Asperger Syndrome Counseling

 

Several misconceptions seem to pervade current thinking on the above diagnostic categories. I suppose that should not be surprising given that there is no scientific evidence of any particular cause for any of the above. Thin correlations do not amount to causation. There is currently no scientifically valid evidence of any direct neurological or genetic cause. This is very disturbing given the seemingly growing numbers of patients who meet the diagnostic criteria.
In the face of such a problem, perhaps the most we can hope for is to clear up such misconceptions as our clinical experience allows. In my work with dozens of Asperger patients I have found that, unlike the stereotype of emotional distance and disconnection, Asperger patients are intensely emotional and that their feelings are so powerful and so near the surface that they must be defended against for fear of being treated the way they were in childhood: horribly neglected, criticized, disdained, and often physically and emotionally abused. Emotions got them in trouble as children so they learned to repress them. Their seeming distance is just a way to protect against further anticipated abuse. They are often desperate to be emotionally connected but do not know how and do not trust that it is possible without more pain than they can endure – again.

If the therapist can tolerate the intensity of what seems to both the clinician and the patient as a veritable volcano of barely repressed emotion, amazing progress can be made quickly. More than one Asperger patient has used the metaphor of the pressure cooker: it is the therapist’s job to help the Asperger patient turn the heat down and let the steam off in a controlled and carefully modulated way. If the therapist can handle it, there is no clinical population that I have worked with where progress can be had so quickly.
The active cooperation and personal work of the spouses of Asperger patients are essential if meaningful progress is to be made. The difficulty is that, frequently, the spouse has failed to recognize her participation in the family dynamic. Most Asperger patients are heterosexual men in relationships with women. The Asperger patient and his symptoms becomes the focus of the wife’s efforts to “fix” him and stop the behaviors that are interpreted as negative without recognizing that she began the relationship for her own pathological reasons and those reasons and their underlying process must be addressed or the relationship is in danger. All couples experience this dynamic, but it is often heightened by the nature of the Asperger patients symptoms and those corresponding symptoms in the wife. A couple will rise or fall together.

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