PTSD, ADHD and ASD. For many, these abbreviations mean little, whilst for others they are difficult diagnoses which have to be lived with. What’s more, many only learn of them as adults. How do autism and ADHD appear? Why are adults tested for autism? How can people with special needs establish a private life? How can Artificial Intelligence help children with autism to survive? To delve as deeply as possible into this topic and receive professional answers, a Kommersant UK correspondent met Yulia Basova, a master of science in psychology, licensed member of the British Psychological Society, practising psychologist, teacher, life coach and founder of the Big Black Cat Meditation project.
Who are your clients? What disorders and problems do people come to you with most often?
My clients are mostly men, although there are also women who’d like to boost their sexuality and attractiveness. But while women, as a rule, approach things more cautiously by first studying my profile on social media, making inquiries amongst my clients and only then making an appointment with me, men are more direct. They come to consultations more decisively and with greater trust. They see me as an expert who can quickly drag them out of a protracted depression. If they are in the middle of a crisis, they hope I can give them a fresh impulse in their business or relationship, make them believe in their own strength and uniqueness and free them from the symptoms of despondency and burnout. Amongst my clients, before coming to me some had already used the services of several psychologists but found that other specialists had been unable to establish contact with them and provide help. So they turned to me. As well as neurotypical people, in my work, I have encountered those with various personality disorders, in states of anxiety, with post-traumatic stress disorder (PTSD), as well as people who have been diagnosed with autism. I have extensive experience working with specialists at remedial educational institutions in Britain and abroad and thanks to my comprehensive academic education, I specialise in two areas of psychology, one of which is developmental psychology. My special niche is working with neurodivergent clients; all autistic spectrum disorders, (ASD), attention deficit hyperactivity disorder (ADHD) and also special educational needs and disabilities (SEND).
Now people have begun to pay more attention to mental illness. For example, autism is diagnosed in adults far more often than previously. What has caused this?
While severe forms of autism, such as Kanner’s or Rett syndrome are afflictions with a distinct pattern of symptoms, ASD is at times not straightforward to identify. Nowadays, with modern methods of diagnosis and a more extensive understanding of the condition, it is always picked up on at educational establishments. Signs include children having difficulties making social contact and exhibiting behaviour such as abruptness of manner, struggling to recognise the emotions of the people they interact with, an unwillingness to make contact with others and a tendency to fixation on certain topics. Yet 15 to 20 years ago, these difficulties were still often taken to simply be manifestations of the child’s personality, especially if the parents showed similar behaviour (pronounced reserve or certain habits and interests). This is why many people who have developmental abnormalities on the autistic spectrum but, for some reason, were not labelled ‘autistic’ in their childhoods, did not, prior to diagnosis, understand why they were so different from others. They experienced a tremendous amount of negative feelings, anxiety, fear, and a desire to hide their unusual perception of the world from all around them. In their careers they may fall far behind neurotypical people, who find it far easier to establish rapport with colleagues, superiors and in their private lives. Their reclusiveness and inability to cope effectively with their internal anxiety significantly reduce their chances of forming harmonious and healthy relationships. Most often, an adult with an undiagnosed ASD seeks out professional help voluntarily, to find answers to the questions of why they feel different and why everything is so difficult in their lives. Having understood that their brains function in a way which is completely unlike neurotypical people, adults with ASD feel enormous relief and, as a rule, they stop trying to force themselves to change and find it easier to accept their differences. Many even stop considering these differences to be disadvantages. This alone is enough to make diagnosis in adulthood worthwhile. In Europe and the USA, by long-established corporate practice, employees are encouraged to be tested for ASD. As well as paying for this analysis, if a diagnosis is established, many companies provide their employees with support, which is beneficial for their productivity.
You’ve just mentioned the employees of large corporations, but can success in business be achieved if someone has autistic traits? For example, Elon Musk has admitted that he has autism.
Those diagnosed with high-functioning autism (HFA) characteristically have high IQ. They can achieve successful careers and bring great benefits to society, Musk is not the only example of this. Many famous personalities have been autistic; the composer Wolfgang Amadeus Mozart, the artist Vincent Van Gogh, the physicist Marie Curie, the director Stanley Kubrick and, amongst those currently living, Bill Gates, the founder of Microsoft, could also be mentioned. Autism is characterised by a degree of fixation, even obsessiveness, which makes it significantly easier for them to achieve high results, whatever the sphere, be it science, art, or finance. By contrast, those who suffer from ADHD fundamentally lack the concentration to stubbornly labour over a project. However, it’s very difficult for people who find themselves in the vicinity of an autistic genius. For example, Marie Curie, who made many scientific discoveries, was so absorbed in her experiments that she even lost interest in her own children.
So this means that, even if they have a successful career, it is quite difficult for people with these conditions to find a partner and raise a family. How should we begin interaction with them? What suggestions do you have?
Sometimes the personal lives of people with ASD can take a tragic path due to their inability to understand other people’s emotions. The focus on a private, internal world is typical of autistic people. Amongst those who, relatively speaking, conform to the psychological norm, this self-preoccupation is usually called selfishness or callousness. Autistic people are not able to talk to their partners and find points of agreement, resolve contradictions and in so doing, save the relationship. Also, among many autistic people, the intimate sphere suffers and this is not due to sexual dysfunction; they may have wonderful natural gifts, strong health and endurance, but, as I have said, they differ in their impaired empathy which has a deleterious effect on their intimate life. In addition, autism often borders on other personality disorders. For example, forms of ASD such as Asperger syndrome have slightly similar symptoms to narcissistic personality disorder (NPD); rudeness, abruptness, negative reactions to failure, including sexual ones, an unwillingness to satisfy their partner and a fixation on attaining their own pleasure. As autistic people are unable to understand why their partners are unsatisfied, due to their low degree of empathy, they become angry, falling into rages, which exacerbates the situation still further. People with severe autism most often have too many different challenges in their lives, such as impaired speech and cognition, seizures and even a preponderance to self-harm, to find the time for a relationship, and instead of a psychologist, they go to a psychiatrist to seek help. If we consider the private lives of people with ASD, we could, for instance, take the example of psychological development disorders such as Asperger syndrome or high-functioning autism (HFA). If someone had clearly expressed autistic traits in their childhood such as delayed development of speech, an inability to make eye contact, problems resolving social conflicts etc, then even if the symptoms become less pronounced in later life, they often prefer not to engage in any romantic relationships. Instead, they focus on their career or some unusual hobby. However, many people with ASD really do want relationships but they suffer from a lack of non-verbal communication skills and they don’t know how to express or accept love. Early intervention is vital to help these people forge relationships which are as healthy as possible.
How can children with these problems be helped?
If verbal communication is impaired, then first of all the services of a speech therapist are required to make it easier for the child to socialise with their peers. A more positive experience of interaction with other children will boost the child’s self-esteem. Whilst growing up, a neurotypical child learns how to select clothes to suit each occasion, charm girls that they like and be attractive to the opposite sex, autistic people, however, need cues for every eventuality, as well as rules and a plan of action. Many people with Asperger syndrome learn about relationships from films, but while girls may watch romantic melodramas, most often, only porn holds boys’ attention. This means that they may behave excessively directly, or even rudely towards the opposite sex (they follow examples set by characters in movies). This can temporarily complicate any interaction. On the other hand, autistic men are often silent and good listeners, which attracts some women. And if a man has a pleasant appearance, a woman may fall for him before she realises that she’s dealing with someone with limited empathy. Autistic girls may have inordinately low self-esteem. As they often have been deprived of male attention, they are vulnerable to flattery and may allow socially disadvantaged people into their lives who are capable of aggression or violence. On this issue, psychologists must help raise their awareness so they can recognise their own and others’ emotions, feelings and intentions. They need to explain how they should interact with people. If someone with autism is sufficiently intelligent, they will understand this. In many countries, there are programmes for autistic people of various ages which inform them about relationships and sexuality. Checklists even exist with rules of behaviour on dates or socialising and with instructions on how to recognise a potentially dangerous partner.
What is the main factor causing autism and ADHD? To what degree are these conditions genetically determined?
Scientists are still arguing about the real causes of the development of autistic symptoms and ADHD. Most researchers have concluded that in both cases the principal reason is hereditary. In fact, on diagnosis with ASD, not only the child is monitored, but also the family. Often the parents exhibit a series of psychological tendencies based on which appropriate conclusions are drawn. However, let’s not forget how harsh it can be for people whose children have developed a severe form of a disorder such as autism. It’s possible to mistake relatives’ poor emotional state for a genuine pathology and a specific disorder. A reason for developing ADHD may be factors such as traumatic brain injury or premature birth. Even slight oxygen deprivation of the foetus may lead to similar consequences. A resemblance between ADHD and ASD is that both complexes of symptoms are incurable (there is only correctional therapy) and they can be passed on hereditarily. Also, children with ASD may exhibit hyperactive behaviour. A baby with ADHD never stays still, they have to do a million things every minute, and routine oppresses them, while children with ASD cling to their protective rituals and repetitive actions. At the same time, they may be disorganised, not catch signals from teachers and peers and have difficulties coordinating their actions. Both children with ADHD and ASD find it extremely difficult to join a study process and communicate with peers and teachers. This is why it’s important to identify the cause of any problems, prescribe appropriate remedies and in doing so, stimulate the development of compensatory skills which can help in the future.
How much can AI help children with autism?
Artificial intelligence has long been used for the diagnosis and treatment of autism. For example, British scientists have developed a system which uses data on child behaviour to identify abnormalities which are not immediately obvious and propose individualised treatment strategies. The speed and accuracy of the diagnosis are the crucial aspects; if the moment is missed, the child may, for instance, develop speech defects which will not occur if the ASD is identified on time. Moreover, autism is not always a striking deviation from generally accepted norms and if there are not highly noticeable abnormalities of motor skills, speech or coordination, parents may consider it unnecessary to begin a lengthy diagnostic process as they do not fully understand that they are missing the opportunity to include their child in the correction process. Also, artificial intelligence provides the opportunity to conduct diagnoses remotely and at the earliest possible age (from a year and a half). This is done simply via the medium of games and also helps children with special educational needs to develop social skills and improve their ability to concentrate. An enormous amount of mobile apps are currently being created that use algorithms to analyse child behaviour while they are performing one task or another and then, with almost a hundred per cent accuracy, assign them either as neurotypical or with ASD. There are even educational robots which help children with autism adapt to society. The robot interacts with the baby like a person whilst using an algorithm to analyse reactions such as body language and gestures. This information is passed on to medics, who can use the data to put together an individual treatment plan for the child. However, I believe that AI-based platforms should not set diagnoses, they should simply indicate problems. Their clear advantage is that they can do this far earlier than a doctor, giving the child a chance at proper treatment and so, a happy future.
How should we behave in a crisis to avoid panic and preserve our psychological equilibrium?
If the condition is not sufficiently severe to require medical treatment, the best way to relieve depressive symptoms and states of anxiety is any form of physical activity. Everyone should choose the most acceptable activity for themselves; walking in the fresh air, running or swimming. Feel the beneficial effect on the cardiovascular system, the working of the brain and the body as a whole. Feel how the ability to study and think critically improves, the emotional state is lifted while, conversely, anxiety is reduced. People who do sport or active meditation generate a special, fresh energy.
In your project, Big Black Cat Meditation, you also use active meditation as a tool for preparing clients for couch sessions. How effective is it?
It is a very effective tool. My online sessions last from 90 minutes to two hours, to allow my clients the time to tune in and create a unified energy field within which we can productively solve the tasks set. As a rule, even before the start of the session, my approach helps clients achieve a certain internal renewal, open up their minds and souls and have confidence in the process. During meditation, clients may express strong emotions (some start crying). This is a good start, because, sitting on the couch in front of me, my clients already look more confident, soothed and relaxed. They are ready for dialogue.
You receive clients at an office in the London district of Marylebone and in Brentwood in Essex. However, many prefer an online format when interacting with specialists. Do you offer this type of session?
I work online, of course. I readily admit that I have only seen some of my clients on my computer screen and never in the flesh. I can absolutely say that this in no way reduces the effectiveness of our work, which is why each of my clients is free to choose whatever format suits them best. It’s true that these are classic 50-minute couch sessions which do not involve joint meditation to get tuned in beforehand. The most reasonable approach, which is practised by most of my clients, is a combination of online and offline sessions. For example, during the week, we might see each other online and on Saturdays, we meet at my comfortable space in central London.