Monday, July 12, 2010

How to Understand the Anger and Rage in People With Autism

"I am very angry and filled with rage. I cannot express my anger, but I feel it. This anger permeates into every part of my being. It helps me to stay alive. It gives me energy to exist. It seems to be functioning to protect me. It is like a person standing over me and protecting me. It feels as if the rage has torn me apart and allows one part of myself to take care of the parts that cannot take care of themselves. My anger and rage are being put to work to function in a way that is helping me inside. This anger and rage is inside waiting to come out. It cannot come out now because it has an important job to do, but when it does it will fill a very large room."
What is this autistic boy telling us? We can break up his message into two parts:
1) The dissociation experienced by autistic individuals and
2) How emotions such as rage and anger function within the autistic individual.
He seems to be telling us that he can feel his anger and rage, but more importantly cannot express it. From his vantage point, these emotions seem to be functioning as an internal protective mode. They protect the weaker parts of him that cannot protect themselves. It is like they are "people" protecting him.
In some regards this can make sense. The autistic individual has not had a completed attachment and thus is left in a dissociated unconscious state (lowest functioning autistic child). This changes as the child develops. Thus he can become more conscious and less dissociated and then we would call him high functioning or with Asperger's. Eventually he may not be identified as being on the autism spectrum at all.
It is important to note that from the perspective of an Incomplete Attachment the child is functioning in a normal state of dissociation. Parts of the self are not conscious to or available to the person to use in their communications with others. It is the state that the ASD individual lives. Bromberg (1994)* believes all individuals begin life made up of multiple self-states. Our wholeness develops through a relationship with another person. Because the autistic person lacks an attachment, he remains in a non-whole state. Thus the individual has different parts of himself that have not integrated.
In this situation, this autistic boy not only is in a normal state of dissociation, but also as he lives in this state of dissociation and as he develops, he learns to adapt to the situation and parts of himself (in this case his rage and anger) become internal methods to handle and cope with his situation.
I believe that as he develops a significant relationship with a person who understands his predicament, together they can forge an attachment that will help him to become less dissociated. He will be able to communicate his rage and anger and other emotions as he becomes less dissociated. As this occurs, he will be able to communicate the feelings that up to this point have only been internalized.
It is important to note that some autistic individuals are filled with rage and anger and that as they do develop we see more of the explosive anger coming out. Some individuals seem to be filled with inordinate amounts of anger. I think of this from three perspectives:
1) the excessive anger might be due to his rage at not having had a direct outlet for these emotions. In other words, he had to live without access to his emotions so he is filled with anger that has never previously seen the light of day,
2) when anger is dissociated the child does not have control over his emotions. Until his angry feelings are understood, they will come out as intermittent explosive acts of rage and
3) he probably has lots of angry feelings towards others that may not have helped him to express his anger. This may not seem logical, but I would imagine the autistic child looks to the caregivers and others to know how to solve his dilemma and when this does not happen in a reasonable time, his anger may grow. When he finally has access to his emotions, there is what I think of as a lot of residual anger to deal with. Thus it would be important that when working with autistic individuals from a 'relational perspective', it would be important to expect this build up anger to come forward. This will be a positive move for the autistic individual, but caregivers and others may not know how to manage their own feelings when they are bombarded with these angry emotions.
* For more information see: Bromberg, P. M. (1994), "Speak! That I May See You" Some Reflections on Dissociation, Reality, and Psychoanalytic Listening. Psychoanalytic Dialogues, 4 (4): 517-547.
Karen Savlov is a psychoanalyst and Marriage and Family Therapist with a private practice in West Los Angeles, California. My specialty is Autism Spectrum Disorders, anger, dissociation, depression, anxiety and relationships. For new and creative ways to think about autism read and follow my blog at I can also be followed on Twitter at Autism Thoughts.

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