Q and A episode 2: Your Questions Answered

Join Dr. Regan for the second Q and A episode in which she answers listener questions related to CBT therapy, parenting, autism in the workplace, non epileptic seizures, and exercise goals

Topics covered in this episode --

askjan.org Workplace Accommodations

Time Timers. Link to physical timer here or you can search app stores for Time Timers

Regan blog post on non-epileptic seizures

Virtual Fitness Challenges

Dysregulation podcast series, episode 1

Momentum for Activities podcast series, episode 1

Dr. Regan's Resources

New Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life

New Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics

Book: Understanding Autism in Adults and Aging Adults, 2nd ed

Audiobook

Book: Understanding Autistic Behaviors

Autism in the Adult website homepage

Website Resources for Clinicians

Read the episode transcript here:

2 00:00:02,540 --> 00:00:05,950 Hello and welcome. 3 00:00:05,960 --> 00:00:08,180 This is Dr Theresa Regan. 4 00:00:08,190 --> 00:00:10,560 I'm a neuropsychologist, 5 00:00:10,570 --> 00:00:18,350 a certified autism specialist and the director of an adult diagnostic autism clinic in central Illinois. 6 00:00:18,940 --> 00:00:20,810 I am the author of books, 7 00:00:20,820 --> 00:00:25,260 a speaker and your host for autism in the adult podcast. 8 00:00:26,430 --> 00:00:32,120 Today we're going to continue our question and answer series. 9 00:00:32,120 --> 00:00:33,750 It's kind of a mini series. 10 00:00:33,750 --> 00:00:41,480 This is number two and will be our final part of the question and answer episodes for a bit of time. 11 00:00:41,480 --> 00:00:44,720 We're going to pause on those and in the future. 12 00:00:44,720 --> 00:00:47,260 We will bring back some more episodes. 13 00:00:49,040 --> 00:00:56,260 Today's questions that I'm going to be answering from listeners across the world 15 00:00:57,200 --> 00:00:59,070 are a little eclectic. 16 00:00:59,070 --> 00:01:03,760 So we're just gonna go through various topics and respond to those. 18 00:01:05,040 --> 00:01:11,950 the first question I'm going to tackle is about CBT therapy for those on the spectrum. 19 00:01:11,950 --> 00:01:16,340 And this stands for cognitive behavioral therapy. 20 00:01:16,350 --> 00:01:17,310 Um, 21 00:01:17,320 --> 00:01:33,160 what this refers to is a talk therapy where the individual in the sessions works with a therapist to identify their inner state and their outer state. 22 00:01:33,160 --> 00:01:38,050 So what are my thoughts and feelings and what are my behaviors? 23 00:01:38,440 --> 00:01:43,850 And those three things are linked sometimes they'll add kind of 1/4 category, 24 00:01:43,850 --> 00:01:48,350 which is what am I feeling physically in the moment. 25 00:01:48,940 --> 00:01:49,560 Um, 26 00:01:50,340 --> 00:01:59,600 so the basis of this therapy is to realize that when we feel angry or afraid, 27 00:01:59,610 --> 00:02:00,570 um, 28 00:02:00,580 --> 00:02:09,860 that a lot of times there are thoughts that we have our beliefs that we have that kind of trigger or feed into. 29 00:02:10,240 --> 00:02:11,050 Um, 30 00:02:11,740 --> 00:02:16,260 this outcome of having an emotion that feels difficult. 31 00:02:16,840 --> 00:02:17,580 So, 32 00:02:17,590 --> 00:02:27,910 if I am really believing and thinking in my head that nothing ever goes right for me. 33 00:02:28,180 --> 00:02:31,350 And let's say I have a flat tire on the way to work. 34 00:02:31,740 --> 00:02:33,220 And um, 35 00:02:33,230 --> 00:02:45,370 I just feel so discouraged and hopeless and I'm not really sure why it hit me that much that a flat tire would do that Well. 36 00:02:45,370 --> 00:02:47,060 In this type of therapy, 37 00:02:47,070 --> 00:02:49,270 the therapist would help the person say, 38 00:02:49,270 --> 00:02:49,510 well, 39 00:02:49,510 --> 00:02:54,580 what kinds of things were you thinking related to that emotion? 40 00:02:54,590 --> 00:03:03,520 So the person is trying to train themselves to become more aware of the thoughts that were linked with that emotion of hopelessness. 41 00:03:04,450 --> 00:03:05,930 And you know, 42 00:03:05,930 --> 00:03:10,530 maybe they realize that they are saying to themselves, 43 00:03:10,530 --> 00:03:14,780 this internal mantra of things are never going to get better. 44 00:03:14,790 --> 00:03:17,370 Nothing happens. 45 00:03:17,380 --> 00:03:18,300 Um, 46 00:03:18,310 --> 00:03:19,900 to give me a break, 47 00:03:19,910 --> 00:03:21,450 nothing goes right for me. 48 00:03:22,040 --> 00:03:22,960 So then, 49 00:03:22,970 --> 00:03:23,370 you know, 50 00:03:23,370 --> 00:03:28,280 the person can then challenge those thoughts and they can say, 51 00:03:28,280 --> 00:03:28,870 well, 52 00:03:28,880 --> 00:03:33,460 is it 100% true that nothing ever goes right for you? 53 00:03:33,940 --> 00:03:41,040 And it's not really that the therapy teaches you to replace negative thoughts with positive thoughts. 54 00:03:41,050 --> 00:03:45,590 It's that it teaches you to replace um, 55 00:03:45,600 --> 00:03:50,250 really skewed thoughts to be more realistic thoughts. 56 00:03:50,740 --> 00:03:53,640 So instead of nothing ever goes right for me, 57 00:03:53,650 --> 00:03:58,420 the therapist would challenge you to get a more realistic statement. 58 00:03:58,420 --> 00:03:58,790 And, 59 00:03:58,800 --> 00:04:09,030 and maybe the statement that you come up with is boy having a flat tire really is not what I wished would happen today. 60 00:04:09,040 --> 00:04:10,650 It is an inconvenience. 61 00:04:11,140 --> 00:04:11,570 Um, 62 00:04:11,580 --> 00:04:17,960 it will pass and there actually have been several good things that have happened lately as well, 63 00:04:17,970 --> 00:04:22,130 so that would be kind of this more realistic thought, 64 00:04:22,140 --> 00:04:32,290 which then affects our emotion to be one of more kind of mild discouragement without a tail spin down into a more despondent state. 65 00:04:35,940 --> 00:04:45,560 The listener was asking whether this approach to therapy can um, 66 00:04:46,840 --> 00:05:00,160 kind of treat the person as a collection of symptoms without a psyche and um being more of a person who's conditioned than behaviorally conditioned um, 67 00:05:00,540 --> 00:05:02,360 in their life experience. 68 00:05:03,640 --> 00:05:04,430 So, 70 00:05:05,010 --> 00:05:12,840 what I would say to that is that it's really quite a bit more complex than just behavioral conditioning. 71 00:05:12,840 --> 00:05:13,800 I know that, 72 00:05:13,810 --> 00:05:14,120 you know, 73 00:05:14,120 --> 00:05:18,600 if you studied skinner or read things about Pavlov's dog, 74 00:05:18,610 --> 00:05:20,400 you can get um, 75 00:05:20,410 --> 00:05:25,150 certainly a pretty extreme view of what conditioning um, 76 00:05:25,930 --> 00:05:27,380 kind of is made up of, 77 00:05:27,390 --> 00:05:41,760 but the CBT therapy really focuses more on helping you identify thought patterns and behavioral patterns that are just not very healthy to your well being and then adjusting those. 78 00:05:42,340 --> 00:05:42,960 Um, 79 00:05:43,420 --> 00:05:45,010 the listener was asking whether, 80 00:05:45,010 --> 00:05:55,260 I think this is a good um type of talk counseling for someone on the autism spectrum. 81 00:05:55,840 --> 00:05:59,050 So what happens is um, 82 00:05:59,440 --> 00:06:04,150 in the therapeutic world CBT is often um, 83 00:06:04,540 --> 00:06:07,140 it's really often recommended for everything. 84 00:06:07,150 --> 00:06:07,980 Um, 85 00:06:08,010 --> 00:06:12,660 it's considered a gold standard in various ways. 86 00:06:13,140 --> 00:06:19,350 Um insurance companies think highly of it and will reimburse for it. 87 00:06:20,240 --> 00:06:20,940 Um, 88 00:06:20,950 --> 00:06:22,010 in reality, 89 00:06:22,010 --> 00:06:25,740 when therapists use CBT therapy, 90 00:06:25,750 --> 00:06:32,090 they're probably mixing in a bit more eclectic approaches um, 91 00:06:32,100 --> 00:06:35,490 with regard to autism. 92 00:06:35,500 --> 00:06:39,460 I know there's even at least one book about CBT and autism, 93 00:06:40,040 --> 00:06:49,860 I I use it um intermittently with some of my clients as a piece of what we're layering in, 94 00:06:50,340 --> 00:06:57,530 but I would say it's not even making up 50% of maybe the approach that I would take. 95 00:06:57,540 --> 00:07:14,260 And my concern with it is this that it's really based on the premise that if we teach someone to retrain their thoughts that they will have a different thought and that then, 96 00:07:14,530 --> 00:07:14,960 you know, 97 00:07:14,960 --> 00:07:21,760 this will relieve their anxiety or this will relieve the depression that they're struggling with. 98 00:07:22,140 --> 00:07:25,410 And I think there's some value to that. 99 00:07:25,420 --> 00:07:44,910 Um my concern about using this and autism is that it doesn't really acknowledge that we're talking about a neurologic base and if you're assuming that you can shift every area of distress in a person's life by just having them think differently. 100 00:07:44,920 --> 00:07:45,470 Um, 101 00:07:45,480 --> 00:07:47,860 I think it really kind of sets up, 102 00:07:48,740 --> 00:07:49,660 um, 103 00:07:51,240 --> 00:08:01,150 expectations that aren't very realistic just by teaching someone to have a different intellectual thought. 104 00:08:01,840 --> 00:08:02,520 So, 105 00:08:02,530 --> 00:08:23,300 the neurology of our intellect and what we know as facts doesn't always hang together with that neurology of experience and what I can pull off in my daily life and there can be this great disconnect that's kind of enhanced in neurologic conditions where, 106 00:08:23,310 --> 00:08:24,110 yeah, 107 00:08:24,120 --> 00:08:31,580 I intellectually know but my nervous system is responding differently. 108 00:08:31,580 --> 00:08:42,760 It's still very heightened in its responses. It still overreacts to sound, you know... it still becomes overwhelmed in crowds... and changing the way I think about 109 00:08:42,760 --> 00:08:52,860 It is not going to be as effective as it might for you know the client with my other example I have a neuro typical neurology. 110 00:08:53,340 --> 00:09:00,290 I tend to think extreme negative thoughts about myself and my circumstance and I happen to have a flat tire. 111 00:09:00,300 --> 00:09:17,560 Well that's different than the student who um can't tolerate being in the school building because it's so neurologically overwhelming and asking them to think differently about how overwhelming it is I think would be inappropriate. 112 00:09:18,040 --> 00:09:22,060 So an example of looking at cognitive distortions and C. 113 00:09:22,060 --> 00:09:22,340 B. 114 00:09:22,350 --> 00:09:22,860 T. 115 00:09:22,860 --> 00:09:32,950 Therapy would be for example that a therapist might point out to a client that they have black and white thinking. 116 00:09:33,540 --> 00:09:42,140 So this experience was all bad and this experience was all good and that's not really capturing reality very well. 117 00:09:42,150 --> 00:09:48,960 So let's think of something that's really um not all good or all bad but in the middle. 118 00:09:49,340 --> 00:09:58,320 Well in the autistic client that's a bit of a problem because their neurology does lean toward black and white thinking or categorical thinking. 119 00:09:58,330 --> 00:10:00,150 Uh this is all good. 120 00:10:00,150 --> 00:10:23,670 This is all bad or this was a success and this was a failure and there are degrees to which individuals with the autistic neurology can consider more abstract and complicated kinds of um beliefs and thoughts but in general that's going to be very likely neurologically difficult. 121 00:10:23,680 --> 00:10:25,840 And so when you get in that area, 122 00:10:25,850 --> 00:10:36,910 it's kind of like sending someone to change their thought process uh to help them see colors better. 123 00:10:36,920 --> 00:10:37,860 So, 124 00:10:37,870 --> 00:10:38,660 um, 125 00:10:38,670 --> 00:10:41,160 you're not very good at color recognition. 126 00:10:41,160 --> 00:10:51,860 We're gonna examine all your thoughts and try to get you back on track with your peers when in actuality this person is color blind. 127 00:10:52,140 --> 00:10:52,480 Well, 128 00:10:52,480 --> 00:10:56,310 you're not going to improve color blindness with cognitive behavioral therapy. 129 00:10:56,640 --> 00:11:01,160 You're not going to improve diabetes with cognitive behavioral therapy. 130 00:11:01,170 --> 00:11:11,180 You may be able to work on some of their thoughts about their health, the way they react and engage in diet and that kind of thing. 131 00:11:11,180 --> 00:11:13,460 But um, 132 00:11:13,840 --> 00:11:14,240 you know, 133 00:11:14,240 --> 00:11:16,880 I think if we're using cognitive behavioral therapy, 134 00:11:16,880 --> 00:11:19,860 we should be very aware of its strengths. 135 00:11:20,240 --> 00:11:20,750 Again, 136 00:11:20,750 --> 00:11:26,490 I do use that at times and then also its limitations within different um, 137 00:11:26,500 --> 00:11:27,730 patient groups. 138 00:11:27,740 --> 00:11:30,960 So that would be my thought about that. 139 00:11:31,740 --> 00:11:38,660 So I would focus more in therapy on helping people recognize their neurologic patterns, 140 00:11:38,660 --> 00:11:40,500 increasing that self awareness, 141 00:11:40,510 --> 00:11:46,430 creating strategies that will help the neurology kind of move forward in those areas. 142 00:11:46,430 --> 00:11:50,540 So what are strategies that you can calm your nervous system with? 143 00:11:50,550 --> 00:11:51,450 For example, 144 00:11:53,140 --> 00:11:54,760 that was a great question. 145 00:11:54,760 --> 00:11:56,050 I appreciate that. 146 00:11:57,340 --> 00:11:57,730 Um, 147 00:11:57,730 --> 00:12:01,560 I also had a question from a mother who asked, 148 00:12:02,140 --> 00:12:03,010 um, 149 00:12:03,020 --> 00:12:03,870 you know, 150 00:12:03,880 --> 00:12:18,360 what could I do when my young adult child with a diagnosis is really resisting talking about autism and feeling categorized and kind of pigeonholed. 151 00:12:18,940 --> 00:12:19,480 Um, 152 00:12:19,490 --> 00:12:28,260 if that discussion comes up feeling sick of everything being described through the autistic lens and therefore dehumanized. 153 00:12:30,040 --> 00:12:33,060 So this is such an individualized, 154 00:12:33,840 --> 00:12:34,950 um, 155 00:12:34,960 --> 00:12:36,490 internal state, 156 00:12:36,500 --> 00:12:36,900 right? 157 00:12:36,900 --> 00:12:42,750 We all have kind of different reactions of what we can take in and process how we feel about things. 158 00:12:43,140 --> 00:12:49,760 And essentially this person seems to be saying that they don't really feel seen and heard. 159 00:12:50,140 --> 00:12:50,700 Um, 160 00:12:50,700 --> 00:12:52,660 and that's an awful feeling. 161 00:12:53,240 --> 00:12:53,790 Um, 162 00:12:53,800 --> 00:12:56,360 even if people around them feel like, 163 00:12:56,360 --> 00:12:56,770 yes, 164 00:12:56,770 --> 00:12:57,870 I do see you. 165 00:12:57,870 --> 00:12:58,980 I do hear you. 166 00:12:58,990 --> 00:13:00,100 Um, 167 00:13:00,110 --> 00:13:00,650 you know, 168 00:13:00,650 --> 00:13:03,460 that internal feeling is still difficult. 169 00:13:05,440 --> 00:13:17,160 I think the best outcomes usually are when we allow people the freedom and space to process things differently than we are. 170 00:13:17,540 --> 00:13:18,140 Um, 171 00:13:18,150 --> 00:13:20,450 I have to say that I don't, 172 00:13:20,940 --> 00:13:21,740 um, 173 00:13:21,750 --> 00:13:22,260 you know, 174 00:13:22,260 --> 00:13:36,940 listeners who've been with me for a while probably know that I have an adolescent son on the spectrum and I have to say that I don't really talk about autism that much at home as far as using that word. 175 00:13:36,950 --> 00:13:39,600 So maybe this will help. 176 00:13:39,610 --> 00:13:40,240 Um, 177 00:13:40,250 --> 00:13:45,220 I don't think we have to bring up the term all the time, 178 00:13:45,230 --> 00:13:46,790 but um, 179 00:13:46,790 --> 00:13:49,910 it certainly is something people are free to talk about. 180 00:13:49,910 --> 00:13:51,350 So we give them that freedom. 181 00:13:51,540 --> 00:13:55,000 But what we tend to talk about more in our household is, 182 00:13:55,240 --> 00:13:55,570 you know, 183 00:13:55,570 --> 00:13:57,030 what do you need today? 184 00:13:57,040 --> 00:13:58,780 What does your system need? 185 00:13:58,790 --> 00:14:01,590 And I talk about what my system needs. 186 00:14:01,590 --> 00:14:02,550 And then I ask, 187 00:14:02,550 --> 00:14:02,780 you know, 188 00:14:02,780 --> 00:14:03,520 my husband, 189 00:14:03,520 --> 00:14:03,870 how, 190 00:14:03,880 --> 00:14:05,740 how have things gone for you, 191 00:14:05,740 --> 00:14:06,590 what do you need? 192 00:14:06,600 --> 00:14:20,600 And we try to learn that kind of talk as a family and what my son needs is going to be different than what my husband needs and what I need just because we're individuals and his individuality, 193 00:14:20,610 --> 00:14:23,730 My son's includes the autistic neurology. 194 00:14:23,730 --> 00:14:25,410 It also includes other things. 195 00:14:25,420 --> 00:14:28,110 He's at a different season of life than I am. 196 00:14:28,120 --> 00:14:29,000 His, 197 00:14:29,010 --> 00:14:29,680 um, 198 00:14:29,680 --> 00:14:34,770 school and peer kind of demands on him are different. 199 00:14:34,780 --> 00:14:36,670 The pace of his day is different. 200 00:14:36,670 --> 00:14:38,940 His physical state is different. 201 00:14:38,940 --> 00:14:39,630 And so, 202 00:14:39,640 --> 00:14:40,250 uh, 203 00:14:40,260 --> 00:14:43,450 we kind of process it that way that, 204 00:14:43,840 --> 00:14:44,350 um, 205 00:14:44,360 --> 00:14:46,560 we're each individuals, 206 00:14:47,440 --> 00:14:47,990 um, 207 00:14:47,990 --> 00:14:57,050 and how we're doing is important and how can we work as a group to help each other get what each person needs. 208 00:14:57,540 --> 00:15:00,290 And then there will be some things that, 209 00:15:00,300 --> 00:15:00,640 you know, 210 00:15:00,640 --> 00:15:02,310 are just important to discuss. 211 00:15:02,310 --> 00:15:12,510 We can't shy away from something that's really important for their health or wellness because we don't want to process things about autism. 212 00:15:12,510 --> 00:15:13,520 But um, 213 00:15:13,520 --> 00:15:18,450 a lot of times we can just talk about each person's individuality. 214 00:15:18,450 --> 00:15:18,850 Like, 215 00:15:19,340 --> 00:15:19,720 um, 216 00:15:19,720 --> 00:15:23,660 it looks to me like you've had a really rough day, 217 00:15:24,240 --> 00:15:26,050 would it feel better to talk about it? 218 00:15:26,050 --> 00:15:27,450 Or do you need alone time? 219 00:15:28,240 --> 00:15:30,040 Or you could say, 220 00:15:30,050 --> 00:15:31,270 you know, 221 00:15:31,280 --> 00:15:33,170 we have a lot of stuff coming up, 222 00:15:33,170 --> 00:15:35,070 You've got college applications, 223 00:15:35,070 --> 00:15:37,030 You've got some job interviews. 224 00:15:37,040 --> 00:15:39,840 It's really important to nail some of this down. 225 00:15:39,850 --> 00:15:44,760 But I'm wondering whether you'd like to process that face to face, 226 00:15:44,940 --> 00:15:49,610 whether you'd like to email together about it and you can put together some thoughts. 227 00:15:50,640 --> 00:15:51,350 Um, 228 00:15:51,360 --> 00:15:51,990 you know, 229 00:15:51,990 --> 00:15:58,420 so sometimes again you can process and say this topic is kind of non negotiable, 230 00:15:58,420 --> 00:16:00,260 we have to figure something out, 231 00:16:00,940 --> 00:16:05,050 but how could we talk about this in a way that meets where you're at. 232 00:16:05,740 --> 00:16:06,530 Um, 233 00:16:06,540 --> 00:16:13,840 and also just being sure to talk about a lot of things not related to the nervous system that um, 234 00:16:13,850 --> 00:16:15,570 we give each other compliments, 235 00:16:15,570 --> 00:16:22,340 like you're really good at this and I just I wish I had your eye for detail. 236 00:16:22,340 --> 00:16:25,560 I wish I was as artistic as you are. 237 00:16:25,570 --> 00:16:29,960 I wish um I had some of the spunk that I see in you, 238 00:16:29,960 --> 00:16:39,160 I really love that and this helps them know that we are seeing them as a whole person and we do love them and value them. 239 00:16:39,640 --> 00:16:40,270 Um, 240 00:16:40,280 --> 00:16:51,660 so those can be a few ways that we can round out what you don't want to do is sometimes when someone shuts down or resist or walks away, 241 00:16:52,240 --> 00:16:57,070 what you don't want to do is then have some chasing after them. 242 00:16:57,740 --> 00:17:04,500 This is a really difficult family dynamic and I see it in couples and families and in the workplace, 243 00:17:04,510 --> 00:17:13,290 it's just a very um common thing if someone becomes quiet that we're trying to talk to and they withdraw. 244 00:17:13,300 --> 00:17:18,840 We can have some chasing behaviors whether that's actually physically following them, 245 00:17:18,850 --> 00:17:20,350 whether it's saying, 246 00:17:20,740 --> 00:17:21,180 you know, 247 00:17:21,190 --> 00:17:21,660 no, 248 00:17:21,660 --> 00:17:23,240 you have to talk about this, 249 00:17:23,240 --> 00:17:24,360 this is important. 250 00:17:26,240 --> 00:17:30,570 That kind of chasing in the relationship usually just makes things worse. 251 00:17:30,600 --> 00:17:31,460 So, 252 00:17:31,840 --> 00:17:34,960 um I would focus more on strategy. 253 00:17:34,960 --> 00:17:42,850 Like I can see this conversation is really tough um how and when would you like to process this? 254 00:17:45,540 --> 00:17:46,350 Other than that, 255 00:17:46,350 --> 00:17:58,010 it may just be helpful for the family or the parent or the individual to have a counselor that they can process individualized recommendations with. 256 00:17:58,010 --> 00:17:59,110 That's a tough one. 257 00:17:59,220 --> 00:18:03,270 It's a tough season and difficult things to talk about. 258 00:18:05,540 --> 00:18:09,930 Um the next question from a listener is kind of related, 259 00:18:09,930 --> 00:18:14,660 it's about parenting and this time it's about parenting in neuro diverse couples, 260 00:18:14,660 --> 00:18:20,120 which means that One of the parents is on the spectrum and one is not. 261 00:18:20,130 --> 00:18:22,710 So um you know, 262 00:18:22,710 --> 00:18:28,950 there are differences in their nervous systems and and what they lean toward what their strengths are, 263 00:18:29,340 --> 00:18:33,270 what kinds of things challenge them. 264 00:18:34,040 --> 00:18:41,780 And so this listener is asking this as a parent and part of a couple. 265 00:18:41,780 --> 00:18:46,670 So they're trying to parent their kids and their spouse, 266 00:18:46,680 --> 00:18:49,750 I'm not sure who is who, 267 00:18:49,750 --> 00:18:55,620 but one of them has that autistic neurology and the person is pointing out that, 268 00:18:55,620 --> 00:18:56,480 you know, 269 00:18:56,500 --> 00:19:01,230 parenting is a lot of just loud, 270 00:19:01,230 --> 00:19:02,600 chaotic, 271 00:19:02,610 --> 00:19:03,710 messy, 272 00:19:03,720 --> 00:19:06,700 unexpected things going on. 273 00:19:06,700 --> 00:19:10,460 You've got the need to communicate as parents. 274 00:19:10,840 --> 00:19:13,300 Um the need to be consistent. 275 00:19:13,310 --> 00:19:15,670 You've got sensory overload in the house, 276 00:19:15,670 --> 00:19:19,170 you've got distractions and changes to routine. 277 00:19:19,170 --> 00:19:30,560 So that is a great point that if anything is going to kind of challenge um the neuro diverse couple this, 278 00:19:30,570 --> 00:19:33,430 this is really difficult. 279 00:19:33,440 --> 00:19:38,620 And so my brief answer is I would say a couple of things. 280 00:19:38,620 --> 00:19:49,070 One is what I just talked about for the other listener that sometimes really being direct and forthright about where are you at today? 281 00:19:49,070 --> 00:19:50,060 What do you need? 282 00:19:50,440 --> 00:19:52,140 Or boy, 283 00:19:52,140 --> 00:19:56,560 it looks like this kid is really melting down a lot. 284 00:19:56,940 --> 00:19:58,440 That's the state they're in. 285 00:19:58,440 --> 00:20:00,960 How are we going to get this? 286 00:20:01,340 --> 00:20:05,520 Kids needs met and this other one has homework to do. 287 00:20:05,520 --> 00:20:06,450 How are we gonna? 288 00:20:06,460 --> 00:20:11,470 So kind of taking a survey of the land and we all need to do that, 289 00:20:11,470 --> 00:20:19,990 but sometimes we forget to do it kind of explicitly... we think our spouse will see what needs to be done or agree with us. 290 00:20:19,990 --> 00:20:26,630 And sometimes when couples go to counseling and maybe they're talking about parenting strategies, 291 00:20:27,040 --> 00:20:30,820 um you kind of get the sense that one of the partners is saying, 292 00:20:30,830 --> 00:20:33,010 why can't you be like me? 293 00:20:33,020 --> 00:20:33,590 You know, 294 00:20:33,590 --> 00:20:35,470 why can't you parent like me? 295 00:20:35,470 --> 00:20:41,180 Why can't you see what needs to be done and kind of do it the way I would do it. 296 00:20:41,670 --> 00:20:49,270 So part of that of success and that kind of role is having this increased self awareness. 297 00:20:49,740 --> 00:20:50,370 Okay, 298 00:20:50,370 --> 00:20:51,810 I really get that, 299 00:20:51,810 --> 00:20:54,030 your neurology is different, 300 00:20:54,090 --> 00:20:55,860 these are your strengths, 301 00:20:56,240 --> 00:21:12,460 these are the things that challenge you and that's different from my neurology and so sometimes what can help once you have this increasing awareness and these open discussions about how you each work differently. 302 00:21:13,040 --> 00:21:19,350 Um one of the things that can help is to have a huddle in the morning and in the evening by huddle, 303 00:21:19,350 --> 00:21:25,770 I just mean like there's kind of a brief checking in about the status quo, 304 00:21:26,240 --> 00:21:26,860 like, 305 00:21:27,240 --> 00:21:28,070 what's your day, 306 00:21:28,070 --> 00:21:29,150 like today? 307 00:21:29,160 --> 00:21:31,950 Uh do you have everything you need, 308 00:21:32,440 --> 00:21:34,950 this kid needs to be picked up, 309 00:21:34,960 --> 00:21:35,190 blah, 310 00:21:35,190 --> 00:21:35,800 blah blah. 311 00:21:35,810 --> 00:21:36,280 So, 312 00:21:36,290 --> 00:21:40,340 so there's this coming together in the morning to say, 313 00:21:40,340 --> 00:21:40,700 you know, 314 00:21:40,700 --> 00:21:41,060 again, 315 00:21:41,060 --> 00:21:42,770 like in a sports analogy, 316 00:21:42,780 --> 00:21:52,170 um huddle is this image of um the sports players getting together on the field and saying this is the play we're going to use. 317 00:21:52,560 --> 00:22:00,430 It's so funny because I remember one of our um high school friends at a reunion and he was saying, 318 00:22:00,440 --> 00:22:01,340 you know, 319 00:22:01,350 --> 00:22:04,950 once you go from two kids to three kids, 320 00:22:04,960 --> 00:22:05,570 you know, 321 00:22:05,580 --> 00:22:08,150 it's like you have to go to a zone defense, 322 00:22:08,160 --> 00:22:11,460 you can't be one parent on one kids anymore, 323 00:22:11,470 --> 00:22:13,060 so that's the kind of thing, 324 00:22:13,060 --> 00:22:13,970 like in the morning, 325 00:22:13,970 --> 00:22:15,260 what's our game plan? 326 00:22:15,740 --> 00:22:17,960 How are we going to divide this up? 327 00:22:18,740 --> 00:22:21,250 Um and then in the evening as well, 328 00:22:21,250 --> 00:22:23,960 and sometimes in the evening it's even more important, 329 00:22:24,340 --> 00:22:31,930 so you've had this whole day of experience and you're coming together and there's these things that need to be done. 330 00:22:31,940 --> 00:22:34,960 So part of the evening huddle can be, 331 00:22:35,740 --> 00:22:51,990 my day at work was unexpectedly horrible and I feel like I'm about to collapse and I also see that the kids are laying on the floor screaming and somebody's drawing on the wall with crayons and you, 332 00:22:52,000 --> 00:22:54,670 you're crying and um, 333 00:22:55,140 --> 00:22:57,580 so what, 334 00:22:57,590 --> 00:22:58,930 let's triage, 335 00:22:58,940 --> 00:23:05,600 what is the most important thing we have to do and what do you need? 336 00:23:05,610 --> 00:23:09,370 This is what I need And then getting a game plan, 337 00:23:09,430 --> 00:23:16,670 like I need 20 minutes of no touching and talking and anything and then I'm going to come back out, 338 00:23:17,340 --> 00:23:20,010 you take the kids for a ride and I'm gonna clean, 339 00:23:20,020 --> 00:23:20,740 you know, 340 00:23:20,750 --> 00:23:23,880 so that kind of thing also, 341 00:23:23,880 --> 00:23:27,430 I think that a lot of times when we have this increase of awareness, 342 00:23:28,240 --> 00:23:38,850 we can assign tasks based on the person's strengths rather than hoping that everybody does all of the stuff. 343 00:23:39,340 --> 00:23:40,290 So, 344 00:23:40,300 --> 00:23:40,970 you know, 345 00:23:40,980 --> 00:23:50,960 one spouse may love doing laundry and organizing and throwing things away and this feels really satisfying to them, 346 00:23:51,340 --> 00:23:55,150 but they really have a tough time giving the kids a bath, 347 00:23:55,150 --> 00:23:57,140 like it's sensory overload. 348 00:23:57,140 --> 00:23:59,260 They struggle a lot. 349 00:23:59,740 --> 00:24:02,620 So if there is a way to integrate in, 350 00:24:03,040 --> 00:24:03,680 you know, 351 00:24:03,690 --> 00:24:05,770 one parent might say, 352 00:24:06,240 --> 00:24:06,750 you know, 353 00:24:06,760 --> 00:24:11,570 giving the kids a bath is not hard for me at all. 354 00:24:11,580 --> 00:24:13,210 So I'll do that, 355 00:24:13,220 --> 00:24:14,500 you do what, 356 00:24:14,510 --> 00:24:17,930 what you connect with and then these other stuff, 357 00:24:17,940 --> 00:24:18,230 you know, 358 00:24:18,230 --> 00:24:19,670 the other things that we both, 359 00:24:20,140 --> 00:24:20,970 hey, 360 00:24:20,980 --> 00:24:25,560 we'll just try to share the load and get through some of the stuff we hate. 361 00:24:26,940 --> 00:24:30,770 Um another way is to reduce talking. 362 00:24:31,140 --> 00:24:34,860 I think one of the pieces of advice that I give, 363 00:24:35,740 --> 00:24:41,950 um family members the most is to talk less. 364 00:24:42,640 --> 00:25:00,350 Um I think our go to strategy for improving things is often talking about it again and again or asking or questioning or um nagging or talking and a lot of times for the autistic that makes a difficult situation like more overwhelming. 365 00:25:00,740 --> 00:25:04,660 So you want me to do this and I have to socially communicate about it. 366 00:25:04,660 --> 00:25:05,880 That's really dreaming. 367 00:25:07,540 --> 00:25:10,860 So one way to reduce talking, 368 00:25:11,340 --> 00:25:15,520 you can have a code word that if a person, 369 00:25:15,520 --> 00:25:18,860 one of the parents is about to just meltdown, 370 00:25:18,860 --> 00:25:20,270 they're in dire straits, 371 00:25:20,270 --> 00:25:26,890 they need to stop this conversation or they need to stop being in the room with the kids. 372 00:25:27,060 --> 00:25:28,960 You guys can use a code word. 373 00:25:29,340 --> 00:25:32,330 So you could pick something that's funny, 374 00:25:32,330 --> 00:25:39,450 you can pick something that's um an inside memory or something and if someone says that word, 375 00:25:40,040 --> 00:25:41,660 you don't have to talk it through. 376 00:25:41,660 --> 00:25:45,560 Everybody just knows that that person needs to leave and regroup. 377 00:25:46,140 --> 00:25:48,100 So it could be pineapple, 378 00:25:48,100 --> 00:25:56,770 it could be hawaii or whatever has meaning and then you can cut down some of that talking in the moment. 379 00:25:57,940 --> 00:26:02,690 Also a way to reduce talking is to use refrigerator magnets. 380 00:26:02,700 --> 00:26:08,230 So sometimes people and families will want to know how everyone's doing, 381 00:26:08,230 --> 00:26:12,010 but this conversation about how I'm doing and how are you doing? 382 00:26:12,010 --> 00:26:13,410 That's really draining. 383 00:26:13,420 --> 00:26:15,520 So for instance, 384 00:26:15,520 --> 00:26:23,890 you could use Refrigerator magnets that are from 1 to 10 and you can have it represent anything. 385 00:26:23,890 --> 00:26:31,110 So maybe it's your stress level that everybody has a column on the fridge where they can put their number. 386 00:26:31,120 --> 00:26:47,760 And so if someone comes home from school and they walk in and they don't talk and they pass mom or dad and they put that Number seven out of 10 on there and walk to their room and shut the door. 387 00:26:48,080 --> 00:26:54,160 That is a way of communicating that my day was really overwhelming and I need to be alone. 388 00:26:54,740 --> 00:26:58,360 So the parents feel like they have a sense of what just happened. 389 00:26:58,740 --> 00:27:00,560 There's some communication, 390 00:27:00,570 --> 00:27:03,810 but we don't have to sit down and socially communicate, 391 00:27:03,810 --> 00:27:05,360 which is also draining. 392 00:27:07,140 --> 00:27:07,510 Um, 393 00:27:07,510 --> 00:27:11,210 and also just thinking about as a couple, 394 00:27:11,220 --> 00:27:13,170 you can't always plan, 395 00:27:13,640 --> 00:27:14,400 um, 396 00:27:14,410 --> 00:27:17,190 all the things that happen in a family. 397 00:27:17,190 --> 00:27:17,660 And, 398 00:27:18,040 --> 00:27:19,570 but sometimes, 399 00:27:19,580 --> 00:27:20,280 you know, 400 00:27:20,290 --> 00:27:21,670 when you're together, 401 00:27:21,670 --> 00:27:22,730 newly as a couple, 402 00:27:22,730 --> 00:27:24,060 you can talk about, 403 00:27:24,540 --> 00:27:24,880 oh, 404 00:27:24,880 --> 00:27:26,280 you want six kids. 405 00:27:26,280 --> 00:27:26,900 Well, 406 00:27:27,140 --> 00:27:27,960 I want, 407 00:27:28,340 --> 00:27:29,860 I'm thinking I would want one, 408 00:27:29,860 --> 00:27:33,250 I think it would be really overwhelming for me, 409 00:27:33,260 --> 00:27:33,720 uh, 410 00:27:33,720 --> 00:27:44,760 and and to try to make plans for your family that take into account everyone's temperament and personality and nervous system. 411 00:27:49,240 --> 00:27:53,460 Another listener asked about things related to the workplace. 412 00:27:53,940 --> 00:27:54,540 Um, 413 00:27:54,550 --> 00:27:56,740 one question was about, 414 00:27:56,750 --> 00:27:57,220 you know, 415 00:27:57,220 --> 00:28:07,480 it's really difficult to know how to negotiate about raises or other issues in the workplace because I feel like I'm not sure if I'm being taken advantage of, 416 00:28:07,480 --> 00:28:14,270 I'm not sure if I'm asking for too much or too little and I don't know how far to push things or how to say it. 417 00:28:14,940 --> 00:28:16,440 Um and you know, 418 00:28:16,440 --> 00:28:19,530 this person feels like as an autistic individual, 419 00:28:19,530 --> 00:28:19,820 it, 420 00:28:19,830 --> 00:28:25,990 it feels harder to um just get a feel for the room like what is politics, 421 00:28:25,990 --> 00:28:26,650 what is, 422 00:28:26,660 --> 00:28:29,950 what should not be said in this room? 423 00:28:29,960 --> 00:28:32,270 Um and you know, 424 00:28:32,270 --> 00:28:35,030 that is a really good point. 425 00:28:35,040 --> 00:28:40,850 A lot of negotiation is getting a feel for how hard to push. 426 00:28:42,140 --> 00:28:42,610 You know, 427 00:28:42,610 --> 00:28:53,860 I think taking advantage of all the data approaches that are available in this age of technology can really help in that regard. 428 00:28:53,870 --> 00:28:57,690 I'm not sure about different countries or cultures, 429 00:28:57,690 --> 00:29:01,210 but In the United States there's been a big push, 430 00:29:01,210 --> 00:29:03,310 particularly over the last 10 years, 431 00:29:03,310 --> 00:29:13,540 I would say um to be very data oriented in um comparing salaries across the region, 432 00:29:13,540 --> 00:29:15,150 across the United States, 433 00:29:15,430 --> 00:29:17,770 there's more available on the internet. 434 00:29:18,740 --> 00:29:20,950 Um as far as benchmarking, 435 00:29:20,950 --> 00:29:22,360 what is common, 436 00:29:22,940 --> 00:29:27,460 um I really relate to this listeners challenge. 437 00:29:27,460 --> 00:29:29,800 I'm not really good um, 438 00:29:29,810 --> 00:29:31,130 at those things either. 439 00:29:31,130 --> 00:29:34,720 So what I tend to do is every five years, 440 00:29:34,720 --> 00:29:46,170 there's um an article published about common um benchmarks for neuropsychology salaries and then of course our workplace benchmarks, 441 00:29:46,170 --> 00:29:46,860 things. 442 00:29:46,940 --> 00:29:55,650 I'm hoping that in the future it will become even more transparent that when you see a job ad it will just have the salary in the ad. 443 00:29:55,650 --> 00:30:10,980 And again I don't know if other countries do that but there it's almost like a card game where you're not quite sure um what benchmark the employer might be using, 444 00:30:10,980 --> 00:30:13,970 they don't show all their cards necessarily. 445 00:30:13,980 --> 00:30:21,920 Um But it I do think that as a strategy it can help anyone, 446 00:30:21,920 --> 00:31:07,450 particularly someone that wants to go by data to kind of have data to put it in a proposal and to hand that in to your boss to say you know this is some data that I found and I wanted to talk about that with you and I would also suggest that you give data about yourself and so you can kind of think of um like a state of the union address where um you can give your boss a summary of all the things that you have accomplished um either that year or in the past five years and bosses know that in the moment. 447 00:31:07,460 --> 00:31:13,600 But I do find that giving the summary Snapchat and highlighting all the things you've done. 448 00:31:14,240 --> 00:31:23,850 Um That's data as well and sometimes you know your boss just cannot have all of that in their head. 449 00:31:23,860 --> 00:31:27,990 And they'll often say things like oh my gosh that's right, 450 00:31:27,990 --> 00:31:32,380 you did this and that and you know for someone in sales, 451 00:31:32,380 --> 00:31:36,450 they can say I earned the company this amount of money etcetera. 452 00:31:36,640 --> 00:31:44,300 So you can hand in data points both about salary benchmarking and also highlighting how you've benefited the company, 453 00:31:44,300 --> 00:31:46,350 what kinds of things you've accomplished. 454 00:31:46,360 --> 00:31:48,240 Um So I would start there, 455 00:31:48,250 --> 00:31:51,560 just try try a very data oriented approach. 456 00:31:53,240 --> 00:31:58,290 Another question was about how to pursue accommodations in the workplace. 457 00:31:58,300 --> 00:32:00,990 Um They seem so open ended, 458 00:32:00,990 --> 00:32:04,620 it's difficult to know what's reasonable as a request, 459 00:32:04,620 --> 00:32:05,480 who to talk to, 460 00:32:05,480 --> 00:32:06,160 etcetera. 461 00:32:06,840 --> 00:32:07,250 Um, 462 00:32:07,260 --> 00:32:15,950 so I would say a few things you I would look on the internet for common accommodations for autism or other things. 463 00:32:15,950 --> 00:32:21,750 And the site that I often go to to look is called ask Jan dot org. 464 00:32:21,840 --> 00:32:25,050 JAN stands for job accommodation Network. 465 00:32:25,060 --> 00:32:25,430 Again, 466 00:32:25,430 --> 00:32:27,170 this is in the United States. 467 00:32:27,640 --> 00:32:28,080 Um, 468 00:32:28,080 --> 00:32:29,930 and again, 469 00:32:29,930 --> 00:32:31,900 in the line of having data, 470 00:32:31,910 --> 00:32:40,340 this gives a lot of common accommodations that could be requested for a variety of conditions. 471 00:32:40,350 --> 00:32:47,950 So you would type in autism as you as the condition that you want to ask for accommodations under. 472 00:32:47,950 --> 00:32:57,060 So you have to have kind of a um something that's considered qualifying for that accommodation. 473 00:32:57,920 --> 00:33:03,820 And then what I would say is Jobs want these accommodations to be individualized. 474 00:33:03,820 --> 00:33:09,100 They don't want to just have a list of 200 accommodations that you want. 475 00:33:09,100 --> 00:33:24,570 So I would say look through those and think about your own self awareness and areas that are particularly easy or difficult for you and try try some of the strategies if you can. 476 00:33:24,580 --> 00:33:25,540 So, 477 00:33:25,550 --> 00:33:26,460 um, 478 00:33:26,840 --> 00:33:35,080 if you're going to ask for an accommodation to where noise canceling headphones in your cubicle while you're working, 479 00:33:35,090 --> 00:33:36,410 um you know, 480 00:33:36,410 --> 00:33:41,700 try some of that at home and see if those headphones really help you. 481 00:33:41,710 --> 00:33:43,760 So you can tie it into, 482 00:33:43,760 --> 00:33:48,830 let's say you've gotten feedback that you're really struggling with timeliness, 483 00:33:48,840 --> 00:33:50,850 that things are taking too long, 484 00:33:50,940 --> 00:33:53,600 and that's part of that executive function, 485 00:33:53,610 --> 00:33:55,330 piece of autism. 486 00:33:55,340 --> 00:33:58,220 And you can say, 487 00:33:58,230 --> 00:33:58,870 you know, 488 00:33:58,870 --> 00:34:02,860 I realize um that this has been a struggle for me. 489 00:34:02,860 --> 00:34:14,300 I really listen to that feedback and I want to improve that the strategy that I'd like to pursue as to where these noise canceling headphones, 490 00:34:14,310 --> 00:34:17,210 because it really helps me focus. 491 00:34:17,220 --> 00:34:22,490 Um I don't have to be processing through all of the noise around me. 492 00:34:22,500 --> 00:34:25,780 Uh and then um you know, 493 00:34:25,790 --> 00:34:30,220 if they say yes, 494 00:34:30,220 --> 00:34:31,130 that's great, 495 00:34:31,140 --> 00:34:37,060 you can talk to them about why it kind of just depends on what kind of relationship you have there. 496 00:34:37,440 --> 00:34:39,230 If they just come back with, 497 00:34:39,230 --> 00:34:39,410 well, 498 00:34:39,410 --> 00:34:41,730 that's not part of our dress code. 499 00:34:41,740 --> 00:34:47,960 Uh then you can present documentation of your diagnosis and just say, 500 00:34:47,960 --> 00:34:53,750 how could I get this formalized that I'm formally asking for this accommodation. 501 00:34:54,840 --> 00:35:00,660 They'll probably send you through to HR to human resources and you can do it that way. 502 00:35:04,160 --> 00:35:09,670 There was a question about preventing seizure episodes that are non epileptic. 503 00:35:10,240 --> 00:35:20,660 Um Non epileptic means that the seizures look like seizures when people are watching and observing, 504 00:35:21,040 --> 00:35:25,610 um but they're not electrical so that when the person is hooked up to the E. 505 00:35:25,610 --> 00:35:25,730 E. 506 00:35:25,730 --> 00:35:26,180 G. 507 00:35:26,180 --> 00:35:28,580 And they see the manifestation of the seizure, 508 00:35:28,580 --> 00:35:32,170 they can see that it's not electrically generated through the brain. 509 00:35:32,540 --> 00:35:43,060 And what that means is that it's non epileptic and these are things that are triggered by stress and really being overwhelmed or traumatized. 510 00:35:43,070 --> 00:35:46,760 And um I do have a blog post on that. 511 00:35:46,770 --> 00:35:56,390 Um So I will put the link in the show notes and also I would recommend listening to the podcast episodes. 512 00:35:56,400 --> 00:36:07,350 We have some series about how to help people with regulation and that's how I would address these non epileptic seizures that these are signs. 513 00:36:07,350 --> 00:36:12,240 These are clues that the person is dis regulated that they're overwhelmed. 514 00:36:12,430 --> 00:36:15,790 So rather than trying to talk them through, 515 00:36:15,790 --> 00:36:24,160 I would use the recommendations in the regulation series and I will link to the first of those series. 516 00:36:24,530 --> 00:36:29,150 I think there's four in that podcast series here in the notes. 517 00:36:31,530 --> 00:37:01,440 Um It should be noted too if it interests you that this phenomenon of non epileptic seizures is more common for autistics than for those who are you're a typical Finally there was a question about why diet and motivation for exercise can become harder with age for the autistic who's entering um Their 40's or 50s. 518 00:37:01,830 --> 00:37:16,210 Um I think that that's really tied in a lot with the executive function issue we talked about where um and I guess I'm referring to the podcast series on behavioral motivation, 519 00:37:16,220 --> 00:37:18,320 exhaustion getting going. 520 00:37:18,330 --> 00:37:27,660 So the center and front part of the brain is in charge of executive function that's always somewhat impacted or involved in autism. 521 00:37:27,930 --> 00:37:32,170 And part of that has to do with what's called behavioral initiation. 522 00:37:32,180 --> 00:37:37,000 So how do I get started from this stopped state? 523 00:37:37,000 --> 00:37:38,240 It's really hard. 524 00:37:38,830 --> 00:37:45,870 Not only is the individual probably likely to have difficulty with the getting going part of behavior anyway, 525 00:37:45,880 --> 00:37:50,320 but executive function can become more difficult. 526 00:37:50,330 --> 00:37:50,650 Um, 527 00:37:50,650 --> 00:37:53,950 less efficient and easy with age. 528 00:37:54,330 --> 00:37:58,760 We talked about this in our aging episode where um, 529 00:37:58,770 --> 00:38:03,920 executive function is always going to be a bit harder as people age. 530 00:38:03,920 --> 00:38:06,650 So their thought process might feel slower. 531 00:38:06,660 --> 00:38:08,840 They can't multitask as well. 532 00:38:08,840 --> 00:38:16,340 Some of the details of their memory gets harder and also this behavioral activation can also be impacted. 533 00:38:17,520 --> 00:38:26,170 Another thing I think that makes this difficult and autism is that for many people on the spectrum, 534 00:38:26,250 --> 00:38:32,460 it's difficult to think abstractly about likely outcomes. 535 00:38:32,920 --> 00:38:33,340 Um, 536 00:38:33,350 --> 00:38:40,330 if you ask someone intellectually what's likely to happen if you don't take your medicine or if you don't exercise, 537 00:38:40,720 --> 00:38:43,360 sometimes they can recite a bunch of facts, 538 00:38:43,360 --> 00:38:49,640 but it doesn't really feel real unless they've actually already experienced it. 539 00:38:50,020 --> 00:38:52,860 So if I say that to someone, 540 00:38:52,870 --> 00:38:55,710 uh there may be an autistic individual who says, 541 00:38:55,710 --> 00:38:55,880 well, 542 00:38:55,880 --> 00:38:57,590 how would I know what would happen? 543 00:38:57,600 --> 00:38:58,950 It hasn't happened yet. 544 00:38:59,420 --> 00:39:03,000 Other people can state facts that they've learned, 545 00:39:03,010 --> 00:39:06,310 but in a lot of ways those feel fear radical, 546 00:39:06,310 --> 00:39:08,900 they don't really feel real. 547 00:39:08,910 --> 00:39:12,360 Um and for example, 548 00:39:12,370 --> 00:39:14,900 I have had patients who say, 549 00:39:14,900 --> 00:39:18,430 well I took cholesterol medication for a month, 550 00:39:18,440 --> 00:39:20,390 but I just stopped it. 551 00:39:20,400 --> 00:39:21,690 I didn't feel any better, 552 00:39:21,690 --> 00:39:22,980 I didn't feel anything. 553 00:39:22,990 --> 00:39:31,360 Um so this conceptual hypothesis that it's probably doing something important, 554 00:39:31,370 --> 00:39:35,030 even though you don't feel it or see it or experience it, 555 00:39:35,420 --> 00:39:35,740 you know, 556 00:39:35,740 --> 00:39:43,650 that can just be really difficult to grab hold of um a few suggestions if you want to try them. 557 00:39:44,020 --> 00:39:47,150 Um I love time timers, 558 00:39:47,160 --> 00:39:55,030 you can get the app or you can buy the physical time timer on places like amazon or other websites on the internet. 559 00:39:55,520 --> 00:39:57,580 A time timer is a visual timer. 560 00:39:57,580 --> 00:40:01,620 So if you have difficulty um with time management, 561 00:40:01,620 --> 00:40:06,700 if you have difficulty getting going or transitioning from one activity to another, 562 00:40:06,710 --> 00:40:11,130 like I'm not exercising now and I have to transition to exercise, 563 00:40:11,510 --> 00:40:28,730 um you can set that time timer and see the visual time disappear and for some reason it just feels very real and compelling and concrete in a way that looking at digits or a clock face doesn't quite feel. 564 00:40:28,810 --> 00:40:30,320 I love these, 565 00:40:30,330 --> 00:40:32,910 I use them in my workplace. 566 00:40:32,920 --> 00:40:34,830 Um I use them at home. 567 00:40:35,210 --> 00:40:44,140 Um so you could set the time timer for when you're gonna start the exercise and also for when you're going to end. 568 00:40:44,610 --> 00:40:57,930 So I only have to do this until the red disappears and then it's a very concrete achievable kind of goal as opposed to this feeling like, 569 00:40:57,940 --> 00:40:58,340 oh, 570 00:40:58,340 --> 00:40:59,890 I have to start this and when, 571 00:40:59,900 --> 00:41:20,020 when is it going to end another technique that I think can make things more concrete and doable is to um set up something that feels real instead of this concept that exercises in some way helpful. 572 00:41:20,030 --> 00:41:22,360 And of course as we age, 573 00:41:22,370 --> 00:41:29,620 we see the results of that less like we we exercise and exercise and eat right and gosh, 574 00:41:29,630 --> 00:41:34,410 my body still doesn't look the way that I would like it to and I'm not really sure what this is doing, 575 00:41:34,410 --> 00:41:37,110 but I have faith that it's good. 576 00:41:37,120 --> 00:41:45,650 Um so we can make it more concrete by using things like challenges um or prompts to move. 577 00:41:45,650 --> 00:41:47,980 So there's a lot of technology these days, 578 00:41:47,980 --> 00:41:50,300 like um smartwatches, 579 00:41:50,310 --> 00:41:57,180 they can vibrate once an hour just to remind us to move or get up and walk. 580 00:41:57,190 --> 00:42:02,590 Um there are challenges on the smartwatches, 581 00:42:02,600 --> 00:42:03,600 different ones, 582 00:42:03,600 --> 00:42:04,770 call them different things, 583 00:42:04,770 --> 00:42:06,420 but there can be games, 584 00:42:06,430 --> 00:42:17,990 there might be like a fitness bingo or these things where you get icons lit up if you walk a certain number of steps or have your heart rate going as active. 585 00:42:18,000 --> 00:42:21,430 So those kind of things can make it concrete and fun. 586 00:42:21,440 --> 00:42:24,510 Like I don't know if my cholesterol changed, 587 00:42:24,510 --> 00:42:25,810 but I got this, 588 00:42:25,820 --> 00:42:31,220 I won this game or I finished this challenge and that felt good. 589 00:42:31,900 --> 00:42:35,360 Um there are also since Covid in particular, 590 00:42:35,360 --> 00:42:39,420 a lot of virtual challenges that you can do with people around the world. 591 00:42:39,430 --> 00:42:52,200 So there are challenges where you can sign up to walk through a particular area of the world and people around the world are doing it with you and then you get a medal afterward and again. 592 00:42:52,200 --> 00:42:54,390 That that makes it feel concrete. 593 00:42:54,390 --> 00:42:55,490 I've achieved this. 594 00:42:55,490 --> 00:42:56,520 This was fun. 595 00:42:56,900 --> 00:42:57,770 Um, 596 00:42:57,780 --> 00:43:00,980 one example of that are the conqueror challenges, 597 00:43:00,980 --> 00:43:12,490 but there are a lot of versions of this and you can google what really works for you and what you think might help you get that really concrete goal, 598 00:43:12,500 --> 00:43:13,810 that motivation. 599 00:43:15,500 --> 00:43:21,210 So this wraps up our second and final episode of question and answer. 600 00:43:21,220 --> 00:43:26,540 We're going to go back to some themes of episodes next and then in the future, 601 00:43:26,540 --> 00:43:31,870 we're going to return to more questions and answers from listeners around the world. 602 00:43:31,870 --> 00:43:32,510 Like you. 603 00:43:33,000 --> 00:43:34,950 If you do have questions, 604 00:43:34,950 --> 00:43:44,570 you can email them to adultandgeriatricautism@gmail.com and I will collect those for episodes in the future. 605 00:43:44,580 --> 00:43:48,020 Thanks for tuning in and I hope you join me next time.