12:18pm October 1, 2014

Exposure Anxiety

youneedacat:

This is something I didn’t realize how much I had and I really need to reread Donna Williams’s book on it. Last time I was too defensive to read it properly, especially when she recommended Risperdal as treatment, which made me too furious to continue. Not that autistic people shouldn’t take Risperdal if they want to, but she’d been told it was a mild anticonvulsant (it’s not, it lowers the seizure threshold) and Risperdal has the potential for severe short-term and long-term side-effects including a severe worsening of autistic catatonia for anyone who might be experiencing catatonia. And remember, lots of autistic people have catatonia without having autistic catatonia. Catatonia is a set of motor traits that are exceedingly common in autism. Autistic catatonia is a progressive amplification of those traits starting in puberty or young adulthood.

Anyway Donna Williams wrote a rough sketch of what the diagnostic criteria for Exposure Anxiety might look like, and I thought it might be useful for autistic people since many of us are prone to it. This is a long post so it has a tl;dr at the end and a cut after the criteria.

If there were a diagnostic criteria for Exposure Anxiety it might fit the following:

A. Present from birth or infancy and persists throughout the person’s life span.

B. A marked and persistent aversion to directly confrontational attempts by even familiar others to share joint activities, communicate directly or cause self awareness, escalating from aversion to diversion, to retaliation responses. (Note: this could also be present in abused children, those with attachment disorders, and those with information processing disorders, sensory perceptual disorders, sensory hypersensitivities or sensory deficits).

C. Involuntary avoidance, diversion and retaliation responses revolving around basic self help skills and toileting even in the absence of any social audience. May later be accompanied by a tendency to mirror others when they are doing these things (can’t do as oneself) or to attribute responsibility to others or to objects to achieve these things (can’t do for oneself).

D. A social style ranging from self isolation to seemingly aimless wandering to highly active, even sometimes seemingly socially threatening approach-avoidance behaviours.

E. A communication style which may include any range of the following:

Selective Mutism, mindless (even self-hypnotic) singing or self chatter.

Short, telegraphic bursts of speech.

Whispered, self directed, rushed or overly slowed speech to the point of being incomprehensible.

Highly characterised stored utterances or scripts.

Persistently impulsive communications which are offensive or distancing.

Obsessive anxiety-driven descriptive or intellectual litanies. Artistic or typed expression far beyond what the person can express directly or verbally.

Note: Provided these are not better accounted for by Tourette’s tics, Semantic Pragmatic Language Disorder, Aphasias, verbal agnosias, Social-Emotional Agnosia, personality or conduct disorders, Alexithymia or other mood or anxiety disorders.

F. Exposure to uninvited praise and attention provokes immediate avoidance, diversion or retaliation responses. By mid-late childhood these EA responses may have differentiated into strategies of “can’t do ‘as oneself’, ‘by oneself’ or ‘˜for oneself’” in which praise and attention are tolerated when the person has assumed a role or character but not when they are caught off guard or when being themselves.

G. A phase in early childhood where there is no remorse for involuntary avoidance, diversion or retaliation responses but by mid childhood-puberty, self directed rage may result from progressive awareness of their own condition and desire but inability to escape it.

H. Avoidance, diversion and retaliation responses or strategies of “can’t do as self”, “can’t do by self” or “can’t do it for self” significantly interfere with the person’s ability to cope with change, transitions, demonstration of academic learning and skills, ability to function in employment, ability to gain or sustain general friendships, manage healthy parenting or sustain long term intimate or sexual relationships.

G. Involuntary avoidance, diversion and retaliation responses and depersonalisation strategies of “can’t do as self”, “can’t do by self” or “can’t do for self”, are not due to the direct physiological effects of any substance or other general medical condition and are not better accounted for by abuse or by other anxiety, conduct, personality, developmental, attention deficit, dissociative, attachment, mood or compulsive disorders.

Read More

Yes!!!! This, all of this.

And: “Holy crap she knew. She knew. And it made me terrified yet compelled to read on. These were things I’d never seen on the printed page. People like me didn’t exist in books, not as fully formed personalities. And here she was dismantling my every defense against the world without even trying. it was sometimes too much to bear.” YES! There were a few times where we threw her books across the room when trying to read them.

Exposure Anxiety is basically what lead us to becoming a multiple system. It’s complicated because… We both agree and disagree with the “only one real emotional self, the rest are just fake/masks/shadows” parts in her books and descriptions. Our brain sort of took a bizarre route where it compartmentalized to deal with EA and do things more indirectly, but what we compartmentalized into ended up being real and the real us. Then Jim in our system got incredibly pissed off about our IRL lack of self-expressive ability and started throwing himself headlong against the anxiety, the “lightning bolts”, for several years until he managed to break through quite a lot and desensitize himself and some of the rest of us along with him. I’m not sure if that exactly fits into what not-real selves are supposed to be able to do, hahaha. We are real. But personally I do know that the fact I am somewhat alexithymic ties in to why I have been one of the main fronters here, it means I can act as an Exposure Anxiety shield in a way because it leads to overall indirectness since I feel a bit disconnected and often have an incomplete picture of what’s going on with us emotionally until I really stop to listen.

Lots more to say but have to get ready for work. Just sort of rambling here anyway. We get excited when we see other people talk about Exposure Anxiety, because it is such a huge part of our autism and even among other autistic people it is very rare to find someone else who understands.

-47

Donna has changed her mind a lot, over the years, about what her plurality represents and whether the others are real people or not. I remember she started off distancing her experiences from “true DID” and then she got diagnosed with DID years later and had to reevaluate everything. A friend& of mine who’s plural has said that they think Donna has spent a lot of time in denial about many aspects of her plurality. So I wouldn’t take her word for much of anything on that, especially since she likes to do the “Some people call themselves plural without severe trauma and they must just want to feel special” thing. :-/

Notes: