Years ago here in the UK there was a series of adverts on TV to try to persuade people to make more phone calls and speak to people more often. The tagline was “It’s good to talk.” That might be true, but for some people it’s not easy. Continue reading
Over the past year, and especially since the publication of Switched On by John Elder Robison, there has been a lot of attention around a therapy called TMS (or rTMS–Repetitive Transcranial Stimulation).
It’s something I have deep reservations about but others have written passionately and eloquently on the subject. What I want to consider is why somebody would choose to undergo such a therapy that literally changes their mind.
I’m no stranger to the negative feelings that arise when considering the gap between how I perceive myself and what I see when I look in the mirror: that’s a big factor in my gender dysphoria.
I also know first-hand how it feels to be teased and ridiculed for hand flapping, physical clumsiness, social awkwardness, unusual speech patterns and eclectic interests. I’ve had life-long difficulty making and maintaining interpersonal relationships, and I have times where I feel keenly the lack of people with whom I feel comfortable opening up about my problems and feelings.
I understand the drive to make physical changes to one’s body. After all, I’m in the process of seeking treatment to modify my own body, bringing it into closer alignment with what I see in my mind by erasing or concealing male characteristics and developing female ones.
There are two parts to my gender dysphoria. First there is my need to have other people respond to me as a woman, reinforcing my gender identity. Second there is my need to see my own body physically match the mental image I hold.
So as a trans woman I am actively seeking treatment to make changes to my body. This is in contrast to my feelings about my autism. Both my gender identity and my autistic identity go to the very heart of who I am.
The thing is, although I will happily modify the physical characteristics of my body I wouldn’t consider altering my mind. My neurology is inextricably tied to my identity: I feel that changing my mind would make me into a different person.
There’s a line there. I’ve put a foot over that line a few times, testing the water so to speak. I’ve experienced the effects of drugs that affect the workings of the brain: alcohol, marijuana, amphetamines, SSRIs (anti-depressant).
Some of them have positive aspects. For example, alcohol reduces my social anxiety. But there are negatives too: I make poor decisions under the influence of alcohol because it inhibits my self-control and risk-aversion: I’ve gotten myself into some dangerous situations as a result.
Speed (amphetamine) left me unable to concentrate, marijuana was relaxing but caused mild hallucinations and a degree of paranoia. The SSRIs reduced the intensity of my emotions, leaving me feeling numb: in the end I had trouble focusing and engaging with things in my life.
These were all temporary effects: my mind returned to its usual functioning state in time for which I was grateful. You see, I wasn’t myself when under the influence of any of these drugs.
I guess my point is that given the complexity of the human brain and the way its many regions interact it is not possible to adjust one aspect without affecting others. Just as a particular drug affects a small number of electro-chemical interactions in the brain with wider-reaching side-effects, so a therapy like rTMS that alters a small region must cause knock-on changes across the entire organ.
My opinion is that it is not like tuning an engine, a relatively simple system with a limited degree of interconnection and feedback between its components. It’s more like introducing a foreign species into an existing ecosystem. The effects can be slow to manifest, and predictions are error-prone due to the complexity and chaotic nature of the system.
There is no way to know what other effects rTMS would have. It might reduce my social anxiety, but even if that was all it did it would make me respond differently to people I interact with (like alcohol). And if my thoughts and behavior are changed then I’m no longer the same person.
I don’t want to change who I am: I’m comfortable with my identity as an autistic trans woman with all that entails. Changing my body doesn’t affect my personality, my thoughts: I remain me. Changing my mind makes me into somebody else. I would lose the essence of what makes me this particular unique individual, and the thought of that fills me with dread.
This leads me to suppose that for somebody to even contemplate such a thing they must not like who they are. Internalized self-hatred, blaming their neurology for what they see as their failings. It’s like body dysmorphia projected onto the ego, the sense of self. The antithesis of neurodiversity’s principles; an inability or refusal to accept one’s differences.
I see this as a result of thinking colored by the medical model of autism that sees it in terms of pathological deficits, as opposed to the social model which instead looks to society’s failures to provide suitable accommodations and acceptance as the causes of disability.
There’s nothing wrong with my mind: I have no reason to change it. I can’t say the same for the society I live in.
I’ve been putting off writing this post. No, seriously, I must have fired up the WordPress editor ten times now and each time I’ve found some distraction to take me away from writing.
Procrastination. Deferring tasks until the last minute and then rushing to complete them by the deadline.
It’s not that I sit there idle, wasting the minutes and hours while I could be working productively. I rarely have any difficulty finding activities to satisfy my need for interesting stimulation.
It’s rather that I need a certain level of stimulation to engage with a task. To feel motivated enough to start it. Dishes pile up in the kitchen sick because although it only takes about five minutes to wash them (I’ve timed it–doesn’t everyone?), and I don’t find the task onerous, I fail to summon enough interest in the activity until it’s nearly bed time and I feel a sense of urgency.
As a child homework presented the same obstacles, except for the few instances such as essay writing that I felt enthused about. To be honest, most homework is a mind-numbingly tedious repetition of what was already learned in that day’s lesson. I used to complete most assignments in the break time before class.
The same afflicts me at work to this day. I’ve been known to spend hours or days coding on personal (although still work-related) projects at the expense of what I’m due to deliver. That work gets put off until I feel that the time remaining fits my gut feeling of the effort required. Having said that, I have a good track record of delivering on time.
That last point is important. I’m fulfilling my obligations. In many ways I view my procrastination as a positive thing. The focus that is instilled in me by the pressure of the impending deadline concentrates my mind wonderfully.
Where otherwise I might tentatively poke around, mind not completely on what I’m doing and consequently making bad choices and failing to consider problems in sufficient depth, instead it’s like a finely-tuned engine running at its peak. It becomes easy to sink into the comfortable mental flow where it all just happens without the sensation of effort.
There’s a fine line between the energizing pull of a looming deadline, fueling the fires of creative endeavor, and a crippling anxiety triggered by fear of failing in my task. I’ve become adept–at least in the absence of external factors that strew tacks in my path–of maintaining my balance on that razor’s edge.
It’s exhilarating, such a sense of capability, of almost unbounded potential. It feels as if I can achieve anything I set my mind to. The sheer pleasure! It’s an addicting experience but one that appears to cause no harm.
They call procrastination the “thief of time” but I disagree. For me it’s a form of time management that maximizes my overall productivity, the key to unlocking my highest abilities. Far from stealing time from me it gives me the ability to use my time to its fullest potential.
When I was about 13-14 I was bullied at school. Not physical attacks; it was nothing so obvious. Name calling, “teasing”. I was the quiet one, the one who didn’t get involved in playground games but would rather spend time around books. I didn’t have anyone I’d call a friend, not because I didn’t want friends but because I had no idea how to form friendships.
I became more and more fearful of being at school. I used to fantasize on the journey there in the mornings about opening the car door and jumping out, although I was too afraid of injuring myself to attempt it. At the time I couldn’t articulate how I felt: I wasn’t able to put a name to my emotional state. My grades declined and I often didn’t complete homework, leading to punishments. I felt completely alone, insecure and vulnerable.
Things reached a climax one morning. I’d dressed in my uniform as usual but I guess my fear and anxiety had risen to some critical threshold and when my father called for me to get in the car I stayed in my room. He got impatient, started shouting and came into my room to fetch me. I was afraid of the shouting and when I saw a clear path past him, out of the room, I bolted.
I ran across the hallway and into the room opposite, slamming the door shut and leaning up against it. He banged on the door, demanding that I open it and come out: I didn’t move or respond. He broke through the door, breaking it from its hinges. I think at that point I had broken down in tears: my memory is not clear. I think my mother must have intervened because he left and I was able to return to my bedroom, wedging the door closed with a screwdriver driven into the door frame.
I stayed in my room for weeks, even months, only venturing out occasionally during the day when I knew it was only me and my mother at home. I don’t know what went on outside my own little world during that time but eventually, because I’d not been attending school, social services became involved. I was taken, rather unwillingly, to see a couple of child psychologists.
They spoke to me as to a young child, completely failing to make any kind of connection with me. I think when I did respond to them I was monosyllabic. There was never any indication that they had any insight into how I was feeling and I wouldn’t have been able to enlighten them given my alexithymia. I knew I couldn’t go back to that school, but I couldn’t even explain the reasons inside my own head. Not for years, until I eventually learned to identify and put names to my emotional experiences.
You’ll notice I haven’t described, except in the broadest terms, what bullying I suffered. If I do retain any detail about it in my memory I am unable to access those portions of my life. Approaching where they are locked away triggers warning pangs of fear even now, nearly 30 years later, and I back away.
I know I still have issues that stem from being bullied. Any teasing is immensely hurtful to me. I’m often afraid to be as expressive as I’d like to because I expect to be ridiculed. Even though I often don’t show much feeling, particularly negative emotions, I make an effort to give nothing at all away about how I feel unless I’m somewhere I feel comfortable. I’ve suppressed some aspects of myself for so long I wonder if they’ve withered away.
Most days I don’t think about that period of my life, and I’m happy about that. However the recent activity centering around an awful article on ADN that casts bullying in a beneficial light has brought old feelings back up towards the surface, unsettling me. I hope I’ve explained here why I fail to see anything positive about bullying.
UPDATE: Starting to wish I’d not written about this: it’s triggered stuff I’d rather not have to deal with. It’s too late now: the damage is done and I’ve got to let the tears and residual anxiety pass. Get on with my life. But we can never completely leave our past behind us.
Some of my readers will be aware I finished working at Quantel at the start of this month. After more than eight and a half years–by far the longest I’d spent at any one place–I felt it was time to move on. A merger with another company had brought a lot of new faces into the office, and a recent department restructure on top meant too much change: it no longer felt like the same place I’d become used to.
There was a lack of clarity in my mind about where I fit into the new, different organization and my comfort was disturbed. I was suffering high stress levels and recurrent anxiety attacks and decided it would be best for my health if I left. I was confident I had the means to keep Anne and me going until I could find a new job.
The day I left I met with the department head and HR; they shook my hand and wished me well. I slipped out quietly. The emotionally charged process of saying goodbye would have been too much for me. It all seemed a little unreal as I drove home, closing the door on that chapter of my life, but I did feel an increasing sense of relief as the stress dissipated. I simply relaxed for the rest of the day, refreshing myself and recovering from the weeks of exhausting, overwhelming mental turmoil.
The next day was a Friday. I woke feeling energized and strongly motivated, and quickly set to work putting together an up-to-date resume which I posted to a website I’d used the last time I was seeking a new job. Within hours I started receiving emails and phone calls from recruiters.
Now phone calls are a thing that often cause me problems. Conversation and interaction with strangers are things that can trigger anxiety. But it’s a question of context: in this case the interactions were predictable and hence manageable. I had a clear picture of what I was looking for and was able to easily communicate that. Plus I’d been through this kind of process before and understood how it works.
In a nutshell the process goes like this: I put my resume together with an emphasis on my skill set and experience. I post my resume and details in a place where I know recruiters will see them. Then I sit back and wait. The recruiters do the leg-work of searching among their lists of open positions for ones that match what I’ve got and when something comes up they contact me and market that “opportunity” to me. They earn their money through commission, just like sales-people, so they try to make sure they offer suitable matches based on the information I’ve provided. The better the definition I give them of what I want, the more appropriate the jobs they approach me with.
It worked very well. Within a week of starting my search applications had been submitted to several companies and I had my first interviews arranged. In the past, over 8 years ago, I’d almost always been asked to attend these first interviews at the company offices where I would meet people face to face. Not this time. This time around the first contact was conducted by phone (plus an initial web-based test in a couple of cases).
My biggest area of concern was that I usually get mistaken for a man on the phone. It’s just the way my voice sounds, the effect of hormones on my development as I grew up with a body that increasingly diverged from the way I felt it ought to be. But I needn’t have worried: the people phoning me had my details in front of them and I’d deliberately used my full name, Alexandra, as a gender hint rather than my usual ambiguous Alex.
I know that many people find job interviews to be highly stressful experiences. I’m unusual in that I don’t. Not any more, at least. When I was looking for my first job all those years ago I did suffer with nerves. I was going into a place I’d never been before, meeting people I’d never seen before, and had little idea what to expect. These days I have a degree of familiarity with the process which makes it largely predictable.
I also have a lot of confidence in my technical skills. I’ve got a lot of experience behind me and I know that I can provide an answer to pretty much any relevant technical question. I work in a technical field, software development, and it’s those concrete technical skills that mean a lot in the interview. They’re not the whole story though: the bottom line is that the interviewers are looking for somebody who will fit into their existing organization. It goes both ways too: I need to feel that it’s right for me and I’ll be comfortable there.
This is the point at which I throw most of the standard interview technique advice out of the window. Typical advice mentions such things as researching the company in depth, practicing answers to common questions, and having prepared questions to indicate your interest. My research consists of finding out what technologies underpin the company’s products. I’ve never practiced my answers or even spent time thinking about what they might ask me in advance. And I don’t compile a list of questions to ask them.
Things I do spend time on beforehand: I take reasonable care with my appearance. I dress in a suit, make sure my nails are tidy and the polish isn’t chipped, and wear light, neutral makeup. After all, an interview is a formal setting so it’s important to conform to business conventions regarding appearance. Beyond that, though, I favor the honest approach: I speak and act as I would normally in a work environment. I want the people interviewing me to see me as I am rather than me putting on an act, trying to appear as somebody I’m not and impress them with my people skills (such as they are!). After all, if successful I’ll be working alongside them and there’s no way I could keep such a pretense going.
That avoidance of pretense was also the reason I never considered trying to present as anything other than my everyday female self. I’m a trans woman in the (lengthy) process of transitioning who has not yet started any medical treatment. My view going in was that if somebody I met was not comfortable with this, with me, that wouldn’t be a good place to work. I’m the person you see in front of you and if you can’t accept me as I am then we’ll not be working together. As things turned out I saw no indication at any point that being trans affected how I was treated.
Things I commonly get asked: there are always questions about particular projects I’ve worked on in the past and about relevant experience I’ve highlighted in my resume. Not things I need to rehearse because, obviously, I was there and did those things. I can speak about them at length, and indeed tend to do just that. Interview advice is usually to keep your responses short and to the point but that’s not me. If I’m offered a chance to infodump about something I’m interested in I’ll grab it. My interviews usually overrun the scheduled time as the interviewer and I end up conversing about common technical interests. It’s not intentional, but it seems to work out well.
In fact, a couple of my technical interviews started with the expectation that some of the time would be spent taking a written technical test. The interviewers in both cases arrived with a sheet of questions, but they presumably decided it was unnecessary after a few verbal exchanges. I must confess that I enjoy the chance to talk about the technical aspects of my work to people who have the knowledge to understand the details, and tend to make the most of the opportunities that an interview presents.
I mentioned above that the interview process goes both ways. Yes, I need to find a job, but it has to be one where I’m confident the role and company will suit me. I can reasonably expect that I’ll be in a job for a number of years, so it’s important to me that I choose carefully. I rely on my gut feeling for this: I form a subconscious impression of a workplace as I talk to the interviewers. I need to feel comfortable with these people because I’ll potentially be working with them, so if there’s something that makes me uneasy–even if I can’t consciously identify what’s causing it–I’ll decide against accepting an offer should one be forthcoming.
The end of this tale is that I received a verbal offer at the end of last week, only two weeks after I began searching. It’s the quickest job hunting experience I’ve ever had: it seems there’s plenty of demand for software developers. I’m feeling very happy, excited and positive about this next step in my career, and I’m really enjoying the absence of stress and anxiety right now.
I fear my traitorous mind;
Prized asset, golden treasure
In which lurks a monster:
One I cannot hope to control.
Lying in wait it watches,
Senses when I am weak,
Releases its psychic poison
Infecting me with fear.
As I lie besieged by doubt,
Assailed by anxiety’s forces,
I begin to believe its lies:
That I am alone, unloved and broken.
All that I have, all that I am
Lies scattered: small trinkets
Dot the empty wasteland;
I lie in pieces in this desert.
Furnace heat of merciless sun
Makes the very air dance;
All else is stillness and silence.
Laid bare I cannot hide.
In the midst of this ruin,
In the eye of the storm of fear
There is a mote, a tiny seed
Holding my essence in trust.
Though the ground is barren
Where the beast has raged
I plant this seed of hope,
Water it with my tears.
I spend the last of my strength
To protect and nurture this spark,
I give all of myself to it
And rise again, renewed.
The monster has vanished,
The burning sun become a fount
Out from which streams the warmth
Of healing love from friends.
The barren wastes turn green,
Meadows and woodlands host life
Amid which I sit at ease,
Healing in these peaceful arms.
I’m not very good at planning ahead, considering consequences of my actions. I exist in the present and the past; the future is too abstract to engage with. This is an executive function deficit. I am poor at planning and organizing my life, and cope with this by relying on routines. Running round the same circles day after day.
Μή μου τοὺς κύκλους τάραττε! — Ἀρχιμήδης
(Do not disturb my circles! — Archimedes, popularly supposed to be his last words)
This works well enough under normal circumstances, but a recent change in my life — gender transition — has disturbed my circles, my routines. The old familiar sequences I used for years as a male to get ready for work in the morning are no longer completely applicable to me as a female.
When I don’t have an established routine in place it takes me a long time to complete a task. I spend more time thinking about the various steps I need to complete than I do actually completing them — like I said I’m not good at planning. Every step along the way between getting out of bed and leaving home to go to work must be consciously considered and executed.
More than that there is a feeling of unease, of insecurity. Having no routine to rely on means I constantly view it as an unfamiliar situation, and the unfamiliar makes me anxious. Anxiety makes it more difficult to think clearly about what I am doing, makes it harder to plan what steps I must take.
When I have a routine I do not need to think about what I am doing: force of habit guides me through the sequence of steps effortlessly. I refer to it as being “on autopilot”. And like an autopilot I am unable to handle the unexpected: changes. Those times when the pilot must step in and take manual control.
For over two months now I have been struggling to establish new routines to replace the old ones. It is a slow process, requiring a patient, incremental approach. But I am getting there. The components that will build my morning routine are becoming established, steps are being aggregated into short sequences. I am now at the stage where I can start to join these components into a seamless whole.
It still took me over two hours to get ready this morning, with about an hour of that being spent thinking through what my next moves should be: this is progress. I believe that within another few weeks I will have learned my new routine and will no longer have to think about what I am doing every morning. I will be able to cope again.
My new circles are close to completion. I hope nothing disturbs them.
I have Aspergers Syndrome, anxiety disorder and, right now, depression. These are disabling conditions: I am disabled. But I’m not broken.
Is my autism a blessing or a curse? How do I see it myself? That’s a difficult and important question and I will try to answer it.
I don’t do arguments. That whole in-your-face shouting business? Take it somewhere else because I don’t want to know. I’ve gotten my reasons for avoiding these situations, some of which relate to my autism, others to my anxiety.