OCD and the nature of autism

[Nadador]

I agree with the overall suggestion that the best way to treat OCD (or any disorder) is to get specialized professional help. One of your statements didn't sit right with me, though. How can the number of successful OCD self-helpers be quantified? Like the most functional Aspies, those folks aren't as likely to present for treatment. Or if they do, the success they eventually have on their own isn't likely to be documented, since it would be most likely to happen after the treatments prescribed by doctors have failed.

The above is posted as context for what follows, from SignOfLazarus.

Studies are done frequently involving various individuals, with various cohorts- at times one of those cohorts may be precisely that group which you describe. At times several of the cohorts may consist of those who have recovered or have improved symptoms sans treatment or at a time when they are not being treated.

Ideally, but rarely, in my experience and from my reading. Accessing successful self-helpers is a major problem.

How would one have any information other than anecdotal regarding the group of "most functional aspies"? The same way. Research studies.

Research studies in which the class in question is grossly underrepresented. If the high-flyers were adequately documented, the clinically accepted picture of ASDs would be markedly different than it is now. There is a better sample of us here than in any study I've read to date.

Look at the number of members here who didn't discover their autism until later in life, and the number of us, like me, who have been denied diagnosis for our long history of adaptation [and other factors].

People who function well aren't generally inclined to visit a mental health professional. When they seek treatment for isolated symptoms, ASDs are missed and misdiagnoses are made.

Much of the information that's out there on the highest-functioning autistics is found in venues like this one, not in research literature. One example: The extrovert Aspie, a group that seems to be more adaptive than its more common introvert counterpart. I have yet to find a single study on this group, yet there are several of us just on AC.

If information were to only be gathered via treatment records, it would be useless as a whole picture because it wouldnt be the whole picture, and actually would be extraordinarily biased.

Which is exactly the situation that faces autistics today. How often have you seen related grumbles here?

I thought we were doing the sciency evidence thing here as well, but no? I dont really get it but did feel the need to respond because Im crazy.

This comment was unnecessary, and based on your personal perspective. Part of good science is recognising what's missing, and what can't, or can't well, be determined.

 

[Nadador]

The suggestions of improving ones OCD severity using avoidance, suppression, alternative/replacement response and rewards for any of the above makes me wiggy.

Basic principled research in OCD shows that at minimum avoidance and suppression feeds the OCD beast in cases of OCD, rather than complex symptom overlap or when having recurring periods of severity.

In this way, OCD can often be like quicksand, which is why treatment is often pretty specialized for anyone who has a moderate to severe case. It can remit for a time, even for quite a while and that is more common when comorbids are present.

When I was disabled by OCD, the British medical establishment was still using methods like ECT, and aversion therapy with smaller shocks à la Arnold A. Lazarus. The track record of these methods was dubious at best. Treatments like Exposure and Response Prevention (ERP) had yet to reach the mainstream. I was quite young but I did my research...I knew I didn’t want either to be electrocuted or to risk being branded disabled in a national health system, which could significantly interfere with my employment, and thus, my personal goals. So, I had to get creative and go it alone.

At that juncture, I was spending more than half my waking day checking light switches, checking knobs on the cooker, and standing with my ear pressed to the walls to listen for irregularities in the hum of old wiring. I would check my door lock no less than twenty times before leaving my flat [that was my minimum standard], then walk or bus less than a mile before I had to turn round and go back to check twenty times more. I would become so mired in my loops that I would rock, hum, and click my fingers, frightening myself to death just as I was trying to calm myself. I lost my job and what little social life I had, plus two stone of weight on an already slim body. I could only rarely make it to the shops to get food. Then I employed self-styled treatments of the sort that make you “wiggy”, and over time, my life normalised, more or less completely. The same process worked for my writing, as I mentioned before.

So I say to hell with “basic principled research” that suggests what I did shouldn’t work. At the time, said research of the day would have had me jolted with the same electric current that terrified me. We do those things in the interest of our own care that are appropriate to us as individuals. For me, what you might call a bad idea was very good medicine. If it worked in my case, there may be others for whom it would have the same beneficial effect. I’m not saying everyone, but I am saying some, unless we are to conclude that I may not be human.

Let me make clear, I fully agree with you that today, the best course for anyone whose functioning is markedly impaired by OCD is to seek out a specialised clinician for evidence-based treatment. It’s true to say, though, that not everyone has such a specialist within range, not everyone can afford professional care, not everyone has the requisite confidence in mental health practitioners, not everyone responds to the preferred treatments of the day, and not everyone wants to seek professional help until they’ve exhausted all avenues for mastering themselves on their own. It is to those persons that I address my suggestions. Yes, I did see that you allowed for the possibility of independent success, but your full post felt hard-bent towards the inadvisiblity of such efforts.

I don’t mean to sound hostile, Laz. You know I have an affection for you. I am, however, a bit disappointed by the way you introduced your post. My methods may make you "wiggy", but they are effective for some sufferers when currently accepted treatments are not. The reality that not every method works for everyone is why a variety of approaches often exist even within psychiatric practise.

 

[Nadador]

However that said, this does makes me wonder if social anxiety is truly a separate comorbid issue independent of Aspergers, or just a classic manifestation of Aspergers. Yet one can be diagnosed with social anxiety, and not even be on the spectrum of autism. Is this the medical rationale used to separate the two?

It is a question of degree. Asperger's entails traits of social anxiety, but when most all traits of SAD and a certain level of severity is present, it can fairly be considered a proper co-morbid condition.

I've just said to Royinpink that unfortunately, the line between these two situations is ultimately left to the judgement of the individual practitioner.

I was diagnosed with GAD, or rather, its equivalent at the time, when I was a child. In my twenties, I self-diagnosed OCD and Tourette's, which were eventually officially confirmed. I'm quite convinced that symptomalogical overlap has been an obstacle to confirming my Asperger's, though there is no doubt in my mind the shoe fits. Because Asperger's is known to include traits of all three of my other disorders, it's easy to assume those other diagnoses are explanation enough of what's going on with me. I'm afraid I'd have to seem more socially impaired than I currently do for any doctor to believe I could ever be an Aspie. So much for saving the best for last.

My apologies for repeating things I've only just said to you on another thread this week. I felt it was relevant to your post here as well.

 

[SignOfLazarus]

I cant participate in this anymore or probably any other threads on OCD for a while because, as I said, I'm crazy- a comment which I now realize has likely been misunderstood by multiple people. Wasnt intended as an insult or subtle jab,to clarify.

Was a reference to my personal OCD crap which makes me feel theneed to return to things again and again to clarify, rephrase, ask, assure, apologize, etc because Im convinced I have it wrong or have misrepresented or am actually accidentally lying- and this is a soundtrack that plays 24/7, one of many at this point.

Awesome thing about OCD: it can makes you appear like a complete and total as whole and has the potential to alienate EVERYONE. Not because they just find you odd, in attempting to rectify one mistakeyour brain sets up you create five more.

I meant absolutely no malice by anything I wrote here, so apologies.

haha, I know one topic I should avoid. good to know our weaknesses...

 

[royinpink]

I cant participate in this anymore or probably any other threads on OCD for a while because, as I said, I'm crazy- a comment which I now realize has likely been misunderstood by multiple people. Wasnt intended as an insult or subtle jab,to clarify.

Was a reference to my personal OCD crap which makes me feel theneed to return to things again and again to clarify, rephrase, ask, assure, apologize, etc because Im convinced I have it wrong or have misrepresented or am actually accidentally lying- and this is a soundtrack that plays 24/7, one of many at this point.

Awesome thing about OCD: it can makes you appear like a complete and total as whole and has the potential to alienate EVERYONE. Not because they just find you odd, in attempting to rectify one mistakeyour brain sets up you create five more.

I meant absolutely no malice by anything I wrote here, so apologies.

haha, I know one topic I should avoid. good to know our weaknesses...

Hey, just want you to know that I did not interpret anything you said as an insult, jab, or anything other than an earnest attempt to contribute (and was sorry to see it taken otherwise). I've really appreciated your posts, and I can definitely relate to the anxieties about even posting on this thread.

Myself, I've had to take a couple breaks to off-load anxiety before returning to it. My first attempt to reply to Nadador (which never saw the light of day) was like purely obsessive listing...until I ended up lying down, staring intently at the wall with my thoughts on endless loop and was asked by my boyfriend if I was okay (he actually automatically laid on top of me to give me deep pressure, because he has learned what to do, aw). Had to go eat, walk around the block in circles, then return, delete response, try again.

 

[royinpink]

My response to Nadador will have to be a separate post again, haha.

In my own case I'm inclined to believe that anything directly connected to Aspergers has to have a common denominator of socialization. That without being in the company of another human being, it's not likely to be an issue.

However that said, this does makes me wonder if social anxiety is truly a separate comorbid issue independent of Aspergers, or just a classic manifestation of Aspergers. Yet one can be diagnosed with social anxiety, and not even be on the spectrum of autism. Is this the medical rationale used to separate the two?

Conversely, my manifestations of OCD and Clinical Depression don't usually involve socialization at all. Yet I have OCD in different ways. Some reflecting a connection to traumas of my past, and others which just seem inherent to me.

Enough for me to argue both sides of such issues. Or simply admit to being confused.

Currently, there are two categories of symptoms for ASD: social impairments, and rigid and repetitive behaviors. As the latter may not be primary symptoms themselves but a result of other anxieties, sensory sensitivities, etc., I can definitely see where the social aspect seems to be the key identifying factor for whether it's a direct result of ASD/Asperger's. However, I think the current criteria are not quite right, and we're beginning to see how the social impairments are also secondary to differences in thinking, which have other effects as well. And all of these factors may be tied to common comorbids with ASD (this is why in an earlier post, I mentioned autistic attention to detail, associative thinking, and all-or-nothing thinking as they relate to OCD and depression).

I think others, including Cynthia Kim, have mentioned that social anxiety for autistics isn't irrational, and on this basis she objects to considering it a disorder. It's considered to be a disorder in NTs with no social deficits, but anxiety is part of healthy human functioning when it's about genuine threats, and for someone with social impairments, social situations do present a genuine threat. On this basis, I'm not sure if social anxiety really ought to be considered comorbid with ASD, but I suppose if the anxiety truly gets to ridiculous levels, a label might help for getting treatment for that specifically, on a practical level.

I beg yer pardon! I did indeed gots it and I says so yesterpage.

Sorry, I really phrased this poorly and in fact considered editing my post again to fix this but suppressed the urge since I'd already edited it at least four times. I meant 'got from the video', not got as in 'understood at all'. Anyway, apologies.

Sometimes I feel like language is my second language, and images are my first. Some of my favorite thinkers are also those who agonize over their inability to express themselves in a way that enables others to understand the image in their head (not because of the agonizing, but because their words seem to make better sense to me and hold my attention). I wonder if some of my perfectionism is then a direct result of a genuine difficulty with expression and my fixation on correcting it (which relates to what On the Inside says below), rather than a totally irrational desire for perfection. ...Does that makes sense to anyone? Not sure I've quite got it right.

I'm not certain that my desire for transformation triggered OCD, maybe. Anxiety up the wazoo, yes. I find it difficult to fully relate to the description of Obsessives and Compulsives, maybe it's denial. But if it helps explain something, I'll go along with it, especially if it is something that can be treated. My obsessiveness and anxiety sprung mainly from trying very hard to do what I needed to in order to get somewhere, and continually coming up short. I became fixated on the need for transformation as the only way I was going to make it. Every thing I would try to do became loaded with this need. The transformation I longed for was a result of a deep need to be recognized, understood, accepted, to reach my potential, to find my true place in life.

Yes, I wasn't sure how to respond to your original post, because although I related to it, I was having trouble separating the aspects that seemed to deal with 1) fixations on your perceived flaws that were a direct result of ASD and could be helped by diagnosis and accepting yourself as you are, versus 2) your particular OCD fears, and how that relates to perfectionism.

 

[Slithytoves]

Can we be born with comorbidities, and/or are they instilled in us - as if by osmosis - by our parents? Are parents with such conditions more likely to have Autistic children or are their own conditions indicative of their own Autistic traits? I'm not sure if I'm just reading this too literally..?

On your first question, my guess is probably both. Genetic predispositions can be triggered by environmental factors; that I know. My father has rapid-cycling mixed Bipolar Disorder. I dodged that bullet, inheriting his genetic burden as Major Depressive Disorder instead. (There is evidence that major mood disorders exist in a cluster, such that a parent who manifests one can pass it down to their children to manifest as either the same disorder or another from the group.) I was carrying "latent" MDD around for years until finally a trauma brought it to the surface. Now I am forever susceptible to further episodes and with less provocation than the first trauma that kicked it off. My current psychiatrist (a mood disorder specialist) explained all of this to me. I'd also done some reading on it in the past, but it was a while ago so I don't have citations handy.

About your second question, I personally have never read anything to indicate that parents who have expressed or latent genetically-linked mental health conditions, but don't possess unexpressed "suspected" autism genes, would pass on autism to their offspring. The disorders aren't related that way. But if those parents do have the genes for autism, it stands to reason that a kid could inherit the whole shebang. The first sentence of this paragraph was wicked long. I hope you get what I mean.

I realise now that I feel disempowered (not quite the right word, as I know now that I never felt empowered in the first place) for this lack of nurturing in my young life and I believe this has set me up to think that, no matter how much I've achieved over the years, I've never felt/believed I was adequate/successful/equal - I always feel I'm setting myself up for failure, I'm never good enough.. and yet, I know rationally that I've never really failed at anything I've tried.. except wolf-whistling and juggling perhaps..
What a contradictory state - rationality Vs self-belief.
Thank god for rationality!

I really feel you on this one. My childhood nurturing went to heck once my father's Bipolar Disorder hit full gear; neglect as well as abuse. I was told I was inadequate in one way or another almost daily. For a long time I was a master of self-sabotage and self-fulfilling prophecy. All my potential went down the toilet. I'm still in recovery and I'm sure it exacerbates my anxiety and depression immensely. I guess all we can do is make a conscious effort to resist the old "tapes" that want to play in our heads and make sure to count every success until we have too big a pile to ignore.

I'm not certain that my desire for transformation triggered OCD, maybe. Anxiety up the wazoo, yes.

My obsessiveness and anxiety sprung mainly from trying very hard to do what I needed to in order to get somewhere, and continually coming up short. I became fixated on the need for transformation as the only way I was going to make it. Every thing I would try to do became loaded with this need. The transformation I longed for was a result of a deep need to be recognized, understood, accepted, to reach my potential, to find my true place in life. I might even say to fulfill my destiny(?!!, there has always been a tendency for me to think there really was a reason for everything).

That's pretty much what I was interpreting from your other post.

On my own end, I have found that my desire to transform -- which is really about improvement -- does more or less directly trip my OC wire. I think I get bogged down in an obsessive-compulsive cycle in creative projects because the unconscious part of me seems to know things/how to do things that my conscious self can't access. I feel something there that I can't reach, and I go crazy trying to get to it. That's my version of needing to "get somewhere", to be recognized/understood/accepted, to reach my potential; all the things you said. I know my best potential is rooted in communication and creativity, so getting that stuff right becomes HUGE for me. When I can't, I crack.

So I guess what I see is this chain: Desire for transformation > Anxiety about elusive capacities (in my case) > OC freakout

How would one have any information other than anecdotal regarding the group of "most functional aspies"? The same way. Research studies.

If information were to only be gathered via treatment records, it would be useless as a whole picture because it wouldnt be the whole picture, and actually would be extraordinarily biased.

I thought we were doing the sciency evidence thing here as well, but no? I dont really get it but did feel the need to respond because Im crazy.

You're no more crazy than I am, Laz. No disclaimers required.

Nadador covered a lot of what I would have said to your response, so that's good enough. I'll just add that from my own, albeit limited experience working in biomedical science research labs and on social science research projects (assisting PIs with recruitment, etc.), the group that is darn near impossible to recruit and quantify is the elusive self-helper/high-functioner. We always know they're out there but they are extremely hard to connect with for study.

I'm one of the grumblers Nad referred to. I feel like the group of Aspies I fit into is virtually invisible for the lack of data and awareness of us. I get what you're saying, though. We just have different experiences/takes. It would be boring if we all agreed.

I cant participate in this anymore or probably any other threads on OCD for a while because, as I said, I'm crazy- a comment which I now realize has likely been misunderstood by multiple people. Wasnt intended as an insult or subtle jab,to clarify.

Awesome thing about OCD: it can makes you appear like a complete and total as whole and has the potential to alienate EVERYONE. Not because they just find you odd, in attempting to rectify one mistakeyour brain sets up you create five more.

So you may not even see this. But Laz, don't be so hard on yourself.

 

[Judge]

I suspect we can all agree that basically we're at the mercy of a highly subjective process on the part of medical professionals to diagnose people. Whatever that process actually is....

Which to me remains nothing less than unnerving. Fear of the unknown....in wondering if I am one of those persons who cannot definitively be diagnosed under the existing circumstances.

 

[Judge]

I meant absolutely no malice by anything I wrote here, so apologies.

No offense ever taken...not by me at least. Don't stop posting!

One person with OCD to another.

 

[AsheSkyler]

I think others, including Cynthia Kim, have mentioned that social anxiety for autistics isn't irrational, and on this basis she objects to considering it a disorder.

Aye, and I agree with her. It's not a disorder if it's rational and of regular proportions. I've long been using the same argument with depression. WHY are you depressed? Did Grandpa die, are you getting bullied at school, or is there something chemical going on? If it's Grandpa, ya just need to mourn. If it's bullying, the bully needs a good smack upside the head. If it's chemical imbalance, or you stay depressed much longer than average after the previous examples are dealt with because your chemicals likely got imbalanced in the process or you just don't have a healthy lifestyle, medication and further natural things like meditation and hobbies is recommended.

Sorry, I really phrased this poorly and in fact considered editing my post again to fix this but suppressed the urge since I'd already edited it at least four times. I meant 'got from the video', not got as in 'understood at all'. Anyway, apologies.

I tried to say it silly so you wouldn't think I was mad.

Sometimes I feel like language is my second language, and images are my first. Some of my favorite thinkers are also those who agonize over their inability to express themselves in a way that enables others to understand the image in their head (not because of the agonizing, but because their words seem to make better sense to me and hold my attention). I wonder if some of my perfectionism is then a direct result of a genuine difficulty with expression and my fixation on correcting it (which relates to what On the Inside says below), rather than a totally irrational desire for perfection. ...Does that makes sense to anyone? Not sure I've quite got it right.

I know the feeling. A lot of my communication OCD comes from the fact that somewhere in that short little transit from brain to tongue, the words get lost along the way. As if they're ADD little buggers and went to go pick flowers instead of going to Grandma's house like they were supposed to.

I cant participate in this anymore or probably any other threads on OCD for a while because, as I said, I'm crazy- a comment which I now realize has likely been misunderstood by multiple people. Wasnt intended as an insult or subtle jab,to clarify.

I avoid saying "crazy" or "psycho" in a lot of my commentary because knowing my luck I would end up with a blood feud on my hands. Quite frustrating, ain't it? @_@

 

[Maelstrom]

The suggestions of improving ones OCD severity using avoidance, suppression, alternative/replacement response and rewards for any of the above makes me wiggy.

Basic principled research in OCD shows that at minimum avoidance and suppression feeds the OCD beast in cases of OCD, rather than complex symptom overlap or when having recurring periods of severity.

In this way, OCD can often be like quicksand, which is why treatment is often pretty specialized for anyone who has a moderate to severe case. It can remit for a time, even for quite a while and that is more common when comorbids are present.

I guess Im just suggesting if individuals have struggled for a long time with OCD, possibly find a provider who specifically specializes in moderate to severe OCD as their main clinical interest and has several different ways to approach it.

Also, if it is severly affecting your life, it obviously can happen that we fix this kind of thing on our own but public awareness doesnt really match up to the numbers on the matter. The numbers really tell us that if it is affecting your functioning you need help from people who know what they are doing.

something key to understand is, from a subjective point of view of an individual who may be autistic and experience OCD, there is a difference.

Autism has us do things out of expectation, comfort, things being "right". That can be generized to a lot of persepctives to suit specific people and situations but Im trying to be simple about it.

With OCD, everything starts with intrusive and/ or unwanted thoughts. About anything and everything. There is always a thought [obsession] and a response to that thought to compensate for it [compulsion]. With academic perfectionism for example- a thought/obsession would, obviously, center around perfectionism. The compulsion could be any of the following: rewrite a sentence over and over, freeze and try to "set" ones mind just right before writing, writing pages and pages and pages beyond what is necessary, avoiding writing at all, avoiding school... yes avoidance is a compulsion.

I deleted the post I had before because, honestly, I felt kind of like an idiot... but thats not anyone elses problem. Thats my problem [because yay OCD]… and this isnt criticsm really of personal experience, just I mean if things are getting to the point where they are affecting functioning it is more likely that you would get better relief from a provider with a specific clinic interest.

<3

Hi Laz took a little look at your blog hope you don't mind. Anyways thought I pop in to say I hope you are doing well. Your comments on OCD are quite interesting I will have to read more, my brother has OCD he is very perfectionistic and seems to want to punish himself a little too much when he isn't the best all the time. I didn't know there were any treatments. Best wishes to you Mael

 

[royinpink]

Can we be born with comorbidities, and/or are they instilled in us - as if by osmosis - by our parents? Are parents with such conditions more likely to have Autistic children or are their own conditions indicative of their own Autistic traits?

About your second question, I personally have never read anything to indicate that parents who have expressed or latent genetically-linked mental health conditions, but don't possess unexpressed "suspected" autism genes, would pass on autism to their offspring. The disorders aren't related that way. But if those parents do have the genes for autism, it stands to reason that a kid could inherit the whole shebang. The first sentence of this paragraph was wicked long. I hope you get what I mean.

I know at least some studies have suggested higher rates of depression, anxiety, and OCD among families of autistic children, although I can't speak to how trustworthy they are. A quick Google search turns up this one. Of course, correlation does not equal causation, and I would guess that, if there is in fact a correlation, these disorders are linked to the 'broad autistic phenotype' in much the same way comorbids are linked to autism--secondarily, as the result of difficulties socializing, communicating, or other functioning, or perhaps even intelligence. Depression also correlates to high IQ.

Also, it's been known that parents have similar obsessive thinking since Kanner did his original work on autism, and it was one of the reasons he mistakenly came to believe that autism must be caused by nurture, not nature. The father who contacted Kanner about the behavior of his autistic son, for instance, wrote a 33-page paper detailing all of it. Eventually Kanner went from thinking that autism must be innate to that the parents he was seeing were causing autism by being so cold (from wikipedia):

In his 1943 paper that first identified autism, Leo Kanner called attention to what appeared to him as a lack of warmth among the fathers and mothers of autistic children.[2] In a 1949 paper, Kanner suggested autism may be related to a "genuine lack of maternal warmth", noted that fathers rarely stepped down to indulge in children's play, and observed that children were exposed from "the beginning to parental coldness, obsessiveness, and a mechanical type of attention to material needs only.... They were left neatly in refrigerators which did not defrost. Their withdrawal seems to be an act of turning away from such a situation to seek comfort in solitude."[3] In a 1960 interview, Kanner bluntly described parents of autistic children as "just happening to defrost enough to produce a child."[4]​

 

[Slithytoves]

I know at least some studies have suggested higher rates of depression, anxiety, and OCD among families of autistic children, although I can't speak to how trustworthy they are. A quick Google search turns up this one. Of course, correlation does not equal causation, and I would guess that, if there is in fact a correlation, these disorders are linked to the 'broad autistic phenotype' in much the same way comorbids are linked to autism--secondarily, as the result of difficulties socializing, communicating, or other functioning, or perhaps even intelligence. Depression also correlates to high IQ.

Great info. Thanks for the study. I find this stuff fascinating. This really has been a thread among threads. Thanks for that, too.

I have definitely found that most people I've met with high IQ live with depression, at least. Get a real "plus" in one column and nature seems to balance with a negative in another. I guess it's up to the individual whether the advantage is worth the liability.

 

[royinpink]

Hey, sorry for the very delayed response. Had a paper due, which is something that has come up in this thread before so I won't say more... anyway, I hope it's not too late to add this.

Read the quote above with even just one, blurry eye and you’ll see that this mess is far more inaccurate than any simplifications I’ve done for the purposes of this discussion.

Okay, I'm going to stick my response to all your comments about the quality of the video and/or the danger a video like this poses here (so, uh, if anyone isn't interested in this part of the discussion, please skip down!):

I have no objection to you saying the video is inaccurate. I don't think I claimed it was accurate... to me, the video had a different function. Part of that is the context I was coming from, but part of it may just be how I approach blogs or vlogs in general: not for scientific accuracy, but for interesting ideas to play with. I suppose if I thoroughly disagreed with everything he said, I would be more dismissive, but for me, there was enough in there that wasn't confused nonsense that I could draw out the ideas he wanted to call into question. It 'reads' to me like an high-schooler attempting PhD-level work--not someone totally off-base but someone who doesn't have the background to support the ideas they want to argue.

Of course, I would place higher standards on myself. It might even be the case that the video would have been more influential (it's not as if this is a particularly popular video, after all) if it were either more scientifically grounded or more based in the authenticity of personal experience. However, I'm not sure if I want to hold everyone to the standard of rigor I might demand of myself or of science. In fact, I'd go so far as to say doing so would be more dangerous than uninformed bloggers, a totalitarian externalization of my perfectionism.

I generally try to take a step back before I externalize that tendency and look at things 'sociologically'. When I do so, I see him as only one voice among many that support a general trend toward viewing autism as something that shouldn't be pathologized, which is a trend I support. There are better voices in that trend, to be sure, but what trends do is grow and gain influence. Socially speaking, the bigger your group is and the more symbolic and social capital it has, the more people pay attention to you, whether or not your arguments hold water. Some of those people who must pay attention will, eventually, be scientists. If it were the case that science had definitively proven him wrong and he was purely spreading lies around, I might be more critical, but I don't think that's what he's trying to get at (see below for what I think that is).

In summary, the problems of interpretive judgement loom just as large in the physical sciences as they do in the social...judgement being subject to preconceptions, personal bias, conflicts of interest, matters of culture [scientific and otherwise], and many other factors that taint the research process. And it is ultimately by judgement that it is decided if the results of any experiment support a hypothesis or not.

Here I totally agree. I love that there are scientists like Anne Fausto-Sterling (somehow Sexing the Body is available online, what? I can finally finish reading! Left my copy in the US) who actually are versed in social theory and (in her case) biology who can do the necessary work of exposing those problems.

What I meant was that although researchers in the physical sciences always need to deal with "preconceptions, personal bias, conflicts of interest, matters of culture" and so on, the phenomena they investigate do not. They do not study bias or culture itself. But when I said this, I was really thinking of the distinction between 'creatura' and 'pleroma', which I got from Gregory Bateson, an anthropologist-turned-psychologist who stole them from Jung to avoid the division between mind and matter, and used them for information theory and cybernetics. The distinction goes like this:

In summary then, we will use Jung's term Pleroma as a name for that unliving world described by physics which in itself contains and makes no distinctions, though we must, of course, make distinctions in our description of it.

In contrast, we will use Creatura for that world of explanation in which the very phenomena to be described are among themselves governed and determined by difference, distinction, and information.​

So when I said that social sciences have to deal with problems of meaning and interpretation that physical sciences do not, I really meant that creatura have meaning and interpretation inherent to them in a way that pleroma do not. And that includes all organisms and their evolution. However, the actual social sciences do have an additional layer of meaning and interpretation to deal with in their object of study: culture. I think that it's all these layers of meaning that create methodological problems for the social sciences, as the more they try to get 'hard, quantitative data', the more they ignore context.

Indeed, I’ve seen good firsthand evidence that the pressure of the charges you describe often motivates today’s social scientists to be more faithful to Scientific Method than their counterparts, who level accusations relatively free of similar scrutiny except among their own. The real tragedy of this antagonism is that the aforementioned pressure is what’s largely behind the “hunger” of social scientists, “to be more quantitative and reductionist.”

I couldn't agree more with your last sentence, and that is what upsets me. Perhaps here I should admit that first degree was in anthropology and linguistics, which of course use ethnography (which has its own problems, but in the opposite direction ...maybe interdisciplinarity is the way to go). I tend to think that rather than making scientists more faithful to the scientific method, the pressure from the physical sciences or others to be a 'real science' has made them blind to what would truly be more scientific in their own subject, imitating methods that are not necessarily best applied to the questions they pursue (this obviously depends somewhat on the sub-discipline). But I'd agree that psychologists and other social scientists are in general more aware of this problem than physical scientists.

There’s no denying the challenges of classifying these disorders. It’s why lines of investigation and diagnostic manuals evolve over time, if sometimes clumsily. It’s why new disorders are established, existing ones are reassessed and updated, and why old ones are sometimes discarded. ... Abnormality is decided in the sciences by numbers, first and foremost.

First, I'm not sure what you mean by 'decided by numbers'. The only abnormality I'm aware of that's defined statistically is IQ--two standard deviations above or below makes you abnormal. I think most would find that definition completely arbitrary, not to mention impossible to apply due to lack of any reliable quantitative measure, for other traits. I believe most abnormalities are decided by "impaired functioning," but correct me if I am wrong. Autism is one of them. You need to have clinically significant impairments in work, social life, or school to be considered autistic. Or depressed. Or any number of other things. Autism is different, however, in that you also need to have symptoms present in the early developmental stage, a tie to biology.

Second, distinguishing specific disorders (after you've decided what constitutes abnormality in general) relates to what I said about this problem belonging to the border of philosophy and science. I thought of what it is: the problem of natural kinds. Someone should tell the guy in the video that what he really wants to do is argue that psychological disorders are not natural kinds, as that is what it means to say that disorders are "created" rather than discovered. It's an interesting topic, bet I could come up with an answer...

I excised the relevant comment, but be assured I find nothing condescending in anything you’ve put here. I’m quite enjoying this, though I’m a bit frustrated that we can’t just discuss it in person over a good bottle of wine. I think we’d get on very well.

I'm flattered. Although currently I'm a bit of a mess, so I'd probably be intimidated to death, drink too much wine, and become a huge grouch because it messes with my medication. (ETA: my poor attempt at a joke...)

That was your understanding, but that isn’t what he said:

Thanks for transcribing all that. Saved me from watching the stupid thing again! Anyway, my interpretation is based on the last part: "I have encountered enough people diagnosed with autism that I can now say I know it when I see it, for the most part. But what am I seeing and identifying? It is nearly impossible to say." When he says 'thin air', he doesn't mean it doesn't exist. He means that you can't pin it down--that the symptoms that are currently used to diagnose ASD are actually symptoms of comorbids, but there is 'something' beyond those symptoms causing them that we can't quite grasp yet.

I'm still reading The Autistic Brain, and today I came across this. I think Temple Grandin has a lot clearer statement (no surprise there) of the problem with the current symptoms:

Researchers might not trust self-reports, but to my mind these quotations [referring to self-descriptions of sensory sensitivities] are an invaluable resource, not just for the information they contain but for the larger lesson: If you want to know what the symptoms of autism mean, you have to go beyond the behavior of the autistic person and into his or her brain.

But wait. Isn't the diagnosis of autism based on behaviors? Isn't our whole approach to autism a result of what the experience looks like from the outside (the acting self) rather than what the experience feels like from the inside (the thinking self)?

Yes. Which is why I believe the time has come to rethink the autistic brain.​

(This is after several pages describing how symptoms, especially of nonverbal autistics, have been misunderstood and miscategorized by observers, e.g. behavior that is the result of sensory overload being interpreted as "underresponsive")

I said obsessive-compulsive behaviour is natural to Asperger’s. Symptomalogical overlap. There is a point of demarcation after which the severity of traits indicates a full-blown disorder, but unfortunately, that judgment is ultimately left to individual practitioners in the field.

I still think it's not just a matter of degree of severity....like the same way OCD must be ego-dystonic (felt to be intrusive and externally imposed) and OCPD must be ego-syntonic (felt to be right and part of one's self), there is a difference in kind between obsessive autistic behaviors versus true OCD. What do you think the point of demarcation is?

Our disorders are part of our identities, the same as our sex, gender idenentity, race, etc.

How can autistics honestly embrace our difference if we won’t accept that we are measurably different? That’s all “disorder” is. Difference from the norm. This lad is assigning a value judgement to the term that isn’t inherent to it. I’ve seen this issue argued here before. Why it fails resonate escapes me.

Here I disagree. First, most people with mental illnesses or physical disabilities don't see them as part of their identity in the same way autism is a part of someone's identity. This is a big reason why autistics reject the PC "person first" terminology used for physical disability and instead use terms like autist, aspie, and neurodivergent. And although I've been depressed and anxious, and now apparently have OCD, I wouldn't say any of these are part of my identity in the same way. They're a part of my experience, and my inclination toward them--perhaps a critical mind, etc.--is part of my identity, but being an aspie or a woman or bisexual or other aspects of my personality are more core to my sense of self and less something I endure. That said, I admit this is a hard distinction to make, at least in my own case, as I have had lifelong mental health issues and can't ever remember not having them. I guess I'd say the struggle is a part of me.

Second, the DSM or ICD is not simply a catalog of 'differences', or they wouldn't have taken homosexuality out. It's a catalog of psychological conditions in need of treatment. It's a medical manual. If an abnormality goes in it, the value judgment assigned to it is 'illness'.

The science isn’t wrong, it’s incomplete. Most all scientists acknowledge this.

Science is fallible. Therefore, sometimes it is wrong. This is part of the nature of science and why we aim to have falsifiable theories--so that they can be proven wrong.

 

[Slithytoves]

FYI: Nadador is back off the grid for the next several weeks. Bummer. I was really enjoying your conversation!

It might even be the case that the video would have been more influential (it's not as if this is a particularly popular video, after all) if it were either more scientifically grounded or more based in the authenticity of personal experience.

I see him as only one voice among many that support a general trend toward viewing autism as something that shouldn't be pathologized, which is a trend I support. There are better voices in that trend, to be sure, but what trends do is grow and gain influence. Socially speaking, the bigger your group is and the moresymbolic and social capitalit has, the more people pay attention to you, whether or not your arguments hold water. Some of those people who must pay attention will, eventually, be scientists.

I read Nadador’s comments with knowledge of his thwarted efforts toward starting an education and advocacy nonprofit for adults with Asperger’s, so I may see more of where his frustration is coming from. It’s great that there is finally a trend toward viewing autism as something other than pathology, but it currently lacks critical components of a solid social movement, most conspicuously organizations. Social Movement Theory recognizes organizations as playing a key role in defining a coherent community identity and goals, acquiring and deploying resources, and executing careful and consistent messaging. I’m pretty sure Nadador is familiar with how trends work, and he seems to be seeing what I’m seeing, which is too many voices and not enough discipline to draw the right kind of attention to the cause. If we had an organization with even half the influence of Autism Speaks, I don’t think the fumbles of a vlogger would be nearly as distressing. When I watch this video I see someone speaking for a cause I have a personal stake in but for which the messaging is currently all over the place. I share Nadador's hunger to be better represented.

The capital that matters most for being taken seriously by scientists and other authorities is woefully lacking in the trend this vlogger is supporting --that I think most of us support -- right now. Having Asperger's and an opinion about it isn't enough, definitely not if that opinion isn't very well-stated. We need a good core of more formidable advocates and financial capital to buy political influence. Meanwhile, the sky has fallen in the U.S. with the excision of Asperer's Disorder from the DSM, and Autism Speaks is footing the bill for research with the opposite aims to what our community wants and needs. That's not this poor vlogger's fault, but I see how his video can be seen as frustrating against the backdrop of the bigger situation.

I give the kid credit for trying, though. I agree with you that his central theme is an important one.

Here I disagree. First, most people with mental illnesses or physical disabilities don't see them as part of their identity in the same way autism is a part of someone's identity. This is a big reason why autistics reject the PC "person first" terminology used for physical disability and instead use terms like autist, aspie, and neurodivergent.

This subject wanders into my wheelhouse since I’ve worked a lot with NAMI and with multiple offices and groups for people with disabilities.

Many people with mental illness and physical disability do see them as part of their identity, and lenses through which the world is viewed/the world views back, no different from autistics. When more social members of these communities are given the opportunity, they construct an identity culture with their peers based on shared experience and POV just like we do. Our identity-based community here on AC and those for MI and physical disability I’ve worked with previously are essentially the same. It’s true that many people with MI or a physical disability prefer people-first language. That said, none of the many I’ve discussed it with embrace PFL because they don’t see their conditions as part of who they are; they simply feel it affords them more dignity and is more suggestive of full personhood than the alternatives. Partiality to linguistic prescriptivism is understandable in groups whose members suffer labels like “crazy” and “crippled”.

That’s all “disorder” is. Difference from the norm. This lad is assigning a value judgement to the term that isn’t inherent to it. I’ve seen this issue argued here before. Why it fails resonate escapes me.

Second, the DSM or ICD is not simply a catalog of 'differences', or they wouldn't have taken homosexuality out. It's a catalog of psychological conditions in need of treatment. It's a medical manual. If an abnormality goes in it, the value judgment assigned to it is 'illness'.

I see two different issues in discussion here and it looks like they're causing a disconnect. Based on his comments on previous threads, it seems Nadador is arguing the same case I do about the term "disorder"; that it originates on the research end where it is generally considered value-neutral. It's because of that that neither of us have a problem with its usage.

What you're talking about is more self-evident in your actual post and stands very well as stated. When ASDs are included in a diagnostic manual with illnesses, a value judgment is automatically inferred.

There are enough well-functioning people on the spectrum that it's fair to consider autism a natural human variation (much like homosexuality, since you mentioned it). But there are also enough people who are significantly impaired by the primary symptoms of ASDs that it's valid to believe they belong in the DSM, especially since the APA now classifies the entire array of disorders as a single diagnosis (which I think is a crime).

I see this as the biggest dilemma faced by the spectrum community. It may be one we can never overcome. Higher-functioning autistics resent being classified in a way that suggests illness or dysfunction. Profoundly affected individuals and their representatives feel very differently. I think what it comes down to is that ASDs are so unique that there is no one correct way to frame them in our current system.

 

[Aspergirl4hire]

Something about this thread reminds me of my former ethnographic and PsyD colleagues, as well as a more recent medical person I cut ties with. The desperate pursuit of a particular form of respectability results in neither good data nor respectability. The chiropractor can't make himself an MD by making everyone call him "doctor" and wear open blue plastic gowns.

Videos that tell part of the truth are doing what great con artists do. It's much harder to disprove a partial untruth, whether it's actually told with intent to mislead or not. Good intentions should not be confused with good performance, and that guy's a demonstration of that principle.

It isn't helpful to introduce bad data. It is helpful to say "I don't know." Confirmation bias is not education--and every study on this that sees the light of news reminds us that people do not change their opinions easily because they can't discern fact from fiction.

Presentation is nearly everything to the casual viewer.

This is how politics makes science sick.

If you repeat lies, over and over, people will believe the repetition but not the refutation. The repetition creates the confirmation bias. This is exactly how deniers of any inconvenient history or fact dispatch their more knowledgeable, more verbose, and more naive, colleagues. This is how confirmation bias and marketing defeat advances: as long as you have to dignify falsehood with discussion, you have endowed it with all it needs to survive and thrive: the opportunity to repeat itself.

Welcome to the Weeds of the Grove of Academe.

 

[AsheSkyler]

FYI: Nadador is back off the grid for the next several weeks. Bummer. I was really enjoying your conversation!

Oh, bah! Hrmph! That little conversation tease!

 

[royinpink]

FYI: Nadador is back off the grid for the next several weeks. Bummer. I was really enjoying your conversation!

Thanks for the heads up. Now I don't have to worry if I was too boring or stupid

It’s great that there is finally a trend toward viewing autism as something other than pathology, but it currently lacks critical components of a solid social movement, most conspicuously organizations. Social Movement Theory recognizes organizations as playing a key role in defining a coherent community identity and goals, acquiring and deploying resources, and executing careful and consistent messaging. I’m pretty sure Nadador is familiar with how trends work, and he seems to be seeing what I’m seeing, which is too many voices and not enough discipline to draw the right kind of attention to the cause.

I definitely agree with you guys if what you want is to support a stronger social movement. I just don't think that should come at the cost of censoring vloggers. If we want organizations, we need to work on building them, not policing our members on how they speak (unless they are truly creating division, intolerance, and violence, e.g. if we supported NT-bashing.). I worry someday something out of my mouth will sound like this vlogger and I'll get shouted down, haha.

With such an organization, also, there could be an authority-granting 'backer' to the videos or messages we wanted to put out, which would make him look like the independent vlogger he is rather than being a lone representative of the group.

I don't know much about Social Movement Theory, but I don't mean to imply that Nadador doesn't know any of this. It really is just a personal perspective I take...born largely of a great many arguments with my best friend in which I didn't like how other people did things 'because it's wrong!'. It helps me visualize what is really important and put it in perspective.

Anyway, thanks for explaining where you are coming from. It does help me understand your reaction.

Our identity-based community here on AC and those for MI and physical disability I’ve worked with previously are essentially the same. It’s true that many people with MI or a physical disability prefer people-first language. That said, none of the many I’ve discussed it with embrace PFL because they don’t see their conditions as part of who they are; they simply feel it affords them more dignity and is more suggestive of full personhood than the alternatives.

I appreciate your perspective...I started wondering more about the problems of this even as I wrote. Originally, I had heard people explain their aversion to PFL as (to paraphrase) "To me, 'person with autism' is like saying 'person with female-ness,'" and that really brought the point home to me in terms of why Asperger's/autism is part of identity. I had kind of disregarded the specific terms used before, it matters more to me what is meant than how it is said. How people label it doesn't change my relationship to Asperger's.

But the implication of PFL is that somehow the condition that comes at the end is distanced from the person--that can be because it is literally external, or because it has a negative connotation we want to distance ourselves from. For mental illness or physical disability, the negative implication is that these conditions make one somehow 'less' or 'unhealthy', even without anyone calling you crazy, just in the terms illness and disability themselves. People see them as things that happen to us. But things that happen to us shape our experience, and our experience makes us who we are, so I'm not sure it can be cleanly separated from identity.

However, the traits of ASD--if we get away from the diagnostic manual and look at the actual experienced traits of autism--are not wholly negative. Largely, they are two sides of the same coin. On one side might be impeccable attention to detail. On the other side might be devastating criticism and perfectionism. On one side, communication problems. On the other, incredible honesty and visual thinking. I think this is the distinction--not a hard and fast line between 'part of identity' and 'not' but ASD being (for many but not all) value-neutral, influencing one's whole way of thinking and valuing and being in the world. If I had a term for OCD that encompassed both the negative and the sometimes-positive attributes of thought that contribute to having it, then I think I would have no problem considering it part of my identity.

I know, here comes the 'but what about low functioning autistics' objection. I guess my question there is: is the problem really the autism? Or is it something else, from epilepsy to distress caused by ABA to a mind-body disconnect (apraxia)?

I really recommend anyone interested in this conversation read The Autistic Brain, which is Temple Grandin's newest book and tackles the DSM-5. I'm about halfway through now, and she's getting at the fact that not only are the genetics often 'value-neutral' when the behavior that gets picked up for diagnosis is, of course, only the problematic stuff, but that the symptoms are connected to distinct biological causes, which is why we're seeing this huge overlap with non-autistics who have mental, learning, conduct, or communication disorders as well as autistics who exhibit as much difference from one another as from NTs--think not just OCD, but Irlen's Syndrome, sensory sensitivities, even apraxia. She's basically saying even Asperger's/PDD-NOS/autism wasn't enough to capture the variation, and ASD may be called 'spectrum' but doesn't actually deal with the way a spectrum of traits manifests, not to mention dooming future research into the variation--the whole thing was flawed from the ground up due to a focus on external behaviors. There are even a few researchers who she cites as beginning to look into this, but of course not enough.

Back to the identity subject: Of course, identity is also social identity, which is why we focus on race, gender, etc. when we talk about identity, and another aspect of why some might prefer PFL for disabilities but not for autism. I never quite got how those are supposed to be more essential to my identity than my personality, but I guess it's true that I do not know what it would be like to be a man.

 

[royinpink]

Something about this thread reminds me of my former ethnographic and PsyD colleagues, as well as a more recent medical person I cut ties with. The desperate pursuit of a particular form of respectability results in neither good data nor respectability. The chiropractor can't make himself an MD by making everyone call him "doctor" and wear open blue plastic gowns.

I assume from the following comments that you must be making a connection to the vlogger here, but as I was reading, the only connection I could think of was to psychologists who are desperate to imitate the physical sciences. (This is probably because I didn't see the vlogger as pursuing a particular form of respectability--or at least not one above his actual status--and so the only other instance in this conversation I could think of was that.)

Videos that tell part of the truth are doing what great con artists do. It's much harder to disprove a partial untruth, whether it's actually told with intent to mislead or not. Good intentions should not be confused with good performance, and that guy's a demonstration of that principle.

It isn't helpful to introduce bad data. It is helpful to say "I don't know." Confirmation bias is not education--and every study on this that sees the light of news reminds us that people do not change their opinions easily because they can't discern fact from fiction.

This, to me, is just an argument for censorship. You can object to the opinions presented in the video all you want, but I don't think there is any action to take but to put out your own better message or encourage others to do so.

And actually, aside from confusing the diagnostic process with the research process and being a bit unclear in general, I don't think he's putting out untruths.

ETA: I do appreciate what you're saying. In science, I would certainly agree that we should have scientific ethics about introducing bad data (this is why I hate the pressure to 'publish or perish' etc.).

But in the public sphere, I can only say...this is why it's important to educate people to approach things critically. Personally, I try to disregard the things I have no proof for and look for the stuff that that I haven't thought of before to investigate or analyze. I realize this is not how most people consume media, and we may never attain a system that educates people to be properly critical--maybe it is just human nature. When I become frustrated over this, therefore, I remind myself that society needs all types of minds.

However, I also realize I am only human, and humans like things that play to their prejudices and beliefs. This is why our politics and television, beyond centering on conflict and tragedy to attract views, spends much of its time relying on cliche, stereotype, and appeals to identity--it's an instant way to gain a certain demographic's trust and approval. Most people don't like being challenged. I don't really see how this video contributes to that--people will continue to have opinions to share, uninformed or otherwise, regardless. I do see how capitalism and an increasing tendency to split off into groups that reinforce our own beliefs through greater variety of options in news outlets and social media contributes to it. The problem is one of what the current system is set up to reward and perpetuate.

(I can't help but think of my favorite philosopher Peirce here, and his "The Fixation of Belief," although it was written in 1877 and is not his more mature thought. "It is not to be supposed that the first three methods of settling opinion present no advantage whatever over the scientific method. On the contrary, each has some peculiar convenience of its own. ... Yes, the other methods do have their merits: a clear logical conscience does cost something -- just as any virtue, just as all that we cherish, costs us dear. But we should not desire it to be otherwise.")

 

[Egyptian]

My PsyD and I finally went to be assessed for what I am positive is Asperger’s. I say my doctorate attended because as a clinical psychologist, it’s hard to leave it at home when I’m talking to a colleague. I’m glad I brought it. It made it much easier for me to understand why, when I exhibit so many Asperger’s traits, I was denied a diagnosis of the new Autism Spectrum Disorder.

Do I still think I am an Aspie? Sure I do.

Now I watch the YouTube video in the OP. I see a self-righteous kid arguing (very badly) that he’s been lumped in with severe autistics who wear diapers when what he wants is to be free of medicalization. I laughed. He’s missing the point! He’s so busy crying out for change that he doesn’t see it’s already happening.

The prayers of those who don’t believe Asperger’s should be considered a disorder classified alongside mental illness have been answered. It isn’t anymore.

All that’s left of Asperger’s in the DSM-V is a note at the bottom of Diagnostic Criteria for 299.00 Autism Spectrum Disorder:

“Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.”

The DSM-VI will assume this has been done, and the term ‘Asperger’s’ will be out of the DSM forever--unless Aspies shoot themselves in the collective foot and insist the disorder be reinstated.

The problem now is actually on our end. Two years after the release of the DSM-V, we still aren’t seeing clearly.

We have been liberated.

We are now in a period of transition. One I lived through with my homosexuality in 1986, with the release of the DSM-III. Homosexuality was minimized in the DSM-II before it was removed altogether. This is how it goes, people.

Are we ready to shift our focus to what we should really be working out, and working on? Here are some things we need to be thinking about.

Does the removal of Asperger’s from the DSM pose a problem for those of us who like identifying as Aspies? No. We are now free to build a group identity out from under the shadow of medicalization. The self-diagnosed are now relieved of peer pressure because according to a handful of studies, most of our peers would lose their diagnosis if re-evaluated.

Does the removal of Asperger’s from the DSM pose a problem for those of us who need mental health services? No. Asperger’s-related problems of daily living that affect our psychological well-being can still be addressed in therapy without the label. So can co-morbid conditions. People whose symptoms are severe enough to warrant a specialized diagnostic label will be accommodated under Autism Spectrum Disorder or Social (Pragmatic) Communication Disorder.

Does it pose a problem for those of us who have impairments that require special accommodation? Yes. We have to figure that out. Nobody said this would be easy. Gays still have struggles in the workplace, too.

Does it pose a problem for those of us who identify as autistic as well as with Asperger’s? Yes. But a growing body of research suggests we’re biologically distinct anyway. Maybe it’s time we consciously reframe Asperger’s.

Does it pose a problem for those who have Asperger’s but have yet to discover it, and would benefit from an identity group? Yes. Right now it does. We have to convince sociologists to adopt us now that our psychiatric parents have given us up. It can be done. They’ve adopted homosexuality and I hear they still have a bed or two to spare.

Does it pose a problem for future research on Asperger’s specifically? Not necessarily. Homosexuality is still the subject of dozens of studies per year. There is no compelling reason to assume that science will forget Asperger’s exists just because it has been culled from the DSM.

You can probably think of other Q&A. Welcome to Change. It leaves a lot to sort through.

My point is, the kid in the video is emblematic of our cognitive dissonance on the current trajectory of Asperger’s. The hardest part has been done for us. We need to stop wagging our fingers at the psychiatric community and focus on what comes next in the change process. Hint: It has nothing to do with the APA anymore, and we should be celebrating.

Congratulations, YouTube Kid! You've won!

Doug