Component 2. Identifying individual stress, anxiety, and non-coping.

This component of Dr. Shah's plan is designed to keep helping you (and your carers) figure out exactly why you are dealing with such heavy burnout/catatonia. A different chapter in Dr. Shah's book, Chapter 5, gives some good lists of possible causes. Reading these lists, you might feel like they are pretty obvious--the experiences they describe can sound like just another Tuesday for an autistic person--but remember that part of the goal of some of this stuff is to help you communicate with everybody around you. Here are some of the potential psychological causes of catatonia that Dr. Shah lists (pp. 80-81):

* Negative social experiences like bullying, abuse, violence, or exploitation

* Feeling emotionally "crushed" by institutional settings like schools, workplaces, or group homes

* Sensory overload

* Lack of autism diagnosis, which can lead to difficulties in accessing appropriate support, accommodation, or understanding

* Feelings of pressure, guilt, and underachievement ("particularly in girls with autism, there can be immense pressure to succeed, which may lead to feelings of guilt and the perception of not meeting expectations.")

* Novel or surprising social situations that make masking suddenly feel impossible

* Emotional overload, caused by the intensity of autistic emotion

(The language in the list, above, comes largely from pp. 80-81 in Dr. Shah's book, although I have adapted it by making the language slightly more accessible and autist-focused.)

Again, all of the experiences in the above list can contribute to the onset of autistic catatonia. None of this is likely surprising to anyone on this forum, but having the list spelled out by a clinician might help to get the point across to a doctor? It's often useful to have a checklist in any case.

Also from Chapter 5, here's a list of possible "ecological" causes of breakdown or catatonia:

* Being in a setting or program that doesn't meet your specific needs as an autistic person (whether it's supposedly designed for autistic/ND people in mind, or not)

* Having too much, too little, or the wrong kind of stimulation (intellectual or sensory)

* Being placed in majority-NT settings, without accommodation or without enough accommodation (for example, taking a new job with a boss who won't make accommodations/with a company that won't honor the ADA)

* Dealing with a recent loss of support, especially one brought about by a life transition (new home/new job/new school/etc)

* Dealing with inappropriate peer groups and pressure from social media.

* Being exposed to environments and situations that cause sensory overload or overwhelm their autistic senses, like loud noise, chaos, or lack of structure. (80)


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