PART 1 LOOKING AFTER YOUR AUTISTIC SELF
Chapter 2 Taking Control of Your Triggers
What Is a Trigger?
A trigger is something that sets off your stress response.
Why Autistic Adults Need to Know Their Triggers
I now know that I never panic for no reason; there's always a trigger that can either be explained by my autism, or by something in my past emotional development.
Learning what triggers you to feel overwhelmed is vital to learn how to look after yourself.
The Five Steps to Managing Triggers
1. The Detective Habit: Identifying your triggers.
2. Coping Strategies: Learn to manage your triggers.
3. Rationing: Spread out your triggers.
4. Recovery: Plan your recovery time between triggers, and after triggers.
5. Quick Calm Strategies: These are strategies to help you calm down quickly. As developing immediate calming strategies is a huge topic, this will be dealt with in the next chapter.
How to Use the Detective Habit To use the detective habit, I look back at a scenario and ask myself these questions:
•What happened?
•What did I feel? Did I feel stressed, scared, out of control, angry etc.?
•Was there anything in the environment that could have been a trigger? Was there a sensory stressor?
•At what point did I start to feel a stress response? Was it when someone started talking to me? Was it when someone tried to get eye contact? Was it when I walked into a shop? Was it when the environment changed? Was it at the point of transitioning from one task to another?
•Were my basic needs met before I encountered the trigger?
•What were my strengths in the situation, i.e. what did I manage well? Which of my strengths could I use in similar scenarios in future?
•What would have helped me to feel more comfortable, or avoid becoming stressed and/ or overwhelmed?
•What coping strategies could I use if that situation happens again, or if I'm exposed to the same trigger or triggers?
Plan Your Recovery Time
The world is full of triggers, and dealing with them takes energy, mental planning, and work. I don't have infinite energy to cope with triggers;
KEY POINTS
◊ Triggers are things that set off a stress response in our brains, and make our body feel the need to fight, flight, or freeze.
◊ Autistic people can get overwhelmed or stressed from exposure to their triggers.
◊ Every autistic person has different triggers, so it's important to get to know your own.
◊ The detective habit is a method of reflection that can help identify one's triggers, and then create strength-based coping strategies.
◊ Other people can be helpful in identifying your triggers, but take caution that the person you ask is sensitive and uncritical.
◊ Autistic people can react differently to triggers at different times. If your basic needs are not met, or if you are stressed, you are more likely to react strongly to a trigger.
◊ Rationing out your triggers helps avoid triggers building up and becoming overwhelming.
◊ Planning time to rest after a build-up of triggers is really important, as is having a few techniques to calm yourself when out and about.
Chapter 3 Quick Calm Plans
A Quick Calm Plan is a series of strategies or tools that you can use to calm down, refuel your energy, and to reduce the feeling of being overwhelmed.
Ideas for Quick Calm Plans
- Remove yourself from the stressful situation, if possible.
- Ask yourself are your basic needs met?
- Controlled breathing.
- Take a drink.
- Find somewhere you can be alone.
- Go home and go to bed for a while, if your responsibilities allow you to.
- Hold a hot water bottle, heated pad, or warm mug just under your chest bone.
- Lie under a weighted blanket.
- Put something heavy on your lap.
- Smell something lovely like soap or a preferred herb (lemon verbena,
- Splash cold water on your face, the back of your neck, and on your palms and inner wrists.
- Get fresh air.
- Watch a favourite TV show.
- Avoid people putting demands on you if possible.
- Listen to music or an audiobook.
- Stimming helps a lot of autistic people calm down
- Darken the room.
- Reduce visual stimulation.
- Take a shower or bath.
- Singing
- Turn off the internet on your phone, or turn off the phone so you can disconnect from people, if the overwhelm is caused by social stress.
- Exercise
KEY POINTS
◊ 'Quick Calm Plans'are plans of what strategies you will use to help you calm down from being overwhelmed.
◊ Our body gives us clues that we are getting overwhelmed, and the earlier you listen to these clues and implement a Quick Calm Plan, the easier it will be to feel calm again.
◊ It's important to make your Quick Calm Plan when you are calm, so it's ready to use when you hit overwhelm.
◊ Making a visual image or version of your Quick Calm Plan will allow you to use the strategies when you are overwhelmed.
◊ Stimming, when it feels soothing and good, can be part of your Quick Calm Plan.
◊ When stimming doesn't feel good or is causing harm, you can try and give your body the feedback it craves in a different way. If this doesn't work, an occupational therapist who specialises in sensory processing might be able to help you to manage the problematic stim.
Chapter 4 Well-Being and Special Interests
The PERMA Model of Well-Being
• P – Positive emotion.
• E – Engagement.
• R – Relationships.
• M – Meaning.
• A – Accomplishments.
In his book The Complete Guide to Asperger's Syndrome, Tony Attwood (2015 ) states that the three main tools to decrease agitation in autistic children are:
1. physical release of energy
2. solitude
3. engaging in their special interest.
KEY POINTS
◊ The PERMA model is an example of a model that can be used to identify what is important to bring meaning to your life.
◊ Autistic people can improve their well-being by making special interests part of their daily life.
◊ Making a daily routine can help ensure you find time for what's important to bringing meaning to your every day.
◊ Caution needs to be taken with special interests as they can become a problem when they are engaged in too often, or if they cause harm to you or others.
PART 2 SENSORY SELF-CARE
Chapter 5 The Sensory System and Autism
KEY POINTS
◊ Our body is full of senses, which gather information from both inside and outside our bodies.
◊ The main eight senses are sound, taste, touch, sight, smell, vestibular (balance and head position), proprioception (where you are in space), and interoception (what's happening inside the body including emotion, hunger, pain etc.).
◊ Our senses send information about our bodies and our environment to our nervous system. The nervous system comprises our brain, nerves, and spinal cord.
◊ Sensory integration is the process of gathering information through our senses, interpreting the information, and reacting appropriately to the information.
◊ Autistic people have very high rates of experiencing difficulty or differences in sensory integration.
◊ Sensory seeking means seeking out a certain experience for your senses.
◊ Sensory avoiding means your body over-reacts to a sensory experience, and thus you avoid exposure to that experience, e.g. covering your ears from loud noise.
◊ You can seek sensory stimulation at the same time as avoiding other sensory stimulation.
◊ Autistic people with ADHD may experience SPD differently.
Chapter 6 Getting to Know Your Own Sensory System
WHAT CAN MAKE YOU MORE LIKELY TO REACT TO A SENSORY TRIGGER?
- An accumulation of sensory stress.
- Cognitive stress.
- Your basic needs not being met.
- Hormonal changes.
- Anxiety.
- Ageing
- Health changes.
Three steps to regulate the sensory system:
1. 'How full is your cup?'
2. What sense or senses need soothing or regulating?
3. What sensory soothing strategies can I use to 'empty my cup'?
KEY POINTS
◊ No two autistic people have the same sensory differences, so it's important to spend some time figuring out your unique sensory profile.
◊ There are many factors that can affect how your sensory system processes information, such as your health status, your hormones etc. ◊ Seeing your sensory system as like a cup of water can help you become aware of when you need to soothe your sensory system by 'emptying some water'.
◊ Paying attention to and recording how your feel can help you spot patterns that will help you identify your sensory triggers.
Chapter 7 The Anchor Senses: Vestibular and Proprioception
The Vestibular Sense : The vestibular sense collects information about balance and where your head is.
Challenges with a dysregulated vestibular sense may include:
- Accident prone
- Coordination
- Difficulty with sport
- Need to lean on something
- Gravitational insecurity
- Poor postural control:
Sensory Soothing Strategies: Vestibular
- Chewing and crunching
- Sucking:
- Exercises that work on your balance,
- Swimming:
- Put your head lower than your heart:
- Rolling head over heels:
- Shake or tilt your head from side to side, gently:
- Gently lean your head back, supporting your head and neck with your hands:
- Spinning:
- Rocking chairs
The Proprioceptive Sense : Proprioception is the body awareness sense. The proprioceptive sense collects information through our joints and our muscles, to tell us where our body is in space.
Sensory Soothing Strategies: Proprioception
- Weight lifting:
- Weighted blanket:
- Deep pressure:
- Chair lifts:
- Lean into walls:
- Tight spaces:
- Swimming or water walking:
- Weight on different body parts:
- Weight-bearing exercise:
- Roll yourself over a gym or peanut ball and walk your hands on the floor
KEY POINTS
◊ Well-regulated proprioception and vestibular senses can help us feel 'grounded', like we are anchored in place.
◊ When the Anchor Senses are regulated, the other senses are easier to regulate.
◊ When the Anchor Senses are not regulated, this can lead to many daily challenges including clumsiness, movement problems, and poor posture.
◊ There are many sensory soothing strategies we can use to regulate our Anchor Senses.
Chapter 8 The Basic Need Sense: Interoception
What Is Interoception?
The interoception sense gathers information about how we feel, and what we feel inside us.
KEY POINTS
◊ The interoception sense tells us what is going on inside our body.
◊ It helps us to meet our basic needs, such as telling us when we are hungry or thirsty.
◊ It helps us regulate our emotions by telling us how we feel.
◊ Poor interoception can lead to many difficulties with everyday life including difficulty recognising your own emotions, not recognising thirst, hunger, or fullness, and difficulty regulating your temperature.
◊ There are many strategies to help you to care for your interoception sense, which will help you to regulate it.
◊ Having a regulated interoception sense will help the other senses stay regulated also.
Chapter 9 The Famous Five Senses: The Good, the Bad, and the Soothing Strategies
KEY POINTS
◊ The Famous Five Senses include the sound sense, the taste sense, the smell sense, the sight sense, and the touch sense.
◊ How we react to each of the Famous Five Senses being stimulated can have a significant impact on our lives. It can affect how we experience the world, how we join in with society, our relationships, and the decisions we make.
◊ Having a difference in how you experience any of the Famous Five Senses can bring challenges, but also strengths.
Chapter 10 Looking After Your Senses during Intimacy and Sexual Activity
KEY POINTS
◊ Intimacy and sexual activity can bring their own unique challenges to the sensory system. ◊ Setting the scene for the senses can help each sense feel calm, and thus increase your ability to enjoy intimacy or sexual activity.
◊ There are a number of sensory soothing strategies to support your touch sense during intimacy or sexual activity.
◊ The power of consent is a very important part of managing the senses during sexual intimacy. ◊ It is important to establish a method of communication for giving or taking away consent during intimacy or sexual activity.
Chapter 11 Managing Sensory Overload, Shutdowns, and Meltdowns
What Are Meltdowns and Shutdowns?
A meltdown is an intense response to becoming overwhelmed. The cause of overwhelm can be sensory, emotional, or cognitive. A meltdown can be described as the loss of control of yourself, or of your emotions.
A shutdown, on the other hand, is more like the 'freeze' response to stress, where you tend to go in on yourself, and your brain feels as though it has shut down.
Five Steps to Deal with Sensory Overload
- What sensory soothing strategies can you use to help you deal with the sensory trigger? Do you have sensory soothing tools with you, for example a sensory kit with ear plugs, an eye mask, a squeeze ball, a soft scarf to rub your fingers over, a favourite song etc.?
- Are your basic needs met? Hunger, thirst, pain, and exhaustion can all make you hit your sensory limit a lot faster than usual. It's also a lot harder to come back from your limit if you don't meet these basic needs, so it's really important to prioritise eating, drinking etc.
- Do you need to remove the sensory stressor from your environment?
- Do you need to remove yourself from the environment?
- Are you heading towards a shutdown or a meltdown? If the answer is yes, what is your Sensory Soothing Plan?
Sensory Soothing Plan Ideas
- Change into very comfortable clothes
- Lie down under a weighted blanket:
- Hold a hot water bottle to your heart or tummy:
- Eat and drink:
- Close the curtains:
- Listen to music or an audiobook:
- Shower or bath:
- Turn off my phone:
- Engage in my special interest:
- Watch a favourite TV show:
- Read beloved books:
- Sensory box:
KEY POINTS
◊ Sensory overload can occur when our sensory system becomes overwhelmed or over-stimulated.
◊ Sensory overload can lead to shutdowns or meltdowns.
◊ Shutdowns or meltdowns can also be caused by emotional or cognitive overwhelm.
◊ Shutdowns and meltdowns are different for every autistic person. They might involve physical, verbal, emotional, and cognitive reactions or behaviours.
◊ Using the five steps can help you spot if you are getting close to a meltdown or shutdown.
◊ Having a Sensory Soothing Plan can help you prepare for environments and activities, to reduce your sensory overwhelm.
◊ Bringing a portable sensory toolkit with you can ensure you have the equipment you need to calm your sensory system.
PART 3 EMOTIONAL REGULATION
Chapter 12 Recognising and Naming Your Emotions
KEY POINTS
◊ If you don't know how to recognise your emotions, and name what you are feeling, it will be much harder to learn how to regulate your emotions.
◊ Our ability to recognise and name our emotions can fluctuate, depending on how stressed we are.
◊ Alexithymia means finding it hard to recognise and name your emotions.
Chapter 13 Getting Comfortable with Uncomfortable Emotions
However, the first psychotherapist I went to explained there are no positive and negative emotions; instead we can feel comfortable or uncomfortable feeling any emotion in any one moment.
Four-Step Strategy to Manage Uncomfortable Emotions When I feel a strong uncomfortable emotion, I follow this four-step strategy:
1. Name the emotion.
2. Scan the body.
3. Ask yourself, do you know the cause of this emotion? If not, just move straight on to step 4. 4. What can you do about it?
KEY POINTS
◊ Autistic people can feel emotions more intensely than non-autistic people, and are more prone to certain uncomfortable emotions including shame, guilt, anxiety, and fear.
◊ If you don't validate and manage the first uncomfortable emotion that arrives, it is more likely that other uncomfortable emotions will follow, in an emotional domino effect.
◊ The four-step strategy for emotional regulation includes:
1. Naming the emotion.
2. Scanning the body.
3. Asking yourself, what is the cause of the emotion? If you don't know the cause, just move straight on to step 4.
4. Asking yourself, what can you do about it?
Chapter 14 Emotional Regulation Plans
KEY POINTS
◊ Having an Emotional Regulation Plan for individual uncomfortable emotions can help reduce emotional overwhelm.
◊ Having a visual plan prepared for each uncomfortable emotion eliminates the need to think flexibly or problem solve when you are feeling distress from an emotion.
◊ It's important to include sensory soothing strategies in each Emotional Regulation Plan, as soothing the body helps to reduce the chances of feeling overwhelmed by an emotion.
◊ Using your creativity can be a useful way to regulate your baseline emotions. There are many ways to be creative, and it's worth exploring what creativity works for you.
◊ Some emotions last for a long time. Grief is an example of an emotion that is expected to last for prolonged periods, and can come and go. However, if you experience recurring and continuous uncomfortable emotions, it may suggest you need professional help managing your emotions. It may also indicate a mental health illness, for which help is available.
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