Autism in the Adult Autism and ”Just Right”: The Quest for Balance
Join Dr. Regan for this episode on the quest for balance on the autism spectrum. Whether it's emotional regulation, attention, sleep, social interactions, task initiation, finances and more, finding the "just right" state is difficult for many on the spectrum.
Book: The Science of Making Friends
Dr. Regan's Resources
Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
Read the Transcript Here:
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Hello and welcome back to the podcast Autism in the Adult.
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I am your host,
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Dr Theresa Regan,
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a neuropsychologist,
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a certified autism specialist.
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The director of an autism diagnostic clinic for adolescents,
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adults and aging adults in central Illinois and the mother of a teen on the spectrum.
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I'm glad you're joining me today for this episode that I'm going to call autism and "just right." This is actually a great topic that was suggested by a listener from Finland and I hope that I am pronouncing the name correctly.
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I think it's Maya ... Maya wrote about questions and struggles within the topic of balance in life when you have that autistic neurology,
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Maya wrote this.
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I would so much love to hear what you have to say about autistic people and the struggle we have with striking a balance in situations where we have to create an appropriate view on or understanding of things?
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I am convinced that this is the major autistic difficulty that I personally struggle with.
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It shows up in different forms for me and on many levels.
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I could take a few examples so that you understand what I mean?
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Because most often this is not linked to intelligence,
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for example,
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is this person,
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a friend who respects me or not,
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am I too skinny or even to fat?
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Should I contact a doctor because of this thing that I'm feeling right now.
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How far should I stand by this person's side?
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How much should I help him or her?
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Exactly how well should I perform in this university course in order to pass.
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I want to thank Maya for writing about that.
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Um this is something I've thought about as well and I think it's one of those really great ways to conceptualize autism aside from specific details.
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So sometimes to get the most meaning out of what you're feeling,
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it can help to step back and say how is it that all these little pieces of the autistic experience hang together in some ways it can feel so granular,
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like so many things are impacted.
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Why do these things happen at the same time and when we have ways of conceptualizing it?
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Um I think it brings meaning.
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It helps these little pieces come together as why do I have trouble with these 12 things?
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Well,
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these 12 things have a thread that go through and when we can step back and see that thread that joins things,
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I think it really makes things more meaningful.
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Um and so that's what I want to do with this topic.
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Today I call this the just right state.
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So she was talking about balance.
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That's another great way to term it.
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Um A lot of times with the neurology that we're talking about,
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somebody will have difficulty finding that just right spot of balance where whatever they're attempting is not too much or too little.
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And ideally our neurology should help us flow in these areas that we can flow and adjust and we have this innate sense of where we should land to be just right for this context for this person for this topic and we can shift because just right will look different in one setting that it will in another setting or across time.
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So there's a lot of innit nous and flow in this ability to find just right.
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We've talked about difficulty with regulation in a very broad sense.
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We did a series on regulation issues having to do with alertness and attention and emotions and getting to that just rate state in those areas.
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But I think what Maya is pointing out is that regulation and balance and just right is a thread that goes through a lot of other areas with autism as well.
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So let's take a few areas and see how this just right.
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Uh this quest for just right is difficult.
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Let's take the social area.
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So some things that were struggling with that would capture this difficulty with just right would be,
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how much should I be speaking right now to this person?
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How much detail should I be giving?
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How much personal information should I share?
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What is the just right intensity and level of excitement for this context or person?
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What is just right as I'm interacting with a boss versus an acquaintance?
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How much eye contact?
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Too much or too little?
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How much emotional expression should I be using without looking false or like I'm putting on a show or that I don't care at all.
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For example,
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opening gifts without looking just flat or board,
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but without looking like an actor that's pretending to be happy with a gift.
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How much should I give this person?
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How long should I stand by them?
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How much money should I loan them?
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How many times should I give them a ride or a lift?
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How much leeway should I give in a relationship?
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For example,
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I know people are complex and I can be friends with people who do things that I don't agree with.
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But at what point do I say?
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Yeah,
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this is really not a healthy relationship for me.
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I need to end this relationship.
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How close should I make this relationship?
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And how soon what is the just right closeness and the timing of a relationship?
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So some people on the spectrum struggle because they really want some definition to the relationship quickly because this in between state,
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this undefined state feels really uncomfortable.
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So they might say,
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well let's just get married right away because we know we're right for each other and in essence defining and structuring the relationship feels better than this.
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Huh?
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I don't know what's gonna happen with this relationship.
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It feels safer and more defined and more predictable.
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Others will break up a relationship because they don't want to be in that undefined spot that in between place.
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Um So how much is just right as far as closeness in a relationship.
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What is the just right number of times to text or phone someone if they don't call you back or to extend an invitation to someone.
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Now sometimes there are rules of thumb for something like that.
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There's a nice book that I like called the Science of Making Friends that I'll link in the show notes that talks about,
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you know,
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you don't text or call again once you've done so twice without a return text or call.
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I once worked with a couple and we were trying to really increase his ability to bring some nurturance and emotional content to the relationship.
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And I worked with him on being aware that one way to show his wife love is to compliment her.
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So we kind of worked on that as a goal,
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practiced it,
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role played it and he put it into action.
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The problem was then his wife said,
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well now he's complimenting me too much.
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It is the difficulty,
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isn't it?
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Like I can learn a strategy,
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I can apply new knowledge,
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but the getting the just right amount,
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the just right moment,
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the just right compliment boy.
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That's really difficult.
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It's difficult for anyone.
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Uh,
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and even more so on the spectrum,
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let's look at finances for that just right state.
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It seems common for individuals on the spectrum to either lean toward spending too much perhaps on their special interests or other things that cut their eye or to spend too little.
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Um,
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there are people that have lots of money in a savings account or other type of account but they don't want to withdraw anything to fix the roof or to buy an updated phone.
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What is the amount of spending that is just right.
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There are guides for budgeting but it can still feel really elusive to get just right in specific personal situations.
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So yeah,
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this is the principle,
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this is the guideline,
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this is the percentage,
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but it is hard to have to look that framework up and not have a sense,
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an innate sense like yeah,
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I really need to get this roof repaired some will say,
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yeah,
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I know that I can ask for advice,
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I know that I can use this budget but I wish I had this innate sense of yeah,
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I really need to update this in my home or boy,
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I've spent too much on this area and not enough on this other area.
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They'll say,
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you know,
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it's difficult to have a feel for it instead of having to stick to some type of formula and maybe feeling like,
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well what would that rule of thumb look like in this situation and how would it apply to this other case.
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Let's look at just right as it relates to task completion on the spectrum.
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What is the just right amount of completion for some people on the spectrum,
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completion is very important but when is something complete and what is the just right amount of accuracy and detail?
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Some may feel like I need to finish one task before I start another task or I can't go to bed until I read all of these pages assigned from the class of the previous day.
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What is the right amount of detail?
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What is the right amount of speed?
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Have I done enough that this assignment is complete,
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especially when we get to adulthood tasks don't have a clear cut off.
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It's not like there are five math problems and we finish each one and we know the task is complete and maybe that we have a research paper or we have a software project.
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Well,
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when is it complete?
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When is it good enough?
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That difficulty knowing?
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Hey,
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I haven't attended a task B at all,
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but I've overworked on task A and how do I balance that?
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When do I know that?
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That's the difficulty.
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One person I worked with said I've always had the strong feeling that a newspaper needs to be read completely from cover to cover from every page that there,
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there is a completion that's important.
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You can't just read an article here and there.
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That's just not right.
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Another person may feel I have to finish this test completely before I start this other project.
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Even though the first task was something a coworker asked me about and this next one I have to complete is something my boss asked me to work on.
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It's difficult sometimes for the individual with that autistic neurology to understand that all details do not have the same importance.
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Um There are people um on the spectrum who feel like,
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well every detail is going to be important so it has to be included and the neurology there just isn't helping the person know like Yeah,
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but in this instance this part is not as important as this part,
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it can be really hard to get the neurology to shift uh to adjust if a task needs to be done quickly but does not need to be as accurate.
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So meeting deadlines might really be difficult if your boss says to you,
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hey this project needs to be done quickly.
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It doesn't really need to be detailed but I have to have it ready for a meeting tomorrow at noon.
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I just want to give a broad overview.
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Details are not important that can feel actually very stressful.
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Well what does a broad overview look like?
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And will,
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will I feel okay stopping when there are other details available.
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This is also related to the topic that maya brought up about working on a course,
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a university class.
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How much work do I need to do in order to do a good job?
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What if I could have done more?
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Could have done better.
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How many a's do I need to get to be a good student?
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How can I hit the mark of balance with accuracy and speed?
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How can I balance that?
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Everything doesn't have the same importance at the same time,
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something may be able to go undone while something else cannot wait another minute.
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So triaging,
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how do I triage quickly based on importance?
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How thorough do I need to be on this project?
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If the professor said I need to cite 10 sources,
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Can my brain let go?
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The other 25 sources I might be able to get and how can I just innately have a feel for?
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Okay,
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this is done,
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this is this project is finished and it's good to go.
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Maya also noted in her email that sometimes the approach to dealing with this difficulty is to get input from others about what might be just right in a situation,
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but that approach doesn't always feel practical.
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Like who could I ask or there's a deadline and people aren't around this just isn't practical.
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It also takes a lot of energy.
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And do I always bother the same person or how many times do I ask for input and who do I ask?
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So first of all,
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let's talk about that difficulty finding the just right state.
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So this could be within alertness and behavioral activation,
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it can be within attention.
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Like what is the just right amount of attention.
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It's somewhere between distractible and hyper focus.
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What is the just right space for our emotions while it's to be psychologically present and um clearheaded and calm.
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What is just right for test completion,
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finances working out nutrition,
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dieting all of these things.
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Let me give you an example for my own life that has to do with another physical just rate dilemma.
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So one of the things that I think about that I think also highlights this is that personally,
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it's kind of a joke in my family that I have really bad depth perception and again,
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it's kind of a joke because at some point you just have to laugh and luckily I always think I have less room.
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So it's not that I go around hitting things with the car,
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but you know,
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there's lots of room left and it does get kind of funny,
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I wish so in the back of my mind that I could learn to compensate for that because I do get tired of laughing at myself and having to be a good sport about this,
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just silly thing that I've parked so far away from where I could have parked,
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I realized that I always leave two ft from where I could have pulled up.
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So there's this remarkable consistency for me in that area that I can't tell what's just right,
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but somehow I'm always two ft from where I probably should be.
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So I thought,
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okay,
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well I will compensate for this difficulty with just right by going an extra two ft because I actually think I can Gauge what two ft would be.
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So I started to do that and lo and behold I that just does not work.
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I cannot compensate to get to intellectually get to the where the just right status.
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So as you can imagine I'm either to end up touching the wall or the um edge of the parking space with my car or I end up still being well below where I could be.
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So for me that's just another example that if my eyes in my brain are not able to show me the just rate state,
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there's not much I can do about that unfortunately.
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Um And even though I intellectually think of a strategy to compensate,
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it still doesn't mean that I can hit the just right spot.
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Well I should do this more,
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I should do this less.
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Um So I actually believe and in my experience with clients I think that ability that flow for that feel for the just rate state is something that is very difficult to compensate for.
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And I'm not sure that there are great ways to do that.
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I think what we typically do is we suggest intellectual compensations kind of like what I tried to do for my uh driving and parking.
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Um And I think those things are helpful in some ways but there's still this gap between where we would want to be as far as having a flow and an efficiency a feel for that would be so great rather than having to try to gauge to hit that spot a little bit better.
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Some of the compensations that are helpful would be,
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um,
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I think having the self awareness is helpful.
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So for example,
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I know that I have this difficulty,
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so if I have a passenger in the car and they're like,
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you know,
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you can pull up some more because I have that self awareness.
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I have a place for that to integrate that comment.
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And I can say,
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oh yeah,
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I probably can,
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I can't really tell you,
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tell me when to stop.
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Um,
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so I'm able to say yes to that comment.
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Like,
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oh yeah,
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I have a place for that.
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That makes sense.
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I have that awareness.
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I have that understanding of myself and I can't compensate myself.
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But if you're here and you're willing to help,
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let's do that.
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So having a place to put comments like,
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um,
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you know,
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you don't have to call me so many times or um I really don't think that person is mad at you.
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You know,
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when we get feedback like that,
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it it does help us to have a place where we say,
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oh,
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I didn't realize that,
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but I do know I can make errors in that in that area sometimes.
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Um,
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I also think that the awareness can be about what we lean toward.
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So if we have trouble finding the just right spot,
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sometimes we lean toward going toward too much or too little and in my case I lean toward uh leaving too much room or thinking I don't have enough room.
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So I lean in the same direction.
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Um,
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in the case of autism and the categories that we've talked about sometimes that's true for individuals in those categories as well.
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So I have clients that always lean toward thinking that they haven't done enough or they always lean toward thinking,
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um,
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someone's mad at them or thinking that they shouldn't spend money on something.
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So they have a way that they lean so they can say to themselves,
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I realize about myself that when I am off of just right,
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I'm usually in this direction in this category.
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That's also helpful.
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Um,
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because I do think again,
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it gives us a place to put things.
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So let's say that someone is working on a university project and there's nobody there to guide them through and they're thinking,
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I've checked all these specific boxes that the professor asked for,
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but I just have this feeling that I should do more.
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I know I could do more,
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at least they're able to say to themselves,
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you know,
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when I'm uncertain about whether I've done enough,
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usually I've already done too much.
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Um,
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so that can be a guide for them of sorts where they could say,
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okay,
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I'm gonna,
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I'm gonna complete this task,
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I'm gonna call it completed because um,
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I know I lean in that direction and I feel like I've ticked the basic boxes.
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Another thing that can be helpful then is to have some way to communicate.
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Maybe some uh sentences or phrases or ways of putting things that you've practiced ahead of time,
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that communicate to others about your difficulty finding just right in a specific area.
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So let's take some examples.
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And this could be communication beforehand or uh in the midst or after something has happened,
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an example would be,
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let's say someone is starting a new romantic relationship and they have the self awareness that sometimes when they come home from work,
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they are really shut down psychologically and they're in their own head,
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you know,
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that they don't talk a lot to their partners,
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they don't interact much and sometimes partners need something that they aren't,
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aren't giving.
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So with that awareness,
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they could say to the partner ahead of time,
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hey,
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I'm I've been learning about myself uh and one of the things I've learned is that I guess I tend to be shut down after work when I come home.
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So if you need help with something,
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if you um you know,
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want to tell me a specific story or something that's happened,
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you might really just have to um have me look you in the eye and tell me exactly what you need because I might not read the situation very well on my own.
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So that would be a case where,
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you know,
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you have difficulty finding just right,
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you're not going to be able to compensate after work,
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you're already kind of offline,
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but you could explain a bit of the context even though you can't compensate yourself or shift that you could give some context.
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I think the value of that is not only giving the person that information,
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but I think telling people that you're trying to learn more about yourself,
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I think is just a really good thing to communicate.
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People value that we all know we're imperfect humans and we're learning about ourselves and we're growing and that we're open to feedback.
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So,
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you know,
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if feel free to give me feedback,
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if I'm if I'm offline and and I can try to adjust an example of communicating after the fact or maybe in the midst of a fact.
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So let's take a different example.
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We're going to take the example of being at work and there is a project that you've been put in charge of and you miss the deadline and your boss is gonna do coaching with you about that.
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Um So you get feedback from your boss who is frustrated that the deadline was missed.
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That you know,
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he he really needs to be able to count on someone that can meet deadlines because these are very important to the bottom line of their department.
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And if you can't be a team player and get those deadlines done,
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then the whole team suffers again.
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This would be an opportunity for you to say in your head,
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you know,
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to think uh here here,
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this comes up.
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I know that I do tend to focus on accuracy more than speed and I didn't realize it,
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but uh that's come into play here and so out loud to your boss,
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you could say a similar thing,
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you could say,
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you know,
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I'm really sorry that that happened,
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I've been learning about myself that I really do tend toward getting into the detail and sometimes I sacrifice speed without really meaning to and what I realize helps me is and then you can give a specific thing that you would like.
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Um so one of the things an employee might ask for would be,
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it would help me if I could set uh deadlines for parts of the project rather than the completion so that I really stay on pace and what I'd like to do for this next project you've given me is break it into six parts and I'm going to,
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you know,
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give you dates for my deadlines for each of these parts and you can tell me if the deadlines need to be adjusted.
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Um so what you're doing is saying I have this self awareness and I'm growing in this area,
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you're showing that you're open to feedback and then you're also showing that you're going to try a new strategy.
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So sometimes there can be ways of trying to um navigate this difficulty with just right,
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we talked before about how another navigation tool might might be rules of thumb or general principles.
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So here's my budget,
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this is what I'm supposed to spend or not spend or um rules of thumb for completing a university course.
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But I think the truth of that struggle of not having that innate feel for just right really is something core in the autism neurology that I haven't found um a way to shift.
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I think that's really a core neurologic piece that I'm either too much or too little and if I hit just right,
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that's great.
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But I have such a hard time staying there.
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I want to thank my again for that insight and um I think even when there aren't answers to correct a challenge or to kind of make it easier over time,
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I think that awareness that conceptualization that oh why do I do this?
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Why am I really good at detail?
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But I really struggle with deadlines.
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Well this all hangs together neurologically,
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it's part of that difficulty finding just right and I do think that that conceptualization that self awareness is important in and of itself.
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Um and I do think the understanding that that crosses over categories,
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social and task completion and sleep and attention and all of these other things that are really difficult to balance.
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Thank you Maya and I hope you all join me for our next episode