Coping with Mind-Blindness and Alexithymia

Two traits often found in children and teens with Aspergers are mind-blindness (i.e., the inability to predict the beliefs and intentions of others) and alexithymia (i.e., the inability to identify and interpret emotional signals in oneself or others), which reduce the ability to be empathetically attuned to others.

Mind-Blindness—

Mind-blindness is essentially the opposite of empathy and can be described as “an inability to develop an awareness of what is in the mind of another person.” Generally speaking, children with mind-blindness are delayed in developing a “theory of mind,” which normally allows developing children to “put themselves into someone else's shoes” (i.e., to imagine the thoughts and feelings of others). Thus, kids with Aspergers often cannot conceptualize, understand, or predict emotional states in other people.

Alexithymia—

Alexithymia can be described as a state of deficiency in understanding, processing, or describing emotions, and is defined by:

1. a stimulus-bound, externally oriented cognitive style
2. constricted imaginal processes, as evidenced by a scarcity of fantasies
3. difficulty describing feelings to other people
4. difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal

There may be two kinds of alexithymia:

1. primary alexithymia: an enduring psychological trait that does not alter over time
2. secondary alexithymia: is state-dependent and disappears after the evoking stressful situation has changed

Typical deficiencies that result from alexithymia may include:

• a lack imagination, intuition, empathy, and drive-fulfillment fantasy, especially in relation to objects
• a lack of understanding of the feelings of others
• concrete, realistic, logical thinking, often to the exclusion of emotional responses to problems
• confusion of physical sensations often associated with emotions
• difficulty distinguishing between feelings and the bodily sensations of emotional arousal
• few dreams or fantasies due to restricted imagination
• may treat themselves as robots
• oriented toward things
• problems identifying, describing, and working with one's own feelings
• very logical and realistic dreams (e.g., going to the store or eating a meal)

Alexithymia creates interpersonal problems because these children and teens avoid emotionally close relationships, or if they do form relationships with others, they tend to position themselves as either dependent, dominant, or impersonal (such that the relationship remains superficial).

Alexithymia frequently co-occurs with other disorders, with a representative prevalence of:

• 34% in panic disorder
• 40% in posttraumatic stress disorder
• 45% in major depressive disorder
• 50% in substance abusers
• 56% in bulimia
• 63% in anorexia nervosa
• 85% in autism spectrum disorders

Alexithymia also occurs in people with traumatic brain injury.

A second issue related to alexithymia involves the inability to identify and modulate strong emotions (e.g., sadness or anger), which leaves the child prone to sudden affective outbursts such as crying or rage (i.e., meltdowns). The inability to express feelings using words may also predispose the child to use physical acts to articulate the mood and release the emotional energy.

Aspergers children and teens report a feeling of being unwillingly detached from the world around them. As adults, they may have difficulty finding a life partner or getting married due to poor social skills. The complexity and inconsistency of the social world can pose an extreme challenge Aspergers children and teens.

It is unclear what causes alexithymia, though several theories have been proposed. There is evidence both for a genetic basis (i.e., some people are predisposed to develop alexithymia), as well as for environmental causes. Although environmental, neurological, and genetic factors are each involved, the role of genetic and environmental factors for developing alexithymia is still unclear.

What Can Be Done?

Aspergers children and teens can learn to compensate for mindblindness and alexithymia with the parent’s help and a lifetime of constant counseling by therapists who specialize in Aspergers. With good help, Aspergers children can grow up to lead nearly normal lives.

Parents must understand that their Aspergers kids must be taught to use logic to make sense of the world and the people in it, one personal situation at a time. Here are some “rules” that may help parents in assisting their Aspergers kids (teach these rules to your child):

1. Every human behavior has a reason behind it, even if I don’t see it.
2. Most people usually talk about the things they want, and openly say what they believe.
3. Some people are so messed up that it is just not possible to figure them out. Know when to give up.
4. When somebody’s behavior flies in the face of logic, concentrate on that person’s feelings.
5. Women talk more than men and focus on feelings more.

A parent’s strategy should be to:

• get their Aspergers child obsessed with the need to make sense of the world and help him/her understand that the mysteries of human behavior disappear when one understands the appropriate states of mind behind them
• help him/her realize that once the state of mind is understood, people’s future behavior can be anticipated

But, how does a parent do that when the Aspergers child isn’t motivated to do so because they don’t realize there’s a need?

A parent must:

1. Constantly explain people’s states of mind to the child and what they mean until he learns to figure them out on his own. This means explaining the wants, needs, and beliefs that drive human behavior and the reasons behind all the unwritten rules that are part of human relationships.

2. Convince her child that he can and will make a success of life, as many other Aspergers people have. You must explain the states of mind of these people and why they do what they do – over and over.

3. Explain before punishing. If you punish a child for doing “behavior A,” all that he is going to learn is that if he does “behavior A” again, he is going to be punished again. He will not understand why he should not do “behavior A” in the first place.

4. Explain his challenges and that he is in a state of confusion without being aware of it.

5. Explain his own needs to him. It is only when he understands what he wants himself that he will have a basis for understanding that others also have wants, and that peoples’ wants are what makes them behave the way they do.

6. Explain how each person feels about the world and about his own life.

7. Explain that every person has a different set of values and that their behavior is driven by these values.

8. Explain that he should ask you questions about things he doesn’t understand.

9. Explain why you explain things to him.

10. Explain your own state of mind and emotions constantly.

11. Protect her Aspergers child from the cruelty of bullies. Some people are not going to pass up the opportunity to treat him badly. You should explain that this is going to happen, and that he should not feel ashamed to go to you for support.

12. Teach the child to make sense of the world by himself (eventually).

It is this constant explaining by parents – and counseling by therapists – over years and years of living, repeated over and over again, that eventually will help the Aspergers individual break through the bonds of mindblindness and alexithymia. You child WILL learn to handle life successfully, on his own. Don’t give up – keep trying and get others to help you.

The Aspergers Comprehensive Handbook