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Kathy Marshack News

Male and Female Differences in Autism Spectrum Disorder

Monday, October 02, 2017


Have you ever wondered if you’re autistic? Do you wonder about your daughter, your mother or your sister? After living with an Aspie for a few years, you may be a bit quirky yourself. Tragically, girls are typically under-represented in studies and treatment programs for high functioning autism, because they do look different.

In fact there’s emerging research that demonstrates that women on the Autism Spectrum have different brain organization than men on the Spectrum. For example, ASD women and girls seem to have more access to some of the empathy circuits in the brain. Not as much as NT women, but enough that they also are quite confused and suffer in relationships with ASD males.

Current estimates of the ratio of ASD male to female is 4 males to 1 female. However Simon Baron-Cohen suggests that once female ASD is diagnosed effectively, the numbers will change to 2:1. Right now females tend to get diagnosed for ASD only when they’re low functioning. More often than not they’re receiving alternate diagnoses like ADHD or OCD.

Have you noticed the differences between male and female Autism? Or would you like to discuss this topic further? If you’re a member of our Asperger Syndrome: Partners & Family of Adults with ASD meetup, be sure to register for the free, international Teleconference: Male and Female differences in Autism Spectrum Disorder on Thursday, October 19, 2017 at 2:30 PM PT. We’ll dig into the research on girls and autism. Bring your personal examples. Even if you have no experience with women and girls on the Spectrum, you’ll gain insight into your male Aspies by comparison.

Other resources:
NPR’s Morning Addition: ‘Social Camouflage’ May Lead to Underdiagnosis of Autism in Girls.
Barry Carpenter Education pdf
What is it like to be a girl with autism?
“Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions

Do you suspect that one of your female family members has undiagnosed autism? With a proper diagnosis, you can begin the process of helping her live a better life. If you live near Portland, OR/Vancouver, WA please contact my office and schedule an appointment.

You can read my story and that of others’ in my book, Out of Mind – Out of Sight: Parenting with a Partner with Asperger Syndrome (ASD). Click on the image below to download a free chapter.

Why Do Those with Asperger’s Syndrome Say the Strangest Things?

Tuesday, September 26, 2017


Here are four reasons why your Asperger friends or family members sound like Mr. Spock when they’re sharing their feelings, and what you can do about it.Have you ever noticed that your Aspie friend or family member sounds like Mr. Spock when they’re sharing their feelings? So unattached and impersonal. Why is that? It’s because people with Asperger’s Syndrome have a disconnect between cognitive empathy and emotional empathy. Many also have Alexithymia, which contributes to a disconnect between understanding their own feelings and finding words to tell us what they’re feeling.

In addition to that, Aspies also have developed a belief system as a result of living in a world where others make no sense. For example, have you noticed how they draw a conclusion based on one experience and hold to it forever, no matter how much you plead with them that it’s no longer true?

Another confusing element is when they’re trying to chit-chat but can't remember any important information about the person they’re talking to…as if this is their first encounter? They could be talking to your aunt or the next door neighbor and be totally clueless.

It's like a primary school child who is learning to read and only sounds at the words. By third and fourth grade most children are starting to gather information from their reading, not just dutifully reading words on the page. Our Aspies seem stuck in first grade when it comes to social interaction. They have a few basic rules of engagement but haven't mastered the depth of connecting with others.

Some of you may not care why they say the strangest things, or you may have given up trying to translate. However, some of you are still trying to understand the unfathomable logic and language of our Aspies. I actually think the key to our mental health comes from understanding their disability just a little bit better. This enables us to detach and not take so seriously the odd, hurtful and sometimes mean things they say.

If you’re a member of our Asperger Syndrome: Partners & Family of Adults with ASD Meetup, be sure to register for the October Video Conference: Why do Aspies say the strangest things? There are still opening for this low-cost, hour-long session on either Wednesday, October 11, 2017 at 3:00 PM PDT or Thursday, October 26, 2017 at 9:00 AM PDT. Please bring your questions about this phenomenon. I bet you have insights too.

Would you rather have a one-on-one session with me? If you live near Portland, OR/Vancouver, WA please contact my Jantzen Beach office and schedule an appointment. Or if it’s more convenient, I also offer online therapy.

Autism Caretakers – It’s Time Someone Took Care of YOU!

Wednesday, August 30, 2017


Autism Caretakers – It’s Time Someone Took Care of YOU!There is no way around it. If you live with someone on the Autism Spectrum, whether a child, or a spouse, or a parent, you are a caretaker. It is not easy! You deserve to know that we appreciate you and all that you’re doing. You are not alone in your struggles.

But not everyone is so understanding…

How many times have you been told to take care of yourself? As if you have time to actually get a pedicure, a massage, or just a nap, right? How many strings do you have to pull to actually make time for yourself?

It's one thing to put down your foot with an NT family member and demand some time for yourself. Not so with ASD loved ones. If you try the tough love approach with them, there’s no telling the damage they can wreak. They don't fully understand their connection to others, do they? It's always up to the Autism caretakers to clear the path.

Did you notice that I intentionally didn’t use the word "Caregivers" for this post? Why? I chose “Autism Caretakers” because the process of caring is not reciprocated by our Aspies much of the time. The word "Carers" is appropriate, of course, because it implies neutrality. But don't we often feel like caretakers?

It’s time we take care of you! If you’re a member of our Asperger Syndrome: Partners & Family of Adults with ASD Meetup, please join us on the free teleconference on the topic of Caretakers Dilemma on Thursday, September 21, 2017 at 2:30 PM. We’ll talk about realistic ways to create self-care in an environment where your options are very limited. You can do it with the support of those who care.

If you prefer one-on-one counseling, live near Portland, OR/Vancouver, WA please contact my Jantzen Beach office and schedule an appointment. I also offer online therapy if that works best for you.

Autism Caregivers – Are You Down and Depressed?

Monday, August 28, 2017


Autism Caregivers – Are You Down and Depressed? Living in a constant state of emotional distress can cause a variety of health concerns, not the least of which is depression. Sadly this describes a chronic state for many of our Asperger Syndrome: Partners & Family of Adults with ASD members. I think they’re a good sampling of families with Autism. This means that there are too many people dealing with this problem alone. Let’s change that!

Medicine and psychotherapy can help some, but what do you do when the stressors from caregiving someone with Autism never goes away?


One of the best methods of psychotherapy for depression in general is Cognitive Behavioral Therapy (CBT) which relies on helping you change your beliefs in order to alleviate the depression. It’s based on the idea that the depression is due to faulty thinking.

However, in the ASD setting we must factor in other experiences… ASD caregivers live in a depressing atmosphere, and they live with oppressive people.

I found that a more successful approach is a combination of education about ASD/NT relationships plus strategic intervention. This makes our Asperger Syndrome: Partners & Family of Adults with ASD Meetup part of the solution. Knowing that you’re not alone; knowing that others understand from personal experience; knowing that you do not have faulty beliefs; knowing that you need new strategies; this is what helps us cope with depression.

We’re kicking off the fall with a discussion about strategies that effectively keep us sane and connected to others who are loving and supportive. The next videoconference entitled “Down and Depressed?” will be held on two dates: Thursday, September 14, 2017 at 9:00 AM PT and Wednesday, September 27, 2017 at 3:00 PM PT. Maybe you’ll even discover that you aren't really depressed at all; just down. And that can be fixed!

Note: We had to modestly increase the price for our low-cost videoconferences. For $18.00 per person you get a solid hour of healthful interaction with me and 11 other supportive attendees.

If you’d prefer one-on-one counseling and live near Portland, OR/Vancouver, WA please contact my Jantzen Beach office and schedule an appointment. I also offer online therapy if that works best for your busy schedule.

Girls with Autism – They’re Different Than Boys with Autism

Wednesday, August 09, 2017


Here are seven ways that girls with autism are different than boys with autism and the reason why girls and women are being undiagnosed or misdiagnosed. Historically it’s been thought that autism is four times more common in boys than in girls. However, studies are now suggesting that the true ratio is one in two. Why the shift?

The current methods for diagnosing autism are skewed toward how autism affects boys. To be diagnosed with autism or Asperger’s, girls need to display more behavioral problems or a significantly higher intellectual disability. Girls with less severe symptoms are more likely to be misdiagnosed with attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD) and anorexia.

Behavioral and preliminary neuro-imaging suggests that autism manifests differently in girls. Scientific American has a must-read article outlining some of these differences. Here are some highlights:

  1. Females can more easily mask, camouflage or compensate for ASD symptoms than males.
  2. Girls obsessively focus on reading, looking for rules for social life so they can connect and fit in.
  3. The difference between typical and autistic development in girls is in their intensity. They may refuse to talk about anything other than their topic of interest.
  4. Autistic girls exhibit less repetitive behavior than the boys do.
  5. The pastimes and preferences of autistic girls are more similar to those of typical girls rather than stereotypically male interests.
  6. Girls with autism are more likely than autistic boys to pretend play; they just don’t put themselves into the story.
  7. A study published in 2014 by Baron-Cohen and his colleagues found that “66 percent of adults with Asperger's reported suicidal thoughts, a rate nearly 10 times higher than the general population. 71 percent of them were women, who made up about one third of the sample”.

Kevin Pelphrey, a leading autism researcher at Yale University's Child Study Center says, “Everything we thought was true of autism seems to only be true for boys." For example, his (unpublished as of yet) studies show that the brain of an autistic boy uses different regions to processes social information such as eye movements and gestures than a typical boy's brain does.


Yet that’s not true of girls. Each girl's brain “looks like that of a typical boy of the same age, with reduced activity in regions normally associated with socializing.” So according to the tests, these girls appear to be normal. But they’re remarkable different from typical girls of their age.

I experienced first hand many of these things when I was raising my autistic daughter. Until she was diagnosed, I was frantic. I know all too well that hopeless feeling of watching a child struggle in life and not knowing what to do.

Do you suspect that one of your female family members has undiagnosed autism? With a proper diagnosis, you can begin the process of helping her live a better life. If you live near Portland, OR/Vancouver, WA please contact my office and schedule an appointment.

You can read my story and that of others’ in my book, Out of Mind – Out of Sight: Parenting with a Partner with Asperger Syndrome (ASD). Click on the image below to download a free chapter.

Three Surprising Scientific Findings about Autism You Might Not Know…

Wednesday, July 12, 2017


Every study on autism spectrum disorder is bringing us closer to understanding it, so here are some recent findings that you may not have heard of yet…There is a lot we don’t know about autism, but every study is bringing us closer to understanding its cause and the why it affects people so differently. In an effort to keep you up-to-date, here are some recent findings that you may not have heard of yet:

1. Scientific American reports that “autism and schizophrenia may be independent outcomes of the same genetic syndrome.”

Both conditions are associated with the deletion of a stretch of DNA on chromosome 22. Carrie Bearden, professor of psychiatry, biobehavioral sciences and psychology at the University of California, Los Angeles found, “Up to 30 percent of individuals missing this region, called 22q11.2, develop a psychotic disorder (schizophrenia). Up to 50 percent are diagnosed with autism.” (Does that mean someone with autism will develop schizophrenia later in life? Not at all.) What researches are now concentrating on is finding the biological causes of the features of these two conditions and discovering why they trigger the behaviors they do.

2. Generally, the earliest parents notice the first signs of autism is age 1, however MRI scans can see it in the brain much earlier than that.

According to Heather Hazlett, a psychologist at the University of North Carolina’s Carolina Institute for Developmental Disabilities (CIDD), enlargement of the brain seems to correlate with the arrival of autistic symptoms.

3. 50% of those with autism also have alexithymia, a condition defined by a difficulty understanding and identifying one’s own emotions.

Recognizing emotion depends in part on reading peoples’ faces. Those with autism often avoid looking into other people’s eyes, which contributes to their difficulty detecting emotions. Interestingly, if they don’t have alexithymia, they scan the eyes and mouth in a pattern similar to those without autism.
By contrast, people with alexithymia (with our without autism) look at faces for a typical amount of time, but scan the eyes and mouth in altered patterns.

Ongoing research is vital. The more we understand autism, the better our treatments will be. If you’d like to learn more, I provide online education specifically for how families with Autism Spectrum Disorder (ASD) can apply neuroscience and psychology to improve their relationships. And if you have specific issues you need help with, you might qualify for online therapy as well. Contact my office and schedule a session.

Keep that ‘Summer Vacation Feeling’ Going with your Aspie Loved Ones

Wednesday, July 05, 2017


Summertime is the time for vacations, fun in the sun, and getting away from it all to relax. You should definitely make time for it this year. I know I’m really looking forward to my time off in August!   But I do remember the crazy-making times I spent getting my family ready for vacation, when the kids were young. It’s a real struggle getting our Aspies (loved ones with Asperger’s) out the door.   They obsess about packing and where you’re going to stay. Yet once you're seated on the plane and your Aspie can sleep or read, they begin to participate and maybe even enjoy the vacation. (To help you prepare for your trip, you can read some stress free travel tips here.)   Our Aspies seem to have fun on vacation. And what’s really surprising is that your communications go well – better than they have in years. You actually start believing in your relationship again. You begin to let your guard down…   And then wham! Reality hits you in the face. As soon as you get home, the stress and confusion begins all over again, maybe even worse than it was before. What's up?   Vacations do take us away from the demands of ordinary life and that's why they’re relaxing. But for the Aspie the return to the "real world" is even more stressful than before they left.   You’re not alone in experiencing this. In my practice, I’m often asked: “Why do we communicate well on vacation but not otherwise?” It makes sense if you think about it. You’re not being distracted by day-to-day demands.   Do you have some good ideas for easing back after vacations? Or perhaps you’ve figured out how to get out the door without all of the fighting. Please share your strategies with our Asperger Syndrome: Partners & Family of Adults with ASD meetup. Join the free teleconference on Thursday, July 20th at 3:00 PM PST. It’s entitled: “Why do we communicate well on Vacation but not otherwise?” It will help you enjoy your re-entry into life after vacation.   If you’re seeking specific information on ASD, please consider my online education or online therapy. It’s convenient and cost effective.Summertime is the time for vacations, fun in the sun, and getting away from it all to relax. You should definitely make time for it this year. I know I’m really looking forward to my time off in August!

But I do remember the crazy-making times I spent getting my family ready for vacation, when the kids were young. It’s a real struggle getting our Aspies (loved ones with Asperger’s) out the door.

They obsess about packing and where you’re going to stay. Yet once you're seated on the plane and your Aspie can sleep or read, they begin to participate and maybe even enjoy the vacation. (To help you prepare for your trip, you can read some stress free travel tips here.)

Our Aspies seem to have fun on vacation. And what’s really surprising is that your communications go well – better than they have in years. You actually start believing in your relationship again. You begin to let your guard down…

And then wham! Reality hits you in the face. As soon as you get home, the stress and confusion begins all over again, maybe even worse than it was before. What's up?

Vacations do take us away from the demands of ordinary life and that's why they’re relaxing. But for the Aspie the return to the "real world" is even more stressful than before they left.

You’re not alone in experiencing this. In my practice, I’m often asked: “Why do we communicate well on vacation but not otherwise?” It makes sense if you think about it. You’re not being distracted by day-to-day demands.

Do you have some good ideas for easing back after vacations? Or perhaps you’ve figured out how to get out the door without all of the fighting. Please share your strategies with our Asperger Syndrome: Partners & Family of Adults with ASD meetup. Join the free teleconference on Thursday, July 20th at 3:00 PM PST. It’s entitled: “Why do we communicate well on Vacation but not otherwise?” It will help you enjoy your re-entry into life after vacation.

If you’re seeking specific information on ASD, please consider my online education or online therapy. It’s convenient and cost effective.

What Question Would YOU Like to Ask Me about Asperger’s?

Monday, June 26, 2017


What question would you like to ask Dr Kathy about aspergersIf you could ask me anything about Aspergers and your AS/NT relationship, what would you ask?

Coming up in July you’ll have three opportunities to actually do just that. Each one of my low cost video conferences will be dedicated to answering your nagging questions. Because that’s what it's like living with Aspies, isn't it? There are these confusing moments, loose connections and vague gut feelings.

What might some of your questions be about?

  • How do I parent my Aspie children with an Aspie partner?
  • How can I help my NT child deal with his/her Aspie parent?
  • How can I find a measure of romance in my AS/NT relationship?
  • What are some ways to keep my sanity in a trying situation?
  • What specific rules of engagement will help my Aspie and I connect?
  • How can I help my Aspie to at least acknowledge my feelings?
  • How can I feel whole despite the craziness and loneliness?

Do any of these questions strike a cord with you? Perhaps they at least get you thinking about a topic that’s important to you. Please write your ideas down, so you don’t forget between now and the conference.

Let's gather to share our collective wisdom. I don't have all of the answers, but beneath the surface of our perplexing lives is a pattern. I believe this pattern is discoverable. These low cost conferences will be held on Thursday, July 6th at 9AM, Wednesday, July 12th at 2PM, and Thursday, July 27th at 4PM. The spots are filling up quickly, so, if you’re a member of our Asperger Syndrome: Partners & Family of Adults with ASD Meetup be sure to register very soon. (Not a member yet? If you are the neuro typical partner in a NT/AS relationship, request an invitation.)

If you prefer to consult with me one-on-one and you live near Portland, OR/Vancouver, WA please contact my office and schedule an appointment. Otherwise, you might qualify for either online therapy or online education. Check out the services I provide and choose the one that’s the right fit for you.

Lessons I Learned about Helicopter Parenting from My ASD Daughter

Wednesday, June 21, 2017


I was a classic helicopter mom to my daughter with Asperger’s Syndrome, and these are some of the lessons I learned and wish I’d done differently.When you discover that your child has Asperger’s Syndrome, it makes you feel utterly helpless. I know, because I’m a trained psychologist, with a master’s degree in social work and a doctoral degree in psychology and I still felt that way about my own daughter who, by the age of 14, was officially diagnosed with ASD.

Recently I wrote an article for PsychCentral about my experience, hoping that it would let others know they’re not alone. (You can read the full article here.) One aspect that I wish I’d done differently is that I became a classic helicopter mother.

I found all kinds of ways to work around the school system. I hired tutors to coach her. I negotiated high school credit from outside activities. I tried Brownies, soccer, piano lessons, and summer camps. I forced her to audition for a prestigious private choir because of her marvelous singing ability—even though she was frightened of the other choir members. I tried everything I could think of to make my autistic child smile.


Being a helicopter parent is a natural outcome of the crazy-making AS/NT world. Our natural instincts are to protectively hover over our children when they have such a serious disability.

However, there are serious drawbacks to helicopter parenting. It leaves you very little time to relax and enjoy your children. As the super-responsible parent, you circle your child with help while not leaving enough time for hugs and play.

Lessons I learned from my ASD daughter:

Helicopter parenting is a natural by-product of loving your very dependent child. Don’t let anyone tell you that you are over-reacting. Your strongest asset is your heart.
  • Channel your helicoptering into finding a good psychologist or Asperger Syndrome specialist.
  • Join a support group like Asperger Syndrome: Partners & Family of Adults with ASD
  • Read everything you can about Asperger Syndrome.
  • Join your local Autism Society affiliate. It’s important that you socialize with other parents and spouses who share your experience.
  • Don’t blame yourself for your mistakes. Love yourself enough to keep on creating a meaningful life in spite of them.
  • Take time to relax and play.

Yes, there have been tremendous improvements in understanding Asperger’s Syndrome. But we have a long way to go to help our AS/NT families. I’ve made it my mission to be a source of knowledge and support. If you live near Portland, OR/Vancouver, WA please contact my office and schedule an in-person appointment. If you live elsewhere and are seeking information on ASD, please take advantage of my online education.

Does Contempt Signal the End of a Marriage or Committed Relationship?

Monday, June 05, 2017


Does Contempt Signal the End of a Marriage or Committed Relationship Do you agree with John Gottman, Ph.D. and author of "Seven Principles that Make Marriage Work"? He tells us that once a couple has descended to the level of contempt for each other, the marriage is irretrievable. I don’t totally agree with his assessment, especially since I’ve been working with so many couples who are dealing with Asperger’s in their marriage or committed relationships.

Contempt is a very strong emotion – the feeling that a person is beneath consideration, worthless, or deserving scorn. Generally, one doesn’t get to that emotion over night. It usually takes a gradually erosion of respect. (Unless there has been one particularly horrific act that destroys all respect and love. Certainly when the love is gone it probably makes no sense to try anymore.) Yet, there are ways to reverse the erosion and rebuild your relationship.

As awful as is contempt, it actually comes fairly quickly in ASD/NT relationships. Why is that? My theory is that the Aspie doesn’t have empathy, so they may resort to saying pretty awful things to their partner, but contempt is not on their mind. NTs on the other hand take these unkind comments as contemptuous. Sometimes we build up resentment, too, and then our Aspies are puzzled by our anger. Such a crazy, painful, mixed up situation.

If you’re feeling contempt, or you believe your Aspie does, we need to talk. This is no way to live. Contempt, like passive-aggressive behavior is a counter-productive solution. We need ways to be open about our feelings, respectful of our differences, forgiving of others, and expecting forgiveness from our loved ones.

This last one is important isn't it? I sure would like forgiveness if I get frustrated with my Aspie loved ones, or really lose my cool and yell or withdraw. We’re only human and contemptuous comments are hurtful.

If you’re a member of the Asperger Syndrome: Partners & Family of Adults with ASD Meetup, I invite you to please join us for our free teleconference: Cleaning Up Contempt on Thursday, June 15th at 3:00 PM PT. Let’s get these feelings out in the open and figure out how our words and actions can help us cope.

Also, if you haven’t read my book, “Out of Mind – Out of Sight: Parenting with a Partner with Asperger Syndrome (ASD)”, you can get your first chapter free by clicking here. This book has become an important resource for those who want to understand their Aspie partners better.



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