void/Readwise/Looking After Your Autistic Self.md

Looking After Your Autistic Self

Metadata

• Author: Niamh Garvey
• Full Title: Looking After Your Autistic Self
• Category: #books

[!tldr] Autistic people often feel overwhelmed by sensory stress and emotional changes in their daily lives. Recognizing their triggers can help them manage these feelings and create a sense of safety. Using sensory tools and strategies allows them to participate in activities without becoming overwhelmed.

Highlights

In my experience, there is a misconception that autistic children grow into ‘less autistic’ adults. I believe this stems from our ability, as autistic adults, to adapt our behaviour to ‘stand out’ less, and to ‘fit in’ more. We learn how to hide our differences and hide our overwhelm. But this takes its toll on us, and can actually increase our levels of stress. View Highlight)

Autistic people can react differently to stress than non-autistic people. Research has found that autistic children release higher amounts of the stress hormone cortisol than non-autistic children. Additionally, the levels of cortisol last longer in their bodies, even after the thing that caused the stress has gone (Spratt et al. 2012). View Highlight)

What Skills Are Involved in Executive Function? • Planning: Recognising that a task needs to be done, and planning how to do it. • Organising: Getting ready for a task: Recognising what tools or skills you will need. • Initiation: Starting a task. • Flexible thinking: Seeing a task through and not giving up when faced with problems. • Time management: Being able to divide your time appropriately to complete all the steps of a task. • Finishing a task: Not giving up on a task, keeping focused and motivated until the end. • Evaluation: Looking back at how you did a task, evaluating how you did it, and learning from it. • Emotional regulation: Managing emotions throughout a task so that the task can be completed. View Highlight)

A study published in 2015 (Bishop-Fitzpatrick et al. 2015) found that autistic adults without intellectual disability experienced substantially higher levels of stress than non-autistic adults. Not only that, but when stress levels increased, autistic adults’ social functioning went down significantly. View Highlight)

Research has found that autistic adults have significantly more challenges with executive function skills than non-autistic adults, with one study finding that 20–30% of autistic adults had difficulty with planning, while 20% had difficulty with flexible thinking (Johnston et al. 2019). This study also found that having a higher IQ did not equate to having better executive function skills. Only 35% of autistic adults were found to have no impairment in executive function skills. View Highlight)

A trigger is something that sets off your stress response. There are endless types of things that may trigger your stress response. For autistic people, a trigger could be a type of environment (e.g. a busy crowded room), a social difficulty, a sensory experience (e.g. a loud noise), a communication challenge, a demand on your organisation skills, a change in routine etc. View Highlight)

There might be no real danger, but our brains and bodies acts like there is. When we are stressed, our bodies experience changes that may include dizziness, a racing heartbeat, high blood pressure, breathing fast, and sweating (World Health Organization 2008). View Highlight)

Triggers can cause you to feel anxious or overwhelmed, angry or frightened, unsafe or under attack. Sometimes individual triggers may not cause an immediate stress response, but a build-up of triggers, or too many triggers at once, can lead to fight, flight, or freeze mode, and you might experience anxiety, overwhelm, shutdown, or meltdown (see Chapter 11 for information on meltdowns and shutdowns). View Highlight)

Learning what triggers your stress response is not just important to reduce the psychological impact of stress, but it also improves the physical health of your body. Putting strategies in place to deal with your triggers will help reduce the damaging effect of chronic stress on your body. Over-exposure to the stress hormone cortisol from chronic stress can increase the risk of anxiety, depression, headaches, muscle pain, problems with digestion, heart disease, sleep disturbance, difficulty maintaining a healthy weight, and impaired memory and concentration (Mayo Clinic 2021). View Highlight)

The Five Steps to Managing Triggers

1. The Detective Habit: Identifying your triggers.
2. Coping Strategies: Learn to manage your triggers.
3. Rationing: Spread out your triggers.
4. Recovery: Plan your recovery time between triggers, and after triggers.
5. Quick Calm Strategies: These are strategies to help you calm down quickly. As developing immediate calming strategies is a huge topic, this will be dealt with in the next chapter. View Highlight)

Executive function is the ability to get things done. It is the ability to organise yourself, and carry tasks through from beginning to end. Our daily lives are full of tasks, and thus we rely on our executive function skills to do everything from getting dressed to leaving the house on time, from working to preparing meals etc. View Highlight)

In order to start identifying what my triggers are, I began to develop my ‘detective habit’. This is a habit of reflecting on how I felt and behaved in a scenario, so I could learn to identify my triggers. View Highlight)

The detective habit is about looking back at a scenario that I found hard, analysing it with non-judgemental eyes, and giving thought and consideration to what could have caused the stress. Once I identify the triggers, I then make plans to support myself when exposed to the identified triggers. View Highlight)

How to Use the Detective Habit ... What happened? • What did I feel? Did I feel stressed, scared, out of control, angry etc.? • Was there anything in the environment that could have been a trigger? Was there a sensory stressor? ... Did the environment mean there was too much information to take in at once? Did the environment create challenges for any of my executive function skills? ... • At what point did I start to feel a stress response? Was it when someone started talking to me? Was it when someone tried to get eye contact? Was it when I walked into a shop? Was it when the environment changed? Was it at the point of transitioning from one task to another? ... Were my basic needs met before I encountered the trigger? By basic needs, I mean hunger, thirst, sleep, body temperature, and physical comfort. ... • What were my strengths in the situation, i.e. what did I manage well? Which of my strengths could I use in similar scenarios in future? • What would have helped me to feel more comfortable, or avoid becoming stressed and/or overwhelmed? • What coping strategies could I use if that situation happens again, or if I’m exposed to the same trigger or triggers?

The DSM-5 (Diagnostic and Statistical Manual, 5th edition) is the American Psychiatric Association’s guide to mental illness and disorders, including diagnosing autistic people. It suggests that autistic people have rigid thinking, insist on sameness, are inflexible, and are overly ritualised. ... What the DSM-5 doesn’t explain properly, in my opinion, is that many of these diagnostic traits come out when we are stressed, but may improve when we are calm and happy.

Every time I came up with a coping strategy, I asked myself what strength I was using to develop that strategy. View Highlight)

Interestingly, an autistic friend of mine lately told me about her strategy for getting the staff to turn down the music in restaurants. She taps her ear and says to the staff, ‘My hearing aid is buzzing from the music being so loud, could you please turn it down?’ It works every time. I expressed my discomfort with this as it’s a blatant lie (she has no hearing aid), and she said, ‘No, it’s not a lie, my ear is a hearing aid, in a way, and my ear hears the loud music as a horrible buzzing’. View Highlight)

Sometimes I’m not aware of my own triggers, or autistic differences, until someone else points them out to me. ... Validating the feelings of an autistic person is one of the best things someone else can do to support that autistic person, especially in times of stress. ... if you plan to ask others about your own triggers and traits, be prepared for some surprises, and be aware that you may find some observations upsetting.

When I first began to identify my triggers, my first thought was ‘Now I know what to avoid’. But I soon realised that I would become agoraphobic if I tried to live a life avoiding all my triggers. I also wouldn’t be able to experience so many things that bring me joy. View Highlight)

I therefore realised that I cannot shut all triggers out of my life; instead I need to learn to deal with them. Taking control of my triggers means taking care of myself while still living a full life. This involves planning and preparing myself to cope with triggers. View Highlight)

One of the ways I take control of my triggers is by rationing them out. This means being careful that I don’t plan too many triggering events or activities close together. By spreading triggers out, I give myself time to recover after each one, and time to prepare and plan for the next one. View Highlight)

The world is full of triggers, and dealing with them takes energy, mental planning, and work. I don’t have infinite energy to cope with triggers; I need time to rest and refuel my energy levels. I therefore pre-emptively plan time for myself to rest or decompress during and after social situations, or any situation that I know will require a lot of my coping strategies. View Highlight)

KEY POINTS ◊ Triggers are things that set off a stress response in our brains, and make our body feel the need to fight, flight, or freeze. ◊ Autistic people can get overwhelmed or stressed from exposure to their triggers. ◊ Every autistic person has different triggers, so it’s important to get to know your own. ◊ The detective habit is a method of reflection that can help identify one’s triggers, and then create strength-based coping strategies. ◊ Other people can be helpful in identifying your triggers, but take caution that the person you ask is sensitive and uncritical. ◊ Autistic people can react differently to triggers at different times. If your basic needs are not met, or if you are stressed, you are more likely to react strongly to a trigger. ◊ Rationing out your triggers helps avoid triggers building up and becoming overwhelming. ◊ Planning time to rest after a build-up of triggers is really important, as is having a few techniques to calm yourself when out and about. View Highlight)