The following are criteria for Aspergers that have been excerpted from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV):
- Qualitative impairment in social interaction, as manifested by at least two of the following:
- Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
- Failure to develop peer relationships appropriate to developmental level
- A lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)
- lack of social or emotional reciprocity
- Restricted repetitive & stereotyped patterns of behavior, interests and activities
- The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.
- There is no clinically significant general delay in language
- There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction) and curiosity about the environment in childhood.
They are often physically awkward and socially tactless. They seem to be perfectionists but often live in chaos. They know more about some obscure or highly technical subject than seems possible — and go on and on about it. They may seem to lack empathy, and are often accused of being stubborn, selfish, or even mean. They can also be extremely loyal, sometimes painfully honest, highly disciplined and productive in their chosen field, and expert at whatever they decide to be expert at. They are the Aspies, adults with Asperger’s Syndrome.
The number of adults with Aspergers is still difficult to determine. The syndrome wasn’t even officially acknowledged in the DSM until 1994, even though it was described by Hans Asperger in 1944. The result? Many older adults weren’t diagnosed — or helped — as children. Teachers found them exasperating because they were so disorganized and uneven in their academic performance despite often being clearly bright. Other kids considered them weird and either bullied them or ignored them. As adults, they are only now discovering that there is a reason they’ve had difficulties with relationships their entire lives.
For many, having a diagnosis is a relief.
“I never could figure out what other people want,” says Jerome, one of my Aspie clients. “People seem to have some kind of code for getting along that is a mystery to me.”
Jerome is a brilliant chemist. He has the respect of his colleagues but he knows that he’s not well-liked. The finely tuned intuition he uses to do research breaks down completely in relationships.
“I know I’m well-regarded in my work. As long as we’re talking about a research problem, everything is fine. But as soon as people start doing that small talk stuff, I’m lost. It’s good to have a name for it. At least I know there’s a reason.”
Jerome is now starting to put the same intelligence he uses in his lab to learning better social skills. For him, it’s an academic problem to solve. Like many other Aspies, he wants to get along and have friends. He’s highly motivated to learn the “rules” most people take for granted. He just never understood what those rules were. Having the diagnosis has given him new energy for the project.
The press coverage of the syndrome of the last several years has been very helpful as well.
“I was working on a highly technical engineering project with a new guy last week. In the middle the morning, he put down his pencil, looked at me and said, “You have Aspergers, don’t you.”
Ted was explaining a recent encounter to me. “I got real nervous, thinking he was going to leave.”
“What did you say?” I asked.
“Well. I know now that’s my problem so I just said he was right. And you know what he said? He said, ‘I thought so’ and told me I could relax because he works with another guy who has the same thing. We had a great morning solving the problem. That wouldn’t have happened even a few years ago. I would have upset him somehow without understanding why. He would have gone back to his company thinking I was some kind of jerk. Things are just better now that there’s some understanding out there.”
Having the diagnosis has also saved more than a few marriages. Now that the kids are grown, Judy was ready to separate from her husband of 27 years when she first came to therapy.
“If Al and Tipper Gore could do it after 40 years of marriage, I figured I could manage it too. I don’t know what their problems were but I was just exhausted. I felt like I’d been single-parenting our two kids forever. Actually, I felt like I had three kids. Most of my friends couldn’t figure out what I saw in a guy who could only talk about one thing and who would rudely disappear in the middle of a social evening. He never seemed to be able to understand any of our feelings. Our finances were always a mess because he would lose track of bills. Yes, he was really sweet to me in our private life and he’s always been great about doing things like building the kids a tree house — that was really, really cool. But it became harder and harder to see that as a fair exchange for all the times I had to smooth things over because of something he did or didn’t do that bothered someone.
Then my daughter emailed me an article about Aspergers. It changed everything. I realized he wasn’t deliberately making life so hard. He couldn’t help it. As soon as he took an Aspie quiz online, he saw it was true. He does love us. He didn’t want the family to fall apart. He went right out and found a therapist who works with adults with Aspergers. He’s far from perfect but he’s honestly trying. He’s even apologized to the kids for not being more involved while they were growing up. I can’t ask for more than that.”
A diagnosis is primarily used to drive treatment decisions and to make it easier for clinical people to communicate with each other. But in cases like these, it can also be an enormous comfort to the individual and their families. As long as someone with Aspergers feels like they are being blamed or criticized for something they don’t even understand, they can only be defensive or bewildered. When the people around them feel offended or disrespected, they can only get exasperated, argue, or write them off. But when the thing that makes a relationship difficult is named and understood, it becomes a problem that can be worked on together. That shift can change everything.