Why don’t people realise they’re autistic? On concrete thinking, the double empathy problem and other matters.

Before I realised I had high levels of autistic traits I used to read articles about women who didn’t know they had autism and never for one minute considered that the authors might be referring to me.

As my husband said when I finally realised that I might be autistic and aced the AQ-50 test I took to check:

“You can’t possibly be autistic, you have empathy.”

This one has been done to death elsewhere, but just in case you’re hearing it for the first time. No autism =/= sociopathy. Some autistic people have “normal” empathy, some (including me) have alexithymia – so we don’t even know what our own emotions are, how can we know what you’re feeling, please tell us. The part of empathy I struggle with is cognitive empathy, which means I don’t know what to do with myself to make you feel better when you’re upset. I probably have come across very badly and as insensitive to upset people in the past. But I’m getting better at doing what the “world” expects of me as I age because cognitive empathy can be learnt. Remember, autism is a neurodevelopmental condition and some stuff that neurotypicals find easy is hard for me (and vice versa actually).

By the way, psychopaths do not lack cognitive empathy. In fact they tend to be excellent at reading people and have very high cognitive empathy that they are only too happy to use against you. Autism isn’t psychopathy-lite, they’re completely unrelated conditions caused by different “differences” in the brain.

Now, the funny thing is, it’s not just autistic people who have an empathy problem. When autistics interact with neurotypicals, sometimes we’re not treated with empathy (let’s start with bullying shall we…). The science is suggesting ever more strongly that the empathy gap goes both ways and there is in fact a double empathy problem. Imagine every neurotypical child speaks a language (let’s call it Klingon), but every autistic child is fluent in another language (let’s call it English). Because only 1 in every 50 people is autistic, the dominant language around the world is Klingon. In a bid to fit in every autistic child tries to learn Klingon to be accepted, but neurotypicals don’t bother to learn English because everyone speaks Klingon.

“OK where are you going with this, Kate. I thought we were going to talk about why don’t people realise they have autism?” I don’t hear you cry.

Every autistic person with even an ounce of self-awareness has spent their whole lives trying to learn Klingon fluently if only to not be bullied. We grow up believing that we’re defective and broken. The mental health of the average autist is awful – but it’s now being recognised that there are high rates of undiagnosed autism in those who complete their own suicide as well as those who have anorexia and other eating disorders.

We see all these psychologists, and psychiatrists, clinicians and therapists and locum GP after locum GP and not one says, “Have you ever been assessed for autism?”

So we’re left to work it out on our own.

Only media autism doesn’t look anything like real-autism. Like my life.

Besides we’re concrete thinkers.

I’m not Rain Man so I can’t have autism.

I’m not a boy-genius so I can’t have Asperger’s.

And all the definitions of the traits are written by neurotypicals. Very rarely do these traits get put into language that I can relate to and go “yes, I do that too.”

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