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Experts Reflect on ‘Parenthood’ Finale

Emotions run high in the season finale of NBC‘s ‘Parenthood,’ and Max responds. Here is a clip of Max’s meltdown.

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The Experts Speak: Hard Times Come Again No More

Intense emotional experiences are difficult for people with autism/Asperger’s. This is very true when the emotional experience involves other people and is not related directly to the needs or desires of the person with autism/Asperger’s. In this episode, Max is unable to relate to the feelings Sarah is experiencing when Amber is in the hospital. Indeed, the disability in being able to connect with other people and to develop an understanding of how someone else might be feeling is difficult and at times even completely alienating. A patient of mine (and an avid “Star Trek” fan) once told me that “having autism/Asperger’s is like being a Vulcan living among Klingons.”

For those of us who are “neurotypical,” we generally get a feeling of connectedness, satisfaction, and comfort when sharing in intensely emotional situations – especially those involving grief and/or death. For people with autism/Asperger’s, they just don’t get those same positive feelings that reinforce the interaction. In fact, a person with autism/Asperger’s will usually find encounters with others who are sharing feelings and comforting one another to be confusing and even frightening. The whole process simply makes little sense to them, and there is certainly nothing that is pleasant or reinforcing about the situation. Trying to get a person with autism/Asperger’s to understand and empathize is to reach the very core of their disability: social and emotional connectedness is the very thing that they are unable to do, or at least not able to do very well. Teaching empathy to someone with autism/Asperger’s is almost like teaching a pig to sing – it is a waste of time and annoys the pig (at least most of the time).

That being said, there are ways that people with autism/Asperger’s can learn to at least approximate feelings of empathy and compassion. With social stories and direct interventions in specific social situations, as Adam attempts to do with Max in this episode, people with autism/Asperger’s can at least “learn the rules” for how someone “should” act in an intensely emotional situation. When this goes well – when they get the rules correctly – they can feel a great deal of satisfaction with themselves for “getting it right.” As much as they don’t understand why people feel a certain feeling, they do often care if people respond to them in an odd or hostile way. When the important others get frustrated, disappointed or even angry with the person with autism/Asperger’s because they are not empathetic or “understanding” someone else’s point of view, it changes how that important other would generally interact with the person with autism/Asperger’s – and that’s confusing and scary.

When Frankie was very young, we began to intervene and attempt to teach the appropriate response to him when he was in a situation where he should clearly be expressing some empathy but “just didn’t get it.” This meant that we had to be vigilant about monitoring his interactions with others. It also meant we had to be ready to step in whenever there was a situation that provided a teaching moment. For many years, Frankie would not follow through independently on any of our “examples.” Eventually, he began to respond to situations in which he should show some empathy but in a very scripted way. Nonetheless, we would reinforce with praise and attention. As time has passed, Frankie has continued to respond in an almost appropriate way to situations where he should show empathy but he is clearly not directly impacted.

Like everything else with autism/Asperger’s, the key has been the intensity and persistence of the teaching. At this point, Frankie may even feel some semblance of empathy, but I know that he will never receive as much from these interactions as I do. I am grateful that at least at this point he, like Max, can feel good about himself and experience others feeling good about him as he struggles to connect socially in a world that often makes little sense to him.

Written by Roy Q. Sanders, M.D.

Visit our Topic of the Week, ‘How do you manage meltdowns?‘ to hear from the community.

  1. Gerry
    April 20, 2011 at 11:07 am

    Thanks for this response. It was very helpful. I thought the subject of empathy was portrayed and handled very well on Parenthood. Living in a family with a ten year old with autism I find watching Parenthood helpful and hope it shows those not familiar with autism what it is like and helps them become more understanding of what families are dealing with every day.

  2. Robin
    April 20, 2011 at 11:08 am

    Loved the show….its so on key with Aspergers and how our daily lives can be sometimes. The balance and the will go move foward are displayed well in this show. I wish it was on every night.

  3. Darlene
    April 20, 2011 at 11:31 am

    I thought this whole episode was amazing! Max’s portrayal was dead on, as was everyone’s response to his meltdown in the hospital. Sometimes, we never have time for pre-teaching. With all of that being said, I also couldn’t help but think of Temple Grandin’s quote….
    “Autism is no excuse for bad manners.”
    She goes on to explain that she was never allowed to use her disability as an excuse to get away with anything a neurotypical child wasn’t. She was expected to behave, be patient, and be kind, as were her siblings. I am an occupational therapy practitioner and this is my favorite population. I am on the autism team in the outpatient facility I work in, as well as a PASS worker for a 7 y.o. Asperger’s boy. I take him into the community every weekend, and he is expected to be kind, and patient and respectful of others. I look for every opportunity to teach him that when I am with him. He is awesome and has never had a meltdown with me, until we transition back to his home.
    I would like to see more opportunities to show Max basic manners that would result in less meltdowns when the unexpected pops up.

  4. KCD
    April 20, 2011 at 11:48 am

    I am a bit conflicted by the show because in some episodes they have made a few mistakes. For Example: the way they told their son, in a very sad dramatic way, that he had Asperger Syndrome. It is not the end of the world, or a death sentence, as the way they expressed on the show.

    But this scene was very on target. At least with my Aspie experience and this can be the most difficult thing to deal with. Trying to help them connect more with people’s feelings, beyond their own. I do want to say, though, that these kids do show empathy, just in different ways. Something that doesn’t bother us as much, may cause the Aspie kid to break down. Example: if my child see’s another kid getting bullied, he will intervene on that child’s behalf. Or stick up for his brother when he gets in trouble.

    • Kelly
      April 20, 2011 at 4:06 pm

      I agree with KCD about the empathy display. I love their portrayal of life with an aspie, but people need to know that there are many different behaviors. My aspie may not realize that he says something inappropriate, but he is very sensitive to other’s sadness. Every child is different and it’s the same with an aspie. With that being said, I think Parenthood does an amazing job!

      In regards to how they explained the diagnosis to Max, their doctor did correct them about their behavior during the conversation. Parents make mistakes sometimes and that’s true to life.

  5. Amy Bergeron
    April 20, 2011 at 3:32 pm

    I disagree withyou KCD. I think think the drama and sadness was on the part of the parents. They didn’t know how to tell Max about his Aspergers. They were afraid of what would happen to Max upon knowing about his diagnosis. This seems very normal to me. They feel bad. They don’t want Max to feel different than other kids. They don’t want Max to feel self concious.
    i think Parenthood is doing a great job keeping it real!

  6. Mom of 2 on the spectrum
    April 20, 2011 at 6:17 pm

    I think Max Burkholder who plays max should be nominated for an emmy. Write in campaign anyone? As the parent of 2 on the spectrum I can say from my “expert” point of view ,he nailed it. Yes the writers provided good material but the 0-60 way meltdowns develop was nailed by this young actor. It was like watching one of my children. I so wanted to yell at craig nelson to shut up and sit down, this is autism , yelling at Max isn’t going to stop it or make it better, only worse. The way mom and dad tried very hard to speak quietly and calmly while reasoning with him and when that didn’t work to remove max from the situation was also dead on. the angry physical outburst from max was again dead on. not directed at someone like a punch just swinging out at anything near by.

    and KCD as the parent of 2 on the spectrum when your child is first diagnosed it can seem like the end of the world and a very sad thing that your child has this condition and they will NEVER get all better and having to explain that to your child is a sad hard thing. the show nailed that aspect of it. Most of us have learned to live with autism over the years and try to ignore blue elephant in the room while we get on with our lives but those first few months after diagnosis are hard and sad. There is an element of grieving involved. And the elephant is always there subtly making us adjust how we go about in the room and in life.

  7. KCD
    April 20, 2011 at 8:57 pm

    @Mom of 2, I am a mother of 3 children with mitochondrial disease and ASD traits. My oldest is the most autistic. As you know, all kids on the spectrum are different. The day my son saw me researching a cure for autism, I had a rare moment of clarity. My son asked me if I was going to cure his autism. I told him I was doing research. He said, ” mommy, if you cure my autism, you will change who I am.” He left me speechless. From that point on, I changed my view of how I would approach autism. He is high-functioning like the character, Max. But for those who are more affected, I understand their need for healing. My goal, is to find a cure for Mitochondrial Disease. For my family, the big elephant in the room, is the Mitochondrial Diagnoses. I respect everyone,s opinion. Every family, affected by autism, will have their own journey to take…

  8. KCD
    April 20, 2011 at 9:01 pm

    I would also like to add… I had much therapy to get to this point. I had to morn the life I thought I was going to have and learn to accept my reality. I did this, for the sake of my children.

  9. April 21, 2011 at 4:02 pm

    Because it is the “spectrum” it is hard to unequivocally say this show is accurate or inaccurate in it’s portrayal.

    My name is Zidlow Marx I have an autistic son named Elijah who is he 16 years old.
    When he was diagnosed at 2.5 it was an unbearable blow to me, both as a parent and as a father. I don’t mean this in any way to be sexist or chauvinistic, but Elijah as my first born male child to be “told”, he isn’t perfect, strong or going to grow up to defend Olive Oyl from Bluto like Popeye was the single most emasculating feeling that could ever have been tattooed on to my being.
    How wrong those feelings turned out to be.
    This son of mine has given me more smiles and more feelings of “kvelling”(Yiddish term for glowing with pride)
    He is not only an “A’ student he is sweet and very funny, has unbelievable perfect pitch and can draw like nobody’s business. In fact he has illustrated both of the books I’ve written about our relationship.
    Moral of the story?
    Simple, don’t let some medical diagnosis throw you into despair and hopelessness like it did to me.
    Many times potluck tastes better then vanilla.
    PS I’m told Bluto is scared of Eli

  10. Rowena Beatty
    April 22, 2011 at 8:15 pm

    I am a parent with a 28 year old daughter who is beautiful inside and out and also has a disability of Autism/ID. She is an individual who is empathetic, sensative and loving. I love the show Parenthood and have not missed an episode. I appreciate what the show is doing in educating others about the disability of Autism. It has always been very offensive to me to see all persons with Autism portrayed as unfeeling and unable to empathize. My hope is for Parenthood to continue to do the great work it has been doing but also portray persons with Autism as “individuals” with different personality traits not just stereotypes.

  11. April 24, 2011 at 9:37 pm

    Although I agree with the author of the article that empathy is a problem-area with people having autism disorders, I would not be so categorical about the fact that the issue stems from being unable or not very well able to socially and emotionally connect. It may simply be that the perception of the emotions ring so differently and bring the person with autism or asperger’s disturbing feelings that are being so uncomfortable, that they filter them as naturally, in order to self-protect and preserve their own balance.

    I have found that acknowledging this possibility with my own son with autism has allowed both of us to navigate highly emotional situations in a much better way. I do not like reading that “teaching empathy to someone with autism/Asperger’s is almost like teaching a pig to sing – it is a waste of time and annoys the pig (at least most of the time)” it sounds a little dismissive – if I had autism I would be offended to read that I can’t be tought something – some of the abilities that people on the spectrum are so high end, that they would probably think that I am useless and that trying to teach ME how to achieve what they naturally can do is like teaching a pig to sing.

    As an expert, I appreciate your input, but the best experts remain those living with the condition, and I prefer to take the clues from them. In “Parenthood”, I really liked how Max was enacting so well what is actually at stake for him: his logics are right, as soon as he understands that his cousin is not going to die, he can shift from the reason why he was explained he had to stay with the others, whose anxiety is so heavy and so palpable, that he’d rather be eating something comforting. Being denied by his father his legitimate request on the account of social graces is more than he can take, and I am sure that anyone else would be relieved to have the ability to evade from anxiety with ease like he would have been able to do, had he been able to access the pancakes immediately.

    Anyway, I really liked how “Parenthood” has shown asperger’s to the mainstream public, and Max is never unbearable, always shown in a very loving light, and I thank the director for his angles (I know his son is on the spectrum, and I liked his vision a lot).

  12. Mary Beth Collins
    April 25, 2011 at 7:02 am

    I agree with much that has been said here, and also believe that the show and actors are doing a tremendous job with including Aspergers in a show that is not “about Aspergers.” It doesn’t have the be the center of your life, while it is certainly something you will touch each and every day. I think for those that don’t believe it to be an “accurate portrail” that it is simply the experiences that one family may deal with. Since Aspergers is part of a spectrum disorder, one example can not accurately portray all experiences, and all family responses. But I think what they portray is very much dead-on with many families that I’ve talked to. I am so impressed with how they have created these characters. You feel for them when the challenges arise, and you are proud of them for moments like when Max apologizes for him meltdown to his aunt, or in other episodes when the father ached to find some emotional connection with his son and finally creates something. And that on other episodes, it isn’t focused on at all and the family is just going on with everyday life. That is the life with Aspergers..for better or for worse. I enjoy this show and hope it returns next season.

  13. Sue
    August 13, 2011 at 9:50 pm

    Dr. Sanders,
    I think you need to talk to older people on the spectrum and realize, “The whole process simply makes little sense to them, and there is certainly nothing that is pleasant or reinforcing about the situation. Trying to get a person with autism/Asperger’s to understand and empathize is to reach the very core of their disability: social and emotional connectedness is the very thing that they are unable to do, or at least not able to do very well. Teaching empathy to someone with autism/Asperger’s is almost like teaching a pig to sing – it is a waste of time and annoys the pig (at least most of the time).” is wrong.

    My daughter is a teenager on the spectrum and she definitely expresses empathy. She and her younger brother sat in my aunt’s hospice room with my extended family and me for hours at a time in December 2008. She handled in very well and commented later that she loved seeing the love and support my family shared during this time. She understood that the trip to visit family was specifically for this purpose too. Please do not generalize based on your experiences with your child and/ or your patients.

    My friend Rachel also does a blog Autism and Empathy: http://www.autismandempathy.com/?p=305 with posts from multiple people on the spectrum including my daughter, Miranda, and also from families of those on the spectrum about this subject. I love what Parenthood is doing, but it could be even better with more understanding.

  14. Jennifer
    November 28, 2011 at 9:01 pm

    I don’t fake empathy. Not expressing a feeling, including but not limited to, empathy in a socially appropriate manner is not the same as not having it. Learning the socially appropriate manner of expression is not the same as learning to “pretend” you have the emotion. Maybe Frankie might do better if you learned to treat him like a person. I wouldn’t respond too well if someone tried to teach me how to behave appropriately towards others by insisting that I didn’t and could never understand how others felt, either. And people being “frustrated, disappointed, or angry” with me based on the false assumption that I find the concept of “others who are sharing feelings and comforting one another to be confusing and even frightening” is extremely hurtful–but not because its “confusing and frightening.” It’s because it’s ignorant and mean–often flat-out dehumanizing.

    Regarding your client who said that “having autism/Asperger’s is like being a Vulcan living among Klingons,” you might want to reflect on the part you haven’t addressed–you’re the Klingon. Klingons are not known for being too friendly themselves.

    There’s also no need to put “neurotypical” in scarequotes. If I wrote an article about gay people that put “straight” in scarequotes, I’d be implying that it was really just a polite way to say “normal.”

  15. November 29, 2011 at 11:40 pm

    It’s not that people with autism aren’t empathetic. It’s that they sometimes don’t express it appropriately.

  16. Pamela
    December 1, 2011 at 4:35 pm

    I have Asperger’s, and I can tell you this is absolute nonsense. People with Asperger’s feel intense, overwhelming empathy with others.

    The best way to learn about Asperger’s is to speak to people who have Asperger’s, not those who appoint themselves to speak on our behalf. Presuming to know someone’s mental state better than they do themselves? Not much empathy there!

    Such arrogance.

    • December 12, 2011 at 11:41 pm

      Pamela, i could not POSSIBLY agree with what you said more my friend, THANK YOU FROM THE VERY BOTTOM OF MY HEART & SOUL FOR LEAVING THAT COMMENT, i would comment these people BUT i can’t right not because im too angry after reading it & my mommy taught me to say NOTHING if i have NOTHING NICE TO SAY AT ALL (LMFAO), im being silly & ironic but you get EXACTLY what im saying im certain, i can’t leave a comment without saying f**k every other word & being VERY VERY VERY hostile towards whoever wrote this TRAVESTY so i will let myself cool down before i say anything to these people, my name is Brian Parker & i have Autism too & i can tell your a very nice & very awesome person already so you should add me as a friend on facebook if you want to, http://www.facebook.com/ourbondisallbutgone is me, friend request me on FB if you want to & i promise i will confirm it ASAP & you can write me anytime you’d like to chit chat, i hope EVERY SINGLE DAY of this winter brings you & EVERYONE you love & care for ALL the joy happiness & SHEER MAJESTIC TRANQUILITY your hearts desire & a whole lot more also

  17. AnnaBWell
    January 24, 2012 at 6:16 pm

    I just have to put in my 2 cents about Vulcans (and autistics.) Please recall that Vulcans have very high and intense emotions and feelings. Vulcans learn to control such high feelings so that they do not lose control. And they have incredible empathy — remember the mind meld? So there!

  1. September 9, 2011 at 1:02 am
  2. January 22, 2012 at 12:11 pm

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