Hello everyone. You clicked on a video about trauma, so here's a content note: I'll be discussing pretty heavy themes in this video. Ptsd, generalized trauma and traumatic events. In, hopefully, kind of a generalized and intellectualized non-triggering way, but it still might be a pretty heavy video. So consider this your warning! I was commissioned to do this video several months ago. Thank you so much to Chelsea, who commissioned it, for your patience. And I've been kind of putting it off, because I like to make jokes about things. But the problem with trauma is that it's not funny. If you are affected by the issues that I raise, please seek help and advice outside of this video, outside of youtube. I cannot stress that enough. I'm not a licensed therapist and I'm not a trauma specialist. So please find someone who is. But I have had PTSD in the past and I'm also autistic. So it's an important topic that needs gravity dedication and a serious approach. [Voiceover] No, Sam! [Editor] She never lets me have any fun. So let's take a tour of the autistic mind. Why we might be more susceptible to trauma, more likely to develop PTSD and C-PTSD, why autism and trauma resultant behavior might be mistaken for each other. And why being autistic in this world might just be traumatic in itself. It's going to be good. It's going to be dense. So, I would suggest saving this to a playlist for later if you want to come back to it and if you like it please give it a like. Because, super long 20 minute + video, about trauma and autism. It's kind of niche territory. So give it a chance on youtube, please! So let's start by explaining some of these terms that i'm going to be talking about, so we're all coming from the same place. Well, we kind of know what autism is already. If you don't then I would suggest saving this video and going back to one of my other videos on the channel that explains it. Let's start with PTSD or post-traumatic stress disorder as defined by the DSM-V. Which is the american psychiatric association, basically their handbook for mental disorders. PTSD is diagnosed specifically after one-off traumatic events. Which involve: direct or indirect exposure to actual or threatened death, serious injury or sexual violence. And it has symptoms in four distinct clusters: Re-experiencing symptoms like recurrent distressing memories or dreams flashbacks; Cognitive and behavioral avoidance of traumatic reminders; Negative alterations in cognition and mood, like the inability to experience positive emotions, having negative beliefs or expectations; And alterations in hyper-arousal such as startle responses, Irritable behavior, anger and sleep disturbances. Now, this is all very much psychologist mumbo jumbo as it were. So to put that in really plain language: flashbacks, avoidance, depression and always being on alert. So PTSD involves these symptoms and is something that happens to you after a single traumatic event. But what is C-PTSD? It stands for complex post-traumatic stress disorder, and this is a bit of a newer term coined in 1992. And this is included in the ICD-11, which is the World Health Organization's version of the DSM. But the criteria for C-PTSD have not yet been approved by the americans. So this is why this is not included in the DSM-5. It gets very complicated. So diagnosis of C-PTSD may very well be dependent on which country you're in, as you can imagine. The clue is in the name C-PTSD is a little bit more complicated than PTSD, a little bit more complex. In addition to PTSD symptoms. Symptoms of C-PTSD might involve the following: difficulty controlling your emotions; Feeling very hostile or distrustful towards the world; Constant feelings of emptiness or hopelessness; Feeling as if you are permanently damaged or worthless; Feeling as if you are completely different to other people; Feeling like nobody can understand what happened to you; Avoiding friendships or relationships or finding them very difficult; Often experiencing dissociative symptoms such as: depersonalization or derealization; Or regular suicidal feelings now. I suspect that many of the autistic people watching this might be a bit like: "But that's me all the time". So, please don't diagnose yourself with this yet. I will explain, watch the whole video. It will become clearer. I hope. C-PTSD might also be called Desnos or desnos typically in america. Which stands for Disorders of Extreme Stress not otherwise Specified. Catchy C-PTSD is typically what's developed after a prolonged or chronic exposure to traumatic events or experiences. Typically in the first few years of your life, childhood, adolescence. that sort of things. This might include childhood abuse; Neglect or abandonment; Ongoing domestic violence or abuse; Repeatedly witnessing violence or abuse; Being forced or manipulated into prostitution; Torture, kidnapping or slavery; Or being a prisoner of war. Is it time for some kittens yet? I think so Now interestingly enough, C-PTSD is often misdiagnosed as BPD, which stands for Borderline Personality Disorder, and this is where things start to get a little bit interesting. Because a lot of autistic people also get misdiagnosed with Borderline Personality Disorder and quite often, these are women. It really seems to me like, the psychologists who developed these handbooks, sort of, take the approach of throwing different colours against the wall in the hopes that they will create a Kandinsky. And then just sort of go good enough for diagnostics. So we've got autism, C-PTSD and BPD which all kind of look extremely similar, can be comorbid with each other and get frequently mistaken for each other. And of course, this is extremely frustrating and problematic for all the undiagnosed autistic people out there who have also experienced trauma, because during the diagnosis process when the trauma comes up from childhood or wherever that's where the focus goes. And that's understandable psychologists. They love a bit of trauma, don't they? But you can be autistic and also have trauma. And if the autism gets missed that's really something significant to miss. And that's incredibly relevant to any potential course of treatment. So why do autism and trauma look so similar? I mentioned the symptoms of C-PTSD specifically and how a lot of those symptoms or traits seem very similar to autistic traits, and this is the main problem with only look at the behaviors or the symptoms the outward signs. Is that the root cause can often be quite different. Let's take one of the examples from C-PTSD, feeling like you are completely different to other people. For autistic people that's a fact of life. We are different. Similarly feelings of emptiness or hopelessness sound pretty awful for neurotypical people. But that's potentially just our reality as existing in this world as autistic. When the world is just not set up for people like us it can make you feel hopeless. Unless you really have a good diagnostician who can look past the outward behaviors, which you know you'd hope that they would, but I can tell you from the messages that I've received from people that they really don't. You end up in a position where it's actually the person that you see that affects the diagnosis. More than what you might potentially actually have! And this is extremely problematic and it's the same reasoning why they ended up lumping all the autism conditions into a single autism spectrum disorder, or conditions, I prefer. Because different professionals would give different diagnoses So you might think well I've been diagnosed with Asperger's but you might have seen another professional and they might have diagnosed you with What's it called autism? POS? Okay, I didn't write this down. Oops! You know, they might have diagnosed you with classical autism or something like that. And so they found that it really was more about the person diagnosing than about the person being diagnosed. That's a problem, but I don't think this problem is limited to autism. I think it's reaches out into trauma and all the other psychological issues, and that is a wider conversation that psychologists need to have because it has huge implications for what we think we know about psychology. And because many psychological disorders do not have biological markers. There's no blood test for depression. It's a question of the best we can do is write criteria and then look for those criteria and hope that the person who looks for them thinks, interpreted in the same way. And that carries a huge potential for bias and personal opinion along with it, which disproportionately affects vulnerable populations, especially those from minorities. so I'm not saying we need to reform the whole of psychology But so we've made a bit of an intellectual mess here Well, it's not really my fault actually, but let me try and explain how it all relates. Let's go back to autism. We know that autistic people tend to be hypo or hyper sensitive to stimuli and we're going to focus on the hypersensitive ones right now for obvious reasons. The sensitivity... This isn't an emotional choice I don't choose to be a delicate little flower. It's hardwired into neurons and nerves. We are different at the fundamental cellular level. The autistic trait of noticing really small details and everything it's because we're exceptionally sensitive. So it kind of makes sense that autistic people are more likely to be traumatized not just by the obvious traumatic events but by events that other people might not even consider traumatic. Research in this area is still very young but it indicates that autistic people might be up to eight times more likely to develop PTSD Than the general neurotypical population and that autistic women in particular might be more susceptible to this than autistic men. We don't really know why this is actually. Isn't it exciting to be on the cutting edge of research from the comfort of our own homes? But it kind of makes sense because autistic women tend to be diagnosed later, might have a tendency to mask more, which means that there is less support for them throughout life and more expectation that we should just Power through things. power through different difficult events because that's what everyone else is doing. So that's what you should be doing. So autistic people when asked about their most stressful life experience, sixty percent of them put down a social event. Compared with twenty percent of the neurotypical population,that was surveyed So think about bullying, not just something that happens in school. It turns out this is an example that might involve one or more social events that would result in traumatizing an autistic person. Potentially to an extent where they would develop PTSD or C-PTSD. And we know that neurotypicals can really sense when someone's different sometimes in a matter of seconds. Which is why autistic people are often the target of bullies. Even when we keep our heads down and we might be more vulnerable to the action of bullying. And research shows that it really only takes a matter of seconds for people to make, So-called, thin slice judgments about other people. We make very quick judgments about people and it's very hard to reverse that. And I did do another video on that last year actually. which has the somewhat provocative title of why autistic people seem weird and I include myself in that. I did get some comments about "this is a very rude title", but I don't consider weird fundamentally derogatory term, anyway. I know that so much of my mask was built up out of a desire to fit in and to not be noticed to not be bullied. And that was my strategy in addition to trying to be funny all the time. You see much has changed. It worked though to an extent in terms of not being bullied. I wasn't actually bullied at school. I was probably some kind of an object of derision to some. But not actively bullied. But this masking strategy that I built up was much less effective at preventing bullying type behavior, once I left school and entered the real world. And I think bullying at adulthood can actually be harder somehow because we don't have grown-ups to step in. We are the grown-ups. Well, that's a terrifying thought. And I very naively expected everyone to act that way, but it turns out that especially my experience at university just it just kind of turned into a wild west for bullies. And bullying in adulthood is very different from, like pointing and laughing at somebody in you know in the school yard. It's it's kind of different, it's more subtle and more pervasive. But I think it can be just as traumatic. Autistic victims of bullying can really bear the brunt of this. Bringing trauma with them throughout their lives the trauma that is the result of other people's actions and that's really hard. It makes you angry and resentful and ashamed, because we don't live in a society that recognizes people developing PTSD from a social event. Society's understanding of PTSD and trauma is very much like "oh! You weren't in a war your trauma isn't that bad? It's not the worst trauma there could ever be stop complaining Why are you such an attention seeker?" But the DSM is very clear, PTSD is not just for people who've been in war. in fact, It's estimated that only 20 to 30 percent of those who've been in combat actually develop PTSD and for women This might also be due to the fact that there's a really high prevalence of sexual assault in the military. So kind of being traumatized by your own side. This is not the time to go into mental health in the military. Is it ? I'm just gonna drop that, but not all military PTSD comes from war and that's an important point to make. Now I mentioned earlier that I did suffer from PTSD several years ago, And I'm sure you're very curious as to why. So i'll tell you. Just before my last term at Uni I had a head injury which involved a security light, you know, Yay, Big swing it, fell off the wall and swung into my face. And it was a very windy day, like it swung with some force into my face. And I kind of laugh about it every time I talk about it. I laugh about it and you can begin to see how my hilarious persona hides a fragile and hurts little girl. Ah, but yeah, I was walking down the street and it swung out of nowhere and broke my glasses clean off my face, hit me kind of thusly and luckily as far as physical damage, He was classed as uh, medically speaking a minor head injury, but it did hit me very hard and I had a mild concussion. So instead of going back to Uni, I was supposed to go back to uni the next day, I took a couple of weeks off before I went back which seemed reasonable at the time. But I had a dissertation to finish. I had to finish that in order to complete my degree. So I sort of had to go back. But not only was I very traumatized from the accident, but when I told people about what happened and how shaken up I was, they actually laughed at me. People laughed at my face! And some people even told me that I wasn't taking responsibility for my commitments by taking two weeks off. And hum... Yeah. And that accident changed the way my brain worked for sure. Before you say anything. Yes. I was also definitely autistic before that. So it didn't give me autism. But that was really the point where my body started being anxious. In body as well as in mind. So an anxious mind is like having anxious thoughts. You know, "what am I saying the right thing blah blah blah" Of course, I had that that's kind of an autistic state of being, is an anxious mind. I think. But an anxious body is having heart palpitations, feeling little surges of adrenaline through your arms and legs, panic attacks and it was this accident that led me to develop really awful periods of anxiety throughout my 20s and I used to be much more of a kind of calm but depressive kind of person and since then it's kind of like my body's been rewired for hyper vigilance and anxiety. But the point that I really wanted to make is that it wasn't just the accident and a lot of where the trauma came from was the way that people treated me afterwards. And the situations that I got myself into... Social events, you might call them. So I just I I just want to say the thing about PTSD is that it's been 12 years since I was in an accident that from their assessment was not sort of medically significant caused, no physical harm. Yet when I was sitting writing out the script, this is not the first time that I've read this through I've had a lot of practice at reading this through, but when I was sitting there writing out the script, it brought it all back. The inability to breathe, the feeling of sheer terror and that's 12 years and that's with therapy. That's with medication. That's with now an autism diagnosis and support. So I guess I'm trying to say that it is really not about the event. It's not about how bad the event was. And PTSD is not a whose trauma was worse competition. Essentially, it's how your brain reacts to it Look at it this way if 70 to 80 percent of people who go to war come back without PTSD, it's not about the event and it's about the person what their brain is like and what support they have. I think I need a cup of tea. Okay, be right back. It's actually yorkshire tea and biscuits flavor, which is not as disgusting as it sounds. Right, so far we have established that there is a big crossover comorbidities, misdiagnosis surrounding autism and traumatic disorders But I want to briefly talk about the autistic experience from the inside and why I think that just growing up autistic in this world can be enough to traumatize us without really significant events happening. I think I've said before that I would like in growing up autistic to experiencing millions of microaggressions throughout your life, it's kind of like death by a thousand paper cuts. So even if you can't identify specific trauma the hostility of society to autistic people can be enough. You might not be able to say "that's what happened to me." "This event caused this". But every negative interaction, that we are more sensitive to, it's like kind of like a gradual chipping away at us and once that's gone past a specific point, you know, I think that it can get to a sort of trauma autism or trautism if you will. I'm just making up diagnoses now, all the cool psychologists do it after all. But think about the way that trauma or traumatic event was defined in the DSM direct or indirect exposure to actual or threatened death, serious injury or sexual violence and there is some evidence to suggest that autistic people might simply experience stressful events as traumatic and it's suggested that this might include intense sensory stimuli, changes in routine, medical ordeals. Which has quite some implications for autistic mental health in a variety of ways. But an autistic person with PTSD May not be recognized because it doesn't count. Because the event that caused it doesn't fall under what is described in the DSM. There are so many characteristics unique to autistic people for example sensation, perception, social awareness and cognition. And these unique differences may determine which events would be experienced By us as traumatic and therefore kind of more likely to lead to a trauma disorder. We also know that autistic adults report Significantly higher stress and poorer ability to cope with stress in everyday life compared to neurotypical adults. So I was kind of joking about the trautism, but I also kind of wasn't. The society that has been largely built by neurotypical people puts intense stress on us, doesn't recognize our resultant trauma. Sometimes doesn't even recognize our autism. So how many traumatized autistics is it going to take for the psychological establishment to take notice of this and to convince them to include it under certain diagnostic criteria. Because, just spending time around the autistic community you can see how most of us are carrying trauma around just from existing. Let alone counting the people who have actually suffered significant traumatic events or whose. Very existence is enough to put them in danger on a daily basis, due to their skin color gender presentation or visible disability. So understanding how all of this relates to each other is very important for the next part. Which is treatment or management. So, right now I would just like to reiterate that if you have trauma please explore these options under the supervision of a professional. Even benign mindfulness or meditation techniques can be dangerous. And I am not the only person who's had a full-blown panic attack brought on by meditation. So just be careful with yourself, basically. Meditation, everybody suggests it. But people don't realize that it can actually bring up a lot in people who've gone through trauma. So be careful. Obviously therapy is something that plays a large part in most treatment for trauma and there are various different kinds of therapy CBT is very mainstream but not necessarily suitable for autistic people. Its aim is to challenge your thinking patterns and sort of change your thought process but I found it problematic personally, because challenging my own thoughts became a judgment on them and I felt like I was trying to force myself to have new different thoughts that weren't mine and you know, it really turns out I don't think my thoughts were the problem. It was the assumptions behind them. They were the things that really could be challenged. And so unless you work with someone who's very experienced. I think it can fall a bit flat for autistic people. So i'm not saying that CBT can't be helpful at all. But if you have had similar issues with CBT and you just found it didn't work very well, you didn't like it, you didn't find it very effective, have a look into DBT, which stands for Dialectical Behavior Therapy. I don't know why I always want to call it diabolical behavior therapy. Or also Acceptance and Commitment Therapy ACT which are both acceptance and mindfulness-based therapies and they are targeted towards people with BPD, autistic people or those with significant emotional dysregulation or a predisposition towards stress. So I had about six months suffering with quite acute PTSD and it took about a year to more or less recover. Although really significant recovery took years. I mean, I don't even know, like up to five years. I think trauma takes a really long time to recover from but I want to assure you that with the right treatment and support it's possible. So during my time with a clinical psychologist right after my accident. We would do visualization techniques, which are like replaying the event backwards, you know, like you're rewinding a video. God! It's just occurred to me that actually some of you will never have done that! So, back in the olden days, ee used to have to rewind videos and everything went backwards. It was very funny. But I found that techniques, like that worked pretty well in processing the terror that I felt surrounding the the accident itself. But I don't really know whether that would work so well with social events. This seems like a better technique for the kind of one-off events. I also tried things like viewing the memory from above, as if you're playing The Sims, something like that. To detach yourself from the memory and be less involved with it. Because with flashbacks you're kind of right back there again. So both of these techniques kind of attempt to detach yourself from being right in the memory and maybe slightly alter that original memory. Which has become hard coded in people with PTSD? There is also a relatively new therapy, and I say new, it's only like a few decades olD, called EMDR, which stands for Eye Movement Desensitization and Reprocessing, where a therapist redirects your eye movements As you are focusing on your traumatic memories and it sounds very weird and often involves, tapping and things like that. But it actually seems to be quite effective, with long-term results indicated for PTSD sufferers. But I've never actually tried this myself. I've never done EMDR. I'd be interested to hear your thoughts if you have done it in the comments below. But I thought this was amazing because it was developed by a woman named Francine Shapiro who made this Observation that moving her eyes from side to side helped reduce her negative thoughts and traumatic thoughts in herself. And I think it's incredible that she made this observation in herself and out of that the whole therapy was born. That actually seems to be really helpful. Now of course trauma is often treated by medical professionals with drugs, from anti-anxiety meds to antidepressants and I have been on both at various times. But i'm particularly interested in a slightly different sort of drug the potential coming out of psilocybin trials. Psilocybin is the active ingredient in magic mushrooms, which is better known as a hallucinogen. It works quite well for mental health related issues because it interacts with your serotonin receptors. Actually interacts really well. But there are a lot of trials that show promise when it comes to treating conditions such as addiction, severe depression, OCD and of course PTSD. I thought it was very interesting that some of these trials involved taking psilocybin in conjunction with a therapy session. So before you go out and try it yourself, It is extremely illegal in almost every country, apart from the one that I am actually living in right now. The Netherlands, where I can walk into a smart shop and go buy some - I think I can even order it online. You can actually do psilocybin therapy weekends, If you have a few thousand euros to spare and a free weekend to visit Amsterdam. Just saying. And it's funny because every healthcare professional that I've talked to about it in this country has actively approved of the use Of psilocybin for managing mental health. I should clarify I do not condone law breaking. This video is not suggesting that anybody goes out and break the law. I would not dream of it. But I think it's very interesting research. But the problem with all these therapies is that they're kind of developed for PTSD, They might be developed for autistic people, but there is no one therapy or treatment that specifically targets the PTSD trauma/autism Comorbidities. if a population, like the autism community, disproportionately suffers with trauma-related disorders there needs to be more research done in this area. Like, we just don't know enough about it. Enough about the relationship, how it works in order to treat it effectively. That's what I used to say all the time in essays, right? Like, "I would recommend further research on the subject". Cecause what else are you supposed to put in your conclusions? This really did end up actually taking me back to my undergraduate days. It was almost an undergraduate dissertation. This probably turned out a little bit better than the dissertation I did turn in while suffering from PTSD. I turned it in the end and I got my degree. So I guess it was a happy ending. Thank you for keeping with me until the end. I do have some other people to thank as well as you gentle viewer Thank you to Chelsea for commissioning this video and for being eternally patient while I procrastinate. Thanks to Ana Muhlethaler for her help with research for this video. This video was researched. Thank you to Heather for coining the term trautism that I've ruthlessly stolen and taken as my own. Thanks to the Samdy Supporters and the Yo Samdians for making this video possible. If you are interested in joining, possibly the coolest club around, do click that "join" button below to find out more. Yes, It's a new button! It was not there last time. So have a look and see what you think. The thing about having monthly supporters is that I can talk about drugs and trauma on my channel and I don't need to worry about getting demonetized because it's not "advertiser friendly". So with this support I can really start to tackle some more interesting dark, inappropriate topics, that kind of thing. Please, tickle the algorithm buttons appropriately and I will see you next time. Thanks for watching. Bye
