From a Child's Shadows to an Adult's Reflections: Trauma's Puzzle of Autism-Like Traits
As a trauma therapist practicing in the digital age, where platforms like TikTok and Instagram can deliver information to anyone and everyone at the snap of a finger, I often have clients come to me ready to process their complex upbringings and dark childhood experiences. My clients tend to get invested in our work, which often have an impact on their "for you" feeds and the influencers that they follow. The more we learn together, the more they learn outside of the therapy chair.
Something I'm seeing more of in my practice is over time, as the work with my clients continue on, many of them approach me with the question: "Do you think that I'm on the spectrum?" Having worked with young people of various levels of neurospiciness, various degrees of adverse early experience and a combo of the two, I began to look deeper and harder at these two realms and the intersectionality of the two. We know that both can exist at the same time. We know that each realm has their own unique presentation and are not at all synonymous with one another. Yet, the longer I worked with my clients the more I began to wonder if childhood trauma can look like autism spectrum disorder in adulthood.
From a brain science point of view, the answer seems clear. Trauma therapists know that deeply stressful events, especially in formative years, have a great deal of impact on neurodevelopment. When your upbringing was volatile and full of high conflict, possibly abusive and critical, full of neglect and lack of guidance, it will result in a variety of behavioral and emotional difficulties. Just like those that fall somewhere on the spectrum of neurodivergence, people have to learn how to survive. They mask. They isolate. Use learned coping strategies and defense mechanisms. They may struggle in relationship.
Complex Post-Traumatic Stress Disorder (C-PTSD) and Neurodevelopment: C-PTSD is the formal diagnosis that may result from experiencing chronic and severe trauma during childhood. Some research suggests that early trauma can impact brain development and neural pathways, leading to difficulties in emotional regulation, interpersonal relationships, and impulse control. These difficulties can sometimes be mistaken for autism-like symptoms.
Attachment Issues and Social Difficulties: Developmental trauma can disrupt the formation of secure attachments in early childhood, leading to challenges in forming and maintaining relationships in adulthood. Social difficulties resulting from attachment issues may be mistaken for social communication deficits seen in autism. Clients have highlighted for me that they struggle inside relationships greatly - they get into conflicts that they didn't even realize was a conflict, they don't miss people when they're gone, the phrase "I love you" doesn't carry much meaning for them, so on and so forth. These are just a handful of examples from individuals who have questioned the possibility that they may have Autism Spectrum Disorder.
Emotional Dysregulation: Trauma survivors may experience heightened emotional reactivity, difficulty managing emotions, and seemingly atypical emotional responses. These emotional challenges can sometimes resemble the emotional regulation difficulties observed in individuals with autism. For a trauma survivor, they may feel great benefit from sameness, rigidity and routine because it breeds a sense of safety and control. A lack of this might result in anger, irritability, outbursts, etc. This is a common dynamic that we see of individuals who fall on the ASD spectrum.
Communication Difficulties: Developmental trauma can impact language development and communication skills. In some cases, survivors of trauma may have difficulty expressing themselves or understanding social cues, which can be mistaken for autism-related communication challenges. For both realms, body language may be something that is absolutely foreign. On the other hand, it may be something that the individual is so highly tuned into and is reading every move made.
Sensory Sensitivities: Both trauma survivors and individuals with autism may experience sensory sensitivities. Hypersensitivity (elevated sensitivity) to stimuli and sensory overload can lead to similar behavioral responses in both groups. Hyposensitivity (deflated sensitivity) to stimuli and sensory deprivation can also be present in trauma survivors and those on the ASD spectrum. In both worlds, therapists work with these clients to regulate their nervous systems and develop healthy methods of meeting
sensory stimuli needs.
Misdiagnosis and Overlapping Symptoms: Some studies suggest that individuals who have experienced trauma in their early lives might receive a misdiagnosis of autism due to the overlap in symptoms. It's important to emphasize that while there might be overlapping symptoms between trauma-related conditions and autism, they are distinct entities. It highlights the importance of working with specialized providers who can offer careful assessment and are equipped to wear a trauma-informed lens when exploring an individual's complex history and evaluating behavioral and developmental concerns. Proper assessment is crucial to differentiate between the two and provide the best possible care for clients.
Gravitz, L. (2018, September). At the intersection of autism and trauma. Retrieved from https://www.spectrumnews.org/features/deep-dive/intersection-autism-tra…
Stavropoulos, K.K.M., Bolourian, Y., & Blacher, J. (2018). Differential Diagnosis of Autism Spectrum Disorder and Post Traumatic Stress Disorder: Two Clinical Cases. J. Clin. Med, 7, 71.
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