Autism Cymru Workshop

1. Autism Cymru Workshop

2. Autism CymruManaging Feelings 23rd April 2008

3. Cognitive Behaviour Therapy • Affective Development. (maturity, vocabulary and repair). • Cognitive Distortion. (dysfunctional thinking and incorrect assumptions).

4. Assessment

5. The Perception, Expression and Regulation of Emotions • An inherent characteristic of Asperger’s syndrome?

6. Anxiety • Very good at worrying. • Generalised anxiety (pessimist) • Obsessive Compulsive Disorder (25% of adults with Asperger’s syndrome)

7. Anxiety • Cleanliness, performance anxiety (fear of making a mistake) • PTSD from being teased or bullied • Sensory experiences • Social anxiety • Controlling and oppositional

8. Depression • Occurs in one in three adolescents and adults • Low self-esteem due to being rejected and ridiculed by peers • Painful awareness of being different

9. Depression • Loneliness • Mental exhaustion • Depression ‘attack’ • Suicide attempts in adults

10. Anger • Two out of three people with Asperger’s syndrome have a problem with anger management. • Sadness and anxiety expressed as anger

11. Anger • Achieve solitude • Dominance and control • Anger due to not being valued and accepted (arrogance) • Agitated externalized depression

12. Assessment • Self report scales. • Mood diary. • Triggers.

13. Assessment • Change.(circumstances, routines, caregivers, expectations). • Frustration • Sensory overload • Unfamiliar or confusing situations. • Shouting

14. Assessment • Clinical interview and observation in different contexts. • Family history of mood disorders. • Unconventional signals of distress (giggling) • Misinterpretation. (friendly or unfriendly laughter).

15. 71% of children and adolescents with Asperger’s syndrome are teased and bullied more than typical children

16. Assessment • Sensory experiences

17. www.cat-kit.comStructure to organize emotional experiences

18. Background Factors Crisis Escalation Recovery Background Factors Trigger

19. Affective Education

20. Affective Education • A project on a specific emotion. • Start with happiness or pleasure. • Create a scrap book that illustrates the emotion. • Diary with new experiences. • Compare and contrast other children’s scrap books.

21. Affective Education • A thermometer to measure the degree of intensity. • Place photographs and words at the appropriate point on the ‘thermometer. • Increase precision and accuracy in verbal expression. Alexithymia.

22. Affective Education • Point to the degree of expression in a particular situation. • How much other people’s words and actions affect their feelings. • How much their words and actions affect the feelings of other people.

23. Affective Education • Appropriate tone of voice. (counting,). • Different ways to say “Yes” or “come here”. • Select a word or phrase and a mood and say the word according to the mood. • Drama games for body language. (charades).

24. Affective Education • Emotion statues. • Non-verbal sounds. (cough, tut, mmm). • Guess the message. (raised eyebrow, frown). • Music. • Colour to represent the emotion.

25. www.jkp.com • www.transporters.tv

26. Internal Signals • “How did you know…..” Two stages • 1: Not perceiving or being conscious of internal emotional states. • 2: Recognising but not expressed in converstion. • Need to ‘listen to their body’, to ‘be in touch with your emotions’

27. The Understanding and Expression of Emotions. • Happy- Sad. • Relaxed-Anxious. • Affection-Anger. • Problems with emotional arousal for both negative and positive emotions. • Rapid expression of extremes of emotion

28. Exploring Affection

29. The Understanding and Expression of Affection • Ability to read the signals when someone expects affection. • Ability to express the appropriate level of affection.

30. The Understanding and Expression of Affection • Affection to repair someone’s feelings. • An immature expression of affection. • A limited vocabulary of expression that may not include subtle or age appropriate expressions. • Sometimes needing frequent expressions of affection for reassurance.

31. The Asperger’s Perspective • Why are typical people so obsessed with expressing reciprocal love and affection? • A hug can be an uncomfortable, constricting squeeze. • Don’t cry because someone will squeeze you. • Not comforted by affection to the degree that neurotypicals expect.

32. Cognitive Restructuring • Emotion Management • Energy management.

33. Emotional Toolbox: To Fix The Feeling

34. Physical Activity Tools. Quick release of emotional energy • Physical exercise, walk, run, trampoline. • Sport. (Basket Ball, golf, weight lifting) or dancing. • Creative destruction (recycling).

35. Physical Activity Tools. • Drum Kit. • Swing. • Orange squeezing. • Bite an apple. • Break a pencil.

36. Relaxation Tools. Slow release of emotional energy • Relaxation training. • Music. “Feelings put into sound” Matthew. • Solitude. • Massage. • Comedy programs. • Repetitive action. • Sleep

37. Social Tools • Time with a family member or friend. • Diclosure (typing, music, poetry) • Seek advice. • Being with a pet.

38. Solitude • The mental and emotional exhaustion from socializing. • One hour of socializing needs one hour of solitude.

39. Social Swimming • I describe my social life with this analogy. Swimming in the water is nice at first, but if it goes on for too long, or too often, I start to drown. (Yeshe)

40. Social Tools • Helping someone. • Being needed. • Meeting someone with similar issues. • Counselor or mentor with Asperger’s Syndrome.

41. Social Tools: Affection • Intensity • Duration

42. Thoughts and perspective • Put the events in perspective. • Imagine what you would like to do or say. • Being calm is being smart (IQ)

43. Thinking and Perspective • What else could you do? • Flexible and creative thinking • Think of the outcomes • The smart thing to do • Social Story

44. Temple Grandin • When I was in my twenties, my Aunt Anne successfully used cognitive therapy on me. When I was depressed and complaining, she gave me objective reasons why I should be happy. She said, “You have a nice, new truck and I have an old, crummy one.” She also gave me other examples of things that were positive or were going right in my life. It perked me up when I compared the pictures in my head of the two trucks. It concretely helped me understand that some of my thoughts were illogical and not based on fact. Emotions can do that; they confuse thinking.

45. Antidote to Poisonous Thoughts • P (poisonous thought) or A (antidote). Evan • I’m a loser.( ). • I can stay calm. ( ). • Relaxing makes me think better. ( ). • Everyone hates me. ( ). • Create antidotes to the person’s ‘poisonous thoughts’.

46. Special Interests • A means of relaxation, pleasure. • Knowledge to overcome fear. • Keeps anxiety under control • Thought blocking. • Interest or OCD. Is it irresistible?

47. Collecting and cataloguing (personal defrag). Distraction during a meltdown. The ‘off switch’ Motivation and conceptualization ( Dr Who) Special Interest

48. Sensory Tools • Sounds. Ear plugs, headphones. • Light. Irlen Lenses, hat, sun glasses. • Aroma. deodorants, cleaning products. • Tactile. Clothing.

49. Medication As a Tool • Treatment of an anxiety disorder or a clinical depression. (SSRI). • Impulsive. (Stimulants). • Mood cycles. (anti-convulsants). • Sedation. (anti-psychotics)

50. A Social Story Using the Toolbox to Stay Calm and in Control