Do trauma & autism go hand in hand?

Rainbow in dark sky
An article by Katy Elphinstone
  • Defining autism

    We could describe people as 'autistic' either when they:

    a) display a number of the known symptoms of autism, or when they
    b) possess a genetic predisposition towards developing autism(1)

    Depending on which of these definitions we use, we are going to get a very different result in terms of who is going to be considered autistic. We are currently constrained to using only the displaying of symptoms for diagnosing. 

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    Autism as a genetic condition

    During the last years, the genetics of autism has been extensively studied by researchers. A significant amount of funding is given over to this pursuit, with the ambitious goal of one day being able to preempt and cure the 'disorder'.

    We know know that, while attempts to find any specific genes responsible for autism have been unsuccessful (results have been limited to purely causal links with known genetic conditions such as Fragile X, Jouberts Syndrome and Tuberous Sclerosis), some notable differences in the brain circuitry and nervous system (synapses) of autistics have been found.

    If we redefined 'autism' as a different type of brain connectivity and as a hypersensitivity, instead of as a pathology, then perhaps tests could soon become available to predict whether babies might later develop autism(2).

    I imagine there are many non-diagnosed people out there, in whom, if you looked closely, you might find traits such as:
    - High sensitivity,
    - Pronounced empathy (often combined with a blurring of boundaries between self and others, including non-humans),
    - Intolerance for spending too much time with people or in groups,
    - Creativity and specific unusual talents (often practiced to a high degree of expertise, and/or obsessively),
    - Inability to concentrate on things that are not of interest,
    - Strong non-conformist tendencies,
    - Tendencies to startle easily,
    - Inability to spend time in harsh or loud environments.

    All of this begs the question; why would some predisposed people become diagnosable as autistic and other not?

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    Suffering traumatic stress

    As we've seen, a number of genetic traits can combine and produce unusually high levels of sensitivity and empathy. Children with hypersensitivity are far more likely to suffer from trauma and emotional shut-down as a result of their experiences - even experiences others might consider mild or unlikely to be traumatic(4).

    There is also the question of parallel disabilities or challenges. A higher-than-average proportion of autistic people suffer from (or have suffered from) disabilities of various sorts - with features such as chronic illnesses or pain, and/or degenerative conditions. None of these (despite extensive research) has ever proven to be a direct cause of autism(5). But what they have in common is they could easily lead to trauma.

    There is a strong statistical link between suffering birth traumas and developing autism. More than half of those living with ADD, ADHD, or ASD experienced some form of birth injury, as compared to around 0.6% of the general population. Exposure to toxins 'in utero' is also known to increase the incidence of autism(6).

    Particularly hard to explain are statistics such as a higher prevalence of autism in people who are blind or in those who are gender divergent. While not having any clear genetic cause, in our current set-up and society those are factors which, I imagine, could make one's life significantly harder.

    Can it be a coincidence that the symptoms of autism, as we currently define it, are identical to those seen in individuals suffering from Complex Post Traumatic Stress Disorder (CPTSD)? To demonstrate how striking this is, I've listed the symptoms side-by-side here.

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    On epigenetics and evolution

    The genetic part of autism manifests as ‘hyperconnectivity’ within the brain – leading to hyper-perception, hyper-empathy and overall hypersensitivity to stimuli of all kinds. These things, given the right circumstances, are extremely precious qualities. They are even quite likely to be important in the course of human evolution. However, possessing these qualities also makes it signicantly more likely you'll become traumatized by your experiences.

    What few people are aware of is that traits/symptoms can be both trauma-based and genetic.

    The emerging field of epigenetics has shown how our experiences can be inherited. Trauma does not only happen on an individual level. Kellermann's scientific paper ''Can Nightmares be Inherited' (published in 2013), represented a milestone study in this field.

    Certain gene mutations caused by environmental factors such as toxins or trauma are passed on to our children and grandchildren in our DNA. The sensitivities and hypervigilance associated with traumatic stress can, quite literally, be genetically passed on from generation to generation.

    The effects of collective and intergenerational trauma must therefore be brought into account when we consider the role of trauma in (the genetic component of) autism. It is our collective experiences as humans, including trauma, which drive our evolution. Necessarily so, since we and our environment must both continually adapt to suit one another. Sometimes in quite drastic and painful steps.

    Trauma (and healing from trauma) has been closely linked with higher degrees of empathy and insight, and even spiritual awakening. Indeed, there are many ways and contexts in which we could perceive hyper-empathy and hypersensitivity to be good things. See my article on The Awesome Symptoms of Autism for more on this.

    Hyper-empathy, hypersensitivity, inability to conform, a much-heightened intolerance of violence, unfairness or unkindness. For far too long our society has strongly favoured a competitive, conformist and narcissistic typology (and few would deny that collectively we now find ourselves in a bit of a mess).

    If genetic tests for autism did somehow become possible, then we could use them beneficially in order to make sure those with hyper-empathy and hypersensitivity (and therefore a predisposition towards autism, as we currently define it) do not get thoroughly scared off by their early expereriences in this world. Who knows, perhaps it may then come about that 'blessed are the meek', and a more beautiful and inclusive world may emerge.

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    Compassion and logic

    Many autistic (and otherwise neurodivergent) people openly talk about how much they feel they suffer, in a world that was not designed for us and does not seem to accomodate our needs. And, now that cPSTD has, in most parts of the world, become a valid diagnosis, many autistic people are currently seeking a comorbid diagnosis with cPSTD and asking many questions about the inter-relationship between the two conditions.

    So, what if we do not have to decide either/or? One autistic friend told me that, using an 'inter-related' model, he estimated his autistic symptoms were due to 20% genetics and 80% reacting to his experiences in the world. Maybe, e.g. among the painfully and terminally disabled, the latter figure could get close to the 100% mark. Whereas in others, perhaps in cases e.g. where there is lots of autism and hypersensitivity already within the family and no physical ailments or parallel disabilities, the figure might go down to a very small percentage. Indeed, we get some autistic people whom no one will diagnose as such, due to the lack of currently-accepted symptoms, and yet they are certain (as am I) about their own condition.

    As a society we are, unfortunately, still quite attached to the idea that autistic people are somehow intrinsically wrong or sick. We refer to autism as 'ASD', Autistic Spectrum Disorder. Why is this?

    As a parent I have sometimes been told, "It's genetic. It's nothing you did." Being autistic myself and fond of logic, this has puzzled me greatly. And it set me to wondering - could it come down to the role of blame and exoneration in our culture? We love the term 'genetic' (often without having much understanding about the extremely nuanced meaning of the term). It cries out, 'It wasn't me' and 'It wasn't us!'

    It seems the word 'genetic' can have the effect of thoroughly exonerating all but the sufferer(7). Might this explain why we are so determined to stick to it through thick and thin? I see how, in a twist of irony, autistic people may also become invested in the idea that it's something very specific and genetic that sets us apart. Without a formal diagnosis, should people be permitted to join our ranks? This is most understandable, as we have have more often than not suffered exclusion and discrimination among neurotypicals and have finally found a sense of community among other autistic people. We have often found our identity along with our diagnosis - and an acceptable, recognised reason for simply being the way we are.

    It appears that people, both autistic and not, may have their reasons for adhering to the idea that autism is a clearcut genetic condition, something very specific and unrelated to broader things. And as such, we feel we must exclude it from being trauma-related.

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    Why change?

    This belief in the 'genetic', the 'written in stone', through nobody's fault, does play into the hands of the status quo and the maintaining of a system which divides us from one another. People suffering the results of their own and their forebears experiences may be labelled as neurologically disordered - sometimes in a myriad of quite imaginative ways(8).

    There is currently a logistical need to diagnose specific conditions in order for children and their families to gain access to the support they need. This, in our current set-up, is a useful tool.

    But what if, instead of categorising people by which disorder they have, we categorised them by what sort of support package would help each person most, i.e. we could label the packages and not the people? If anything, this approach might prove even more practical. Anyone who has worked with autistic adults or children will know how varied the needs are even within the category of ASD.

    When we begin to recognise how closely trauma-related most of the conditions currently known as 'neurological disorders' are, this will do two things. Firstly, it will take the onus off the sufferer. They are not 'wrong' or 'disordered'. They are sensitive, and reacting. Secondly, trauma (even Complex Post Traumatic Stress Disorder) is something from which we know it is possible to heal, at least to some degree - provided it is possible to remove aggravating factors and access the right resources for trauma recovery.

    I would like to see a day when, for the majority at least, being autistic does not necessarily equate to suffering trauma. When it is fine to be one's neurodivergent self, safely and in public. When things are kinder and more equitable for all the more vulnerable people in our society. I've a feeling those two things may walk hand in hand.

    Will this happen? Eventually, perhaps. I think these ideas are slowly entering the public consciousness, but are not even over the horizon let alone actually among or within us. On the part of the mainstream, I believe defining autism as a disorder is mainly due to a momumental fear of the unknown. A defensive subconscious reaction to the strong implication that the way we currently do things doesn't work for us, individually or collectively.

    Autistic people show us this all too clearly by acting as the canaries in our coal mine. I believe we would do almost anything to continue in our comfortable belief that their condition is a personal illness of some kind, and not a profound reflection upon the condition of us all.

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    Approaching trauma

    In a follow-up article to this one, I'll go into more detail about the fundamental role trauma can play in the lives of people genetically predisposed towards autism. It will compare the symptoms of post-trauma with those of autism, examining and discussing each one and how it manifests itself in ASD and CPTSD respectively (with real-life examples).

    It's important to recognize that trauma can be caused by many, many different things. People, in particular vulnerable infants and children (e.g. if they possess that hypersensitivity which appears to be the basis of autism), can be traumatized by all kinds of things that are regarded by our society as perfectly normal(9).

    Babies (from conception on) and children who are predisposed towards autism could become traumatized by any of a large number of extremely diverse environmental factors. I think examples could include: maternal stress and/or trauma during pregnancy, birth traumas, neglect (even at a level thought acceptable in our culture), family conflict, exposure to toxins, nutrient deficiencies, allergic reactions, exposure to abuse or cruelty, encountering habitual deceit and manipulation, disapproval, non-acceptance, ostracism, separation from loved ones, routine medical procedures, sensory overload, bullying or exclusion at school. And of course a multitude of other things.

    It is impossible for us to avoid all these things – but it certainly helps us to be aware of them when keeping in mind the high sensitivity levels of our autistic children.

    The next article on 'The Role of Trauma in Autism', will shortly be published on the web site for those who are interested in following this topic in more detail.

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    Footnotes

    1. Over the last years there has been a great deal of research into which genetic factors may be significant in autism. The most well-known studies in this area are listed in the Reference section of the Wikipedia entry on the Heritability of Autism. On the same page, under the title 'Candidate gene loci' there is also a list of the genes and gene factors which are considered to play a role. The section begins "Known genetic syndromes, mutations, and metabolic diseases account for up to 20% of autism cases". Perhaps that depends on how you define 'to account for', since (when one considers the role of trauma in autism) many of these things could be indirect rather than direct causes.
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    2. A genetic study (see New Scientist article, 25 March 2017: 'Why a simple autism test is unattainable') showed that if you test infants using 5 blood biomarkers known to indicate that a child might later develop autism, 4% of the children in the study resulted 'autistic' according to those markers. As only 1 percent of the population are currently diagnosed autistic, then that apparently shows that 3 out of 4 children appear to have been incorrectly labelled autistic by using the blood test. But not if you take into account the possibility of various factors in the child's life actually playing a role in developing the symptoms of autism. It is interesting to note that in the article it mentions that some of the 5 blood compounds thought to indicate autism 'are in pathways involved in helping cells resist damage from inflammatory chemicals or toxins'. It makes one wonder if the body is already (or has already been) trying to defend itself from something it's deemed potentially harmful to the system. It seems those infants' bodies are already on high alert, for some reason we have yet to discern.
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    3. By now, the lack of genetic markers specific to autism is overall accepted in the scientific community, but the mainstream is taking its time to catch up. I would not be surprised if scientists experience strong resistance from certain groups on this issue, and perhaps find it hard to gain an audience when their evidence points to environmental factors playing a significant role. Even the simple fact of it being perfectly possible in the case of identical twins (who share the same DNA), for one to develop autistic symptoms and the other not, shows clearly that it cannot just be about genetics. The recent scientific paper Genetics of Autism states "It is now believed that ASD is a result of complex gene-environment interactions, (though) with strong and clear genetic influences".
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    4. The Markrams in their paper on the 'Intense World Theory' describe in detail what the brain of an autistic person looks like, and how it is different from the brain of neurotypical people. They describe 'hyper-functioning of local neural microcircuits, best characterized by hyper-reactivity and hyper-plasticity'. They look at 'hyperconnectivity' and how there are far more connections than average (both between and within the brain's circuits) in autistic subjects... up to two thirds more in fact. It was also found in the study that those autistic subjects had more intense fear responses and stored those responses for far longer than is usual – which is extremely significant if we are considering potential trauma to these individuals.
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    5. An example of this: it has been assumed that 'Fragile X' syndrome has a very significant role to play in autism. In fact it is commonly described as "the most common known single gene cause of ASD". However not all people with autism have Fragile X, and not all people with Fragile X have autism. This precludes a direct causal link and would instead indicate a common denominator. Fragile X is a debilitating, progressive condition which is known to cause the sufferer considerable, if varying, amounts of emotional and physical distress.
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    6. A number of studies have revealed a clear link between birth traumas of various kinds and the statistical likelihood of developing autism or other developmental delay disorders. Statistics for birth traumas in the general population can be seen here (US). It was also noticed that women medicated with valproic acid, in the 60s, had a much higher risk of giving birth to an autistic child. This article summarizes the most important routes of exposure to environmental neurotoxins, and explains how these toxins are related to the remarkable increase in the prevalence of autism.
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    7. You may say here 'but of course it's not their fault either!', but the reality is they do get soundly punished – because of the way we currently think in our society. In fact we constantly blame and punish people for things over which they have no control. Somehow we adhere to an underlying belief that people get what they deserve – leading e.g. to a culture where we do not believe in helping the poor, weak, or otherwise unfortunate.  'You make your own luck. Just try a bit harder!' I think we do this, usually subconsciously (even though it is illogical) because it justifies the way we live, and blatant unfairnesses inherent in our system, so that we do not have to feel guilty. How about getting rid of the concept of guilt and blame, instead? That way we could live more freely and fairly, and be safe from judgement ourselves.
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    8. There are some disorders which have me wrinkling my brow in puzzlement - for example, ODD (Oppositional Defiance Disorder) and DAD (Demand Avoidance Disorder). I have wondered if I may be afflicted with GAWALMAD*, one of the lesser-known disorders (*Go Away World and Leave Me Alone Disorder).
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    9. Of course I think we should be doing our utmost to avoid traumatizing ANY children (which I believe we are constantly doing in our culture, it's just those children manifest their distress in myriad different ways, not just by showing autistic symptoms). I've seen that there is some wonderful work being done by parents and carers, support workers etc. in doing exactly this – providing infants and children in families with high likelihood of autism (e.g. where more family members are already diagnosed) with ongoing support, therapies, loving and affectionate relationships, unconditionality... then later, sensory and creative activities, contact with animals and nature etc. It has been noticed that these things all greatly reduce the likelihood of developing autism. They are also all well known to be things that provide inner stability and resilience against trauma (note: my book 'Dos and Don'ts', could alternatively be described as a parent's manual on both avoiding and healing from trauma).
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