Individuals on the spectrum who are going through a season of struggle often describe episodes of dysregulation (not feeling centered in their alertness, attention, or emotions). Join Dr. Regan for this first episode in a 4 part series on dysregulation to learn how to recognize a dysregulated state and why these states are often misinterpreted or mishandled. The Alert Program: Your Best Self The Testing Psychologist podcast: Best of 2021 Zur Institute webinar Feb 2022: ASD Interventions Across the Lifespan Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website Resources for Clinicians Episode Transcript 1 00:00:00,340 -- 00:00:17,760 Welcome to autism in the adult podcast. 2 00:00:17,770 -- 00:00:18,750 I'm your host, 3 00:00:18,760 -- 00:00:20,290 Dr Theresa Regan, 4 00:00:20,300 -- 00:00:22,560 an adult neuropsychologist. 5 00:00:22,640 -- 00:00:28,050 I specialize in brain behavior relationships for those 14 and older. 6 00:00:28,540 -- 00:00:35,050 I'm the parent of an amazing teen on the autism spectrum and a certified autism specialist. 7 00:00:35,740 -- 00:00:38,200 I am deeply grateful to bring validation, 8 00:00:38,200 -- 00:00:42,850 hope and purpose to individuals and their families living on the autism spectrum. 9 00:00:43,540 -- 00:00:45,430 With this mission at its core, 10 00:00:45,440 -- 00:00:52,580 I founded and currently direct the OsF healthcare adult diagnostic autism center in central Illinois. 11 00:00:52,590 -- 00:01:10,560 My books include Understanding Autism in Adults and Aging Adults and Understanding Autistic Behaviors. For more information and to join my online community for free visit www.adultandgeriatricautism.com. 12 00:01:11,440 -- 00:01:13,550 Please join me in helping individuals, 13 00:01:13,560 -- 00:01:18,550 couples and families thrive while living life on the autism spectrum. 14 00:01:20,540 -- 00:01:24,460 Hello and welcome to this episode of Autism in the Adult. 15 00:01:25,240 -- 00:01:29,460 And I'm glad you joined me for this first episode of 2022. 16 00:01:30,240 -- 00:01:35,050 I just want to highlight a few things that have gone on recently. 17 00:01:35,050 -- 00:01:44,680 I was happy to be named in the episode Best Of for 2021 that The Testing Psychologist produces. 18 00:01:44,680 -- 00:01:46,520 This is a podcast by Dr. 19 00:01:46,520 -- 00:01:47,550 Jeremy Sharp 20 00:01:47,940 -- 00:02:02,790 talking about issues related to assessment in psychology, and my episode in august Identifying Adult Autism was the second downloaded episode of the season. 21 00:02:02,800 -- 00:02:03,290 So, 22 00:02:03,290 -- 00:02:14,720 I was so honored to be among many very accomplished people talking about important topics and assessment of Autism in the adult was right up there at # two. 23 00:02:14,720 -- 00:02:14,990 So, 24 00:02:14,990 -- 00:02:16,900 I was happy about that. 25 00:02:16,900 -- 00:02:19,920 I'll put the link below if you or someone you know 26 00:02:19,920 -- 00:02:22,800 would like to learn more about assessment. 27 00:02:23,340 -- 00:02:29,160 This episode of the testing psychologist was produced for clinicians. 28 00:02:29,160 -- 00:02:36,450 So people who are trying to understand how to assess and evaluate autistic characteristics in their clients. 29 00:02:37,040 -- 00:02:44,660 I also have an exciting opportunity for clinicians coming up in February on the 26th of 2022. 30 00:02:45,100 -- 00:02:50,030 This is a two hour live interactive webinar with Zur Institute. 31 00:02:50,040 -- 00:02:50,480 And again, 32 00:02:50,480 -- 00:02:52,330 I'll put the link below. 33 00:02:52,840 -- 00:02:58,210 This is entitled Autism Spectrum Disorder: Interventions Across the Lifespan. 34 00:02:58,640 -- 00:03:05,150 So not everyone on the spectrum will need support or intervention at all seasons of life. 35 00:03:05,540 -- 00:03:26,890 But for those who are clinicians, we have people come to us asking for assistance during a tough period or about a difficult thing that they're grappling with and to understand the neurology of the client is so important to drive the strategies that will be most helpful for them. 36 00:03:27,140 -- 00:03:42,770 So I'll be talking specifically about strategies that are likely to help the autistic client and ... things that we typically do in a counseling sessions, will highlight those that wouldn't be likely to be as helpful. 37 00:03:42,770 -- 00:03:45,730 So that's February 26, 38 00:03:45,730 -- 00:03:46,340 2022. 39 00:03:46,350 -- 00:03:48,850 And I'll go ahead and put that link below. 40 00:03:51,540 -- 00:03:55,260 Today's topic is dysregulation. 41 00:03:55,840 -- 00:04:00,240 I envision this to be the first episode in a four part series. 42 00:04:00,250 -- 00:04:04,160 And so today we're going to talk about what this regulation is and 43 00:04:04,170 -- 00:04:06,060 how to recognize it. 44 00:04:06,840 -- 00:04:09,290 In the next episode of the series, 45 00:04:09,290 -- 00:04:15,880 we're going to talk about how to reduce the amount of dysregulation that someone experiences. 46 00:04:15,890 -- 00:04:20,550 The third episode will be how to recover from dysregulation. 47 00:04:21,040 -- 00:04:27,820 The fourth will be how can you recognize when someone is trying to regulate. 48 00:04:27,830 -- 00:04:31,350 So someone around us maybe trying to regulate, 49 00:04:31,360 -- 00:04:35,650 and we may criticize them or ask them to stop it, 50 00:04:35,660 -- 00:04:37,230 but there would be other, 51 00:04:37,230 -- 00:04:41,050 more impactful ways to get a good outcome. 52 00:04:41,940 -- 00:04:44,020 You'll understand more about what I mean 53 00:04:44,020 -- 00:04:48,750 when we start to talk about this thing called regulation and dysregulation, 54 00:04:50,440 -- 00:05:05,650 Everyone's brain and nervous system are in charge of helping us to stay centered with various things and part of what we stay centered with has to do with alertness. 55 00:05:05,660 -- 00:05:08,070 Can we wake up in the morning? 56 00:05:08,070 -- 00:05:11,690 Can we calm down and fall asleep at night? 57 00:05:11,700 -- 00:05:16,830 That's kind of our ... the tone of our alertness, 58 00:05:16,940 -- 00:05:18,760 our brain helps us with that. 59 00:05:19,440 -- 00:05:23,900 We also have this attention regulation. 60 00:05:23,900 -- 00:05:31,520 So our brain is supposed to help us focus on what's most important and just release and let go 61 00:05:31,520 -- 00:05:38,670 things that are no longer important or uh you know... if the information in our environment has changed. 62 00:05:38,680 -- 00:05:46,990 So we need to switch gears and attend to something else... so our brain helps us regulate alertness and attention. 63 00:05:47,740 -- 00:05:53,190 So when we talk about these two aspects of regulation (alertness and attention), 64 00:05:53,740 -- 00:06:05,050 there is an analogy that is commonly used with the occupational therapists that often try to help people learn how to regulate better. 65 00:06:05,540 -- 00:06:09,560 And that analogy is "how is your motor running today?" 66 00:06:10,340 -- 00:06:14,560 So if your motor is running sluggish, 67 00:06:15,340 -- 00:06:17,420 you are tired, 68 00:06:17,470 -- 00:06:20,370 you may describe yourself as feeling lazy, 69 00:06:20,370 -- 00:06:21,540 unmotivated. 70 00:06:21,540 -- 00:06:22,910 I can't get going, 71 00:06:22,910 -- 00:06:24,250 I feel sleepy. 72 00:06:24,730 -- 00:06:31,750 I'm just a bump on a log ... that is when your motor is running too low. 73 00:06:32,640 -- 00:06:35,620 Your motor can also sometimes run too high. 74 00:06:36,140 -- 00:06:41,260 It's revved up and it's not in that just right state. 75 00:06:41,640 -- 00:06:47,250 And a motor that's too high will be someone who is hyper, restless, 76 00:06:47,640 -- 00:06:48,290 angry, 77 00:06:48,300 -- 00:06:49,240 agitated, 78 00:06:49,250 -- 00:06:50,070 anxious, 79 00:06:50,070 -- 00:06:54,700 that extra alertness that we just don't need all the time. 80 00:06:54,800 -- 00:06:56,970 This high level of alertness. 81 00:06:57,440 -- 00:07:07,360 Um that is the motor that is running too high, and we would like our motor to be running just right. 82 00:07:09,240 -- 00:07:13,370 The Alert Program is one program you might want to investigate. 83 00:07:13,380 -- 00:07:19,830 It's run by occupational therapists who are very experienced in regulation strategies. 84 00:07:19,840 -- 00:07:23,160 And I have a link to the alert program below. 85 00:07:23,640 -- 00:07:23,960 Now, 86 00:07:23,960 -- 00:07:28,870 they train occupational therapists in strategies to help others. 87 00:07:28,870 -- 00:07:41,060 But they also have a new online program called Your Best Self that people can investigate to figure out regulation strategies for themselves. 88 00:07:43,040 -- 00:07:43,540 Now, 89 00:07:43,540 -- 00:07:46,450 we've talked about alertness and attention. 90 00:07:46,840 -- 00:07:51,280 There's also this area of emotional regulation. 91 00:07:51,290 -- 00:07:54,160 So when we have a strong emotion, 92 00:07:54,170 -- 00:07:58,700 our brain should help us make sense of it. 93 00:07:58,710 -- 00:08:06,810 Our brain should help us center it and help it be present in our mind that we're aware of it, 94 00:08:06,810 -- 00:08:08,400 but it's not overwhelming, 95 00:08:08,410 -- 00:08:10,070 it doesn't hijack us, 96 00:08:10,080 -- 00:08:11,770 it doesn't take control of us, 97 00:08:11,780 -- 00:08:13,550 It doesn't hurt other people. 98 00:08:13,560 -- 00:08:20,160 And that would be regulation or dysregulation of emotional experiences. 99 00:08:22,440 -- 00:08:28,060 When we talk about a dysregulated state in the area of emotions, 100 00:08:28,120 -- 00:08:31,560 we can talk about a fight reaction, 101 00:08:32,240 -- 00:08:36,950 flight reactions or freeze reactions. 102 00:08:38,040 -- 00:08:56,000 So a fight reaction in the area of emotions is that this very strong emotional experience ... comes in and the person feels so overwhelmed that there is this externalized expression of distress. 103 00:08:56,640 -- 00:09:01,950 And what I mean by that is I would include meltdowns in this category. 104 00:09:01,960 -- 00:09:04,170 I would include outbursts, 105 00:09:04,180 -- 00:09:05,320 crying spells. 106 00:09:05,320 -- 00:09:08,480 I even include, even though it's not fight, 107 00:09:08,490 -- 00:09:14,960 but I'd like to capture all the externalized reactions in this category. 108 00:09:15,440 -- 00:09:18,050 That I am going to argue with you. 109 00:09:18,050 -- 00:09:19,950 I am going to explode. 110 00:09:19,960 -- 00:09:23,230 And you can picture this volcano, 111 00:09:23,240 -- 00:09:23,820 right? 112 00:09:23,830 -- 00:09:29,480 that is just to the point of being uncontained and out comes 113 00:09:29,480 -- 00:09:41,650 this spewing of tears or yelling or throwing things... so that is the externalized sign of a dysregulated state. 114 00:09:41,920 -- 00:09:43,890 In the area of emotions, 115 00:09:46,040 -- 00:09:52,660 flight is another reaction that someone could have when they are dysregulated. 116 00:09:53,340 -- 00:09:58,650 This could look like ... I'm going to walk away from you and quit this conversation. 117 00:09:59,040 -- 00:10:04,460 I'm going to spend all day in my room doing things I enjoy but not interacting with you. 118 00:10:05,140 -- 00:10:08,760 I'm going to quit school and do home schooling. 119 00:10:08,760 -- 00:10:10,450 I'm going to quit this job. 120 00:10:10,940 -- 00:10:15,560 I'm going to quit this relationship because it's so up and down. 121 00:10:15,560 -- 00:10:17,000 It's like a roller coaster. 122 00:10:17,000 -- 00:10:18,650 It's just too intense for me. 123 00:10:18,650 -- 00:10:20,000 It's too unpredictable. 124 00:10:20,040 -- 00:10:21,620 I have to quit this, 125 00:10:21,630 -- 00:10:23,060 I have to escape, 126 00:10:23,440 -- 00:10:28,630 I have to withdraw. Then there are freeze reactions. 127 00:10:28,630 -- 00:10:32,150 So this is the time when you're physically present, 128 00:10:32,160 -- 00:10:34,980 but you're not psychologically present, 129 00:10:34,990 -- 00:10:36,710 that your brain shuts down, 130 00:10:36,720 -- 00:10:46,300 Someone might say the veil just seemed to go over his eyes and I just knew he was there but not processing what was happening during that time, 131 00:10:46,300 -- 00:10:47,720 someone may say, 132 00:10:47,730 -- 00:10:48,200 you know, 133 00:10:48,200 -- 00:10:49,320 I hear what you're saying, 134 00:10:49,320 -- 00:10:52,460 but my mind is blank and I don't know what to respond. 135 00:10:52,470 -- 00:10:54,140 That's a freeze reaction. 136 00:10:54,150 -- 00:10:59,010 So it signals that the person is dysregulated. 137 00:10:59,010 -- 00:11:04,260 They're having difficulty being fully present in the midst of the strong emotion. 138 00:11:05,940 -- 00:11:28,150 Another part of the freeze reaction can be what we call a somatization response to stress and that just means that the stress is not able to come into the person's emotional awareness and kind of sit there and be recognized and felt. 139 00:11:28,740 -- 00:11:30,300 And so the body says, 140 00:11:30,300 -- 00:11:30,910 hey, 141 00:11:30,910 -- 00:11:35,150 I will help you escape from this really difficult emotion. 142 00:11:35,160 -- 00:11:45,140 I will process the stress for you so that you don't have to feel this deep fear or this deep pain or anguish or anger. 143 00:11:45,150 -- 00:11:52,690 I'll just process that stress right through the physical system in these cases, 144 00:11:52,700 -- 00:11:56,390 the symptom which could be a staring spell. 145 00:11:56,400 -- 00:11:59,740 It could be something that looks like an electrical seizure, 146 00:11:59,740 -- 00:12:01,350 but it's really not. 147 00:12:02,040 -- 00:12:08,600 It could be something like a loss of memory for chunks of time or days or weeks, 148 00:12:09,040 -- 00:12:17,000 it could be a weakness where the person feels like their limbs are weak or paralyzed. 149 00:12:17,010 -- 00:12:19,860 So it could be a variety of things like that. 150 00:12:20,240 -- 00:12:24,340 Physical systems also could include issues of pain, 151 00:12:24,350 -- 00:12:27,600 issues of stomach distress, 152 00:12:27,600 -- 00:12:28,470 headaches, 153 00:12:28,480 -- 00:12:30,550 so lots of different things. 154 00:12:30,550 -- 00:12:35,960 Lots of different physical systems can process stress for us. 155 00:12:36,340 -- 00:12:39,570 And these symptoms, 156 00:12:39,570 -- 00:12:42,760 these physical expressions are real. 157 00:12:43,140 -- 00:12:46,580 They are not produced by the individual, 158 00:12:46,580 -- 00:12:47,850 They're not feigned, 159 00:12:47,860 -- 00:12:50,290 they're not exaggerated, 160 00:12:50,290 -- 00:12:51,760 they're not used to manipulate, 161 00:12:51,760 -- 00:12:56,250 they are really experienced and they are distressing in themselves. 162 00:12:56,840 -- 00:13:04,260 But they do help the individual ... kind of shield the individual from having to process in their awareness 163 00:13:04,260 -- 00:13:05,660 such strong emotion. 164 00:13:07,340 -- 00:13:11,560 And it can also include what we call dissociation. 165 00:13:11,940 -- 00:13:17,410 So I feel like I'm not even in my own body right now, 166 00:13:17,420 -- 00:13:22,620 I don't feel like I even know who I am or what's reality and what's not reality. 167 00:13:22,630 -- 00:13:25,550 I don't remember parts of the day, 168 00:13:25,550 -- 00:13:28,090 I feel disconnected from myself. 169 00:13:28,100 -- 00:13:34,790 So this dissociation can also be this form of a freeze state, 170 00:13:34,800 -- 00:13:36,550 a dysregulated state. 171 00:13:38,040 -- 00:13:39,200 So in summary, 172 00:13:39,200 -- 00:13:48,820 I'm talking about regulation as being that centered state that the brain should help us maintain, 173 00:13:48,840 -- 00:13:58,410 its that state where you're just right with alertness, with attention, and with emotional centeredness, 174 00:13:59,040 -- 00:14:03,080 you're not too low and sluggish and out of it, 175 00:14:03,540 -- 00:14:05,090 you're not too high, 176 00:14:05,090 -- 00:14:06,620 being overwhelmed, 177 00:14:06,620 -- 00:14:08,460 restless or agitated, 178 00:14:09,840 -- 00:14:13,420 You're not in a fight, flight, or freeze mode, 179 00:14:13,840 -- 00:14:17,010 you're psychologically present, 180 00:14:17,020 -- 00:14:23,520 You're physically present and you can maintain some sense of centeredness, 181 00:14:23,520 -- 00:14:25,060 you're not overwhelmed. 182 00:14:26,640 -- 00:14:27,040 Now, 183 00:14:27,050 -- 00:14:33,850 every human who lives life has periods with where they are dysregulated. 184 00:14:33,860 -- 00:14:35,750 It's a very human thing, 185 00:14:35,760 -- 00:14:36,320 right? 186 00:14:36,330 -- 00:14:52,450 We're living in a life day to day that is sometimes very difficult to navigate and we'll have periods of times where we lose it or where we go in our room and shut the door or we just freeze. 187 00:14:52,840 -- 00:14:58,170 And that's just a very human thing. For individuals on the spectrum, 188 00:14:58,180 -- 00:15:06,440 that nervous system pathway through the center and the front of the brain is particularly involved for them 189 00:15:06,440 -- 00:15:10,760 and it also is particularly in charge of regulation. 190 00:15:11,240 -- 00:15:26,240 So everyone on the spectrum will have difficulty in some way with getting to a regulated state and they'll probably have seasons of life where that is much more achievable, 191 00:15:26,250 -- 00:15:29,940 but seasons where... if anything gives them trouble, 192 00:15:29,950 -- 00:15:32,550 it very well may be the issue of regulation. 193 00:15:34,840 -- 00:15:40,860 That is why we talk about regulation on this program for Autism in the Adult. 194 00:15:41,240 -- 00:15:49,970 Because oftentimes when people are seeking assistance or they are in pain or there's something that they're struggling with... 195 00:15:49,980 -- 00:15:50,570 Uh, 196 00:15:50,580 -- 00:15:55,960 it very well may be in the area of getting to a regulated state. 197 00:15:58,230 -- 00:15:58,570 Now, 198 00:15:58,570 -- 00:16:06,930 one thing to understand is that the type of dysregulation that the individual shows can be somewhat specific to them. 199 00:16:06,930 -- 00:16:09,470 We kind of have our, 200 00:16:09,480 -- 00:16:12,950 our general ways of handling things. 201 00:16:12,960 -- 00:16:13,480 Um, 202 00:16:13,480 -- 00:16:20,970 and so one thing I recommend is knowing what you as an individual, or this person that you love, 203 00:16:20,980 -- 00:16:30,950 what they lean toward when they're dysregulated, because one thing we want to do is recognize what dysregulation looks like in this person. 204 00:16:32,840 -- 00:16:34,960 So for example, 205 00:16:35,640 -- 00:16:47,590 the person who is exploding and ranting because their usual parking space at work is being used by someone else, 206 00:16:47,600 -- 00:16:56,300 and the person at the entryway to work gave them a hard time because they don't have their badge on, and on the way to work 207 00:16:56,300 -- 00:16:59,660 they couldn't get the gas that they typically like to get... 208 00:17:00,040 -- 00:17:02,690 So they're feeling very uncentered, 209 00:17:02,690 -- 00:17:08,260 They're feeling off, and for this particular person when they're uncentered, 210 00:17:08,260 -- 00:17:11,270 they tend to get elevated. 211 00:17:12,140 -- 00:17:16,490 Um and tend to externalize that stress. 212 00:17:17,940 -- 00:17:19,860 So for this person, 213 00:17:20,240 -- 00:17:22,830 this outburst that they may have, 214 00:17:22,830 -- 00:17:26,560 maybe they come in and they have an outburst toward their colleague or something. 215 00:17:26,940 -- 00:17:32,220 Well that is often nothing to do with the colleague in particular. 216 00:17:32,220 -- 00:17:33,680 It just may be that, 217 00:17:33,690 -- 00:17:34,060 wow, 218 00:17:34,060 -- 00:17:36,050 this is a sign, 219 00:17:36,060 -- 00:17:37,810 this is a clue. 220 00:17:37,820 -- 00:17:40,860 This person is really off center. 221 00:17:40,870 -- 00:17:45,100 They're struggling to feel in that just right state. 222 00:17:45,110 -- 00:17:46,480 And for this person, 223 00:17:46,480 -- 00:17:48,190 when they struggle to feel that way, 224 00:17:48,190 -- 00:17:51,960 it happens to be that it comes out as irritability. 225 00:17:53,740 -- 00:17:58,560 Another person may lean toward quieter reactions. 226 00:17:59,140 -- 00:18:00,930 So this person, 227 00:18:00,940 -- 00:18:06,120 let's say we have another individual who experiences the very same thing, 228 00:18:06,130 -- 00:18:17,590 but this person comes in quietly, walks to their office and shuts the door, and doesn't open their office door as typical. 229 00:18:17,600 -- 00:18:24,080 Uh maybe they're in there for three hours without opening it, when typically they would go get some coffee, 230 00:18:24,080 -- 00:18:26,460 maybe say good morning to their coworkers. 231 00:18:26,840 -- 00:18:27,760 So wow, 232 00:18:27,760 -- 00:18:30,350 they've really retreated and become quiet. 233 00:18:31,840 -- 00:18:45,350 Now the difference between the fight reaction and the flight reaction is that one is very noticeable and everyone around that first person is like, 234 00:18:45,350 -- 00:18:45,780 wow, 235 00:18:45,780 -- 00:18:50,600 stay away from Joe today because he got up on the wrong side of the bed. 236 00:18:50,600 -- 00:18:51,390 He's really, 237 00:18:51,400 -- 00:18:52,860 he's really irritable. 238 00:18:53,540 -- 00:19:03,940 Um Now they may misunderstand the reason for that and they may not like the fact that he is loud and irritable. 239 00:19:03,950 -- 00:19:05,080 So they may not say, 240 00:19:05,090 -- 00:19:07,490 oh he's really in a dysregulated state, 241 00:19:07,490 -- 00:19:08,450 that poor guy. 242 00:19:08,940 -- 00:19:11,940 Um but they do notice it. 243 00:19:11,950 -- 00:19:16,310 They notice he's off center. On the other hand, 244 00:19:16,310 -- 00:19:21,500 for the person who reacts with flight to being dysregulated, 245 00:19:21,510 -- 00:19:23,580 they are often missed, 246 00:19:23,590 -- 00:19:24,250 right? 247 00:19:24,250 -- 00:19:32,550 So they may spend all morning in their office and either nobody will notice or they might misinterpret it and say, 248 00:19:33,420 -- 00:19:33,910 you know, 249 00:19:33,910 -- 00:19:35,350 she's kind of stuck up. 250 00:19:35,360 -- 00:19:37,130 She's just in her own little world. 251 00:19:37,130 -- 00:19:47,160 She doesn't socialize ... when really both the first person and the second person are in a state of dysregulation, 252 00:19:47,160 -- 00:19:49,160 which means that they are struggling. 253 00:19:50,240 -- 00:19:51,460 They're not doing well, 254 00:19:52,840 -- 00:19:58,660 But the quieter one may not be noticed and the louder one may be misunderstood. 255 00:20:02,140 -- 00:20:14,430 Now we also have freeze, of course, and let's say that there's a third individual and they have the exact same thing happen and yet they're walking into work... 256 00:20:14,450 -- 00:20:19,560 and someone asked them a question about a recent project. 257 00:20:19,940 -- 00:20:21,890 They can't think of the details. 258 00:20:21,890 -- 00:20:25,960 They're really feeling shut down and kind of out of their own system. 259 00:20:26,340 -- 00:20:36,770 And they're also realizing that they ... their stomach doesn't feel that well and they are starting to get some chronic pain in their muscles that they're feeling. 260 00:20:37,140 -- 00:20:41,060 Uh they just really don't physically feel well. 261 00:20:41,940 -- 00:20:49,760 Um Now this may be their state of dysregulation... that I'm feeling disconnected. 262 00:20:50,140 -- 00:20:56,160 It's hard to think through things and they may even say it's probably because of my headache. 263 00:20:56,170 -- 00:21:01,860 I can't think clearly because of my headache or my stomach ache and then they may go home for the day. 264 00:21:03,140 -- 00:21:03,760 Again, 265 00:21:03,760 -- 00:21:07,990 this is actually... in this scenario I'm describing... 266 00:21:07,990 -- 00:21:10,890 this is the same thing. 267 00:21:10,890 -- 00:21:12,500 It's dysregulation. 268 00:21:12,760 -- 00:21:24,860 It looks different, but it's the state of having things happen in your day that threw you off center and you're really struggling to know how to get back to center. 269 00:21:25,740 -- 00:21:31,050 And so all three of these people may look very different, 270 00:21:31,320 -- 00:21:33,860 but they're all struggling with dysregulation. 271 00:21:34,210 -- 00:21:43,050 Now one of the interesting things can be... if these people were sent to get help for their dysregulation. 272 00:21:43,740 -- 00:21:57,450 The first one might be sent to anger management training and perhaps he'd be diagnosed with something like bipolar because he has these swings of mood and regulation... 273 00:21:58,140 -- 00:22:13,490 Perhaps the second person goes for help and they coach her on social skills with colleagues and they tell her that as part of her job 274 00:22:13,490 -- 00:22:15,770 she really needs to speak up more, 275 00:22:15,840 -- 00:22:16,750 be a leader, 276 00:22:16,750 -- 00:22:20,340 be more engaged in the social milieu of the office. 277 00:22:20,540 -- 00:22:24,760 And so she's being coached on getting out there and maybe she, 278 00:22:24,770 -- 00:22:26,370 she gets a diagnosis, 279 00:22:26,370 -- 00:22:27,860 if she goes to a clinician, 280 00:22:27,870 -- 00:22:30,280 maybe she gets a diagnosis of anxiety, 281 00:22:30,280 -- 00:22:32,860 generalized anxiety or social anxiety. 282 00:22:34,340 -- 00:22:45,200 The third person goes to get help because they often leave work feeling cloudy in there thinking they have some staring spells, 283 00:22:45,200 -- 00:22:46,320 they feel disconnected, 284 00:22:46,320 -- 00:22:47,770 they feel physically ill. 285 00:22:48,440 -- 00:22:52,860 So they go to the doctor and they get diagnosed with chronic headaches, 286 00:22:52,860 -- 00:22:54,470 maybe fibromyalgia, 287 00:22:54,480 -- 00:23:10,470 maybe um some um digestive sensitivities... and I'm definitely not here to say that nobody has those diagnoses and physical issues and this person may as well... 288 00:23:10,480 -- 00:23:15,270 What I'm saying though is that for this hypothetical individual, 289 00:23:15,280 -- 00:23:16,950 it's just not that simple. 290 00:23:16,960 -- 00:23:32,940 We don't want to miss the internal struggle of it because... if we understood that those physical symptoms in that state of fogginess were at least worsened by some of this dysregulated state, 291 00:23:32,950 -- 00:23:33,240 you know, 292 00:23:33,240 -- 00:23:34,170 that trigger, 293 00:23:34,540 -- 00:23:45,460 we could help much more efficiently without adding medications that may make things worse or extra doctor's appointments or extra stress. 294 00:23:45,940 -- 00:23:46,780 Um, 295 00:23:46,790 -- 00:23:47,600 we could say, 296 00:23:47,600 -- 00:23:47,900 hey, 297 00:23:47,900 -- 00:23:48,590 you know what, 298 00:23:48,590 -- 00:23:51,370 when you are are off center, 299 00:23:51,370 -- 00:23:53,970 when you are stressed and things have gone wrong. 300 00:23:53,980 -- 00:23:58,510 I feel like your system responds in this way, 301 00:23:58,520 -- 00:24:05,590 you know that your stress is expressed through your system and that you feel disconnected. 302 00:24:05,590 -- 00:24:13,860 I'm wondering if we could hypothesize about that and see if there's a more efficient way to get you to feel more centered. 303 00:24:14,840 -- 00:24:18,100 And I bring this up for a couple of reasons. 304 00:24:18,220 -- 00:24:22,160 One is ... dysregulation is common on the spectrum. 305 00:24:23,640 -- 00:24:24,860 Two is, 306 00:24:25,440 -- 00:24:31,870 it can be misunderstood and depending on the type of dysregulation, 307 00:24:31,880 -- 00:24:39,660 it can add diagnoses to a person's list that aren't the most helpful diagnosis. 308 00:24:40,540 -- 00:24:41,090 Um, 309 00:24:41,100 -- 00:24:43,360 often autism isn't on there. 310 00:24:43,940 -- 00:24:44,510 Um, 311 00:24:44,520 -- 00:24:52,080 but there may be this gathering of diagnoses that fit the symptoms in the moment. 312 00:24:52,080 -- 00:24:54,040 Like they fit some characteristic in the moment, 313 00:24:54,040 -- 00:24:58,060 but they missed the big picture of why this person is dysregulated. 314 00:24:58,840 -- 00:24:59,200 You know, 315 00:24:59,200 -- 00:25:03,070 they're dysregulated because the rhythm of their day, 316 00:25:03,070 -- 00:25:18,260 the structure of their day that they depend on as an autistic individual... that that was disrupted and that triggered this dysregulated state and in them it happens to look like fight or flight or freeze. 317 00:25:19,240 -- 00:25:25,660 And so the topic of this podcast then is to introduce you to this concept of regulation. 318 00:25:27,840 -- 00:25:33,620 And when you see yourself or someone you love in a dysregulated state. 319 00:25:33,630 -- 00:25:38,030 And instead of telling them to get it together, 320 00:25:38,040 -- 00:25:39,290 calm down, 321 00:25:39,290 -- 00:25:40,380 get out there, 322 00:25:40,380 -- 00:25:41,360 get over it. 323 00:25:41,740 -- 00:25:42,370 Um, 324 00:25:42,700 -- 00:25:45,060 you can say to yourself, 325 00:25:45,440 -- 00:25:46,110 wow, 326 00:25:46,110 -- 00:25:48,230 this is dysregulation. 327 00:25:48,630 -- 00:25:49,890 I know what this is. 328 00:25:51,040 -- 00:25:52,580 For example, 329 00:25:53,140 -- 00:26:02,730 if my son, who's on the autism spectrum, comes home from school and drops his book bag on the floor and walks past me without saying hello, 330 00:26:02,810 -- 00:26:07,060 lays on the couch and puts a cover over his whole body... over his head. 331 00:26:08,040 -- 00:26:09,220 I could say, 332 00:26:09,230 -- 00:26:10,050 Hey, 333 00:26:10,540 -- 00:26:12,010 you didn't say hi to me. 334 00:26:12,020 -- 00:26:13,630 You threw your stuff on the ground, 335 00:26:13,630 -- 00:26:14,140 which you know, 336 00:26:14,140 -- 00:26:15,300 it doesn't go there! 337 00:26:15,420 -- 00:26:16,740 Come out here and make this 338 00:26:16,740 -- 00:26:17,070 right. 339 00:26:17,080 -- 00:26:18,610 This isn't a hotel for you. 340 00:26:18,610 -- 00:26:20,350 I'm not your maid. 341 00:26:21,340 -- 00:26:24,230 But, if I really wanted to get the best outcome, 342 00:26:24,240 -- 00:26:25,320 I would say, 343 00:26:25,330 -- 00:26:26,110 oh, 344 00:26:26,120 -- 00:26:27,300 I know what this is. 345 00:26:27,300 -- 00:26:29,740 This is a clue to me. 346 00:26:29,750 -- 00:26:30,650 This is data. 347 00:26:30,650 -- 00:26:31,860 This is information. 348 00:26:32,240 -- 00:26:50,200 This is telling me he is dysregulated ... so it's not going to help things for me to punish him for being dysregulated, and it's not going to help me to tell him to get better regulated because he already doesn't know how to do that. 349 00:26:50,200 -- 00:26:51,460 He's already overwhelmed. 350 00:26:52,240 -- 00:26:55,020 What would really help is if I said, 351 00:26:55,640 -- 00:26:56,080 wow, 352 00:26:56,080 -- 00:26:58,500 this is a flight reaction, 353 00:26:58,500 -- 00:26:58,750 right? 354 00:26:58,750 -- 00:26:59,690 He's hiding. 355 00:26:59,700 -- 00:27:00,950 He's withdrawing. 356 00:27:01,340 -- 00:27:02,760 He must have had a bad day. 357 00:27:02,760 -- 00:27:04,590 So then I can go in and say, 358 00:27:04,590 -- 00:27:05,060 hey, 359 00:27:05,540 -- 00:27:07,270 it looks like you had a rough day. 360 00:27:08,040 -- 00:27:16,290 I'm going to give you five minutes, and I'll be back and we can figure out what you need to get more centered. 361 00:27:17,540 -- 00:27:18,800 So number one, 362 00:27:18,810 -- 00:27:20,330 I'm recognizing it, 363 00:27:20,340 -- 00:27:21,460 which is important. 364 00:27:22,240 -- 00:27:22,590 You know, 365 00:27:22,590 -- 00:27:23,850 this isn't bad behavior. 366 00:27:23,850 -- 00:27:25,270 This is dysregulation. 367 00:27:25,840 -- 00:27:33,170 This is someone who is overwhelmed and uncentered and it's expressed as flight in this particular person. 368 00:27:34,640 -- 00:27:43,610 I'm also explaining to him what I see because ... you know when we're overwhelmed, we often don't know what we're feeling, 369 00:27:43,620 -- 00:27:45,510 we're just surviving, 370 00:27:45,510 -- 00:27:46,060 right? 371 00:27:46,540 -- 00:27:48,360 So I'm saying to him, 372 00:27:48,940 -- 00:27:49,550 wow, 373 00:27:49,560 -- 00:27:56,460 it looks like you've had a hard day and you probably need something to get centered. 374 00:27:57,740 -- 00:28:05,150 And then we're also introducing this topic that there are strategies that you could use to help yourself get centered. 375 00:28:05,150 -- 00:28:11,570 Let's figure out what those are and let me partner with you to get centered to get regulated. 376 00:28:12,040 -- 00:28:19,450 So in the future in this series we're going to talk about not only how to recognize it ... which we did today. 377 00:28:20,340 -- 00:28:29,400 We're going to talk about how to prevent episodes of dysregulation or you know lessen them as humans. 378 00:28:29,400 -- 00:28:34,550 We're going to have them but... not to have them so frequent that someone's not functioning well. 379 00:28:35,240 -- 00:28:46,160 How to recover from a dysregulated state, and how to recognize when someone around you is trying to regulate. 380 00:28:46,740 -- 00:28:48,400 Um for example, 381 00:28:48,400 -- 00:28:50,270 my son under the cover, 382 00:28:51,140 -- 00:28:54,300 his being under the cover is him trying to regulate. 383 00:28:55,040 -- 00:28:57,210 So I don't want to punish him for that. 384 00:28:57,220 -- 00:28:59,250 I don't want to chastise him for that. 385 00:28:59,260 -- 00:29:20,330 I want to recognize what that is and then help him have different strategies ...more effective strategies to regulate and to let him know that I come alongside him to do that with him because I also really commit that his well being is important and I'm on his side. 386 00:29:20,490 -- 00:29:21,060 You know, 387 00:29:21,070 -- 00:29:24,360 I want him to feel just right. 388 00:29:26,540 -- 00:29:39,670 I'm glad you joined me for this first episode of 2022 as we dive into this concept of regulation and dysregulation and the role that the nervous system has in helping us be centered. 389 00:29:40,140 -- 00:29:43,900 And I hope you'll check out the links below. 390 00:29:43,900 -- 00:29:46,180 I have the alert program link, 391 00:29:46,190 -- 00:29:52,250 I have the link to the Best Episode of the Testing Psychologist podcast in 2021. 392 00:29:52,260 -- 00:30:04,460 I'm happy, happy to be the number two episode... and I have a link to my upcoming webinar for clinicians about interventions for the autistic client, 393 00:30:04,840 -- 00:30:05,390 um, 394 00:30:05,400 -- 00:30:07,100 across the lifespan. 395 00:30:07,120 -- 00:30:12,460 So I will see you for next episode on how to prevent dysregulation.

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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