Is Anorexia the New Female Aspergers?

Asperger Syndrome (AS) is thought to be the highest functioning form of Autism Spectrum Condition. Females on the Autism Spectrum are underdiagnosed and often come into a clinic with other mental health issues, many labels or diagnoses, some of which include: anxiety disorders, ADHD, sleep disorders, panic disorders, obsessive-compulsive disorder, depression, bi-polar disorder, borderline personality disorder, eating disorders or schizophrenia.

Females on the Spectrum are generally much more social, really good at “faking” it, understanding non-verbal body language, working very hard to “fit in” and “pretending to be normal”.

Women tend to be much more social than men, observe and watch others more in order to learn what to do, learn how to hold their bodies, what to say and when to say it. All of these skills do not come naturally and an enormous amount of energy is put into these skills. Females are generally able to hold it all together during the day and then let it all out at night. At night, the “falling apart” may look like, jumping, screaming, flapping, outbursts or withdrawing into their caves.

Women generally tend to have better empathy and theory of mind skills. However, these theory of mind skills become affected by sensory issues, stressful situations, social situations, processing of verbal information, high levels of anxiety, conflict and/or arguments.

Of those that come into clinics, anorexia nervosa appears to be the most common eating disorder that females (21.7%) on the Spectrum tend to experience (Nichols).

What is the link between eating disorders and Autism Spectrum Conditions (ASC)?

There is a overlap, possibly a genetic link between ASC and AN.

The lifetime prevalence of an eating disorder is 0.9%. ASD is highly over represented in AN (12-32%). Some commonalities between ASC and AN include:

1. Executive function deficits

2. Mood and anxiety disorders

3. Perfectionism

4. Rigidity in behavior and thinking

5. Theory of Mind Deficits

Autism Spectrum Characteristics that increase the risk of developing an eating disorder include:

1. Clumsiness and knowing where one’s body is in space

2. Body awareness issue, distorted image of body in space

3. Limited social insight; difficulty with understanding how others see their body

4. Stomach issues, a feeling of no appetite, bloatedness

5. A lack of sense of being hungry or thirsty

6. Medication side effects (SSRI’s, antipsychotic and associated side effects of weight gain)

7. Sensory processing sensitivities

8. Stress management

9. Transitioning

10. Picky eating

Where does a percentage of almost 1/3 of the population with AN having ASC come from?

51 women over 18 years were evaluated using formal interviews, developmental histories and 32% of those met criteria for ASC, but only 11% of them knew that they had ASC. Their families had no idea that they had ASC. The highest prevalence of personality disorders (OCD) were also present.

In terms of intervention and treatment, a modified treatment schedule is important due to learning difficulties, mental health issues including ASC, a balanced/different course load.

What is desperately needed is a routine global screening program for all females who come into a clinic with an eating disorder. It is critical to know if a client has an ASC or has symptoms of an ASC because the symptoms of ASC do not go away post-treatment. The eating disorder may be alleviated, however the symptoms of the ASC have not. This will help the client, their families and their treatment professionals.

Goals for treatment of an ASC and AN include:

1. Treating the sensory processing condition

2. Improving the rigidity and inflexible thinking processes

3. Improving the range of foods eaten

4. Rigid repetitive behaviors need to be replaced with more functional behaviors

5. Increasing and widening the range of foods eaten

6. Decreasing anxiety levels and improving depression levels

7. Work with the preference for sameness and routine

8. Improving sensory processing issues and desensitizing to aversive foods

Resources

https://nedic.adobeconnect.com/_a1094990891/p8era9wae5y/?launcher=false&fcsContent=true&pbMode=normal

S Baron-Cohen, A Jaffa, S Davies, B Auyeung, C Allison, S Wheelwright (2013)
Do girls with anorexia nervosa have elevated autistic traits?

http://docs.autismresearchcentre.com/papers/2013_BC_etal_Anorexia_nervosa_elevated_autistic_traits.pdf

Gillberg C, Cederlund M, Lamberg K, Zeijlon L: Brief report: “the autism epidemic”.
The registered prevalence of autism in a Swedish urban area. J Autism Dev Disord 2006,
36:429–435.

Eating Problems and Overlap with ADHD and Autism Spectrum Disorders in a Nationwide Twin Study of 9- and 12-Year-Old Children

The sociocommunicative deficit subgroup in anorexia nervosa: autism spectrum disorders and neurocognition in a community-based, longitudinal study

CAVEAT: My research is focused on females, due to the lack of research and information on the female profile

Tania Marshall 2013. All rights reserved.

Tania Marshall©. 2013.  All rights reserved. Duplication in
whole or part is explicitly forbidden. Thank you.

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Professional FAQ Series: Highly Sensitive People, Female Aspergers, Referred Emotion and the Superpower 6th Sense gift

Updated December 11th, 2016

There has been intense interest in the area of high sensitivity, different perceptual experiences, and the 6th sense, including Synaesthesia and will be written about in more detail in the future.

Professional FAQ Series: High Sensitivity, Female Aspergers, Referred Emotion and the Superpower 6th Sense gift

My writings are based on my professional work with individuals of all ages, most diagnosed with Autism or Asperger Syndrome (and some with co-existing conditions). I work full-time with individuals of all ages with Asperger Syndrome or Autism. I have supported hundreds of females with diagnoses of Asperger Syndrome. I also blog, write articles and am now writing a book series.

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FAQ: My daughter was diagnosed with Asperger Syndrome three years ago. Since very early on in her life, she has regularly told me things she couldn’t possibly know. She seems to just “know” things all the time. It’s spooky and I worry about her.

FAQ: I am a self-diagnosed Aspie and have known for a long time that I cannot cope being around people. I just get so emotional and at times, even break down crying. I broke down walking past an obese man the other day. I don’t know what it wrong with me.

FAQ: I am a diagnosed Aspie who has been told I “care too much” about the world. I can’t even watch the news anymore, without going into a meltdown over the latest war, injustice, or crime. How is it that others just don’t seem to care or that it doesn’t affect them like it does me?

I have interviewed hundreds of girls, teens and women with Asperger Syndrome who have talked to me about high sensitivity, referred emotion, a “sixth” sense, knowing things without knowing how they know them, “feeling” presences, knowing when people are lying (through their feelings), and much more. It appears that females with Asperger Syndrome have a unique way, or “channel”, of accessing information about others or about events, or another way of “reading” people. Many females I have seen have expressed difficulties reading people in the usual way, that is through reading others non-verbal communication (facial expressions, hand and body movements). However, all have discussed their unique abilities to accurately sense what they cannot easily explain.

When should you consider that you may have Superpower 6th Sense?

In interviews I have listened to females, who are extraordinarily sensitive to the pain and feelings of others, so much so, that they are unable to watch the news, read the paper, listen to the radio or watch horror or violent movies. They have discussed being able to feel other people’s feelings and being able to tell or feel when people are lying to them, even though they were given no indication through body language evidence, but had later on found out through physical evidence. They have described their sensitivity as akin to a “fragile flower with a gentle breeze blowing them right over”. They describe being in continual emotional pain in the presence of other people. Many females have discussed “feeling” the emotional atmosphere of the room, “feeling” someone’s anger (although the person said they were not angry, did not look angry, but were actually angry on the inside) or “feeling” someone’s sadness as they passed by the person on the street. They have also discussed experiencing referred emotion or others thoughts (picking up stuff from other people or being “invaded” by other people’s thought’s). Many of the females I have worked with have told me they have been told by others that they “care too much”, are “”too sensitive””, are “highly sensitive”, and/or “need to stop caring” or “harden up”.

Some females have discussed knowing about future events happening before they happened, experiencing “precognitive dreams”, experiencing extrasensory perceptions and describing their experiences as seeing pictures in their head of what they are supposed to know (a “knowing” of a future event, the location of an item or a person, where a person is).

Many females have discussed realizing that they need to limit the time that they spend around people or avoid social situations because they are overwhelmed by others moods, feelings, emotions and/or the emotional atmosphere or because they simply just “know” too much about the people they are around, even though these people are strangers to them. Some of them have discussed how they have immensely benefited from a medication to “take the edge” off their emotional sensitivities, learned how to harnass and utilize their extra-sensory abilities (including learning to differentiate between the emotions of themselves and those of others, how to shield and protect themselves, among other techniques), and what to do when they pick-up on or feel the pain of people or animals in their environment. There exists females with Asperger Syndrome who are professional psychics and/or mediums.

The Superpower of referred emotion, ESP, the “6th Sense” is a gift. In my experience, females with Aspergers tend to have this gift to a greater degree than others. This is not to say that males with Aspergers or people without Aspergers do not also have this gift. However, my research is on females with Asperger and so I write with this focus in mind.

Females with Aspergers are often much more aware of the emotional atmosphere that others miss. Many clients have discussed with me about their experiences in group, family, or conference settings, where they can “see” right through a person (their intuition tells them to be careful) whilst everyone else appears to really like them. Neurotypicals pay much more attention to other people’s words, non-verbal body language, actions, facial expressions, whereas Aspiens use a different sensing channel that tells them important information about a person. Learning to trust the “gut”, “ïnstinct”, “ïntuition”, “6th sense”, is crucial to overcoming naivety that tends to comes with being an Aspien, so that the individual is not taken advantage of.

Helpful Tips:
1. Knowledge and awareness. Believe your traits are real. Learn all you can about highly sensitive people, “empaths” and/or “ïntuitives”. Accept that you have this gift.
2. Learn about emotions. What are your emotions? What are degrees of delight and distress? What are other people’s emotions? How do you know what emotions are yours and what emotions belong to others?
3. Journal regularly. This will enable you to get to know yourself and provide a greater knowledge of what is yours and what is NOT your “stuff”
4. Learn to self-regulate your emotions
5. Learn shielding techniques, so that you do not ‘soak up’ others pain and emotions like a sponge.
6. Learn to separate your pain and emotions from those of other people, animals, nature.
7. Learn to trust and listen to your feelings, your vibes, your intuition. They are your guide in life.
8. Learn to embrace this gift, utilize it and trust it.
9. Take solitude (meditation, alone time)
10. Get enough rest and/or sleep.
11. Take minimum one day off per week
12. Cut down on the stimulation (TV, radio, newspapers, advertisements)
13. Learn to say Say NO
14. Be preventative. Take breaks often. Eat before you are hungry and drink before you are thirsty.
15. Learn about your gifts, strengths, assets and utilize them.
16. Reframe your life based on your high sensitivity, your Aspergers, your whatever. This will take time for you to do.
17. Work on healing your childhood, your upbringing, your sensitivities.
18. Meet and be friends with other highly sensitive people.
19. Embrace your spirituality, whatever that is.
20. Use your sense of justice in a healthy and empowering way.

Helpful Resources:
1. Aron, Elaine. The Highly Sensitive Person, http://www.hsperson.com/
2. Bogdashina, Olga, Autism and the Edges of the Known World
Sensitivities, Language and Constructed Reality. (2010). Jessica Kingsley Publishers

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Tania Marshall©. 2013. Professional Q and A Series I. All rights reserved. Duplication in whole or part is explicitly forbidden. Thank you.

Aspergers, Girls and the Social World: A Brief Look

I have mentioned previously in my work about what I refer to as a “Social Spectrum”, meaning that all people have varying levels of preference or ability to socialize. In terms of Aspiens, I have found that, as a group, they also have a social range. I have met Aspiens who at one end, the quite shy, introverted Aspiens who at times can be mute in social situations and need much encouragement to participate socially, in classes or groups. At the other end of the social Spectrum, some Aspiengirls present as quite extraverted, often ‘too’ social, in that they overstepping others boundaries and socially innappropriate. (Just to clear up any confusion, AspienGIRL™, Planet Aspien™, Aspien, Aspienpowers are from my new book series. The word Aspien means a female with Asperger Syndrome. Book Series and website coming shortly.)

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Aspiengirls may have a preference to spend their time in solitude and/or with animals, their dolls, teddy bears or imaginary friends or imaginary animals. Their animals or toys may be their best friends.

Aspiengirls who want and have friendships, are more likely to interact intensely with one other girl or boy. Remember, one of Aspiengirls superpowers is her ability to work exceptionally well one-one-one or presenting to others or a group. Her friend often provides support, guidance and social information to her to help her navigate the unwritten social rules and the playground. Aspiengirls are most often very loyal friends. They find gossip, bitchiness and back-stabbing a complete mystery and are uninterested in these types of behaviors.

Aspiengirls are known to be naive, socially and emotionally immature (often years behind their peers) and particularly vulnerable to being taken advantage of, especially if they are lonely and desperate for a friend. Aspiengirls are often more successful socially with boys, as they find boys, generally speaking, less complicated, their ‘play’ is fun, more functional and interesting. Aspiengirls find their female peers engagement in conversational and emotional play boring and confusing. Many Aspiengirls fidn they have more in common with their males peers and get along with them better as conversation is less confusing and mutual interests more appealing.

There is a sub-type of Aspiengirls that “flitter” from group to group not forming any close friendships with their peers, not knowing or understanding how to navigate the various cliques or groups. Aspiengirls have trouble understanding the levels of friendships, the social hierarchy and the social roles that various members of a group or groups play. In school, girls with Aspergers can feel quite lonely, they may make friends with peers from a variety of other cultures, .

Most often, Aspiengirls have flown under the radar and may not be identified as all as being Aspien until the tricky teenage years. I have seen various sub-types in my clinical practice. One group of teenage Aspiens I have worked with is a group characterized by very good grades, an embracement of good moral behavior, and a late development of interest in romance. This group often finds it challenging to be assertive and stand up for themselves. Some of them may be described as ‘puritan-like’, rule-bound or late-bloomers. Girls appear to be better than boys at masking the traits of autism in social situations,. However, girls are less able to do so in unfamiliar settings.

The other sub-type of Aspienteens I have seen is the opposite of the group I mentioned previously. Rather than embracing the moral code, they reject social, moral and authority codes, which combined with naivity, social and emotional immaturity, a belief in the ‘good’ in others, leads them a number of difficulties, ranging from experimention with drugs, to a history ofabusive relationships, continually being taken advantage of, in addition to dropping out of school. This type of Aspienteen has been described to me by many a parent as having “gone off the rails”. One particular example was of a parent who brought in pictures of what her Aspien looked like the year before and then showed me pictures of what she looks like now. There had been a dramatic change in appearance and attitude, along with her choice of social contacts, her sexual behaviors and dress. Some seek out a “counter-culture to fit into.

Social differences and difficulties are common among Aspiens and social skills training, drama lessons or coaching can be quite helpful. The type of social skills training is important and the above two groups need different intervention in terms of social skills training.

Tania Marshall©. 2013. All rights reserved. These writings are a part of the AspienGIRL™ Book Series. AspienGIRL™ and Planet Aspien™ are registered Trademarks. Duplication in whole or part is explicitly forbidden. Thank you.

The Chameleon World of AspienGIRLS™: Fantasy, Acting and Masking

CAVEAT: AspienGIRLS™ is a registered and trademarked 3D character and book series

The Chameleon World of AspienGIRLS™: Fantasy, Acting and Masking

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Females with Asperger Syndrome, Aspiens, tend to live in their heads, caught up with endless analyzing, copious amounts of thoughts, creative processes, ideas and worries. Aspiengirls™ are different in many ways to their peer and also to male Aspies. Females are known for their aspienpower super-abilities to fly under the radar by using advanced chameleon coping strategies of imitation, copying, acting, mimicking and masking.

A social meter does exists with Aspiens, in which some Aspiens seek out and want more social interactions than other Aspiens do. Females with Autism Spectrum Condition (ASC) who do want more social interactions have been observed mimicking socially successful and popular people, (usually a peer or a character on television) and copying or mimicking the person’s personality by copying their speech, words, tone of voice, accent, style of language, body language, clothing, hobbies or interests.

Aspiens are usually aware from very early on in life that they are different than their peers. To fit in and/or be accepted they may become someone else, a persona who is more likely to be accepted, not be viewed as different, or stand out from the crowd. Aspiens learn very quickly how to act in specific social situations, a strategy so successful that other people, and even at times the Aspien herself, may not be aware that her social intelligence is actually an act or performance. Her performance is facilitated by her above average to genius intelligence, chameleon-like skills and acting abilities. Aspiens have been observed to change their personality’s according to their environment, group or the situation they find themselves in. Over the long-term, this  coping strategy comes at the cost of her self-identity and self-esteem. The cost is that no-one really knows the Aspien, including herself. Many an Aspien believes that if others knew who she really was that she would be excluded, bullied, out-cast, or worse, institutionalized. These remarkable coping abilities have additional costs in terms of a “social hangover”, a period of exhaustion from social activities, people or the world. Aspiens typically return home from school or work completely socially exhausted and often meltdown, in front of their family members and/or pets. Only solitude will restore their energy levels and emotional world.

Aspiengirls™ who do not seek as much social contact tend be engaged with fantasy and imagination. Aspiens often identify with fictional book or movie characters that are fantasy based (Harry Potter or Hermione Granger are two examples). Aspiens often have imaginary animals or imaginary friends, with whom they talk to, interact with and it is these imaginary relationships that provide support, comfort, and company. Many an Aspien finds it far more i interesting to be in their fantasy world than the dreary and boring existence of day-to-day activities on Planet Earth. Other common worlds that Aspiens find fascinating include other cultures, languages and eras, where they may feel like they may fit in better.

Aspiens often develop an interest in science fiction and planets, fantasy worlds of unicorns, fairies, witches, and so on. While, it is common for typical females to sometimes enjoy escaping into imagination, Aspiengirls™ have an intensity in this area. For example, one girl I know of was so upset about a fantasy book series ending at Book 6, that she proceeded to write the next Book 7 installment herself! 

The array of camouflaging and coping strategies often mask the unique traits, gifts, talents and characteristics of Asperger Syndrome for some time over the course of elementary school. This is one major reason why Aspiengirls™ are underdiagnosed, diagnosed much later than males. or misdiagnosed.

Aspiengirls™ tend to fly under the radar, often until high school. Now, in adolescence, the psychological, social and emotional cost of masking becomes apparent. Aspiens are often only diagnosed in their adolescent years, if they are at all due, to their first nervous breakdown, when an eating disorder, identity issues, anxiety disorder, depression and/or traits of Borderline Personality Disorder become apparent. Years of pretending to be normal, constantly watching and analyzing their peer’s social behaviors, trying very hard to fit in, not make social faux pas, being a chameleon and wrestling with identity and self-esteem issues, takes it’s toll. Coupled with bullying, the  enormous stress often causes an Aspien teenager to have a breakdown in their ability to  function in day-to-day life. It may or may not be at that time that the Aspien is given an explanation for what she has felt and known all along – of why she is different – that she is, in fact, an AspienGIRL™.

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For more information on the AspienGIRL™ Book Series and Planet Aspien™, please go to:

Website (Currently under construction): http://www.aspiengirl.com.au
Facebook: http://www.facebook.com/AspienGIRL
Twitter: https://twitter.com/aspiengirl

Tania Marshall©. 2013. All rights reserved. AspienGIRL™ Book Series, AspienGIRL™ and Planet Aspien™ are registered Trademarks. Duplication in whole or part is explicitly forbidden. Thank you.