COVID-19 emerged as a new frightening and dangerous respiratory virus with many deaths due to a lack of immunity and natural protection.
The deadly virus has had a devastating impact globally and taken an enormous toll on the lives of vulnerable individuals and communities. As with any natural or human-made disasters, a time comes for gradual containment, mitigation, rebuilding, healing of wounds, and revelation of deeper truths and knowledge to ensure a better and safer future.
“In this postmodern age we find ourselves enmeshed in civil wars, tribal prejudices that we thought we had outgrown long ago. We can dare to counter the spirit of hate and separation with the romantic view of connectedness”.The Art of Is: improvising a way of life by Stephen Nachmanovitch, pg 203
Many factors have been blamed as the growing and heated partisan divide in our country’s politics. It is essential to look at any underlying contributors to hatred and violence. One is the prevalent use of divisive rhetoric in public discourse that leads to conflict rather than peaceful coexistence and inclusiveness.
are common in our population and may contribute to unique advantages or disadvantages. There now is better recognition and awareness of autistic traits. Current scientific evidence supports that there is a predominant genetic origin of AST.
Autism Spectrum refers to the varied presentation of individuals that may have unique strengths but also challenges with difficulties in social skills, communication, motor coordination, repetitious movements or behaviors, and early-life developmental issues.
found in a valuable minority of our population. Individuals can similarly have exceptional potential and skills, but also have significant difficulty in such areas as social and cognitive functioning. When labels as “autistic traits” or “Autism Spectrum” are inappropriately used, there can be unfavorable inferences or consequences.
I had an older brother who lived the best productive life he could. He was disadvantaged from birth with genetic and developmental differences that distinguished him from others in his age group.
Instead of Autism Spectrum Disorder (ASD) or a person with Asperger’s syndrome, some have a preference to be seen as an “aspie” person or as one that has aspie traits. Looking at the diversity of features found in aspie individuals, some will only have a few and others will have many of the traits and characteristics. Often there is a preference for a positive name or identifier when a person has some unique differences. A name is preferred that brings forth a response from others that would focus on potential, meaningful affirmation, acceptance, and accommodations.
Will aspie be a positive identifier, an ennobling and uplifting expression, in our vocabulary, or will it end up in the wastebasket of other derogatory terms as nerds, egg heads, geeks, and other words that are demeaning?
In 2013, the American Psychiatric Association published the Diagnostic and Statistical Manual, Fifth Edition, known as the DSM-5, and intended this as a manual for the diagnosis of mental disorders. Before DSM-5, Asperger’s Syndrome was the diagnostic label. It referred to individuals with a qualitative impairment in social interaction and communication with repetitive and restricted behavior. Now in a positive way, this is sometimes referred to as “aspie traits’.
The new DSM-5 changed the diagnostic name to Autism Spectrum Disorder (ASD or referred to as high-functioning autism spectrum). The essential features in DSM-5 for ASD were: persistent defects in reciprocal social communication and social interaction, and restricted repetitive patterns of behavior, interests or activities.
The DSM-5 is a Diagnostic text and sourcebook for the clinician. It is an aid with the categorization of different mental health disorders. The level of the impairment and severity of illness are also represented.
Observed weaknesses, symptoms, and behaviors are categorized by diagnosis per the manual’s criteria. It helps qualify people for insurance coverage. It can be important in qualifying for services or programs as vocational rehabilitation. The DSM-5 can be a guide for research and population studies. It defines clusters of symptoms, traits, attributes, and clinical presentations. A condition once classified or named, in the DSM-5, is an aid to the clinician. A diagnosis can help in the selection of a matched research-validated treatment protocol.
Once diagnosed, the individual becomes a person with Autism Spectrum Disorder (ASD) – before DSM-5 this was known as Asperger’s Syndrome. The labels of illness – thought of value in medical research and treatment – can also be the basis of stigmatizing a group of people – as sick defective or impaired. The label can misplace the focus of the potential or strengths of an individual. Acceptance of their differences and advantages needs to be the emphasis.
The diagnostic criteria for ASD are also the defining characteristics of many people that have comparable traits, which do not want to be stigmatized or treated with arrogance by others. They reject the negative inference of being a diagnostic label, an illness, or a defective population.
Looking at the diversity of features found in aspie individuals, some will only have a few and others will have many of the traits and characteristics. The expression of a developmental or genetic trait can afford significant advantages without any associated impairments. Another side of the spectrum shows the expression of many developmental problems, autism spectrum impairments or disabilities.
To be assigned a diagnosis or a disease label can contribute to a “poor self-concept of being defective” vs. being a person to be respected and seen for potential as having unique talents and worthiness. An association with an illness or diagnosis can lead to discrimination from others. High functioning aspie individuals can still experience:
just as those diagnosed with ASD or Asperger’s Syndrome do. “They need to be informed and learn the secrets of typical social understanding and require help to negotiate through the social world that surrounds them. The challenge may be more comfortable for aspies than for those with Asperger’s Syndrome as a direct result of the people who surround them”.*
See Attwood paper “Aspie Criteria”*
Patients would have difficulties interacting with their peers or staff. If problems following the guidelines of the unit occurred, difficulties would ensue. The staff’s expectations were for each patient to behave and interact as expected. Individuals involved in conflicts did not take well to correction or admonishment. Incidences could escalate, from agitation to combative, aggressive, or destructive behavior. The staff could be reactive with more verbal or aggressive behaviors than needed.
When a careful history was taken on identified offenders, developmental issues or traits were found associated with high functioning autism spectrum, an Asperger’s profile, or a person with significant aspie traits. These characteristics would then be considered as an important influence on the conflicts that occurred between peers or with staff. Some of these individuals identified had other exacerbating problems as:
Other existing problems like – ADHD, obsessive-compulsive disorder, anxiety, and depression – can improve with behavioral or other treatments.
Positive characteristics can be strengths for success and contribution. Negative characteristics may contribute to rejection and discrimination. Several significant traits together can be problematic. Difficulties may occur in daily functioning, work, and related social activities.
Education and instruction to all participants involved can improve a conflict situation. A more positive therapeutic milieu can develop in the physical and social setting. The education would include a discussion about individuals and their differences.
Negative traits would be viewed in a constructive manner and not as a defect or a “pathology.” Aspie attributes have a positive potential to contribute to the group. Recognition of differences in social interactions, interpersonal communications, and behaviors is a start on the path toward acceptance, flexibility, tolerance, and non-discrimination.
In a medical setting, this could be with other staff members as well as with some patients. High achievers in any field can have successes because of their unique aspie attributes. The same people, however, may appear to others as having negative characteristics as being:
Resolution involves interventions such as team-development-work along with focused education about:
Consideration is to bring in a consultant who is knowledgeable about aspie individuals for training. If an individual of concern has aspie characteristics, but in addition, a history of other significant co-occurring problems as noted above – earlier life trauma for example – would be a candidate for focused therapy work in that area. Use of an executive-functioning-coach can be essential if executive functioning is a major difficulty.
With their talents and genius, they are able to do complex tasks as well as complete projects. They are able to complete tasks which other neurotypical people (those who do not have the aspie traits) either couldn’t do or have failed. Peoples’ differences are essential for the survival and success of a group or organization. It takes a team with diversity.
Talented people with unique traits make our society function. The person who can see the big picture can come up with novel strategic ideas and solutions to the problem. The person that can stay on task can bring a project to completion. They can get past small failures or distractions to get things done. An accepting and supportive culture stops discrimination with training and education where needed. These principles apply to couple’s relationship work as well. Acceptance and understanding of each partner’s strengths and weaknesses comes first. Then a successful relationship that operates in a complementary fashion can ensue.
You often find these characteristics in other family members. Early life experiences or environmental influence can affect these characteristics or traits as well. There is great diversity in presentation and features seen in the aspie population. Performance and levels of functionality will depend on each person’s pattern of development. Adaptation to a “neurotypical” population (the majority of the population that does not have the aspie traits) is a challenge where acceptance is lacking. Successes with societal participation, work, independence, and social integration comes with support and education.
High functioning aspie individuals can have difficulties or disabilities. The degree can depend on the presence of other co-occurring problems or debilitating conditions. There may be the need for significant support, specialized programs, and sometimes medication.
Bob*is a highly-paid staff in resource development at a high-tech software company. He had difficulty finding and keeping a job. At age 38 he discovered that he had an aspie profile. Bob was intelligent and had admirable skills – especially in the tech areas. He related well to others that had similar interests. He lacked executive skills, as in organization and time management. It would take him forever to complete any of – what he deemed – important projects. He would misplace important papers and be easily distracted. His self-esteem was low. He had experienced rejection and discrimination at prior jobs and during his school years.
Bob found an employment advisor who worked with aspie clients. First, there was a referral to an executive-functions-coach, who helped him plan his time. Time blocks were set up to help him organize his work schedule, allowing him to get all his priorities accomplished. He learned how to avoid procrastination, and how to break large tasks down into doable chunks. He became better at prioritizing, starting a task, focusing and finishing. He began to use a planner to organize things. With his employment advisor, he worked on presentation and interview skills.
He chose companies where his unique skills and aspies were accepted and valued. His current company was a good fit, and he thrived there. He made some friends in his new organization. These new friends shared some of his interests and even some of his “aspie” traits.
*To protect confidentiality, the above is a composite of some clinical experiences and does not represent an actual person or any prior patients.
Their strengths need appreciation and support. Recognition and encouragement are needed throughout childhood, in school, organizations, and the community. They can be the person that comes out with a money-making product that saves an industry. They could be the general that wins the war. They could be a surgeon and master mechanic that can fix things and save lives.
An aspie individual may need support and guidance from their employer. Job expectations should be clear. Help with interpersonal skills to aid effective and cooperative teamwork is important. Help with organizational skills, time management, and priority setting is also valuable. Successful employment or career opportunities offers the many potential benefits – an increase of income, improvement of self-esteem, offering a place to apply talents and abilities, and provide a setting to develop a positive social network. Help is available from resources as the Job Assistance Network (JAN) that offers help with work accommodations or Vocational Rehabilitation Services – see resources below.
Whatever the name, label or diagnosis one chooses – or with which one best identifies in their search for meaning, help or support, whether Autistic Spectrum, High Functioning Autism spectrum, Asperger’s Syndrome, or Aspie – is fine and supported by me. In this article, I wanted to explore and to get a better understanding of the different names and classifications. My intent was not to offend anyone or to undermine any individual’s beliefs regarding their learning and struggles to either comprehend or understand this complex area. This article was a little Aspie lengthy and Aspie loaded with some of my bias, but it is all about sending some love and support to all that want to know more about this
topic, for those who have been confused about some of the terms and labels used, or for those who have personally struggled with some of these issues.
The Asperger / Autism Network (AANE) A positive presentation and understanding of Asperger’s are available in several articles written by staff on the ANNE website – which works with individuals, families, and professionals to “help people with Asperger Syndrome and similar autism spectrum profiles build meaningfully connected lives.”
Following is a quote from the ANNE website with a link on “Neurodiversity”:
“Diagnostic labels, by nature, define disorders and tend to ignore the strengths, gifts, and adaptive benefits of the individuals diagnosed. In contrast to this, the Asperger constellation of traits has more recently been described as the product of natural variations in human neurology that lead to differences in individual experiences, sensitivities, and perceptions.
It is not necessarily a neurological “dysfunction”; rather, it is evidence of “differently” functioning neurology. “Neurodiversity advocates propose that instead of viewing this gift as an error of nature . . . society should regard it as a valuable part of humanity’s genetic legacy while ameliorating the aspects of autism that can be profoundly disabling without adequate forms of support” (Silberman, p. 470*). Just as the natural world thrives through a web of diversity, offering up a range of valuable interconnected attributes, so does humanity”. http://www.aane.org/neurodiversity/
“The Complete Guide to Asperger’s Syndrome” by Tony Attwood an excellent resource and review
Been There. Done That. Try This!: An Aspie’s Guide to Life on Earth
“Aspie Criteria” – A helpful article by Attwood.
“NeuroTribes – The Legacy of Autism and the Future of Neurodiversity” by Steve Silberman – important book, excellent read, and resource for an in-depth history, present and future overview of the Autism Spectrum and Asperger’s, written by a very talented journalist and a New York Times bestseller.
What is Asperger’s Syndrome? – article by Atwood
“Asperger’s from the Inside Out“ by John Carley – a helpful book, for Asperger adults.
GRASP – Global and Regional Asperger Syndrome Partnership – a good resource – an organization run by people with Asperger’s and Autism Spectrum Disorders, to help their peers with programming to increase the independence of Autistics and individuals with Autism Spectrum Disorders. They have established workshops, social events, and groups, and helped increase the visibility of ASD adults within society with emphasis on Community-Based Outreach and Individual Self-Advocacy – advocating for Individuals on the Spectrum.
Autismspeaks.org – Another source of information on recognition and understanding Asperger’s.
Take an online Asperger’s screening test, as the AQ test, if interested at any of site linked below:
Article by Ron Parks, MD and edited by Shan Parks
How does “aspie” traits related to you, your family, or your work? Comment below.
Peace of mind and personal happiness may elude sufferers who deal with significant anxiety or panic attacks. You may discover that you are one of the many who find these issues replacing life plans, career, social and personal needs with pain and fear. Then you watch a TV commercial, hear a radio advertisement or read ads offering products, pills and all types of remedies for relief. Amidst all this, how do you sensibly choose the best way to get help or relief?
Barbara* a 30-year-old radiology technician, walking to her bus stop after work, was startled by an unexpected, overwhelming feeling of terror and panic. She felt flushed, lightheaded and dizzy. There was a weird sensation of chest constriction and difficulty breathing. Her heart raced and pounded in her chest. Thoughts of dying, losing control, or of going crazy flashed through her mind. With each wave of fear, her heart began to pound even louder. Her hands now felt sweaty, numb and tingling. There was a sense of unreality about things. A friend, noticing her distress, approached, and helped her to a bench near the bus stop. Over the next 5 to 10 minutes the feelings gradually subsided. Feeling some relief, but still shaky, her friend helped her to the nearby hospital emergency room. *(To protect confidentiality, the above is a composite of some clinical experiences and does not represent an actual person or any prior patients).
Unlike the brief and mild anxiety caused by a stressful event, the more severe anxiety disorders are serious medical illnesses. These affect approximately 40 million adults, 18% of the population, age 18 years and older — one in four adults in the U.S., at least once during their lifetime. Anxiety disorders cost the U.S. more than $42 billion a year, about one-third of the country’s $148 billion mental health budget. An estimated 75% of people with an anxiety disorder have at least one other accompanying psychiatric condition. See: http://www.adaa.org/about-adaa/press-room/facts-statistics
These disorders cause overwhelming, even debilitating, anxiety and fear that can become worse if not treated. Less than 30% of individual with these problems seek treatment, and many go undiagnosed by their primary care physicians. Common signs and symptoms of anxiety include muscle tension, trembling, fast heartbeat, fast or troubled breathing, dizziness or impaired concentration, palpitations, sweating, fatigue, irritability, and sleep disturbances.
Panic disorder, a type of severe anxiety, is estimated to affect over two million adult Americans, and is twice as common in women then in men. The lifetime prevalence of panic disorder in the U.S. ranges from 1.5% to 3.5%. Symptoms of a panic attack include feelings of terror that suddenly strikes. An episode can occur as a one-time event only or can repeatedly happen, triggered by something remembered or appear without warning — out of the blue. Panic can cause waking at night; a pounding or racing heart; sweaty, nausea, numbness, tingling, weakness, faint or dizzy feeling. There can also be a sense of unreality; chest pain; fear of impending doom, of going crazy, of losing control; and avoidance of going to certain places. See: Advances in the Treatment of Anxiety Disorders
As many as 20% of American’s are affected at least once in their lifetime. Considered one of the most distressing conditions that a person can experience, early recognition and proper treatment are important. Many of the symptoms reported by Barbara above are typical of panic attacks and are considered to be major health problem in the U.S..
Panic is different from fear and other types of anxiety – as panic attacks are unexpected. They are often unprovoked, appear suddenly and increase in intensity over a 5 to 10 minute period, peaks and then rapidly goes away over 20-30 minute period. These episodes can be disabling. One explanation for the cause of the panic disorder is the bodies normal alarm system of mental and physical responses to an actual threat, which triggers and activates to a non-actual threat. Panic increases in severity by hyperventilation or focusing on catastrophic thoughts or fears.
Panic disorder – as in most types of anxiety – affects women more than men, often begins in the 20’s and 30’s, and appears to be more common in some families. Sometimes an initial episode might be related to some identified causal or contributing factors:
If the panic attack occurs in a specific setting, as in a store or car, irrational fears or phobias about these situations, may occur. If a person begins to avoid these situations, he (or she) can become increasingly housebound, unable to drive and develop agoraphobia (fear of public place) in addition to the panic attacks. If the person doesn’t receive effective early treatment, major incapacitation may develop.
Panic disorder mimics many other medical conditions, and it is not unusual for the sufferer to be seen by a multitude of other medical or health-related services before receiving appropriate treatment. They will often go through extensive testing at great cost. The reassurance that “nothing is wrong that’s serious,” or “it’s all in your head,” doesn’t help. Medical personnel – not familiar with the potential ravaging effect and disability caused by the illness – often treat panic disorder lightly. Treatment of panic is often done with a mild tranquilizer or just reassurance. Dr. Weissman and Associates on November 2, 1989, New England Journal of Medicine, clearly point out the need for concern. Compared with other psychiatric condition, untreated panic disorder has an increased risk of suicidal ideation. There is an almost three-fold increase in actual suicide attempts, independent of coexistence of major depression, alcohol or drug abuse or agoraphobia.
Recovery starts with the person deciding to seek help, treatment and a more life-affirming path. Hindrances that may need attention early on could include:
Change happens with:
Through an integrative approach, individuals can gain direction, move past the immobilization of misinformation and erroneous beliefs, and find possible solutions for their adverse health conditions.
Click here for more information; Another Resource to read;
For support: Anxiety and Depression Association of America, ADAA
Article by Ron Parks, MD and edited by Shan Parks September 2015
What is your next step to help yourself or others that seemed troubled with anxiety or panic? See next post — “Best Treatment of Panic and Anxiety?”
Marge* had gone to an ADHD specialist as she was losing her business and marriage. She couldn’t focus or attend to things and felt very scattered. She took a stimulant medication but developed disabling anxiety, panic and depression with suicidal thoughts. She switched her care to a more attentive holistic practitioner. Their work together revealed recent significant trauma. Six months before the onset of her problems, she was assaulted after leaving her place of business. Soon after, she developed severe problems with attention, focus and symptoms of post-traumatic stress syndrome (PTSD). Also, it was found that she had a severe iron deficiency anemia and early signs of thyroid disease. She stopped her stimulant medication, started a PTSD therapy program and started treatment for her other medical issues. Her symptoms rapidly responded to treatment, and now her attention and focus are back to normal. Her business and marriage are now again successful.
* (To protect confidentiality, the above is a composite of many clinical experiences and does not represent an actual person or any prior patients.)
Having attention/focus problems (AFP) and ADHD difficulties can be problematic when an individual finds himself (or herself — gender assumed) in an adverse work or life situation. Examples would be: not being able to relate to others effectively, unable to get work done or meet the demands for performance and productivity. Ill health can develop from being chronically overextended, not getting adequate sleep or from continued stress from the AFP.
There is often discrimination against people with AFP and ADHD in work, academic and social situations; however, attention problems in all forms are common in our population. ADHD, when diagnosed, allows for a workplace or school accommodations under ADA laws (American Disability Act). Many with attention/focus (including ADHD) problems, if minor, would not be considered significantly impaired or disabled, even though they might struggle to remain focused or attentive at times . When in a positive fit with their life situation and operating within their capacity, many with AFP are some of our most creative, talented and productive citizens.
There are many conditions that can masquerade and significantly contribute to attention/focus problems or the actual condition of ADHD. Information gathering and a holistic consultation can be helpful, especially when there hasn’t been a good response to simple or conventional treatments.
A significant percentage of childhood and adolescent with AFP or ADHD will continue to have symptoms and problems into adulthood. The inattentive type of symptoms seem to be the most prevalent ones in adulthood – as difficulties with organizing, sustaining
attention, distraction, finishing tasks, procrastination, losing things, forgetfulness and making mistakes.
In adults with AFP and ADHD, symptoms as internal restlessness, substance abuse may be common. Less likely symptoms of hyperactivity, difficulties with decision making and poor impulse control could also, though less likely, be present. In Childhood and Adolescent, one would more likely see difficulties with fidgeting, feeling settled, relaxing quietly, talking excessively, intruding into the conversation, blurting out answers, or running & climbing dangerously. See the following links for further information: ADDA, Adult ADD Univ. of Maryland questionnaire and Web MD.
Contributing factors often overlooked (important to find before considering medication) include:
It is recommended that if any if these approaches are considered that they be done under the careful supervision of a qualified holistic health-care practitioner.
For more information and references on AFP and ADHD click here. To learn more about assessment and treatment approaches offered by Integrative psychiatry, medicine and holistic therapy practitioner. Further reading re: ADD Resources – ADD R. Recent review available for purchase: ADHD IN CHILDREN AND ADULTS, Audio-Digest Psychiatry, Volume 44, Issue 16, August 21, 2015, Managing ADHD in Preschoolers – Robert R. Althoff, MD, PhD, Adult ADHD – James Margolis, MD.
Article by Ron Parks, MD and edited by Shan Parks August 2015
What is your next step, if you or your family is affected by AFP and ADHD?
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