Autism in the Adult

Recognizing Dysregulation on the Autism Spectrum: Fight, Flight, Freeze


Listen Later

Individuals on the spectrum who are going through a season of struggle often describe episodes of dysregulation (not feeling centered in their alertness, attention, or emotions). Join Dr. Regan for this first episode in a 4 part series on dysregulation to learn how to recognize a dysregulated state and why these states are often misinterpreted or mishandled. 

 

The Alert Program: Your Best Self

The Testing Psychologist podcast: Best of 2021

Zur Institute webinar Feb 2022: ASD Interventions Across the Lifespan

 

Dr. Regan's Resources

Book: Understanding Autism in Adults and Aging Adults, 2nd ed

Audiobook

Book: Understanding Autistic Behaviors

Autism in the Adult website

Resources for Clinicians

 

Episode Transcript

1

00:00:00,340 --> 00:00:17,760
Welcome to autism in the adult podcast.

2

00:00:17,770 --> 00:00:18,750
I'm your host,

3

00:00:18,760 --> 00:00:20,290
Dr Theresa Regan,

4

00:00:20,300 --> 00:00:22,560
an adult neuropsychologist.

5

00:00:22,640 --> 00:00:28,050
I specialize in brain behavior relationships for those 14 and older.

6

00:00:28,540 --> 00:00:35,050
I'm the parent of an amazing teen on the autism spectrum and a certified autism specialist.

7

00:00:35,740 --> 00:00:38,200
I am deeply grateful to bring validation,

8

00:00:38,200 --> 00:00:42,850
hope and purpose to individuals and their families living on the autism spectrum.

9

00:00:43,540 --> 00:00:45,430
With this mission at its core,

10

00:00:45,440 --> 00:00:52,580
I founded and currently direct the OsF healthcare adult diagnostic autism center in central Illinois.

11

00:00:52,590 --> 00:01:10,560
My books include Understanding Autism in Adults and Aging Adults and Understanding Autistic Behaviors. For more information and to join my online community for free visit www.adultandgeriatricautism.com.

12

00:01:11,440 --> 00:01:13,550
Please join me in helping individuals,

13

00:01:13,560 --> 00:01:18,550
couples and families thrive while living life on the autism spectrum.

14

00:01:20,540 --> 00:01:24,460
Hello and welcome to this episode of Autism in the Adult.

15

00:01:25,240 --> 00:01:29,460
And I'm glad you joined me for this first episode of 2022.

16

00:01:30,240 --> 00:01:35,050
I just want to highlight a few things that have gone on recently.

17

00:01:35,050 --> 00:01:44,680
I was happy to be named in the episode Best Of for 2021 that The Testing Psychologist produces.

18

00:01:44,680 --> 00:01:46,520
This is a podcast by Dr.

19

00:01:46,520 --> 00:01:47,550
Jeremy Sharp

20

00:01:47,940 --> 00:02:02,790
talking about issues related to assessment in psychology, and my episode in august Identifying Adult Autism was the second downloaded episode of the season.

21

00:02:02,800 --> 00:02:03,290
So,

22

00:02:03,290 --> 00:02:14,720
I was so honored to be among many very accomplished people talking about important topics and assessment of Autism in the adult was right up there at # two.

23

00:02:14,720 --> 00:02:14,990
So,

24

00:02:14,990 --> 00:02:16,900
I was happy about that.

25

00:02:16,900 --> 00:02:19,920
I'll put the link below if you or someone you know

26

00:02:19,920 --> 00:02:22,800
would like to learn more about assessment.

27

00:02:23,340 --> 00:02:29,160
This episode of the testing psychologist was produced for clinicians.

28

00:02:29,160 --> 00:02:36,450
So people who are trying to understand how to assess and evaluate autistic characteristics in their clients.

29

00:02:37,040 --> 00:02:44,660
I also have an exciting opportunity for clinicians coming up in February on the 26th of 2022.

30

00:02:45,100 --> 00:02:50,030
This is a two hour live interactive webinar with Zur Institute.

31

00:02:50,040 --> 00:02:50,480
And again,

32

00:02:50,480 --> 00:02:52,330
I'll put the link below.

33

00:02:52,840 --> 00:02:58,210
This is entitled Autism Spectrum Disorder: Interventions Across the Lifespan.

34

00:02:58,640 --> 00:03:05,150
So not everyone on the spectrum will need support or intervention at all seasons of life.

35

00:03:05,540 --> 00:03:26,890
But for those who are clinicians, we have people come to us asking for assistance during a tough period or about a difficult thing that they're grappling with and to understand the neurology of the client is so important to drive the strategies that will be most helpful for them.

36

00:03:27,140 --> 00:03:42,770
So I'll be talking specifically about strategies that are likely to help the autistic client and ... things that we typically do in a counseling sessions, will highlight those that wouldn't be likely to be as helpful.

37

00:03:42,770 --> 00:03:45,730
So that's February 26,

38

00:03:45,730 --> 00:03:46,340
2022.

39

00:03:46,350 --> 00:03:48,850
And I'll go ahead and put that link below.

40

00:03:51,540 --> 00:03:55,260
Today's topic is dysregulation.

41

00:03:55,840 --> 00:04:00,240
I envision this to be the first episode in a four part series.

42

00:04:00,250 --> 00:04:04,160
And so today we're going to talk about what this regulation is and

43

00:04:04,170 --> 00:04:06,060
how to recognize it.

44

00:04:06,840 --> 00:04:09,290
In the next episode of the series,

45

00:04:09,290 --> 00:04:15,880
we're going to talk about how to reduce the amount of dysregulation that someone experiences.

46

00:04:15,890 --> 00:04:20,550
The third episode will be how to recover from dysregulation.

47

00:04:21,040 --> 00:04:27,820
The fourth will be how can you recognize when someone is trying to regulate.

48

00:04:27,830 --> 00:04:31,350
So someone around us maybe trying to regulate,

49

00:04:31,360 --> 00:04:35,650
and we may criticize them or ask them to stop it,

50

00:04:35,660 --> 00:04:37,230
but there would be other,

51

00:04:37,230 --> 00:04:41,050
more impactful ways to get a good outcome.

52

00:04:41,940 --> 00:04:44,020
You'll understand more about what I mean

53

00:04:44,020 --> 00:04:48,750
when we start to talk about this thing called regulation and dysregulation,

54

00:04:50,440 --> 00:05:05,650
Everyone's brain and nervous system are in charge of helping us to stay centered with various things and part of what we stay centered with has to do with alertness.

55

00:05:05,660 --> 00:05:08,070
Can we wake up in the morning?

56

00:05:08,070 --> 00:05:11,690
Can we calm down and fall asleep at night?

57

00:05:11,700 --> 00:05:16,830
That's kind of our ... the tone of our alertness,

58

00:05:16,940 --> 00:05:18,760
our brain helps us with that.

59

00:05:19,440 --> 00:05:23,900
We also have this attention regulation.

60

00:05:23,900 --> 00:05:31,520
So our brain is supposed to help us focus on what's most important and just release and let go

61

00:05:31,520 --> 00:05:38,670
things that are no longer important or uh you know... if the information in our environment has changed.

62

00:05:38,680 --> 00:05:46,990
So we need to switch gears and attend to something else... so our brain helps us regulate alertness and attention.

63

00:05:47,740 --> 00:05:53,190
So when we talk about these two aspects of regulation (alertness and attention),

64

00:05:53,740 --> 00:06:05,050
there is an analogy that is commonly used with the occupational therapists that often try to help people learn how to regulate better.

65

00:06:05,540 --> 00:06:09,560
And that analogy is "how is your motor running today?"

66

00:06:10,340 --> 00:06:14,560
So if your motor is running sluggish,

67

00:06:15,340 --> 00:06:17,420
you are tired,

68

00:06:17,470 --> 00:06:20,370
you may describe yourself as feeling lazy,

69

00:06:20,370 --> 00:06:21,540
unmotivated.

70

00:06:21,540 --> 00:06:22,910
I can't get going,

71

00:06:22,910 --> 00:06:24,250
I feel sleepy.

72

00:06:24,730 --> 00:06:31,750
I'm just a bump on a log ... that is when your motor is running too low.

73

00:06:32,640 --> 00:06:35,620
Your motor can also sometimes run too high.

74

00:06:36,140 --> 00:06:41,260
It's revved up and it's not in that just right state.

75

00:06:41,640 --> 00:06:47,250
And a motor that's too high will be someone who is hyper, restless,

76

00:06:47,640 --> 00:06:48,290
angry,

77

00:06:48,300 --> 00:06:49,240
agitated,

78

00:06:49,250 --> 00:06:50,070
anxious,

79

00:06:50,070 --> 00:06:54,700
that extra alertness that we just don't need all the time.

80

00:06:54,800 --> 00:06:56,970
This high level of alertness.

81

00:06:57,440 --> 00:07:07,360
Um that is the motor that is running too high, and we would like our motor to be running just right.

82

00:07:09,240 --> 00:07:13,370
The Alert Program is one program you might want to investigate.

83

00:07:13,380 --> 00:07:19,830
It's run by occupational therapists who are very experienced in regulation strategies.

84

00:07:19,840 --> 00:07:23,160
And I have a link to the alert program below.

85

00:07:23,640 --> 00:07:23,960
Now,

86

00:07:23,960 --> 00:07:28,870
they train occupational therapists in strategies to help others.

87

00:07:28,870 --> 00:07:41,060
But they also have a new online program called Your Best Self that people can investigate to figure out regulation strategies for themselves.

88

00:07:43,040 --> 00:07:43,540
Now,

89

00:07:43,540 --> 00:07:46,450
we've talked about alertness and attention.

90

00:07:46,840 --> 00:07:51,280
There's also this area of emotional regulation.

91

00:07:51,290 --> 00:07:54,160
So when we have a strong emotion,

92

00:07:54,170 --> 00:07:58,700
our brain should help us make sense of it.

93

00:07:58,710 --> 00:08:06,810
Our brain should help us center it and help it be present in our mind that we're aware of it,

94

00:08:06,810 --> 00:08:08,400
but it's not overwhelming,

95

00:08:08,410 --> 00:08:10,070
it doesn't hijack us,

96

00:08:10,080 --> 00:08:11,770
it doesn't take control of us,

97

00:08:11,780 --> 00:08:13,550
It doesn't hurt other people.

98

00:08:13,560 --> 00:08:20,160
And that would be regulation or dysregulation of emotional experiences.

99

00:08:22,440 --> 00:08:28,060
When we talk about a dysregulated state in the area of emotions,

100

00:08:28,120 --> 00:08:31,560
we can talk about a fight reaction,

101

00:08:32,240 --> 00:08:36,950
flight reactions or freeze reactions.

102

00:08:38,040 --> 00:08:56,000
So a fight reaction in the area of emotions is that this very strong emotional experience ... comes in and the person feels so overwhelmed that there is this externalized expression of distress.

103

00:08:56,640 --> 00:09:01,950
And what I mean by that is I would include meltdowns in this category.

104

00:09:01,960 --> 00:09:04,170
I would include outbursts,

105

00:09:04,180 --> 00:09:05,320
crying spells.

106

00:09:05,320 --> 00:09:08,480
I even include, even though it's not fight,

107

00:09:08,490 --> 00:09:14,960
but I'd like to capture all the externalized reactions in this category.

108

00:09:15,440 --> 00:09:18,050
That I am going to argue with you.

109

00:09:18,050 --> 00:09:19,950
I am going to explode.

110

00:09:19,960 --> 00:09:23,230
And you can picture this volcano,

111

00:09:23,240 --> 00:09:23,820
right?

112

00:09:23,830 --> 00:09:29,480
that is just to the point of being uncontained and out comes

113

00:09:29,480 --> 00:09:41,650
this spewing of tears or yelling or throwing things... so that is the externalized sign of a dysregulated state.

114

00:09:41,920 --> 00:09:43,890
In the area of emotions,

115

00:09:46,040 --> 00:09:52,660
flight is another reaction that someone could have when they are dysregulated.

116

00:09:53,340 --> 00:09:58,650
This could look like ... I'm going to walk away from you and quit this conversation.

117

00:09:59,040 --> 00:10:04,460
I'm going to spend all day in my room doing things I enjoy but not interacting with you.

118

00:10:05,140 --> 00:10:08,760
I'm going to quit school and do home schooling.

119

00:10:08,760 --> 00:10:10,450
I'm going to quit this job.

120

00:10:10,940 --> 00:10:15,560
I'm going to quit this relationship because it's so up and down.

121

00:10:15,560 --> 00:10:17,000
It's like a roller coaster.

122

00:10:17,000 --> 00:10:18,650
It's just too intense for me.

123

00:10:18,650 --> 00:10:20,000
It's too unpredictable.

124

00:10:20,040 --> 00:10:21,620
I have to quit this,

125

00:10:21,630 --> 00:10:23,060
I have to escape,

126

00:10:23,440 --> 00:10:28,630
I have to withdraw. Then there are freeze reactions.

127

00:10:28,630 --> 00:10:32,150
So this is the time when you're physically present,

128

00:10:32,160 --> 00:10:34,980
but you're not psychologically present,

129

00:10:34,990 --> 00:10:36,710
that your brain shuts down,

130

00:10:36,720 --> 00:10:46,300
Someone might say the veil just seemed to go over his eyes and I just knew he was there but not processing what was happening during that time,

131

00:10:46,300 --> 00:10:47,720
someone may say,

132

00:10:47,730 --> 00:10:48,200
you know,

133

00:10:48,200 --> 00:10:49,320
I hear what you're saying,

134

00:10:49,320 --> 00:10:52,460
but my mind is blank and I don't know what to respond.

135

00:10:52,470 --> 00:10:54,140
That's a freeze reaction.

136

00:10:54,150 --> 00:10:59,010
So it signals that the person is dysregulated.

137

00:10:59,010 --> 00:11:04,260
They're having difficulty being fully present in the midst of the strong emotion.

138

00:11:05,940 --> 00:11:28,150
Another part of the freeze reaction can be what we call a somatization response to stress and that just means that the stress is not able to come into the person's emotional awareness and kind of sit there and be recognized and felt.

139

00:11:28,740 --> 00:11:30,300
And so the body says,

140

00:11:30,300 --> 00:11:30,910
hey,

141

00:11:30,910 --> 00:11:35,150
I will help you escape from this really difficult emotion.

142

00:11:35,160 --> 00:11:45,140
I will process the stress for you so that you don't have to feel this deep fear or this deep pain or anguish or anger.

143

00:11:45,150 --> 00:11:52,690
I'll just process that stress right through the physical system in these cases,

144

00:11:52,700 --> 00:11:56,390
the symptom which could be a staring spell.

145

00:11:56,400 --> 00:11:59,740
It could be something that looks like an electrical seizure,

146

00:11:59,740 --> 00:12:01,350
but it's really not.

147

00:12:02,040 --> 00:12:08,600
It could be something like a loss of memory for chunks of time or days or weeks,

148

00:12:09,040 --> 00:12:17,000
it could be a weakness where the person feels like their limbs are weak or paralyzed.

149

00:12:17,010 --> 00:12:19,860
So it could be a variety of things like that.

150

00:12:20,240 --> 00:12:24,340
Physical systems also could include issues of pain,

151

00:12:24,350 --> 00:12:27,600
issues of stomach distress,

152

00:12:27,600 --> 00:12:28,470
headaches,

153

00:12:28,480 --> 00:12:30,550
so lots of different things.

154

00:12:30,550 --> 00:12:35,960
Lots of different physical systems can process stress for us.

155

00:12:36,340 --> 00:12:39,570
And these symptoms,

156

00:12:39,570 --> 00:12:42,760
these physical expressions are real.

157

00:12:43,140 --> 00:12:46,580
They are not produced by the individual,

158

00:12:46,580 --> 00:12:47,850
They're not feigned,

159

00:12:47,860 --> 00:12:50,290
they're not exaggerated,

160

00:12:50,290 --> 00:12:51,760
they're not used to manipulate,

161

00:12:51,760 --> 00:12:56,250
they are really experienced and they are distressing in themselves.

162

00:12:56,840 --> 00:13:04,260
But they do help the individual ... kind of shield the individual from having to process in their awareness

163

00:13:04,260 --> 00:13:05,660
such strong emotion.

164

00:13:07,340 --> 00:13:11,560
And it can also include what we call dissociation.

165

00:13:11,940 --> 00:13:17,410
So I feel like I'm not even in my own body right now,

166

00:13:17,420 --> 00:13:22,620
I don't feel like I even know who I am or what's reality and what's not reality.

167

00:13:22,630 --> 00:13:25,550
I don't remember parts of the day,

168

00:13:25,550 --> 00:13:28,090
I feel disconnected from myself.

169

00:13:28,100 --> 00:13:34,790
So this dissociation can also be this form of a freeze state,

170

00:13:34,800 --> 00:13:36,550
a dysregulated state.

171

00:13:38,040 --> 00:13:39,200
So in summary,

172

00:13:39,200 --> 00:13:48,820
I'm talking about regulation as being that centered state that the brain should help us maintain,

173

00:13:48,840 --> 00:13:58,410
its that state where you're just right with alertness, with attention, and with emotional centeredness,

174

00:13:59,040 --> 00:14:03,080
you're not too low and sluggish and out of it,

175

00:14:03,540 --> 00:14:05,090
you're not too high,

176

00:14:05,090 --> 00:14:06,620
being overwhelmed,

177

00:14:06,620 --> 00:14:08,460
restless or agitated,

178

00:14:09,840 --> 00:14:13,420
You're not in a fight, flight, or freeze mode,

179

00:14:13,840 --> 00:14:17,010
you're psychologically present,

180

00:14:17,020 --> 00:14:23,520
You're physically present and you can maintain some sense of centeredness,

181

00:14:23,520 --> 00:14:25,060
you're not overwhelmed.

182

00:14:26,640 --> 00:14:27,040
Now,

183

00:14:27,050 --> 00:14:33,850
every human who lives life has periods with where they are dysregulated.

184

00:14:33,860 --> 00:14:35,750
It's a very human thing,

185

00:14:35,760 --> 00:14:36,320
right?

186

00:14:36,330 --> 00:14:52,450
We're living in a life day to day that is sometimes very difficult to navigate and we'll have periods of times where we lose it or where we go in our room and shut the door or we just freeze.

187

00:14:52,840 --> 00:14:58,170
And that's just a very human thing. For individuals on the spectrum,

188

00:14:58,180 --> 00:15:06,440
that nervous system pathway through the center and the front of the brain is particularly involved for them

189

00:15:06,440 --> 00:15:10,760
and it also is particularly in charge of regulation.

190

00:15:11,240 --> 00:15:26,240
So everyone on the spectrum will have difficulty in some way with getting to a regulated state and they'll probably have seasons of life where that is much more achievable,

191

00:15:26,250 --> 00:15:29,940
but seasons where... if anything gives them trouble,

192

00:15:29,950 --> 00:15:32,550
it very well may be the issue of regulation.

193

00:15:34,840 --> 00:15:40,860
That is why we talk about regulation on this program for Autism in the Adult.

194

00:15:41,240 --> 00:15:49,970
Because oftentimes when people are seeking assistance or they are in pain or there's something that they're struggling with...

195

00:15:49,980 --> 00:15:50,570
Uh,

196

00:15:50,580 --> 00:15:55,960
it very well may be in the area of getting to a regulated state.

197

00:15:58,230 --> 00:15:58,570
Now,

198

00:15:58,570 --> 00:16:06,930
one thing to understand is that the type of dysregulation that the individual shows can be somewhat specific to them.

199

00:16:06,930 --> 00:16:09,470
We kind of have our,

200

00:16:09,480 --> 00:16:12,950
our general ways of handling things.

201

00:16:12,960 --> 00:16:13,480
Um,

202

00:16:13,480 --> 00:16:20,970
and so one thing I recommend is knowing what you as an individual, or this person that you love,

203

00:16:20,980 --> 00:16:30,950
what they lean toward when they're dysregulated, because one thing we want to do is recognize what dysregulation looks like in this person.

204

00:16:32,840 --> 00:16:34,960
So for example,

205

00:16:35,640 --> 00:16:47,590
the person who is exploding and ranting because their usual parking space at work is being used by someone else,

206

00:16:47,600 --> 00:16:56,300
and the person at the entryway to work gave them a hard time because they don't have their badge on, and on the way to work

207

00:16:56,300 --> 00:16:59,660
they couldn't get the gas that they typically like to get...

208

00:17:00,040 --> 00:17:02,690
So they're feeling very uncentered,

209

00:17:02,690 --> 00:17:08,260
They're feeling off, and for this particular person when they're uncentered,

210

00:17:08,260 --> 00:17:11,270
they tend to get elevated.

211

00:17:12,140 --> 00:17:16,490
Um and tend to externalize that stress.

212

00:17:17,940 --> 00:17:19,860
So for this person,

213

00:17:20,240 --> 00:17:22,830
this outburst that they may have,

214

00:17:22,830 --> 00:17:26,560
maybe they come in and they have an outburst toward their colleague or something.

215

00:17:26,940 --> 00:17:32,220
Well that is often nothing to do with the colleague in particular.

216

00:17:32,220 --> 00:17:33,680
It just may be that,

217

00:17:33,690 --> 00:17:34,060
wow,

218

00:17:34,060 --> 00:17:36,050
this is a sign,

219

00:17:36,060 --> 00:17:37,810
this is a clue.

220

00:17:37,820 --> 00:17:40,860
This person is really off center.

221

00:17:40,870 --> 00:17:45,100
They're struggling to feel in that just right state.

222

00:17:45,110 --> 00:17:46,480
And for this person,

223

00:17:46,480 --> 00:17:48,190
when they struggle to feel that way,

224

00:17:48,190 --> 00:17:51,960
it happens to be that it comes out as irritability.

225

00:17:53,740 --> 00:17:58,560
Another person may lean toward quieter reactions.

226

00:17:59,140 --> 00:18:00,930
So this person,

227

00:18:00,940 --> 00:18:06,120
let's say we have another individual who experiences the very same thing,

228

00:18:06,130 --> 00:18:17,590
but this person comes in quietly, walks to their office and shuts the door, and doesn't open their office door as typical.

229

00:18:17,600 --> 00:18:24,080
Uh maybe they're in there for three hours without opening it, when typically they would go get some coffee,

230

00:18:24,080 --> 00:18:26,460
maybe say good morning to their coworkers.

231

00:18:26,840 --> 00:18:27,760
So wow,

232

00:18:27,760 --> 00:18:30,350
they've really retreated and become quiet.

233

00:18:31,840 --> 00:18:45,350
Now the difference between the fight reaction and the flight reaction is that one is very noticeable and everyone around that first person is like,

234

00:18:45,350 --> 00:18:45,780
wow,

235

00:18:45,780 --> 00:18:50,600
stay away from Joe today because he got up on the wrong side of the bed.

236

00:18:50,600 --> 00:18:51,390
He's really,

237

00:18:51,400 --> 00:18:52,860
he's really irritable.

238

00:18:53,540 --> 00:19:03,940
Um Now they may misunderstand the reason for that and they may not like the fact that he is loud and irritable.

239

00:19:03,950 --> 00:19:05,080
So they may not say,

240

00:19:05,090 --> 00:19:07,490
oh he's really in a dysregulated state,

241

00:19:07,490 --> 00:19:08,450
that poor guy.

242

00:19:08,940 --> 00:19:11,940
Um but they do notice it.

243

00:19:11,950 --> 00:19:16,310
They notice he's off center. On the other hand,

244

00:19:16,310 --> 00:19:21,500
for the person who reacts with flight to being dysregulated,

245

00:19:21,510 --> 00:19:23,580
they are often missed,

246

00:19:23,590 --> 00:19:24,250
right?

247

00:19:24,250 --> 00:19:32,550
So they may spend all morning in their office and either nobody will notice or they might misinterpret it and say,

248

00:19:33,420 --> 00:19:33,910
you know,

249

00:19:33,910 --> 00:19:35,350
she's kind of stuck up.

250

00:19:35,360 --> 00:19:37,130
She's just in her own little world.

251

00:19:37,130 --> 00:19:47,160
She doesn't socialize ... when really both the first person and the second person are in a state of dysregulation,

252

00:19:47,160 --> 00:19:49,160
which means that they are struggling.

253

00:19:50,240 --> 00:19:51,460
They're not doing well,

254

00:19:52,840 --> 00:19:58,660
But the quieter one may not be noticed and the louder one may be misunderstood.

255

00:20:02,140 --> 00:20:14,430
Now we also have freeze, of course, and let's say that there's a third individual and they have the exact same thing happen and yet they're walking into work...

256

00:20:14,450 --> 00:20:19,560
and someone asked them a question about a recent project.

257

00:20:19,940 --> 00:20:21,890
They can't think of the details.

258

00:20:21,890 --> 00:20:25,960
They're really feeling shut down and kind of out of their own system.

259

00:20:26,340 --> 00:20:36,770
And they're also realizing that they ... their stomach doesn't feel that well and they are starting to get some chronic pain in their muscles that they're feeling.

260

00:20:37,140 --> 00:20:41,060
Uh they just really don't physically feel well.

261

00:20:41,940 --> 00:20:49,760
Um Now this may be their state of dysregulation... that I'm feeling disconnected.

262

00:20:50,140 --> 00:20:56,160
It's hard to think through things and they may even say it's probably because of my headache.

263

00:20:56,170 --> 00:21:01,860
I can't think clearly because of my headache or my stomach ache and then they may go home for the day.

264

00:21:03,140 --> 00:21:03,760
Again,

265

00:21:03,760 --> 00:21:07,990
this is actually... in this scenario I'm describing...

266

00:21:07,990 --> 00:21:10,890
this is the same thing.

267

00:21:10,890 --> 00:21:12,500
It's dysregulation.

268

00:21:12,760 --> 00:21:24,860
It looks different, but it's the state of having things happen in your day that threw you off center and you're really struggling to know how to get back to center.

269

00:21:25,740 --> 00:21:31,050
And so all three of these people may look very different,

270

00:21:31,320 --> 00:21:33,860
but they're all struggling with dysregulation.

271

00:21:34,210 --> 00:21:43,050
Now one of the interesting things can be... if these people were sent to get help for their dysregulation.

272

00:21:43,740 --> 00:21:57,450
The first one might be sent to anger management training and perhaps he'd be diagnosed with something like bipolar because he has these swings of mood and regulation...

273

00:21:58,140 --> 00:22:13,490
Perhaps the second person goes for help and they coach her on social skills with colleagues and they tell her that as part of her job

274

00:22:13,490 --> 00:22:15,770
she really needs to speak up more,

275

00:22:15,840 --> 00:22:16,750
be a leader,

276

00:22:16,750 --> 00:22:20,340
be more engaged in the social milieu of the office.

277

00:22:20,540 --> 00:22:24,760
And so she's being coached on getting out there and maybe she,

278

00:22:24,770 --> 00:22:26,370
she gets a diagnosis,

279

00:22:26,370 --> 00:22:27,860
if she goes to a clinician,

280

00:22:27,870 --> 00:22:30,280
maybe she gets a diagnosis of anxiety,

281

00:22:30,280 --> 00:22:32,860
generalized anxiety or social anxiety.
282
00:22:34,340 --> 00:22:45,200
The third person goes to get help because they often leave work feeling cloudy in there thinking they have some staring spells,

283

00:22:45,200 --> 00:22:46,320
they feel disconnected,

284

00:22:46,320 --> 00:22:47,770
they feel physically ill.

285

00:22:48,440 --> 00:22:52,860
So they go to the doctor and they get diagnosed with chronic headaches,

286

00:22:52,860 --> 00:22:54,470
maybe fibromyalgia,

287

00:22:54,480 --> 00:23:10,470
maybe um some um digestive sensitivities... and I'm definitely not here to say that nobody has those diagnoses and physical issues and this person may as well...

288

00:23:10,480 --> 00:23:15,270
What I'm saying though is that for this hypothetical individual,

289

00:23:15,280 --> 00:23:16,950
it's just not that simple.

290

00:23:16,960 --> 00:23:32,940
We don't want to miss the internal struggle of it because... if we understood that those physical symptoms in that state of fogginess were at least worsened by some of this dysregulated state,

291

00:23:32,950 --> 00:23:33,240
you know,

292

00:23:33,240 --> 00:23:34,170
that trigger,

293

00:23:34,540 --> 00:23:45,460
we could help much more efficiently without adding medications that may make things worse or extra doctor's appointments or extra stress.

294

00:23:45,940 --> 00:23:46,780
Um,

295

00:23:46,790 --> 00:23:47,600
we could say,

296

00:23:47,600 --> 00:23:47,900
hey,

297

00:23:47,900 --> 00:23:48,590
you know what,

298

00:23:48,590 --> 00:23:51,370
when you are are off center,

299

00:23:51,370 --> 00:23:53,970
when you are stressed and things have gone wrong.

300

00:23:53,980 --> 00:23:58,510
I feel like your system responds in this way,

301

00:23:58,520 --> 00:24:05,590
you know that your stress is expressed through your system and that you feel disconnected.

302

00:24:05,590 --> 00:24:13,860
I'm wondering if we could hypothesize about that and see if there's a more efficient way to get you to feel more centered.

303

00:24:14,840 --> 00:24:18,100
And I bring this up for a couple of reasons.

304

00:24:18,220 --> 00:24:22,160
One is ... dysregulation is common on the spectrum.

305

00:24:23,640 --> 00:24:24,860
Two is,

306

00:24:25,440 --> 00:24:31,870
it can be misunderstood and depending on the type of dysregulation,

307

00:24:31,880 --> 00:24:39,660
it can add diagnoses to a person's list that aren't the most helpful diagnosis.

308

00:24:40,540 --> 00:24:41,090
Um,

309

00:24:41,100 --> 00:24:43,360
often autism isn't on there.

310

00:24:43,940 --> 00:24:44,510
Um,

311

00:24:44,520 --> 00:24:52,080
but there may be this gathering of diagnoses that fit the symptoms in the moment.

312

00:24:52,080 --> 00:24:54,040
Like they fit some characteristic in the moment,

313

00:24:54,040 --> 00:24:58,060
but they missed the big picture of why this person is dysregulated.

314

00:24:58,840 --> 00:24:59,200
You know,

315

00:24:59,200 --> 00:25:03,070
they're dysregulated because the rhythm of their day,

316

00:25:03,070 --> 00:25:18,260
the structure of their day that they depend on as an autistic individual... that that was disrupted and that triggered this dysregulated state and in them it happens to look like fight or flight or freeze.

317

00:25:19,240 --> 00:25:25,660
And so the topic of this podcast then is to introduce you to this concept of regulation.

318

00:25:27,840 --> 00:25:33,620
And when you see yourself or someone you love in a dysregulated state.

319

00:25:33,630 --> 00:25:38,030
And instead of telling them to get it together,

320

00:25:38,040 --> 00:25:39,290
calm down,

321

00:25:39,290 --> 00:25:40,380
get out there,

322

00:25:40,380 --> 00:25:41,360
get over it.

323

00:25:41,740 --> 00:25:42,370
Um,

324

00:25:42,700 --> 00:25:45,060
you can say to yourself,

325

00:25:45,440 --> 00:25:46,110
wow,

326

00:25:46,110 --> 00:25:48,230
this is dysregulation.

327

00:25:48,630 --> 00:25:49,890
I know what this is.

328

00:25:51,040 --> 00:25:52,580
For example,

329

00:25:53,140 --> 00:26:02,730
if my son, who's on the autism spectrum, comes home from school and drops his book bag on the floor and walks past me without saying hello,

330

00:26:02,810 --> 00:26:07,060
lays on the couch and puts a cover over his whole body... over his head.

331

00:26:08,040 --> 00:26:09,220
I could say,

332

00:26:09,230 --> 00:26:10,050
Hey,

333

00:26:10,540 --> 00:26:12,010
you didn't say hi to me.

334

00:26:12,020 --> 00:26:13,630
You threw your stuff on the ground,

335

00:26:13,630 --> 00:26:14,140
which you know,

336

00:26:14,140 --> 00:26:15,300
it doesn't go there!

337

00:26:15,420 --> 00:26:16,740
Come out here and make this

338

00:26:16,740 --> 00:26:17,070
right.

339

00:26:17,080 --> 00:26:18,610
This isn't a hotel for you.

340

00:26:18,610 --> 00:26:20,350
I'm not your maid.

341

00:26:21,340 --> 00:26:24,230
But, if I really wanted to get the best outcome,

342

00:26:24,240 --> 00:26:25,320
I would say,

343

00:26:25,330 --> 00:26:26,110
oh,

344

00:26:26,120 --> 00:26:27,300
I know what this is.

345

00:26:27,300 --> 00:26:29,740
This is a clue to me.

346

00:26:29,750 --> 00:26:30,650
This is data.

347

00:26:30,650 --> 00:26:31,860
This is information.

348

00:26:32,240 --> 00:26:50,200
This is telling me he is dysregulated ... so it's not going to help things for me to punish him for being dysregulated, and it's not going to help me to tell him to get better regulated because he already doesn't know how to do that.

349

00:26:50,200 --> 00:26:51,460
He's already overwhelmed.

350

00:26:52,240 --> 00:26:55,020
What would really help is if I said,

351

00:26:55,640 --> 00:26:56,080
wow,

352

00:26:56,080 --> 00:26:58,500
this is a flight reaction,

353

00:26:58,500 --> 00:26:58,750
right?

354

00:26:58,750 --> 00:26:59,690
He's hiding.

355

00:26:59,700 --> 00:27:00,950
He's withdrawing.

356

00:27:01,340 --> 00:27:02,760
He must have had a bad day.

357

00:27:02,760 --> 00:27:04,590
So then I can go in and say,

358

00:27:04,590 --> 00:27:05,060
hey,

359

00:27:05,540 --> 00:27:07,270
it looks like you had a rough day.

360

00:27:08,040 --> 00:27:16,290
I'm going to give you five minutes, and I'll be back and we can figure out what you need to get more centered.

361

00:27:17,540 --> 00:27:18,800
So number one,

362

00:27:18,810 --> 00:27:20,330
I'm recognizing it,

363

00:27:20,340 --> 00:27:21,460
which is important.

364

00:27:22,240 --> 00:27:22,590
You know,

365

00:27:22,590 --> 00:27:23,850
this isn't bad behavior.

366

00:27:23,850 --> 00:27:25,270
This is dysregulation.

367

00:27:25,840 --> 00:27:33,170
This is someone who is overwhelmed and uncentered and it's expressed as flight in this particular person.

368

00:27:34,640 --> 00:27:43,610
I'm also explaining to him what I see because ... you know when we're overwhelmed, we often don't know what we're feeling,

369

00:27:43,620 --> 00:27:45,510
we're just surviving,

370

00:27:45,510 --> 00:27:46,060
right?

371

00:27:46,540 --> 00:27:48,360
So I'm saying to him,

372

00:27:48,940 --> 00:27:49,550
wow,

373

00:27:49,560 --> 00:27:56,460
it looks like you've had a hard day and you probably need something to get centered.

374

00:27:57,740 --> 00:28:05,150
And then we're also introducing this topic that there are strategies that you could use to help yourself get centered.

375

00:28:05,150 --> 00:28:11,570
Let's figure out what those are and let me partner with you to get centered to get regulated.

376

00:28:12,040 --> 00:28:19,450
So in the future in this series we're going to talk about not only how to recognize it ... which we did today.

377

00:28:20,340 --> 00:28:29,400
We're going to talk about how to prevent episodes of dysregulation or you know lessen them as humans.

378

00:28:29,400 --> 00:28:34,550
We're going to have them but... not to have them so frequent that someone's not functioning well.

379

00:28:35,240 --> 00:28:46,160
How to recover from a dysregulated state, and how to recognize when someone around you is trying to regulate.

380

00:28:46,740 --> 00:28:48,400
Um for example,

381

00:28:48,400 --> 00:28:50,270
my son under the cover,

382

00:28:51,140 --> 00:28:54,300
his being under the cover is him trying to regulate.

383

00:28:55,040 --> 00:28:57,210
So I don't want to punish him for that.

384

00:28:57,220 --> 00:28:59,250
I don't want to chastise him for that.

385

00:28:59,260 --> 00:29:20,330
I want to recognize what that is and then help him have different strategies ...more effective strategies to regulate and to let him know that I come alongside him to do that with him because I also really commit that his well being is important and I'm on his side.

386

00:29:20,490 --> 00:29:21,060
You know,

387

00:29:21,070 --> 00:29:24,360
I want him to feel just right.

388

00:29:26,540 --> 00:29:39,670
I'm glad you joined me for this first episode of 2022 as we dive into this concept of regulation and dysregulation and the role that the nervous system has in helping us be centered.

389

00:29:40,140 --> 00:29:43,900
And I hope you'll check out the links below.

390

00:29:43,900 --> 00:29:46,180
I have the alert program link,

391

00:29:46,190 --> 00:29:52,250
I have the link to the Best Episode of the Testing Psychologist podcast in 2021.

392

00:29:52,260 --> 00:30:04,460
I'm happy, happy to be the number two episode... and I have a link to my upcoming webinar for clinicians about interventions for the autistic client,

393

00:30:04,840 --> 00:30:05,390
um,

394

00:30:05,400 --> 00:30:07,100
across the lifespan.

395

00:30:07,120 --> 00:30:12,460
So I will see you for next episode on how to prevent dysregulation.

 

...more
View all episodesView all episodes
Download on the App Store

Autism in the AdultBy Theresa M Regan, Ph.D.

  • 4.9
  • 4.9
  • 4.9
  • 4.9
  • 4.9

4.9

95 ratings


More shows like Autism in the Adult

View all
ADHD Experts Podcast by ADDitude

ADHD Experts Podcast

1,294 Listeners

The OCD Stories by Stuart Ralph

The OCD Stories

741 Listeners

The Testing Psychologist Podcast by Dr. Jeremy Sharp: Licensed Psychologist & Private Practice Consultant

The Testing Psychologist Podcast

189 Listeners

Where Should We Begin? with Esther Perel by Esther Perel Global Media

Where Should We Begin? with Esther Perel

14,840 Listeners

Neurodiversity Podcast by Emily Kircher-Morris

Neurodiversity Podcast

396 Listeners

My Friend Autism by Orion Kelly

My Friend Autism

61 Listeners

Hacking Your ADHD by William Curb

Hacking Your ADHD

670 Listeners

THE AUTISM ADHD PODCAST by Holly Blanc Moses

THE AUTISM ADHD PODCAST

583 Listeners

Uniquely Human: The Podcast by ART19    Uniquely Human

Uniquely Human: The Podcast

394 Listeners

Meet My Autistic Brain by The Autistic Woman™

Meet My Autistic Brain

262 Listeners

We Can Do Hard Things by Glennon Doyle and Audacy

We Can Do Hard Things

40,873 Listeners

The Autistic Culture Podcast by Dr. Angela Kingdon

The Autistic Culture Podcast

145 Listeners

AuDHD Flourishing by Mattia Mauree

AuDHD Flourishing

71 Listeners

Adult Autism: A Spectrum of Uniqueness Podcast by Christopher J. Quarto, Ph.D., PLLC

Adult Autism: A Spectrum of Uniqueness Podcast

8 Listeners