By Clem Bastow
What happens, what triggers them and how can we help? In an edited extract from her book Late Bloomer, autistic author Clem Bastow takes us inside a meltdown.
Meltdowns are perhaps the least understood aspect of autistic behaviour, especially as they manifest in children.
To the casual observer, an autistic kid experiencing a meltdown just looks like, well, a kid chucking a tantrum. There is an essential difference. Tantrums are wilful: a behaviour a child will engage in consciously, usually to achieve a desired effect.
Meltdowns, on the other hand, will happen even without an ‘audience’, and are an innate reaction to feeling overwhelmed. They may involve crying, yelling, thrashing about or striking out. In autistic people who are minimally verbal or nonspeaking, a meltdown can also be a reaction to the frustration of not being able to accurately communicate their feelings or needs.
SENSORY OVERLOAD AND TRIGGERS
When I was little, and undiagnosed, having my hair brushed was a campaign of emotional terror that had to be approached with military precision. The sensation of someone lightly brushing a hand across my skin still feels like I’m being attacked with a vegetable peeler. The sound of people chewing their food makes social dining an act in high-wire terror. Sensory overload – whether courtesy of a clothing tag, scary noises, or a weird smell – is often a one-way ticket to a meltdown.
The first meltdown I can fully remember is still as clear as day. When I emerged from the maelstrom of emotion that had gripped me senseless, I was lying on the floor of Dimmey’s, near the haberdashery section. My parents were somewhere else in the store, having presumably walked away while I disgraced myself with what must have appeared to be an uncontrollable display of id-fuelled naughtiness.
Meltdowns can be thought of as having three stages: the build-up, the explosion and the recovery. The build-up can be triggered by sensory overload, or sensory overload can be exacerbated by the build-up. There may be obvious signs of increased stress levels, like pacing, fretting, or tense posture or expression, too. The explosion occurs when the person’s ability to regulate their emotions ceases: there may be crying, screaming, thrashing about, self-harm or biting, or fleeing. Finally, during the recovery, language processing may slow down and the person will feel drained, and may experience a sense of confusion or shame. It can take a long time to recover from a meltdown.
Meltdowns continue to occur throughout an autistic person’s life; they may lessen in intensity, stay about the same, or get worse, depending on the person’s circumstances at the time. One thing remains a constant: when a meltdown hits you, there’s not much you can do about it. I don’t know what it’s like to be possessed, but I imagine it feels something like a meltdown: a sudden seismic shift that you cannot control.
My throat tightens, like someone is drawing a belt tighter and tighter around my neck. A wellspring of pure rage, or sadness, comes shooting up from my core.
Hot tears shoot out of my eyes. And then … BANG! It’s every Donald Duck spin-out playing at once on fifty televisions in a locked room. It’s Arnold Schwarzenegger screaming as his eyes pop out of their sockets on the surface of Mars.
I have learned to control this, up to a point. I will vacate a room, or alight from the tram, anything to stop myself being crushed beneath that wave of rage, my face dragged across the sandbar by the undertow as I claw desperately for air. If I remove myself from the stimulus, I can avoid the response. Most of the time.
WHAT YOU CAN DO TO ASSIST
People generally want to know how they can help when a meltdown occurs. And, to be sure, a meltdown (particularly in a teenager or adult) can look really scary!
In order to prevent stress leading to build-up, an approach could include helping to provide a sense of routine, or a predictable home, school or office environment: things like schedules and visual timetables (pictures of the things that will happen throughout the day). In the build-up phase, this might include offering a safe and quiet place for the Autistic person to chill out, or recognising things that might be exacerbating sensory input (turning down radios and TVs, not using noisy appliances, offering a weighted blanket or favourite soft toy). During the explosion, a supportive but hands-off approach can work wonders; you could talk to them about their interests, or see if they want to sing a favourite theme song.
The question of what to do if someone has a meltdown in a public space is also concerning to many; acting as ‘crowd control’ is one option – keeping onlookers away, or asking the shop manager (for example) if there’s somewhere quiet the person could go for a while.
Looking back, I don’t blame Mum and Dad for walking away from me in that moment in Dimmey’s; they didn’t know it was a meltdown. To them, it would have looked like a tantrum, and the early-eighties approach to tantrums was to refuse to entertain them.
Were I given the choice, I would probably walk away from myself in the midst of a meltdown, too, because on some deep level, I am always aware of the shame that will follow it. Sometimes that shame is immediate and intense, and other times it just lurks at the back of your mind as you piece together the memory of what just happened. There is nothing more embarrassing than coming out the other side of a meltdown, for you have torn off your human costume and revealed your raw and writhing nerves to the world.
Late Bloomer by Clem Bastow published by Hardie Grant Books RRP $34.99