Tag: Grey Matters

• Reimagining and Rethinking the Autistic Female Experience

  September 2, 2014 7:57 pm Comments Off on Reimagining and Rethinking the Autistic Female Experience

  Autism Spectrum Disorder (ASD) has been diagnosed around four times more often in boys than in girls (Whiteley, et al., 2010). Researchers in the past 5-10 years have only started to question whether ASD may in fact be more common amongst females than has previously been thought (Zwaigenbaum, et al., 2012). Misdiagnosis of females with an ASD may be because diagnostic criteria, concepts and practices have historically been predisposed towards the conventional (a.k.a. male) presentation of ASD (Dworzynski et al., 2012). Also, importantly, females may be better able to adapt to, or compensate for, aspects of ASD symptomatology than males, sometimes referred to as the ‘camouflage hypothesis’ (Gould & Ashton-Smith, 2011). Because of how they camouflage their ASD traits, females are never referred for diagnosis. They are then accordingly missed from the statistics even if they have the exact some profile as their male counterparts. Even people who have ‘classic autism’ are still are given the run around from clinicians because autism is apparently “a boy thing”.

  My PhD project intends to explore whether the ‘camouflage hypothesis’ is related to the conditioning of femininity in girls. The conditioning of femininity is accomplished through an active process of interacting with others in a particular social context. How the performance of femininity impacts on the diagnosis of females on the autistic spectrum will therefore be examined.

  I’m sure I’m preaching to the choir but yes, masculinity and femininity are learned.

  Here is a quote from Meghan Murphy’s blog Feminist Current to help illuminate the above point:

  “There are many other things women are taught in our culture – they are taught to be polite, to be passive, to take up as little space as possible. They are taught that they will be treated better if they do a good job of performing femininity. They are taught that they will be successful at ‘womanly’ things like husband-getting and that they will be rewarded for being physically attractive above all else.” (Murphy, 2011)

  To apply these ideas to women on the spectrum, autistic author Zosia Zaks says this:

  “Whenever a girl acts in a sensitive manner towards the people around her and her community, she is praised and her behaviour is reinforced. This served as another chance social lesson: People liked me when I was kind, when I did a favour, when I volunteered, when I helped, when I asked if there was something that I could do. So I build more successful experiences on the last. I discovered early that I could “win” people over and that they would assume I was a good girl with no problems – if I did nice things.” (Zaks, 2006: 297)

  Obviously, these do not match (heavily contested) stereotypes of being either abrupt and abrasive or insular and indifferent.

  Another constructive adaptation in performing successful femininity is females will camouflage through imitation and imagination (Attwood in Holliday Willey, 2010). Females will observe someone who is “socially successful and popular”, either from her peers or a character in television and novels. They will then “adopt that person’s persona in mimicking speech patterns, phrases, body language and even clothing and interests using a social script. She becomes someone else, someone who would be accepted and not recognised as different.” (Attwood in Holliday Willey, 2010: 13). However, this camouflaging of Asperger traits causes many women and girls to “slip through the diagnostic net” and this had led to more problems (Attwood in Holliday Willey, 2010: 14).

  To specify what kind of problems that autistic females experience without a diagnosis, Dale Yaull-Smith says this:

  “The fact that girls with undiagnosed autism are painstakingly copying some behaviour is not picked up and therefore any social and communication problems they may be having are also overlooked. This sort of mimicking and repressing their autistic behaviour is exhausting, perhaps resulting in the high statistics of women with mental health problems.” (Yaull-Smith, 2008)

  Professor Attwood is adamant that clinicians need a “paradigm shift” in assessing the female presentation of autism. The performance of femininity needs to be considered in how it has caused them to slip through the “diagnostic net”.

  Further reading on the autistic female experience:

  Safety Skills for the Asperger Woman by Liane Holliday Willey

  Aspergirls by Rudy Simone Life and Love: Positive Strategies for Autistic Adults

   

   

  Bibliography:

  Coombs, E., Brosnan, M., Bryant-Waugh, R., & Skevington, S. M. (2011). An investigation into the relationship between eating disorder psychopathology and autistic symptomatology in a non-clinical sample. British Journal of Clinical  Psychology, 50(3), 326-338.

  Dworzynsky, K., Ronald, A., Bolton, P., & Happe, F. (2012). How different are girls and boys above and below the diagnostic threshold for autism spectrum disorders? Journal of the American Academy of Child and Adolescent Psychiatry, 51(8), 788-797.

  Gould, J., & Ashton-Smith, J. (2011). Missed diagnosis or misdiagnosis? Girls and women on the autism spectrum. Good Autism Practice, 12(1), 34-41.

  Hambrook, D., Tchanturia, K., Schmidt, U., Russell, T., & Treasure, J. (2008). Empathy, systemizing, and autistic traits in anorexia nervosa: A pilot study.  British Journal of Clinical Psychology, 47(3), 335-339.

  Holliday Willey, L. (2010) Safety Skills for the Asperger Woman: How to Save a Perfectly Good Female Life. Jessica Kingsley Publishers: London

  Murphy, M. (2011) “My performance of femininity and why it isn’t all about me.”, Feminist Current, viewed 20/08/2014,http://feministcurrent.com/3011/my-performance-of-femininity-and-why-it-isnt-all-about-me/

  Whiteley, P., Todd, L., Carr, K., & Shattock, P. (2010). Gender ratios in autism, Asperger syndrome and autism spectrum disorder. Autism Insights, 2, 17-24.

  Yaull-Smith, D (2008). ‘Girls on the spectrum’, Communication, Spring 2008. 30-31.

  Zaks, Z. (2006) Life and Love: Positive Strategies for Autistic Adults.Autism Asperger Publishing Co: Shawnee Mission

  Zwaigenbaum, L., Bryson, S., Szatmari, P., Brian, J., Smith, I., Roberts, W., et al.  (2012). Sex differences in children with autism spectrum disorder identified in a high-risk infant cohort. Journal of Autism and Developmental Disorders, 42(12), 2585-2596.

   

• Tame the Mind

  7:35 pm Comments Off on Tame the Mind

  “Breathing in, I know that I am breathing in.” – Thich Nhat Hanh

  The human mind has a tendency to be swayed away effortlessly from this moment to the world of random thoughts. The mind can become a dangerous master if it takes control of us. Stress, anxiety and depression are becoming common in today’s hectic life and most of these problems have their origin in our mind as  it has the capacity of imagination. Can we try to take control of this mind? Yes, we can practice mindfulness.

  ‘Mindfulness’ finds its origin in the Eastern world. It has been a principal practice in Buddhist tradition for last 200 years to lead a path to overcome suffering. In the last couple of decades, this practice has found its place in the West as a part of psychological approach among mental health practitioners.

  The major reason for greater adoption of this practice is the proven benefits from scientific research. Mindfulness can lead to greater awareness of thoughts running in one’s mind, reduced worry and anxiety, improved response to stress rather than emotional reactions, enhanced concentration, reduction of mental-health risks, improved pain management, and better mood regulation.

  Mindfulness is the awareness of ‘now’ without any judgement of the experience. In Full Catastrophe Living, Jon Kabat-Zinn described the essence of mindfulness as ‘a way of bringing conscious awareness and attention to the present moment, with an attitude of openness and curiosity’. It is the state of observing the sensations without any judgement or identification with them, anxiety is the struggle in mind and body between the reality and expectation. Mindfulness practice aims at acceptance of ‘what is’ and let it be rather than struggle to change it and cause inner turmoil.

  Why do we need mindfulness? The book Brain Rules based on scientific research by Dr. John Medina suggests that multitasking is a myth and that our brain cannot focus on more than one activity at a time.  Therefore, it is better to improve upon our ability to concentrate. We have a tendency to get lost in random thoughts in an automated manner.  Mindfulness allows us to improve our capacity to be alert to the present moment and lead to relaxation. After all,  if you are always rushing to the next moment, what will happen to the present and who will live in the ‘now’? With mindfulness, we gain the ability to settle the murkiness of random thoughts and reach a calm, clear state of mind.

  How does one practice mindfulness? Mindfulness can be practised as meditation or in daily-life tasks. Meditation can be in two forms – i) concentration meditation by focusing on specific objects or sensations, and ii) insight meditation involving observation of one’s own thoughts and emotional state. In daily life, mindfulness can be practised by paying attention and being alert to daily activities as waking up, brushing, washing, drinking, eating, and walking etc. As Thich Nhat Hanh says, “Breathing in, I know that I am breathing in”.

  Simple mindfulness exercises – As mindfulness can be practised with simple activities, here are the few basic exercises to start with:

  Walking and counting your steps – Try this every time you walk so that you are alert about your steps.

  Focusing on breathing – Our mind is a wanderer and it is hard to control it. Our breath can be used as an anchor to the mind. Try focusing your attention to your breath and whenever your mind is getting lost in thoughts, bring it back to your breath.

  Sitting and observing thoughts – Close your eyes and try to observe your thoughts. Look at them as clouds without any judgment or over-identifying with them. This brings awareness that ‘thoughts are just thoughts’.

  Observing emotions – You can observe your emotions as negative and positive, pleasant or unpleasant. Just watch them without resisting them. This helps to get over your emotions without over-reacting.

  Sitting/walking with a background sound – Try to listen to a soothing music and focus your attention to it.

  Mindfulness with body sensation – Notice the touch of an object to any body part, pay attention to the sounds around you or the music you are listening, observe the taste of food in your mouth with every bite. More awareness means more peace and joy.

  Our thought process is regulated through:

  Sustained attention by focusing on an object as breath or sound.

  Attention switching by noticing our thoughts and bringing them back to the object of focus whenever it has drifted away.

  Inhibition of elaborative thinking by observing thoughts and dropping the chain of randomness. The moment you realize that a chain of thought is creating a trap, drop the thought.

  This mindful regulation eventually leads to relaxation of the mind.

  “When we stop trying to force pleasant feelings, they are freer to emerge on their own. When we stop trying to resist unpleasant feelings, we may find that they drift away by themselves”

  Williams, Teasdale, Segal, and Kabat-Zinn – The Mindful Way through Depression.

  The ANU Counselling Centre runs a program – ‘Everyday Mindfulness’ which helps people better understand the practice and importance of mindfulness. Reading Sarah Edelman’s ‘Change Your Thinking’ provided me the motivation to write this piece. A workshop on mindfulness is being organised by ANU’s Department of Psychology and this gave me enough push to have the final shape of the article.

   

• “No one should be made to feel like crap, just for being who they are” Beyondblue’s national campaign highlighting the impact of racism on Indigenous Australians

  7:32 pm Comments Off on “No one should be made to feel like crap, just for being who they are” Beyondblue’s national campaign highlighting the impact of racism on Indigenous Australians

  Beyondblue recently released a new campaign named ‘Invisible Discriminator’ This campaign is aimed at drawing attention to subtle racism experienced by Indigenous Australians  and the ongoing negative effect racism can have on Indigenous mental health. The television advertisement was released in response to national data and a BeyondBlue survey of 1000 Non-Indigenous Australians. The survey found that almost ten per cent of non-Indigenous respondents would not hire an Aboriginal jobseeker, based on their cultural identity. One in ten said they would avoid sitting next to an Aboriginal or Torres Strait Islander person on public transport, and one in three people said they believe Indigenous Australians are sometimes a “bit lazy.” Of the males surveyed, more than a quarter said it was hard to treat Indigenous Australians equally to everybody else. “We have launched this campaign to tell people that it doesn’t matter if it’s subtle or overt – racism is still racism and it ruins lives. [Australian Bureau of Statistics] data tells us that Indigenous Australians are twice as likely to die by suicide as non-Indigenous Australians, and are almost three times more likely to experience psychological distress. Racial discrimination contributes to these tragic statistics and it’s about time things changed,” Beyondblue chairman, the Hon. Jeff Kennett AC said.

  The campaign is due to run for six weeks through television and digital media, through an advertisement highlighting subtle forms of racism that experienced by Indigenous Australians on a regular basis. Beyondblue CEO Georgie Harman said the Invisible Discriminator character in the campaign represents the voice inside the heads of some non-Indigenous Australians.

  “You’re not staying there, right?”

  “What do you think she’s up to?”

  “Could you really rely on her?”

  “Don’t make eye contact.”

  “Come on. It’s only a joke.”

  Kennett is acutely aware of the impact of racism on Indigenous Australians. “Research shows that racism in Australia is still common and that many people engage in racist behaviour. Racism, like any form of discrimination, leads to distress, which in turn can lead to depression and anxiety.” Several studies have shown a clear link between experiences of racism, and the development of mental health issues among Aboriginal and Torres Strait Islander people including depression, anxiety, substance use and attempted suicide. One in three Indigenous people currently experience high or very high levels of psychological distress on a regular basis, nearly three times the rate of non-Indigenous Australians. A recent Victorian study by the Lowitja Institute showed that a shocking 97 per cent of Aboriginal and Torres Strait Islander people surveyed had experienced racism multiple times.

  Engagement with Indigenous people was central to the campaign. Beyondblue canvassed the views of Aboriginal and Torres Strait Islander and non-Indigenous people across six locations, through focus groups and interviews. Aboriginal Senator Nova Peris, supporter of the campaign, has spoken out on racism in Australia. “The fact of the matter is racism is very in real in Australia, hopefully this makes Australia stand up and realise how hurtful it is. We are all Australians and Aboriginal people have suffered systemic policies throughout the years which makes us feel invaluable, invisible and worthless in this county. When you look at the high rates of suicide in Aboriginal people and [compared to] non-Indigenous Australians, the difference is just overwhelming.”

  “Beyondblue recognises that much needs to be done to address depression, anxiety and related drug and alcohol problems in Aboriginal and Torres Strait Islander communities. Over time and across Australia, generations of Aboriginal and Torres Strait Islander people have experienced trauma, grief and loss. Psychological distress is high amongst Aboriginal and Torres Strait Islander people and this is exacerbated by ongoing social and health factors.” The key message of this campaign is that casual racism is just as hurtful as more obvious forms. The message ‘Stop. Think. Respect’ encourages Australians to think about their behavior in relation to Australia’s first peoples.

  To see the advertisement and find out more visit:http://www.beyondblue.org.au/resources/for-me/stop-think-respect-home/the-invisible-discriminator

  Beyondblue Support Service is available on 1300 22 4636 orwww.beyondblue.org.au/get-support

   

• Mental Health From the Perspective of One Carer

  7:26 pm Comments Off on Mental Health From the Perspective of One Carer

  N.B Trigger Warning – Depression, Suicide

  This piece reflects my personal experience in dealing with mental health issues with a family member. It does not reflect all experiences of mental health amongst individuals and families.

  November 19th, 2011. 7:30am. It was just over a month before I was due to leave for Vancouver, Canada for six months on exchange.

  Dad called. It was early but unbeknownst to me he’d been up all night. On the phone he was quick to his point, a different tact to his usual long-winded lawyer talk. He spoke with something I couldn’t pinpoint until the words came out.

  “Your sister is in hospital. She attempted suicide. She’s ok, sorry I couldn’t call you earlier.”

  I rushed out some meaningless words, put my phone away and left for work.

  My younger sister, Katie suffered from depression for almost three years. For that time, I was living in Canberra, whilst she was in high school in Sydney. In the summer of 2011-2012, we had a conversation that will stay with me for life. It was the first time she had ever shared her real thoughts to me, shown her vulnerable side and engaged with these negative thoughts with someone else. To her, nothing mattered anymore. Life had lost meaning, social connections were fraught with anxiety and it had started to get too much. On that night in a holiday house on Hyams Beach, she made me swear to not tell my parents, not tell her friends; to not tell anyone that could potentially help her.

  Having someone who is close to you live with poor mental health, whether it be a short period or for an extended time is a tough experience. It’s difficultly intertwines with the complex set of emotions that are felt, and the respective actions that are taken. When my sister first brought to me how she felt, I felt caught. Was it worth the risk to keep it a secret and know that she could trust me? Or was it better to lose that and protect her health and wellbeing? I chose the former.

  In the period between this first confession and her suicide attempt, Katie and I had many conversations about how she felt, and that it wasn’t getting any better. In these months, I had a few brief phone calls to my parents where I suggested that they needed to take what she was saying and doing seriously. I couldn’t have asked for a more receptive and timely response from them, but it certainly took a toll on all of our relationships with one another.

  Self-care for those who have family members or friends who are experiencing poor mental health is so important. If you’re not in a position where you can manage how you’re feeling, being there for someone else becomes infinitely more difficult. I was never in the capacity to be a carer for my Katie; the physical distance between us meant I was only witness to some of what she and my parents experienced.

  Katie’s recovery was up and down. There were days where she felt as bad as she did when she was really down, but there were moments, increasing periods of time where she was able to conceptualise a life outside of her depression and anxiety. One part of this was speaking out for women her age. She appeared in the documentary, “I am a Girl”, a movie about the lives of six different young women across the globe. Through this, Katie demonstrated the strength in sharing experiences with mental health. She showed to others that there was and is nothing to be ashamed about.

   

• May the odds be ever in your favour… Why We Need Better Mental Health Literacy

  7:21 pm Comments Off on May the odds be ever in your favour… Why We Need Better Mental Health Literacy

  If you fell off your bike, got hit by a car, caught a cold or just felt physically ill chances are you would seek help. In fact, you are encouraged to do so. In some circles if you decided to not seek help and to ‘tough’ it out you would be judged as there is generally a common understanding that seeking help is the appropriate response when you are unwell.

  Now consider a situation in which you feel unwell but are not sure why. You are feeling down, sad and disconnected from things that you once enjoyed. You are having difficulty sleeping and may have noticed a change in your appetite and or weight. Now what do you think your chances are of seeking help when you and those around you may not even be aware that you need it?

  When we begin to talk about chance, we reveal the unfortunate reality of mental health in Australia: that your mental health is a matter of luck. Not only does education, socioeconomic background, geographic location and a myriad of other complex factors influence your ability to receive help, sometimes it can be as simple as who you know.

  Being connected to others who have a sound mental health literacy can be the vital step in facilitating early interventions and possibly preventing short term problems morphing into longer term, more serious issues down the track. But where do you find these people? More often than not, they are everyday people who have possibly developed their knowledge of mental health from personal experiences, may have been chucked in the deep end when they had to support a friend or family member or happen to be studying in a related field.

  While there are courses out there such as Mental Health First Aid, we still have a long way to go to develop an understanding on the population level equal to that of physical health.  With the field of mental health constantly evolving, the next few years should see greater collaboration of organisations towards a common goal. This includes the anticipated release of some amazing innovations such as evidence based mHealth apps or mobile health applications.

  But we don’t have to wait to start enacting change. While your state of mental health may be left up to luck, you as an individual and ‘we’ as a community can stack the odds to be in our favour. By taking it upon yourself to improve your mental health literacy, not only do you improve your own chances but also that of your networks (friends, family, colleagues, classmates etc.) of accessing appropriate professional help if experiencing mental health problems.

  Let’s put the need for greater mental health literacy into context and look at your individual potential to create change by imagining that you are sitting in Manning Clark for a first year lecture of around 400 students. Based on current statistics; of those 400 students, 100 (25% of 16-24 year olds) will experience mental health problems and/or problematic alcohol and substance use problems within a 12 month period. However, of these 100 students, on average only 25 will receive appropriate professional support (80% of males and 70% of females do not receive professional help).

  It is important to note that this is a generalisation and caution should be taken when applying population level statistics to sub groups. However, it speaks to the impact you as an individual can have within your community.

  To get you started on your journey to greater mental health literacy I have included some pointers below.

  1. Be Proactive

  You never know what will happen or when someone will need help. Be prepared and be that awesome person who has crisis and help lines saved as contacts on their phone. But make sure you take 5 minutes to investigate what the services offer, are they are a crisis line? Is it appointment only? What are their opening hours i.e. 24/7 or 9 to 5pm?

  Some relevant ones for Canberra/ANU:

  • ANU Counselling – 6125 2442
  • Lifeline – 13 11 14
  • Kids Helpline – 1800 55 1800
  • Crisis Assessment and Treatment Team (CATT) – 02 6205 1065
  • Suicide Call Back Service – 1300 659 467
  • Alcohol and Drug information service – 1800 422 599
  • OzHelp Foundation (suicide prevention) – (02) 6251 4166
  • QLife- 1800 184 527

  2. Education

  Being informed about the services is a great step, but check out some information on common mental health problems and their warning signs. Here is a list of great organisations to google to bulk up on knowledge.

  • ANU Counselling
  • Beyond Blue
  • headspace
  • Reachout.com
  • Butterfly Foundation
  • Suicide Prevention Australia

  3. Training

  The first 2 step tips are something you can realistically do in your spare time, but if you are interested in gaining skills to assist those close to you should the need arise there are some great courses on offer. For example, ANUSA this year through its Mental Health Committee organised free Mental Health First Aid and Suicide Prevention Training open to all students. These courses provide you with practical skills to use in support situations as well as a sound overview of the different mental health issues. Email sa.vicepres@anu.edu.au to express interest in next round of trainings.

  May the odds be ever in your favour…