For therapy to be effective it is usually required that the cuases of one’s trauma be sympathetic. If they refect upon one’s reputation unsympathetically then it is sometimes almost impossible to get effective treatment. Many of the earliest articles on this blog concerned themselves with the overreaction to minor social mistakes. A serious reason for mental illness among the autistic community is the fact that lots of their trauma ultimately resulted from reactions to unsympathetic things that they did, regardless of how minor.
Of course, social mistakes increase proportional to cortisol, norepinephrine, epinephrine, and the limbic system supersceding the prefrontal cortex. The less their prefrontal cortex is in control, the less able to discipline their own behavior. The traditional approach of causing people to fear retribution for misconduct doesn’t work and has the opposite effect because by inducing fear, the amygdala overpowers the prefrontal cortex and the person becomes dominated by their petrified lizard-brain. Deterence by negative reinforcement should usually be reserved for behaviors resulting from major positive neurochemical rewards like dopamine, oxytocin, serotonin, and so forth. Deviant behaviors resultant from negative neurochemicals, especially out of fear-based emotions, or because of social misunderstandings with no major neurochemical reward should not be punished.
If the negative neurochemicals are removed and the triggers are reduced then the behavior of people on the spectrum usually improves drastically. In fact, many times, a higher functioning person is made less functional precisely because they were overreacted to. Entire lives can easily be destroyed this way. As therapy is not very effective for aforementioned reasons, strong anti-anxiety or anti-trauma drugs are likely warranted, possibly as extreme as MDMA or ketamine. That’s the first-aid for an anxiety attack. There are other means of doing it which I have posted to this website and like at the bottom of this article.
The ultimate point, though, is that society should be more tolerant of mild weirdness and deviancy and if it is not then the result will be greater deviancy and greater weirdness. If it is merely a matter of preventing them from being offended and the major volumes of human suffering are not considered, then such tolerance is the best avenue. The experience of autism insofar as it relates to offending people and getting in trouble is among the least explored areas of the spectrum in the popular media. The Good Doctor and The Big Bang Theory don’t dive into the daily terror of living in a society prone to overreact to social deviance. That’s not the autism they do. They do the clean, sparkly, autism. Not the messy, dirty, tragic, and painful autism of making social mistakes and living the Jon Ronson book “So You‘ve Been Publicly Shamed” every day of your life.
The Autistic Resistance 