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Jun 30 2023
What is alexithymia?

Recently i wrote about alexithymia and it’s ramifications for our mental health. Since publishing that post, it has come to my attention that many people feel this is an underdiscussed area and weren’t sure exactly what it means.

So, what is it?

Simply put, it means that you can’t match up the internal signals of your emotions with words to describe your emotions. For example, I can’t tell the difference between anxiety and excitement. This means that when I’m experiencing either of these emotions, I don’t know what I am feeling.

This is because alexithymia relies on one of our senses called interoception. This sense allows us to feel the internal state of our body. Interoception covers more than emotions as it also tells us things like how fast our hearts are beating, whether we’re the right temperature, or if we’re thirsty or need the toilet.

Because Autistic people experience interoception differently, it affects our ability to identify and describe our emotions.

Alexithymia appears to have links to atypical burnout, meerkat mode (as conceptualised by Tanya Adkin), and psychosis. Alexithymic people might not recognise their burnout, and therefore will not take time to recuperate. Alexithymia has been seen in around 50% of Autistic people studied, although studies tend to only look at those with a formal diagnosis.

Alexithymia is perhaps one of the least understood aspects of Autistic experience among autism professionals; therefore representing an area requiring a great deal of attention for those working with Autistic service users. In particular, mental health professionals.

David Gray-Hammond 4 Comments
Jun 28 2023
Autism and alexithymia: The fallout for our mental health

Autism and alexithymia are two things you might see discussed in tandem quite regularly. In fact, Vaiouli and Panayiotou (2021) found a strong postive correlation beween Autistic experience and alexithymia with Kinnaird et al (2019) finding a prevalence rate of nearly 50% among Autistic people. Considering the very high rates of alexithymia among Autistic people, it is necessary to think about how this might contribute to issues in healthcare settings where professionals are largely trained in non-autistic expressions of emotion.

Alexithymia (according to the Merriam-Webster dictionary) is the inability to identify and express or describe one’s emotions. In other words, an alexithymic person experiences emotions in a way that means they struggle to attribute the internal sensations to descriptive language. It is subset of interoceptive differences which is discussed by Adkin (2023) in relation to their concept of “Meerkat Mode”.

This obviously presents issues with accessing support for our mental health. How can we explain our struggle if we can’t put it into words? Professionals often take us less seriously because if it was “that bad” we would be able to voice our suffering. Unfortunately it is not as simple as this. Even in my own experience, I often struggle to feel the difference between emotions like anxiety and excitement. Happiness and sadness also feel similar to me, and exhaustion is something I often can’t recognise until I am at the point of crisis.

This is a significant enough issue to face as an Autistic adult, but it happens to Autistic children as well. We regularly see Autistic people turned away from services such as CAMHS because they are in no way equipped to help us. Children are naturally less adept at describing emotions, especially the big emotions, and when you throw alexithymia in on top of that it leads to a breakdown in communication that can have life threatening consequences.

I have found myself at multiple points in my life being administered medication that I did not need because the ways I have learned to articulate my very abstract feeling emotions have been misunderstood (accidentally and willfully) by psychiatrists. We live in a world that pathologises our suffering, meaning that we can face horrific side effects to treatments that we might not have needed had professionals been culturally competent with regards to mental health in Autistic people. Tanya Adkin and I have written about the importance of competence previously (Gray-Hammond & Adkin, 2023).

I often ponder on the relationship between my early experiences of not being able to communicate my emotions effectively to professionals and my subsequent years of a drug and alcohol addiction. Honkalampi et al (2022) found a positive correlation between alexithymia and substance use, which in my opinion may indicate a mechanism behind the findings of Weir et al (2021) showing significantly higher rates of self-medicating with recreational drugs among Autistic adolescents and adults. In fact, one of the primary drivers behind my drug use was having control over my emotional experience. I would hazard a guess that drug use is so common in the Autistic community because it allows us to feel a familiar and more easily described feeling.

It is clear that alexithymia is a significant issue for not just Autistic people, but also for professionals working in healthcare and wellbeing practices. The links between alexithymia, poor access to mental health support, and risk taking behaviour are clear. It’s necessary for professionals working with Autistic people to find ways to help Autistic people articulate their emotions rather than to just ignore us or belittle our struggles.

Our lives depend on it.

References

Adkin, T. (2023). What is meerkat mode and how does it relate to AuDHD? https://emergentdivergence.com/2023/06/06/what-is-meerkat-mode-and-how-does-it-relate-to-audhd/

Gray-Hammond, D., & Adkin, T. (2023). Creating Autistic Suffering: Autistic safety and neurodivergence competency. https://emergentdivergence.com/2023/04/11/creating-autistic-suffering-autistic-safety-and-neurodivergence-competency/

Honkalampi, K., Jokela, M., Lehto, S. M., Kivimäki, M., & Virtanen, M. (2022). Association between alexithymia and substance use: A systematic review and meta‐analysis. Scandinavian Journal of Psychology, 63(5), 427-438.

Kinnaird, E., Stewart, C., & Tchanturia, K. (2019). Investigating alexithymia in autism: A systematic review and meta-analysis. European Psychiatry, 55, 80-89.

Vaiouli, P., & Panayiotou, G. (2021). Alexithymia and autistic traits: associations with social and emotional challenges among college students. Frontiers in Neuroscience, 15, 733775.

Weir, E., Allison, C., & Baron-Cohen, S. (2021). Understanding the substance use of autistic adolescents and adults: a mixed-methods approach. The Lancet Psychiatry, 8(8), 673-685.

David Gray-Hammond 6 Comments
Jun 24 2023
Autism and pain: When pain management options are limited

I have recently been writing about the Autistic experience of pain and the risk that it presents to Autistic people when medical professionals do not understand the way we display pain. Some of us, however, live with chronic pain and are prescribed painkillers. For a lot of people in that position, narcotic pain relief serves as the only option. What people often don’t realise is that being able to use narcotic pain relief is a privilege, and not all of us have that privilege.

I am not only Autistic, ADHD, and Schizophrenic. As of this year (2023), I am seven years sober from drug addiction. The drugs I was using that are most relevant to this conversation were opioids, benzodiazepines, pregabalin, cannabis, and spice. I was using all of these drugs very dangerously and, as a result, have chosen a life of complete abstinence. If I hadn’t, doctors would not prescribe anything similar to them anyway.

This has left me with very few options for the pain I experience related to my hypermobility. Realistically, I can only take paracetamol and naproxen. Neither of these offer much relief from bad pain days, but they do reduce the pain just enough that I can mask it.

Addiction isn’t the only exclusionary factor that can stop people from accessing the privilege of strong pain relief though. Allergies, or an intolerance to side effects, make the use of strong pain relief impossible. Even in countries where medical cannabis is legal, cannabis is not suitable for everyone. For me personally, cannabis use always ends with me using harder drugs. For some, it affects their mental health or makes them experience unpleasant thoughts and feelings.

This has landed many Autistic people in a sticky situation. We have nowhere to turn for pain relief. Pain we may not express in a “typical” way or be able to articulate. It means living in a state of constant dysregulation. Despite this dire need for strong pain relief that does not have mind altering effects, pharmaceutical companies are yet to create anything.

Autistic people are significantly more likely to experience chronic pain, with Autstic children being twice as likely to experience it as their non-Autistic peers. We then have to consider the risk of addiction in Autistic people due to self-medicating. To top that off, just over a third of addicts in this study were abstinent upon successful discharge from treatment. To me, these statistics say that there are a significant number of Autistic people unable to manage their pain effectively without the risk of relapse into addiction. Let’s also not forget the risk of habituation among people new to opioid pain relief.

The cherry on top of all of this is that recovering addicts who ask for pain relief are often accused of drug-seeking and ignored. This can only be compounded by professionals who do not understand Autistic presentations of pain. There is a great deal of stigma around addiction in professional circles. With chronic pain being a risk factor in already elevated suicide rates amongst Autistic people, this is an issue that can not be ignored.

When researchers are spending millions on looking for why we exist, rather than trying to improve quality of life with regards to things like this, is it any wonder that there is a gulf between us and them?

David Gray-Hammond 1 Comments
Jun 21 2023
Being Autistic doesn’t automatically make you a good person

When I was new to the Autistic community, I was somewhat naive. Compared to the circles I had existed within during active addiction, everyone seemed very supportive and generally decent. Unfortunately, I had a rude awakening. Not all Autistic people have good intentions. We are human, and thus subject to making the mistakes and bad choices that most other humans do also.

One of the primary ways that Autistic people are infantilised is in the assertion of our perpetual innocence. The truth, however, is far from that. We are a community that has been traumatised time and again; subsequently reacting to things through our trauma. Beyond that, we have a fair share of bigots. BIPOC, Queer, and gender diverse communities within Autistic circles know this only too well.

Despite a huge part of our community being multiply marginalised, we are a community where those with privilege still speak over others. Even as a write this, I am aware of my cis-, white privilege. Despite the intersections I exist within, I have a great deal of privilege because of the colour of my skin and gender identity.

It was a great disappointment to me to discover the bigotry within our own community. Having come from a life where I was surrounded by bad people, and in fact could probably have been one of the bad people, I had hoped so desperately that there was a place in this world that was untouched by hate. Sadly, hatred is insidious and seeps into the cracks that are available.

It did teach me the important lesson, though, that Autistic people are not inherently good or bad. It helped to humanise not just other Autistic people, but also me. It showed me the pervasive attitudes towards Autistic people that we are trapped in childhood, incapable of having agency over our lives. So, while I cannot stand the bigotry, there is value in the lesson I have learned.

In order to fight back against hatred within our own community, we first have to acknowledge that it is there. We have to acknowledge that Autistic people are capable of hateful behaviour. We are human beings, and we will not fix our problems without acknowledging they are there.

David Gray-Hammond 3 Comments
Jun 18 2023
Today is Autistic Pride Day: Let’s celebrate our diversity

I have been active in the Autistic community for some years now. I have come to realise that autism as a diagnosis has been somewhat of a failed experiment. Diagnostic models have failed to capture the intricacies of what they dub “autism spectrum disorder”. A lot of the issues with the diagnostic process itself come back to racial and socioeconomic bias in research literature; there are also significant issues with people gendering autism, creating exclusion by denial of gender and sexually diverse experiences.

The Autistic community is diverse. While autism itself is an abstract concept, the very real Autistic people that exist come from all parts of the tapestry of life. One might hope that the days of autism being a diagnosis of middle-class white males is coming to an end, but there is still significant disparity. This article highlights the significant gulf in diagnostic rates in the US alone. It is clear that BIPOC people are being ignored despite the countless voices from their communities speaking up.

I also recently wrote about queerness and being Autistic. Gender diversity and sexualities that do not fit into perceived heteronormativity account for a great deal of the Autistic community. Again, these groups may have a harder time getting a diagnosis due to ideas that position autism as something that is only observed between cis-gendered males. It is clear that if you don’t fit the historical research, diagnosticians will deny you exist.

But you do exist, like all of us. You have the same strengths and struggles, plus other struggles that I can not know as a person with the privileges I have.

When we speak of Autistic pride, I think many view it as cute little get togethers, spending time amongst our own people. That’s not entirely wrong, but Autistic pride, much like any pride, is so much more than celebrating. We are protesting. We are refusing to be ashamed, and what we need to stand against moving forward is the bigoted gatekeeping of the few who believe that multiply marginalised communities should be targeted and minimised.

Autistic pride requires us to root out the bigotry in not just wider society but also our own community. If there is even one person who can not celebrate their Autistic pride, then none of us can. Autistic people are a diverse people, and our fight will not succeed if we are not also fighting for our neurokin who exist at the intersections.

So today, and for all days to come. If someone asks you what Autistic pride is; tell them it is our fight to make sure the world has a place for all Autistic people, not just the select few who fit into the world normative standards. Let’s build a world together where intersectional communities can feel safe to express their experiences without fear of backlash or risk to wellbeing and life.

There is no Autistic liberation while any one of us is being oppressed.

David Gray-Hammond 7 Comments
Jun 17 2023
CAMHS refusal to work with Autistic children violates ethical standards created by the House of Commons

If you are unaware of current issues with CAMHS, you can catch up by visiting my CAMHS Crisis resource page. However, the cliff noted version is this; Child and Adolescent Mental Health Services (CAMHS) are turning away Autistic children and young people from their services. This is very unethical, but that lack of ethics goes further.

You could be forgiven for not knowing what “Parity of Esteem” is. Parity of Esteem is a concept set forth by the House of Commons. The basic premise is that it requires an ethical approach that places mental health in equal priority with physical health. This has been important to the world of unschooling and EHCPs as it gives the two legal parity, allowing parent/carers to remove their child from the school environment for the best interests of their mental health.

One might think that this is a game-changing approach to the prioritisation of mental health, but unfortunately, one of the groups avoiding these particular ethical considerations is NHS mental health services themselves. CAMHS is regularly turning away Autistic people, which, in my opinion, gives the impression that Autistic young people’s mental health is of a lower priority.

Now, strictly speaking, they don’t leave you hanging every time. There are satellite services that deal with Autistic and learning disabled children. However, these services are often somewhat indifferent to psychological distress, and due to diagnostic overshadowing treat it as something that we should accept as an inevitability of Autistic experience.

Tanya Adkin and I have recently written about some of these issues. Even if CAMHS threw open their doors to Autistic service users, the infrastructure of that service is not fit for purpose. So, services that do agree to see us very often offer no meaningful support.

This highlights ethical issues over the lifetime of an Autistic person and could even create a CAMHS to prison pipeline. Allow me to explain.

Autistic young people who recieve no appropriate support for their mental health grow into Autistic adults with mental health issues. Mental health issues can result in a need to use emergency services. Here’s where it gets messed up.

There have been pushes for approaches to those who use emergency services due to mental health concerns to be approached with an intervention called “Serenity Integrated Mentoring” (SIM). Under SIM, people regularly detained under Section 136 of the mental health act can face criminal prosecution. This particular approach caused such outcries that NHS England has now distanced itself from the intervention.

This highlights, however, a move towards a world where Autistic people can face criminalisation for mental health issues no one will provide support for. I am certain that other unethical interventions will appear as we move forward. Let us not forget that Autistic people are already significantly more likely to attempt or die by suicide.

Until true legal parity is achieved between mental and physical health, marginalised groups will continue to suffer at the hands of under-resourced services. Never forget, when priorities are underestimated, disabled people are usually the first to be considered acceptable losses.

Help us start to tackle this issue by signing this petition.

David Gray-Hammond 4 Comments
Jun 17 2023
Autistic people are dying early; medical perceptions of pain are contributing

I recently posted about Autistic people and the expression of pain. One thing that has become clear to me is that not only do we not have the same relationship with pain as non-Autistic people, people in the wider environment constantly invalidate that relationship because they don’t want to believe our lived experiences.

Original post on Twitter

There are a lot of aspects of Autistic life in which we don’t highlight the disparity in cultural competency amongst professionals. Unfortunately, healthcare is not a battle we cam choose to walk away from. Our lives literally depend on being taken seriously and treated respectfully. There are some troubling statistics around Autistic life expectancy and mortality. In my opinion, there is correlation, if not a causative relationship between medical mistreatment of Autistics and these harrowing statistics.

Of the statistics, I have seen life expectancies around the age of 36 to 39 years of age (see here and here) for Autistic people. I have also seen suggestions that we are 51% more likely to die in a given year than the general population. I don’t think I need to push the point much further. It is clear that we are not a demographic that necessarily has the best outcomes in life.

Our experience of pain is intimately linked with our sensory experience. In particular, interoceptive differences mean that we can have a completely different response to pain than our non-Autistic peers. Monotropic brains mean we might not be able to stop thinking about the little pains, but may not even notice something significant or life-changing.

The way we embody pain is different as well. Autistic people are known for having different physical expressions, and when you throw in the significant relationship between the Autistic community and the chronic pain community, we can see why an Autistic person may not appear to be in as much pain as they claim to be.

This doesn’t absolve medical professionals of their lack of understanding. When a person works in healthcare, they should be taking people seriously, regardless of whether an ailment presents in the way that is expected or not.

I posit that dismissive attitudes amongst medical professionals and medical gaslighting lead to further health complications from i jury and illness. To consider it another way, if doctors took us seriously, we would probably live longer and happier lives.

For those working in healthcare, I applaud the care you give to many, but there is so much not being done for Autistic people that it can not be ignored. Autistic people are dying every day from ailments that needn’t have been terminal. Next time someone tells you their experience, believe them.

David Gray-Hammond 2 Comments
Jun 14 2023
The link between autism and Queerness

The other day I live recorded a podcast episode about neurodivergence and queerness. In it, we discussed the fact that Autistic and otherwise neurodivergent people are more likely to be Queer/2SLGBTQIA+. The discussion was very good, and we really got into some of our experiences.

It’s no secret that Queerness is a significant intersection with Autistic experience. Aside from anecdotes from within the community, studies such as Janssen et al (2016) and Strang et al (2020) indicate that not only are we more likely to be gender-diverse, but that Queer communities are more likely to contain Autistic people. Strang on particular speaks of the lack of research looking into experiences over the lifespan and the need for such longitudinal study to be carried out.

With so much Queerness in the Autistic community, one might wonder why this intersection is so significant. I think the answer is quite simple. Albeit somewhat theory heavy.

Neuronormativity.

Neuronormativity is pervasive, and if you think that it only effects neurodivergent people you are wrong. Both BIPOC and 2SLGBTQIA+ communities have fallen foul of the belief that there is a standard of neurology we should all achieve. It was not so long ago that being gay or transgender was listed in the DSM as a psychiatric disorder.

Autistic people naturally queer neuronormative standards. In this sense, queer is a verb. It is the subversion of societal expectation. Through our rejection of neuronormativity, we create space to explore our gender and sexuality (or lack thereof) unencumbered by the chains of bigoted standards of being.

When we begin to dismantle neuronormativity, we also begin to dismantle heteronormativity. Our experience of ourselves and attraction (or lack of attraction) to others is built upon the experiences we have of our environment. Experiences that we have through the lens of being Autistic. You can not separate autism from our queerness any more than you can separate a person from their brain. They are part of us, and without them, we would be someone different.

Thus, to neuroqueer in society is to become more than just neurologically queer, but also queer with respect to gender and sexuality.

With this said, there is still bigotry in the Autistic community. There are those who weaponise our intersectionality against us, and wield it as a tool to invalidate and oppress us; and yes, there are oppressive attitudes within our own community.

We must continue to build a community that is loving and accepting of all of the diversity within Autistic experience and recognise that Autistic people all experience the world in their own unique way.

David Gray-Hammond 16 Comments
Jun 10 2023
Autism and drug-use: drowning in the void

It’s no secret that I’m a recovering drug addict. It’s certainly even less of a secret that I am also Autistic/multiply neurodivergent. When one considers the reality of meeting diagnostic criteria for autism, ADHD, and schizophrenia; It’s easy to see how drug use was an inevitability. I often joke that AuDHD isn’t descriptive enough for me, and that I should describe myself as AuDphrenic.

It’s important to note that I don’t like to differentiate between “drugs” and “alcohol” given that alcohol itself is a drug. The separation of the two has been instrumental in the dehumanisation of those struggling with their use of things outside of the world of alcohol.

Autistic people can and do use drugs. Many professionals believe that we don’t, but we do. We often have access, means, and reason to use drugs. Allow me to present some statistics on drug use, found in this study:

  • Despite over all being less likely to report recreational drug use, there were some significant findings:
    • We are nine times more likely to report using recreational drugs to manage our behaviour.
    • We are more likely to report using recreational drugs to manage our mental health.
    • We are more likely to report vulnerabilities associated with drug use such as;
      • Childhood drug-use
      • Being tricked or forced into drug-use

This highlights some significant points of consideration for Autistic people. Those of us on the AuDHD intersection may be experiencing atypical burnout. This presents a high likelihood of Tanya Adkin’s concept of meerkatting coming into play. For an Autistic person in meerkat mode, drug use may offer a great deal of reprieve and give the feeling of an extended number of spoons/cognitive resources (see spoon theory).

When I was using drugs, I treated myself as a science experiment. For an AuDHD Schizophrenic, drugs allowed me to find a flow-state. They made the management of my Self and identity more manageable. I would keep journals of my drug use in order to see how far I could push it. Just how high could I get?

Some Autistic people use drugs safely. Cannabis and psychedelics are very popular options for self-medication, and I know of many who use them as such. It’s important that we recognise the risks without invalidating those who use them safely as medicine. In a world where a trip to the doctors can bankrupt you, we should not judge those who self-medicate. We should create a space where it is okay to explore all the pros and cons.

It’s also important to note the aforementioned risk of forced drug use. Many of us wish desperately to be part of friendship groups, which places us in a vulnerable position. Mate crime and criminal exploitation can often start with forced drug use. We need to protect Autistic people against the inevitable black market that has arisen from prohibition.

Addiction is a real risk, I know because I am an addict. For many of us, things can spiral out of control. Societies framing of addicts as something inhuman has created a world where it is unsafe to discuss this fact of life. We need to build communities where people can access meaningful peer-based support and advice for drug-use that has spiralled out of control.

In a world where up to 66% of Autistic people have considered suicide, and 35% have attempted suicide (see this study), we need to take a really good look at how we support Autistic people with things such as drug-use.

David Gray-Hammond 3 Comments
Jun 6 2023
What is meerkat mode and how does it relate to AuDHD?

This article was authored by Tanya Adkin

“

Lovingly dubbed “meerkat mode” by Tanya due to the heightened state of vigilance and arousal it presents, it involves constantly looking for danger and threat. It is more than hyper-arousal, Tanya believes that it is actually an overwhelmed monotropic person desperately looking for a hook into a monotropic flow-state.

This is not just sensory hyper-arousal, it is the tendency of monotropic [AuDHD] minds to seek out a natural and consuming flow-state to aid recovery from burnout and/or monotropic split. Because of the heightened sensory-arousal and adrenal response that comes with it, monotropic flow becomes difficult to access, leading into monotropic spiral.”

Adkin & Gray-Hammond (2023)

Recently David and myself have written a few articles on atypical burnout (Adkin & Gray-Hammond, 2023) and the burnout to psychosis cycle (Adkin & Gray-Hammond, 2023). In those articles I’ve mentioned something that I refer to as “meerkat mode”. People seem to relate to the concept as discussed in the articles, so I thought it may be wise to dedicate a whole article to what I mean by this concept.

Firstly, I want to explain that I am a very visual thinker, who happens to be plagued with good ol’ imposter syndrome. Said imposter syndrome tells me I should have thought of a more academic terminology, but that’s not the way my brain works. Truthfully, I can’t think of a much better visual representation for what i’m about to describe.

Meerkat modes presents an answer to the diverse forms of burnout I have witnessed through my work with a wide range of neurodivergent people. David agrees with the assessment as a fellow “autism professional”. I don’t set out to reinvent the wheel or change entire paradigms, this is and was a way for me to simply explain a phenomenon that is more common than people realise. A phenomenon that I see described on an almost daily basis as hypervigilance or a trauma response, but in my experience is more than that.

What is meerkat mode?

  • Hypervigilance
    • Hypervigilance is not a diagnosis. Rather, it is the brains biological adaptation to ongoing stress and trauma, which we know that Autistic people experience at a higher rate than non-Autistic people (Gray-Hammond & Adkin, 2023). It is the way it maintains a state of high alert on the look out for threat. It’s a description of a state of being that is commonly seen in diagnostic criteria for things such as PTSD, anxiety disorders, schizophrenia spectrum disorders, psychosis and psychotic phenomena, some personality disorders, and much more.
    • Interestingly, a lot of these mentioned diagnoses are seen to be co-occurring with Autistic experience.
  • Seeking a monotropic flow-state (Hyperfocus)
    • Flow-state in terms of monotropism refers to the tendency for monotropic brains to fall into deep attention tunnels that are intrinsically motivating. It has been reported by Autistic people that entering this flow-state is beneficial to monotropic peoples mental wellbeing.
    • Flow-state and hyperfocus are often used interchangeably and there is a general acceptance of it’s occurrence but no solid definition.
    • Anecdotally, when we see this as a person seeking to be in a constant flow-state, it can often indicate dysregulation or adaptations needed within the environment. Sometimes (when dysregulated) this flow state can be quite negative and turn into a monotropic spiral.
    • Because of hypervigilance people experiencing “meerkat mode” have a significantly more difficult time accessing flow-state.
    • Hyperfocus/flow-state is reported in autism, ADHD, and schizophrenia (Ashinoff & Abu-Akel, 2021).

“Refers to a state of being engrossed in a task that is intrinsically motivating during which task performance improves, there is a tendency to shut out external environmental stimuli, and internal signals”

Ashinoff & Abu-Akel (2021)
  • Increased Sensory Dysregulation
    • Interoception
      • Interoceptive differences do not only occur in Autistic people. They are thought to be largely caused by early-life stress (Löffler et al, 2018) and trauma (Schulz, Schultchen & Vögele, 2021).
      • Interestingly, interoceptive differences are seen to occur in ADHD people, Schizophrenic people, eating disorders, anxiety disorders, emotionally unstable personality disorder (EUPD), and more.
      • I am not stating that Autistic interoceptive differences are created by trauma, rather that the generic understanding of interoceptive differences is attributed to stress and trauma.
    • Alexithymia
      • Alexithymia refers to the difficulty or inability to sense or decipher one’s own emotions or the emotions of others. It could be described as a subcategory of interoceptive differences.
      • The general view is that alexithymia is created or arises from extreme stress or trauma, some research does suggest it could have biological or developmental links (Thompson, 2009).
      • Again, alexithymia occurs in more or less every diagnostic category I have pointed out previously, including ADHD, or any situations that create stress or trauma.
    • Link between interocetion (alexithymia), vestibular, and proprioception
      • Those that are displaying “meerkat mode” (in my experience) will generally seek proprioceptive and vestibular input, e.g. bouncing on a trampoline, rough play, being upside down. They may be “clumsy” or meet criteria for developmental coordination disorder (dyspraxia).
      • Interestingly, the above sensory profile is highlighted in guidance to be of clinical significance with a PDA profile of autism (PDA Society).
      • Generic advice for someone experiencing “meerkat mode” would be to increase proprioceptive and vestibular input in order to regulate interoception.
      • Interoception takes the leading role in emotional regulation.

“Interoception works the vestibular and proprioceptive senses to determine how an individual perceives their own body. Well-modulated interoception helps the individual detect proprioceptive and vestibular sensation normally.”

sensoryhealth.org
  • May be unable to stop or rest
    • As David and I have discussed previously in our articles on atypical burnout and the burnout to psychosis cycle those that appear to be meerkatting may not be in a position to stop and recover.
    • This could be due to co-occuring ADHD (AuDHD) or life demands such as parenting or work, maybe interoceptive differences mean that the person does not “feel exhausted”. They could be in a monotropic spiral of flow-state which is shutting out everything else.

Concluding thoughts

There are infinite possible interactions between an AuDHD person and their environment. And this is why I think we often struggle to define our experiences through something that can be outwardly observed and measured.

This is just one explanation for something that I have witnessed in a sea of possibilities.

References

Adkin, T. & Gray-Hammond, D. (2023) Creating Autistic Suffering: The AuDHD Burnout to Psychosis Cycle- A deeper look. emergentdivergence.com

Adkin, T. & Gray-Hammond, D. (2023) Creating Autistic Suffering: What is atypical burnout? emergentdivergence.com

Ashinoff, B. K., & Abu-Akel, A. (2021). Hyperfocus: The forgotten frontier of attention. Psychological Research, 85(1), 1-19.

Gray-Hammond, D. & Adkin, T. (2021) Creating Autistic Suffering: In the beginning there was trauma. emergentdivergence.com

Löffler, A., Foell, J., & Bekrater-Bodmann, R. (2018). Interoception and its interaction with self, other, and emotion processing: implications for the understanding of psychosocial deficits in borderline personality disorder. Current Psychiatry Reports, 20, 1-9.

Schulz, A., Schultchen, D., & Vögele, C. (2021). Interoception, stress, and physical symptoms in stress-associated diseases. European Journal of Health Psychology.

Thompson, J. (2009). Emotionally dumb: An overview of alexithymia.

Tanya Adkin 4 Comments
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