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Sunday, January 24, 2010
Aspergers ...

BOOK REVIEW: Asperger Syndrome and Anxiety by Nick Dubin. As I’ve said before on this blog, I have taken an interest in Asperger Syndrome over the past few years. A lot of what I read about Asperger sounds familiar. I’m not formally diagnosed, and I don’t fit all of the major characteristics that the typical “Aspie” is said to possess. But a lot of those characteristics do hit home with me, especially the characteristic of anxiety. Anxiety is indeed an issue in my life.

Well, you might want to respond here that anxiety is an issue in EVERYONE’S life. True, but Aspies have a special way with it. They (we?) have various mental techniques to create anxiety even when there is no rational justification for it. And of course, when there IS justification for being anxious, we take it to the max; we see doom and dark clouds in every little set-back. Obviously, that is not good for one’s health and well-being. It isn’t a pleasant way to live one’s life.

So, Dr. Nick Dubin, a recent doctorate in psychology and an Aspie himself, recently wrote a book about anxiety issues in the lives of adults with Asperger Syndrome. I recently read it, and overall I give it a “thumbs up”. Dr. Dubin subtitled this book “A Guide to Successful Stress Management”. In other words, this is not an academic study on why people with Aspergers seem to have anxiety issues, nor is it addressed to professional shrinks and therapists who treat Aspies. This book is aimed at the nervous adult like me who constantly struggles with “being different” from the crowd, thinking differently and seeing life thru different sunglasses. I wouldn’t necessarily call it a “self-help” or “do-it-yourself” book, as Dr. Dubin clearly urges readers to seek professional help. But he also provides much thought and many techniques that the typical Aspie can use to help control their own bouts of anxiety. Again, though, he does not promise that these alone will be enough; in fact, he clearly states that most Aspies can NOT take care of their anxiety issues alone, even if they faithfully apply what he lays out.

Just what does Nick Dubin lay out regarding Aspie anxiety? Mostly he provides a “talking cure”, or better said, a “thinking cure”. Under the banner of “cognitive behavioral therapy” or CBT for short, he explains logically why many Aspies feel apprehensive, and how they take this logic way too far, to the point of irrational fear and panic. Dr. Dubin prescribes a variety of “schemas” to show that “there’s not as much to fear” as the anxious Aspie thinks.

Basically, this is the faith of the psychotherapist; i.e., that an affective problem can be talked-through (at a cost of maybe $100 per hour). With enough talking (and enough $$$ to pay for all that talking with the shrink), the person suffering a psychological imbalance will see the light of reason and get themselves back together. I.e., they will get well. Dr. Dubin points out that there are anti-anxiety medications that a psychiatrist can prescribe, and that these do have their place. But, he concludes that “alleviating anxiety takes hard work; a pill alone won’t do it”. Obviously, that hard work involves lots of talking and thinking it over.

As such, it’s not surprising that Dr. Dubin does not at all mention in his book the growing research into brain structure factors that could contribute to heightened anxiety in people with Aspergers. Just a quick Google search will bring up a variety of information about neuron connectivity differences and lower-capacity connection structures between the limbic system (the emotional center of the brain, especially the amygdala) and the pre-frontal cortex (where most of the thinking and logic gets done). In other words, it IS possible that Aspies are fighting something that is partly genetic, something that is hard-wired in their brains. I.e., something that might require drug therapy to fully compensate, if the neurological problem can be fully understood and an appropriate medication devised and fully tested . That could be many years away; for now, the available anti-anxiety medications are relatively crude and un-targeted to the Aspie’s particular brain factors, and thus can be expected to have varying effectiveness along with negative side-effects.

Thus, at present there’s not much that the typical Aspie can do directly if in fact he or she is “wired up differently”. But I think it would have been good for Dr. Dubin to have included something about this, as it might help those of us dealing with the anxiety monster to feel a bit better about ourselves. Dr. Dubin devotes a whole chapter to “Anxiety and Shame” (chapter 9), and talks about “forgiving yourself” for having all these problems. Yes, I myself feel stupid sometimes for getting so wound up about little things. As such, I believe that it would help to know that a lot of the problem is not your fault, that it was locked-in genetically on the day that you were conceived.

By the same token, there is much temptation to take such information as a crutch, as an excuse not to try to get better. But Dr. Dubin makes a good case that “talking cures”, especially if done with a professional therapist, can be effective in helping Aspies to deal with anxiety (although he does not cite any effectiveness studies in that regard), and that self-forgiveness is a step in the process. In the context of his overall message, I feel that ignoring the neuro-structural factors relating to Aspergers Syndrome is regrettable.

If Dr. Dubin did miss one important aspect to understanding and dealing with anxiety in the life of an Aspie, he did not ignore another issue that is of major proportion: i.e., the question of SPIRITUALITY. Wow, imagine that — an acolyte of the great religion of psychology (and that’s what it ultimately is today, a religious faith system) admitting in effect that shrinks and their logic can only go so far!

Ya think?

Dubin thus includes an important chapter on “Anxiety and Spirituality” (i.e., Chapter 11). He tells us that although he was brought up in one of the major faith traditions, he is not today a practicing member of it. However, he has much regard for its spiritual wisdom, and seems to give some credence to the notion that “there’s something more” to reality than science and logic can explain. Or, at least BELIEVING that there is can help with the ultimate issue that we all face, i.e. death and dying. Obviously, scientific and quasi-scientific psychological logic are having their problems in helping people in this regard. Ultimately, all anxiety points to the issue of death. Most modern therapists and psychological researchers don’t want to admit this, as they don’t have a very good answer to it. (Freud would have done a lot better had he stuck to the death issue and not gotten so hung up on sex.) Dr. Dubin is to be commended for facing up to it.

Dr. Dubin’s approach to spirituality is a fairly typical modern mash of eastern wisdom and stretching some of the implications of modern scientific paradigms beyond their empirical boundaries (e.g., quantum weirdness, non-local quantum entanglement, ‘butterfly effects’ of chaos theory, and Dubin’s favorite, “morphogenetic fields”, which is based on X-file implications regarding certain strange events like monkeys across thousands of miles learning at the same time how to wash potatoes, or birds simultaneously learning how to remove caps from milk bottles. Coincidence? I don’t think so!). He doesn’t mention Ken Wilber, but that’s basically what we’re talking about. And yet, Dr. Dubin does tip his hat a bit to good old fashioned Judaism and Christianity. In sum, Dr. Dubin wants to help heal people, and he seems to recognize that modern psychology alone isn’t doing the job. So he’s willing to cross some lines and risk taking heat from the defenders of the “hard science” approach.

That is why I like this book so much. You can tell that Nick Dubin wrote it because he really wants to help others. There’s a warmth that comes through in his writing style. He shares a lot about himself throughout the book, including a discussion of the failures of his dating life to date (but he’s only 31, still has lots of time to get it together yet), and an interview with his parents regarding his childhood. He is willing to be vulnerable in order to get across some ideas that he believes will really help adult Aspies to deal with the many challenges in their lives. There are a lot of books out these days about Asperger Syndrome, some of which were written by people with Asperger Syndrome; but I can’t think of any Aspie books (and I’ve read a handful of them) that seem so warm and caring.

It is commonly believed that Aspies are robot-like geeks who lack empathy and are ultimately incapable of expressing emotion. And in person, a lot of Aspies come across that way; I know that I do at times. Perhaps Dr. Dubin is also like that face-to-face; I couldn’t say (but here’s a YouTube interview; he does seem a bit geeky). But down inside, many Aspies really DO care about others, even if they can’t always express it in the ways that society recognizes. Nick Dubin has shown that he does care, and has used this book to express it. That’s worth the price of the book alone. Even if his CBT techniques or schemas never do the reader any good, the anxious Aspie will feel better just knowing that Nick Dubin cares (and that it’s good for them to care for others too).

◊   posted by Jim G @ 12:53 pm      
 
 


  1. Jim,
    Your comments this time are more in the line of a book review; so I don’t think I have too much to comment on—except for pulling out two points. And I fully admit here that I am going off on my own idiosyncratic tangents.

    First, your point about “BELIEVING that there is help with the ultimate issue that we all face” caught my attention. This point about BELIEVING is something I’ve been thinking about for years. This idea has caught my attention in variously different forms. One such form was when I read about a man who before the western part of the U.S. was settled married and had a child. He left his family in the East, moved out West to find a “stake”, built a home, established himself, and many months later wrote for his wife and child to join him. He worked diligently and in anticipation of their life together when they arrived at his new home in the West. However, his wife and child died on the trip out West, and it was several months before he knew of their deaths. During those months when his wife and child were dead, he lived in joyful anticipation of their arrival, planning on a wonderful life with his family. Then finally word arrived that his family was dead, and he was “alone” in this world. He fell into a terrible depression from which he never recovered.

    This story set me to thinking (and is pertinent in my “catching” the idea of BELIEVING). It seemed to me that it was not the actual fact that his wife and child were alive or dead that gave the man’s life purpose but the fact that he BELIEVED that they lived and that he had some purpose other than himself to work for; he BELIEVED his wife and child were alive.

    This concept of BELIEVING is one that pops up in the strangest places. It seems to me that the important thing is NOT the actual fact of what might be the reality of a situation but what one BELIEVES about the situation. This concept then sets me thinking about the power of the mind and what one THINKS is the case. One sees this same concept in the medical phenomenon known as the “placebo effect.” In effect the “placebo effect” is the same thing—if one BELIEVES a particular pill, therapy, etc., will work, then indeed it will work for the believing individual. If one thinks about it—what an intensely powerful phenomenon is this power of BELIEVING.

    Second, I wonder (to take this idea even further)—if when one discusses religion, spirituality, atheism, whatever it is one believes—if in the end by the power of our belief, it is we who end up being the creators of what is. (I fully realize I am far afield of the discussion here, but thinking about what one believes always leads me to this point.)

    Furthermore—and paradoxically—I wonder if those who find believing in some “higher power”, however defined, would benefit from a study of the more mystical aspects of spirituality. I wonder if the mystical aspects of whatever spirituality one might find helpful in one’s life would be of more benefit than the hard line aspects of “you must believe this or that to belong to a particular religion.”
    (Continued below)

    Comment by MCS — January 26, 2010 @ 12:39 am

  2. (Continued from above)
    And my last point concerns your last paragraph—the aspect of caring about others. And here again, I realize I’m off on my own tangent. But I have just about had as much as I can take of the approach to life—which approach started with the baby boomers and has continued and intensified through the following generations—that emphasizes YOU, YOU, YOU. Or “translated” is really ME, ME, ME. This aspect of concentration on one’s self to the practical exclusion of others pervades all of our society and culture these days. I say a good dose of genuine concern and care for others would be most beneficial to anyone who really wants to make the ME the center of their lives. And here I do not mean the pseudo-caring of well-everybody-else-is-doing-this-so-I will-too or the I’ve-been-made-to-feel-so-guilty-for-not-helping-out-I’ll-help out-a-bit or the I’ll-participate-in-this-event/movement/charity-because-everybody-else-is-participating. I mean the simple honest and straightforward caring for another person just because that person deserves someone to care for him/her. It seems to me that such caring, which paradoxically removes one from the center of everything actually meets the needs of being at the center of where real growth of any human being—however neurologically configured—can take place.

    I realize I’m off on my own tangents here, but these are the thoughts I had as I read your thoughts about the book by Dubin.
    MCS

    Comment by MCS — January 26, 2010 @ 12:42 am

  3. Great log entry Jim. Very informative. I'll have to add this book to my HUGE list of books that 'I'm gonna read someday'. :-D

    Interesting comments from you to MCS.

    Comment by Will Doohan — January 29, 2010 @ 7:55 am

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