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Recently I encountered a problem while collaborating with a group therapist with whom I share a patient.My patient has progressed quickly in therapy, as do many adults on the spectrum. It took a few sessions to realize this fine gentleman suffered mightly with the symtoms of Asperger Syndrome, which he kept well managed and thoroughly hidden.No one realized - in fact he often went without realizing - that his baseline anxiety approached panic on a regular basis.As soon as he was out of bed, existential angst was his constant companion.After even minor social interactions he routinely found himself exhausted, and would retreat to soothing, isolated activity: sculpture, writing, woodworking. In fact, the only person to suspect he was on the spectrum was his wife, who puzzled endlessly about this curious man. Yet he ignores my birthday and hangs up before saying goodbye.He's so charming with others, yet so silent at home.His difficulty managing his thoughts made rudimentary conversations minefields to be navigated.
Partners of people on the spectrum are drawn to what they can sense is inside their partner.
Yet they feel shut out, left pining for connection with this special person who remains unreachable.
However he did not start off as stereotypically autistic. Contrary to the stereotyoes of adults on the spectrum, my patient displayed no "meltdown" behavior, was keenly (TOO keenly) aware of people's reactions to him and exhibited no bizarre special interests or encyclopedic knowledge of vaccuum models.
In fact, initially he presented as many of my patients do: shy, articulate, witty. In fact, "Joe", as we'll call him, socialized quite well.
He seemed quietly confident and wry, intelligent and perceptive.
People responded well to him, really liked him, though probably none of them would describe him as a close friend.