Question
I’m a 35-year-old male. My therapist has suggested that I may have high-functioning Aspergers (symptoms are difficulty with talking, words and overall social ability; extreme difficulty with change in routine; isolation; astounding and detailed long-term memory with poor short-term, etc.). I find it hard to believe that a "fully developed" adult can actually remedy this.
Should I confront this diagnosis as a behavioral issue with cognitive behavioral therapy …or a biological one with medication? At this point, can a treatment do anything besides make me more comfortable with the disorder? I've asked my therapist, but because most medical literature addresses intervention in childhood, he can't say much.
Answer
Aspergers (high functioning autism) is nearly impossible to identify outside of the context of traditional social and cultural settings. The brain is simply wired a bit differently and acts on different sets of cues. You're not defective.
If your “impairment” is mild, you may have just always been considered "socially awkward" – and there may not be any particular medication available that doesn't have side effects or risks greater than the problems you already have. As a general rule of thumb, stay away from drugs. There's nothing to fix! If you have secondary symptoms (e.g., depression, anxiety, OCD, etc.), then maybe you should consider medication (but make sure you get an opinion from an ASD specialist).
Treatment alternatives may be as simple as behavioral therapies, behavioral coaching, or group therapy. Aspies may need to work with a therapist longer than neurotypicals do, because the Aspie’s social skills are somewhat lacking. It can take longer for an Aspie to achieve the desired results compared to someone with a different, non-developmentally based problem. But, you may do more harm than good by going to a therapist who knows little about Aspergers.
The interpersonal relationship models that most therapists use are not really applicable to those with Aspergers. You'll find conventional therapy telling you to read body language, take social cues, and all sorts of things that the Aspie brain is not wired for. A therapist who specializes in Aspergers will key you in on things that will work.
The interpersonal relationship models that most therapists use are not really applicable to those with Aspergers. You'll find conventional therapy telling you to read body language, take social cues, and all sorts of things that the Aspie brain is not wired for. A therapist who specializes in Aspergers will key you in on things that will work.
The areas you'll need to focus on are primarily interpersonal relationships (e.g., manners, courtesies, diplomacy, social conventions, dress, hygiene, etc.). Neurotypicals generally acquire those things from an early age through socializing, but Aspies don't pick up on it as well.
Any adult who has been told that they “may have” Aspergers should ask himself/herself the following questions:
- What am I trying to change in my life?
- Will an official diagnosis (as opposed to being aware that I probably have Aspergers) do anything or create any opportunities to help me change those things?
- If my therapist is correct in his diagnosis, what does he have in mind to make it worth my while …what's his plan?
- Should I get a second opinion before doing anything else?
Aspergers is definitely not a death sentence – far from it. So what if you find out that you really have Aspergers? If you have it – you have it – and you always had it. So it’s really nothing new.
