Strategies to Address Low-Frustration Tolerance in Adults with ASD

Strategies designed to address the autistic adult's difficulty in handling day-to-day frustrations have been developed along with comparable interventions for emotional problems relating to anxiety and depression. 

 

Here are the “big three”:

1. Self-control techniques have been used in the treatment of both aggressive and anxious adults on the spectrum, and given the difficulty that some have controlling these emotions, it may be advisable to make this deficit a key target of interventions for these individuals.

These individuals develop better self-control over their emotions by learning to recognize the physical signs of anxiety or anger (e.g., heart pounding, muscle tension, etc.), by practicing positive self-talk (e.g., “I’m upset right now, but I need to stop and think before I open my mouth”), and the utilization of relaxation techniques (e.g., muscle relaxation, deep breathing, etc.) to reduce emotional arousal and delay an immediate response to a stressful situation. This will permit careful reflection (e.g., problem solving, cognitive restructuring, etc.) prior to taking action.

2. Problem-solving skills are common to cognitive-behavioral treatment targeting behavioral or emotional problems. Adults with ASD are helped to think of several possible solutions to a given problem, and to reflect on the positive and negative consequences of each in order to choose the strategy that will maximize positive consequences in both the short and long term. These individuals who get frustrated easily rely too heavily on aggressive solutions, whereas depressed adults often default to avoiding their difficulties.

Problem-solving skills can be used in either case to broaden the repertoire of constructive coping strategies and enhance decision-making. Decreasing depression and anxiety related to low-frustration tolerance would be beneficial in itself for the adult with ASD, but it may have the added benefit of reducing negative moods that render the individual vulnerable to engaging in explosive, emotional and reactive aggression.

3. Reframing techniques have been used to deal with aggression, anxiety, and depression. The central feature of reframing is to identify thoughts that increase anger, anxiety or sadness, challenge their accuracy, and replace them with interpretations that are more realistic and less harmful. 

 

With regard to anxiety, a person on the spectrum may learn to recognize that her anxiety levels rise when she assumes that all of her coworkers would “think she is stupid” if she made a few typos in a business letter. Instead, she may be encouraged to take a more realistic view, recognizing that everyone makes mistakes, and that when other people make mistakes, she does not usually think badly of them.

To reinforce this perspective, the adult might use some encouraging self-talk (e.g., “It’s alright to make mistakes from time to time …that’s how I learn to avoid making the same mistakes in the future”). Applied to address emotional difficulties, reframing techniques are often used to emphasize that there is more than one way to explain the actions of other people.

Autistic adults who are easily frustrated over things both big and small face a complicated array of social and emotional challenges, and it is imperative that they recognize the full extent of their difficulties and tailor interventions to match their complex needs. More research is urgently needed to create and evaluate treatment strategies that integrate cognitive-behavioral strategies for the therapeutic intervention of both behavioral and emotional problems.

In the meantime, therapists who work with these adults may broaden the focus of existing clinic-based interventions by flexibly applying techniques such as cognitive restructuring, problem-solving skills training and self-control skills, along the lines described above. 

Parents may play a key role in advocating for their older teens and adult children with low-frustration tolerance, seeking referrals where appropriate to mental health centers where individual therapy may be provided, as this may be a particularly appropriate context to tailor interventions to the specific needs of the adult on the autism spectrum.

Resources for Neurodiverse Couples:

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living With Aspergers: Help for Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by Asperger's and High-Functioning Autism  

==> Online Group Therapy for Couples and Individuals Affected by Autism Spectrum Disorder

 ==> Cassandra Syndrome Recovery for NT Wives

Paranoia in the Asperger's Mind

Help for adults with Asperger's and High-Functioning Autism who struggle in relationships:

The Paranoid Aspie

The paranoid Aspie is often hypersensitive and easily slighted. He often thinks he is in danger and looks for threats of that danger, not appreciating other evidence. He tends to be guarded and suspicious and has quite a constricted emotional life. His reduced capacity for meaningful emotional involvement and the general pattern of withdrawal often lend a quality of isolation to his life experience.

Other characteristics of the paranoid Aspie include:

• a combative and tenacious sense of personal rights and “the truth” 
• excessive sensitivity to setbacks and rebuffs 
• preoccupation with unsubstantiated "conspiratorial" explanations of events
• refusal to forgive insults and injuries
• suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous
• tendency to bear grudges persistently
• tendency to experience excessive self-importance, manifest in a persistent self-referential attitude

One man with Aspergers describes his Aspergers-related paranoia as "Assholeperger's Syndrome." He states:

"You made an excellent illustration of what I call my 'Assholeperger's Syndrome'. Usually I can realize that I have made a big mistake but it may be long after everyone involved has moved on. It is really hard for me to know what to do when this happens so I usually find myself just avoiding that person."

While it is fairly normal for everyone to have some degree of paranoia about certain situations in their lives (e.g., worry about an impending set of layoffs at work), the paranoid Aspie takes this to an extreme. It pervades nearly every professional and personal relationship she has.

The Aspie who is prone to paranoid thinking is generally difficult to get along with and often has problems with close relationships. Her excessive suspiciousness and hostility may be expressed in argumentativeness, recurrent complaining, or by quiet yet hostile aloofness. Because she is usually expecting to be slighted by others, she may act in a guarded, secretive, or devious manner and appear to be "cold" and lacking in tender feelings. Although she may appear to be objective, rational, and unemotional, she more often displays a hostile, stubborn, and sarcastic attitude. Her combative and suspicious nature often elicits a hostile response in others, which then serves to confirm her original expectations.

Because the paranoid Aspie lacks trust in others, he has an excessive need to have a high degree of control over his environment and those around him. He is often rigid, critical of others, and unable to collaborate, and he has great difficulty accepting constructive criticism.

Because of reduced levels of trust, there can be challenges in treating this Aspergers adult. However, psychotherapy, antidepressants, and anti-anxiety medications can play a role when the man or woman is receptive to intervention. If suspicions are interfering with your relationships or work, please watch the video above.

==> Relationship Skills for Couples Affected by Aspergers and High-Functioning Autism