Module 6: The Feared Self Client Copy

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

The Feared Self

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Sometimes, our brains trick us into believing some pretty scary stories

Those scary stories are all based around your Feared Self/Vulnerable Self Theme.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Bridging

Theory

The Feared self

Neurodivergent Stories

The Obsessional Story

The Logic OF OCD

Recap

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Your true self is actually the exact opposite of the OCD Feared Self. The Feared Self is who you are afraid of becoming.

Understand that the Feared Self is not real; it is an imaginary construct formed through inferential confusion.

Understand how the theme of vulnerability may influence the types of obsessions that you experience.

Learning points:

Identify your Feared Self and your theme of vulnerability.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Who you are afraid of becoming.

The selective doubts to which you are more prone.

VS

FEARED SELF

Vulnerable Self Theme

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Having a negative agenda.

Being an imposter.

Rejection Sensititivy

Somebody prone to illness.

Somebody that causes harm.

S.omebody that is embarrassing

Who you are afraid of becoming if you don't engage in your compulsions

Feared Self

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

The type of doubts you are more prone to:

(HARM OCD)

(ROCD)

(HARM OCD)

(P-OCD)

What if I hit a pedestrian?

What if I cheat on my partner?

What if I harm my life?

What if I’m a pedophile?

Feared Self: Somebody that causes harm

Vulnerable Self Theme

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

you aren't limited to just 1 feared self

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Feared Self

Constructed entirely within the imagination.

It uses actual logic but flawed reasoning processes to create a story about who you could become if you don’t engage in your compulsions.

Highly selective due to reasoning about the doubt.

The Feared Self is contradictory to the Real Self.

Constructed entirely within the imagination.

Thematic

Story Telling

Selective

Contradictory

Imaginary

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Why not Norovirus?

Why not MRSA?

Why not Staph?

Why not Strep?

Doubt:What if this door knob has COVID germs on it?

how selective is your doubt?

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

In I-CBT, there is no intolerance of the uncertainty

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

In I-CBT, there is no intolerance of the uncertainty

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

People without OCD do not tolerate the uncertainty about whether they will stab someone or molest a child; they simply know they won't do those things.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

People without OCD do not tolerate the uncertainty about whether they will stab someone or molest a child; they simply know they won't do those things.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

By realizing that the dreaded possible Feared Self is just another illusory construct produced by OCD, you can gain the same confidence and peace of mind.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

By realizing that the dreaded possible Feared Self is just another illusory construct produced by OCD, you can gain the same confidence and peace of mind.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

What do all of these doubts & behaviors have in common?

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Reveal

Avoiding applying for a promotion because I'm afraid I won't get it.

Avoiding a social gathering because I'm afraid people won't like me.

BEING Rejected

Seeking reassurance from my partner that they won't leave me.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Reveal

Refusing to go through an X-ray machine at an airport due to fear of radiation.

Googling symptoms of cancer.

being prone to illness

Washing my hands in a ritualistic manner.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Reveal

Ruminating about whether you turned off your hair straightener.

Repeatedly taking your pet to the doctor despite them being healthy.

Being negligent

Obsessing over whether you gave someone incorrect information.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Examples:

+compulsions

Many sufferers of OCD fear being negligent or careless. This fear drives them to obsess over areas that require concentration and attention.

Being a negligent person.

+ADHD & AUTISM

• Harming somebody accidentally due to inattention

• Doubt about having left the door unlocked

• Fear of hitting a pedestrian

• Forgetting to turn an appliance off

• Concerns over having sent an email with mistakes

• Doubt about giving somebody the wrong information

• Not washing your hands properly, resulting in somebody getting sick

• Fear of forgetting an event

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Examples:

+Compulsions

+LEARN MORE ABOUT MASKING

I like your personality.

Thanks, I made it just for you. I have one for each person.

The fear of having a hidden agenda involves an irrational worry that one's actions, thoughts, or motives may secretly be malicious.

Having a negative agenda

• Worrying about having ulterior motives in offering help or kindness to others

• Fear that adapting ones behavior in social settings is deceitful

• Worrying that adopting a different persona at work or school is false

• Doubts about morality for using scripts for social interactions

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

AUTISTIC MELTDOWNS

+Info

PDA

The fear of losing control involves individuals worrying about losing control of their actions, thoughts, emotions, or impulses, which could lead to potentially harmful consequences for themselves or others.

LOSING CONTROL

Some examples:

• Concern that you'll lose control and publicly humiliate oneself

• Anxiety about losing control and breaking social norms

• Losing control of your thoughts, leading to psychosis

• Fear of emotionally losing control emotional control, leading to inappropriate outbursts

• Doubt about losing control and being unable to resist intrusive thoughts or compulsions

+Info

Did you know?

REJECTION SENSITIVITY

Rejection Sensitive Dysphoria (RSD) is described as an intense emotional response to the perception of rejection or failure. Often seen in people with ADHD, RSD makes them highly sensitive and overly reactive to situations where they feel criticized or rejected. This sensitivity typically stems from past experiences of rejection or criticism.

Examples

• What if I accidentally offend someone during a conversation?

• What if I make a mistake and everyone judges me for it?

• What if I say something embarrassing, and everyone laughs at me?

• What if my partner doesn’t love me?

• What if my partner finds someone better and leaves me?

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

+CO OCCURING MEDICAL CONDITIONS

For neurodivergent individuals, the intersection of OCD and health concerns can be particularly nuanced due to real medical conditions that may go unrecognized or misdiagnosed.

BEING PRONE TO ILLNESS

Examples

• Anxiety over-interpreting every physical sensation as a disease

• Concerns over dietary preferences leading to nutritional deficiencies

• Worrying about being perceived as a hypochondriac when seeking help for legitimate concerns.

• Worrying about environmental sensitivities (chemicals or food) causing chronic health problems

• Concerns over medication side effects

+Info

Examples

Several factors contribute to a complex interplay between autism and OCD, where fears of being perceived as an imposter can become a significant source of distress. This often leads to compulsive behaviors aimed at mitigating these fears.

• Am I only pretending to be competent at my job?

• Do I truly deserve my achievements, or was it all just luck?

• What if others discover I'm not as skilled as they think?

• Am I pretending to be someone I'm not without realizing it?

• What if my success is exposed as a fraud?

BEING AN IMPOSTER

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Autistic individuals may develop a Vulnerable Self Theme around the fear of embarrassment due to a combination of factors related to social understanding, anxiety, and a heightened desire for predictability and control.

BEING EMBARRASSED

Examples

• Fear of saying something inappropriate or offensive.

• Concern over not understanding social cues and reacting

• Fear of accidentally sharing too much personal information.

• Worry about being perceived as rude or inconsiderate.

• Anxiety about being seen as incompetent or unintelligent.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

+Info

A common Vulnerable Self Theme is the fear of being someone who will cause harm. This can present in two ways: intentional harm and accidental harm.

CAUSING HARM

EXAMPLES

• Did I accidentally harm someone with my words today?

• What if I accidentally shared misinformation that leads to harm?

• Could I have left something dangerous in a place where someone could get hurt?

• Did I accidentally push someone in the hallway at school?

• What if I forgot to wash my hands and spread germs to my family?

• What if I made someone sick by coughing near them?

• What if I didn't clean up a spill and someone slips on it?

Autistic people are often at a higher risk of being misunderstood due to differences in communication, social interaction, and sensory processing. These chronic experiences of being misunderstood can exacerbate feelings of anxiety, making social interactions more distressing. This heightened sensitivity can lead to a persistent fear of future misunderstandings.

BEING MISUNDERSTOOD OR MISPERCEIVED

EXAMPLES

double empathy problem

• What if I get accused of something I didn't do?

• What if the way I empathize with others by sharing relatable experiences is seen as dominating the conversation or rude?

• What if I get fired for attempting to offer my boss a suggestion?

• What if people mistake my passions around justice as aggressive?

• What if people misunderstand my morals as rigidness?

• What if I say something wrong and am judged for it?

• What if my lack of eye contact is seen as rude or that I'm bored?

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

What if I left the hair straightener on?

If I leave it on, my house could catch on fire and harm my family and pets.

I couldn't live with myself being so negligent.

I'd better turn around and go back home to check again.

Compulsion

Anxiety

Consequence

Doubt

Trigger

Leaving the house.

Identify your doubt sequence.

01.

How to identify the Feared self

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

How to identify the Feared self

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

What if I left the hair straightener on?

If I leave it on, my house could catch on fire and harm my family and pets.

I'd better turn around and go back home to check again.

I couldn't live with myself being so negligent.

Compulsion

Anxiety

Consequence

Doubt

Trigger

Leaving the house.

Turn your attention to the Anxiety

02.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

What if I accidentally touch them inappropriately?

Changing my baby's diaper.

I couldn’t live with myself knowing I harmed someone.

If I did, I could traumatize and ruin their life.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Being somebody that causes harm

Anxiety

Avoid changing the baby's diaper.

Doubt

Compulsion

Consequence

Trigger

Turn your attention to the Anxiety

02.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

I couldn’t live with myself knowing I could have prevented it.

Taking my dog on a walk.

Take my dog back inside to ensure his safety.

He could get really hurt or even die.

What if he gets loose and gets hit by a car?

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Being somebody that is negligent

Anxiety

Doubt

Compulsion

Consequence

Trigger

Turn your attention to the Anxiety

02.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Just like with obsessive doubts, Vulnerable SELF-THEMES are formed and maintained through genuine logical processes

And just like any other obsessive doubt, it uses faulty logic and reasoning.

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

Reveal

I'm not feeling well, so I'm going to the doctor. After the doctor runs some tests, I hear him tell me I have tuberculosis. He tells me that the treatment is antibiotics for 8 months. As I read the bottle's side effects, I feel my heart pounding in my chest. I read that some of the side effects of these antibiotics include becoming paralyzed, worsening of symptoms, and even death. I've heard stories about people having adverse reactions to antibiotics. I had an adverse reaction to a vaccine when I was younger. It could happen again. The last time I had an adverse reaction, I got really sick. If it happens again, I could get really sick again. The doctor insists I take them for so long. What if I have an adverse reaction to it?

Vulnerable Self Theme: Being exceptionally prone to illness

Obsessional Story

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

What is Chad’s Vulnerable Self Theme?

What storytelling devices is he using? (facts, rules, hearsay, personal experience, possibility)

Chad is a chef who experiences a lot of anxiety about his job. He meticulously washes his hands before preparing any food. Constantly, he checks to see if any glass could have fallen into the dishes he makes, driven by stories he's heard about people finding objects in their food. To prevent customers from getting sick, he often overcooks his meat. Additionally, he repeatedly checks food's expiration dates before using it. Chad gets his meat from a trusted local farmer who doesn’t use antibiotics on their animals and treats them very well.

Should Chad be concerned that he is going to harm his customer?

Monitors symptoms in others who ate the food and asks for reassurance that no one else is getting sick.

VST: Being Somebody that causes harm

Person 2

Overcooks the food, then googles symptoms of foodborne illnesses and ruminates about getting sick.

VST: Being Prone to Illness

Person 1

2 OCD's, "What if this food isn't cooked enough?"

Overcooks the food, then googles symptoms of foodborne illnesses and ruminates about getting sick

VST: Being Prone to Illness

Person 1

Monitors symptoms in others who ate the food and asks for reassurance that no one else is getting sick.

VST: Being Somebody that causes harm

Person 2

….because it is another doubt!

The Feared Self is unique to each person, exists within the realm of imagination, is highly selective, and employs the same narrative strategies as other forms of obsessive doubts.

By exploring the recurring issues that form the foundation of your obsessions and compulsions, we aim to pinpoint your Vulnerable Self Theme.

20%

Recap:

Adapted by Brittany Goff from: O'Connor, K., & Aardema, F. (2012). Clinician's handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.

20%

Next up, OCD is an Imaginary

No experience required!

Perfectionism and High Standards for Oneself: Autistic individuals, especially those with a strong focus on details, might set very high standards for themselves in various aspects of life, including work, academics, and social interactions. Failing to meet these self-imposed standards could trigger OCD-like obsessions regarding their capabilities and authenticity. Anxiety and Stress from Uncertainty: The heightened state of anxiety and stress that often accompanies autism can make uncertain situations or environments feel particularly threatening. This can lead to an obsessive need to control one's environment or identity to avoid being perceived as an imposter, further fueling OCD tendencies.

Imposter Syndrome

Masking and Camouflaging: Many autistic individuals engage in masking or camouflaging their autistic traits to fit into neurotypical social norms. This constant effort to hide one's true self and to perform roles that feel inauthentic can lead to an internalized fear of being discovered as an "imposter," which might manifest as OCD with obsessions about being exposed as a fraud. Social Communication Challenges: Difficulties with social communication and interaction can make it hard for autistic individuals to gauge social responses accurately. This might lead to obsessive thoughts about not being good enough or fears of being wrongly perceived, contributing to imposter feelings.

Masking

A person who is late or undiagnosed with autism may develop the OCD fear of having a hidden agenda due to the cognitive and emotional stress caused by "masking" their autistic traits. Masking involves suppressing one's natural behaviors and mannerisms to conform to societal expectations or to avoid negative social consequences. This adaptive strategy, while often subconscious, requires significant mental effort and can lead to increased anxiety and self-doubt. The fear of having a hidden agenda may arise from the disconnect between their internal experiences and the persona they present to the world. As they continuously monitor and adjust their behavior to fit in,

they might start to question their own motivations, fearing that their actions could be perceived as manipulative or deceitful, even when no such intention exists. This constant vigilance and doubt can manifest as OCD-like fears, where the individual obsesses over the possibility of unintentionally misleading others or harboring subconscious motives.The combination of trying to navigate social interactions without a clear understanding of unspoken social rules, due to undiagnosed autism, and the effort to conceal this difficulty can exacerbate feelings of being out of sync with one's true self, leading to fears about hidden agendas as a manifestation of OCD.

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• Direct Communication & Indirect Requests

• Emotional Expression

• Interest Sharing

• Physical Contact

• Friendship Initiation

• Empathy Misconceptions

• Joke Timing

• Honesty Levels

• Workplace Dynamics

• Social Cues Interpretation

• Sarcasm Misunderstanding

• Sensory Sensitivities

• Eye Contact Expectation

• Routine Importance

The Double Empathy Problem

The mutual lack of understanding between autistic and non-autistic people. The concept emphasizes that social challenges occur because both groups have different experiences and ways of perceiving the world, leading to a "mismatch" in communication and understanding

Autism, ADHD & Negligence

Individuals with Autism or ADHD may develop OCD, including fears related to negligence, due to the overlapping neurobiological and cognitive profiles that these conditions share. Both Autism and ADHD involve challenges with executive function, which includes planning, organization, and impulse control. For someone with Autism, there might be an intense focus on specific interests or a heightened need for routine and predictability, which could translate into obsessive-compulsive behaviors when they're worried about making mistakes or being negligent in situations that disrupt their sense of order or predictability.

For those with ADHD, difficulties with attention, impulsivity, and executive functioning might lead to fears of negligence because they might struggle with tasks requiring detailed attention or follow-through.The fear of making mistakes or forgetting important tasks can become a source of anxiety, leading to obsessive-compulsive behaviors as a coping mechanism to manage that anxiety and to try to prevent negligence.OCD symptoms in individuals with these neurodivergent conditions can be seen as an attempt to manage or mitigate the challenges they face, seeking to control their environment or behaviors to prevent negative outcomes.

• Food Allergies and Intolerances

• Chronic pain /
• Fibromyalgia

• ME/CFS
• Long Covid
• Chronic tick-borne diseases
• PCOS
• Endometriosis

Co-occuring medical conditions

• Ehlers-Danlos Syndrome (EDS)
• Mast Cell Activation Syndrom
• Fibromyalgia
• POTS / Dysautonomia
• Chronic Fatigue

• Epilepsy
• Gastrointestinal Disorders
• Sleep Disorders

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The fear of being a negligent person

I couldn't live with myself being so negligent.

Anxiety

If this doubt were to come true, what would it say about their identity?

Ask them..

Autistic individuals with PDA often have a profound fear of losing control, which underpins their demand-avoidant behavior. This fear is not merely about defying or opposing requests but is deeply rooted in the need to manage overwhelming anxiety related to expectations placed upon them. Their demand avoidance is thus a coping mechanism to prevent the sense of losing control, which can be extremely distressing. This fear of loss of control can significantly impact their daily functioning, making it challenging to navigate typical social, educational, and family environments.

Pathological Demand Avoidance (PDA)

Pathological Demand Avoidance (PDA), also referred to as a Persistent Drive for Autonomy, is a profile of Autism characterized by an extreme avoidance of everyday demands and expectations. This avoidance is rooted in an anxiety-driven need to control their environment and maintain autonomy. People with PDA experience intense anxiety when faced with external demands, leading to strategies to avoid these demands, such as:

• Controlling behavior
• Procrastinating
• Distraction
• Negotiating
• Role play/fantasy
• Incapacitating themselves

• What if I get canceled?
• What if I'm unable to perfectly articulate my thoughts and I'm misunderstood or dismissed?

More examples

• What if my colleagues secretly dislike me and talk about me behind my back?
• What if I show my true self and people find me weird or unappealing?
• What if I express my opinion and people reject me for it?

• What if my friends are just pretending to like me?
• What if I'm not loveable enough for a lasting relationship?
• What if I'm destined to be alone forever?
• What if the report I submit has a typo and it ruins my professional reputation?
• What if my appearance isn’t flawless and it affects how people perceive me?
• What if I'm not the ideal partner and my friends think I'm unworthy of love?

On average, children with ADHD hear about 20,000 more negative statements than their neurotypical peers by the time they're 12 years old . This statistic underscores the significantly higher amount of criticism that individuals who are neurodivergent, might receive compared to neurotypical individuals. The heightened criticism is not only indicative of the challenges faced by those with ADHD or autism in navigating social expectations but also highlights the potential for negative impacts on self-esteem and mental health.

Did You Know?

• Regularly revising schedules to avoid overlooking important tasks
• Repeatedly sanitizing hands or objects to avoid contamination.
• Continuously asking for reassurance about not having made a mistake.
• Frequently checking on loved ones to ensure their safety.
• Excessively checking news or information to avoid being uninformed.
• Constant monitoring of body sensations to detect potential health issues.

Compulsions related to negligence

• Repeatedly checking locks to ensure safety.
• Continuously verifying stove knobs are turned off to prevent fire.
• Overchecking emails and messages for mistakes.
• Constantly reviewing conversations to ensure nothing harmful was said.
• Continual checking of work done to prevent errors.
• Excessively organizing items to maintain control and prevent accidents.
• Frequently checking social media or messages to avoid missing out.

Triggers for meltdowns

• Sensory Overload: Loud sounds, bright lights, or overwhelming smells can trigger a meltdown.
• Routine Changes: Unexpected changes in daily routine or environment.
• Anxiety: High levels of stress or anxiety.
• Communication Difficulties: Struggles with expressing needs or understanding others.
• Sensory Differences: Individual sensory sensitivities, such as discomfort with certain textures or tastes.
• Overwhelm: Situations that feel overwhelming in terms of social

interaction or expectations.

Autistic Meltdown

An autistic meltdown is an intense response to overwhelming situations, characterized by a loss of behavioral control. This can manifest through physical or verbal outbursts, or in both ways. It happens when an autistic person becomes completely overwhelmed by their current situation and temporarily loses behavioral control. Unlike tantrums, which are goal-oriented and often occur in response to someone not getting what they want, meltdowns are a reaction to overload and are not used to manipulate a situation. The lack of control during a meltdown is directly related to the individual's inability to cope with the sensory or emotional overload they are experiencing at that moment. Meltdowns are a part of the neurological condition and the challenges that come with processing information and stimuli differently.

Am I a good person?

Compulsions

• Over-preparing for social interactions to avoid suspicion.
• Repeatedly asking friends or family if they think you're being genuine.
• Obsessively analyzing past interactions for signs of having revealed too much.

• Continuously questioning the authenticity of one's feelings and reactions.
• Mentally reviewing conversations to assess for authenticity
• Continually researching how to appear more authentic.

More examples..

• Worrying about impulsively shouting offensive or inappropriate remarks in public.

• Concerns over suddenly becoming aggressive or violent

• Anxiety about losing control over one's vehicle and causing an accident.

• Concerns about impulsively jumping off a bridge

• Fear of acting on unwanted thoughts

• What if my lack of attention causes someone physical injury?
• Did I improperly dispose of something, causing environmental harm?

• What if my negligence causes a pet to get hurt or lost?
• What if I recommended a product/service that turns out to be harmful?
• Did I forget to turn off the stove, and could it start a fire?
• Could I have poisoned someone by not washing my hands properly?

• What if I spread a disease by not sanitizing enough?
• Could I have caused someone emotional distress without knowing?
• What if I'm responsible for someone's failure by not offering enough support?
• Could I snap and hit my boss?