ANGER & AUTISM SPECTRUM DISORDERS Adults on the autism spectrum may be prone to anger, which can be made worse by difficulty in communicating feelings of disturbance, anxiety or distress.

Anger may be a common reaction experienced when coming to terms with problems in employment, relationships, friendships and other areas in life affected by autism or Asperger's syndrome. There can be an ‘on-off’ quality to this anger, where the individual may be calm minutes later after an angry outburst, while those around are stunned and may feel hurt or shocked for hours, if not days, afterwards. Family members and partners often struggle to understand these angry outbursts, with resentment and bitterness often building up over time. Once they understand that their loved one has trouble controlling their anger or understanding its effects on others, they can often begin to respond in ways that will help to manage these outbursts.

In some cases, the individual on the autism spectrum may not acknowledge they have trouble with their anger, and will blame others for provoking them. Again, this can create enormous conflict within a family or relationship. It may take carefully phrased feedback and plenty of time for the person to gradually realize they have a problem with how they express their anger.

The next step is for the person to learn anger management skills. A good place to start is identifying a pattern in how the outbursts are related to specific frustrations. Such triggers may originate from the environment, specific individuals or internal thoughts. Common causes of anger in relation to autism spectrum disorders • Being swamped by multiple tasks or sensory stimulation

• Other people’s behavior e.g. insensitive comments, being ignored

• Having routines and order disrupted • Difficulties with employment and relationships despite being intelligent in many areas • Intolerance of imperfections in others

• Build up of stress.

Identifying the cause of anger can be a challenge. It is important to consider all possible influences relating to:

• The environment e.g. too much stimulation, lack of structure, change of routine.

• The person’s physical state e.g. pain, tiredness.

• The person’s mental state, e.g. existing frustration, confusion.

• How well the person is treated by those around them. Recommended Steps for Anger management Steps to successful self-management of anger include: Becoming motivated The person identifies why they would like to manage anger more successfully. They identify what benefits they expect in everyday living from improving their anger management. Self-awareness A person becomes more aware of personal thoughts, behaviors and physical states which are associated with anger. This awareness is important for the person in order for them to notice the early signs of becoming angry. They should be encouraged to write down a list of changes they notice as they begin to feel angry. Awareness of situations The person becomes more aware of the situations which are associated with them becoming angry. They may like to ask other people who know them to describe situations and behaviors they have noticed. Levels of anger and coping strategies As the person becomes more aware of situations associated with anger, they can keep a record of events, triggers and associated levels of anger. Different levels of anger can be explored (e.g. mildly annoyed, frustrated, irritated and higher levels of anger). Develop an anger management record The person may keep a diary or chart of situations that trigger anger. List the situation, the level of anger on a scale of one to ten and the coping strategies that help to overcome or reduce feelings of anger.

A simple and effective technique for reducing levels of anger is the Stop – Think technique. STOP - THINK Technique A person notices the thoughts running through their mind.

1 Stop! and think before reacting to the situation (are these thoughts accurate/helpful?)

2 Challenge the inaccurate or unhelpful thoughts

3 Create a new thought.

A plan can also be developed to help a person avoid becoming angry when they plan to enter into a situation that has a history of triggering anger. An example of a personal plan is using the Stop - Think technique when approaching a shopping center situation that is known to trigger anger. My goal To improve my ability to cope with anger when I am waiting in long queues. Typical angry thoughts ‘The service here is so slack. Why can’t they hurry it up? I'm going to lose my cool any moment now’.

Stop thinking this! New calmer and helpful thoughts ‘Everyone is probably frustrated by the long line – even the person serving us. I could come back another time, or, I can wait here and think about pleasant things such as going to see a movie’. other possible approaches • Relaxation techniques

• Self-talk methods • Use visual imagery (jumping into a cool stream takes the heat of anger away) • Find anger management classes in your area

• Creative destruction or physical activity techniques to reduce anger

• Cognitive Behavior Therapy. Coping with high - extreme anger It is hoped that people with an Autism Spectrum Disorder can make use of these strategies when they notice themselves becoming angry and therefore avoid feeling high - extreme anger. However, this is clearly not always possible. For situations where people feel they cannot control their anger they can have a personal safety plan. Possible steps in a personal safety plan • Plan ways to become distracted from the stressful situation e.g. carry a magazine

• Explain to another person how they can be of help to solve the problem

• Leave the situation if possible

• Phone a friend, or a crisis Centrex to talk about the cause of anger

• Avoid situations which are associated with a high risk of becoming angry

• Make changes to routines and surroundings e.g. avoid driving in peak hour traffic

• Explore the benefits of using medication with a doctor or psychiatrist. Click here to go to the home page to view the full range of autism fact sheets at www.autism-help.org

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