Asperger Syndrome and Patient Interactions (PART 2/2)

ICM taught me about what things were considered taboo and personal to most patients (ie Neurotypicals). I found this quite beneficial as I could also apply this to non-Medical social situations. Previously I openly talked about some of these things while upsetting or offending some NTs without realizing it, but now I know why, and I shall only discuss these topics in the appropriate social groups, whether online or in person.

Here is a basic list of topics from clinical conversations and the ICM booklets that I’ve discovered to be Taboo/ R-rated/Covertly discussed among most NTs:

- Sexual activity, Sexuality, Pornography

- Issues relating to Primary Sexual Characteristics (eg penis, vagina) along with breasts and bottom

- HIV/AIDS and other STIs (Sexually transmitted infections)

- Bowel movements

- Urination

- “Illicit” drug use

- Prescription drug abuse (especially Opioids and Benzodiazepines)

- Drug (including Alcohol) addiction

- Severe/Clinical Depression

- Bipolar Disorder, Schizophrenia and other psychiatric conditions that are (unfortunately) stereotyped by mainstream public and mainstream media to be “crazy” conditions

Engaging in clinical conversations also STRONGLY encouraged me to suppress my impulsivity in saying whatever comes into my head. I have quietly learnt (not from bad experience) that if I automatically say comments that may appear judgmental or not directly relevant to the medical condition, then it’s just going to hinder the conversation, not to mention having a very high chance of offending the patient.

Here’s a segment of me thoroughly censoring myself. I was conducting a sexual interview with a woman who had Bipolar II Disorder (fake name of Cassie). My internal thoughts are in brackets:

Me: (Ok start with the rote “politeness”)

Good morning Cassie, I’m Ken, I’m a third year Medical student from Melbourne Uni. I’ve been told by your GP to conduct a sexual interview on you before you proceed with the main consultation with her. This will involve me asking you about your potential relationships and sexual activity. I’d like to assure you that whatever you tell me will remain entirely confidential between you, me and the doctor. Are you alright with that?

Cassie: Yep that’s fine.

Me: (Ok good.)

Ok Cassie, firstly, are you in any form of intimate relationship?

Cassie: Yeah, I have a boyfriend.

Me: (Just as I expected.)

Ok. Are you sexually active with him?

Cassie: Yes I am.

Me: (I knew it, it appears that practically all of the patients that I’ve spoken to that have a partner or a spouse are sexually active with them! Very few of them seem to be able to cope with no sex life whatsoever.)

Ok, how often do you have sex with him?

Cassie: Um, usually 3 or 4 times a week.

Me: (OMG she’s really horny! I though most adults had sex once a month, or perhaps once a week at the most, but 3 or 4 times a week?! That sounds like heaps! That sounds very tiring and stressful to me! I bet she’s having all that sex when she’s hypomanic , I wonder if she’s even taking her Seroquel?!)

Alright, and how long do your sex sessions go for?

Cassie: With foreplay? Uh about 30 minutes.

Me: (Hmm I wonder what proportion of her sex involves foreplay. From the movies that I see that have sex in it, I estimate the ratio of foreplay:penetrative sex to be around 1:2 or 1:3. But this is probably irrelevant as she’s still doing penetrative sex anyway which has a risk of pregnancy and contracting STIs. I need to focus on any penetrative sex that she engages in.)

What kind of sexual activities do you and your boyfriend engage in?

Cassie: The usual foreplay, feeling each other, and penis-in-vagina.

Me: (hmm I’ll need to ask about contraception/protection now.)

And do you or your boyfriend use any protection when having sex?

Cassie: Well he uses condoms, and I’ve had the Implanon in me for around 3 months so it’s working out pretty well. It’s really cheap, I have a Health Care Card so it was around $5! We only have sex with each other and nobody else, so STIs aren’t an issue, but yeah I really don’t wanna be pregnant.

Me: (That sounds reasonable. Oh wow the Implanon’s that cheap with Concession Health Care Card, I wish I had a Concession Health Care card so I could get my prescription medications for that price! OMG shut up shut up, stop having irrelevant thoughts. What shall I say now? Oh yeah, talk about the Implanon.)

Alright, I can understand that you don’t want to be pregnant, and it’s good that you have very little or no chance of contracting an STI based on what you’ve said. Are you feeling any side effects from the Implanon?

Cassie: Actually no! It’s way better than being on the pill. When I was on the pill, my mood became even worse, and sometimes my face would go all red!

Me: (Ok, now say something good about her Implanon, to show that you heard what she said. I can please her a bit.)

That’s good to hear that the Implanon isn’t giving you any negative side effects, and that it’s doing its intended action.

.

. [further questions regarding Cassie’s partner]

.

Me: (Ok I need to conclude now, I’ve collected all the information and it sounds like she’s horny and she has a very active sex life despite her Bipolar II Disorder. She’s unlikely to get pregnant or contract an STI, so that’s good. I need to thank her for revealing her info, to show that I appreciate her. Don't wanna piss her off.)

Well Cassie, that’s the end of the interview, thank you very much for your patience and cooperation.

Cassie: You’re welcome!

----------------------------

I’m appreciative and grateful for the theories and explanations that I’ve learnt, and have become slightly more aware of how the things I say impact on NTs, and I often try to use the “clinical communication rules” in non-Medical conversations with them, which has so far been more beneficial for me compared to the stage when I was “socially naïve/innocent” (prior to age 21). I still think that the majority of NTs are overly sensitive (emotionally) and very emotionally demanding, but unfortunately (for me, being that I’m in the minority group) that’s how their brains are wired, just like how AS wires my brain differently, so I can’t fully blame them.

In conclusion, ICM and clinical conversations with patients have been very useful to me as they’ve explained various complexities of communication and the thoughts and emotions that get created in patients who are primarily NT. My AS causes me to have a reduction in emotional complexity, and ICM teaches me how to appear sensitive and empathetic even though my condition causes me to not automatically be like that in regards to NTs. I’m still very inexperienced in Clinical communication despite having noticed a lot of social/psychological theories, so I’ll need to practice more and more when I enter Clinical rotations. As a matter of fact, I enjoyed the majority of clinical conversations that I’ve had with patients, because the conversation appears more structured, and the rules are more spelt out via textbooks and professional guidelines etc, and I get to collect information which is practical within a time limit.

I sincerely hope that the attraction and pleasure that I gain (despite the great stress) from such patient interactions don’t diminish in the future, and that as I gain more skills later on, such interactions in the hospital (and in life in general) will be even more manageable and less painful, like a positive loop.

Asperger Syndrome and Patient Interactions (PART 1/2)

I haven’t had too much experience in talking to patients as I’ve only completed my Preclinicals (first 2.5 years of Med course). During the entire Preclinicals, I’ve visited different hospitals and GP clinics around 30 times and there, I had the opportunity to interact with patients. I know that it’s very petty compared to the Clinical rotations that I’ll experience later on, but I felt that I learnt a noticeable amount of communication skills that would benefit me professionally and also socially in non-medical situations, so it can gradually reduce my innate social difficulties due to my Asperger Syndrome to an extent.

Along with such visits, we had many tute classes for a component in our Health Practices subject called ICM (Introduction to Clinical Medicine). ICM teaches you basics in how to conduct medical conversations with patients, how to say certain things, and what to say in reaction to certain comments by a patient. I need rules and details (step by step) on how to talk to patients and people in general, so I found the booklets quite useful because it was well written despite not being specifically intended for people with an ASD.

For starters, it gave extra enforcement of the concept that patients have FEELINGS, and how you say certain things will impact on their mood and subsequent interaction with you, for the remainder of the interview and in further visits. I always knew that practically everyone (including me) had feelings, but my AS caused me to have a reduced Theory of Mind which impairs my ability to intuitively understand the feelings of Neurotypicals (who comprise the vast majority of patients) based on their body language, facial expressions, and subtle social cues. The AS also causes me to innately communicate in a more objective/pragmatic/blunt manner as opposed to a style that’s primarily sentimental, hence causing me to appear “rude”, “weird” or “insensitive” to many NTs.

The ICM booklets were helpful in that they explained the types of feelings that get ignited in patients when you use certain communication styles, because what you say SHOWS something to them, and they often don’t take things literally or word-by-word like people with ASDs tend to do. For example, I learnt that after a patient tells me a load of information about their condition/illness, it really helps for me to paraphrase or repeat what they said, to confirm the info AND TO SHOW that I’m proactively listening to what they’re saying, and that I’m not ignoring them. They can also correct any mistakes that I make, while FEELING less offended.

Another thing I learnt is that when patients are feeling anxious or upset because of their pain or illness, it helps to acknowledge their anxiety/depression by saying a sentence like “I’m sorry to hear that you’ve been having [X condition] for [Y amount of time], it would certainly affect [Z aspects of patient’s life], so I can imagine that this would be very frustrating/upsetting for you.” By saying such a sentence, it SHOWS to the patient that their illness isn’t trivial and that they’re being taken seriously. However, my problem is that my AS causes me to have difficulty with reading body language and facial expressions as previously mentioned, so it’s hard for me to figure out when people are a bit anxious/depressed, so I have to compensate by using more verbal info such as asking “How are you feeling today?” (near the very start of interview), “How’s Uni/work going for you?” or “How’s your family?”, and seeking for certain cue words in the patient’s answer to indicate their mood such as “pisses”, “sucks”, “hard time”, “bitch”, “tired”, “shit”. ICM also taught me that if I see a patient crying, that I should offer them a box of tissues.

ICM taught me that it can be helpful to say certain things in a more indirect manner to avoid offending or upsetting the patient, to avoid appearing aggressive and to SHOW that the patient plays a role in directing their own healthcare and that it’s not being forced on them. For example, if I spoke to a person who’s a chronic smoker, I learnt that I shouldn’t say “You should quit smoking coz it’s bad for you.” , but you suggest it by giving other alternatives or asking questions such as “Have you considered quitting smoking?” , “How do you feel about stopping smoking?”, “Have you tried Nicotine Patches or Zyban?”.

But it also states that at certain times, it’s better to be direct for certain sensitive questions (which I’m very grateful for coz I’m naturally blunt), because if you were to ask it another way, it can appear judgmental and offend the patient even more. For example, the ICM booklet states that when asking people about “illicit” drug use, it’s best to ask directly like “Do you use Cannabis/Marijuana?” instead of “You don’t happen to use Cannabis, do you?” because by asking it in the indirect manner, it actually ignites the patient into feeling like they’re being stereotyped or judged negatively. I also appreciate that ICM taught me how to ask questions in a specific order and explains why. For example in the area of “illicit” drug use, you start off by asking the usage of the most popular drug, progressively to the less popular ones. If the patient asks why you ask in such an order, you then have the medical excuse of stating that you’re asking in terms of epidemiological relevance, and that you’re not being judgmental. There are many “illicit” drugs in existence (in fact the list of “illicit” drugs is astronomical in Australia due to the ridiculously insane Analogues Act), so you only ask the top 5 or so, ie Cannabis --> Methamphetamine --> Ecstasy (MDMA) --> Cocaine --> Heroin (if I recall this order correctly).

So for some situations, it’s best to be indirect, but in others direct is better, and this is quite confusing for me as my AS causes me to have a naturally more rigid mindset. Hopefully as time goes on, I’ll gain more decent Clinical experience and learn to be more rapidly flexible in figuring out how which questions are asked more appropriately and in the least offensive manner.

Then there’s the case where I learnt that you have to be direct, but delicate with the words that you use, as verbal differences are converted into social subtleties that are intuitively noticed by NTs, igniting further emotions.

For example, when I begin to conduct a breast examination on a woman, I’m extremely tempted to say:

“I want to see and touch your breasts to see if you have Breast Cancer.”

coz it’s the direct/blunt Aspie method. If I was to say this to a woman with an ASD, she most likely wouldn’t be offended at all. HOWEVER in the minds of many NT women, the segment “I want to see and touch your breasts” is automatically correlated with sexual harassment despite this being a medical examination, and the segment “to see if you have Breast Cancer” is also alarming due to mention of the potential pathology, igniting fear/anxiety. Therefore I was taught instead to say:

“I want to inspect and palpate your breasts to make sure that they are healthy.”

The words “inspect” and “palpate” (both are synonyms of “see” and “touch” respectively) are used because these words are used less frequently in informal conversations and therefore have a more professional/clinical tone to it, hence having less correlations with sexual harassment. The segment “to make sure that they are healthy” is used instead because it avoids mentioning any pathologies, but it still directly retains the intention of the examination, ie just said differently. “Healthy” is considered by many to be a positive word and hence the breast examination APPEARS to have more positive connotations with it by NT women, and so they’re more willing to proceed.

I’ve learnt that not only do the majority of NTs care about substance, but the vast majority of them also care about APPEARANCES and what you SHOW to them by the way you talk (social subtleties), sometimes even more so than substance!!!

It appears that if you cater to the patients’ emotions to an extent, the entire conversation is more likely to be cordial. Although very tiring and difficult for me, I treat the talking in an “emotionally sensitive/empathetic” manner as a price to pay for a smoother medical conversation and for a politer relationship.

Honesty (PART 2/2)

As you can see in the previous entry, there exists negative responses to an Aspie’s innate drive for honesty. There are negative responses that are even worse!

In some malicious cases, an NT (at work for example) that’s particularly psychopathic (could be a coworker or EVEN a boss/manager!) might want to find out what the Aspie thinks about something just to see if that person is “loyal” to their side, or if he can be manipulated. The innocent, unsuspecting Aspie then reveals his true thoughts in response to the question and the NT can make his decision. If he reckons the Aspie is a “threat” or “vulnerable” to him, he can easily gossip to other NTs and manipulate the information to make the Aspie look bad, and subtly encourage other NTs to harass and bully the Aspie (or he can do all the dirty work himself), which very often leads to the Aspie quitting their job despite having the required skills.

The Aspie’s reduced Theory of Mind means that he lacks the innate ability to see what other people *TRULY* want (mostly NTs) in a conversation, and that they may want something else other than direct honesty or that they want to use the honest remarks for other potentially negative purposes (like in the psychopathic example I’ve given). There exists an initial incompatibility, and this impairs his ability to easily form friendships with NTs (compared to other NTs).

Through negative experiences in adolescence and/or adult life, an Aspie may develop various coping mechanisms to “survive” better socially with NTs and not be so ostracized or treated like shit so much by them. In my case, because I’m not sure as to whether an NT truly wants me to be honest, I’ll use *WHITE LIES* (lies to compliment a person or avoid hurting their “feelings”) in conversations which aren’t fully serious/severe. Note that I would NEVER use a White Lie on a patient though in regards to their medical condition, medications, treatment or prognosis, as that’d be professional incompetence as well as unethical, and I can get into very deep trouble for it. Also, for the markedly few NTs who genuinely appreciate my full honesty by specifically stating so, I don’t use White Lies on them either.

I used to feel guilty and upset about making White Lies, as I still consider that dishonest. However due to multiple bad experiences with NTs (via bullying and ostracizing) when I was being completely honest, I’ve decided to give them a taste of their own medicine. I also fear that a few nasty NTs will somehow use my honesty against me. I no longer feel guilty about giving white lies to NTs. Now I think “If you want me to lie to you, then I’ll bloody lie to you then!!!”

Here’s one that happened in real life in an MSN conversation:

Words in brackets “( )” are internal thoughts. Stephanie isn’t the girl’s real name.

Stephanie: Hey Ken, I got a new boyfriend.

Ken: Who’s your new boyfriend?

Stephanie: Paul!

Ken: You mean Paul from the year above us?

Stephanie: Yeah! What do you think?

Ken: (Hmm, I don’t know Paul well and I don’t think he’ll last long with Stephanie seeing that she only lasted a few weeks with her previous boyfriend in which she dumped for reasons that I personally deem superficial. I dunno if they have much in common, but perhaps they’ll actually enjoy each other’s company. How they enjoy each other’s company, I can’t imagine coz I don’t see how they have much in common, but then again I don’t know Paul that well. Stephanie likes shopping, reading, jewellery and fashion, and she likes checking out the horoscopes section in The Age newspaper. Bleh, I think they’ll probably be in their honeymoon phase, where they’re still enjoying the thrill of being in some sort of intimate relationship that I can’t understand. I wonder why Stephanie is asking me what I think of her newly formed relationship if I dunno Paul that well? If she knows that I dunno him well and I say that I don’t think it’s good, then she might retort by accusing me of saying that coz I dunno Paul well! Omg, is this a trick question? I think I shall have to give her a compliment then. After all, she’s being superficial by asking me about something which I dunno much about, so she may as well expect a superficial answer. And she knows she’s being superficial. She’s not that dumb, she’s in Med School! If I give a simple compliment, then I doubt that she’ll hold anything against me. That’s it. I think she wants me to give her a compliment to make herself feel happy. Very well then, I shall lie to her about how I’m happy for her, but I shall make it sound as sincere as possible.)

Well you seem happy, and I imagine that Paul would be happy as well, so I’m happy for you!

Stephanie: Awwww thanks Ken! : - )

NOTE THAT I TOOK 20 SECONDS OF INTERNAL THOUGHTS TO COME UP WITH THAT COMPLIMENT IN AN MSN CONVERSATION ON THE INTERNET. IMAGINE HOW STRESSFUL IT IS FOR ME TO COME UP WITH WHITE LIES AND “APPROPRIATE/POLITE” RESPONSES TO NTS IN CONVERSATIONS IN REAL TIME!!!!!!!!!

As you can see, my lack of Theory of Mind in regards to NTs makes it very tiring for me to engage in conversations with them without appearing offensive and rude. However I know that if I constantly compliment people on things which they talk about, they may ironically regard me as a doormat (vulnerable person) or somebody that’s a “Yes-Man”, so I have to remain assertive to a degree without appearing all out aggressive. This is when I use my other coping mechanism of MORE INDIRECT SPEECH/EUPHEMISMS.

I’m usually very direct and honest coz as an Aspie, that’s what my innate traits are. To talk in any other style strains my mind and makes me tired as I have to cognitively think of another response, such as the White Lies. However if I still want to at least stay by my stance, then I’ll use the more indirect speech to convey my thoughts. For example if someone was annoying me by doing a certain action, instead of saying “Stop doing that, you’re pissing me off!”, I’ll say “I’d appreciate it if you didn’t do that.”

And in other times, when I feel tempted to say a remark, I double-check in my head to see if it may offend anybody. If I’m positively sure it won’t offend anybody, then I’ll say it. If I’m not sure if it’ll offend somebody, then I won’t say it, unless it’s of genuine importance in which I will. I’m comfortable with not saying certain remarks anymore. After all I realized, that if I don’t comment on somebody’s actions or appearance, then I couldn’t possibly be lying because in order to lie, you have to make a *statement* with the deliberate intention of misleading others! Not saying anything = Not saying a statement. For example I no longer comment on people being overweight unless they’re a patient and I’m talking about it from a medical perspective.

By the way, I get irritated when I frequently talk to people who often insist on white lies and dislike brutal honesty. From experience this includes lots of NTs, who will ironically even be weirded out or offended when you respond that you’re not good with a detailed reason when they asked “How are you?”

Geez, why did you ask “How are you?” if you didn’t genuinely cared about me? Do you expect me to say “I’m good!” every single time? It turns out they don’t care about me at all, they dislike my honesty, and they’re only asking that question to make THEMSELVES look polite. In other words, a lot of their social interactions are based on maintaining appearances of looking polite and their position in a social hierarchy, hence that superficial gesture. I don’t wish to feel like I’ve wasted my breath for revealing my true feelings to somebody who places me low on their “social priority list”. Therefore from now on, I use the White Lie on them, and I tell them that I’m “Good!” even though I’m not necessarily so…

I tend to reduce my contact with them socially, instead preferring to be friends with other Aspies and the few NTs who have no regards for conformity or pleasing others intentionally, and will appreciate my untainted remarks.

Overall, an Aspie’s innate honesty is a double edged sword in the predominantly NT world. His honesty can make him appear vulnerable to other NTs and lead to abuse by the ones that are malicious, and it makes it stressful and a lot harder for him to flourish socially with other NTs. On the other hand it may also be a very positive thing in terms of employment, where certain jobs themselves require a very high standard of honesty with very little or no “sucking up” to superiors, for example Scientific Research, Medical Pathology/Radiology, Data Entry, Auditing, Translating, and perhaps Visual Arts. In a positive work environment with no psychopathic NTs, the boss and his colleagues will value the Aspie’s honesty and competence, and may entrust him other job tasks that require more confidentiality.

So to any of you Aspies who may feel lonely or frustrated, this is the reality about how your honesty impacts on others. It’s not you that has the problem of wanting to be constantly honest, it’s them (many NTs) for not appreciating your positive trait! Please don’t feel guilty about compromising your values by white lies and indirect comments etc if you want to survive in this world, coz it’s not your fault! I guarantee you there are people out there (both Aspies and NTs) who’ll truly like your innate honesty. They’re hard to find unless you go to specific meeting groups online or in person, but when you find them, they’ll make you feel better about yourself in that you don’t have to live a lie when you’re with them.

Honesty (PART 1/2)

Aspies and others on the Autism Spectrum have an innate drive to be honest, and have a heightened sense of integrity. This is most likely due to the way they’re neurologically wired. Aspies have the natural compulsion to be honest when talking to other people and when being asked questions, and actually feel quite hurt and/or guilty inside when lying. However, various experiences (especially negative) with NTs (Neurotypicals), which I’ll elaborate on later in this entry, will change the Aspies’ attitude towards honesty.

If you’ve ever spoken to an Aspie child or adolescent who hasn’t had much social experience with NTs, you’ll find that they’re typically down to earth, trustworthy and have unique insights. The way they talk has far less filtering, and if they want to say something, they’ll just say it directly with no sugarcoating bullshit. And if you ask them to explain their thoughts, they’ll explain it in more detail with no inhibition. They can mention patterns, observations or comments that you’d probably never thought of, or dared to say in front of others. A conversation with such a “pure” Aspie with little prior NT influence can be extremely refreshing and amusing.

As an Aspie (and like most others with ASDs), I believe honesty is an excellent thing and is a trait of AS that I cherish (along with directness). When I’m talking to other Aspies and my Psychiatrist, I can confidently rely on pure honesty in order to discuss things productively, because we innately rely on words themselves for communication, and have much less need to rely on body language or any other subtle social cues. Conflicts and arguments may get brought up quicker but they get resolved quicker too because it can be openly discussed with no hidden malice.

However because Aspies and others with ASDs happen to be in the minority (with NTs occupying the majority of adult society), due to the innate difference in communication intentions/styles between ASD and NT people, their innate honesty becomes a disadvantage very quickly and can lead them to being ostracized, bullied or taken advantage of by some NTs.

For starters, Aspies primarily communicate for conveying and receiving information. They usually connect to other people by talking about specific topics, and how those topics relate to them, expecting that in return, the other person will respond with more information about that topic, or how they relate to it as well, ie a factual discussion where both people learn things about each other, no jokes/sarcasm/fluffy crap. This is why it’s naturally hard for Aspies to connect to other people when they don’t have much in common, because the Aspie doesn’t have enough knowledge about the other person’s interests/hobbies/background themselves to have a decent conversation, and has difficulty engaging in conversations for purposes other than direct information transfer, such as banter (friendly joking) and flirting. However, put an Aspie and another person (especially an Aspie) with the same interests/views in the same room, and they can have a rich, flowing discussion that lasts for hours! It feels very euphoric for an Aspie to have a long uninhibited conversation with another person about common topics, and they can remember such conversations (even word for word) for the rest of their life!

NTs don’t have the innate need for honesty like Aspies however, and often communicate for reasons other than direct information transfer. For polite examples, they’re able to bond with other NTs by bantering, gossiping and flirting even though they don’t have much actual interests/hobbies/philosophies in common. They emotionally connect and relate to other NTs quite easily, and can make many relatively positive social contacts easily.

Because the Aspie rarely uses those communication styles (besides direct, honest information transfer), he’ll initially assume that other people are like that as well, which is an impaired Theory of Mind on his part. This will lead to lots of conflict, due to the misinterpretation of the Aspie’s style of talking by NTs and vice versa. THIS IS WHERE THE PROBLEMS CAN OCCUR!!!

An Aspies’ honesty is often misinterpreted by NTs as rudeness, arrogance or naivety as NTs themselves would’ve been dishonest in numerous social contexts. If the Aspie gets informed that the honest remarks they say have offended an NT, they’d initially get puzzled because they would’ve thought that the NT would appreciate their honesty, when in reality the NT wanted a dishonest answer because he had other desires in the communication, for example for his ego to be stroked, to maintain “group harmony” or to maintain his position in the “social ladder”. This can quickly get an Aspie to be ostracized by a bunch of other NTs, who not only aren’t used to such honesty, but feel offended/fearful/”weirded out” towards the Aspie as they don’t understand the reasons for such honesty, thus shying away to avoid their mind and social dynamics from being disrupted by such pure, unfiltered statements.

Here’s a classical example:

NT Girl: Does my bum look big in these jeans?

Aspie Guy: Yes it does.

NT Girl: You’re so rude!

Aspie Guy: But it does look big!

Analysis - The Aspie guy was being honest and direct coz that’s how his mind automatically works, and he thought that the NT girl wanted to know his honest thoughts. But the NT Girl, even though her bum does appear big in the jeans, she asked the question because she wanted a compliment (eg “No it doesn’t, you look great!”), and not because she wanted to know the truth. Because the Aspie guy gives a response that’s contrary to her expectations, she then gets offended and feels that the Aspie guy is intentionally antagonizing her even though that wasn’t the case.

Here’s one that happened in real life:

(In a computer lab, I’m talking to 3 NT girls: Sarah, Emily, and Natasha. Girls’ names changed for privacy)

Natasha: So Ken, who do you think’s better looking, Sarah or Emily?

Ken: Hmm, I’ll have to say Sarah!

Emily: AHHH!!!

Ken: But Sarah’s got great skin!

Emily: AHHHHHHHHHHHHH!!!!!!!!

Sarah: Rule! You do not say that in front of other people!

Ken: But Natasha asked me a question, so I gave her an answer!

Analysis - At the time, I thought that Natasha genuinely wanted to know my honest reply to her question about who was better looking. I immediately replied to her without taking into consideration of Emily’s feelings at the time. In retrospect, she was taking advantage of my pure honesty and manipulating the conversation so I’d offend one of her friends and make myself look bad in front of them. Her friend Emily did get quite offended and Sarah also thought that my comments were rude. But at least Sarah told me later on that the “correct and non-offensive response” is to lie and say “You’re both equally pretty!”