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6 months ago

978-1572305441

autism

Sharon 63 eccentric,

Sharon 63 eccentric, even as a child. Sharon felt that, more and more, these difficulties were getting in the way of her job and her relationships with close friends and potential clients. Architects have to meet prospective clients, understand what they want, and express themselves confidently and precisely. They have to anticipate what the client wants, almost before the client finishes a thought. They need to exhibit considerable personal charm in meeting with clients during the design process. Sharon said she needed lots of explanation to help her understand what other people wanted in the makeup of a building. She needed to write it down and go away and think about it. Often during a conversation, she had to repeat to herself what another person might be saying and deduce his or her meaning in a logical fashion. She also had to monitor what she wanted to say in return and to make sure that it was not inappropriate. She had little intuitive understanding of others and had to regulate her interactions with a continuous stream of self-monitoring. She was, however, brilliant at being able to translate into visual images and then drawings what the clients desired but could not articulate by themselves. It was this skill that made her so successful as an architect. Sharon knew that other people did not have these difficulties in making social interaction as fluid and as automatic as possible. One day she read an article about autism in a newspaper and experienced a flash of recognition. She went on to do more research, including reading the firsthand accounts of people with autism written by Temple Grandin, Gunilla Gerland, and Donna Williams. Reading these had been a revelation for her. What she originally thought was a personal failing or a fault in her character perhaps now had a name and held out the hope of greater understanding and of support from others with similar experiences. I asked her to give me some examples of how she had coped with these difficulties. She told me that, years ago, she had learned to write rules in her head to guide her behavior. In this way she could compensate for her lack of intuitive understanding. She usually did this in bed at night after a particularly humiliating day at school or at the university. Each social disaster was meticulously analyzed and categorized. A rule was written for each situation and either added to the list or else subsumed under some other more general rule: Look at people when you talk to them; put out your hand to shake theirs; smile if they smile when making a joke. Although this approach was generally effective, the number of rules soon began to increase out of control. There were too many rules to cover all possible social situations. Experience was

64 A MIND APART simply too varied to be cataloged in this way. Besides, the rules did not always help to govern behavior in the actual encounter. Often, Sharon could not remember the rules fast enough in the hurly burly of social interchange to avoid making a blunder. It was only upon reflection that the disasters of the day made their full impact felt. The realization would come to her that if only she had followed a particular rule, all this could have been avoided. The filing system that governed her social behavior was just not efficient enough; sometimes it let her down. Through much of her life Sharon felt she could not intuitively understand what other people really meant when they said something. She took everything people said literally, without necessarily understanding the context. Neither could she see immediately that her own behavior was socially clumsy. She would comment on somebody’s gray hair without realizing that the person might be offended, or she might tell a joke that nobody found funny over and over again. She would misconstrue their facial expression as puzzlement, not as boredom. Too often there was little correspondence between what she said and what she meant: “I spoke, and different meanings rushed in and attached themselves to my words. I seemed to be in a kind of time lag. I felt no meaning when something happened; only later, the meaning hit. Then in memory, I would really see what happened. Out in the real world, I was in a fog. I was never there at the moment something happened. First something happened, then, hours later, I felt it.” As she told her story I listened very carefully, puzzled but intrigued. These comments were precisely the kinds of experiences I had heard adolescents and young adults with AS describe when they reflected on their own experiences. I had heard from others bits and pieces of what Sharon was describing but never in one individual and in such an articulate fashion. This was quite remarkable. I asked whether she had any friends. She had very few friends, but those were very close and long lasting. It was very difficult for her to navigate social banter with potential acquaintances. She stated that she very much enjoyed being with other people but often felt so nervous that this anxiety seemed to get in the way of her social skills. She did not often initiate social interactions because she recognized that her approach was clumsy and inappropriate. She found it difficult to sense other people’s thoughts and feelings and often felt detached from what was happening around her. For example, when she went to a sad movie it took her a while to understand why everyone around her was crying. She described difficulties in understanding the emotions of her friends and her own emotions

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