do i have autism or trauma? (autism & cptsd/ptsd)

[Music] I thought we talk about autism and complex PTSD and PTSD there's a considerable amount of research that says that children who experience maltreatment in childhood things like eggshell parents narcissistic parents immature parents mentally physically and or emotionally unsafe experiences often have similar brain differences and challenges and changes similar to children who also have autism say that again similar to the brain differences we see in autism I'm going to read this to you it says in their extensive review this study concluded that early life stressors in particular childhood maltreatment is also associated with significant Brain Change in adults particularly in the hippocampus Corpus colossum insula dorsal lateral prefrontal cortex often called the PFC the orbital frontal cortex the anterior singulate gyrus and the codite nucleus each of these areas has also been implicated in the brain differences we see in autism functional connectivity of the migdala the fear center of the brain and the PFC have been found in both autistic children and in traumatized children so this is our Baseline we're talking about the fact that this is where we're at right now we are at the beginning of understanding this Dynamic of autism I think that it is important to hold space for the fact that there is so much we still don't know that we've done a lot of research on trauma but not every everything is about trauma in terms of understanding the additional challenges people might face that people with Autism to have autism is to almost inherently have some forms of relational diffuse complex trauma and or PTSD and so I'm going to try to make this video short it's gone longer and I've been remaking it multiple times but I can save you this part and say if you think you have complex trauma and you think you have autistic traits and or Autism you probably have both for many reasons so what we're going to do is we're going to talk about as much as I can without this being six hours long the core differences first because there aren't that many but they are important and then the significant overlap between complex PTSD and autism as I said earlier I forgot to say this but this is really important there was a time and if you read the book neurotribes which I highly recommend there was a time when we just said that bad mothering caused autism and that was the belief among very educated people in large part so it's really important that you don't hold any one of us up to anything like they're saying one thing so it's all true that we hold space that we don't yet know a lot I might come back in a year and say oh that was wrong right we don't know but we don't know so to say it's dangerous to talk about this to say what whatever it's sort of a joke it's like there aren't that many uh resources for people with Autism anyway I think that the removal of Asbergers as a term I understand why I understand why for so many reasons but it's easier for people if I made a video and I said oh I have Asbergers in complex trauma I think that because of the lack of awareness and understanding and education that would be received differently for example than something like autism and Trauma I mean autism and complex PTSD so either there's all these nuances and words and changes and things we're realizing that we just didn't know and that's really important but to hold that if the brain changes the neurod divergencies of trauma and childhood trauma and autism are similar right there we've got an issue right and the core of those I really believe goes to it seems like the biggest piece is the nervous system for both of them and that's in part why a lot of trauma treatments can be helpful for those with autism the problem is there are places where it's not going to work enough so things like grounding really helpful but other parts we might get some trauma worked through but not understand the underlying pieces so let's get into it the first thing to understand is that really quickly complex trauma and PTSD are acquired they happen to you you are not born with them autism you're born with and if you look around your family it's probably likely that someone in your family your kids your parents your siblings your aunts your uncles you go hm we have some similarities there it's it's much more likely in your family system doesn't mean that necessarily is but it's more likely so one is happening and is acquired and one is happening as a result of sort of the way that everything kind of came together in the womb and then perhaps the way it expresses itself can change based on your environment and things like that or the parenting of course can affect how those things play out safe environments not safe environments but the core piece is already there so I want to talk first about some core pieces of autism that can express themsel and maybe some flavors of complex trauma that are very much the Hallmark of of of autism number one repetitive and self soothing behaviors through the use of routines so a lot of repetition a lot of routinized life and schedules and systems there's a safety in that there's a Reliance upon that now if you happen to have ADHD that can be another piece of this also very common with autism we're not going to discuss that today so let's pretend that doesn't exist but that can that can interfere with that need to have routine but this can look like you know stemming although anybody can stem but it can stemming can provide a source of not only pleasure but also of Regulation but a lot of that repetitive Behavior whether it's thoughts Behavior patterns whatever it is it pro there's a there's a self soothing to that that is very ground to the nervous system for those with autism number two difficulty intuitively reading neurotypical cues so cues that the neurotypical world sets up and I also believe that as opposed to complex trauma part of the problem with autism is that it's not just like a fear of rejection or you know or shame or being like not accepted which can be a huge part of the trauma personality it is that everything is an issue what you say do you share over overshare unders share the smell the lights the sound taking everything in what face are you making how do you respond to those things did you say too much the anxiety it is everything for for for that when I think about the differences it's like with with complex trauma maybe someone's afraid of being rejected or you know having that narrative reinforced in their childhood where for me at times like I don't really care what you think of me but the whole thing is freaking stressful what you're saying what I'm saying what I'm supposed to say where I stand how long do I stay God that table over there with the appetizer smells disgusting like I'm not eating that food I never eat buffet food like it's so many things okay we're going to come back to that actually that leads me to the next piece which is sensory sensitivities which are also common in trauma but these are your Baseline right so it's to I believe if you have autistic uh traits you have a lot of sensory triggers now maybe they're not they're not all the same right they can be very different and one can be stronger than another but you have this profile of sensory sensitivities and it's smell and texture and taste it's everything right sound it's like it's everything and we'll come back to that but it's part of your Baseline you were always that way and that affects things like how you regulate your mood right if you're triggered in your sensory issues it's really hard to regulate and then lastly special interests are often very common with for those with autism now let's just say you have PTSD or cptsd you're going to have to have a traumatic event you do not need a traumatic event in autism you're going to have avoidance behaviors right especially around things that trigger the trauma so with autism you might have lots of things you avoid that trigger intrusive thoughts or difficulty managing things or disregulation but it's not necessarily focused on something like avoiding trauma related triggers number three intrusive memories and flashbacks mostly related to the trauma those with autism can have a lot of intrusive thoughts about all kinds of things not just trauma related not just oh I could like drive my car that way but like huh I wonder what that means and then that leads you to the next thing and next thing you know your brains down a rabbit hole like there's all kinds of thoughts that are happening at once but around the PTSD experience or cpts experience there can be sensory emotional or physical visual flashbacks of course if you have trauma and autism you can have these two but we're acting like they're separate for now okay hypervigilance very common in both right but when you have a trauma you've learned to scan and hypervigilance that fight ORF flight for safety again and again and again and so your nervous system is in that state a lot of the time but maybe not all of the time in the same way or around the same triggers or issues whereas with autism you have this almost chronic state often of hyperarousal hypervigilance it's like always happening in there even if it doesn't appear so on the outside and you've learned to fake it and lastly nightmares now sleep issues are a huge problem in autism but nightmares specifically around the trauma or related events are going to be much more common with with complex trauma or trauma PTSD okay so that's the core difference right and even though I was still saying that I was still sharing the similarities let's talk about the overlap it is significant dissociation right so for trauma we're trying to manage where our trauma responses a lot is happening in the purpose of dissociation for autism we can be doing the same thing because we may have trauma but also our brains can have different thoughts different parts of ourselves are going other places for different reasons in response to our sensory profile in response to the social issues in response to our own stories it's common intimacy difficulties number two obviously with autism as I made a video a few weeks ago I believe that the process of not just communication and connection and all the things required to be in relationship but your sensory issues can be a huge problem in intimacy the saliva the smell the sounds the taste of being intimate can be very very triggering and we've learned to push through that and mask through that but it can be at the core very disregulated and for someone with trauma if they're having difficulty with intimacy might be around like safety with their body or trusting people of course they can also have sensitivities with sensory issues but it's more about the maybe once safe State and now not safe state if that makes sense so I don't think you're going to see it to the same intensity and degree as you might with autism number three increased risk of victimization so we know that those with autism are at a much higher risk as are those with trauma for many reasons negative beliefs about the self and the world world and of course if you've had a violation of trust and a repeated Dynamic at home with maltreatment you're going to feel bad about yourself that's the core right I'm bad there's something wrong with me and also with autism if you've had that the world hasn't responded to you well you've been punished for it bullied victimized and or you have a lot of often rumination and overwhelming like you're often aware of what's Happening isn't going well but you can't stop that and so between experiences and the way your brain works there can be a deep uh like flawed sense of self for both of them but for different reasons a heightened sensitivity to sensory input so with trauma of course you're going to have like I'm talking about especially trauma related sensory issues but with autism your Baseline is is going to be always sensitive and maybe it's hyperactivated by certain experiences but at the core that's what it is high rates of substance abuse depression and self- wounding for both a very common and I think the core of this is about the nervous system disregulation for both and trying to manage hypervigilance overactive nervous systems heightened startle response all of that makes sense right except for the person with autism I would say is born with more likely a disregulation to occur much more frequently in the podcast I'm going to link down below that was very helpful and and uh the there's really great uh visuals from Dr Megan Nev she provides uh this this example of a study where they gave shots to autistic kids and non-autistic kids and they found that it took the autistic kids longer to kind of like get back to regulation after the you know the discomfort trauma whatever of of getting of getting a shot but that even when autistic kids looked like they were fine they were still disregulated and I think she calls that reference to some researcher faux regulation which makes me think a lot about avoiding attachment but this idea that you've learned to put on the face that you're fine but inside you are just massively anxious disregulated whatever um so at the core but with with a trauma you're going to have to have you know you develop this and of course you're more now that you've had bad things happen or whatever you're going to be more responsive impulse control difficulties for both for different reasons but also similar to that brain in the beginning I was talking about the brain changes same thing goes for executive functioning same same Dynamics sleep issues for different reasons and Trauma and autism and stemming as I said stemming can have lots of reasons why we do it but an Autism it really provides not only pleasure but also a way to regulate but that'd be true potentially for those with with trauma so those are what make it complicated and it also means that I found is that to have autism and then trauma means that the way trauma expresses itself can look different for you that trauma can exacerbate underlying autistic traits like rumination regression of skills communication as well as stereotyped behaviors and speech and that we can see a lot more rumination in autism when we have trauma so if you think about the if you come into the world with a heightened sensory response right and you have a predisposition to ruminate to to think through things to overthink and you have a trauma you're sort of set up to have the trauma be more impactful and in fact some research shows that for autistic people even social situations can actually be traumatic but that's not part of the DSM criteria and and depending upon which research you look at in some cases more for women to have social traumas makes a lot of sense but that for many people with Autism that social dynamics can be traumatic for them so we're looking at things like 70% of those with autism also have a co-occurring mental health issue things like anxiety depression OCD and that up to 60% of those with autism have experienced PTSD in some form compared to the general population so what that also means is that just because you have a trauma if you don't have autism really any anything for example it doesn't mean you're going to have PTSD in fact most people don't go on to have PTSD they have the trauma they work through it but if you have autism and you have a trauma you are much more likely up to 60% 30 to 60% to have PTSD like symptoms so at the core we have this overactive amydala this fire alarm part of our brains in both trauma and autism we have a lot of hyperarousal and one study said that for people with autistic more autistic traits they often display a specific form a certain flavor of PTSD that is character characterized by hyperarousal more startle responses more insomnia and they're more predisposed to anger and anxiety and or issues with concentration so the core of this is that with autism we're encoding things more we're responding more with our brains and it's making us more likely more vulnerable to have trauma the last thing I want to share is something I found too which I think is what my whole goal of this is to make it in some ways probably more confusing but to stop forcing you to just like really only decide is it one or the other but to perhaps look at those more nuanced things around autism to start to differentiate because it does make a difference you know and the problem is a lot of therapists don't understand autism myself until this last year included especially High masking and if you don't really understand it I think you can really miss out on helping people and you can misdiagnose them for sure that's a different video but some research shows that autistic people find certain things more traumatic than non-autistic people for example abandonment by someone or the loss of a pet sensory experiences like a fire alarm actually going off Transitions and changes so things like School transitions routine changes in the seasons unpredictability in day-to-day life and I would argue things like moves I've thought a lot about I've always said that I think the most traumatic thing for my kids through my divorce was the moving and the changing and in some ways I think that did more damage and now I'm starting to wonder because of my profile in which flavors and which parts of them and which which of them may have been more impacted social difficulties and confusion so difficulties interpreting social cues and misunderstanding maybe you misunderstood something and you were embarrassed I'm not going to share it here but I've had three very distinct experiences where I felt like I was misunderstood and punished for those things as a child and as an adult for things I thought I was just being like normal about and not until I went through this research have I been like oh my God what if that's what it was I don't know but they were all traumatic events in different ways two of them were traumatic one was just like I still think about it a lot I wouldn't call it traumatic and then events related to one's own mental health so having like a psychotic break severe mental health issues all can cause trauma and that autistic people may be more likely to find these experiences traumatic due to traits such as sensory sensitivities communication and interaction difficulties distress around routine changes and distress if they're prevented from taking part in repetitive and restrictive behaviors such as stemming so stemming can help us work through some things and so the core of this is this some theories suggest that that other factors associated with being autistic May mean an increased risk of developing or maintaining PTSD symptoms such as neurological and genetic factors detailed focused processing in other words a tendency to focus on the details very common in autism to like get hyperfocused and not see the big picture increased rumination so you can't stop thinking about your negative feelings and the events and thoughts being more flexible in your thinking and avoidance and emotion regulation difficulties so I think the challenge is that I know this probably doesn't help in some ways oh my one of my dogs is getting fussy I'm going to wrap this up is to understand I just spilled my coffee there we go with my proprioception issues always dropping or spilling something I didn't even get into that one but the core of that is that these issues are difficult and we have to hold space like I said in the beginning for what we don't know but if you're questioning it I'm going to just go back and say look at your Baseline if you're saying I have I know I have complex trauma or trauma I'm not sure about autism spend some time researching your history of sensitivity around your sensory issues look at your communication and social dynamics historically look at your repetitive behaviors and how you might self Soo the routines because that's where I think it gets difficult I think many of us go yes get says cptsd trauma makes sense I get it but we're like oh I don't know about this other piece and that is why I went on this deep dive and as I've been saying I think my experience is pretty typical is I'm going to slow down I think my experience is pretty typical I had a client say to me a couple months ago oh I found your Tik Tok I didn't know you were autistic and I was like I'm not autistic what do you mean that was my first thought because I don't know that yet I'm still at the place where I'm researching and understanding and making space and learning and I think it as I was saying is typical to start to have this thing in your brain going off and to be like I don't know if that's what it is but I know it's not that right and it explains so much I think last thing I'll say is that I just think that because of the language that we're evolving with autism I think if there was a word for high masking that felt like it and I know there's Arguments for why not to do this because you're either you're not a littleit you're not a little bit autistic you are aren't but I think that it gets the language because people aren't educated enough and we still don't know we still don't I am like stuttering right now we still don't know enough that it's making it difficult to for those of us to say oh yeah that's that's all true too but I have to say that there is nothing in any of that when I talk about autism that doesn't feel true for me and when I look around in my immediate family I see I see it I do see it and uh once you see it you can't unsee it so so that's a different story but I hope this helps for you I hope it really does because I think that it's so confusing and so overwhelming and at the same time it's important because if you know that there are some core parts of yourself that you believe are autistic there are some therapies and things that are not going to help you there are some things that will make you feel bad about yourself that you cannot control for example like rage responses to sensory triggers for me it is a huge one and is very disruptive it is it determines where I go what I do how I respond my sensory issues as much as everything else and it's been incredibly validating to understand so I know I had to leave some stuff off I'll make some more videos on this topic but because I made that video last weekend and it seemed like many of you like really resonated with it and so many comments are about okay I get all this I feel like this could be autism but I also have trauma I really wanted to kind of really focus on the overlap but also direct you where to go if you're not quite sure still so and last thing I'll say is that a a diagnosis you want to research in many places it may not be helpful there aren't resources it could be a negative impact in your life many places it could be a positive impact so it's not just like oh I think I have this should I get diagnosed you should really research where you live and where you are whether or not a diagnosis will benefit you and then what are the things that's my next hopeful goals in this this year to say okay I don't I don't know that I need need a formal diagnosis but I need some help with these things what helps what doesn't that's my goal and I'm going to end this video by saying that if you have one or the other or both that grounding techniques things that help you get that nervous system regulated poly Bagel techniques nervous system regulation somatic therapies very very helpful I just got a new workbook on somatic interventions and so I'm still reading about it but I want to share I will share more and more of that and the last thing I will say is that I am going to be publishing hopefully a course on eggshell parenting on childhood Mal treatment specifically around mentally physically unsafe parents who you could not predict who you walked on eggshells with and I'm going to add a section in the course or at least one or two lessons what do you do if you also believe you had autism and you have these kind of parents because I think that is incredibly important to understand so that's it please stay safe and well and I think thank you so so much for your time and thoughts here um take care and have a good day all right [Music] bye [Music]

Channel: Dr. Kim Sage, Licensed Psychologist

Views: 136,152

Keywords: autism, autistic, cptsd, cptsd or asd, asd, high masking autism, aspergers, childhood trauma, complex ptsd, trauma, masking, hypervigilance, sensory issues, alexithymia, depression, anxiety, signs of autism, signs of cptsd, neurodivergent, neurodiverse, adhd, autistic women, autistic females, social anxiety, dr kim sage, do i have autism, repetitive behaviors, stimming, social communication

Id: wnTlIx7tbos

Length: 26min 5sec (1565 seconds)

Published: Thu Feb 01 2024