I’ve got so much to say about this that I don’t even have the capacity right now to do it, but you know I’ve got a thing for the question of the autistic brain’s perception of trauma, and this particular paper set me off down several paths I’m going to get into during Monday’s postponed therapy session.
Just a couple of thoughts: after the VocRehab job placement that blew up in my face and sent me into sobbing breakdowns, and the mounting stress of continuing to manage a micro-nonprofit in the wake of that job placement, the state’s disability determination services consultant diagnosed me with Adjustment Disorder with Mixed Anxiety and Depressed Mood.
Technically speaking, this diagnosis doesn’t fit, since one criteria is that the impairment is unrelated to another, preexisting condition—when, of course, the only reason the job placement and other stressors impaired me was because of my preexisting Autism Spectrum Disorder.
However, the Adjustment Disorder diagnosis made as much sense as he could make given what the DSM makes available. Diagnosis sometimes is an art as much as it a science.
What strikes me now, though, is that if you drew a line from Adjustment Disorder to Post-Traumatic Stress Disorder, my actuality likely sits somewhere along that line.
Looking at the linked paper yields some interesting things.
Symptoms of PTSD include (a) re‐experiencing the trauma through flashbacks, intrusive memories and nightmares, (b) suppression of these re‐experiencing symptoms and avoidance of trauma reminders, (c) hyperarousal, (d) negative alterations in mood and cognition, and (e) an impact on social and/or occupational functioning.
My aphantasia and severely deficient autobiographical memory precludes me from “re‐experiencing the trauma through flashbacks, intrusive memories and nightmares” (well, nightmares are possible) but you’d be hard pressed to argue that my life doesn’t include “(b) suppression of these re‐experiencing symptoms and avoidance of trauma reminders, (c) hyperarousal, (d) negative alterations in mood and cognition, and (e) an impact on social and/or occupational functioning”.
(Certainly, although I can’t “re-live” past experiences, traumatic or otherwise, my brain’s fight, flight, or freeze response still kicks in if and when I need to discuss such things as that job placement and it’s resulting impairment. Which further suggests it would kick in should I ever try the VocRehab process again. In the early going post-VocRehab, just getting on public transit in the direction of what had been my commute was triggering.)
((It’s also worth nothing that (b) through (e) arguably are a fair description of autistic burnout.))
And then there’s this.
However, the definition of “trauma” has been widely debated across the field and the utility of Criterion A challenged. A range of non‐Criterion A events have been reported to trigger the development of PTSD symptoms. Such as, learning of the sudden unexpected death of a close relative or friend, or cumulative and prolonged stress from bullying or harassment. Furthermore, it has been posited that PTSD symptoms may be more easily triggered by lower intensity non‐Criterion A traumas in individuals with heightened stress reactivity or altered perceptual experiences such as psychosis, other delusional states, and ASD.
It would not be a stretch to add to “cumulative and prolonged stress from bullying or harassment” the idea of the cumulative and prolonged stress from masking and camouflaging.