Episode 053: Symptoms vs. Behaviors - When do you want to learn how to swim?
Isabelle and David explore a bit about dyslexia, dyscalculia, and all the ways we walk around accommodating ourselves without knowing it. From making ADHD pasta, to thinking about ourselves in behavioral terms and moving from being driven by feelings to being able to make choices, the question really is, when do you want to learn how to swim? When you're in a pool, or when you're thrown into the ocean?
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Isabelle describes hanging out with a dear friend (who she hopes will be a guest on the podcast soon) who late in life was diagnosed as being on the autism spectrum and also with a mild form of dyscalculia and dyslexia; her handwriting is all over the place, and she may have a mild form (not officially diagnosed), but realizing that she may be accommodating a lot more than she realized, and now she thinks that she may have a moderate form of dyscalculia, and her numbers and analog time switch on her. David wants to give her a hug; neurodiversity is our brains working differently, and we can get hung up on the pathology of it, but all things like slow processing, dyslexia, dyscalculia, and all of it—it changes how we think about attention cycles and how to attend and how to use accommodations. Some kids have ADHD symptoms, then they get glasses and suddenly they lose the ADHD symptoms. But they were blurting things out because they weren’t seeing prompts and once they could see them, they could move through it better. So many of us just move forward going “it’s just me” because we don’t want to talk about the broken or damaged parts of us and we think it’s just going to be hard. This is where it gets complicated, the part of this that David gets stuck with—neurodivergence, dyslexia, dyscalculia, ADHD, autism—that’s your brain all the time. That’s not your brain breaking. For David, ADHD is part of his brain all the time, but it makes things awesome. We don’t say “that’s ADHD pasta, you like that pasta, huh?” Because he’s experimenting with cooking. We could say, that’s creative, or we could say that’s impulsive. For people who have to learn differently, we’re creative, out of the box thinking, problem solving is through the roof. They’re not symptoms, they’re behaviors. We gotta normalize people and experiences, often times it’s used as an excuse. “I can’t, because my ADHD, or it’s out of control all the time.” Isabelle also has ADHD pasta, which is the spices she gathers that’s different every week and it’s so interesting, even the way she frames it. Friend was telling her about how to take the reading comprehension test; she would read the passage, then read the question, then re-read the passage to answer every question. And friend pointed out that some people are able to read the passage and keep that in their working memory as they then answer the questions. It’s a fleeting moment of talking with her, that makes it feel like someone gets what it’s like to do it the way you do it, and what it might be like to be neurotypical. A near peer mentor, especially someone who is doing well. We’re caught in that damaged place where we think it’s just our fault and we’re bad at the thing everyone else can do. The way that David has always thought about it, is that it could be working memory, or it could be that when you read the questions, you get structure about where to put everything else. We have incredible visual and spatial memory, David gets caught in how we organize stuff, and there’s this incredible guy Barkeley, who does a lot of great work, and he talks about it in a medical model where he talks about it with a symptoms and problems. David talks really fast—it’s either a symptom of ADHD or a behavior with ADHD. One is about sickness and one is just a thing. Isabelle is reminded of Sam Kean’s “Tale of the Dueling Neurosurgeons” and his glorious tangents and neurodivergent-friendly, fact-filled writing style, and she takes away that we commonly think our prefrontal cortex makes a decision and then our motor neurons follow it. Like if she wants to reach for the coffee cup, she decides to reach for the coffee cup, and then does the movement to reach for it. But your body actually reaches for the coffee cup before you consciously decide you are reaching for the coffee cup. Our brain and explanation for what we do is always lagging to the motions and things we’re doing. David’s turn to the do the Isabelle moment: whoa. The behavior comes first, our thoughts about it come second. Same with emotions, they come first, the thoughts come second. David’s first training was behavioral psychology, he thinks we’re stimulus and response creatures, but we really like to imagine we make a lot of conscious choices, when we don't. Nine times out of ten we think we make decisions, but we are on autopilot and don’t look at the menu at the fast food restaurant, we know what we’re getting already. We have to practice the habits we want to institute in our lives when it doesn’t matter. We need to initiate the routines, habits, and rituals when there’s low stakes, no time pressure, and nobody holding me accountable? WHAT?! Thinking about accommodations: when do you want to learn how to swim? Do you want to learn how to swim in a swimming pool, or jumping off a ship? That’s what military training is in a way, you make it automatic so that the behavior is going to happen when you’re in that zone. As David points out, they also intentionally desentisize people to threats and vulnerabilities so they don’t get derailed when practicing the automated parts. So getting rid of threats is negatively reinforcing, which is removing the thing that’s painful as you go so you get relief. Other forms of negative reinforcement are the beeping going away when you buckle your seatbelt, or the sweet silence when the annoying alarm clock sound goes away when you hit the snooze button. Isabelle wonders if that connects to medication or caffeine, is it habit building because it gives a sense of calm? David counters: medication or not, any successful intervention dramatically increases self-esteem, dramatically makes the person feel better; it is naturally reinforcing because you’re able to feel the difference in your pain points. Reinforcement is just increasing the frequency of the thing that came before it. When we’re taking medications or doing any accommodations that work, we are more accurately appraising our performance, we are not motivated by feelings, we are motivated by behaviors, which is very different, and it creates a more tangible grasp on time. If you’re going to be motivated by behavior v. emotion, it’s reintroducing choice—what if folx who are neurodivergent, what if it’s just there less of a hold, ‘no no no, explain it all, make it all make sense’ that lives in us. More neurodivergent ways of thinking, like a horse with no reins—don’t get why anyone would need them? Imagine half the world is rockets with tail fins and they shoot off and people come down with parachute. And every once in a while, there is a rocket with no fins on it, and that’s David. It’s terrifying, but also goes everywhere, and you may be dodging it, the point is that accommodations, the medications, are fins for the rockets. We’re going to self-medicate with emotions, with anxiety, anger, excitement, shame, OR you can have that medication, you can take that coffee, you can go for that run, and then you increase that stimulation but you get to pick the feeling it’s attached to. Without accommodations, we’re just going to move from one threat to the next. With accommodations, we’ll face a threat and then have 30 minutes to pass before the next threat arises. And in terms of use incorporating something in our habits and then seeing what it results in 20 years down the road. If David hadn’t found medication (for him), he wouldn’t have likely met his partner, finished college, gone to grad school, he wouldn’t have the job he now has and he wouldn’t be talking to Isabelle right now. But it’s not woe is me, he would’ve been awesome, he may have been a stand up, a carpenter, doing drywall, but it gave him choices.
Tale of the Dueling Neurosurgeons by Sam Kean
DAVID’S DEFINITIONS
Dyslexia: (from Mayo Clinic): a learning [difference] that involves difficulty reading due to problems identifying speech sounds and learning how they relate to letters and words (decoding). Also called a reading disability, dyslexia is a result of individual differences in areas of the brain that process language. For more on this, check out the Black and Dyslexic podcast hosted by Winifred A. Winston and LeDerick Horne.
Dyscalculia (from understood.org): a learning disability in math. People with dyscalculia have trouble with math at many levels. They often struggle with key concepts like bigger vs. smaller. And they can have a hard time doing basic math problems and more abstract math.
Negative reinforcement: Feeling relief as the thing you are pained by goes away. Like the beeping before you actually buckle the seatbelt, the stimulus (of the beep sound) is removed. Or when you wake up and turn off the alarm clock and get sweet silence—that’s negative reinforcement.
Reinforcement: Increases the frequency of the thing that came before it. Not necessarily good or bad, feeling good or bad, just ta-dah! You do it more.
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Cover Art by: Sol Vázquez
Technical Support by: Bobby Richards