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Cake day: June 16th, 2023

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  • Thanks for the additional detail here! I knew I was making a broad generalization with “ground up” and don’t mean to imply that if you start with details (ground) you never make it to the big picture. As you said, more data and examples are necessary and while the overarching structure can eventually be seen, autistics are less like to wave away outliers as quickly as neurotypicals.

    Still, I think it’s been well documented that in general autistics much more likely to utilize inductive reasoning whereas neurotypicals rely more on deductive reasoning. Both and strengths and downsides and work best in combination.

    It’s almost as if we need each other and should cherish the differences that make us better together! In my experience, that means NTs need to adjust more to autistics because autistic people are constantly adjusting to a society that overvalues NTs.


  • It’s no so much stacking that’s a notable symptom, it’s collecting, arranging, sorting and displaying, often without playing with the toys as intended. Instead the focus is more on neatly sorting by color / shape / size etc. and sometimes preferring to keep them in that configuration over playing with them.

    This is similar to the tendency for some autistics to focus on the part of a toy, like spinning the wheels on a toy truck, instead of playing with the truck doing truck things.

    While these are commonly associated with autism, these two examples are neither necessary or sufficient symptoms to diagnose autism. Meaning that you can see this symptom in an allistic (not autistic) person and it does not mean they have autism and you can have autism and not have these symptoms.

    One thing common to many autistic people is ground up processing. Their minds do incredibly well with details (the spinning truck wheel, the defining characteristics of the toys they sort) but sometimes don’t see “the big picture” as easily. It can be an incredible strength in many ways, especially when embraced and harnessed instead of shamed and “corrected.”


  • If a professional is required by law to make these reports, and makes you aware of these duties at the start of your care, then there is no valid ethics complaint and no violation of trust. The therapist must tell you in their informed consent about these limits to confidentiality and should have done so before any personal information was disclosed to them.

    While there is a potential of some harm due to this disclosure, therapists are not in a position to investigate and determine if abuse / credible threats of violence occurred and are explicitly not supposed to do so. They are supposed to make a report and allow other state agencies to investigate. If OPs family ended up hurting someone and the therapist was drawn into legal proceedings, they could equally be sued for having this information and not following their duty to warn.

    OP, these issues do belong in therapy and you should be able to get support for them.



  • Please get a better assessment and differential before you make any conclusions about yourself. The HARE is very old. The PCL-R is more recent and draws from some of the original HARE development. Even so, that instrument alone is not enough to make a diagnosis like that and you’d need convergent validity from other measures and at least a clinical interview. Again, true psychopathy is exceedingly rare and because of it’s nature, less studied than other conditions.

    There are also many things that can look like psychopathy and aren’t including trauma, severe attachment issues and narcissistic personality disorder.



  • Don’t forget to include base rates in your calculations. Autism estimates can be as high as ~1 in 20 or 30 (for AMAB) depending on how you measure it and Psycopathy is far lower even accounting for measurement challenges. Also, the HARE, even the updated one, is more than 40 years old. I would be very suspicious of people using that measure clinically.

    Anecdotally, autistic people can be prone to overly concrete / dichotomous answers on some measures, which leads some to endorse actions or thoughts they have had, but occur extremely rarely, when the measure is asking about a prominent and repeated symptom.

    It is possible to be both, but there are many things that distinguish the conditions. Also, if a person is autistic and has not had that understand or proper accommodations, then “antisocial” habits that develop out of self-protection may be misconstrued as pathological personality traits.

    This is a deep and nuanced conversation and it would be worth deconstructing your answers on the HARE with a therapist or someone who knows you well to see if your perceptions of your symptoms match with other’s perceptions.


  • I work in the field and am constantly shocked at the number of otherwise skilled practitioners that have a huge blind spots for autism, especially mild or low support need individuals.

    The thing about masking is that it can also hide “impairment” so a good diagnostician should ask about the ways you might mask and the physical and emotional costs of the masking. Sure you can socialize with the best of them, but are you a hollowed out shell at the end of the day? Does the masking leave you with zero resources for your hobbies, less capacity to deal with stress, and burnout? High maskers tend to have higher burnout because they are working hard to function in a world that expects them to appear counter to their nature. All too often someone can appear to function typically but a few times a month or a year they have epic drops in functioning and can’t get out of bed or leave their dark room. They’re diagnosed with depression, which admittedly can be exacerbated by burnout. However, treating burnout with depression coping skills might miss the mark. Anyway, this is a huge frustration for me professionally and I’m sorry you are dealing with it.



  • We actually don’t have the same emotional expressions. The early studies on “universal” emotional expressions (joy, disgust etc) were extremely biased. The researches paid western actors to make facial expressions, took pictures of those expressions, then showed those pictures to various uncontacted / low contact tribes. However, the researches tended to ask the tribes what expression they saw repeatedly until they gave the answer the researches expected.

    Even smiling isn’t universal. Think about cultural differences between smiling even in modern day Russia. There’s evidence that smiling might have been an expression of joy but was deemed socially inappropriate in Ancient Rome.

    Emotional expressions in the brain differ between individuals and even differ within the same individual on separate occasions of the “same” emotion. Lisa Barrett has an excellent book on this topic: How Emotions are Made.


  • OCD doesn’t have to have rituals necessarily but that’s what most people think of as a hallmark of OCD. A differential dx like this is important, but hard to do without a professional who can help you not just list your symptoms, but assess the qualitative nature of them.

    Regardless, it does sound like this impacts your functioning and happiness, I’m glad you’re reaching out and getting some support.


  • I agree that sensory sensitivities are also more common in ASD, but ADHD, especially in more severe cases, can also have sensory sensitivities as can OCD and other conditions.

    OP I think there’s enough here to justify an evaluation by a psychologist if you can afford it / it’s available where you are. If not, reading about ADHD and applying some of those strategies will not hurt you. I’d recommend ADHD 2.0 as a starting point.

    ADHD and anxiety are also comorbid, and some of your symptoms may be more about anxiety and might respond well to anxiety related interventions. ACT (acceptance and commitment therapy) has several good workbooks about anxiety which could be helpful.



  • It’s frustrating that an assessment is so expensive. And the psychologist will probably only get reimbursed for 4hrs of testing so your report will be short and cursory anyway… I’ll avoid going on a long angry insurance rant here.

    Do you have any Universities near you? See if they have graduate psychology programs. Those students need people to practice giving assessments to and are supervised well. They usually give assessments for very cheap because it’s a training program.


  • PsychoNot@lemmy.worldtoADHD@lemmy.worldBurnt Out
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    3 years ago

    I can’t sit down and read anymore either, but I found that audiobooks work well. I can take a walk, do the dishes, clean, laundry, commute, etc. while also being more entertained. I also listen to books with a sleep timer when I go to bed. That lets me distract my mind while I fall asleep and has been a huge help for falling asleep faster.

    If you manage to find a way to make reading tolerable, start with ADHD 2.0. It’s worth it.


  • PsychoNot@lemmy.worldtoADHD@lemmy.worldBurnt Out
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    3 years ago

    Hey, You’re in a tough spot and I know how hard it can be. I’m sure people have recommended everything under the sun to you and sometimes doing the work to accommodate ADHD feels like more work than just suffering the consequences. Especially as an adult. I love the Spoon Theory and I’m glad you have that as an analogy. I’m going to recommend a few things here, assuming that you don’t have a lot of clinical knowledge about ADHD.

    Sleep and exercise are a must. Exercise can (temporarily) improve processing speed which is relatively low in many people with ADHD. You don’t have to be a mega athlete, but a routine of exercise that gets your heart rate up each day can and usually does help. Outside of stimulant medications, exercise and sleep are the two biggest things you can do for ADHD. Read / Audiobook

    Why We Sleep by Matthew Walker

    The meds you listed do not help with ADHD directly, but maybe some of the downstream emotional effects. Ask directly about stimulants, they can be a game changer for some, but you will need to be careful with sleep and appetite.

    The recommendation to avoid food dyes and additives was huge in the 80s, recent research suggests only 1/3 of people with ADHD benefit from disarray changes. Read / Audiobook: Getting Ahead of ADHD: What Next Generation Science…” by Joel Nigg ^ Can be a bit dull but clearly explains research and evidence as well as examining what treatments are supported by science and to what extent. Use more as a reference than cover to cover.

    For the love of all that is distracted, learn about ADHD for real from good sources! I’d start with ADHD 2.0, an update from Hallowell and Ratey, two psychiatrists who have ADHD and are big names in ADHD research. Some interesting suggestions about cerebellum involvement in ADHD and movement / balance therapies still under study.

    As a personal tip, try not to get angry or down on yourself with the ADHD instances as much as possible. Forget your wallet in the house? You have to go back anyway, you can go back chuckling at yourself or furious, but you still have to go back. I’f you are angry or otherwise activated then you’re taking up mental resources, making it more likely that you’ll grab your wallet, but leave your sunglasses on the table.

    Also look up Rejection Sensitive Dysphoria. Essentially a culmination of micro frustrations by peers and authority figures over the course of your childhood results in something like 20000 instances before age 12. That can lead to social sensitivity, overreacting to social stress, and a sense that people might be about to leave you / social self-doubt.

    Also, if you have access and the money for it, go to a qualified psychologist and get a good psychological evaluation. Knowing your cognitive profile (relative strengths and weaknesses in cognitive functioning) as well as your memory abilities (visual often weaker in ADHD) can really help you assess how difficult various tasks will be for you and you can cope accordingly.

    I hope this helps.