Asperger's syndrome

Written by Bonnie Gifford

Bonnie Gifford

Counselling Directory Content Team

Last updated on 25th March, 2022

We recognise that Asperger Syndrome can be a controversial diagnosis. Many people who fit the profile traditionally associated with Asperger syndrome are now being diagnosed as having autistic spectrum disorder (ASD), or may prefer the terms autistic spectrum condition (ASC) or just autistic. Each person is different. It is up to each individual how they choose to identify, and which term they prefer to use.

The terms used on Counselling Directory are those that are used in the UK currently by some people. We refer to these terms throughout, with the hope of supporting and reaching as many people as possible.

Autism and Asperger's syndrome

Asperger’s syndrome is part of a group of neurodevelopment conditions collectively known as autism spectrum disorder (ASD). No longer an official diagnosis, some who were previously diagnosed may continue to use the label.

Autism is a developmental disability that affects the way people interact with the world. Falling within the neurodiversity spectrum, Aspergers can affect people and present in different ways. Asperger’s syndrome is considered a type of autism. Affecting an estimated 700,000 people in the UK alone, around one in every 100 people in the UK are thought to be on the spectrum, across all ages including children and adults.

Autistic individuals see things differently from how neurotypical people see them. This can include social situations, social cues, and even how they process or interpret information or events. Aspergers and autism are not diseases, nor are they something that can be ‘treated’ or ‘cured’. Neurodivergent people’s brains learn, function, and process information differently. However, for some people, there are 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 may be able to help.


What is Asperger's syndrome?

Asperger’s syndrome is a diagnostic profile that was used until 2013, when it became part of the umbrella diagnosis of autism spectrum disorder. Affecting people around the globe regardless of gender, race or social background, people on the autistic spectrum may share similar difficulties but will be affected in different ways. Some autistic people will have learning disabilities and other mental/physical health concerns. 

People with Asperger’s syndrome do not typically have a learning disability, however, they may experience challenges e.g. specific learning difficulties, anxiety, or other conditions. They typically have fewer problems with speech than other autistic people, but may still find it hard to understand and process language. Those diagnosed with Asperger's tend to have average or above-average intelligence.

The typical hallmarks of Asperger’s syndrome include:

  • Difficulties with social interactions (such as nonverbal social cues, facial expressions, body language, or difficulty predicting or interpreting others' thoughts, feelings, or actions).
  • Highly-focused interests (also referred to as ‘special interests’, which may seem like intense obsessions to some).
  • Repetitive behaviours or trouble with changes to routine (this can lead to becoming upset if routines are interrupted).
  • Sensory sensitivity (such as to lights, sounds, or textures).
  • Difficulty managing emotions (which may lead to outbursts). 

What is the difference between autism and Aspergers?

Those who were previously diagnosed with Asperger’s may be less likely to have language delay, or may show milder symptoms than those diagnosed as autistic. While someone with a historical Asperger’s diagnosis may have good language skills, they may still have trouble ‘fitting in’ with their peers or colleagues. However, it’s important to note that autism is a spectrum, meaning that the range of symptoms, how those are expressed, and experiences can vary greatly between individuals.

What are the three main symptoms of Aspergers?

There are three main difficulties often shared by those with a historic diagnosis of Asperger’s Syndrome. These include:

  • Difficulty with communication. This could include knowing how to use language appropriately in social situations, trouble moderating their non-verbal ways of communication, or difficulty interpreting non-verbal cues from other people.
  • Difficulty with interaction. This could include wanting to be social but being unsure how to make or maintain friendships or relationships.
  • Difficulty with social imagination. This could include trouble predicting, understanding, or interpreting others’ thoughts, feelings, or actions. This can make it difficult for them to predict what will happen next, or to picture alternative outcomes to a situation other than what they had anticipated in their mind.

Developing an intense or obsessive interest around a single or several favoured subjects (often referred to as a ‘special interest’) which may persist over time or change, having a strong preference for structure or keeping things in order, or difficulty deviating from routine can also be difficult for some who have Asperger’s syndrome. 

What causes Asperger’s syndrome?

The causes of ASD and Asperger’s are unknown. Experts think that genetics may play a role, however, they do know that ASD is not the result of a child’s upbringing, poor parenting or vaccinations. While boys and men are more likely to receive a diagnosis of ASD, research suggests that autistic girls and women may be more prevalent than previously thought, but may struggle to receive the right diagnosis. 


Getting a diagnosis of Asperger's or autism 

As Asperger’s syndrome affects people in different ways, it can be hard to recognise. Unlike some on the autistic spectrum who are diagnosed during early childhood, those with Aspergers may not be diagnosed until later in childhood or adulthood. It’s worth noting that people of any age can be diagnosed as on the spectrum.

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, and 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 with 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). 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 are not conditions that can be ‘treated’ or ‘cured’ (as they are neurodivergencies, not illnesses). For many autistic people, the concept of a ‘cure’ is considered offensive. Instead, many prefer finding ways (such as frameworks, strategies, and approaches) that can help support autistic people in their daily lives, help them to better understand others, and to handle any difficulties that they might experience. 

Making simple changes to home or working environments, as well as small adaptations to how we communicate can prove to be hugely beneficial. Not all autistic people will want or need more formal help in the form of therapy or medical support; others will. 

Some options that people may find helpful include the National Autistic Society’s SPELL framework, the TEACCH programme, visual aids and social stories. 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.

As with many forms of help and support, the range of options available can feel overwhelming, and in some instances, there may be little to no data on how effective specific interventions may be. Ultimately, the goal for support should be to help keep the individual safe, healthy and happy, whilst enabling them to do the things that they are passionate about.


Counselling and Asperger's

Working with a professional counsellor or therapist can be helpful. Speaking with an external professional can provide a sounding board without the worry of upsetting friends and family, or of being judged by those closest to us. Therapy can be particularly helpful for those affected by other common mental health issues such as anxiety. A therapist can help someone on the spectrum to discover new, healthy coping strategies, as well as to learn relaxation techniques they can incorporate into their day-to-day lives. 

Depending on what you are looking for help and advice with, your counsellor may use a specific psychological approach. These can include:

Cognitive behavioural therapy (CBT)

Evidence shows cognitive behavioural therapy (CBT) can help reduce anxiety symptoms in some autistic people. Looking at the way your thinking relates to your behaviour CBT can help you to make positive changes. Unhelpful ways of thinking can make everyday interactions more difficult for some people on the spectrum. These kinds of unhelpful ways of thinking can include:

  • polarised thinking (someone is either your best friend or worst enemy)
  • all-or-nothing thinking (‘I have to do everything now and it has to be perfect’)
  • fatalist thinking (‘no matter what I do, things are bad’)

CBT can help you to understand and recognise unhelpful thoughts, learn how they may be affecting you, and discover ways you can challenge and change them. 

Solution-focused brief therapy

Instead of focusing on problem-solving, this type of therapy looks at building solutions.  Solution-focused brief therapy helps you to look at the future, focusing on using your strengths to achieve your goals. Offering practical applications, solution-focused brief therapy tends to take place over a limited period of time but has long-lasting effects. 

Psychoanalytic approach

This approach looks into your past and unconscious mind. Aiming to improve your self-awareness and help you better understand the power you have in your relationships, the psychoanalytical approach, can be more challenging for some people on the spectrum. 

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 symptoms of Asperger’s is an overwhelming experience. You may have difficulty understanding and relating to others, feel different, or like others don’t understand you. Anxiety and autistic burnout can also be common experiences. 

An invisible disability, others may not be aware that you are autistic, which can place additional stress on you if you socially mask. 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 may have trouble understanding sarcasm, reading social cues, or interpreting language. While people diagnosed with Asperger’s typically have good language skills, they may still have difficulty with these, or may not understand what is expected of them within a conversation – or to express themselves. 

Special interests

Many people have hobbies and interests, but autistic people may have one or two interests they are incredibly dedicated to. This can lead to them taking a lot of time studying or interacting with said interest, and may find spending time on that interest to be key to feeling happy and fulfilled. 

Repetitive behaviours

Having a regular routine can offer a sense of security for those on the spectrum, helping them feel safe when otherwise overwhelmed or anxious. This can lead to them feeling reluctant to changes in their routine.

Sensory sensitivity

Sensory sensitivity 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 with 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

An estimated 40% of autistic people experience anxiety symptoms, compared to 15% of neurotypical people. Anxiety disorders can lead to fears and phobias of certain situations, creating a vicious cycle. Without treatment, this can lead to depression. Talking therapies can help reduce symptoms and break unhealthy thought patterns. 

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, this can be a sign of 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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