Asperger’s and the Power of ‘Joy’: Treating the Whole Person, Not Just the Diagnosis

In my 30-plus years of treating children, Young Adults and their families, they are the ones who have taught me the most. Today, I am lucky enough to recognize just how many times my assumptions were incorrect.

This is especially true at the Optimum Performance Institute where we work in a supportive system that affords our “Participants” enough time to teach us and enough time for us to learn from them while they progress in our therapeutic environment.

This is of phenomenal benefit when treating young adults with Asperger’s Syndrome. It has led me to realize that the clinicians who can help them the most are those who can give them the degree of love and understanding that they need.

This is the clinician who:

• Has the most diverse armamentarium of therapeutic approaches (access to multiple and varied experiential opportunities) to draw from in order to mobilize and engage these complex Young Adults.
• Has a capacity for critical thinking and access to multiple venues of engagement so they can create an appropriate treatment plan based on that complex individual’s needs.
• Is surrounded by a compassionate, diverse and committed community of peers and staff who provide opportunities for this person to practice and reinforce skills they are learning.

For instance, I have learned to challenge the assumption that Young Adults with Asperger’s are categorically unable to “pick up” on social cues because of biological or neurological factors. In truth, I believe the ability to learn these skills are achievable and it is a matter of degree. There is always a spectrum.

For someone with this disorder to read social cues they must be motivated enough to pay attention. For many, being motivated to put the tremendous amount of concentration required to do something others do effortlessly, is not there because past efforts:

• Have only resulted in ridicule and
• Haven’t gotten them anything close to the compassion, love and acceptance they get from parents or family.

This only intensifies their dependence on the family and their fear of moving outside the family constellation. They become more dependent on the love and acceptance they get at home and are progressively more frightened and disappointed by reactions they get outside the home.

So, one must listen to their stories. Solely relying on textbook descriptions or statistically derived information may be helpful but most times is insufficient.

What sounds like idiosyncratic thinking that is irrational and inconsistent with reality, may be nothing of the kind if one takes the time to understand the internal logic of a Young Adult with Asperger’s Syndrome.

Many times that person’s initial assumptions are based how he/she perceives a particular circumstance. Their sequence of decisions that follow are based on that perception. They are logical but unfortunately, in reality, inaccurate and therefore cause only further isolation and alienation.

Take a Young Adult with Asperger’s who walks in late for a class: He/she may think “Everyone is noticing me. They’ll think I’m a loser or that I don’t care. Therefore it’s wiser for me not to go to the class. Maybe I should just stand outside the door.”

When this occurs, anxiety quickly builds up. It’s more difficult to go to the next class because the individual already believes they have been identified as different, not caring or even hostile.

Eventually these seemingly illogical responses become habits resulting in a decrease of self-esteem, resiliency and greater suffering. The Young Adult with Asperger’s becomes more and more alienated and finds it progressively more difficult to compromise. They may begin to habituate to a rigid, black-and-white thinking style, which only makes it more difficult to achieve longer-term goals and objectives, most of which absolutely require adaptation and moderation to be skillfully completed.

In order to fit in and be part of a group at this age, there is a need to deal both with the biological and psychological needs for intimacy and close relationships. These Young Adults look out into the world and want what their peers have—intimacy, relationships and love.

What must it be like to see people “connecting with others” when that process seems overwhelming to you? To see love in the eyes of others when you, yourself, seem unable to feel it with the same degree?

Being subject to the same emotions and defense mechanisms as we all are, this inability to connect can create anger, jealousy, envy and hopelessness. They deny, rationalize and establish a rigid thinking style.

“Why deal with it?” they say, whether it is socialization, engaging peers, teachers and their environment and even individual or group therapy. They grow more isolated.

But the Young Adult with Asperger’s Syndrome can be taught to understand the logic of feelings and utilize more skillful defenses to fight the misinterpretation that they can’t. They can slowly learn to experience feelings to a degree that is possible and then learn to practice more skillful ways of expressing their anxieties and fears.

Progress happens when the Young Adult with Asperger’s truly feels understood and connected with his/her therapist, peers and their environment. Resonating with the mind and heart of the patient is the basis of all therapeutic relationships.

When Young Adults engage in this process of learning about feelings and their skillful expression, many tell me they are “faking it.” They feel insincere and awkward.

It takes time to explain the underlying meaning and reasoning behind the request, “Act as if you feel such-and-such and express it as if you really mean it.”  It takes a lot of trust to believe that “over time, these actions eventually can result in love and acceptance being reflected back to you. Over time, you actually CAN mean it and WILL feel it—even if just a little.”

Over time, they can learn not to judge the degree of intensity of their feelings, which will help decrease feeling alienated and allow for space to experience more opportunities for peace and joy.

This approach requires dynamic exploration and exposure both inside and outside the therapy room and in compassionate, interactive and experiential groups. The overall objective is to help them develop a capacity to trust others in the world while understanding that the love they discover will be different than the love they got from a loving parent.

At OPI, we utilize many therapeutic interventions without judgment. Our success is not based on a static, evidence-based model, but on whether that complex individual is responding to our treatment approach: Is it helpful and allowing for positive progress for the individual?

They can go to shopping center, for instance, to practice meeting people and engaging with others and then return to a safe environment where the experience can be processed collectively.

They may engage in one-to-one coaching, a cooking group, martial art activity or in a variety of socialization experiences. Medications may be prescribed, if needed.

Another essential aspect of the therapeutic approach we have utilized at OPI for nearly a decade is exposure to a diverse spectrum of peers modeling more appropriate ways of handling issues common to everyone this age, in a compassionate, non-discriminating way allowing for natural and supportive development.

At OPI we focus and stimulate their gifts and passions and help participants learn to share these with others. We teach and try to demonstrate compassion, tolerance and patience.

It takes time to create, practice and reinforce positive experiences. It takes a playful attitude, a therapist and a village of people who can model joy, love and who therefore can support, inspire and provide hope.