Asperger's syndrome

Autism is a developmental disability that affects the way people interact with the world. As a spectrum condition, it affects people in different ways. Asperger’s syndrome is considered a type of autism. Affecting an estimated 700,000 people in the UK alone, autism is relatively common.

Autistic individuals will see things differently to other people. It is not a disease, nor is it something that can be ‘treated’, there are however approaches and support frameworks that can be helpful.

On this page, we will explore Asperger’s syndrome in more depth. We’ll look at associated mental health conditions and how counselling can help with these.

What is Asperger’s syndrome?

Asperger’s syndrome is a diagnostic profile that sits within the autistic spectrum. The developmental disability affects people across the globe regardless of gender, race or social background. People on the autistic spectrum will share similar difficulties but will be affected in different ways. Some autistic people will have learning disabilities and other mental/physical health concerns.

Those diagnosed as Asperger's may not have the learning disabilities often associated with autism, but can have more specific learning difficulties. They typically have fewer problems with speech compared to autistic people, but may still find it hard to understand and process language. Those diagnosed as Asperger's tend to have average or above average intelligence.

The usual hallmarks of Asperger’s syndrome include:

  • difficulties with social interactions
  • highly-focused interests
  • repetitive behaviours
  • sensory sensitivity

Diagnosis

As Asperger’s syndrome affects people in different ways it can be very hard to recognise. Unlike autism which is usually diagnosed during early childhood, it often isn’t diagnosed until later in childhood, or further into adulthood.

Diagnosis often involves a team. This may include a speech and language therapist, a doctor and a psychologist/psychiatrist. In order for someone to receive a diagnosis, they will be assessed as having ongoing difficulties with social interaction, repetitive (and restrictive) behaviour patterns that have existed since early childhood that impair everyday life.

Those seeking a diagnosis now are more likely to be diagnosed as autism spectrum disorder (ASD) or autism spectrum condition (ASC). Asperger's syndrome was removed from the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, in 2013 (the DSM is often referred to as the 'psychiatrists' bible' in the US) and seems to be getting phased out by medical professionals here in the UK. Those who have already received a diagnosis of Asperger's syndrome, however, will retain it unless seeking a second private re-assessment.

For some, receiving a formal diagnosis of autism feels unhelpful, for others, however, it can be beneficial. Understanding what it means to be autistic can help autistic individuals and their loved ones. It also opens the door to further support.

Understanding Asperger’s helped me to realise what I needed to bring to the relationship with my neurotypical wife. Our relationship settled into a much better place and we became more supportive and consistent as a couple and as parents.

- Read Gavin's experience.

What support is available?

Autism and Asperger’s syndrome are not conditions that can be ‘treated’ or ‘cured’ (it is not an illness), however, certain strategies and approaches can be helpful. These include the National Autistic Society’s SPELL framework, the TEACCH programme, visual aids and Social storiesTM. You can find out more about these strategies on the National Autistic Society’s website.  

In terms of general support, there are various charities and online forums which provide information and a space to talk for autistic individuals. For more tailored support with concerns, counselling can be useful.

Counselling

Those on the spectrum may find it helpful to speak to a professional. Counselling can help those affected by anxiety, for example, develop coping strategies and learn relaxation techniques.

Counselling provides a safe space for people to talk about how they’re feeling in confidence and without fear of judgement. Depending on what the person is seeking support for, the counsellor can use specific psychological approaches to help. The following are just a few of the approaches that can be helpful.

Cognitive behavioural therapy (CBT)

Evidence shows cognitive behavioural therapy (CBT) can help reduce anxiety symptoms in some autistic people. This therapy looks at the way your thinking relates to your behaviour and how you can make positive changes.

Some people on the autistic spectrum have unhelpful ways of thinking that make everyday interactions difficult. These include:

  • polarised thinking (when someone is either a best friend or worst enemy)
  • all-or-nothing thinking (‘I have to be great at everything all the time’)
  • fatalist thinking (‘things are bad whatever I do’)

CBT can help those affected understand such thoughts, how they affect the way they act and ways of changing them.

Solution-focused brief therapy

Rather than problem-solving, this form of therapy looks at solution building. Solution-focused brief therapy helps clients look to the future, using their own strengths to achieve goals. Aiming to be concise with practical applications, this therapy is often time-limited (although effects are long-lasting).

Psychoanalytic approach

If a counsellor takes a psychoanalytical approach, they will look to the person’s past and their unconscious mind. The aim is to improve the client’s self-awareness and how they have power within relationships. Some people on the autistic spectrum find this method more complex.

Watch John Clark describe his experience of Asperger's syndrome, clinical depression and generalised anxiety disorder (from the National Autistic Society).

Living with Asperger’s syndrome

For some, living with Asperger’s is an overwhelming experience. It can be very hard to understand and relate to those around them. They may feel different, ‘odd’ or that other people don’t ‘get them’. Feelings of anxiety and burn-out can also surface.

As autism is an invisible disability, other people will not immediately know they are autistic. Indeed, those on the spectrum may be highly intelligent and able to converse with ease. Below are examples of what some autistic individuals experience.

The most interesting people you’ll find are ones that don’t fit into your average cardboard box. They’ll make what they need, they’ll make their own boxes.

- Dr Temple Grandin.

Difficulty with social interactions

Autistic people can find it difficult to interpret language and may struggle to understand sarcasm and/or read social cues. Although people diagnosed as Asperger's typically have good language skills, they can still experience difficulties. They may fail to understand what is expected of someone within a conversation.

Reading other people’s feelings and intentions can be hard. They may also find it difficult to express how they themselves are feeling.

Special interests

Most people have hobbies and interests, but autistic people may have an interest they are incredibly dedicated to. This can lead to them taking a lot of time studying or interacting with said interest (this could be art, computers or collecting memorabilia). Many autistic people say having a special interest or hobby like this is key to them feeling happy and fulfilled.

Repetitive behaviours

Having a regular routine can offer a sense of security to those on the autistic spectrum. It can help them feel safe when other things may be making them feel overwhelmed or anxious. This can make them resistant to change, which is why it's helpful to build up to changes in routine.

Sensory sensitivity

For some autistic people, sensory sensitivity can occur. This is when you experience an over, or under, sensitivity to smells, sounds, light, temperature or even taste. For example, loud noises may cause physical pain and even anxiety. Alternatively, someone diagnosed as Asperger’s may be especially curious about light and colour. 

Mental health and Asperger’s syndrome

Those on the autistic spectrum can be more likely to experience mental health concerns than those not on the spectrum. The following have been found to be more prominent:

Anxiety

It is estimated that 40% of autistic people suffer from anxiety symptoms, compared to 15% of those not on the spectrum. There are a variety of reasons for this, including biological differences in brain structure and dealing with social difficulties.

Anxiety disorders can lead to fears and phobias of certain situations, creating a vicious cycle. If left untreated, it can lead to depression. Talk therapies that look at changing negative thought patterns can help break the cycle and reduce anxiety symptoms.

Depression

While all of us can feel sad or down from time to time, if low moods last a long time and get in the way of day-to-day tasks - it could be depression. Those on the spectrum are just as likely as anyone else to develop this.

It can be hard for autistic people to vocalise how they’re feeling. They may be more worried about asking for help than usual. There is help available however and it can be useful to speak to someone who understands autism and the challenges it can bring.

Obsessive compulsive disorder (OCD)

Obsessive compulsive disorder (OCD) has been found to be more common in those on the spectrum. The condition involves recurring and intrusive thoughts as well as compulsions to carry out certain behaviours. As people diagnosed as Asperger’s can display repetitive behaviours, OCD can be overlooked. The two are, however, very different.

Speaking to your doctor about your concerns is a great first step to an accurate diagnosis. There are several different treatment options to help with OCD including medication and talk therapy.


What should I be looking for in a counsellor or psychotherapist?

There are currently no laws in place stipulating what training and qualifications a counsellor must have to help someone on the spectrum. However, NICE has developed a set of guidelines that provide advice about the recommended approaches.

In terms of psychological support, NICE recommend cognitive behavioural therapy and/or behavioural therapy. To help manage symptoms such as anxiety and/or repetitive thoughts, medication may also be offered. The guidelines also list various therapies and treatments that should not be offered, including chelation therapy.

Counsellors supporting autistic people may have to adjust the way they work. For example, including more visual information. Therefore, it is advised that you seek a professional who has specific training and experience in working with people on the autistic spectrum.

Read the full NICE guidelines:

Managing autism in children and young people

Diagnosing, supporting and caring for adults with autism

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