# Understanding the Intersection of Autism and Trauma
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Chapter 1: The Question of Autism
Last year, I began to question whether I might be autistic. This inquiry emerged after discovering that individuals who are highly sensitive could fall under the category of level-one autism—a perspective widely recognized in autism circles. Dr. Elaine Aron initiated her research on high sensitivity back in 1991 and introduced the concept of the "highly sensitive person" (HSP).
Having taken Aron’s high-sensitivity self-assessment years ago, I’ve identified as highly sensitive ever since. To summarize high sensitivity, Aron’s “DOES” model outlines four key traits:
- Deep processing of information
- Tendency to become overstimulated
- Heightened emotional reactivity
- Acute perception of subtle details
Recent insights have revealed that Dr. Aron’s initial findings were based on family members who were later diagnosed with autism. This revelation raises questions about the accuracy of the highly sensitive label. Are we missing out on identifying undiagnosed autistic individuals, particularly those who are primarily white and female? Might this label prevent those who identify as HSPs from receiving an autism diagnosis?
After delving into this controversy, I approached my trauma therapist with the question, “Could I be autistic?” His response was, “It’s possible. Differentiating between autism and early childhood trauma can be quite challenging.” This made me ponder how I could ever arrive at a definitive answer.
Section 1.1: Understanding Autism Levels
Before exploring the link between autism and trauma, let’s clarify what is meant by “levels” in autism for those unfamiliar with current diagnostic terminology. Autism is categorized into three levels based on the amount of support required by the individual.
- Level Three: Individuals require high support and often struggle with communication and may have intellectual disabilities.
- Level One: These individuals have lower support needs and frequently learn to mask their autistic traits, appearing neurotypical at a personal cost.
Previously referred to as Asperger’s Syndrome, level-one autism has seen notable individuals like Sir Anthony Hopkins, Daryl Hannah, and Greta Thunberg publicly acknowledge their autistic identities. This challenges the misconception that autism looks a certain way; it is a spectrum with immense diversity in symptoms.
Section 1.2: The Link Between Autism and Trauma
I have faced various traumatic experiences throughout my life. As a child, I lived in fear of encountering a dangerous man in my neighborhood. That fear culminated in a paralyzing experience that remains etched in my memory. In my young adulthood, I endured an assault in my home, which resulted in a PTSD diagnosis. The nightmares persisted for over a year, and I struggled with being alone after dark for many years.
Additionally, I suffered a severe bike accident, causing long-lasting anxiety around driving. This leads me to question whether my autism might have preceded and contributed to my PTSD. Research indicates that while only 4-8.9% of the general population experiences PTSD, the likelihood is significantly higher among autistic individuals, with estimates ranging from 30% to 60%.
According to Dr. Megan Anna Neff, autistic individuals face an increased risk of PTSD for several reasons:
- A more sensitive nervous system
- A heightened risk of victimization
- Sensory profiles that encode memories more vividly
- Increased stress from navigating a neurotypical world
While I’ve primarily discussed shock trauma, it’s important to also recognize childhood trauma (Complex PTSD) as another possible factor that coexists with autism.
Chapter 2: Distinguishing Symptoms of PTSD and Autism
The overlapping symptoms of PTSD and autism complicate the diagnostic process. Often, those diagnosed with PTSD may have their autism overlooked, particularly among high-masking women, BIPOC, and gender-queer individuals. Dr. Neff has developed a Venn Diagram that illustrates the similarities and distinctions between PTSD and autism symptoms.
Reflecting on my life, I’ve grappled with trauma and now seek to uncover if I am also a level-one autistic. I was curious about the unique symptoms of autism that do not overlap with PTSD, which Dr. Neff identifies as follows:
- Repetitive behaviors and self-soothing through routines
- Challenges in intuitively reading social cues from neurotypicals
- Sensory sensitivities present before trauma
- Special interests
I recall my childhood sensory sensitivities, my love for reading, and the absence of friends during elementary school. Although I didn’t recognize my repetitive behaviors until recently, they have now become apparent.
Is Seeking an Official Diagnosis Beneficial?
As I approach 72, I realize that many individuals in my age group remain undiagnosed. Is it worthwhile to pursue an official diagnosis at this stage in life? The costs can be substantial—up to $2,500 for an autism assessment and potentially another $2,500 for an ADHD evaluation, given that these conditions often co-occur. Additionally, the lack of adult autism assessors in Hawaii complicates matters.
While an official diagnosis could provide validation, I question whether self-validation might suffice. Many in the autistic community support self-diagnosis, provided individuals have conducted thorough research and completed standard online screening tests like the Autism Quotient (AQ) and the Ritvo Autism Asperger’s Diagnostic Scale (RAADS).
Devon Price eloquently expresses the importance of self-determination in the autistic community, emphasizing that diagnosis can often act as a gatekeeping process that excludes marginalized individuals. Although I don’t foresee myself seeking an official autism evaluation, I stand in solidarity with those who do.
My therapist has noted my autistic traits during our sessions, and I appreciate the support he provides when he recognizes my behaviors, such as rocking or distress during transitions.
The Impact of Trauma Therapy
I’ve witnessed significant improvements through somatic-based trauma therapy, leading to a reduction in many of my trauma symptoms. Nevertheless, my nervous system remains delicate, and I’ve come to realize that I may need autism-specific solutions rather than trauma therapy alone.
No Longer Identifying as Highly Sensitive
I’ve gained immense benefits from embracing and appreciating my autistic-like traits. Daily sensory self-care has become a priority, and I celebrate my special interests instead of criticizing myself. Instead of forcing myself into large social gatherings, I cherish my small circle of like-minded friends.
If you suspect you might be autistic, don’t let a PTSD diagnosis be the final word. Trauma therapy can be more effective when approached through a neurodivergent lens, allowing you to avoid less suitable therapeutic methods. In my case, I believe I’m experiencing both autism and trauma, and I have chosen to move away from identifying solely as a highly sensitive person.
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