I recently co-presented at a workshop on adult autism for Master of Clinical Psychology students. I’d prepared for everything, except for how it would feel to have my lived experience validated by future clinicians in an academic setting.
To the clinician who invited me, the professor who hosted me, and most of all, the students who engaged so knowledgeably and thoughtfully during the whole afternoon: you know who you are, and saying thank you for including me is completely inadequate. You’ve given the rancorous old maid hope for the future.
In my most self-pitying moods, I say (usually to myself) that there’s no such thing as an easy day with a brain wired like mine. The constant tug-of-war between autism’s need for order and ADHD’s propensity to chaos makes even ordinary days an endurance test I usually fail. And bad days? Well, they can be like careening along the event horizon of a black hole.
But, so rarely that it almost never happens, there’s a day so good that it leaves me with more energy than I started with. And I don’t mean the overstrung, overwhelming, can’t-think-can’t-focus energy that even 5 minutes in Bunnings can kick off in my ADHD. (Note to self: next time, get potting mix before normal transmissions cease).
I mean a day so good it leaves me with the dangerous impression that not everything in neurotypical land is hard.
I had the best of all possible good days last week. It was a day so good that being autistic mattered.
I could have been Exhibit A: Autistic Adult, but I wasn’t
I’d been invited several months ago to come along to a workshop on adult autism for a class of Master of Clinical Psychology students. I’d used all of those months to write, research, revise, and do practice runs of my slides. And last Wednesday was, at last, the day.
I was there not as Exhibit A, but as co‑presenter and co‑facilitator with one of the few psychologists who specialises in the area. The course’s professor, with gentle courtesy, referred to me as a subject matter expert despite my own intermittent attempts at graduate study.
I’d been given 2 generous blocks of time. I spent one sharing my ill-starred peregrinations through misdiagnosis and late diagnosis. The other was a breakout session on autistic camouflaging where we discussed a case study.
Was it perfect? Of course it wasn’t. For once in my life, I wished I could have been part of a group in the same room, but the inexorable pandemic sent us online. Despite doing countless practice runs of my slides, there were (self-made) technical glitches. And even though I’m well used to giving presentations, I fell over my words several times.
But none of that really mattered.
The students, already expert in their discipline, responded with intelligence, compassion, and grace. It was a privilege, and it was humbling. But it was also one of the most validating experiences of my life.
I prepared for everything, except for how it would feel
Despite all my planning, it just hadn’t occurred to me to prepare for how it would actually feel to discuss my lived experience with people who will, in all likelihood, meet autistic adults in professional practice.
And how did it feel? For a brief moment at least, it felt like there was some meaning in all the otherwise utterly meaningless ways in which being autistic has been hard.
Before meeting these students, I’d only ever known – outside of my own professional support – that even the kindest and closest of people put up impenetrable barriers to my autism. They’re interested in neither the gifts nor the challenges because both are beyond their ken and, therefore, unsettling. The isolation that comes with being able to show only the acceptable version of myself is just my everyday life.
But for just a few hours, being autistic was the most important thing about me. While even I never pretend that my autism is the entirety of my identity, it is a big part that most people want to ignore. For one afternoon, I was gifted the altogether unfamiliar experience of being treated like that part of me had something worthwhile to say.
And my protective armour of cynicism was stripped away by spending time with a group of people who were on the cusp of careers in which they clearly wanted to excel. I have hope for any future client that finds their way onto this group’s collective caseload.
Will it make any difference?
I’m told psychology degrees usually don’t contain any subjects on autism. It makes sense, because most psychologists have no fucking idea what to do when an autistic adult walks into their consulting rooms.
And this was just a one-off, half-day workshop in a 6-year-long degree.
I did learn something at the workshop though, which was that most psychologists have a caseload of around 50 clients.
There were 15 students in the autism workshop. If they all go on to practise, and practise full time, then about 750 people at one time will be so fortunate as to be supported by them. Then assume part of that caseload is, say, just clients with level 1 autism and fewer support needs, at the same prevalence as the general population of 0.5%[1]. That means slightly fewer than 4 people in that cohort could be safe with a practitioner who may at least remember a workshop that took place one afternoon in the spring.
That’s still a tiny number. But when clinical awareness of adult autism is almost non-existent, it’s potentially 4 human beings who, instead of being outliers in that cohort, may be referred to the support services they need. It’s potentially 4 human beings who may discover they’re not defective, even though the of the rest of the world has always told them otherwise.
If we include autistic adults with more support needs, that number gets a little bit bigger. And if just one of the students decides to specialise in adult autism, then that number grows to something like 50.
I make no claim for having done anything more than be a guest speaker at the workshop. The expert clinician who presented alongside me led the students through fascinating sessions that combined neuropsychological theory and clinical practice with the voices of autistic people from popular culture. If anything made a compelling case for further study in the area, it was that.
But for once, I felt like my experience of an autistic life no longer belonged exclusively to me. And that was a wonderful thing.
Image credit: Brüggmann, E., Sturm, H. (24 February 1961). Leipzig, Universität, Anatomievorlesung (Leipzig, University, Anatomy Lecture). Bundesarchiv Bild 183-80659-0001 via Wikimedia Commons licensed under CC BY-SA 3.0 DE.
[1] Eckerd, M. (2018). Identifying autism spectrum disorder (level 1) in adults. Journal of Health Service Psychology 44, 93-100. https://doi.org/10.1007/BF03544668.
The incidence of individuals with ASD Level 1 “highest functioning” (or as previously designated, Asperger’s Disorder—or as often used, Asperger’s Syndrome) has not been differentiated. Estimates are that 50% of those with ASD have an IQ above 70 and would be called high functioning (Takara et al., 2015). “High functioning” is a misleading term in this context, as it confuses intellectual level and life/social functioning.