Saturday, 25 May 2019

Snap Decisions: My Confused Eighth Sense

One of the reasons I worried about writing a blog like this, is that although my autistic brain retains a lot of information, it isn't good on stuff like references. I will try to add some as links, but mostly this is from memory. 

Last week I went to the National Autistic Society's professionals conference  (which I will blog about next week). One of the keynote speakers was Dr Wenn Lawson who spoke about something called Interoception. 

Interoception is called the Eighth Sense of the body. Unlike the other senses: smell, taste, touch, sight, hearing etc which are about the interaction between the body and the world, interoception is an internal sense. It informs us if we are thirsty, tired, hungry... or even sexually attracted.

Interoceptive difficulties can mean we forget to eat lunch when carried-away with a project (or Facebook!). Everybody has introceptive difficulties at times. Autistic people however, people with trauma, ADHD, dyspraxia, severe depression... can have more persistent difficulties with interoception. 

Listening to this talk, I realised how often I struggled to remember to eat meals - and to regulate my eating. I now use meal replacements for two meals a day so at least I'm eating regularly and don't over-eat in the evenings. I forget to drink until I'm dehydrated, I don't go to sleep when I'm exhausted... generally I have to work hard, put routines in place, so that I don't ignore my body's needs. I have noticed a lot of autistic people have trouble maintaining a healthy weight (under or overweight). I wonder if that is due to interoceptive difficulties? 

But interoception isn't just about these more straightforward sensations, interoceptive difficulties can also affect more complex behaviours. For instance, we may take a long time to recognise how we feel about something. I'm pretty sure I fancied people as a teenager, but it wasn't until my twenties that I recognised the feeling as sexual attraction. Before that, I had assumed that neurotypicals, in films, books and pop songs were wildly exaggerating this sensation of attraction! To me, it was a vague, almost unnoticed sensation; Like that feeling you get that you've forgotten something not terribly important. 

What I learned about interoception is that for me, it is as if the sensations are out of focus and gradually come into view. But the important thing to remember is that those sensations are there - just unrecognised. 

For counsellors, by the way, interoception is important to know about. Maybe the client isn't 'repressing' their sexual attraction - maybe they literally haven't noticed it? Maybe the overweight client doesn't have psychological issues causing him to overeat. Maybe he just doesn't sense when he's full? It is important to talk to the client about how they sense things like hunger or sexual attraction and listen to what they say with an open mind.

Always consider the possibility that you're looking at a neurological impairment rather than a psychological problem. 

I was reminded of a person I worked with recently, who has terrible time management problems. Have they, as they believe, a psychological issue around control and timekeeping? Or do they simply have interoceptive difficulties around their sense of time? If it is the latter, all the talking about their childhood in the world won't fix it; a time management app might help though! 

But what have interoceptive difficulties got to do with snap decisions, as per my title? Well after blogging about my difficulties in counselling training for some weeks, I decided to switch to another school for my Diploma. I intended to blog about this decision, but it was a delicate thing, because some of my reasons are private. So, instead of blogging about my reasons, I'm blogging about how I processed those reasons into my decision to resign. 

During the conference, I was musing about how I came to important decisions. To many people, autistic people like me can appear to make very sudden, life changing decisions without much warning. I can invariably give you a nice pros-and-cons list with reasons for my decision. What seems to be 'missing' is the run-up to that where I talk to my friends and mentors, talk about problems, explore various options, talk about how I feel etc. Sure, I shared my concerns, told them things I wasn't happy with, but in a neurotypical, talking about minor irritations at work doesn't usually proceed a sudden resignation. 

So, this is how I can explain it: I became unhappy with my course gradually, but I did not register that 'unhappiness' as such, until it had built up to a certain level. This, by the way, is the reason autistic people may appear fine one minute and in total meltdown the next. This lack of awareness of my own emotional state is a feature of my interoceptive difficulties. 

But there is another feature of autistic processing, which Dr Wenn also touched on in his talk: difficulties with 'Big Picture' thinking. 

My interpretation of Dr Wenn's point was that neurotypicals (non-autistic people) solve complex problems top-down. That is rather like drawing the lines round the picture and then gradually colouring it in. So, the 'Big Picture' is "I am unhappy with my course" - that is where they start - and then they gradually fill in the details as they process their thinking. So, the solutions, including 'Resign from my course' are considered right from the start. 

But autistic people like me can't do Big Picture thinking. Instead, we have (as per the diagnostic criteria) "excessive attention to detail and parts of the whole".

So for me there is no drawing I have to colour in, for me it's more like a jigsaw with pieces missing. I was not aware of the overall Big Picture, only of individual difficulties I was having, each like an isolated puzzle piece, placed on the table. Only when sufficient puzzle pieces had been collected was I able to shuffle them about until a picture emerged. "Ah huh!" I say, "I can see the Big Picture now". (This by the way relates to the Pattern Matching I discuss in my previous blog 'My Autism Superpower').

The puzzle pieces are the various feelings and sensations I have which are numbed by interoceptive difficulties. As with so many things in an autistic person's life, I am having to use my cognitive abilities to compensate for my impairment, using my reason to metaphorically place the puzzle pieces on the table and shuffle them around to find the picture. 

Despite my interoceptive difficulties and my struggles with developing the Big Picture, a picture does finally emerge. I see the pattern and having processed everything there is no need to second-guess. The conclusion is clear: I must switch courses if I am to successfully complete my training. 

No comments:

Post a Comment

Autism is Everywhere!

The other day I got particularly fired up after reading a newspaper article suggesting that autism in UK was being over-diagnosed. Apparentl...