Wednesday, April 28, 2010

More thoughts on Rosie and Auditory Processing Disorder: Controlling the Chaos

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Rosie's article  about her son's Auditory Processing Disorder (APD)  has lead me to reflect more on APD.  One thing, I notice is that I want more Control.  Other people with APD have noticed they really want a lot more control over their environments.

“Where I run into a lot of conflicts with friends (is) sometimes, I accidentally control their environment as well. Instead of telling me that I’m doing it, they get mad and don’t talk to me about it.”

“Others may not like that (establishing control) and see it as us wanting our own way too much.”

“Some see exercising this level of control as an implicit criticism of them - as a standard they have to live up to. They are put off because they think I expect them to live up to my strict personal standards. I have trouble explaining to them that it is not necessary.”

“I tend to organise everyone and they rely on it, then every now and again I get annoyed because I am doing everything!”

I found a good little article on the APDUK newsletter about this:

For people with auditory processing problems, normal life can seem noisy, nasty and chaotic. It can be difficult to know what is going on and how best to respond to others. Being in chaotic situations can create feelings of powerlessness, confusion and frustration. These feelings arise in situations where others without listening problems cope easily. For people with APD, one way of reducing this chaos is to know what is going to happen without having to find out by listening.

One way to know what is going to happen is to exercise as much control possible over one’s environment, so that it is predictable. Having a level of predictability in the environment reduces the level of confusion and distress. As one person eloquently put it, “structure and control are our fortresses against emotional chaos”.

There is a need for people with listening problems to have routines, as well as their capacity to control their environment by seemingly ‘bossing others’ to achieve predictability. Others may not respond well to this attempt to control their environment, seeing it as an attempt to control them- conflicts and resentment may result.

Stress impacts cognitive function.  APD is a disease that impacts cognitive function relating to hearing.  Our brains just do not process meaningful sounds in a noisy background very well to begin with.  It gets worse when we know that there is something we really have to pay attention to in the middle of a field of noise.  For me, being in a cubicle farm is the worst.  It is noisy to the point of being uncomfortable.  In the days before headphones, it was really intolerable trying to concentrate on finishing complex work with even a normal amount of people talking in the background.   In a pressure situation with a lot of noise and hubbub, I would just grit my teeth trying to focus.  I really wanted to stand up and shout at my coworkers to knock it off.   Many times I try to compensate by wearing noise-canceling headphones.  However, there are days when even having some soft background music is too much and is interfering with my concentration and I really need SILENCE to concentrate.  At the end of the day, all I can do is grin and bear it.   Theoretically, I should be able to ask for my own office or to work from home as a reasonable accommodation; but, the reality is that even asking for these accommodations put you in difficulties vis-a-vis your boss and coworkers.   It is seen as asking for a special privilege that you have not earned.   You get along better when you go along with what people at your level in an organization have in terms of workplace flexibility.   What you may gain terms of getting an accommodation for your disability is lost because you aren't fitting in.  Your coworkers don't owe it to you to be quiet. 

I now understand why working as a waitress in college was so stressful.  It was the worst environment for me.  I had to work in a noisy environment and respond quickly to verbal commands that were often interrupted.

When we are stressed, we start to operate in a fight or flight mode.  Our auditory system is scanning the environment trying to help us make decisions in a survival mode in order to keep us safe.  The middle ear, especially the tensor tympani and the stapedius muscles,  plays a key role in keeping us safe by blocking out  low frequency, loud sounds that could damage the delicate cells of the inner ear while at the same time, amplifying the volume of sound within speech so that we can communicate with one another.   This skill of auditory figure-ground, where the ear and brain work together to block out noise and focus on important sounds is very important to keeping us feel safe and secure.  Under stress, we want to block out sound.  When we aren't safe, we don't want to hear; we shutdown; we want to flee. When stress is lifted, we want to hear.   Or, we choose to fight and act out.  Sometimes this is done constructively and other times, it is not.  Some people do reach a point where they get out and out behavioral disorders with the point of the behavior to be removed from the environment.  This mechanism of sensory overload and its interaction with a fight or flight mechanism is true not only of auditory processing disorder but other sensory processing disorders such as visual, tactile, vestibular (balance), etc.

So you can see why having basic issues relating to safety will make a person with APD want more control of their environment.  You want to make yourself feel safer.  It is a very basic need.  For me, this is also coupled with my whole "low registration" scoring on a Sensory Processing Test.  Low registration means that my nervous system has shutdown sensory inputs.  Ironically, in trying to make myself feel safer by filtering out auditory and other sensory overload, I also make myself less safe in that I am not getting the warning signs of impending danger.  I just don't hear, see, feel, smell, etc problems in my environment.  This is all done on the subconscious level.  I don't mean to do this.

So, you end up wanting to control your environment.  At home, this is easier.  I notice I tell my husband who loves loud, booming action movies and shows to go watch them downstairs while I have quiet classical or new age music on upstairs.   I have come to truly detest current news talk shows where people shout at or over each other.  I can turn off air filters that are drowning out TV conversations.

I like large cocktail parties; but, I prefer small intimate gatherings.  I just don't have to work so hard to hear everybody.   I notice I like to have friends over one at a time and not in packs.  Don't get me wrong, I like to have a bunch over for dinner but I am just more comfortable with one or two people over.  Just another way to have a little bit more control in a non-invasive manner.  I don't have so many conversations to filter out when I am listening to people.

However, I  find that I  want to head off situations that will lead to upset or pressure before the situation explodes.  In a positive way, I just sort out problems in advance and manage to keep the peace.  In a negative way, this is where desire to control  the environment can lead to friction.   For people with substance abuse problems or victims of abuse, this can seemingly lead to a very ugly replay of some primal conflicts as they have been very bruised in terms of keeping themselves safe and by honoring their sense of "agency" and boundaries.   So keeping me safe can collide with what other people must do to keep themselves safe.

Work environments rely more and more on team.  Well, large meetings apparently aren't my thing either.   I really can't see walking in with a headset and handing a harness with a special microphone over to the speaker.   Technically, I should be able to request an accommodation for such an FM device.  I don't see any senior level manager choosing to humor me.  Nor do I see even opening my mouth to have such a discussion as in my best interest.  It would be seen as bucking the power structure.  Teleconfercing has its own special problems for APD as well.  By definition, if you have a lousy connection, you have more background noise that us APD folks just don't process well.   Headphones for this just don't work out as a solution.

In a deeper sense, APD problems collide with current workplace practices.  Teamwork is ever more important as a function of holding a steady job.  First of all, the grating personality is the first one laid off.   Asking people to repeat themselves, not remembering verbal instructions, being "slow", or not conforming to group norms are all ways to grate on the collective nerves.  Trying to manipulate the environment when it is not seen as apporpriate to your grade level also gets on people's nerves.  The quiet back office jobs which might seem more appropriate for APD are the ones that are more susceptible to being outsourced:  computer programming, clinical research, radiology, financial analysis, etc. All these are going overseas  or are being contracted out to body shops where the work is on contract basis of less than 1 year and the benefits are lower (including access to good quality health insurance).   The high touch jobs in sales, relationship management, and management are the more stable jobs that also involve the ability to hear.   Being adaptable to fluid environments is necessary in today's workplace; having auditory problems that lead you to want to control your environment makes you less adaptable and less employable. 

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