Matty Angel (who created the painting above) responded to Questioning Pain: Autism, and the experience and expression of pain. Here is a sample:
I feel pain, I even cry if I feel very sad also, but not so often. It just happens when it happens I guess. But sometimes when I am in pain, I am not sure why I am in pain if its not visible to me. I usually try to explain that I feel sore but am not sure why. This has been bad because I have found blisters on my feet or have had rashes and not noticed at all. I also have trouble knowing when I am very hungry. I only eat once a day unless someone reminds me or helps me to eat more. My facial expressions do not show I am in pain, so I have to tell people if I am. Like yesterday I burned my finger and I had to tell someone. ALSO I never ever shout or yell. When I was little a nail went through my big toe and I cried, I didn’t shout and I had a hard time getting someone to help with that. IT HURT! Because I didn’t yell out that a nail went through my foot. But I did tell them it hurt as best I could when younger and I expressed that in a more tearful way.
I replied to Matty:
Nice to meet you! I hope you are well.
I read your narrative with great interest. I think you describe very well what typically happens in people with autism during pain (my cousin, who has asperger’s, is just the same).
The connection you made about pain and hunger is REALLY important.
Rather than seeing pain only as a sensation like pressure, the connection between pain and hunger in autism reminds us of the role of pain in self-preservation (i.e., survival and well-being).
Compare pain to vision or audition. The function of vision and audition is to represent the world. But, they do not have the (motivational) ‘feel’ of a pain. Pain is more like hunger, thirst, or temperature. As with thirst or cold, pain signals coming from the body motivate the person in pain to get rid of it (‘correct’ it). When hungry, we eat. When thirsty, we drink. When cold, we put on a top. When in pain, we seek to get rid of it. These links are compromised in autism. What do you think?
Matty, you wrote: ‘I also have trouble knowing when I am very hungry.’ Have you had, or continue to have, the same experience with thirst and temperature?