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Psychological Terminology on the Autism Spectrum

Dale Johnson: This week on the podcast I’m delighted to introduce you all to Johanna Pressley. She is a wife and mother of three young children; she holds a Master of Arts in Biblical Counseling from The Masters University. She’s been blessed to be able to serve many people affected by autism, even in her own family, as a Bible teacher in an inclusive Christian School and as a counselor at the Lowcountry Biblical Counseling Center in Charleston, South Carolina.

Johanna, even before we came on live we were getting to know one another, and I really appreciate a part of your story. I’m looking forward to our time together, so welcome today.

Johanna Pressley: Thank you. I’m glad to be here.

Dale Johnson: Yeah. Looking forward to this discussion. And you know, this is a discussion where, when the issue of autism or autism spectrum or what used to be known as Aspergers comes up, people get sort of wide-eyed and they’re not sure what to say, where to go, what to think about. And this topic, this word, all of the sudden is introduced into your household. I want you to give, if you can, a case study example of how it could be for biblical counselors to be aware of these types of traits that we see with level 1 autism.

Johanna Pressley: Absolutely. So you’re going to deal with this differently with maybe a mother and a child versus a husband and wife. So a husband and wife situation is going to be more difficult. And the difficult thing, especially with level 1 autism, is that you can’t immediately see what’s going on. And that is what makes it tricky. So imagine you’re dealing with a husband and wife. Let’s say the husband has a trait described as abnormal prosody, so that’s where he is unable to recognize patterns of speech like loudness, pitch, intensity, and tempo. So the husband and the wife are both unaware that the husband has this. So when the husband speaks the wife interprets his manner of speech as anger and says something like, “I don’t know why you’re angry. Could you please stop yelling at me?” And the husband then actually does become angry because he feels misunderstood and falsely accused. But see, they get stuck because they can’t solve the problem because they’ve got the problem wrongly identified. They both believe the other person is intentionally sinning against them. So if you, as a biblical counselor, are aware that there are things like this, you’re able to ask questions in a way that points to a wider solution and clarify the problem in a more biblical way.

So you want to point out that we’re dealing with how we need help with weakness. But we also need to do some gaining knowledge and training and certain communication skills and confronting sin. So when you’re able to see it in this wider way, as many things going on at once, you’re able to point to, to make clear, what the problems are and then lead to biblical solutions.

Dale Johnson: Now as we’ve been talking with problems and identifying those problems in the way that they appear in real-life situations, you know, the only terminology that we have, even the title that we gave this, is talking about the issue of autism. Do you think it causes greater difficulty for families when problems like this are identified using terminologies that are not biblically derived?

Johanna Pressley: Absolutely. I have different shortened ways I will talk about the problems that come up. So what I just described is what I call the problem of “interpreting through bad.” So sometimes people will say they think the problem is that their husband or child is just sinning, right? But there’s an opposite problem that can even be almost worse, which I call the problem of “interpreting through broken,” just broken. So sometimes when you start to introduce psychologically derived terms, let’s say we’re using the same scenario, the wife would shift from viewing her husband as just a sinner to and she can really become hopeless when she thinks that the issue is that he has a brain disability that’s the cause of all their problems and there’s absolutely nothing that can be done about it. So these terminologies can lead you into thinking that there’s no hope, that there’s no change. But when you’re able to put it into biblical terminology, that’s where you’re able to see, well, I know, 1 Thessalonians 5:14 says we help the weak, right? We admonish the unruly, we teach people who need to learn, we train people who need training, right? And we have tons of hope once we reframe that according to Scripture.

Dale Johnson: And it’s important you mentioning even here that it’s important for us to describe these identities, these traits if you will, in biblical or actionable terminology. And I think that’s really helpful to put it in these types of terms. How do you describe some of the things that are often associated with autism in this particular way?

Johanna Pressley: So this is a way I try to think about biblical, actionable terminology. When we’re talking about telling someone, “Who are you,” so I’m going to tell you when I tell my own son, “Who are you?” and I try to teach him who he is based on Scripture. In order for something to be a biblical term, it has to have several attributes. So it has to show the intimacy of our relationship with God in our family. It has to show the capabilities that a person has based on what God says. It has to show the unity that we all have as believers and it has to show the progressive nature of our sanctification, and I’ll give some examples in a minute. Also, by actionable, I mean that I try to focus on what we’re going to use to worship God. So to whatever degree you have a skill, we’re going to try to take that degree and we’re going to use it in an actionable way to worship God. I also will use my children and other people will also often have idiosyncratic terms that they particularly will use, so I will try to use those because they mean something to that person.

So here’s an example: when my son was little, when he would become angry he would point to his chest and say “I feel the fire!” and so we started talk about “Well, you can be a fire tamer because you can be a hero,” and so we all began to use that word, “We are fire Tamers.” So when he was young, he was a novice fire tamer, and then he became an apprentice fire tamer as he would grow in skills to worship God, because God has said that he has the ability to control his anger, right? And as a family, something that’s important to us is not to be divided into groups, like, “Oh, you guys over here are the ones who are sick, and we’re the ones over here who are well.” And so we try to use terms that everybody in the family can use together so that we’re a team of fire tamers and we’re all working together. We all have areas we can grow and encourage each other.

So when we get in the van to drive anywhere, I put the kids in the car and I say “Who are you? Okay! We need to remember who we are, and we’re going to go out into the world!” and one person will say “I’m God’s man” and the other kid will say I’m “laser-focused boy” and somebody will be a “word chooser” and somebody’s going to be a “friend maker.” And then I say, “You know, you’re my beloved Son.” So we talk about who you are being biblically grounded but also actionable. What area do I want to take the resources God has given me and pour them out in worship to God?

Dale Johnson: Now, you’ve been dealing with this for a while. So this is an introduction to so many people. How does your awareness of autism-like traits really help you make choices about the ways in which you communicate, you know, personally in your own family, but then also, in the way in which you communicate in the counseling room?

Johanna Pressley: Of course, this is a huge deal. So when we talk about beginning a counseling session, we’re familiar with we want to start with involvement and commitment, right? So involvement and commitment is a very difficult thing when you’re dealing with someone on the autism spectrum.

I’ll give you an example. Let’s say you’re starting a counseling session with a mother and a daughter. When I am teaching counseling with an Autism family, I’m not really focusing on building involvement between me as the counselor and the child, I’m working on building it between the mother and the daughter. I want to teach the mother how to build involvement with the child, and I want the child to work on building commitment to the mom. So I have passages that are in my mind. Hosea 11 where God says He guides us with cords of kindness, with ropes of love. And so I’m going to teach the mom that we want to use really tangible things that the child can grasp that make sense to her. So one of the things I do is I’ll take a ball of yarn, and I give it to the mom, and I say, “Okay, pass the string to your daughter and tell her something true,” and maybe it’ll be something she loves about her daughter or something like that. So she passes the yarn and then the daughter passes the yarn back to mom and tells the mom something true. So we pass the yarn back and forth and do this and we say, you know, when there’s one thread between the two of you guys, how strong is that? But now that there’s five or six, we have a really strong cord. And this is how you are going to guide your daughter, by hordes of love and trust that are built; and so, both of you have to be giving it and receiving that chord. So we use tangible things like that.

Also, Proverbs 2 is a very big verse for me. Bend your ear to knowledge. And so, I want for the daughter to really understand that it’s her job to actively bend her ear, to be willing to be guided. So I call this pair “a guide” and “an ear-bender.” So we talk about the superpower of the ear bender and do all kinds of things like this, but I do actions where the mother and the daughter will move their arms and they’ll do guiding. And the mom is to put her hand out, and the daughter puts her hand in and pulls her near to her, and the daughter must bring her ear to the mother’s mouth to show visually that she is going to bend her ear and let herself be guided. So I want to speak the child’s language in ways that she understands. I want to remove any possible hindrance that I can. A lot of times we’ll go outside, that helps a lot. We’ll walk while we counsel sometimes shoulder-to-shoulder, just talk, talk, talk, and walk and move, acting things out and do a lot of that, making it tangible, drawing pictures. I do a lot with my facial expressions, tone of voice, and body language. I do repetition things, music things, drills, all this kind of stuff.

Dale Johnson: All this is helpful and what’s so cool to me as I’m hearing you describe this is, as you’re talking and you’re wanting to use a language of the child, you’re just simply helping them to understand biblical ideas, biblical concepts, using language that they already have that they utilize. And so, I think that’s really critical.

You’re bringing the Word in very applicable ways directly to the child. You’re helping them to understand the Word, which is the point. You’re explaining the Word and the concept of the Word; you’re acting out the Word. I mean, if we had a video right now… I love it. You could not be described as being dull or tame. You are very expressive, and I love that. And I think working with children, particularly in this way, that communicates a certain joy, too, about the Scriptures, which is really, really helpful. And you’re demonstrating this is a part of what Deuteronomy 6 describes is helping our children in everything that we do, everywhere that we go, rise up, lie down, walk by the way, everywhere that we are that they’re with us and they’re engaging in this learning, you know, as we go the truth of Scripture and how to implement them in their life.

As you’ve talked about this idea, you mentioned Hosea, there’s some critical Scripture passages that you’ve found very helpful for you personally and your family and then other families affected by autism. I want you to give us some of those particular passages that really help guide your thinking here.

Johanna Pressley: I love Matthew 25:14-30, the parable of the talents. So, we’re parents. I think the most important thing to highlight is that parenting is an act of worship to God. I think we get off of this and in a variety of directions. Sometimes we think our efforts at parenting is about, you know, our child-building skills or it’s about our child not bothering us as much as they do or something like that, but it’s about worship to God. And it’s tough as a parent because many times you will pour out so much work and not see very much change and that’s very challenging. But when you view this as an act of worship to God, you see that these moment-by-moment things you’re doing, you’re doing out of obedience to Him and that’s really the joy, that’s the motivation. When we think about the parable of the talents, we’re taking the resources that God has given us and we’re just pouring those resources back out to Him. And that’s such an important passage to me because as a parent you want to sometimes try to pull resources from yourself and you can get so depleted trying so hard to care for your children. But when you’re taking from yourself, you don’t have anything to give. So that passage, the parable of the talents. Or John 15. I am the vine you are the branches. Any kind of visual where the parents can see, you know, I’m drawing up from the vine and I’m pouring out fruit out of the resources He has given me, and that’s so encouraging.

I also love Luke 21:1-4, the widow’s mite. That’s such a great visual that, as parents, if you just feel tired and dried up and you’ve got nothing left but just a tiny little bit of energy, you can offer that tiny little bit of energy to God, and it is beautiful in His sight. And that’s so encouraging. Or Romans 11:36. From Him, to Him, and through Him are all things. These are the passages that are very encouraging to me and that I love using with these families.

Dale Johnson: When I hear you describe this, I get really excited, honestly. The Lord, in the way in which He’s created you and your husband and you guys working through this biblically and the ways in which you just have a creative mind to work with children in this way, I think it’s outstanding. One of the things that we were talking about even before we came live was that there aren’t many resources that describe thinking about autism or dealing with autism in these types of ways. And that’s one of the things, you know, you’re still in this process of learning and growing and explaining these things biblically. I’m going to say that I think it’s really important that you start to put these things down on paper. There’s so many people who are out there who are listening now, and they’re interested in how you are working these things out biblically, and I think this would be a wonderful resource developed for so many parents who feel hopeless.

Johanna Pressley: Well, I work at Lowcountry Biblical Counseling Center in Charleston, South Carolina, and we’re hoping in the next year to create some video resources. You can follow our progress on that at LCBCC.org/autism. So as we get these resources developed or we have any updates, we will put that there and you can follow us there.

Dale Johnson: And those will be things as they come out that I’ll continue to let our listeners know about because this is an area where biblical counseling needs to grow and flourish. We need to speak into this world. The Bible has a lot to say about how we can work with our children in the places at which they are and helping parents work with them as well. And Johanna, I’m so grateful that the Lord has tasked you with this role and given you some wisdom and creativity to bring these things to life in families that oftentimes feel hopeless and they question so much about what’s going on, especially in relation to God, and your reinvigorating them, giving them the beauty of the Scriptures to handle these types of issues that they face.

Johanna Pressley: Thank you so much, Dale. It’s been wonderful to be here with you today.


Helpful Resources:

Check out the ACBC High School Curriculum: Foundations for Biblical Discipleship here. [1]