradoxically, is completely new but also absolutely familiar to me. I will tell you as much as I can about it all in the weeks to come, but I’m not going to say exactly what it is yet. Let me just say that it has blown my mind, changed my life, and made sense of almost everything. If you already know what it is or have guessed, then don’t reveal it yet in case there are those who like a story. I’ll tell you very soon, I promise – after I’ve given you just a little bit of background in the next post.

I am still very much me. The same me. Much of my life will return to a normal, maybe not that different from the old one, once I have fully recovered from the seismic effects that the discovery is currently having on my brain, but I am learning a new way to live. A gentler, more forgiving way. A way that I hope will make life a bit easier and more suitable for me, now that I finally know what I am dealing with.