This post is in the Executive function category

Dear Reader

On occasion I mention to people that my diagnosis of Asperger’s Syndrome is relatively recent, only a few years in fact. One of the first questions I am asked is how I got this far, if I think that the condition has such a profound impact on my life. The question is answered through some examination of particular times and experiences. ASD “symptoms” can be experienced in “waves” that can have a cycle of days, months or years. That is, one can be more or less “aspie” at any given time on one’s life, perhaps related to stress, general health or indeed not attributable to anything external. Tony Attwood makes reference to this (Attwood, 2008, p. 136), but it is not an aspect of the condition that has been thoroughly discussed in the scientific and psychology literature. It is however common in anecdotal publications (Aston, 2003; Hall, 2001; Isaacson, 2009; Shore, 2003; Willey, 2003; Winter, 2003) and the various internet blog and discussion sites. While not solely related to Executive Function, the discussion here focuses on some particular events over time, and the role that music and creative expression has had in maintaining some semblance of functional balance.

When I was 15 I had what was then described as a nervous breakdown. It is not a term that is used these days, having been replaced by much more specific diagnostic descriptions of acute short-term mental disorders such as “anxiety disorder” or “depression”. At the time both my mother and my older sibling were also recovering from similarly diagnosed experiences (it was mum’s 3rd that I was aware of). The breakdown included a loss of physical and mental function, a terrible sense of isolation, extreme tiredness and great emotional instability. I was excused from school assessments for six months but given a choice – attend school or be hospitalised. Unable to comprehend how a hospital bed would help my mental state, I chose to go to school and try to ride it out with the help of antidepressant medication –  probably benzodiazepine in 1981 – and psychoanalysis. The psychoanalysis was old school – tell me about your mother – and I rejected it, approaching the sessions more as a battle of wills than anything else. The drugs were good – until I started to get better and then I became strongly aware of their addictive properties. At 2:30 every afternoon I needed my dose, and I didn’t want to need them. I withdrew from them myself cold turkey by flushing the pack. Difficult week.

I have a specific loss of memory from this period – there are significant blanks, where I can recall the start of an event but not its conclusion. I did attend most of my classes, but many times I would find I did not have a timetable, could not find the correct classroom or could not remember where I was supposed to be – a problem that persisted through the rest of high school and into my foray into tertiary education. My mind was blank and I had no thought of how to solve the problem. At such times I went to The Great Hall. There I could be assured of a room with a piano or somewhere to play my trombone.  I couldn’t co-ordinate my hands to play anything recognisable on the piano but I loved the sound, the beating between the notes of chords.  The instrumental music teachers were friendly and understanding, or at least, they did not ask questions. I continued to play in the school orchestra and stage band, the latter conducted by an ex-navy clarinetist known as Nobby – a man who’s musical passion and easy-going nature had a great influence on my life. I am convinced that being able to go somewhere alone and make my own music, to lose myself in the resonance of a piano in a small room, saved at least my sanity if not my life. Music was a saviour then, as it is now. I am lucky that my “autistic special interest”, my obsessive pursuit, is something that has external value rather than something purely personal like bus timetables or keys or broken shells.

If the Great Hall was unavailable as a hiding place, I would ride my bike into the town where my mother had a shop. I would leave the bike at the back, walk through the shop and straight out the front door, returning some hours later with no recall of where I had been. Sometimes I relive these hours, mostly in my sleep. They are pretty much the only dreams I recall on waking – school, lost, confusion, music. Occasionally the feeling returns if I’m blindsided by the unexpected – missing the bus, preparing for the wrong lecture, irrational children. These days there’s nowhere to hide.

Those times of not-knowing, the lost hours, are not unique to me, or to my situation. They are not unique to that time either – I still have them – thankfully more minutes than hours now – when absolutely nothing penetrates or makes sense, and nothing is remembered except the feelings. Which is ironic given that recalling emotions experienced under other circumstances is extremely difficult.  I don’t know if this really belongs here in the discussion of Executive Function. I put it here because of the relationship to memory, levels of consciousness and drive to indulge in the “special interest”. I’m not in a position to properly examine the past, only to reflect on similarities to the present, but it seems that if the EF was working properly I would be able to “direct” my thoughts, my perceptions, my reactions in a logical way, be that conscious or unconscious. On the other hand, I never did have or cause any accidents. I must have been in control, if not fully conscious.

My composition and studio time is similar in that I lose myself for long periods and don’t recall the details except in dreams. The difference is that these are productive times, and the emotional context I do recall is not the despair of the abyss and dark wells, but some kind of lifted, floating awe. There also seems to be some relationship between this state of “not-knowing” and the creative state of “flow” that Csikszentmihalyi (1990) wrote so eloquently about. However many people with ASDs describe that after indulging their “special interest”, they are depressed and exhausted (Depression after Partaking in a Special Interest, 2010) and this is certainly the case for me. Rather than the exhilaration of the “flow” moments remaining after the fact, these hyper-aware times, these periods of focus and creative output are exhausting and leave me drained, both physically and emotionally.  I began taking the newest breed of antidepressants again a couple of years ago, Selective Seratonin Re-uptake Inhibitors. I responded much faster to them than normal, sensitive apparently, but my “balance” dose is nearly three times higher than the standard.  They seem to help control the depth of the waves, but I would prefer not to rely on them.

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