SEVEN MYTHS ON ADULTS WITH AUTISM

“I don’t work within the normal social pauses.”

It began in graduate school, when a young college student came into our clinic frantic, desperate for help.  Next to his desperation, the first thing that struck me was his earnestness.  There was a genuineness, a raw honesty I found both endearing and heart wrenching.  He rapidly explained how he had fallen in love with a girl who did not reciprocate his feelings.  He was articulate, but something was different.  He seemed to want help, but it was hard to interject his rapid rambling speech.  As his story unfolded, it was clear that he had misread his beloved’s cues for many months, and she was actually quite clearly another’s beloved.  How had he missed it?  I marveled.  Something about this young, hurting man was strikingly unusual.  It was the way he looked, or rather, didn’t look quite at me, the unique way he spoke and phrased things, and his apparent cluelessness about social interactions.

It just so happened that at that time, I was working under the mentorship of a psychologist with expertise in identifying and treating Autism.  She taught me to dispel one of the first of many myths I would encounter in my career helping adults on the autism spectrum:

MYTH 1: People who are highly intelligent often lack social skills.

FACT: It is a common misconception that intelligent people are less socially skilled; highly intelligent neurotypical people have social skills that match their intellect.

Our intelligent and broken-hearted friend had been previously mis-diagnosed with just about everything in the book, from Bipolar Disorder to Borderline Personality Disorder.  Unfortunately, there is still a lack of understanding, even among mental health professionals, about the various ways Autism Spectrum Disorder can present in adults.  In fact, it wasn’t until 1994 that high-functioning forms of autism were acknowledged at all.  His social struggles, it turns out, had been mis-attributed to his high IQ.

“I am always told, ‘Don’t say it that way,’ and then they use the same words I just said.”

As my career progressed, I became more and more invested in helping adults on the autism spectrum.  I saw that while this population is often tragically misunderstood, they are also more common than we think.  Chances are, you know someone on the spectrum.

MYTH 2: Autism is rare.

 FACT: Current estimates are that 1/59 children have a diagnosis of Autism Spectrum Disorder.  This diagnosis remains one of the most common and least understood in the mental health field.

I have found many individuals on the spectrum to be articulate, delightful, intelligent, and talented people who need help appreciating and building on their strengths.  As Temple Grandin said, “Parents get so worried about the deficits that they don’t build up the strengths, but those skills could turn into a job.”  Unfortunately, even when the possibility of Autism is recognized, even professionals sometimes hesitate to diagnose, thinking:

MYTH 3: Adults will not benefit from a diagnosis.

FACT: Symptoms of Autism sometimes become more problematic later in life, with the increased responsibilities and need for social interaction that come with employment, and the pressures of social-emotional reciprocity in intimate relationships.  A diagnosis can unlock doors to important vocational and relational help, and many adults express relief to finally have an explanation for their difficulties.

Adults who are newly diagnosed with Autism are truly survivors—they have lived with multiple problems in an overwhelming world, often with little or no explanation as to why these things that come so easily for others are so difficult for them.  They have often developed adaptive coping skills and are quite resilient.  The quotes throughout this article, by adults with Autism, illustrate just a sample of the bewilderment they often feel.  In fact, many individuals have described feeling like “aliens” on the “wrong planet.”

MYTH 4: People with Autism lack empathy.

FACT: Yes, individuals with Autism often struggle to identify and express emotions, they can easily overlook nonverbal cues, and they may often speak without tact.  However, the ability to feel deeply and have profound empathy is not absent, and in many cases, may actually be pronounced. Some individuals actually experience so much empathy that they become easily overstimulated and overwhelmed, which can disrupt their ability to effectively process and appropriately respond in the moment.

“People think I’m weird.”

I have heard many well-meaning individuals refer to individuals on the spectrum as “antisocial.”  While antisocial has a whole other connotation for those of us in the mental health field, and I think what people are often trying to say is “asocial,” this is still not quite accurate.  In fact, many individuals on the spectrum are desperately lonely and strongly desire friendships and romantic relationships.

MYTH 5: People with Autism don’t want friends.

 FACT: Individuals with Autism vary just like everyone else with regard to how introverted or extraverted they are.  Autism is a condition, not a personality.  Many individuals with Autism are painfully aware of their social struggles, and have a deep longing to connect with others.

In recent years, I have begun to see a lot more women who wonder, “Could I be on the spectrum?”  One woman came to me almost uncontrollably tearful, having felt misunderstood and hopeless for many years.  As she disclosed her pain, she fell to the floor of my office crying, wondering why she has been persistently teased, rejected, and ignored.  Traditional treatments for anxiety and depression were unsuccessful for her, and she felt that her providers failed to understand just how difficult relationships are for her.  Now in her 30’s, she shared how she has only recently learned that basic hygiene improves her social interactions.  She tearfully expressed her disappointment that “I’m not a better friend.” She also said that she can “socially freak people out” because they often do not get her jokes and misinterpret her intentions.  She was, like many adults I have encountered, deeply relieved to have a diagnosis and hope for more effective interventions.

MYTH 6: Autism is a male condition.

 FACT: Autism is more commonly diagnosed in males; however, females are often underdiagnosed.  Women tend to be better at “masking” their symptoms, and the diagnosis is often missed in high-functioning females who tend to be more emotionally expressive than males on the spectrum.

There is an incredible variety of men and women who may have this diagnosis; many of them are high-functioning professors and engineers and artists.  Sometimes they are referred to as “quirky,” “eccentric,” “different,” or “unique.”  Often, their humor is subtle, unexpected, and brilliant.  Their loyalty and passion for social justice are just some of their many admirable traits; the range of characteristics on the spectrum of autism is no different than the variety of personalities seen among neurotypicals.

MYTH 7: Autism is a homogeneous condition.

 FACT: There is actually a remarkable degree of variability among individuals on the autism spectrum.  As my mentor taught me, “If you’ve met one person with Autism, you’ve met one person with Autism.”

Emily Crawford-Thompson, Ph.D. is a Licensed Psychologist in Columbia, Missouri who has worked with adults on the autism spectrum since 2009 professionally, and throughout her life personally. She has co-presented on Autism Spectrum Disorder with David Finch, a humorist and author of the acclaimed New York Times best-selling memoir, The Journal of Best Practices.  Read more about Dr. Emily’s work with adults with Autism here.