Autism and the Processing of Trauma

Thinking differences that include Lack of central coherence, Theory of Mind and Mind Blindness (Simon Cohen -Baron), Systematizing, Executive Dysfunction, sensory aversions and preferences, and synaesthesia in the extreme, all alter processing of trauma and subsequent symptomatic presentations of Post Traumatic Stress Disorders (PTSDs) in individuals with Autism Spectrum Disorders (ASDs)..

I have often wondered what freezing and fawning look like in the life of an individual with an Autism Spectrum Disorder (ASD) post trauma? How often are these trauma responses misdiagnosed and mis-medicated? The Aurora Project ( Mansell and Sobsey) documented the significantly increased prevalence of sexual abuse in the lives of individuals with ASD and Intellectual Disabilities (IDs).The multiple determinants this fact sadly continue in the lives of many with ASds

David Hinsberger , recently deceased advocate extraordinaire, authentically offered compassion and empathy to many individuals with ASDs and/or IDs who had been traumatized. He provoked the question, can we teach social skills to promote more positive outcomes and resiliency proactively to individuals with ASds, knowing their high lifetime rates of experiencing abuse.

Many years ago, a client of mine with an ASD was sexually assaulted , and forcibly intravenously injected with cocaine, then discharged from a psychiatric hospital after falsely being accused of using illicit substances Her urine drug triage was positive indeed.What a horrific accusation! If only the hospital staff had empathically held space for her and allowed her to process this trauma in a manner that made sense to her She was subsequently denied a diagnosis of an ASD because she married and loved her two children. She studied Buddhism and after developing Amyotrophic Lateral Sclerosis, and parachuted from a plane paralyzed from the waist down .She was the first female in history to do so. She triumphed despite a system that denied her and her children, basic rights re identify and mental health care She sent me a postcard thanking me for "being one of the few who care " How did she recognize that? What elements came together to allow her to follow her dreams ?

What Happened to You? ( Perry and Winfrey ,2021) is a remarkable new book discussing the genesis of trauma and its neuroscience. In this empowering book , four pillars of traditional healing and the development of Post traumatic wisdom are reviewed- 1-connection to clan and the natural world, 2-regulating rhythm through dance, drumming and song, 3- the set of beliefs,values and stories that bring meaning to even senseless, random trauma , and, on occasion,4- natural hallucinogens or other plant -derived substances to facilitate healing with the guidance of a elder or healer ( page 200 ).Would these elements be amenable to modification to the thinking and sensory styles of traumatized individuals with ASDs. I bet they could .

The crucial elements of Indigenous healing practices- they're being repetitive, rhythmic, relevant, relational,respectful,and rewarding , are also articulated by Perry. How could we foster the development of these elements in the healing journeys of individuals with ASDs who have been traumatized ?

Lots to think about .

Dr Bob King MD FRCPC