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Social problems (Aspergers) are anxiety inhibition of social skills rather than a lack of skills |
adhd
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| Inhibition of social skills by anxiety |
| Facing social rejection |
Socially clumsy children usually do not usually have a social skills deficit. Rather, some social situations, particularly with peers, trigger emotional arousal so the child does not have the attentional resources to learn new social skills or demonstrate the social skills they already have. Remove the anxiety and you will see a far more accurate picture of what they can do.
Inhibition of social skills by anxiety
The same phenomenon described elsewhere that occurs with academic tasks is found in the social skills arena as well. Some children with social skills problems are described as having social skills deficits, being immature or being High Functioning aspergers (HFA). These terms are stand-ins for “he can’t…” (Note: There are children with pronounced deficits in the autistic spectrum disorders who most likely have neurological problems. I am not talking about them here. It has been my experience that children are often labeled aspergers when they have a few social problems or mild symptoms. Those I am referring to here as High Functioning Aspergers-HFA.)The implication is that some delay or abnormality in the development of a child’s nervous system prevents him from behaving appropriately. Though occasionally true, such explanations are usually off the mark. In the vast majority of cases, poor social performance has nothing to do with development or impairment of a child’s nervous system.
If is often suggested that Aspergers and social problems stem from being unable to read social cues or inability to develop the social skills to respond appropriately. This is a gross misunderstanding of the cause of these problems, which in turn leads to ineffective treatment efforts.
Children's actual ability is usually apparent if you look across their lives. There are usually situations where children demonstrate good social skills, such as with their family, a younger friend, or with adults. Many of these children will interact appropriately with adults, but do poorly with their peers. So obviously, they “can” but “do not” always. This contrast is the key to understanding what is going on.
If people demonstrate appropriate social skills in one setting, they clearly have the skills, even if they do not display them everywhere. If the skills they have are not being demonstrated in another setting, it means that these skills are being emotionally inhibited in the problematic situations, just as academic skills are inhibited by fear and frustration. Children tend to perform better with family and adults because those people tend to be more accepting and supportive than peers.
If people demonstrate appropriate social skills in one setting, they clearly have the skills, even if they do not display them everywhere. If the skills they have are not being demonstrated in another setting, it means that these skills are being emotionally inhibited in the problematic situations, just as academic skills are inhibited by fear and frustration. Children tend to perform better with family and adults because those people tend to be more accepting and supportive than peers.
Facing social rejection
As many of us know from our own childhood experiences, peers can be merciless with those who aren’t “cool” or “popular.” Such treatment is painful and not surprisingly causes fear and anxiety. This fear inhibits social skills in future encounters with peers, which becomes a downward spiral.
The problem is not, as often hypothesized, that they miss social cues. They read the cues and know something is going wrong, but their solution does not work.
One of my articulate patients put it well. "I find I’m able to read people really well, but I usually don’t respond accordingly."
The problem is not, as often hypothesized, that they miss social cues. They read the cues and know something is going wrong, but their solution does not work.
One of my articulate patients put it well. "I find I’m able to read people really well, but I usually don’t respond accordingly."
Just like the rest of us, when HFA’s are anxious, their ability to think straight and problem solve situations is out the window. When this happens, they respond in the most innate, reflexive way. They assume that there is something missing in what they are saying to the other person, i.e. there is deficit. (The Deficit Model is discussed in detail in ADHD: Drug-free and Doin' Fine) They feel, “I have not said the right thing” or “I have not given the right answer.” To win the approval of the other person, they try to fill the deficit with what is most fulfilling to them, their interests, ideas and words. In addition, focusing their attention on the subjects they like and feel competent at reduces their own anxiety.
This is what causes their intense talking about their favorite and well rehearsed topics, such as computers, dinosaurs, trains, meteorology, politics or unasked for solutions to problems. These are a way of engaging with the other person in an attempt to fill the imagined deficit.
Though this strategy actually makes the problem worse, and they feel it, their anxiety is draining the attentional resources necessary to shift strategies in real time. A downward spiraling feedback loop develops which results in their “rattling on,” which drives people away. Later, when they are relaxed, many of them can tell you that rattling on about their favorite topics drives people away, but in the pressure of the moment, they cannot implement this insight to change their behavior.
As children face social rejection and failure, they develop anticipatory anxiety, which further reduces their social performance. This generates more negative feedback, which increases their anxiety, which further inhibits their social skills, and so on. This may lead to depression and social withdrawal.
Humans are social animals, and usually find strength, comfort and pleasure in interacting with others. However, if these social interactions are repeatedly unpleasant, then the anticipation and experience of social interaction becomes aversive. This aversion triggers social avoidance, phobia and deprecation of people and situations. You will often hear this in the form of, “they are dumb,” “I do not like them,” “they are immature,” “I don’t like that game,” or “they are stuck up.” This all translates to “I need a good excuse not to risk being rejected again.” The basic human social needs are still there, but being pushed aside by this learned anxiety and avoidance.
In the case of both academic skills and social skills, there is no point in teaching either academic subjects or social and communication skills that children already possess, but is being inhibited by anxiety. It is more effective to extinguish the emotional blocks that inhibit access to these academic and social skills. This offers an avenue to transfer those already developed skills into other areas where the child has experienced anxiety.
This is what causes their intense talking about their favorite and well rehearsed topics, such as computers, dinosaurs, trains, meteorology, politics or unasked for solutions to problems. These are a way of engaging with the other person in an attempt to fill the imagined deficit.
Though this strategy actually makes the problem worse, and they feel it, their anxiety is draining the attentional resources necessary to shift strategies in real time. A downward spiraling feedback loop develops which results in their “rattling on,” which drives people away. Later, when they are relaxed, many of them can tell you that rattling on about their favorite topics drives people away, but in the pressure of the moment, they cannot implement this insight to change their behavior.
As children face social rejection and failure, they develop anticipatory anxiety, which further reduces their social performance. This generates more negative feedback, which increases their anxiety, which further inhibits their social skills, and so on. This may lead to depression and social withdrawal.
Humans are social animals, and usually find strength, comfort and pleasure in interacting with others. However, if these social interactions are repeatedly unpleasant, then the anticipation and experience of social interaction becomes aversive. This aversion triggers social avoidance, phobia and deprecation of people and situations. You will often hear this in the form of, “they are dumb,” “I do not like them,” “they are immature,” “I don’t like that game,” or “they are stuck up.” This all translates to “I need a good excuse not to risk being rejected again.” The basic human social needs are still there, but being pushed aside by this learned anxiety and avoidance.
In the case of both academic skills and social skills, there is no point in teaching either academic subjects or social and communication skills that children already possess, but is being inhibited by anxiety. It is more effective to extinguish the emotional blocks that inhibit access to these academic and social skills. This offers an avenue to transfer those already developed skills into other areas where the child has experienced anxiety.
One method of doing that is the caer treatment that I do. It is designed to extinguish this inhibitory emotional arousal. In the case of treatment for social interaction problems, one needs to both decrease the social anxiety and avoidance as well as reinforce social interaction, so that it becomes intrinsically reinforcing. Once the negative feelings are extinguished from the socially difficult situations, social performance usually improves dramatically, without any social skills training.
Once the anxiety is extinguished, the next step is to re-create the reinforcing experience that is usually part of social interaction. Typically, this is just a matter of “priming the pump” by providing a few initial rewards contingent upon social interaction. However, continuing to force a child into phobic social situations, without first extinguishing the anxiety, will often further condition the anxiety and make the problem worse.
Pump priming can be as simple as first talking to the child about some small bit of positive social performance that was observed and avoiding talking about social difficulties. To create a chance to observe those behaviors, inviting a select few peers over for pizza and computer games, or the like, helps. Many things are likely to go wrong, and avoiding talking about them is absolutely critical. Small rewards can be provided for behaviors such as sharing toys, staying with the group, or letting others help themselves to food first.
Once the anxiety is extinguished, the next step is to re-create the reinforcing experience that is usually part of social interaction. Typically, this is just a matter of “priming the pump” by providing a few initial rewards contingent upon social interaction. However, continuing to force a child into phobic social situations, without first extinguishing the anxiety, will often further condition the anxiety and make the problem worse.
Pump priming can be as simple as first talking to the child about some small bit of positive social performance that was observed and avoiding talking about social difficulties. To create a chance to observe those behaviors, inviting a select few peers over for pizza and computer games, or the like, helps. Many things are likely to go wrong, and avoiding talking about them is absolutely critical. Small rewards can be provided for behaviors such as sharing toys, staying with the group, or letting others help themselves to food first.
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