Reframing Autism: A Psychoanalytic Journey Towards Mutual Recognition
Embracing Autism: Finding a Narrative
I recall standing in the kitchen, puttering on dinner, the children playing nearby. My husband gently brushed against me, touching the small of my back. My body recoils and shudders. Once I realize what I have done, I apologize and explain I was not expecting his touch. Eventually, he stopped providing impromptu touch. Neither of us thought much of this. It became one of the “Megan Anna-isms” that he adapted to.
In college and graduate school, I had a lot of “isms.” My quirky traits became endearing “isms.” At other times, I was the “smartest dumb girl” in the room—I learned to conveniently play off any blunders by attributing such misses to my “blondness.” I then learned how to play up the blond girl stereotype to protect my ego. I channeled my fire and direct communication into religious passion, which served as a sort of holy excuse for my direct nature. Growing up in a fundamentalist subculture, my sins of being a direct, passionate girl could be forgiven if I used these traits to talk about Jesus.
This article marks a departure from what you usually read here at Neurodivergent Insights. It's a repurposing of an academic psychoanalytic article I wrote last year, taking us on a deeper, more theoretical journey into understanding autism and mutual recognition. While my usual posts are more conversational, here, we'll explore the intricate dance of communication between Autistic and allistic individuals through a psychoanalytic and philosophical lens. If you’re here for a lighter read, particularly about adult autism, you might want to check out this article on adult autism. But if you're ready for a theoretical dive into the theories that can reshape our understanding of neurodivergent communication, I invite you to join me in this exploration.
My husband and I barely thought twice of my “isms,” or the way we adapted to them. That is, until our daughter was diagnosed with autism. A few weeks after our daughter was diagnosed, I sat across from my husband and uttered, “I think I’m Autistic.” We knew the research (because I had gone on an autism special interest research deep dive). Statistically, when a child is diagnosed Autistic, one of the parents is often on the broader autism phenotype (Rubenstein & Chawla, 2018).
At first, I had scoured through my husband’s family tree, but now I had settled on mine. Initially, this seemed like an improbable choice. I am hyper-empathetic, hyper-attuned, metaphorical, theoretical, and relational. I was the opposite depiction of the image of autism that my husband and I had available to us. As we learned more, we slowly deconstructed our narratives of autism. We needed to deconstruct these narratives to be able to see our daughter, and eventually to be able to see me.
After hours of reading, research rabbit trails, deconstruction, filling out assessments, and more, I simply knew I was Autistic. It was the kind of knowing that runs deep and solves a thousand mysteries. A lifetime of confusions clicked into place. Once I knew this truth, my body and soul finally had permission to click into alignment. After 37 years of misalignment, I felt at peace in my body for the first time—I was finally given permission to not be at war with my body. This discovery, later confirmed through an official medical diagnosis, changed every fiber of my being. This discovery allowed for self-recognition, which opened spaces for mutual recognition to occur (Benjamin, 2004).
Towards Mutual Recognition: Bridging Neurotypes with Buber and Benjamin
The philosophies of Martin Buber and Jessica Benjamin have deeply influenced my understanding of human connections. Their work is especially enlightening when considering the challenges and richness of connecting across neurotype. My journey into their ideas began with my own experiences of feeling disconnected in social interactions, leading me to seek out philosophy and theories that helped me understand what it truly means to connect authentically.
Buber introduces us to the concept of I-Thou versus I-It relationships. In an I-Thou encounter, we fully engage with another person, recognizing their intrinsic value and humanity. These connections are personal, direct, deep and characterized by deep presence and engagement. This contrasts with I-It interactions, where the other is seen more as an object or a means to an end. In these interactions the person’s humanity is missed. These interactions are often performative and / or mindless.
Jessica Benjamin expands on this by introducing the notion of "The Third" – a space of mutual recognition where both individuals can acknowledge and honor each other's distinctiveness without diminishing it. It’s a space where two people experiencing a meeting of their minds without the space between them collapsing. Benjamin posits "The Third" as a dynamic, intersubjective space that transcends the traditional binary of dominance and submission, allowing for a form of interaction where mutual recognition is possible. This space is not about erasing individual differences or merging identities into one. Instead, it's about acknowledging and respecting those differences, allowing each person to be truly seen and recognized by the other.
She refers to the contrasting, more common scenario as the "doer-done-to dynamic," where interactions become unidirectional, and one person ends up feeling "done to," overshadowed or objectified. This idea is crucial for moving beyond such one-sided interactions, which are particularly prevalent in communications across neurotypes. Benjamin’s emphasis on a space that cultivates intersubjective recogntion across difference is part of what makes it a powerful framework for conceptualizing cross-neurotype interactions.
Echoing Buber, Benjamin's work helps us understand that achieving a genuine connection involves seeing and treating the other as a subject, not an object. This perspective is vital in navigating the complexities of Autistic and allistic interactions, which often default to a "doer-done-to" dynamic, eclipsing the potential for mutual recognition and understanding.
By weaving together the mystical elements of Buber's insights with Benjamin's psychoanalytic approach, we gain a rich framework for approaching relationships. Autistic people, in particular, experience challenges in attaining this profound experience of mutual recognition, challenges that are frequently re-enacted within therapeutic contexts. This article aims to delve into the "barriers to recognition" encountered at collective, interpersonal, and intrapersonal levels. By shedding light on these barriers, therapists can gain a deeper understanding of the obstacles to recognition, thereby enhancing their ability to support Autistic clients in achieving both self-recognition and mutual recognition throughout their therapeutic journey.
Understanding Barriers to Recognition
Connecting with the world and with others poses unique challenges for Autistic people, shaped by societal stigma, differences in communication, and sensory sensitivities. These hurdles can sometimes make it feel like we're navigating a maze blindfolded, leading to moments of misunderstanding where, more often than not, the Autistic person ends up shouldering the blame. Yet, it's more accurate—and fair—to see these challenges as existing not just within one person but within the space between people, affecting how Autistic individuals see themselves as they reflect on these shared experiences. Obstacles to recognition are encountered at the collective, interpersonal and intrapersonal level, as illustrated in the following diagram.
Collective, Interpersonal and Intrapersonal Barriers to Recognition
At the collective level, societal narratives about autism tend to objectify Autistic individuals, often reduce Autistic individuals to mere objects of discussion, creating an environment where they are more likely to be acted upon than interacted with as equals.
Misencounters occur on the interpersonal level, where misunderstandings frequently arise from diverging cultural and communication styles. This phenomenon is aptly described by Milton’s (2012) “double empathy problem,” highlighting that the issue isn't one-sided but a mutual challenge.
Such misencounters at the collective and interpersonal level can unfortunately lead Autistic individuals to absorb ableist and shame-based narratives, significantly affecting their self-esteem and mental health and resulting in failed recognition at the intrapersonal level. Furthermore, due to prevailing narratives of autism the Autistic person may not recognize themself as Autistic, further contributing to thwarted self-recognition.
In therapy, the aim is to help Autistic people to navigate and process these barriers to recognition. However, this process can accidentally reinforce the very issues it seeks to address if therapists haven't taken a hard look at their own assumptions about autism and actively worked to move beyond stereotypes and biases. By understanding and addressing these barriers, mental health and medical providers can better support encounters that foster mutual recognition across neurotype divides, promoting healing and understanding.
Next we’ll break down these barriers by looking more closely at collective barriers, intersubjective barriers and intrapersonal barriers to recognition.
Collective Barriers: Autism Narratives vs. Autistic Stories
As we near 100 years of autism history, no one quite knows what to do with autism. Initially considered a form of schizophrenia, it has been reclassified over time from a medical condition to a mental health disorder, and most recently, as a neurodevelopmental disorder. With the rising chorus of Autistic voices, it's evident that our understanding of autism is set to evolve significantly in the years to come.
The sharp increase in diagnosed cases further complicates autism’s historical narrative. Once deemed rare, with estimated prevalence rates of 1 in 2,500 (Matson & Kozlowski, 2011), recent statistics from the Centers for Disease Control and Prevention (CDC; n.d.) now report a prevalence rate of 1 in 36.
At the heart of this complex history is a pivotal question: Who truly authors the story of autism? The narrative around autism has predominantly been shaped by non-autistic individuals. As Yergeau (2018) points out,
“Despite Autistic people’s increased visibility and, indeed, participation in public policy and political advocacy, Autistic stories are not the autism stories that circulate, dominate or permeate.”
While autism narratives are primarily shaped by the medical model of autism, Autistic stories, in contrast, are the subjective, embodied stories told by Autistic people. Autistic stories are often subjugated to autism narratives, existing within a doer/done-to dynamic.
Autism Narratives: The Limits of the Medical Model
What I’m suggesting is that that autism narratives (narratives about autism) and Autistic stories (the stories of lived experience of Autistic people) exist in a doer-done-to dynamic. The conventional narratives about autism are deeply rooted in the medical model and neuro-cognitive frameworks. These approaches attempt to decode Autistic experiences by focusing primarily on identifying specific cognitive processes.
However, this prevalent focus risks sidelining the true essence of Autistic thinking, which embodies a rich tapestry of bodily sensations, dynamic interactions, relational intricacies, and the unfolding of developmental processes. Such medical narratives often fail to account for these core elements, glossing over the “embodied, interactive, relational, and developmental processes that are integral to Autistic thinking,” as Chapman (2019, p. 424) insightfully notes.
The conventional diagnostic approach, with its reliance on behavioral markers and checklists, systematically overlooks the deeper, lived experiences of Autistic individuals. As a result, the ontological (pertaining to the nature of being) and phenomenological (concerned with the experience of phenomena) dimensions of autism are frequently disregarded. By adhering strictly to such frameworks, the rich, multifaceted nature of Autistic experiences often remains unacknowledged and missed.
This medical-centric view has led to a societal understanding of autism that's narrowly focused on deficits and impairments, suggesting that Autistic people are somehow broken and in need of fixing (Nicolaidis, 2012). Autism awareness campaigns have historically reinforced this view by portraying autism as a tragedy that affects families, reducing autism to an external problem rather than an integral part of a person's identity.
Ironically, while these narratives treat autism as something that happens to people, they themselves act upon Autistic individuals by defining them in limiting ways. This leads to a reductionist view of autism that fails to capture the diversity of Autistic experiences and identities. As a result, many Autistic people struggle with self-recognition, unable to see their own experiences reflected in the dominant stories about autism.
An Objectifying Narrative
Autism narratives, often written by non-autistic medical professionals, advocacy agencies, and family members of Autistic individuals, largely fail to incorporate the views and voices of Autistic individuals. Autism narratives often treat Autistic subjects as unknowable and unnarratable as “utterly abject and isolated and tragic” (Yergeau, 2018, p. 3). Yergeau (2018) described such narratives as ableist, violent, and decisively non-autistic (p. 5). Within the production of autism narratives, the Autistic person is often fetishized, tokenized, commodified, and done-to. Milton (2012) observed how Autistic people are kept outside of the production of autism knowledge:
“Although, compared with many categorisations of disability, autism has attained a great deal more public attention and one could say that the label has become a fetishised commodity and even a global industry (as cited in Mallet, 2019) it is an industry that silences the Autistic voice from any participation, other than in the form of a tokenistic gesture. Therefore, far from owning the means of mental production about one’s own culture, the “Autistic individual” often becomes the “product” of the industry, the “thing” that is “intervened” with…the “Autistic voice” is made “invisible” within the current culture of how knowledge is produced about “Autistic people,” often excluding empowered “Autistic advocates” from the process. (p. 885)
The objectification is perhaps made most manifest in the form of “Autism Awareness” campaigns, where autism fluctuates between being a “fetishesed commodity” and an object of abjection. In 2007, a campaign run by New York University (NYU) Child Study Center portrayed autism as having “kidnapped the nation’s children” (Nicolaidis, 2012). Their campaign included billboards and advertisements designed to look like ransom notes, which included text such as, “We have your son. We will make sure he will not be able to care for himself or interact socially as long as he lives—Autism” (Kras, 2010).
In a similar vein, Autism Speaks' 2009 video, “I am Autism,” features a voice with a sinister tone proclaiming “I am autism,” followed by a litany of claims about the havoc it wreaks on marriages, families, and communities (Savarese & Savarese, 2010). This portrayal frames autism as a malevolent force, casting it in an overwhelmingly negative light. Such narratives cast autism as the doer and as utterly abject.
A Simplistic Narrative of Autism
A second issue with current autism narratives is their tendency to offer a simplified, homogeneous account of autism, failing to capture the diversity and depth of Autistic experiences. Chapman (2019) critiques the neurocognitivist approach for its essentialist perspective, which seeks to pinpoint foundational cognitive mechanisms of autism. Yet, as new research emerges, the limitations of this approach become increasingly apparent.
This is exemplified in the evolving debate around core traits of autism, where recent theories proposing hyper-empathy, rather than the previously suggested hypo-empathy, challenge the idea of uniform Autistic characteristics (Chapman, 2019, p. 424). Chapman underscores the diversity within the Autistic community, noting that “While there may be very general statistical tendencies towards certain cognitive and neurological characteristics, there is no core trait or traits that have been found to be shared by all or most Autistic people” (p. 424).
Furthermore, the reliance on a homogenous narrative encounters practical and empirical challenges. It fails to acknowledge the nuanced, lived realities of Autistic individuals, particularly those who do not fit the stereotypical profile. Much of the foundational research and development of diagnostic tools have centered on white, affluent cis boys. Consequently, recent studies highlight a significant oversight in recognizing Autistic girls, BIPOC individuals, and genderqueer people, indicating a critical gap in our understanding and support of the broader Autistic community (Jang et al., 2014; McCrossin, 2022; Warrier et al., 2020).
Uncovering the Hidden Spectrum: Beyond Gender and Racial Biases
Recent findings indicate a significant underdiagnosis of Autistic girls, challenging the traditionally cited male-to-female autism ratio of 4:1. McCrossin's (2022) analysis, accounting for diagnostic biases, suggests a more accurate male-to-female ratio might be closer to 3:4, revealing that up to 80% of Autistic females may remain undiagnosed by the age of 18. This underdiagnosis is not limited by gender; non-white Hispanic and Black American children are also less likely to be diagnosed with autism, often receiving their diagnoses later than their peers and facing barriers to accessing support and resources (Jang et al., 2014).
Emerging research sheds light on the diverse experiences within the Autistic community. Studies, including those by Supekar et al. (2022), have identified sex-specific differences in the brains of Autistic females and males, with females showing more pronounced impacts in areas related to fine motor skills, executive functioning, and emotional regulation, but often displaying fewer differences in social communication (Cauvet et al., 2020; Jack et al., 2021; Supekar et al., 2022).
Furthermore, the exploration into the lived experiences of those with multiple marginalized identities highlights how societal pressures can lead to the "masking" or "camouflaging" of Autistic traits, complicating diagnosis and understanding (Hull et al., 2020).
Beyond Autism Narratives: The Journey to Self-Recognition
Thin autism narratives not only perpetuate harmful, monolithic stereotypes, but also lead to failed self-recognition, inhibiting the possibility of experiencing true encounter or “The Third” with another. I did not have an autism narrative that matched my daughter ’s hyperverbal presentation. Even when she presented with overtly stereotypical traits, no one thought to recommend an autism evaluation. When she stopped responding to her name, we had her hearing checked, not her neurotype. When she struggled with epic meltdowns and task-switching, we attributed it to her being “difficult” and “sensitive.” We did not have a narrative for Autistic girls, and, because of it, my daughter missed out on years of early supports.
Reflecting on my own late diagnosis, I recognized a profound disconnect: I did not see my experiences reflected in the autism narratives available to me. Without stories that resonate with our experiences, many of us adopt and internalize narratives steeped in shame. I did not see myself recognized in autism narratives. When we do not have access to Autistic stories that match our experience, we often develop and internalize shame-based narratives. While many boys are afforded the language of “autism,” girls, people of color and genderqueer individuals are provided with character-based language to explain their differences.
This lack of appropriate recognition can lead to a deep-seated sense of shame about our inherent differences, leaving us to wonder in isolation what might be "wrong" with us. We understand our differences as “too passionate,” “overly-intellectual,” “over-reactive,” “closed-off,” “rigid,” “cold,” “too much,” “sensitive,” and more. When we are not afforded the language of having a different neurotype, we internalize shame over our felt differences (Hull et al., 2020) while silently pondering what is wrong with us. There is a “lost generation of Autistic women,” many of whom linger in treatment for years with so called treatment-resistant depression, anxiety, and a gnawing sense of emptiness (Brown et al., 2020). We do not show improvements because a core aspect of our identity is missed, resulting in failed self-recognition. And without self-recognition, mutual recognition cannot occur.
My inbox is full of stories of Autistic adults whose mental health providers have told them, “You can’t be Autistic because (insert outdated autism stereotype here).” Autistic women, genderqueer, and BIPOC people are being misencountered by the mental health field at unfathomable rates.
Denial of identity erases the possibility of achieving the Third, a space where true understanding and connection can flourish. Cultivating this requires us to first acknowledge and validate the Autistic identities of those in underrepresented groups. This means challenging the narrow autism narratives and embracing the rich, diverse stories of Autistic individuals themselves. Only through this shift can we hope to foster environments where mutual recognition—and thus, genuine connection—can thrive.
Moving Toward Mutual Recognition: Embracing Autistic Stories
Autistic stories exist in protest to autism narratives (Yergeau, 2018). Where autism narratives objectify the Autistic experience, Autistic stories have emerged in protest, as they attempt to reclaim the subjective experience of Autistic people. Such stories, which celebrate Autistic identity and culture, can be seen within movements such as the neurodiversity movement, a social justice movement that is rooted in the philosophical framework of the neurodiversity paradigm. Jody Singer, an Australian sociologist, first used the term “neurodiversity” in her 1988 thesis, a term later popularized in Robert
Blume’s article in The Atlantic:
Neurodiversity may be every bit as crucial for the human race as biodiversity is for life in general. Who can say what form of wiring will prove best at any given moment? Cybernetics and computer culture, for example, may favor a somewhat Autistic cast of mind.
This theory has since been picked up by Autistic advocates and has been further developed by psychologists and philosophers, such as Nick Walker and Robert Chapman. The neurodiversity paradigm rejects the idea that non-majority neurotypes are deficient and, rather, emphasizes the inherent value of such differences. The paradigm considers autism and other diverse neurotypes to be a natural product of biological diversity and evolution.
From this framework, autism is understood not as a disorder, but as a diverse neurotype. In the same way that there is no one right social class, race, gender, or sexual orientation, there is no one right neurotype (Walker & Raymaker, 2021). Autistic people experience life as members of a marginalized neurominiority and, as such, experience discrimination, minority stress, and marginalization (Chapman, 2020).
Such a framework replaces the medical model of disability with the social model of disability and considers the social and institutionalized dynamics that are disabling for the Autistic person (Chapman, 2020; Woods, 2017). In an article entitled, “Don’t Mourn for Us,” Jim Sinclair wrote (as quoted in Brenner, 2020, pp. 7-8):
Autism isn’t something a person has, or a “shell” that a person is trapped inside. There’s no normal child hidden behind the autism. Autism is a way of being. It is pervasive; it colors every experience, every sensation, perception, thought, emotion, and encounter—every aspect of existence…autism is not something that can be separated out from the person, it’s part of the person, and so you cannot meaningfully say I love my child but I hate the autism.
New metaphors are emerging to consider autism as a social and identity-based classification over a medically-based classification. Robert Chapman (2019), a United Kingdom (U.K.) philosopher writing at the intersection of neurodiversity and psychiatry, drew on Wittgensteinian framing to describe autism “as a different, but not deficient, form of life” (p. 422), and Leon Brenner, a Lacanian analyst based in Berlin, described it as a “mode of being” (Brenner, 2020, p. 7). Such metaphors invite us to consider the Autistic experience through a phenomenological, experiential, relational, and subjective frame of mind. As the conversation shifts from diagnostic checkboxes toward subjective experience, space for mutual recognition opens.
Barriers within the Intersubjective Realm: The Double-Empathy Problem
Beyond experiencing barriers to recognition at the collective level, we also experiences barriers to recognition at the interpersonal level through our day to day interactions with other humans.
Learning Allistic Speech
Beginning at a young age, I taught myself how to move through neurotypical social space. I learned to override my instinct to avert eye contact and braced for impact while I acquiesced to people’s requests for hugs. I became skilled at drawing the other person out, which would save me from being subjugated to their queries. When I failed at dodging incoming questions, I would have pre-scripted responses ready; or, I would skillfully redirect the conversation to a topic of special interest. I learned to turn down my passion and to soften my existence with copious use of qualifiers and apologies.
When I observed someone gracefully gliding through social space, I studied them, watching for phrases, terminology, and gestures I liked. I learned to mimic people through my tone, my body, and my phrasing, and I have logged hours practicing facial expressions and rehearsing non-existent conversations. I also paid attention to norms and rules—typically, it was by accidentally breaking the social norm that I learned it was a rule people seemed to care about. When I made a blunder, I would update my semi-conscious “rule book” that perpetually ran in the backdrop of my mind. I developed a harsh and hypervigilant inner critic that reminded me of these rules when I encroached dangerous social territory.
Such experiences, as described above, are common among Autistic people who mask or camouflage their Autistic traits (Brown et al., 2020; Hull et al., 2020). While I can move through allistic social space, it exhausts me to do so. What allistic brains do subcortically, my brain does through the pre-frontal cortex (analyzing, decoding, and translating). When I do this for a prolonged period, it is followed by a collapse into fatigue, which may ultimately lead to a season of Autistic burnout and depression.
I have learned allistic speech; however, allistic spaces have not learned me. I can blend into allistic spaces, but mutual recognition does not occur.
The Double-Empathy Problem
Current autism narratives eagerly attribute misunderstandings or miscommunications directly to Autistic individuals, labeling these issues as inherent traits. However, the “double empathy hypothesis” shifts this perspective, suggesting that such miscommunications actually arise from the space between individuals.
Prevailing autism narratives point to social breakdown as occurring due to deficits in “theory of mind” and “empathy.” Yet, these views fail to acknowledge that non-autistic individuals also struggle with understanding perspectives different from their own, especially when interacting with people who have different cultural backgrounds or neurotypes. As Milton (2012) has pointed out, the issue isn't a one-way street; it's about the interaction between different ways of experiencing the world. As Milton (2012) observed:
The “theory of mind” and “empathy” so lauded in normative psychological models of human interaction refers to the ability a “non-autistic spectrum” (non-AS) individual has to assume understandings of the mental states and motives of other people. When such “empathy” is applied toward an “Autistic person,” however, it is often wildly inaccurate in its measure. Such attempts are often felt as invasive, imposing and threatening by an “Autistic person.” (p. 884)
Autistic people often find non-autistic communication challenging, just as non-autistic individuals often struggle to understand Autistic communication styles. Traditional narratives tend to blame these communication breakdowns solely on the Autistic person's supposed deficits. However, adopting an intersubjective perspective shifts our focus to the interaction space between individuals.
This space, or “The Third,” is where a mutual sense of connection and understanding of the other's mind exists. Often, communication between Autistic and allistic (non-autistic) people falters not because of a deficit within the Autistic individual, but due to a difficulty in establishing this intersubjective connection, especially across the neurotype divide.
Milton (2012) described this phenomenon as the 'double empathy problem,' highlighting that misunderstandings occur mutually when individuals with differing perspectives attempt to communicate. This difficulty in grasping the other's point of view is a natural outcome of interactions between people who inhabit different cognitive worlds.
According to Crompton et al. (2020) and Milton (2012, p. 884), the issue is inherently a two-way street, arising from bidirectional differences in communication. Milton further defines the double empathy problem as a gap in mutual understanding between two distinct social actors, which becomes increasingly pronounced as their perceptual worlds diverge (p. 884).
Putting the Double Empathy Problem To the Test
Crompton et al. (2020) conducted research to test Milton's double empathy hypothesis through an innovative approach. They organized participants into pairs based on neurotype and engaged them in a series of semi-structured interactions. After each interaction, participants assessed the level of rapport they felt with their partner.
The results were telling: non-autistic pairs reported the highest levels of self-rated rapport, Autistic pairs ranked second, and mixed neurotype pairs reported the lowest levels of rapport. A subsequent study brought in both Autistic and non-autistic observers to rate the interactions. Consistently, mixed pairs were rated lowest in rapport, with non-autistic pairs in the middle and Autistic pairs receiving the highest rapport ratings from observers.
These findings provide solid empirical backing for Milton’s double empathy problem, illustrating that individuals tend to experience higher reciprocity and rapport with those of their own neurotype.
Further insights from the study revealed that Autistic individuals are more likely to share personal information, feel a sense of closeness, exhibit empathy, and show a willingness to assist other Autistic individuals. This evidence supports the idea that Autistic people engage in social interactions in a distinct manner, contradicting the notion of them having deficits in social skills (Crompton et al., 2020, p. 1). Consequently, it’s clear why Autistic individuals might find it easier to achieve mutual recognition among themselves
The Transformative Power of Autistic Spaces
Currently we have seen a rise in Autistic spaces: space designed by and for Autistic people. Jim Sinclair, highlights the profound impact these environments have on Autistic people experiencing them for the first time. Many describe a profound sense of immediate connection, feeling "at home" and a natural belonging among others who are "their own kind." Commonly, the experience is described using metaphors like being on the "same planet," or "speaking the same language," underscoring a deep-rooted sense of kinship and mutual understanding (Sinclair as quoted by Chapman, 2019, p. 427).
In contrast, non-autistic (allistic) individuals stepping into Autistic spaces often report feelings of anxiety, self-doubt, and confusion, struggling with how to interact within these settings (Chapman, 2019). This dichotomy underscores that social communication challenges predominantly arise from the interaction space between different neurotypes, rather than being inherent to one group.
Recent discussions suggest moving beyond the concept of "context blindness" or "mind-blindness" typically associated with autism, and instead embracing the idea of "mutual aspect blindness." This perspective acknowledges that difficulties in mutual recognition and understanding are not one-sided but occur within the intersubjective space between individuals. The concept of "The Third" - the mental connection that flourishes without fear of misunderstanding - becomes particularly challenging to achieve across neurotypes due to this mutual aspect blindness (Chapman, 2019, p. 430).
In my own experience, explicitly addressing the cross-neurotype divide has proved helpful in bridging the gap. In the last year of my personally therapy, my therapist and I began explicitly talking about the cross-neurotype space between (i.e., explicitly talking about the different assumptions present, the meaning of the words spoken, the impact of each other ’s actions and more). As we begin looking at the space between, through an inter-neuro lens, new space opened in our therapeutic work. As we joined efforts—looking at the space between—the Third emerged (a space of mutual understanding and connection that transcends neurotype barriers).
Significance for Clinicians: Moving Toward Mutual Recognition
Benjamin described the “rhythmic experiences” that create capacity for thirdness. When the significant other “surrenders to the rhythm of the baby, a co-created rhythm can begin to evolve. As the caregiver accommodates, so does the baby. The dyad starts to cohere into a pattern” (Benjamin, 2007, p.7). Benjamin understood this as the basis for mutual accommodation, which she attributed to the inbuilt tendency to “match and mirror” and respond “symmetrically” (Benjamin, 2004, p. 17). The rhythmic Third emerges when the other’s energy is recognized, matched, and mirrored.
When I read about the rhythmic Third, I notice emotion swell in my throat. I suspect the rhythmic Third is a rare experience for many Autistic people. There is often a sense of being slightly out of rhythm with the other (and them with me). Establishing rhythm across neurotype is a more difficult dance. The off-rhythm interaction that occurs across neurotype is a less common experience for the non-autistic person (one privilege of being in the neuro-majority is that most interactions occur with people of a shared neurotype), while for the Autistic person cross-neurotype, out of rhythm, interactions are a daily experience (Milton, 2012).
An ideal course of treatment would help the Autistic person grieve the difficulties they experience, address internalized ableism, and create conditions that facilitate self and other recognition. Unfortunately, the barriers to mutual recognition that the Autistic person experiences within the broader society are often re-enacted within the clinician’s office.
Thin, rigid narratives of autism can cause clinicians to misdiagnosis, misperceive, and misunderstand their Autistic clients. And on an intersubjective level, cross-neurotype communication differences can make it difficult to establish rapport and reciprocity (Camm-Crosbie et al., 2019). Attempts made to draw out the client’s emotional world may be experienced as intrusive and misattuned. Collective and intersubjective barriers to recognition collide in the clinician’s office, which often result in the dyad collapsing into a doer-done-to enactment.
This break down of communication is concerning for several reasons. Autistic individuals often deemed “high functioning” experience high rates of co-occurring mental health issues, including:
Depression
Anxiety and specific phobias
PTSD
Substances abuse
Non-suicidal self-harm
Eating disorders
Elevated rates of suicidality
(Source: Lever et al., 2016; Maddox et al., 2017; Rumball et al., 2020; Westwood & Tchanturia, 2017).
An estimated 79% of Autistic individuals will meet criteria for a co-occurring psychiatric disorder at least once in their life (Lever et al., 2016). Autistic adults without intersecting intellectual disabilities have double the risk of substance use-related problems (Butwicka et al., 2017), experience more traumatic events and victimization, and are more predisposed to develop PTSD (Haruvi-Lamdan et al., 2020; Weiss, & Fardella, 2018).
A study done in Sweden (Hirvikoski et al., 2016) found Autistic adults without co-occurring intellectual disabilities were 9 times more likely to die by suicide then the general population. Rates were particularly high among Autistic women who were over 13 times more likely than females in the general population to die by suicide. Autistic adults without intersecting cognitive disabilities have high mental health needs. Unfortunately, few professionals understand how to work with the Autistic neurotype (Camm-Crosbie et al., 2019).
Failed Recognition in Therapy
When therapists have not yet deconstructed autism narratives and worked through ableist and allistic-centered beliefs, they often re-enact doer-done-to dynamics with their Autistic clients. A qualitative study done by Camm-Crosbie et al. (2019) asked Autistic adults about their experiences of accessing mental health services. Several themes emerged, such as a 1) Limited understanding of Autistic social-communication-emotional patterns and 2) Difficulty with their therapist misinterpreting their emotions/communication patterns. For example, one participant reported that,
“I just don’t show emotion the way other people do so…no one believed there was anything wrong with me or that I needed help. There are specific things depressed people are supposed to do, but I don’t do them” (Camm-Crosbie et al., 2019, p. 1436).
Similarly, another participant explained,
“I had communication issues with each therapist because they expected me to be neurotypical, so I would take things too literally and they thought it was a defense mechanism, or I’d try to explain meltdowns and they focused on my thoughts rather than how to deal with over-reactive sensory perception (Camm-Crosbie et al., 2019, p. 1436).
Such comments are particularly important for the psychoanalytic community to heed, as we are keen to interpret such experiences as maladaptive psychological defenses.
Several years ago, while working with a therapist I experienced the double-empathy problem when my therapist failed to engage my primary mode of communication, and we collapsed into a doer-done-to dynamic. During one session, I reflected on some of the powerful things I was pondering on expansion, transformation, aliveness, and creativity. I was reading Jurgen Moltmann at the time—for me, engaging in philosophical ideas is a way of sharing my inner world with others. Ideas are also deeply emotional and personal. Like many Autistic people, I do not separate ideas and emotions. If you ask me about my emotions, I will likely tell you an idea (and I experience the idea as intertwined with emotion).
I shared some of Moltmann's ideas with my therapist as a way of articulating and describing my inner world. After I was done talking, my therapist said, “Yes, but what do you feel about that? Where in your body do you feel it?” In this single moment, my body both collapsed and froze. I felt simultaneously missed, intruded upon, and trapped in swirling feelings of incompetence. Social and emotion-based questions can cause many of us (Autistic people) to feel incredibly incompetent. Furthermore, social-emotion-based questions are experienced as a sensory demand and, as such, can often invoke a freeze response.
I suspect that my therapist felt pulled to do to me. She likely felt pulled to help me get out of my head and into my body. In her attempts to move closer, the space collapsed into a doer-done-to enactment. As my primary mode of communication (intellectual) was cast aside, I felt done-to. Had my therapist rhythmically attuned to me, continuing to use the language I provided (language of an object-based conversation vs. social-based conversation), the conversation and the connection would have deepened. By overtly demanding a rhythmic shift into the realm of the social-emotional-bodily (the primary language of allistic connection), the space collapsed into a doer-done-to enactment. Ironically, my therapist’s attempts to deepen the conversation (from her framework of what deepening means) caused the connection to rupture. In this instance, her inability to rhythmically attune foreclosed the possibility of mutual recognition. We remained entrenched in the doer-done-to dynamic for the duration of our work. I eventually learned to pre-rehearse scripts to fill our appointments times.
In the above examples, the “double empathy problem” can be observed. The communication breaks down within the intersubjective space between therapist and client and mutual recognition becomes an impossibility. When a therapist has limited awareness of Autistic social-communication patterns, they may misattribute meaning to actions and behaviors of their client. Furthermore, the therapeutic practice of holding silence and waiting for the client to speak unprompted often invokes the doer-done-to dynamic, as many Autistic people experience this as a form of pressure and demand. Ideally, a non-autistic therapist would consider their work with Autistic clients akin to cross-cultural therapeutic work—attending to the nuances and differences present within the multiple cultures represented within the room. Only then can the therapist surrender to the rhythm of the client and can a third space open.
Toward Mutual Recognition
There is often an element of surrender-surrending what we think we know, our pre-conceived ideas of how an encounter should go in order to achieve mutual recognition. The late Stephen Mitchell (1993) told a powerful story of parental surrender. He described the excitement upon discovering his two-year-old daughter was old enough to go on walks; however, he soon found the walks agonizing. Mitchell’s concept of a walk turned out to be quite different than his daughter’s. While he imagined brisk movement, his daughter ’s walk was slow, discovery-focused, and tangential. It was not until he could surrender his concept of the walk that he could encounter his daughter. He wrote,
“The implications of this difference hit me one day when we encountered a fallen tree on the side of the road...the rest of the “walk” was spent exploring the fungal and insect life on, under and around the tree. I remember my sudden realization that these walks would be no fun for me, merely a parental duty, if I held on to my idea of walks. As I was able to give that up and surrender to my daughter ’s rhythm and focus, a different type of experience opened up to me…If I had simply restrained myself out of duty, I would have experienced the walk as a compliance. But I was able to become my daughter ’s version of a good companion and to find in that another way for me to be that took on great personal meaningful me. (Mitchell, 1993, p. 147)
It was not until Mitchell (1993) surrendered his concept of the walk that he could encounter his daughter. This provides a poignant metaphor for the mental health world. To encounter Autistic clients, therapists may need to surrender their concept of what an ideal therapy session or course of treatment entails—which may open space for a rhythmic Third to appear. To encounter Autistic clients, therapists often need to surrender their concept of “autism.” Only then will space for mutual recognition and encounter emerge.
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