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I can't carry on any kind of conversation about things other than interests without some kind of script to follow. I can shop, work, see the therapist/psychiatrist, talk about knitting, jewelry, the Middle Ages in England, stuff like that just fine. But having to improvise, especially small talk or getting acquainted with people--forget it.
For me, my interest in psychology has helped me with that. Sometimes when I'm talking to people I'll slip into the role of a psychologist, trying to figure out what makes them tick. Since most people love to talk about themselves, I'll ask them questions about themselves and they'll happily talk on and on without much effort on my part. And because I'm psychoanalyzing them, I don't get bored listening to them!