Expert: James Michael Roan - 3/17/2006

Question
Hi,
  I am a pastor.  A 28 year old man with Aspergers disease has been seeing me 2 days a week for an hour.  He lacks social skills and can't keep a job.  He lives with his elderly parents and gives them a hard time.  
   He is intelligent in ways but just doesn't seem to understand the world and either makes people want to stay away from him or antagonize them to the point of getting in trouble.
   I listen to his stories but don't know how to help him.
   I emphasise with him that he should stay away from what he calls "the crows" people who peck at him and antagonize him.  I am trying to help him find a job.  He is a nice guy if he could find his nitch.
    Can you give me any advice on what I should be emphasizing?

Answer
Hi Don;

Your advice could not be better. Individuals with Asperger's Syndrome (AS) tend to have a rigid concrete thinking style, so they tend to be rule-oriented and expect others to follow the rules also and get angry when they don't. People with AS don't understand social sequences and consequences easily, if at all, and thus are often unable to prepare themselves for the "unanticipated" behaviors of others and thus react strongly when confronted with unexpected social behavior and consequences. Individuals with AS almost always interpret the accidental behaviors of others as deliberate, and blame those around them for presumed transgressions, which ignites anger followed by retribution of one sort or another. To compound the problem they struggle significantly with screening out conversations or chatter and become emotionally overwhelmed by auditory and social overstimulation, which puts them on the extreme edge by the end of their day. To make things even more difficult for them they often have much higher levels of testosterone than others, which increase anger responses and aggressive behavior!

All of that having been said, the best therapeutic approach is cognitive behavior therapy (CBT). Cognitive behavioral therapy is based on the scientific fact that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events.  The benefit of this fact is that we can change the way we think to feel and act better even if the situation does not change. Individuals with AS think very logically and thus respond very well to this approach, which works well with anxiety, depression, and anger.

I hope this helps. He is very lucky to have access to someone like you who cares about him.

Kind Regards,
James