Friday, May 25, 2018

Sensory Processing Difficulties: Part 1 (Touch)

(This is part 1 of a series on sensory processing difficulties.  While I'd initially assumed I could fit them all into one post, the post would unnecessarily long and I really don't want to bore you.  So bite-sized chunks it is!  Here's Part 2 on the vestibular and proprioception senses, part 3 about sight.)

Why Talk About This?

A book I'm reading talks about sensory over- and under-sensitivities in children, and how this is a distinct phenomenon from autism, but that it often goes with autism.  And recently there was an incident in church where a staff member shooed me out of the side room I was using to accommodate a sensory overload.  So I thought it might be interesting for you to have some time inside my skull when it comes to sensory issues in an adult autistic.

The book I'm reading calls for seven senses, rather than the traditional five, which is probably lowballing it, but as good a place to start as any.  The book points out, and I'll underline, that these seven senses are not separate input channels.  They are all processed at once, often several senses for each part of the brain that does the processing.  The autistic person does not get to try to turn off their sense of hearing because it's hurting them, but still leave the vision, touch, and taste senses active.  That isn't how it works.  It's all in the same place: the brain.  So you can distract the whole brain from the painful sensory experience, but you need to distract the whole brain.

One more very important note: all the reactions I'm going to describe to you are involuntary.  I literally do not control how my brain reacts to certain sounds, or to certain types of touch, or anything else I'll tell you about.  I did not choose to be the way I am, I simply...am.  The next time you see a child having a tantrum in a public place, keep in mind they might well be like me... just not as old and as well-practiced at handling their suffering in a socially-appropriate manner.

Many Kinds of Touch

Touch is the first and most basic sense.  But there many kinds: 
  • light touches, like someone brushing your arm, or the texture of grass, sand, or dirt.  This also encompasses having your hair brushed, washing your face, and textures felt in the mouth.  (This is the part of touch that most people with sensory issues have trouble with.)
  • deep pressure, like massage, bear hugs, rolling, bouncing, etc.  
  • vibration, like the feeling of touching a washer on spin cycle, or one of those battery-powered back massager devices.  
  • temperature, your hot and cold senses that spare you from both holding cold packs too long and burning your hand on the stove.
  • pain, which covers everything from a light scratch to broken bones.  
As a child, I couldn't stand having tags in the back of my shirts.  My poor mother had to painstakingly cut the tags out of every one of my shirts.  The same was true of my underwear, I believe.  This is a form of light touch sensitivity, and I continue to have difficulties with it to this day.

I no longer have to snip the tags in my shirts or undergarments, but sometimes when my spouse touches my arm lightly, in affection, it hurts instead of soothes.  The same is true with my back.  Since I got my hair cut short, my spouse will also pet and gently scritch my head.  The former is nice, the latter hurts after a while.  It's emotionally painful for both of us when I have to tell him to stop doing something affectionate because it hurts, but the other option is for him to be causing me physical pain while thinking he's being sweet and affectionate.  There really aren't good options here, is what I'm saying.  I try to be gentle and tactful about it, but I know it hurts him, and that hurts me.

Haircuts Are The Worst

Another way this touch sensitivity manifests is when I get my hair cut, or need to wear jewelry.  While I now tolerate tags, I do not take easily to wearing things around my neck.  And I really don't take kindly to having things put tightly around my neck.  This is most noticeable in my current life when I get my hair cut.

Haircutters tend to fasten a paper neck band around your neck, to keep the hair from getting down your shirt.  I can't stand that.  I have to put my hand to my throat to offset the nearly-unbearable sensation of choking and feeling trapped.  Having that extra sensory input from my fingers at my throat helps confuse the tightening feeling enough that I can tolerate it.  So instead of ripping the stupid piece of paper off and screaming at the poor haircutter, I can instead, seemingly calmly, sit through the application of the neck band. 

After the neck band stops tightening, I can then make myself learn to tolerate the feeling of having something around my neck... particularly if I don't move too much.  That lets my brain try to tune out the feeling as "irrelevant," which it's not great at, but it sometimes succeeds at. 

This unpleasantness has not, obviously, stopped me from getting my hair cut. (And dyed blue, check it out!)

...but it very much does make the process a lot more miserable than it would be otherwise.  Another way this light touch sensitivity manifests around haircuts is afterwards.  Even with a tight neckband, there's inevitably going to be some little bits of hair that escaped into your shirt or stuck to your neck.  Most people just brush these off in annoyance, and after a day or so, they're basically gone anyway.  I... have to go home and use a lint roller to get them off, and can think of little more than doing so until they're off.

If the house caught fire while I was doing this lint-roller hair-bits removal, I would take the freaking lint roller out of the house with me, forgetting the clothes I took off to get at all of my neck.  That's how bad it is.  I am almost invariably miserable when I get home from having a haircut, and don't stop being miserable until all the tiny hair-bits are gone and I've had some time to decompress from my misery.

All is Not Lost, Thankfully

It is possible to accustom oneself to things like this, by the way.  The book has suggestions for how to make this sort of thing a regular activity for children, but autistic adults like myself are kind of on our own unless we're involved in therapy for it.  Which isn't to say we can't do it ourselves... it's just difficult and not very intuitive.

As I type this, I am currently wrapped in a light blue, ridiculously soft and warm polyester blanket.  It's the kind that's almost like short, extremely soft, smooth fur.  My spouse noticed it in the store, and we were looking for a nice warm, blue blanket.  But when I first touched it, I immediately yanked my hand back in discomfort.  It was too soft!  My brain couldn't process the sensation, it was too overwhelming.  This startled my spouse into amusement, which annoyed me. 

I think I glowered at that silly blanket for a couple minutes, scowling as I made myself touch it over and over.  Just lightly at first, and not very much of it, and I still had to pull my hand back due to sensory overload.  But as I kept at it, I started to be able to handle the sensation.  It must have looked pretty silly, a grown woman scowling at a blanket and touching it repeatedly while her spouse stood by.  But nobody threw me out of the store for being extremely weird, so whatever.

We ended up buying the blanket after I was fairly sure I would be okay with it.  And now obviously, I am.  It still feels a little weird to me to touch with my hands, but it no longer overwhelms me, and the blanket lives by my computer chair to keep me warm when the basement is cold.  Which it usually is, so that blanket gets a lot of use.

Texture of food is another complication in this category.  It's not one I've paid a whole lot of attention to, but my spouse is actually pretty picky in some cases about what goes in his mouth.  I was an excessively picky eater when I was growing up.  It drove my mother to frustration quite often.  We ended up having to establish a list of foods I didn't have to eat if they were served to me.  Broccoli, cauliflower, brussels sprouts, and other strong-tasting vegetables tended to top that list.

I'd always assumed my dislike for foods was taste-based.  After all, many of those vegetables do taste pretty strong.  But it may not have been that simple.  I no longer need to have a very limited diet, and make a point of trying new foods as a matter of course.  But I may have to pay more attention to how those foods feel in my mouth.  I do enjoy just-barely-soaked cereal (mostly crunchy, with subtle hints of sogginess) and ice cream blended with M&Ms (which are mostly creamy with some crunch
/and/ subtle hints of sogginess).

All of the above has been about light pressure, and I'm sure if I gave it a week, I could think of more examples.  But that's only one part of touch, so I'd best move on.

Deep Pressure and Vibration

Deep pressure is what I usually advise my spouse to give me when his gentle touches on my arms hurt, or when he accidentally tickles me.  His actual response is usually to stop touching me entirely, which is kind of saddening, but understandable.  I'd much rather he press harder with the arm-touches, thus solidifying the sensation and making it more tolerable.

I do like massages, as a rule.  Not only do I suffer basic neck pain, the deep pressure type of touch is very easy to pinpoint and process.  So unless it actively hurts something, it's definitely the way to go.  I used to give bear hugs a lot as a child.  I have no idea if that was just because I was odd, or because I liked the sensory feedback of giving a tight hug.  Usually people protested, though, so I think I eventually stopped.

I also bounce my leg when nervous.  This is actually a relatively common nervous habit for all kinds of people.  I actually taught myself how to bounce one leg quickly and slightly, mimicking a friend of mine who had hypertension at the time.  (He actually did both legs at the same time, but one leg was hard enough to learn that I stopped there.)  It became a habit, and now I do it when I'm seated and anxious.  So, often. 

Vibration type sensory input is relatively scarce in modern life.  When I've run across it, I haven't really had much issue with it, beyond it making my hands numb after a minute or two.  I'm not actually sure if that's a common experience or not, but either way, I tend not to hold onto the washer or a battery-powered back massager much.

Temperature

I do seem to be more sensitive to hot things than the average person.  When I was younger, I kind of figured that was probably just the fact that I was young, compared to the people I tended to talk to, who weren't.  As you age, you gain calluses on your hands, and the nerves that sense temperature take damage over time, which desensitizes you somewhat.  So something that's a little too hot for comfort to a small child would be just fine to a normal adult.  I would often complain about water being too hot, when my mother thought it was just fine. 

This comes up in my current life when I'm trying to draw a comfortable bath, actually.  I'm still trying to figure out how much boiling water to add to my tub before filling the rest with hot/lukewarm water from the water heater.  Too hot, and I sweat and am uncomfortable in the tub.  Too cold, and it's not relaxing.  

Speaking of too cold, I'm not really sure how my cold sensitivity lines up with everyone else's, but I have very little tolerance for carrying cold things in my bare hands.  And if my whole body gets cold, I get miserable.  Like, pathetically miserable.  "Small child whining and sulking" miserable.  I have very little control over this, which is why I really try not to let myself get that cold, ever.  The last few times it happened, years ago at this point, I felt very stupid and embarrassed as soon as I warmed up.  But not 'til then.  

I had always kind of assumed that was a PTSD-style reaction to getting chilled down to my bones in high school, when I was on a rowing team and the coach sent us out half an hour too early... in 40 degree weather... and the rain.  So we sat out on the river for about an hour, slowly getting colder and colder, until the race actually began.  At which point we rowed on cold muscles and did not do terribly well.  

My parents took me back to their car after the race, had me take off most of my clothes, and turned the heat on full blast.  It took an entire hour of that to warm me back up.  It was a pretty awful experience and I resent that coach to this day for that incident and her general treatment of me and the team... which I think is quite fair, frankly.  But maybe it's not the whole story, I dunno.  

What A Pain

Pain is a complicated one.  There's two factors to how a person deals with pain.  There's your "pain threshold" which is the level of pain you tolerate, objectively, before recognizing it as pain.  And then there's your pain tolerance, which is how well you tolerate pain overall.  Someone with a high pain threshold and tolerance would seem like an action hero, walking away after breaking bones and seeming not to care.  Someone with low tolerance and low threshold would be just the opposite, complaining of small hurts as if they were much worse than they are.  The words "wuss" and "pansy" are usually used to describe these people, which is kind of cruel when they're experiencing those hurts as much worse than someone else would. 

Autistic people, and others with eccentricities in this form of touch, may have one of those two examples above... or they may be in the weird spot where they have a low pain threshold but a high pain tolerance... so they might easily recognize their foot is hurt, but not recognize that the bone is, in fact, broken, and they need to go to the hospital immediately.  They may just assume it will heal over time, as most injuries do, and if they just leave it alone, it will be fine.  This is markedly unfortunate when broken bones and more serious injuries are involved.

Personally?  I've never broken a bone, beyond a hairline fracture in my skull when I was 1 or 2 years old.  I don't remember that, so it's not terribly useful data.  The closest I've gotten to a broken bone was a few years back, and it's the only semi-major incident I can recall.  

So I have these shelves that are actually closet doors, separated by cinder blocks.  They're great, and hold all sorts of things... but at the time I'd thought it would be okay to put my 20 pound weights on the shelf.  It was fine for months... until I leaned on the shelf juuuuust the wrong way while getting out of bed at 2am.  

The shelf overturned, and its contents fell on my foot.  This included the 20 pound weight, which unfortunately managed to catch some decorative spear-like objects on the way down.  The spear-like objects were driven into the top of my foot by the 20 pound weight.  It being 2am, I was rather foggy, but I retained enough coherence to explain what had happened to my startled spouse, go to the bathroom, clean out the injury, put a bandaid on, use the bathroom, and go back to bed.  

Anyone with basic medical knowledge can probably guess what happened next.  I woke up with my foot in a small puddle of blood, within an hour.  So after that, I cleaned it out again and made sure it had stopped bleeding before I taped it up (with gauze and medical tape this time, not a bandaid).  

I'm not honestly sure whether my inability to assess the damage was simply that I was extremely tired, or because my pain tolerance is higher than average.  I'll let you know if I have any other exciting incidents that reveal more...  

What I'm Not Talking About

I am, as I've repeatedly pointed out in this post, an adult with a spouse.  That means there are some kinds of touch that I haven't discussed here.  Sex is its own kind of complicated, but you can probably guess from the things mentioned above that it's more complicated for me than it is for any given person.  I don't know if my blog has a rating, like PG-13 or whatever, but I do not, as of yet, feel terribly comfortable discussing my sex life on this blog.  

If that changes, I expect the resulting posts would probably be useful to adults on the autism spectrum, as well as parents needing to teach sex ed to their children.  It's not that I particularly feel like sex is shameful, like some branches of the Christian church preach, or that I feel like everyone should be private about their sex lives.  I, personally, just do not feel comfortable discussing it right now.  Sorry/You're welcome, pick whichever response suits you better.  

Summary

So this week I've given a rundown on what kinds of touch exist, and a number of examples as to how my body deals (abnormally) with these categories.  Like most people with touch sensitivity, I mostly suffer difficulties with aspects of light touch.  This affects my relationship with my spouse (negatively), my experience with haircuts (very negatively), and possibly my experience of food (positively now, negatively in the past).  

Next week I'll deal with what some people consider facets of touch: proprioception and vestibular senses.  Proprioception is your sense of where your arms, legs, and body are in space, and it relies on being able to understand feedback from your joints.  The vestibular sense is linked to your inner ear.  It's your sense of how fast you're going, whether you're accelerating, and the pull of gravity itself, which in turn affects your balance.  These two senses are the two excluded from the "standard 5 senses," but they're extremely important.  Without them, nobody would ever manage to play sports with any kind of coordination.

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