Individuals with ASD can sometimes exhibit a trait of social withdrawal from others. This can appear to be detachment in conjunction with a strong desire for a great deal of alone time.
In contrast, dissociation is marked by a separation of one’s thoughts or personality from a particular environment.
All of us experience dissociation at one time or another, such as when we drive on autopilot on our daily commute or daydream during the day. However, dissociation and autism can present several unique challenges.
One of these obstacles is catatonia, which is marked by withdrawal from others, staring, staying still for excessive periods, and a lack of awareness. A secondary concern with ASD and dissociation is a high level of anxiety and trauma that leads to withdrawal from others in the form of dissociative behaviors.
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Understanding dissociation
Dissociation is a mental health term by which an individual disconnects from thought and consciousness. This may involve:
- an overall feeling of being disconnected from one’s body,
- memory issues, or
- a radical change from typical behavior and personality.
Often, behaviors of dissociation are the result of protecting one’s self emotionally from trauma or extreme anxiety. Not all dissociation looks the same, however, as several variants exist under this umbrella.
There are four types of primary dissociation formally recognized:
- Depersonalization
- Derealization
- Amnesia
- Identity confusion or alteration
Depersonalization is a feeling that someone is outside, or detached, from bodily experience. For example, you may mindlessly engage in a task over and over.
Additionally, derealization is a thought process in which one sees their environment as unreal. For example, if you ever feel you are in a dream state during your waking hours, you have experienced derealization.
Most of us are familiar with the term amnesia referring to forgetting important information about oneself. This is often used to erase from memory a traumatic event in one’s life.
Identity alteration and/or confusion refers to when an individual shifts a part of their identification or personality. This is sometimes seen in what we call multiple personality disorders, where someone has differing personalities to address severe trauma within their lives.
What is dissociation in autism?
People with autism may experience dissociation differently. Sometimes, it might look like “freezing up” or catatonia. They might also have trouble understanding and expressing emotions, a condition known as alexithymia.
Additionally, they might find it hard to recognize their own body signals, like feeling hungry or tired (interoception). They could also struggle with knowing where their body is in space or recognizing faces (proprioception and prosopagnosia).
For example, when we think of zoning out and staring blankly for an extended period of time, it can be a result of a catatonic state. A medical professional should distinguish this from seizures, which could parallel such an issue.
When we look at alexithymia, an individual cannot label how they feel about a particular situation. For example, in a conflict with a peer, they may not be able to distinguish if they feel anger, sadness, or joy.
In interoception, children may get frustrated or angry without realizing it’s because of a physical issue like feeling sick or tired.
Most of us can walk without thinking about it or touch our noses with our eyes closed, but those with proprioception issues find these tasks difficult.
Recognizing faces is something many of us do easily, but for those with prosopagnosia, telling faces apart is tough, which can make them avoid social interactions.
Causes of dissociation in ASD
One of the most prevalent causes of dissociation is interpersonal traumas (these can be physical, emotional, or sexual abuse). Additionally, issues with social anxiety and difficulties in relating with others may create traumatic or anticipatory anxieties, leading to dissociative behaviors.
Individuals with ASD often have a heightened level of sensitivity to sound, touch, and environmental stimuli. As a result, when their nervous system becomes overtaxed, dissociation may be a type of “circuit breaker” to separate consciousness from the outside world.
Many individuals with ASD find it difficult to comprehend or handle emotional discord, which can lead to extreme stressors of emotional dysregulation and dissociative behaviors.
How does dissociation affect people on the spectrum?
While people with autism share some similarities with the general population in terms of dissociative traits, they also face unique challenges. For instance, 44% to 97.8% of youth with ASD are affected by bullying. These experiences can contribute to their tendency to dissociate.
Additionally, 20% to 57% of children with autism struggle with higher levels of social anxiety, making it harder for them to communicate with peers. Feeling isolated or facing discrimination due to their differences can also lead to dissociation.
As a result, it may be easier for them to retreat into their own imaginary world rather than confront the challenges of their reality.
Many individuals with autism struggle with sensory issues. To manage these sensitivities, they might employ coping mechanisms, including dissociative behaviors such as repetitive actions. They can act as a way to distance oneself from overwhelming sensations or to alleviate physical discomfort.
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On top of that, immersing oneself in imagination can be a strategy to avoid social situations that feel challenging due to difficulties in social skills.
Having strong emotions can be a particularly uncomfortable experience for those with ASD.
When faced with conflicts, children with autism sometimes cope by temporarily disconnecting from their surroundings, which helps reduce the immediate impact of the situation. This dissociation acts as a sort of mental break from what’s stressing the child.
However, when it comes to tasks requiring executive functioning – like planning, organizing, memory, and flexible thinking – autistic individuals often encounter challenges. Dissociation offers a way to take a break from these cognitive demands during stressful times.
How to manage autism and dissociation
Though it is helpful to know why ASD individuals dissociate, how do we manage autism and dissociation? First, consider other issues that mimic dissociation, such as seizures or PTSD. Each of these issues can worsen or be the primary cause of behavior.
Additionally, helping the individual to stay present is useful. You can achieve this by helping them practice mindfulness skills such as:
- focusing on breathing,
- paying attention to physical sensations around them, and
- recognition that they can safely navigate within their present environment.
Other effective strategies include:
- cognitive behavioral therapy (helping to recognize and alter unproductive thoughts),
- dialectical behavioral therapy (learning skills to handle strong emotions),
- eye movement desensitization and reprocessing (utilizing cognitive behavioral therapy with visual exercises).
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Navigating the challenges with support and understanding
It’s important to understand that each person with autism is unique, so the strategies used to address their issues will vary. Treatment might take time as the individual learns to trust and cope with their fears.
Those around them need to show empathy and patience. It’s natural to want to step back from tough situations, but caregivers must realize that progress may be gradual. The goal isn’t perfection but steady improvement.
With the support of those around them, they can confront many of their fears without resorting to dissociation. This involves identifying triggers, sticking to a routine, and practicing mindfulness. By doing this, they’ll realize that the world outside of dissociation is full of brightness and warmth, where they can feel safe and comfortable.
FAQs
Q: Is dissociation common with autism?
A: Dissociation is a common issue for those with ASD. It is believed that approximately 10-15% of individuals with ASD concurrently have dissociative issues.
Q: What does autism dissociation feel like?
Dissociation varies for individuals with ASD, depending on its type. Catatonia feels like ‘freezing up’ or getting lost in thoughts. Alexithymia is not understanding emotions, similar to being in a foreign country without knowing the language. Interoception is feeling angry without realizing it’s due to hunger or lack of sleep. Proprioception is clumsiness due to a lack of self-awareness of one’s body. Prosopagnosia is difficulty recognizing faces or recalling names.
Q: Can autism be caused by trauma?
A: Though we have no specific single origin for ASD, dissociative behaviors can, indeed, be caused by trauma. In many cases, the cause for trauma in neurotypical individuals is trauma that can be physical, emotional, or sexual abuse. Unfortunately, those with ASD are at a much higher risk for issues as well, which can contribute to dissociative reactions.
Q: Can autism cause psychotic episodes?
A: Although ASD cannot cause psychotic episodes, those with autism can also have disorders such as schizophrenia or bipolar disorder. Such mental health issues would make them more prone to concurrent psychotic disorders. Research indicates that those with ASD do have a higher incidence of these disorders when compared with the general population.
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