Asperger's versus the fallout of child abuse

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My psychiatrist can't diagnose me because I'm too complicated of a case. (And AS is not her specialty.) I'm unsure as to whether it's AS or not. I feel so much in common with people on this website. I was at Autreat and felt completely at home among the people there.

But my AS symptoms could also be explained by the amount of physical and sexual abuse in my childhood.

Symptoms that I'm sure are from the abuse: I am afraid of sex. I thought I might be asexual but no, I get sexual feelings I'm just terrified of the deed.

Symptoms that sound like AS but could be abuse:
-Sensory issues - dislike of touch and loud sounds. (could be AS, could be PTSD)
-Poor eye contact (could be AS, could be self esteem related - eyes hurt me, it feels like they can see into my soul. I hate it when people look at/watch me. I'm scared they'll see how broken I really am.)
-Difficulties relating to people (could be AS, could be that I was singled out for abuse as a child and learned that I was unworthy and different from other people, and internalized that and never learned how to be social)
-Musical Theatre (is all encompassing for me. Could be an AS special interest, or could be a world I threw myself into because my real world sucked so much. I wonder this because I don't meet the criteria that says I don't try and share my interests because I'll share what I know about musical theatre with anyone, any chance I get.)

Symptoms that sound like AS that I have no other explanation for:
-When I was very young (I can't remember how young I was when the abuse started but I think it was a bit later, when my mom got overloaded with more kids) I didn't interact with the other children. They would come up to me wanting to play and I would ignore them.

Other complications:
- I was a gifted child who read voraciously. When people came to visit I'd hide in the other room with a book.
- I rock and flap only when I'm alone, but non-autistics stim too.
- I walked late and walked on my toes enough to damage my achilles tendons but I was born three months premature and that could have caused motor skills delay.
- I am a very quiet and reserved person when you first meet me, and have trouble making eye contact and carrying on a conversation, but as I get used to you I get a bit better at it.

So it could be Asperger's, but it could also be a combination of being a smart/gifted kid, abuse, premature birth and I've also been diagnosed with bipolar disorder. However this ends, I still feel a kinship with the people on this site as it was the first place people seemed to be speaking my language.

Does anyone have any thoughts? Is anyone else a complicated case?

Yeah, I have experienced something very similar. I've been to so many shrinks I've lost count. All but one said there's something off about me but no one can quite come up with a DX. Sucks a lot. I try not to get angry & bitter, but it's really hard not to....the knowing that I am different, but can't get anyone to tell me why. All I know is that of all the different afflictions a person can have AS sure fits me like a glove.

Hmm... I'd recommend undergoing a test such as the ADOS (module 4). It picks up on ASDs pretty darn well.

it's possible to have both AS and PTSD.

try consulting a neurologist who is able to do a differential diagnosis or who has experience with both. sounds like it is too complicated for your psych, but that doesn't mean you can't get help.

I think that what matters is how the diagnosis will feed into helping you. If treatments for PTSD, depression etc have not been helpful, then treatments that take account of ASD might be much more effective. For instance, aiming for a certain level of emotional affect following CBT or antidepressant therapy, or aiming for a certain level of calm after anti-anxiety medication, is unreasonable because it is normal to lack affect and normal to be anxious with ASD. So that means that rather than trying to restore function, therapy aims to maximise engagement with activities, like how to cope with daily living like shopping.

I was treated for some other things (depression, anxiety, PTSD, psychosis) before I had a diagnosis of Asperger's and, things are much better.

i am trying to work out the same thing. i haven't been through anything like you've suffered but i was exposed to emotional deprivation / emotional abuse. i'm seeing a therapist to try and work on my very low self esteem because of it.
i seem to have autistic traits but they can't tell what's wrong with me.

Antidepressants have worked for me (Actually I had to try several before one worked), and therapy has improved some things. Social problems continue, but I have access to an occupational therapist and I'm going to see if working with her can improve the social issues.

Therapy mostly helped me not be so self-destructive. I value myself more now.

Once school resumes if I'm having a hard time and therapy isn't helping, I'll look into a specialist. If therapy helps enough, there might be no need to get diagnosed.

Except for some small differences, I could have written the OP. I am definitely a complicated case, which is most likely the reason I was never diagnosed even though I had regular contact with psychologists and psychiatrists growing up.

[Is your username a quote from Jean Luc Picard? ]

My parents never took me to doctors, medical or head shrinky ever. My first experience with a psychiatrist was when I was 23 and got diagnosed bipolar.

That right there is more than likely the core reason why your psychiatrist can't do it, and probably shouldn't anyway. Ask your psychiatrist to put you in touch with a specialist. Not an easy chore now that you're an adult.

Yes, it is.

The only reason I had regular contact with psychs is because I was put into foster care due to the abuse.

The first time, I was 5 years old. I haven't seen or had contact with my abusive father since then, but my mom regained custody of us under the condition that we saw a psychologist. (my siblings and me) The second time was when I was 9 and it was because of the man she married less than a year before. She did not regain custody of me after that, so I was in foster care until I was 18.

I was diagnosed rather early with ADD and Bipolar. I wasn't told about either diagnosis until I was about 17, though. I underwent behavioral modification that included teaching me 'it was okay to look people in the eye'. I just learned to fake it by looking at the hair, nose, mouth... you get the idea.

All in all, no anti-depressant I've been on ever worked. Nor did the behavioral modification for my diagnosed PTSD.

I found some of the treatment that I have had to be like an assault, like a repetition of the events that it was supposed to help with. My current psychologist is certain that some therapies to deal with abuse simply will not work with people with AS. I think he means the kind were the therapist attempts to provoke strong emotional reactions, or get you to re-experience abuse, in order to discuss and deal with those emotions. Personally, I found CBT very unpleasant because I hate being criticized and I hate being told that I am wrong, so being told I have "distorted thinking patterns" etc was not helpful to me.

If you have Asperger's, then interpretations of things like misplaced trust (trusting the abuser, again and again) and failing to show appropriate emotional responses during therapy, and lack of emotional affect all make very different sense. Also, you may find that your anxieties are not provoked by the things that you expect (things that recall abuse, for instance) but by things like disorder and sensory overload (for instance unexpected visitors, or malls with bright lights and music).

One thing that felt like assault to me was when the therapist got straight in my face and told me she wouldn't move until I looked her in the eye. She just kept talking about me pulling away and looking down as if it meant I felt 'less than' and I didn't know how to tell her that wasn't it.

And yes, my anxiety stems more from overloads then anything I'm expecting because of abuse, though I seem to have both problems.

I can relate to this. I was abused as a child, and I've discovered that complex post-traumatic stress disorder has a lot in common with Aspergers. It's taken me many years to untangle the parts of me that were PTSD and the parts of me that are Aspergers. For me, the untangling involved the following realisations:

1. Other people who were abused (including family members whose experiences were very similar to mine) seemed a lot more on the ball socially than me - although we had abuse in common, there was something different about me.
2. I'd worked through the abuse in great detail over the years, had come to terms with it, no longer had nightmares, was pretty happy, and yet there were still social oddities that seemed unrelated to trauma or negative feelings
3. There are a lot of Asperger traits that are very specific and not symptoms of abuse - and I had many of these traits too
4. I spoke to a psychotherapist about it and she asked me various questions and said that I'd clearly worked through the abuse and the particular difficulties I had were specific to Aspergers and not a result of the abuse.

i read the first post and skimmed the rest of this thread, and it looks like some of you could use a little bit of inside info.
im a college student with a similar situation, and although I have recently quit (four weeks and going strong) only because i was heavily abusing it (i have a highly addictive personality and felt too much in a haze after 5 times daily use after 2yrs) i would suggest recreational use of marijuana. smoking helped relax me, it is enjoyable, social woes at first are heightened because of paranoia your first couple of times, but after like the third time ever, you get over it. You don't worry about the people around you because they are high as s**t too, its a good bonding activity if your looking to make friends. Stoners love to hear your perspective on things, and with a heightened intelligence level, the things you think of when your high (and say because you don't give a f**k because your high) are amazing and people learn you for who you are and what and how you think and can see your abilities and your differences and intelligence.

I would respectfully disagree with your conclusion that pot helps deal with Aperger's in a significant way. In the specific situations you mention, yes, it can be helpful. However, you can't stay stoned all the time (trust me, I've tried!), and when you come down you are less capable of appropriate social interaction than you were before you started, because you are out of practice at doing so straight. Also, not everybody is a stoner, so you alienate yourself from more people than you attract, especially as an adult. Potheads may be cool in high school, but they are NOT cool in adult society.

I don't think there's anything wrong with getting high - I enjoy a good hogleg myself! I just think it's a mistake to think that it - even temporarily - "covers" or corrects the social deficits that accompany AS/Autism. You're still not behaving "correctly," you just don't care.