Empathy and Autism (by Kate Altman, M.S.)

From time to time, parents will tell us that they do not believe their child really has autism, despite having all of the symptoms, because they do not “lack empathy.” Like these parents, I have also read literature that makes this assumption: that people with autism have little or no empathy for others. This assumption puzzles me. “Lack of empathy” is not a diagnostic criterion in the Diagnostic and Statistical Manual for Autistic Disorder, Pervasive Developmental Disorder, or Asperger’s Disorder. Similarly, the most seminal and thoughtful research and literature on ASDs (Uta Frith, Lorna Wing, Simon Baron-Cohen, etc.) does not assert that individuals with ASDs lack empathy.

I have asked individuals with ASDs about empathy, and they have described to me feeling extremely empathetic at times; in fact, several of these individuals have mentioned that they feel “too sensitive” towards others. One young man on the spectrum noted that when he sees someone experience something negative, such as falling down and hurting themselves, he winces as he literally “feels their pain.” However, he noted, his empathy is only evoked when he, at some point, has experienced the same situation or same evident emotion as the person with whom he is empathizing. If someone is experiencing something he cannot relate to or understand from his own past experience, he does not “know to empathize” and then may appear insensitive.

This young man’s insight leads me to believe that many people misunderstand (Simon Baron-Cohen’s) “theory of mind” deficiencies in people with autism as a lack of empathy. “Theory of mind”, or ToM, is the theory that we have the capability to attribute mental states to ourselves and to others (or, as the saying goes, to put ourselves in another’s shoes). Theory of mind ability constitutes the first step in empathy. While people with ASDs may struggle with theory of mind ability (probably due to a lower-than-usual amount of mirror neurons in the brain, which facilitate ToM), they do possess at least some of this ability, and studies have shown that they can and do develop ToM abilities over time (in fact, studies show that many individuals with Asperger’s develop ToM abilities nearly on par with most neurotypical adults by adulthood). Therefore, a person with an ASD (especially as a child) may struggle to understand someone else's mental state, but once they do, they can certainly feel for that person.

Literature that suggests that individuals with ASDs lack empathy is not only incorrect, it is dangerous, because it may lead to the belief the people with autism are sociopathic and not safe to have around. Furthermore, it is simply untrue and undercuts the incredible sensitivity towards others that many people with ASDs possess. Over the last couple of months, I have been conducting research with young adults with ASDs in college, and, as a college professor, I can confidently assert that this group of students have been among the most thoughtful, and empathetic, that I have met.

Is it ok to grieve again?

Since our last blog about handling the holidays, we have heard from many readers. Some were doing well and enjoying time with their children, others experienced sadness and some told us about mixed feelings of joy and sorrow. One reader asked us if it was ok to grieve again. No one asked if it was ok to be happy.

Since the question about continued grieving comes up frequently, we are taking it up here, and we welcome readers to share their thoughts and experiences on our blog or Facebook wall, or just respond by email to therapist@alternativechoices.com.

Answer: From Dr. Cindy Ariel:

The sadness left by grief never goes away. At any moment, I am able to look into my grief spots and feel the sadness and emptiness left there by significant losses. Losing the child of our dreams can certainly be one such loss.

There are many losses through life, and seen in a larger perspective, each loss adds meaning and depth to our lives. We all feel grief at various points in our lives but that does not minimize our times of happiness and joy. In fact, grief magnifies joy because happiness is so much sweeter after experiencing sadness.

One strategy is to do extra things that make us joyful so that the happiness in our lives balances or hopefully even outweighs the sorrow. It does not make the sorrow go away but it surrounds it with a cushion of good feelings and makes it easier to manage.

As we come to accept where our children are actually at and who they really are, we dream new dreams for them and for our families and these new dreams are much more likely to be based upon reality and therefore are more likely to be attainable.

When we once dreamed about having philosophical discussions with our child, we may now simply long to hear them call us mommy or daddy or say I love you…just once. Our dreams may involve easing up on hearing our child talk and focusing instead on just having her look into our eyes and smile. When such new goals are reached, it is joyful indeed. This is not to say that sometimes we don’t still wish or long for that once dreamed of discussion. When we focus there, we may always feel sadness that those discussions may never take place.

Dreaming new dreams and rejoicing in new goals helps us feel happier in this new moment with the child we actually have. Nobody wants any hardship to befall their children. We may feel disappointment, guilt, and sadness when our child has a challenge that will make life, which is already difficult, even more so. We get through the adversity and we love our children even as we grieve and we celebrate their unique lives and the time we are given to be together.

From Dr. Robert Naseef:

Grief may come and take you places you never expected to go. This is a normal and natural. It comes and goes. First of all realize that you are not alone when your heart aches. So go ahead and look at your grief. Observe your thoughts and feelings. Notice any sensations in your body. Accept them and be kind to yourself about having them. It doesn’t help to pretend to be positive when underneath you may be lonely, afraid, or sad. I have learned through my son’s 30 years that you don’t have to lie to yourself. You can grieve. You can complain. You can mourn. This helps you to go on, make the best of the situation, and enjoy life.

It is natural to wonder about what might have been especially around the holidays. Your longing for the child of your dreams or a typical life for you and your family may endure. You have to learn to live with that yearning, and you can do that, but you don’t have to lie to yourself about how hard this can be. As Kahlil Gibran reminds us, “joy and sorrow are inseparable . . . together they come and when one sits alone with you . . . remember that the other is asleep upon your bed.”

Secondly, try to accept yourself as you are—a kind and loving parent doing your best with your child who is undoubtedly doing his or her best under trying conditions. A perfectly lovely child with special needs can be very hard to be with because of their behavioral, social, or communication issues. When you love somebody, you love to be with them. When you don’t feel that and think you should, the guilt comes up, and your heart aches. As you can accept yourself in a kind and compassionate way, your heart heals, and then the grief lightens. Acceptance can bring change.

Finally, accepting our pain and ourselves leads to accepting and enjoying our child and our family. This is the gateway to love and happiness. That deep connection that a parent feels with a newborn, or a child’s first steps, or first words can be felt at any moment when we are truly aware and attuned to our child. That deep connection is alive inside you. As you rekindle it, you can actually experience very deep happiness. Let us hear from you about your experiences.

Women on the Autism Spectrum

Girls and woman with ASDs face unique challenges and are often misunderstood (and misdiagnosed). Check out this article by a woman with an ASD, Ruth Elaine Hane, on the thoughts and experiences of women on the spectrum: http://www.autismsupportnetwork.com/news/thoughts-and-ideas-woman-asd2358

Thanks to the AC Blog reader who informed us about this article!

3 Mini Meditations to Help You Through Your Day (or Night) By Ed and Deb Shapiro

From Be the Change: How Meditation Can Transform You and the World

What stops you from sleeping through the night? Is it when things are not going your way or they look topsy-turvy and you just want to scream; when your life appears chaotic and you are not sure if you are coming or going; or when it feels like everything is piled on your shoulders?

Life should be an exciting and outrageous adventure. Isn't it a wonder how a spider weaves a web or a bee makes a hive? Did you ever notice the small, everyday miracles, like the fact that you can breathe in and out? But how many of us get to experience this miracle? Sometimes life just feels too awful. We want to feel good, we want to be happy, in fact happiness is our birthright. But so often there are just too many difficulties to deal with. And although we may know that meditation chills us out, if we are feeling stressed or irritable then it just doesn't seem so appealing.

So here are three mini-meditations, moments to just stop and breathe and remember why you are here. A moment to check yourself out, to look within, and to find what is really meaningful to you. You can get it together even when you think it is all falling apart.

Mini-meditations can be done on a train, walking down the street, at an airport, standing at a bus stop, in an elevator, while sitting in the bathroom (often the only place you can be alone!). Silently count your out-breath up to ten times, or walk with awareness of each step for up to ten steps. Or relax each part of your body, then silently repeat "soft belly" for five breaths.

If you are at work, then use your lunch hour to find a quiet spot, perhaps in a park, or even in the office if everyone else has gone out. If you are traveling then use that time to consciously breathe, letting your awareness follow your breath from your nose tip to your belly and back out again. If you are driving or operating machinery and feel you are getting tense, then stop for a moment, breathe into your belly and silently repeat "soft belly, soft belly." Focus on any part of the body that is feeling tight and breathe into it, until you relax and let go. Silently repeat "soft shoulders" or "soft neck" and so on.

As you walk down the street or ride in an elevator, practice a mini-loving kindness by silently wishing everyone be well, wishing that everyone be happy. In the office you can spend a few moments repeating the names of everyone you work with and wishing them happiness. On your way home from work reflect on your day and generate loving thoughts to all those you met. When you send out relaxing and loving thoughts it relaxes the space around you and often any chaotic or disturbing energies will dissipate. What you put out comes back to you ten fold

1. Mini Breath Meditation

Sit comfortably with your back straight. Take a deep breath and let it go. Begin to silently count at the end of each out breath: Inhale . . . exhale . . . count one, inhale . . . exhale . . . two, inhale . . . exhale . . . three. Then start at one again. Just three breaths and back to one. Simply following each breath in and silently counting. So simple. Do this as many times as you want, eyes open or closed, breathing normally.

2. Mini Walking Meditation

You can do this walking along a country lane, a city street, in the office or the garden. You can walk slowly, normal or fast, whatever feels right. As you walk become aware of your walking, of the movement of your body and the rise and fall of your feet. Become aware of your breath and see if you can bring both your breathing and your walking together. Just walk and breathe with awareness for a few minutes.

3. Instant Letting Go

Find a quiet place to sit, have a straight back, and take a deep breath and let it go. Then quietly repeat to yourself: "My body is at ease and relaxed . . . my heartbeat is normal . . . my mind is calm and peaceful . . . my heart is open and loving." Keep repeating this until you have let go of the tension and are at peace. Then take a deep breath and have a smile on your face!

©2009 Ed and Deb Shapiro, author of Be the Change: How Meditation Can Transform You and the World

Author Bio
Ed and Deb Shapiro, authors of Be the Change: How Meditation Can Transform You and the World, are the award-winning authors of fifteen books on meditation, personal development, and social action. They are featured bloggers for the HuffingtonPost.com and for Care2.com, teach meditation workshops worldwide, work as corporate coaches and consultants, and are the creators and writers of the daily Chill Our inspirational text messages on Sprint cell phones. The Shapiros have taught meditation and personal development for more than twenty-five years. They currently reside in Boulder, Colorado.

For more information please visit www.EdandDebShapiro.com.

Superheroes and the Spectrum

This week on the Philadelphia-area public radio show, Voices in the Family, the discussion centered on comic book superheroes and why we love them. You can listen to "Superheroes" here: http://www.whyy.org/podcast/voices20091116.mp3

Many children (and adults!) on the spectrum love comics and superheroes (as do many neurotypical children and adults, of course)--from traditional comic strips to manga to anime (of course, all of these media now tackle a wide variety of genres, not just of the superhero variety, but I digress). A young man with an ASD recently explained to me that he finds graphic novels easier to read than books because the pictures supply a visual of the action; with books he has to simultaneously read the words and create and sustain a mental image. With graphic novels, he can really let go and escape into a fantasy world.

The speakers on the "Superheroes" radio show said that most people love comics and superheroes for a variety of reasons: the chance to escape, the visual stimulation of the pictures, and, most importantly, the chance to identify with someone who feels like an outcast a lot of the time and may be a little unusual, but has a secret identity with supercool powers and a good heart.

Just Breathe (by Robert Naseef, Ph.D.)

I am frequently requested to talk to parent groups about coping with stress. Life with a child with special needs presents constant pressure and stress to mind and body. Inevitably, you get wrapped up doing all you can for your child. There is little time and energy for personal, marital, and family activities.

Obviously parents need to refresh and recharge. But how does a parent get a break? Mothers especially feel overwhelmed and even guilty that they are not doing enough. If you do convince yourself that you deserve a break, there may be resistance. Who else can take care of your child?

As Dr. Cindy Ariel has written, “Make no doubt about it--the absolute ideal person to spend time with your child is you. You are the best, most competent, most loving person available to care for your child. But this is no reason to never take a break.” As my life-partner, she has inspired much of my personal and professional growth and in this example helped me to understand the passions of mothers.

Recently I was speaking to parents at the Children’s Hospital of Philadelphia in the Pediatric Stroke Program. A father spoke up and told the group that he was no good to his wife and child if he didn’t take care of himself. I asked him how he came to this.

He shared that he viewed this like the safety precautions we get at the beginning of an airline flight. If the cabin loses pressure during flight, you must put on an oxygen mask or risk losing consciousness. That is why airlines tell you to put on your own mask before helping someone else, such as your child, with their mask--if you can’t breathe and pass out, you won’t not be able to help anybody.

Upon hearing this, everyone in the room breathed a sigh of relief. This thoughtful father of a medically fragile child had given everyone in the room permission to take a break.

Pets as Therapists? Animals & Human Emotions (by Kate Altman, M.S.)

My mother swears that her 10 lb dog, Bunny, who is a Bichon-Poodle rescue, has a sixth sense for reading human emotions. Not only is she more attentive to both of my parents when they are feeling blue or under the weather, but she has a knack for sussing out people in need when they stop by for a visit. For example, even though Bunny is usually terrified of men (probably due to her pre-rescue past), when my parents' friend who had recently lost his wife to cancer came over for dinner, Bunny stood diligently by his side, occasionally licking his fingers as he sat and talked.

My cat, Rose (also a rescue), has a similar modus operandi. When I got my wisdom teeth out last year and suffered a subsequent infection, Rose planted herself by my face and gently licked the infected cheek for days until I recovered.

Temple Grandin, an adult with autism, wrote the book, Animals Make Us Human: Creating the Best Life for Animals, in which she discusses animals' emotional lives and their relationships with humans. Grandin asserts that animals' emotional lives are complex, diverse, and important.

I'm not exactly sure how much Bunny and Rose know or understand about peoples' emotions, but they have both proven time and again that they are aware of and interested in the emotional changes in the people they love. Not only are they aware, but they want to help. Sometimes it is hard to know what to say or how to act when someone we care about is struggling, so I suggest we learn a lesson from intuitive pets: just be there, stay calm, and offer the occasional lick (okay, maybe hug) as needed.