Physical clumsiness:

Most sensitive people have some barely noticeable degree of clumsiness at all times. Most also
know that their clumsiness is exacerbated when they are rushed by others or when they are
upset or angry or overwhelmed. Physical clumsiness is about difficulty maintaining motor
function coordination during non-routine circumstances. Most of us can train ourselves out of
clumsiness or at least to minimize its impact on our life through habituation to a variety of
circumstances likely to repetitively present themselves.

Physical clumsiness is about skipping steps. If one is trying to open a pickle jar and it turns
out to be difficult, one may try opening the jar using a towel, then putting the jar under
running hot water, then heating it a little in the microwave… eventually the cap loosens and it
becomes easy to open. Clumsiness means a few things here. It could mean giving up before
completing the process. It could also mean putting the jar in the oven before trying anything
else. Clumsiness may often mean that the jar falls out of the hands of the handler and breaks
on the floor.

When one feels upset, angry, frustrated, depressed or anxious, there seems to be difficulty
accessing the automated processes already stored in the brain. Alternatively, we may only be
able to access bits and pieces of these processes. The brain stores information about
previously observed or practiced processes that come in handy when driving a car or opening
a bottle of champagne or fixing the lawn mower. This information is rendered to a routine on
an average day. Most people learn how to drive at some point in their life and from that point
on, they can turn a car on and drive seamlessly. They don’t have to think about their driving
skills everyday or train on driving cars daily before they go to work. What a relief; and we
have the so-called working memory to thank for storing all these automated procedures.
However, on a day when one has a close call driving on a highway, he suddenly find himself
questioning his driving skills and getting less comfortable driving. This person is either having
temporary problems accessing his working memory or his working memory is temporarily
overloaded with processing new information. That soon goes away after one is able to
process the scary but harmless experience and he suddenly regains his driving skills.

The best athletes in the world dedicate years to perfecting their moves on the field, and they
do them flawlessly without giving them a thought. Yet if they are suddenly put under undue
pressure, they might immediately revert to having to think through their moves. They become
slower, they look less sharp and the risk of injury increases tremendously during that time. As
a sensitive person, when you are feeling clumsy, there are two things you should not do. You
should not abandon whatever you are doing and walk away, because that reflects badly on
self-esteem whether we realize it or not. And second you should not power through anyway
ignoring your clumsiness and thinking if I do it forcefully, it may work. It won’t and you may
end up in a lot of trouble. New relationships are known to falter because of this sort of thing.
Precious acquaintances can be easily lost too. You may even physically harm yourself.

When one is feeling clumsy one has to step back, realize that he has to originally think the
process through as if it were the very first time he has ever done it. It takes a lot of patience
and fundamental thinking to do that but it can be very rewarding and cuts down on the
embarrassment. Most other people are generally patient with someone trying to figure out a
process on his own, no matter how simple it looks or how long it takes. They are on the other
hand, not very tolerant of someone who fumbles and keeps going to fumble some more.

It seems clumsiness originates in an imbalance in dopamine release during stress. Dopamine
release in the nucleus accumbens, prefrontal cortex and cerebellum may not be as streamlined
in sensitive people as it is in insensitive people. Unfortunately current technology does not
allow for figuring out imbalances in central dopamine function accurately in the clinic. That
does not make clumsiness a life sentence. Training, and retraining on driving a car for
example allows for automation of the process. We have a wonderful brain ready to assimilate
motor skills and remember and implement them without any conscious input in the future.
This system may need longer training periods in sensitive people but so be it. In addition,
automated skills may be lost more easily in sensitive people if not frequently practiced and
retraining may be required after long pauses. Accepting who we are and gaining insight into
our shortcomings represents 50% of the solution to any problem.

Social clumsiness:

Sensitive people, when overwhelmed, may not be able to remember behavioral patterns
applicable to a situation and that is another form of clumsiness, social clumsiness. Those of
us who are determined at expanding their social life, should write down what works socially
and what does not and review it – and practice it - before going out in case the crowd
overwhelms their ability to access automated behavioral patterns that are socially favorable. I
hope some of the material in this book will encourage sensitive readers start their notes on
things they frequently forget or neglect to pay attention to.   

Author: Rami Serhan, MD
Medical consultant
Sovereign Research
http://sovereignresearch.org
consultant@sovereignresearch.org
(206) 659-1ASD (273)

Note: this article is an excerpt of the upcoming book, “PSYCHE-SMART AUTISM”.

Copyright 2010 Rami J Serhan, MD
PHYSICAL AND SOCIAL CLUMSINESS
IN AUTISM
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