Monday, October 28, 2013

Autism, empathy, and understanding

The other day, Bud was doing something I didn't want him to do - something I've told him a million times not to do, but something he just keeps doing anyway.  I intervened and redirected, and I tried to make it clear to him, once and for all, that this was important.

"BUD!" I said sharply. "I mean it."

"You're angry, Mom?" he asked half-heartedly, barely glancing in my direction.

"Yes, Bud," I urged.  "I'm angry.  Look at my face."

"Look at my face" is a phrase I use with Bud, not to request that he make eye contact, but to remind him that there are visual cues in peoples' faces - cues that will help him understand what's happening and help him determine what to do next.

Bud turned and searched my face.

"You're not angry, Mom," he said.  "You're sad."

I knew in an instant that he was right.  He watched as it registered on my face.

"Why are you sad?" he asked.

And then the conversation turned in a whole new direction.

I'm tired of reading that children with autism lack empathy.  I'm tired of hearing that they have a compromised ability to understand that someone else's experience of the world is different from their own.

With one look at my face, Bud recognized something I hadn't.  I'd been labeling my emotion, even to myself, as anger - perhaps because anger seemed easier to manage and easier to resolve. But though it was emerging in harsh tones and barked words, at its heart, what I was experiencing wasn't anger.  It was resignation.  Defeat.  Sadness.

I'll remember this exchange the next time I read about what children with autism can't do.  Because this child?  The one with the disability that compromises his capacity to understand - or even want to understand - others?

Sometimes he knows me better than I know myself.


ghkcole said...

I can completely relate to this. But I could never express it as beautifully as you did. Thank you!

C Condy said...

I can so relate to this... They don't lack anything! Sure we had to work a little harder for them to recognize certain signs but my son sure does know when something is making me sad versus when I'm angry!

Christine said...

I'm so glad we have your voice -- and Bud's!! There are just so many things that I think the experts get wrong -- or interpret negatively! Well, I just love this post on so many levels!

Liz's big sister said...

Mom, you have a gift for providing understanding and clarity to your world. A world that we touch but don't understand [in the way that you] do because we don't live it like you. It helps us know you better and understand the people in our lives who live on the spectrum of autism. Thank you.

Anonymous said...

I completely agree with this! I find myself fighting, many times, to show that the students I work with are very empathetic, sympathetic, and have an amazing sense of humor! It may be shown in ways that are different than many expect, but they are some of the most empathetic and funny people I know, and I wouldn't change it for anything!

Marge Blanc said...

Well said! I have always admired the way you 'come clean' with the truth — and face the truth of how our kids are much more perceptive than most of the rest of us are! We label ourselves with this emotion or that — but how do we *really* feel? Takes a kid on the spectrum to nail it!

Jennifer said...

I have often described my son as the "emotional barometer" of a room. I think that instead of not being able to read emotions, he reads them much easier and more accurately than most people, and the confusion comes in when what we say doesn't match what he sees.

farmwifetwo said...

It doesn't mean he has empathy, it means he's been taught to read facial cues. I have an entire book called "Teaching Theory of Mind" that helps with that skill. Empathy is intuitive, not learned.

Some autistic children are emotionally "normal"... my severe one is and he's nearly 12. He reads me and my emotions with ease and responds appropriately all the time.

My 14 HFA, passes for normal, getting 80's in the "univ prep" stream without studying... you'd think he'd get it... He's extremely narcissistic, it's all about him, and he has extreme TOM issues and as I just told the itinerant ASD teacher is missing the "I give a shit gene" and always has. She liked that phrase... it's true. Toss in puberty and he's just nasty to be around all the time.

Some would say "but he has empathy"... no... but he does know how to "play the game". She understood what I meant and his business class is going next semester and is being replaced with resource and social skills help.

MOM-NOS said...

Farmwifetoo, I'd agree that the first statement ("You're not angry, you're sad") was reading visual cues. On the other hand, we all had to learn how to read and interpret visual cues within a cultural context - it's just that many of us learned it at a much younger age.

But interpreting the facial cues is only part of the equation. The other part - the more important part - is knowing what to do with the information we gather.

It was in the second part of the exchange - the "why are you sad" and the ensuing conversation - that Bud exhibited true empathy. He read the cues that told him I was sad - and then he tried to understand and show concern for my sadness.

This morning when I dropped Bud off at school, the path to the door was icy. I commented about the ice to the staff who met us at the door, and without missing a beat Bud turned to me and said "Be careful, Mom."

That's theory of mind - In moments, you and I will part ways. I will go into school and you will go down the icy path. If you are not careful, you could lose your footing and slip. If you slip, you could be hurt. I don't want you to get hurt, so I need to remind you that you have to be careful as you walk.

That's empathy.

bailzebub said...

Great observation. My ASD son has always--since he was 2 been able to read my emotions on my face almost as they are coming. I call him my mood ring. Now that he's 6, he's getting better at not just spotting them, but knowing how to react to them.

Sarah said...

I think it's becoming increasingly recognised that many autistic people have a lot of empathy - in fact sometimes the problem is having too much, i.e. being overly sensitive to and overwhelmed by the emotions of others, that they don't necessarily know how to deal with. This makes a lot of sense to me, as it's a similar thing to the other sensory issues and the hypersensitivity that you can get with autism.

It also makes sense to me that sometimes this sensitivity can lead to a person developing coping mechanisms, so as to not be constantly overwhelmed and distressed. And that this can sometimes look like coldness or selfishness or lack of empathy to those who don't understand it.

Of course we all have different personalities - autistic or otherwise - and some people are nicer and more caring than others! But it's not always as simple as you might think.

MOM-NOS said...

REALLY interesting perspective, Sarah. Thank you!

Forgotten said...

Sometimes I have trouble coping with other people's emotions but I very rarely have trouble with telling what someone's emotions are.

I'm also pretty good at picking up on the vibe of a room when I walk in, who's anxious, who's a jerk, who will be honest with me.

My biggest problem is not being able to filter my responses to everyone else's feelings. I have a tendency to speak my mind before I consider how the other person might feel about it. My mom says I didn't come equipt with an outgoing filter and my incoming filter is too sensitive. :)

Very observant of Bud to pick up on the cues you didn't know you were putting off.

Astrid said...

I have to agree with some point smade in the comment sand this post. Farmwifetwo, please remember that narcissism and autism ar enot the same, and someone can have both. If your HFA kid lacks the "I give a shit" gene, I assume he does not want to have TOM even if he could be taught. That is not autism. While I agree that some autistics have issues with reading and responding to emotions, and some lack an intuitive sense of empathy - I do, for one -, autistics who aren't narcissists often want to learn to read and respodn to others.

I can also, ironically, relate to the person who said her son is an eotional barometer. I sense tension, sadness, anger, etc. much quicker than most people do, but I still lack the intuitive sense of what to do with it. I get confused and in my confusion become pretty self-centered. Is this having no empathy or just not a certain part of empathy?

Anonymous said...

"This morning when I dropped Bud off at school, the path to the door was icy. I commented about the ice to the staff who met us at the door, and without missing a beat Bud turned to me and said "Be careful, Mom."

That's theory of mind - In moments, you and I will part ways. I will go into school and you will go down the icy path. If you are not careful, you could lose your footing and slip. If you slip, you could be hurt. I don't want you to get hurt, so I need to remind you that you have to be careful as you walk." could very well be that he has learned this over the years from other people (teachers, etc.) saying "Be careful" to him (or to others) in his presence in icy/snowy/rainy situations. Many times kids on the spectrum only need to hear this once and then repeat it to someone else when they too are in the same situation.

Anonymous said...

I think much of this argument can be reduced to many adults not understanding the difference between 'feeling' empathy and expressing it. There is cognitive empathy - the internal understanding of someone else's emotions, that they are feeling them, that they may be different than mine - and then there is affective empathy - an outward expression that I understand someone else's feelings and that it concerns me. Expressive communication deficit is a symptom of autism. Lacking empathy is actually not. So, when a mother says her autistic child lacks empathy, she is simply stating her observation of the absence of affective empathy, which does not unequivocally mean the person who cannot express empathy cannot experience it. Bud has clearly developed better ways of expressing himself and that is something to celebrate.

Aimee said...

Having grown up with undiagnosed Asperger's syndrome (diagnosed ADHD in 1994, it'd take a decade before anyone looked further)--people on the spectrum do NOT lack empathy. We may not always be able to COMMUNICATE that we care about and understand what you're feeling, but believe me, we do. Honestly, sometimes I can't be around certain people, because I perceive their emotions too strongly and it's like their feelings are punching me in the face.

Donna said...

I liked Sara's comment. I saw my son Matthew in her remarks. During his forth year life, he baffled me many times. I just kept saying to myself "children with disabilities are only limited by how much we underestimate them."

Danica Surette said...

For almost a month last summer my daughter was admitted to the psychiatric unit of the IWK children's hospital here in Nova Scotia . This was a necessity as she'd been suffering from debilitating anxiety and OCD for 7 years already. The wonderful, overworked doctors there decided on a new prescription for her that did wonders.

Unfortunately with progress came some digress as she eventually developed some type of depression. Not as severe as her anxiety, but worth looking into. Not sure if this was the depression doctors warned us could develop during her teens or some pms dysmorphic disorder, I soon contacted our family doctor. To my surprise, our physician's receptionist advised me to seek help from a pharmacist rather than the doctor as there were no upcoming appointments available. She assured me that a pharmacist was just as well qualified to advise us on homoeopathic remedies for this matter. WHAT?

With nothing else to go by, I did just as the receptionist suggested and reluctantly asked for some homoeopathic medical advice from a pharmacist. She appeared dumbfounded at the question and so I explained that my family doctor's office had sent me there for answers to my problems. Not surprisingly, she admitted that homoeopathic medicines for such diagnosis such as pms were geared more towards headache, cramping, bloating...Now what?

Eventually I was able to speak to a child psychiatrist who further informed me of the reasons and symptoms of adolescent depression and the difference between depression and that caused by pms dysmorphic disorder. He sent me a chart to follow my daughter's "ups and downs" during her cycle to analyse the cause. PHEW! Light at the end of the tunnel.

As a woman with no problem speaking her mind, I am speechless with the lack of service from our family doctor, let alone the lack of compassion.

As Bell's "Let's Talk" approaches this January 28th, I trust that (eventually) all physicians will learn that mental and physical health is fundamentally linked.

Erin Corrado said...

I love this post - so true.