April 22, 2024 • 26 mins
Are my traits or symptoms related to autism? Or are they caused by trauma? This is one of the top questions asked by individuals going through the process of identifying their neurodivergent identity in adulthood.
Join me as we explore how autistic and trauma traits intertwine and differ, with a focus on familial mental health challenges and their impacts.
Get clarity on trauma, autism, and PTSD with insights from researchers and therapists working in the field. Gain a deeper understanding of attachment disorders like reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in children.
Watch this episode on YouTube.
If you'd like to know more about topics discussed in this episode, check out:
"Autism and Attachment Disorders — How Do We Tell the Difference?" by Claire Davidson et al.
"Parental Psychiatric Disorders and Autism Spectrum Disorders" by Elina Jokiranta et al.
"The Long-Term Impact of Parental Mental Health on Children’s Distress Trajectories in Adulthood" by Christina Kamis
"Exploring Potential Sources of Childhood Trauma: A Qualitative Study With Autistic Adults and Caregivers" by Connor M. Kerns et al.
"Autism and Reactive Attachment/Disinhibited Social Engagement Disorders: Co-occurrence and Differentiation" by Susan Dickerson Mayes et al.
"Genetic Overlap Among Autism Spectrum Disorders and Other Neuropsychiatric Disorders" by Yoshiro Morimoto et al.
"PTSD and Autism" by Megan Anna Neff
"Family History of Mental and Neurological Disorders and Risk of Autism" by Sherlly Xie et al.
Theme music: "Everything Feels New" by Evgeny Bardyuzha.
All episodes written and produced by Kristen Hovet.
Send in your questions or thoughts via audio or video recording for a chance to be featured on the show! Email your audio or video clips to otherautism@gmail.com through WeTransfer.
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The views, opinions, and experiences shared by guests on this podcast are their own and do not necessarily reflect those of the host or production team. The content is intended for informational purposes only and should not be taken as medical or professional advice. Please consult with a qualified healthcare provider before making any decisions related to your health, fitness, or wellness.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Kristen Hovet (00:00):
Today I'm talking about trauma, attachment
disorders, and autism; how theyoverlap and how they differ; as
well as familial mental healthchallenges or the mental health
diagnoses that often run infamilies where there is autism.
I've touched on some of thesetopics before, but mainly as
parts of episodes on othertopics, so I wanted to do a
(00:23):
deeper dive this time around.
While you'll find a lot ofcontent about all of this on
YouTube, on podcasts, and inother locations online, there's
always new information comingout and always new ways of
synthesizing or putting theinformation together, so I
(00:43):
wanted to try my hand atcovering it.
Before we get into this topic,you'll probably notice I don't
have my Other Autism neon signbehind me.
I've packed it away.
I'm getting ready to move inJune and I've just started doing
a lot of packing beforehand inpreparation, because I know it's
going to be a really busy time.
(01:07):
Also, I'd like to remindeveryone that The Other Autism
now has a Patreon with bonuscontent for paid Patreon members
.
Bonus content currentlyincludes additional podcast mini
episodes, behind- the- scenesphotos and videos, and audio-
only reading episodes where I'mcurrently going through 20,000
Leagues Under the Sea, onechapter at a time.
Why am I reading thisapparently random book?
(01:31):
Well, these reading episodeshave been requested.
Specifically, I've hadlisteners ask for reading
episodes or meditation episodes,and since reading is more my
jam, I went with that option.
Also, several listeners reportcurrently going through burnout
and just wanted some easylistening.
I also thought it would be agreat opportunity to explore
(01:54):
some classics that I've neverread, that are part of the
public domain and therefore Ican use them without any
copyright issues.
Being a paid member of Patreonhelps fund this podcast and I
have hopes that eventually itwill be a thriving community of
The Other Autism listeners.
I know a lot of podcasts andother online content creators
(02:17):
have Patreon accounts andthey're always trying to get you
to join, so it can be annoying.
I totally get it, as a podcastconsumer myself, but it's one of
the main ways to fund the workwe do.
A huge, huge thank you to thosewho have already joined and I
really appreciate that you'rewilling to give it a try, and I
(02:38):
also appreciate those who sendin recommendations and ideas for
future Patreon member-onlycontent.
If you just can't be convincedto join Patreon, please consider
leaving a rating and or areview, if you haven't done so
already.
You can do that on ApplePodcasts, on Spotify, I think
(02:59):
allows you to just leave thestar rating as long as you've
listened to the podcast.
The other thing you could do isshare this podcast with those
who might find it interesting orhelpful and basically just keep
doing what you're doing.
I also want to try something new.
I'm putting out a call foranyone who wants to to send in a
question or a comment or reallyanything you want to tell other
(03:23):
listeners via audio recording.
This can be messages of support, it can be your diagnosis story
or parts of it, and you cansend your audio clips to kristen
dot hovet at gmail dot comthrough WeTransfer, which is a
website that is totally free touse.
Just record something on yourphone or your computer.
(03:46):
Go to wetransfer dot com that'sW-E-T-R-A-N-S-F-E-R dot com,
upload the file, enter my emailaddress, and send.
I can't promise that all audioclips will be used, but all will
be listened to and consideredfor airing on the show.
Feel free to share as much oras little about yourself as
(04:09):
you're comfortable with.
Okay, let's start with adefinition.
According to Connor M.
Kerns and his team, trauma isdefined as, quote, an event or
circumstance that is experiencedas physically or emotionally
harmful or life-threatening andhas lasting adverse effects on
functioning and well-being, endquote.
(04:29):
When it comes to discussions oftrauma and autism, autistic
people in this day and age willalmost certainly have
significant trauma and resultingmental health impacts.
We may even have formaldiagnoses of post-traumatic
stress disorder or PTSD, or wemay have been told by a
therapist or psychologist thatwe have complex PTSD or that we
(04:52):
have experienced complex trauma.
Basically when there's repeatedtrauma over and over and over
again, often from very early onin life, such that it presents a
bit differently than PTSD andhas a deeper and longer-term
impact on the person's entirepersonality and way of being.
The problem that manylate-diagnosed autistic people
(05:15):
have is figuring out if theirtraits are linked to this trauma
or to being autistic.
As I've said before in pastepisodes, if you are autistic,
your traits are almost certainlylinked to both autism and
trauma, especially as a late-diagnosed autistic individual,
because being late- diagnosedusually means you're also high-
(05:36):
masking, or at least you maskmore often than autistic
individuals who are identifiedas autistic earlier in life.
Being high- masking meansyou've suppressed core
attributes of yourself, bothconsciously and unconsciously,
as a way to fit in and beaccepted by others.
It means you've tamped downyour true self time and time
(05:58):
again because you don't feelsafe to be yourself and you are
made to feel shame aboutyourself and your traits.
But some still wonder ifthey're autistic at all.
Maybe all of their traits canbe explained by trauma, or so
their thinking goes.
(06:20):
This is when it helps to have apsychologist include others in
your assessment or diagnosisprocess, such as parents or
grandparents or aunts and uncles, who have known you since you
were a newborn or very young andwho are very perceptive and can
answer questions about traitsyou had before you experienced
trauma.
If this is just not possible,I'd advise looking into traits
and characteristics that areassociated with autism but not
(06:43):
with PTSD and vice versa.
According to Dr.
Megan Anna Neff, an autisticand ADHDer psychologist who runs
the website NeuroDivergentInsights, these autistic traits
include repetitive behaviors andself-soothing through use of
routines, difficulty reading orunderstanding neurotypical or
(07:06):
non-autistic social cues,sensory differences as core to
your human experience from asfar back as you can remember,
and the existence of specialinterests or very deep interests
that sort of also mark yourcore experience.
For those who are just learningabout these subjects, I think
it's important to briefly coversome of the overlapping traits
(07:28):
between PTSD and autism.
Again using Dr.
Neff's work, individuals whohave PTSD and autistic
individuals can share thefollowing overlapping traits or
characteristics (07:40):
Dissociation, difficulty with intimacy,
increased risk of beingvictimized by others, negative
beliefs about the self and theworld, difficulty managing
intense emotions, high rates ofsubstance abuse, depression,
self-harm and or suicidality,hypervigilance or fight or
(08:03):
flight response that's easilytriggered.
Difficulties controlling someimpulses, executive functioning
difficulties, sleep issues,stimming, and heightened
awareness or sensitivity tosensory input.
I will note that these traitsare temporary in those with PTSD
alone, whereas they exist inautistic individuals as core to
(08:25):
who they are, with no clearbeginning and no clear end.
Actually, the traits never endreally, unless the person has
been forced to try to tamp themdown or hide them.
It's also important to notethat not everyone with PTSD and
not everyone who's autisticexperiences all of these.
They may experience just a few.
(08:45):
Traits that specifically pointto PTSD and not autism include
clear evidence of the presenceof a traumatic event or several
events, avoidant behaviors,intrusive memories and
flashbacks that a person cannotcontrol, and the presence of
nightmares.
There are probably more, butthose are the top ones, again
(09:06):
using Dr.
Neff's work.
Hopefully that's given you abit of clarity between PTSD and
autism.
But what about attachmentdisorders?
It's important to start bysaying attachment disorders are
not the same as attachmentstyles.
Discussions about attachmentstyles, which include secure,
anxious, avoidant, anddisorganized, have really taken
(09:28):
off lately.
But it's important to keep inmind that, while certain
attachment styles likely overlapwith attachment disorders,
attachment disorders arepsychiatric diagnoses
specifically in children.
Attachment disorders includereactive attachment disorder, or
(09:50):
RAD, and disinhibited socialengagement disorder, or DSED,
but these are only present inchildren and both are associated
with clear evidence of abuse,neglect, or other extremely
insufficient or unstable care,according to Claire Davidson and
her team in an article titledAutism and Attachment Disorders,
How Do We Tell The Difference?
(10:10):
Signs and symptoms of bothreactive attachment disorder and
disinhibited social engagementdisorder tend to dissipate or go
away when the child enters asupportive, nurturing
environment and or as they getolder, which obviously is not
the case with autism.
According to Davidson and herteam, both reactive attachment
disorder and disinhibited socialengagement disorder are marked
(10:34):
by a failure to develop socialrelationships that match what is
expected of a child at theirage and developmental level.
Reactive attachment disorder,or RAD, is characterized by a,
quote, failure to seek andaccept comfort and associated
dysregulation in emotions andsocial relationships, end quote.
(10:56):
A child with RAD shows very fewor almost no displays of
positive emotion and severalepisodes of extreme negative
emotion.
They show very little social oremotional responses to others
and they don't seek comfort fromothers.
These are very sad, verydisengaged little children.
(11:26):
Disinhibited social engagementdisorder or DSED, while it can
be diagnosed in the same child,is characterized by, quote,
socially indiscriminatebehaviors and failure to respect
social boundaries, end quote.
A child with DSED basicallydoesn't have any sense of
stranger danger or cautionaround new people.
They will go to anyone toapparently seek comfort, whereas
(11:47):
a child without DSED will showclear preference for primary
caregivers such as parents.
A child with healthy attachmentseeks affection and comfort
from their primary caregiversand will be wary and shy of
strangers or new people.
So according to what I read, achild can have both of these
(12:07):
attachment disorders and theycan kind of move between the
sets of kind of symptoms orcharacteristics.
So they can go from being very,very isolated, very, very
detached to then being kind oflike all over everyone
(12:27):
indiscriminately and not havingpreference for any particular
caregiver or person.
It's kind of odd to see.
I think I've seen kids who havethese traits and i t's kind of
alarming because you don'texpect it.
Like the typical behavior for ayoung child is to be, you know,
very wary and they'll likecling to their parents, and
(12:51):
they'll not want to go to newpeople and they'll have a clear
bond with their parents.
Like that's kind of typicallywhat we see.
I have to say that when I wasreading about these two
attachment disorders, I alsokept thinking that kids with
attachment disorders areprobably more likely to grow up
to develop personality disorders.
I did a quick Google search andapparently this does seem to be
(13:13):
a thing.
Interesting.
I had to force myself to not gointo that further, but I just
wanted to note that.
So, while both RAD and DSED arecaused by abuse and neglect,
there's no evidence that autismis caused by abuse or neglect.
In fact, autism is highlyheritable and in most content I
(13:34):
read these days is treated as agenetic difference or inherited
neurotype.
It is possible for an autisticchild to also be diagnosed with
an attachment disorder like RADor DSED, but typically what
happens as a child gets older isthat they'll lose their RAD and
or DSED traits yet maintaintheir autistic ones.
(13:58):
While autism and attachmentdisorders are not causally
linked,as far as we know, autistic
children may be more likely todevelop attachment disorders
than neurotypical children, butmore about that later.
While autistic children are ata greater risk of experiencing
abuse and neglect while growingup, secure attachment between
(14:19):
autistic children and theirparents is actually super common
, whether the parents areautistic themselves or
neurotypical.
Davidson and her team statethat while the majority of
autistic children have excellentrelationships with their
families, there is a significantsubset of autistic individuals
whose families appear to exhibita wide array of heritable
(14:41):
neurodevelopmental conditionsand or mental health challenges
running through them, throughthe generations.
It may be that, quote, abuseand neglect are more likely to
arise when an already strugglingfamily, in which the parent or
parents may also haveneurodevelopmental problems, has
a child whose complexneurodevelopmental symptoms make
(15:03):
parenting challenging, endquote.
So what are theseneurodevelopmental and I'll add
mental health conditions thatcould be impacting these
families?
In addition to autism itself,which we know to run in families
because of its super highheritability, other conditions
seen in these families includeattention deficit- hyperactivity
(15:24):
disorder or ADHD, schizophreniaspectrum disorders (such as
schizoaffective disorder anddelusional disorder), obsessive
compulsive disorder, affectivedisorders (such as major
depressive disorder and bipolardisorder), anxiety disorders
(such as generalized anxietydisorder, panic disorder, social
(15:46):
anxiety disorder, and phobias),personality disorders, eating
disorders, substance usedisorders, and childhood
disorders (such as oppositionaldefiant disorder and conduct
disorder).
So, of course, these differentconditions appear in a lot of
different families, regardlessof whether there's autism in
(16:10):
those families.
However, the research showsthat these conditions tend to
happen more often in familiesthat already have neurodiversity
, that already have autism andADHD.
There seems to be some type ofgenetic overlap and, with a lot
of these conditions, they areactually identifying some of
(16:36):
those genes, which is reallyinteresting, and I think in the
years to come we'll see more andmore of these genes being
identified.
We know from the research andclinical accounts that having
mental health challenges infamilies impacts children's
health and well-being, whetherthat child's autistic or
neurotypical.
Increased psychopathology inparents, according to the
researcher Christina Kamis, isassociated with poorer parental
(17:00):
functioning or abilities,greater conflict with their
children, more overalldysfunction in the home, and
more severe discipline.
So I want to state thesefindings in really clear
language (17:11):
Parents with mental illness or psychiatric
conditions tend to be lesssuccessful at parenting or have
more struggles with parenting,have more fighting or negative
interactions with theirchildren, their children have
more behavioral andpsychological problems of their
own, and these parents are moreinclined to punish their
(17:34):
children in harsher wayscompared to parents without
these conditions.
These negative experiences canbe very traumatic for the
children and lead to pooroverall life outcomes,
regardless of the neurotype ofthe child.
I want to add here that Isuspect these parents are also
less likely to have adequatesupport, especially in the case
(17:57):
where they're not properlydiagnosed or not receiving
appropriate and adequatetreatments.
But back to trauma.
So for autistic individuals,trauma of any kind tends to hit
us harder than it hitsnon-autistic individuals.
In other words, autistic peopleare more hurt by or more
negatively impacted by traumaacross their entire life course,
(18:20):
for a variety of reasons, andtherefore they're also more
likely to develop trauma-relateddisorders like PTSD and
attachment disorders.
So first of all, let's talkabout some traumas that are
unique to autistic individuals,starting in childhood and
sometimes occurring frequentlyor repeatedly across the life
(18:42):
course.
Autistic individuals, accordingto Connor M.
Kerns and his team, are morelikely to experience being
trapped or entrapment, socialexclusion, and traumatic
incongruities, defined asincongruities or severe
mismatches between sensory,social, and executive processing
(19:02):
styles of the autistic personand their external and social
environments.
Let's break these down furtherbecause I think just listing it
like that doesn't tell the wholestory.
So trauma related to beingtrapped or entrapment includes
trauma resulting from, quote,feeling physically and
(19:24):
psychologically restricted and,at a meta-level, socially
stymied, prevented by societyfrom being able to pursue a full
life, end quote.
These types of entrapmentsinclude literal physical
restraint or sedation andgenerally various types of
physical and medical restraintor control.
It includes loss of autonomy,far more scrutiny than that
(19:48):
experienced by neurotypicalpeers, restrictive learning
environments, loss of theability to make decisions about
one's life, segregatedschooling, and so on, as well
as, quote, a dearth ofemployment opportunities or
appropriate education,vocational training, housing,
and other social services forautistic individuals,
(20:10):
particularly those withoutintellectual disabilities, end
quote.
Trauma related to socialexclusion includes trauma
resulting from bullying, beingkept apart from others or
feeling a lack of socialbelonging, teasing, intimidation
, isolation, differentialtreatment, subtle and ongoing
(20:32):
exclusions, which I think somehave called microaggressions,
repeated discrimination andminority stress, not being
believed regarding experiencesof maltreatment or
discrimination, lack of supportor protection from family or
peers, and betrayal in romanticrelationships, which can be,
quote, particularly devastatinggiven their difficulties
(20:55):
connecting with others ingeneral, end quote.
Importantly under this categoryof social exclusion traumas,
caregivers and parents of Blackautistic children reported
concern about their childrenbeing dually targeted by
authority figures for both theirrace and autistic traits.
And, finally, trauma related totraumatic incongruities include
trauma resulting fromparticularly painful sensory
experiences, such as somemedical appointments, fire
(21:16):
alarms, and so on, that causeintense distress, physical pain,
or severe anxiety; transitionsor changes that lead to the
person experiencingunpredictability in day-to-day
(21:36):
life; and chronic socialconfusion, including the, quote,
reduced ability to understandand predict others' intentions
and actions, end quote.
And I'd note that others hererefers to mainly neurotypicals
and their intentions and actions.
It's typically harder for us toread neurotypicals.
(21:57):
We can actually read each otherquite well.
Interestingly, this category oftrauma also includes repeated
experiences of lack ofdirectness and honesty from
others.
So autistic individuals areknown for tending to be quite
direct and honest, and this isoften at odds with neurotypical
ways of being.
(22:17):
While some autistic people,especially the high- masking
among us, have learned to mimicneurotypical ways in this regard
, it's still exceedinglychallenging to be in
environments where the majorityof people communicate indirectly
or passively and where manywhite lies or even more serious
lies are repeatedly told.
(22:38):
There's a lot of work that hasto go into figuring out what's
going on all the time if you'rein this type of environment.
It's very draining.
There's a clear incongruityhere between the autistic
person's internal abilities andpreferences and the overall
offerings of life in thepredominantly neurotypical world
(22:58):
.
In addition to the above threecategories of traumas that are
more unique to autistic people,autistic people are also more
likely to experience what's beencalled traditional sources of
trauma, including physical,sexual, and emotional abuse;
environmental instability,including housing instability or
homelessness, exposure toothers' mental illness and
(23:20):
witnessing others' suicidalityor suicide attempts; and injury
and illness, which includesmedical trauma, chronic physical
pain, and intense sensorychallenges.
Overall, being autistic canshape a person's vulnerability
to all of the above-mentionedstressors via, quote,
(23:41):
communication barriers (whichmay limit abuse allegations and
convictions), social naivete anda desire for social acceptance
(which enhance a child'svulnerability to manipulation),
and sensitivities to sensoryinput and novel experiences
(which can exacerbate the shockof injury, illness, and medical
(24:01):
treatments), end quote.
While we're focused here ontrauma and vulnerability to
trauma and life stressors, Ialso want to note that research
has also found unique sources ofresilience and resistance to
adversity displayed by autisticpeople, but I don't have time to
get into that today.
For now, it's enough to saythat while we have unique
(24:21):
vulnerabilities to trauma, wealso have unique cognitive
differences and abilities thatcan actually be protective or
reduce the impacts of sometraumas and stressors.
It's especially helpful when wehave the support we need and
people around us who love us andsupport us, no matter what.
Well, that's all I have for youtoday.
(24:42):
Thank you so much for beinghere.
Until next time, bye.
Today I'm talking about trauma, attachment
disorders, and autism; how theyoverlap and how they differ; as
well as familial mental healthchallenges or the mental health
diagnoses that often run infamilies where there is autism.
I've touched on some of thesetopics before, but mainly as
parts of episodes on othertopics, so I wanted to do a
(00:23):
deeper dive this time around.
While you'll find a lot ofcontent about all of this on
YouTube, on podcasts, and inother locations online, there's
always new information comingout and always new ways of
synthesizing or putting theinformation together, so I
(00:43):
wanted to try my hand atcovering it.
Before we get into this topic,you'll probably notice I don't
have my Other Autism neon signbehind me.
I've packed it away.
I'm getting ready to move inJune and I've just started doing
a lot of packing beforehand inpreparation, because I know it's
going to be a really busy time.
(01:07):
Also, I'd like to remindeveryone that The Other Autism
now has a Patreon with bonuscontent for paid Patreon members
.
Bonus content currentlyincludes additional podcast mini
episodes, behind- the- scenesphotos and videos, and audio-
only reading episodes where I'mcurrently going through 20,000
Leagues Under the Sea, onechapter at a time.
Why am I reading thisapparently random book?
(01:31):
Well, these reading episodeshave been requested.
Specifically, I've hadlisteners ask for reading
episodes or meditation episodes,and since reading is more my
jam, I went with that option.
Also, several listeners reportcurrently going through burnout
and just wanted some easylistening.
I also thought it would be agreat opportunity to explore
(01:54):
some classics that I've neverread, that are part of the
public domain and therefore Ican use them without any
copyright issues.
Being a paid member of Patreonhelps fund this podcast and I
have hopes that eventually itwill be a thriving community of
The Other Autism listeners.
I know a lot of podcasts andother online content creators
(02:17):
have Patreon accounts andthey're always trying to get you
to join, so it can be annoying.
I totally get it, as a podcastconsumer myself, but it's one of
the main ways to fund the workwe do.
A huge, huge thank you to thosewho have already joined and I
really appreciate that you'rewilling to give it a try, and I
(02:38):
also appreciate those who sendin recommendations and ideas for
future Patreon member-onlycontent.
If you just can't be convincedto join Patreon, please consider
leaving a rating and or areview, if you haven't done so
already.
You can do that on ApplePodcasts, on Spotify, I think
(02:59):
allows you to just leave thestar rating as long as you've
listened to the podcast.
The other thing you could do isshare this podcast with those
who might find it interesting orhelpful and basically just keep
doing what you're doing.
I also want to try something new.
I'm putting out a call foranyone who wants to to send in a
question or a comment or reallyanything you want to tell other
(03:23):
listeners via audio recording.
This can be messages of support, it can be your diagnosis story
or parts of it, and you cansend your audio clips to kristen
dot hovet at gmail dot comthrough WeTransfer, which is a
website that is totally free touse.
Just record something on yourphone or your computer.
(03:46):
Go to wetransfer dot com that'sW-E-T-R-A-N-S-F-E-R dot com,
upload the file, enter my emailaddress, and send.
I can't promise that all audioclips will be used, but all will
be listened to and consideredfor airing on the show.
Feel free to share as much oras little about yourself as
(04:09):
you're comfortable with.
Okay, let's start with adefinition.
According to Connor M.
Kerns and his team, trauma isdefined as, quote, an event or
circumstance that is experiencedas physically or emotionally
harmful or life-threatening andhas lasting adverse effects on
functioning and well-being, endquote.
(04:29):
When it comes to discussions oftrauma and autism, autistic
people in this day and age willalmost certainly have
significant trauma and resultingmental health impacts.
We may even have formaldiagnoses of post-traumatic
stress disorder or PTSD, or wemay have been told by a
therapist or psychologist thatwe have complex PTSD or that we
(04:52):
have experienced complex trauma.
Basically when there's repeatedtrauma over and over and over
again, often from very early onin life, such that it presents a
bit differently than PTSD andhas a deeper and longer-term
impact on the person's entirepersonality and way of being.
The problem that manylate-diagnosed autistic people
(05:15):
have is figuring out if theirtraits are linked to this trauma
or to being autistic.
As I've said before in pastepisodes, if you are autistic,
your traits are almost certainlylinked to both autism and
trauma, especially as a late-diagnosed autistic individual,
because being late- diagnosedusually means you're also high-
(05:36):
masking, or at least you maskmore often than autistic
individuals who are identifiedas autistic earlier in life.
Being high- masking meansyou've suppressed core
attributes of yourself, bothconsciously and unconsciously,
as a way to fit in and beaccepted by others.
It means you've tamped downyour true self time and time
(05:58):
again because you don't feelsafe to be yourself and you are
made to feel shame aboutyourself and your traits.
But some still wonder ifthey're autistic at all.
Maybe all of their traits canbe explained by trauma, or so
their thinking goes.
(06:20):
This is when it helps to have apsychologist include others in
your assessment or diagnosisprocess, such as parents or
grandparents or aunts and uncles, who have known you since you
were a newborn or very young andwho are very perceptive and can
answer questions about traitsyou had before you experienced
trauma.
If this is just not possible,I'd advise looking into traits
and characteristics that areassociated with autism but not
(06:43):
with PTSD and vice versa.
According to Dr.
Megan Anna Neff, an autisticand ADHDer psychologist who runs
the website NeuroDivergentInsights, these autistic traits
include repetitive behaviors andself-soothing through use of
routines, difficulty reading orunderstanding neurotypical or
(07:06):
non-autistic social cues,sensory differences as core to
your human experience from asfar back as you can remember,
and the existence of specialinterests or very deep interests
that sort of also mark yourcore experience.
For those who are just learningabout these subjects, I think
it's important to briefly coversome of the overlapping traits
(07:28):
between PTSD and autism.
Again using Dr.
Neff's work, individuals whohave PTSD and autistic
individuals can share thefollowing overlapping traits or
characteristics (07:40):
Dissociation, difficulty with intimacy,
increased risk of beingvictimized by others, negative
beliefs about the self and theworld, difficulty managing
intense emotions, high rates ofsubstance abuse, depression,
self-harm and or suicidality,hypervigilance or fight or
(08:03):
flight response that's easilytriggered.
Difficulties controlling someimpulses, executive functioning
difficulties, sleep issues,stimming, and heightened
awareness or sensitivity tosensory input.
I will note that these traitsare temporary in those with PTSD
alone, whereas they exist inautistic individuals as core to
(08:25):
who they are, with no clearbeginning and no clear end.
Actually, the traits never endreally, unless the person has
been forced to try to tamp themdown or hide them.
It's also important to notethat not everyone with PTSD and
not everyone who's autisticexperiences all of these.
They may experience just a few.
(08:45):
Traits that specifically pointto PTSD and not autism include
clear evidence of the presenceof a traumatic event or several
events, avoidant behaviors,intrusive memories and
flashbacks that a person cannotcontrol, and the presence of
nightmares.
There are probably more, butthose are the top ones, again
(09:06):
using Dr.
Neff's work.
Hopefully that's given you abit of clarity between PTSD and
autism.
But what about attachmentdisorders?
It's important to start bysaying attachment disorders are
not the same as attachmentstyles.
Discussions about attachmentstyles, which include secure,
anxious, avoidant, anddisorganized, have really taken
(09:28):
off lately.
But it's important to keep inmind that, while certain
attachment styles likely overlapwith attachment disorders,
attachment disorders arepsychiatric diagnoses
specifically in children.
Attachment disorders includereactive attachment disorder, or
(09:50):
RAD, and disinhibited socialengagement disorder, or DSED,
but these are only present inchildren and both are associated
with clear evidence of abuse,neglect, or other extremely
insufficient or unstable care,according to Claire Davidson and
her team in an article titledAutism and Attachment Disorders,
How Do We Tell The Difference?
(10:10):
Signs and symptoms of bothreactive attachment disorder and
disinhibited social engagementdisorder tend to dissipate or go
away when the child enters asupportive, nurturing
environment and or as they getolder, which obviously is not
the case with autism.
According to Davidson and herteam, both reactive attachment
disorder and disinhibited socialengagement disorder are marked
(10:34):
by a failure to develop socialrelationships that match what is
expected of a child at theirage and developmental level.
Reactive attachment disorder,or RAD, is characterized by a,
quote, failure to seek andaccept comfort and associated
dysregulation in emotions andsocial relationships, end quote.
(10:56):
A child with RAD shows very fewor almost no displays of
positive emotion and severalepisodes of extreme negative
emotion.
They show very little social oremotional responses to others
and they don't seek comfort fromothers.
These are very sad, verydisengaged little children.
(11:26):
Disinhibited social engagementdisorder or DSED, while it can
be diagnosed in the same child,is characterized by, quote,
socially indiscriminatebehaviors and failure to respect
social boundaries, end quote.
A child with DSED basicallydoesn't have any sense of
stranger danger or cautionaround new people.
They will go to anyone toapparently seek comfort, whereas
(11:47):
a child without DSED will showclear preference for primary
caregivers such as parents.
A child with healthy attachmentseeks affection and comfort
from their primary caregiversand will be wary and shy of
strangers or new people.
So according to what I read, achild can have both of these
(12:07):
attachment disorders and theycan kind of move between the
sets of kind of symptoms orcharacteristics.
So they can go from being very,very isolated, very, very
detached to then being kind oflike all over everyone
(12:27):
indiscriminately and not havingpreference for any particular
caregiver or person.
It's kind of odd to see.
I think I've seen kids who havethese traits and i t's kind of
alarming because you don'texpect it.
Like the typical behavior for ayoung child is to be, you know,
very wary and they'll likecling to their parents, and
(12:51):
they'll not want to go to newpeople and they'll have a clear
bond with their parents.
Like that's kind of typicallywhat we see.
I have to say that when I wasreading about these two
attachment disorders, I alsokept thinking that kids with
attachment disorders areprobably more likely to grow up
to develop personality disorders.
I did a quick Google search andapparently this does seem to be
(13:13):
a thing.
Interesting.
I had to force myself to not gointo that further, but I just
wanted to note that.
So, while both RAD and DSED arecaused by abuse and neglect,
there's no evidence that autismis caused by abuse or neglect.
In fact, autism is highlyheritable and in most content I
(13:34):
read these days is treated as agenetic difference or inherited
neurotype.
It is possible for an autisticchild to also be diagnosed with
an attachment disorder like RADor DSED, but typically what
happens as a child gets older isthat they'll lose their RAD and
or DSED traits yet maintaintheir autistic ones.
(13:58):
While autism and attachmentdisorders are not causally
linked,as far as we know, autistic
children may be more likely todevelop attachment disorders
than neurotypical children, butmore about that later.
While autistic children are ata greater risk of experiencing
abuse and neglect while growingup, secure attachment between
(14:19):
autistic children and theirparents is actually super common
, whether the parents areautistic themselves or
neurotypical.
Davidson and her team statethat while the majority of
autistic children have excellentrelationships with their
families, there is a significantsubset of autistic individuals
whose families appear to exhibita wide array of heritable
(14:41):
neurodevelopmental conditionsand or mental health challenges
running through them, throughthe generations.
It may be that, quote, abuseand neglect are more likely to
arise when an already strugglingfamily, in which the parent or
parents may also haveneurodevelopmental problems, has
a child whose complexneurodevelopmental symptoms make
(15:03):
parenting challenging, endquote.
So what are theseneurodevelopmental and I'll add
mental health conditions thatcould be impacting these
families?
In addition to autism itself,which we know to run in families
because of its super highheritability, other conditions
seen in these families includeattention deficit- hyperactivity
(15:24):
disorder or ADHD, schizophreniaspectrum disorders (such as
schizoaffective disorder anddelusional disorder), obsessive
compulsive disorder, affectivedisorders (such as major
depressive disorder and bipolardisorder), anxiety disorders
(such as generalized anxietydisorder, panic disorder, social
(15:46):
anxiety disorder, and phobias),personality disorders, eating
disorders, substance usedisorders, and childhood
disorders (such as oppositionaldefiant disorder and conduct
disorder).
So, of course, these differentconditions appear in a lot of
different families, regardlessof whether there's autism in
(16:10):
those families.
However, the research showsthat these conditions tend to
happen more often in familiesthat already have neurodiversity
, that already have autism andADHD.
There seems to be some type ofgenetic overlap and, with a lot
of these conditions, they areactually identifying some of
(16:36):
those genes, which is reallyinteresting, and I think in the
years to come we'll see more andmore of these genes being
identified.
We know from the research andclinical accounts that having
mental health challenges infamilies impacts children's
health and well-being, whetherthat child's autistic or
neurotypical.
Increased psychopathology inparents, according to the
researcher Christina Kamis, isassociated with poorer parental
(17:00):
functioning or abilities,greater conflict with their
children, more overalldysfunction in the home, and
more severe discipline.
So I want to state thesefindings in really clear
language (17:11):
Parents with mental illness or psychiatric
conditions tend to be lesssuccessful at parenting or have
more struggles with parenting,have more fighting or negative
interactions with theirchildren, their children have
more behavioral andpsychological problems of their
own, and these parents are moreinclined to punish their
(17:34):
children in harsher wayscompared to parents without
these conditions.
These negative experiences canbe very traumatic for the
children and lead to pooroverall life outcomes,
regardless of the neurotype ofthe child.
I want to add here that Isuspect these parents are also
less likely to have adequatesupport, especially in the case
(17:57):
where they're not properlydiagnosed or not receiving
appropriate and adequatetreatments.
But back to trauma.
So for autistic individuals,trauma of any kind tends to hit
us harder than it hitsnon-autistic individuals.
In other words, autistic peopleare more hurt by or more
negatively impacted by traumaacross their entire life course,
(18:20):
for a variety of reasons, andtherefore they're also more
likely to develop trauma-relateddisorders like PTSD and
attachment disorders.
So first of all, let's talkabout some traumas that are
unique to autistic individuals,starting in childhood and
sometimes occurring frequentlyor repeatedly across the life
(18:42):
course.
Autistic individuals, accordingto Connor M.
Kerns and his team, are morelikely to experience being
trapped or entrapment, socialexclusion, and traumatic
incongruities, defined asincongruities or severe
mismatches between sensory,social, and executive processing
(19:02):
styles of the autistic personand their external and social
environments.
Let's break these down furtherbecause I think just listing it
like that doesn't tell the wholestory.
So trauma related to beingtrapped or entrapment includes
trauma resulting from, quote,feeling physically and
(19:24):
psychologically restricted and,at a meta-level, socially
stymied, prevented by societyfrom being able to pursue a full
life, end quote.
These types of entrapmentsinclude literal physical
restraint or sedation andgenerally various types of
physical and medical restraintor control.
It includes loss of autonomy,far more scrutiny than that
(19:48):
experienced by neurotypicalpeers, restrictive learning
environments, loss of theability to make decisions about
one's life, segregatedschooling, and so on, as well
as, quote, a dearth ofemployment opportunities or
appropriate education,vocational training, housing,
and other social services forautistic individuals,
(20:10):
particularly those withoutintellectual disabilities, end
quote.
Trauma related to socialexclusion includes trauma
resulting from bullying, beingkept apart from others or
feeling a lack of socialbelonging, teasing, intimidation
, isolation, differentialtreatment, subtle and ongoing
(20:32):
exclusions, which I think somehave called microaggressions,
repeated discrimination andminority stress, not being
believed regarding experiencesof maltreatment or
discrimination, lack of supportor protection from family or
peers, and betrayal in romanticrelationships, which can be,
quote, particularly devastatinggiven their difficulties
(20:55):
connecting with others ingeneral, end quote.
Importantly under this categoryof social exclusion traumas,
caregivers and parents of Blackautistic children reported
concern about their childrenbeing dually targeted by
authority figures for both theirrace and autistic traits.
And, finally, trauma related totraumatic incongruities include
trauma resulting fromparticularly painful sensory
experiences, such as somemedical appointments, fire
(21:16):
alarms, and so on, that causeintense distress, physical pain,
or severe anxiety; transitionsor changes that lead to the
person experiencingunpredictability in day-to-day
(21:36):
life; and chronic socialconfusion, including the, quote,
reduced ability to understandand predict others' intentions
and actions, end quote.
And I'd note that others hererefers to mainly neurotypicals
and their intentions and actions.
It's typically harder for us toread neurotypicals.
(21:57):
We can actually read each otherquite well.
Interestingly, this category oftrauma also includes repeated
experiences of lack ofdirectness and honesty from
others.
So autistic individuals areknown for tending to be quite
direct and honest, and this isoften at odds with neurotypical
ways of being.
(22:17):
While some autistic people,especially the high- masking
among us, have learned to mimicneurotypical ways in this regard
, it's still exceedinglychallenging to be in
environments where the majorityof people communicate indirectly
or passively and where manywhite lies or even more serious
lies are repeatedly told.
(22:38):
There's a lot of work that hasto go into figuring out what's
going on all the time if you'rein this type of environment.
It's very draining.
There's a clear incongruityhere between the autistic
person's internal abilities andpreferences and the overall
offerings of life in thepredominantly neurotypical world
(22:58):
.
In addition to the above threecategories of traumas that are
more unique to autistic people,autistic people are also more
likely to experience what's beencalled traditional sources of
trauma, including physical,sexual, and emotional abuse;
environmental instability,including housing instability or
homelessness, exposure toothers' mental illness and
(23:20):
witnessing others' suicidalityor suicide attempts; and injury
and illness, which includesmedical trauma, chronic physical
pain, and intense sensorychallenges.
Overall, being autistic canshape a person's vulnerability
to all of the above-mentionedstressors via, quote,
(23:41):
communication barriers (whichmay limit abuse allegations and
convictions), social naivete anda desire for social acceptance
(which enhance a child'svulnerability to manipulation),
and sensitivities to sensoryinput and novel experiences
(which can exacerbate the shockof injury, illness, and medical
(24:01):
treatments), end quote.
While we're focused here ontrauma and vulnerability to
trauma and life stressors, Ialso want to note that research
has also found unique sources ofresilience and resistance to
adversity displayed by autisticpeople, but I don't have time to
get into that today.
For now, it's enough to saythat while we have unique
(24:21):
vulnerabilities to trauma, wealso have unique cognitive
differences and abilities thatcan actually be protective or
reduce the impacts of sometraumas and stressors.
It's especially helpful when wehave the support we need and
people around us who love us andsupport us, no matter what.
Well, that's all I have for youtoday.
(24:42):
Thank you so much for beinghere.
Until next time, bye.
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