The autism thread

Fair points but I have only really told close family so far and their response has been a bit disappointing. My sister has been pretty good to be fair but she will occasionally speak to me like I am a bit simple now. I tried to explain to my brother how my thought process is different to his for him to tell me I am wrong. At the weekend I told him that I had never been a relationship before and he said that I am not that autistic.

I think you right about family having an idea of who you are and finding it difficult to change that. It was like my brother wasn't really taking in what I was telling him.

You seem to be very perceptive and I am guessing quite patient as this chunk is a brilliant description of what is likely to be going through her head. Especially from someone who isn't on the spectrum.

"She's made it clear you upset her and broke her trust.
She likely has no idea how you feel about the matter, or about the relationship.
She isn't sure why you don't speak to her as much as before, and is unsure whether what she said about the trust etc. has now put you off her like it has other people in the past.
She is not playing any sort of a game to try and manipulate you or punish you or get some sort of response out of you.
She likely doesn't know what to do next with regards the relationship, and isn't sure what is the right thing to say.
She possibly doesn't want to see you for some reason that may be related to the above of not knowing what to say, maybe whether you are upset with her about what she said and so on."

I have a friend ( female, 43 ) who was confirmed as autistic a couple of years ago. We were close, she described me as her best friend during covid when I kept in touch. I live at the other end of the country, but have lodged at hers when working in the south.

I fell ill about 18 months ago with stomach ulcers, h pylori, and things I can't pronounce, and was unable to visit much. She's a doctor. She was initially helpful, even contacting my Dr. to point out something that they intended to do as a procedure, may be risking my life ( correctly as it turned out ) but fell out with me because I couldn't be there for several months, going as far as to say that I had broken her trust, although we have sporadically kept in touch. I'm sorry to say that I believe the reason I became ill was because of stress related to being her friend.

I was local to her this past weekend and offered to visit. I had mentioned about two weeks ago that I would be in the area and had suggested meeting up. She declined, and unbeknown to her, I know she has lied to me to avoid seeing me. I have witnessed her lie to others, although she has expressed remorse for doing so. She has professed in no uncertain terms that she detests people lying to her, and says that because she's autistic, is personally unable to lie to anyone herself. This in itself is a lie. In the past I've gone out of my way to provide as much care and friendship as was possible in the circumstances. I didn't see it coming, but it's no exaggeration to say I'm deeply hurt by her recent behaviour towards me, and am now struggling to respond to a recent text that is not only deceitful ( connected to her reasons for avoiding me, too many coincidences to be true ), but also has blatant lies in it that are just too easy to disprove. The text ended with her asking me for a favour to do with signing a petition against local gravel pits.

I don't want to confront her with any of this. She's easily hurt, and suffers with abandonment issues. She makes friends, who come to realise she is difficult, and fade away. I don't want to add to that list. However, I feel like I'm being made a fool of. I know there are autistics on this thread. I want to give her the benefit of any doubts I have, so can someone who can see the other side of what's going on here from what I've said give me some insight? I can't respond to her last text as things stand, I simply don't think I can, without being more direct, and therefore hurtful, than I should be as things stand. And I just don't want to do that to her.

It's no exaggeration to say I'm deeply affected by the loss of what was a great friendship. If I had my way we would still talk every day, but I feel awkward initiating contact now and when she does, she does so in a manner that doesn't encourage conversation. This all comes at a time when I have recently lost my oldest school friend to an early heart attack and am facing up to the gradual demise of my 15 year old dog who is the apple of my eye.
The potential loss of this friendship has left me pretty bereft. The strange thing is though, she hasn't blocked me, nor has she taken me off her phone location services ( she also has mine, we did this years ago ). Do I just let things carry on as they are, do I address it directly, do I block and delete. For my own sake, it's the latter, but it feels a brutal thing to do to a vulnerable person.

I cant tell you what to do, but I can offer some insight.
"She's easily hurt, and suffers with abandonment issues" I think this is key the the whole of the above. Rejection Sensitive Dysphoria is a common trait with autistic people as is cPTSD. Autistic people can grow up with a drip drip drip of negative comments, being left out of friendship groups, being the butt of everyones jokes.

I think there has been a perceived slight, it could be something major, it could be something said innocently and taken the wrong way. You say there was a period when you were ill where she was obviously expecting something from you than you were able to give, maybe caused by a lack of empathy on her part. Whatever that was I suspect that is the root cause.

I myself hate liars, and 'cannot lie'. I obviously can, I've learnt to do it to protect others (your hair looks fine) or protect myself. call them 'white lies', you know the ones, feeling a bit ill, oh I'm out that night too avoid something etc. She maybe protecting herself from being 'hurt again' from whatever she perceived in the first place.

There is of course the fact that Autistic people can be olympic standard grudge bearers as well, this may also be driving the behaviour.

What you do next is up to you? Maybe severing contact is what you need for you, on the other hand maybe confronting......but not in a confrontational manner. The distance possibly makes it harder, but metaphorically go for a coffee, and find out what happened to make her lose trust? Explain your side. Avoid the lying thing its not really relevant. Either way I dont think its good for either of you to continue as is, unless you genuinely think things will change.

Bear in mind if you do sever contact that will be another re-enforcing action adding to the rejection/cPTSD, but as brutal as it may seem she is not a child (where you would hang in to avoid that re-enforcement), and you are not responsible for how she feels/perceives things when you have hung in as long as you have.

Being on the spectrum myself, I'd like to offer an alternative perspective.

I am neither rejection sensitive, nor sensitive in general. In fact I'm quite thick skinned. Nor do I hold grudges, quite the opposite. My logical approach to most things is that such emotional responses are counterproductive.

In my experience, people who are overly sensitive, especially if cPTSD or past trauma is involved, are often suffering from other personality disorders, alongside any autism they might have. It's not uncommon for example for BPD to exist alongside autism, and for some characteristics to be similar, although those with autism tend be less emotionally expresssive and less defensive. Another noticeable difference is that those with autism find it hard to read others emotions, whereas those with emotional disorders are more highly attuned to them, although they're just as often read wrongly and overreaacted to. I offer this perspective largely because the symptoms described are very much like ones I've seen in people with BPD, autistic or otherwise.

Best advice I was given, is that you can't change anyone with either condition, and trying to only affects your own mental health. Nor do you need to cut them off either. Simply do what you like, what you feel is best for you, and they'll either be there or they wont. An autisitc person, if that's all they have, will likely let you drift away, and someone with other issues will mostly try to keep pulling you back in.

Obviously everyone is different and so that's just my experience.

I think a chunk of women-being-un(der)diagnosed is down to Baron-Cohen, who has said (no idea if he's corrected himself) that autism is a male trait.

Sadly he got the ear of the government and the NHS.

Unfortunately this intersectionality means it is near impossible to separate the two i.e. are they really related? is one actually a result of the other and to what degree?

The huge overlap between Autism, Bipolar, BPD and indeed ADHD, do create difficulties sorting out where one starts and the other ends, but careful questioning at diagnosis (again especially with women) can tease out their differences. Question - why is it 75% of BPD is diagnosed in women, and why is the opposite true for Autism? I have no evidence to back it up, but my reckoning is Autism diagnosis is the problem leading to misdiagnosis of women with BPD/Bipolar etc instead of Autism due to masking and as a result of trauma in early childhood because of the autism...

An additional point is that BPD is largely a trauma response and research has shown trauma can arise in people with Autism e.g. cPTSD, and how much of BPD misdiagnosis is as a direct result of the extended and increased trauma of missed autism.. - Question - How many of the misdiagnosed women with Autism, end up with a BPD (and other) diagnosis because they are not initially diagnosed with Autism, adding to the trauma load making a BPD diagnosis more likely, instead of autism.

Obviously the above are rhetorical questions, but I think there needs to be research into these areas by people cleverer than me. BUT the medical profession is not known for owning up to 'mistakes' and maybe there is no appetite to address the women BPD/Bipolar/Autism diagnosis situation.

Aspergers tend not carry such feelings of low self esteem and insecurity, and will often internalise things, rather than act out like BPD. The people I've known with BPD appear perfectly normal, nice in fact (as they can be people pleasers), to people who aren't close, but an absolute nightmare to those who are. As I understand it, I believe it's for this reason that many/most BPD diagoses come from self referrals, as it's mostly hidden.

True So yes, they can overlap, and at some levels they might be similar but, trust me, get into a relationship with someone with BPD and you'll have no difficulty separating the two. The most obvious differences are a tendency to self harm, reckless/impulsive behaviour, threats, and quite childlike emotional reactions.

I don't know why BPD is diagnosed so often in women, and autism in men, but it's not necessarily a misdiagnosis, or gender based imbalance. Men with similar behaviours are often diagnosed with NPD or ASPD instead, even though there are some core differences. Although much of that difference is in the underlying motivation, rather than manifestation.

I'm sure some women aren't diagnosed with autism early enough but, if I were to guess, I'd say that any BPD would run parallel to that, rather than be caused by it. Just my opinion though, as is the rest of the above, based on my own knowledge and experiences.

I suppose masking is true in both cases too. For me, as a male, I would say masking occurs mostly in simulating emotions to meet others expectations. I would add though that is an entirely subcoscious and instictive behaviour, that's been learned over time. I'm not aware of it, and am simply retrofitting that explanation based on my understanding of autism, and being able to examine my own feelings more closely since being diagnosed. Again, from my own observations only, the masking done by those with BPD, is more to hide or suppress emotions, rather than simulate or manufacture them.

On thinking about it, I suspect you also have a point about people with autism being potentially prone to BPD. This makes some sense, as my reading on BPD suggests that, apart from trauma, BPD can also be caused by bonding/attachment issues, especially with the mother, which I imagine can occur in someone with autistic emotional traits. That's me just thinking aloud though.

Thats interesting cos my masking is entirely 'intellectual', i.e. I operatate what I call my 'spreadsheet' which tells me how to behave/respond in situations or when people say things etc i.e.
=vlookup(situation, A:B,2,False) if you know excel :-) i.e. 2 columns - Situation and Response, I search the list for the situation and respond according to whats in the response column. If the response proves to be incorrect, I add another row with a differentiator to the original situation and add the new response. If the situation is not in the list, I add another row completely.

I also use it to 'filter what I am saying', to adjust my language to be more acceptable, 'Thats crap' changes to 'that wasn't to my taste' etc.As part of this I rehearse everything I say in my head, before I say it. Whole conversations with multiple paths thru them are planned ahead.

Its this process that is so debilitating and tiring, and the reason I crash at the end of the day, or get things wrong when I'm tired, or caught unawares in a situation where I have to think on my feet very quickly because an interaction has gone outside the rehearsed scenarios.

Did u know French psychiatrists refused to acknowledge Autism as a dignosis until quite recently, their take was it was bonding/attachment related and 'Refridgerator Mother'. The blaming of the mother has lead to some relatively widespread removal of children, and institutionalisation of children . One of my wifes Masters papers was on this. https://www.theguardian.com/world/2018/feb/08/fran...