ALCOHOLICS WITH AUTISM...
MY name is Helen, and I’m an alcoholic. I first came to AA in December 2000, came back in December 2009 and again in April 2011 and have been sober since 21 April 2011. I also have autism spectrum disorder. I was diagnosed in April 2019 after my GP referred me for a diagnostic assessment on the NHS. I have been reflecting on my own experience - being autistic and being in AA. However, I think there are two key things to bear in mind when providing support and resources for alcoholics with autism. Firstly, although people with autism all have difficulties with social communication and interaction and sensory processing, how this manifests itself in each individual can vary a lot. Secondly, the best support that people with autism can receive is understanding. The slogan of the National Autistic Society is ‘Until everyone understands.’ My life is made so much easier when other people see my autism for what it is and don’t misread it as meaning something else. That said, it might be useful to hear more of the detail of how autism has affected me in AA.
Coming to AA was a great relief for me. Cafes, pubs and clubs tend to be noisy and there is a lot happening at once. For me, part of my autism is poor auditory discrimination which means that I can’t filter out background noise. So, I have never been able to socialise in these environments. In meetings, people talk one at a time, and otherwise stay quiet, so this is a rare environment that enables me to hear what is being said. A core feature of my autism is difficulty switching attention. I also have difficulty in following the to-and-fro of conversations especially in general chit chat. It is really helpful to me that only one person talks at a time in meetings, and then they keep to the topics of alcoholism and recovery. I like top-table shares because I can understand the format of sharing - what it was like, what happened and what it is like now. I like meetings where people share on the topic of a reading, because again I can follow what is going on. Outside a classroom, I had rarely before been somewhere where I could understand what people were talking about.
I have never been shy about sharing in meetings and in fact needed to talk a lot in the early days of my recovery because I was very lonely. I have a certain degree of face-blindness which means that I can only see the more obvious expressions on people’s faces and miss a lot of the detail. I can tell the difference between a happy face and a not-happy face, but I can’t really see the difference between a frightened face and an angry face. I also have a poor theory of other’s minds and difficulties with perspective-taking, so I find it very difficult to imagine that other people might be thinking about me when I am talking or how they might react. I like to share in a meeting because it makes me feel that I belong: a rare feeling for me.
However, autism has caused me some difficulties in AA. Although I have attended a lot of meetings in the past eight years and had various service positions at group and intergroup, I have not made many friends. It is quite common for women with autism to find it easier to be friends with men than women, because women with autism have characteristics that are more stereotypically associated with men: we prefer to talk about interests rather than feelings and relationships and we don’t pick up on subtle, emotional cues. Outside meetings, I only have about four people I meet up with. I have the impression that friendships in the Fellowship are a big part of recovery for most people. There are many women my age in AA locally who also have small children like me, and even share my interest in yoga. However, I don’t seem able to make friends with them and I don’t understand why.
People with autism are often very socially vulnerable especially regarding 13th Stepping. When I first came to AA in 2011, there were a few men who offered to sponsor me. However, during my drinking days I had become very aware of how a certain type of predatory man behaves with socially vulnerable women and I ignored these overtures in the Fellowship. After the first few weeks, I didn’t have any more experiences with potential 13th Steppers.
...AND SPONSORSHIP
I think that having autism has caused me a lot of problems with sponsors. In the first few years of my recovery, I went through a large number of sponsors. Because I am quite face-blind, if someone looks concerned about me, I can often misread it and think they are angry with me. I also struggle to have conversations that are not about a well-defined topic, because I feel lost and don’t know what the point is. So, I have struggled to connect with sponsors. Also, having autism means that I have very little concept of the future, and so when people share about worrying about next Christmas or some other thing that is not today, I often don’t get what they mean. I don’t tend to worry what people are thinking about me, because it is just an odd concept that they might be thinking about me (I am usually not thinking about them!).
I think I may have caused problems in meetings because I don’t know what is or is not appropriate to share in a meeting until someone tells me explicitly. I needed quite a lot of instruction about what level of detail is appropriate in sharing in a meeting. I remember one sponsor reminding me that it tells us in the Big Book that, “We share in a general way our experience, strength and hope.”. It was a big learning curve for me to start to understand about levels of detail when sharing.
Like many people with autism, I tend to take instructions very literally and I like to obey rules. In many ways, this has worked in my favour and has led me to be quite diligent in following the suggestions of the Programme. However, I have really needed the help of my sponsor in understanding other people’s point of view and experiences so that I don’t cause more harm when making amends.
There are some trends in AA which I have found to be not helpful. Sometimes people share in meetings that members should not take any psychoactive medication. People with autism are likely to take this very seriously and want to obey it. However, this may be contrary to medical advice and cause the autistic alcoholic serious conflict. People with autism are more likely to also have conditions such as OCD, epilepsy and ADHD for which medication may be essential. My own experience is that I have really benefited from outside help from psychologists, counsellors and psychiatrists. I take regular medication for some of the side effects of autism and it has been life- changing.
However, in general, I have found AA to be a very helpful environment for this alcoholic with autism. Without the honesty that I have learned in the Rooms, I would not have been able to talk about my difficulties with my GP and I would not have the diagnosis and the self-understanding that goes with that. I am finding that the more I am able to explain that I have autism and how it affects me, the easier it seems to get on with other members of the Fellowship and more importantly, the better I am at finding ways in which I can be of service to others.
HELEN, Milton Keynes