Thursday, June 21, 2007

How Do I Help Him?

Posted by Anonymous.

I think my brother has Asperger Syndrome (AS) and my mother is paying the price.

I am 28 and my twin brothers are 25 years old. One of the twins is a rather socially-awkward kid. He was just like any other kid until he turned 16 or 17. Now well into adulthood (25 years old) it is becoming harder and harder for my parents to interact with him. Mainly because:

*He always misunderstands people (99% of time)
*He is always politically incorrect (or rude) because he wants to be honest
*Although he is finishing university, he has had difficulty with writing exams
*He has never maintained a job or successfully passed an interview
*He is not aware of his appearance (he doesn’t shave often)
*He never dresses appropriately (wears a T-shirt at a wedding)
*He cannot maintain friendships
*He can never get a date with a girl (as a result, sexually frustrated)
*Often he uses language expressions in the wrong way (wrong situation)
*Sometimes he laughs nervously, twitches his eyes or moves his fingers on the table in a repeated rocking motion.
*He remembers strange details of things, even after 20 years
*He repeats exact dialogues from some shows like Dr. Phil to prove an irrelevant point.

So, I am diagnosing him with AS, despite the fact that no doctor ever took the time to fully examine his situation!

The problem is not just AS. Many of you how know psychology, you that the “middle child” often suffers from paranoia that he has been short-changed in the family. Many middle children are sometime in their lifetime jealous of their siblings and blame their parents for their failures. Now add AS to the “middle child” factor and you will get a child that might some day kill his parents or siblings in cold blood!

The good news is that my brother is not violent, otherwise we would all be dead by now because he hates our guts! But my mom gets into a fight with him at least once a day when he misinterprets everything and everyone!

He doesn’t think there is anything wrong with him, but “the whole world needs therapy”. Anything that comes out of his mouth is non-sense jealous rage and hatred toward family members, friends and any stranger.

He believes that my parents never loved him. He believes people just want to mock him all the time or everyone is out there to get him and that’s why he can’t pass a job interview.

He has a special way of making everyone mad and my mom cry. Sometimes I think he will give my father a heart attack. My parents love him to death and they know that he may never fully grow up and despite his degree in Engineering, they may have to financially support him for the rest of his life.

But I worry. When I was 23, I was raped by a guy who had almost the same problem. He was sexually frustrated and didn’t understand the meaning of “I don’t want to have sex with you.” I never told my family what happened, because I should have known better.

My question is “how do we get him help, when he believes he is not the one with the problem?”.

Because of his condition, he is not aware of his awkwardness and it is getting worse day by day. At the age of 25, it is not cute anymore when he dresses himself funny or says the wrong thing all the time! I think he needs to get some help before he gets violent and either rapes a girl (because she wouldn’t go out with him) or seriously hurts a family member.


Lara said...

i'm sorry, i know this isn't the point of your post, but i just have to say one thing.

"i was raped by a guy who had almost the same problem... i never told my family what happened, because i should have known better."

please don't EVER say that. you're taking the blame for a rape onto yourself, and it is NOT your fault. while there may have been circumstances with the guy's mental health to help *explain* his actions, they don't *excuse* his actions, and they certainly don't push the responsibility over to you. it's unhealthy to think that way, and i really hope you understand that, whether or not you ever tell your family.

as for your brother, i unfortunately have very little experience with asperger's. i would recommend being really upfront, taking him to a specialist and talking openly about your concerns. while very difficult, it's the best thing for everyone involved to just find answers.

best of luck to you.

Anonymous said...

I don't know much about Asperger's either, but I'm more inclined to believe that your brother is suffering from a mental illness like schizophrenia. The age of onset and the symptoms make more sense. Either way, you are up for a long haul, trying to figure out exactly what the deal is when your brother has no desire to get help, let alone admit that there is an issue.

And lara has some wise words for you, too. You might consider talking to someone, yourself.

Anonymous said...

Author of the post:

So that you guys don't worry about the rape issue, 4 years ago I went into therapy and resolved all that! I am good now.

Anonymous said...

I am sure there is some state help your family can get where a social worker goes under cover and visits you all as a family in your home. I don't think asking him to go and be diagnosed at an actual dr's office would go smoothly.

I have never heard of AS, but what you've said here makes a lot of sense. I am sorry you are all suffering. There has GOT to be a free connection in your area that can step in, in a non-confrontational way.

Major Bedhead said...

I have to agree with anonymous 7:54 p.m. That sounds like schizophrenia. I don't know if you can get him help without his consent, since he's an adult. Do you have a doctor or therapist that you can talk to about this, to get some ideas? It does sound like he needs some help. Good luck with it.

lala said...

AS and autistic symptoms present themselves much earlier than you say they did in your brother. I agree with everybody else's archair diagnosis. It's going to be tough getting him to acknowledge there's a problem. Good luck.

Anonymous said...

The Author of the Post:

1- schizophrenia involves hallucination and paranoia. My brother is always accurate and factual and has an amazing memory. I am 100% sure he is not schizophernic.

2- I know Autism shows itself in childhood, but if you look at statistics, many people with Asperger are not diagnosed well into their adulthood.

3- I'd like to thank people who suggested some sort of undercover social-worker. Because you are right, he doesn't like to be labled as anything by a doctor. (It will crush his already fragile ego to find out that he might have a genetic problem)

Anonymous said...

I'm familiar with AS and have know a few people diagnosed with it. The engineering degree is, in itself, a nod in that direction. AS folks are pretty detail oriented people.

Eye contact (or lack thereof) is another tip-off. A lot of mental illness expresses itself more fully around in late adolescence (though there are usually ambiguous clues along throughout childhood).

I caution against having a strong suggestion of a specific mental illness when consulting a professional. Although you have loads of experience with your brother's behavior, you don't want to lead your best chance for assistance/intervention down the wrong path by making them only look for a specific condition.

It's hard when your family has an undiagnosed and/or untreated mental illness. Try to talk to your parents about your concerns (gently, of course, they'll get defensive otherwise).

If you can't effect positive change in your family (sometimes you just can't help), it's okay to have a greater distance from your family (emotionally as well as geographically). At 28, your life doesn't have to be controlled by other people's anger or unwillingness to deal with a serious situation.

Good luck. I truly hope your family can find a solution that heals the emotions of everyone involved- especially your brother.

Anonymous said...

It sounds to me like your brother has a mental illness like schizophrenia. Autism is NOT a mental illness and autistic individuals are not ticking time bombs with violent tendencies just waiting to go off. I think you have to be careful not to apply general labels by implying that individuals with Asperger's could be rapists or potential murderers--this is offensive to people who might have close loved ones with Aspergers and it also perpetuates myths about autism that are inaccurate and harmful.

Individuals with Asperger's are very high functioning as far as intelligence goes. They also don't just acquire Asperger's in their teens; they more than likely always exhibited social awkwardness (and by that I mean only that they had few friends and were probably isolated as kids). The marked difference between them and neurologically typical individuals is that they have difficulty relating socially to others and reading social cues.

I would strongly caution against rushing into a label that is probably misapplied. You could do better service to your brother by encouraging him to talk with a psychiatrist--it sounds to me like he definitely needs some help.

Anonymous said...

Your brother may defy a tidy diagnosis, but that doesn't mean helpful treatment is out of the question. Family therapy may be helpful in this case, especially for those living with your brother or dealing with him regularly (i.e. anyone who is feeling "triggered" by his actions).

Hypothetically, say he does have Asperger's. Many with AS are not in need of medication and the treatment involves teaching the person with AS, and the people who are supporting that person, how to negotiate the snags and bumps that pop up so frequently. It's about teaching everyone how to cope, not just finding the right label, the right med, and moving on.

Now that Autism and Asperger's are becoming more understood, and more broadly defined, it is easier for us to see people with some, but not all, of the symptoms that comprise the disorder. Some of those symptoms can be debilitating, but without them all the label might not be given (might not really be appropriate).

That doesn't mean that a good therapist can't work with a family/individual around the symptoms. It sounds like the whole family is struggling to some degree, and everyone needs help solving the problem. I don't have any great ideas about how to get your family to agree to seek help as a group, but being covert and/or solely putting the problem on the most symptomatic (your brother) doesn't have to be the only way to go.

If you confront your family, let them get mad and defensive, let them come around, and have some ideas of what everyone can do for next steps (have some therapists names picked out, for example)... it might get ugly, but ultimately might work out better in the long run. Good luck!

Mert said...

He lives with your parents... I'd say unless they are willing to try to make him see he needs help, there is nothing else you can really do.

I hope he does eventually see he needs help though. Unless he is currently a harm to others, for the most part you can't force him to get help.

Anonymous said...

My brother also suffers from assorted issues. When he first began to act oddly, about ten years ago, I was in a similar situation to you: I knew things that my parents either didn't know, or refused to acknowledge, and I felt I had to take action both to help my brother and to help my parents.

I did two things. My brother said one was helpful and one was not.

Helpful: I told our parents everything I knew about my brother's odd actions. While my brother was furious at the time and didn't speak to me for several months, he agrees now that this was the right thing to do. He didn't have the perspective to see his own actions for what they were, and wouldn't have chosen to be honest with our parents, therefore he would have had to wait a lot longer for their help. My parents weren't thrilled with me either (shooting the messenger, basically). If you choose to have a harshly honest conversation with them you can probably expect it to be hard, and I wish all the best for you. I can only say that my relationship with both my parents and my brother today is good--they all did come to understand why I didn't keep his secrets.

The unhelpful thing I did was to lecture my brother. From what I remember, I wasn't cruel or punitive but I remember being so distressed that he did not seem to understand that what he was doing was wrong. He says now that he knew quite well he was in the wrong, and that my lecture made his already fragile confidence wither--he basically felt that he'd screwed up so badly that he would never be able to repair it, which was of course not true. Even today, he is ridiculously sensitive compared to other people--always interprets things as a slight to him, places completely wrong constructions on what people say, and when he recounts a conversation we've had, it is rarely recognizable as the one I remember. It's taught me that I cannot converse with him on a normal level--I have to be extremely careful and even then he will find a way to be upset by things once in a while. I'm not saying this is what would happen with your brother--only leading into the point that people with any kind of mental or emotional issues have an added barrier to understanding others. You might not know what your brother hears when you speak to him. My brother says the most helpful things people said to him during his worst times were the unconditional messages of love and support.

I would also second the other people here in saying that a professional diagnosis is important--mainly I say this because I was convinced my brother was bipolar and he isn't, although he presented pretty convincingly to my layperson's eye.

This is your brother's path to follow, and it might be a long one. I do know, though, that your love will help, and also that people have ways of getting through even when you don't expect it. Ten years ago I didn't think my brother would survive his twenties; today he's returning to school and he's counselling troubled youth.

margalit said...

I would guess that your brother is not an Aspie. Although much of his behavior sounds like it is possible he's on the spectrum, he could also be NVLD. But because these symptoms you describe were late onset, I'd bet there is a mental illness there. Although others have said schizophrenia, it sounds more to me like Bipolar-1. But it could be PDD-NOS or a variety of other things either on the spectrum, or a combination of spectrum disorders and mental disorders. That does happen quite frequently, too.

What your brother needs is a competent psychiatrist and a neurologist to give him a complete workup. All the internet guessing in the world won't help him, but getting an accurate diagnosis will. Although it is VERY hard to get a good diagnosis right off the bat.

Some patients with schizophrenia do not present with voices and hallucinations. Just thought I'd throw that in as well. This is really why I implore you to please get your parents to help him. If he is not insured, you can get help through your local mental health council.

Anonymous said...

I think it's a bit silly for everyone posting here, none of whom have said they are qualified to offer diagnoses, "telling" you what your brother suffers from.
I'm also not a psychologist, but I have some experience and education in mental health.

Encourage him to see a psychiatrist or psychologist. There may be medication that is helpful for him, or more likely he can be helped by psychotherapy to help him develop better social skills.

In the meantime, if he refuses to go, your parents may benefit from consulting with a therapist about how to be less frustrated and hurt by his behavior.

Remember that if he does have Aspberger's syndrome, this does not mean he is a bad person. It means his brain is wired in a way, probably because of genetics, that makes it hard for him to understand how to act in a socially appropriate way. It does not, by itself, mean that he is any more likely to engage in violence or rape.

Anonymous said...

Wow - the other commenters on here are pretty sure of themselves and I didn't realize that they were all doctors!!! Seriously guys, let's leave that up to the real professionals.

Actually, it does sound like your brother has Aspergers or a form of autism. I have a twin brother who has it, and he wasn't properly diagnosed until he was 16 or so. He now lives on his own and is functioning just fine. Your parents probably will have to support him, as one of the main symptoms is a lack of social skills (therefore making it very difficult to be employed if you can't handle people properly). The main thing is that he should get diagnosed and start going to therapy. It's a start anyway. If he refuses, then they should consider it as well, to help them cope and detach a little more...

Best to your family! I know it's a tough road, I live it.

Anonymous said...

Most of the commenters ARE encouraging the original poster to seek professional help, including the commenters who sound confident (maybe they sound confident because they do have experience with diagnostics or have been through a similar situation - this is a mostly anonymous blog). I don't think giving commenters a hard time for sounding confident is doing the situation any favors. No one is inulting the original poster just because they've had some previous experience and are throwing ideas out there. The original poster sounds intelligent and thoughtful, and very capable of sorting through all of these ideas to find one that fits. People are responding to her in a comparably intelligent and thoughtful manner. Clearly she'll make her own choices about how to proceed.

Sara said...

Hey. Please don't write off the fact that you were raped because you 'should have known better.' It's not your fault, and you didn't do anything wrong. I wish I could say something eloquent and compelling and healing. Instead I'll just hope you can feel my heartfelt hope that you will find someone you can talk to who will help you with this.