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アスペルガー症候群:最も分かりにくい障害(7)

 さて、3つ組の障害の中で、一番目はコミュニケーションの問題について紹介します。

 アスペルガー症候群や高機能自閉症の診断を考えるときには、何の障害があるのかという分類と、その障害の程度がどのくらいかという2つの観点が必要です。

 コミュニケーションの問題は、言語的なものと非言語的なもの、さらに言語については話し言葉の問題と言葉の理解の2つの問題に分けられます。

 磯部(2005)は、次の4つに分類して述べています。
 1.話し方の問題
 2.言葉の使い方の問題
 3.言葉の理解の問題
 4.非言語メッセージの使い方と理解の問題

 話し方の問題とは、その場に合わないしゃべり方や単調すぎる話し方、また音量調節の不適切さなどをいいます。アスペルガー症候群の人は、淡々と抑揚のない話し方をする人が多いのですが、全部がそうというわけではなく、時に病院の面接室などで、周りに聞こえてしまうくらいの大声で話す人もいます。特にグループで話していて、周りには聞かれないようにひそひそと皆がしゃべっている時に、大きな声で一人だけ話すことで、同じグループの人に不快感を与えてしまうというようなことが、ときどき起こります。

 言葉の使い方の問題は、程度の差があって本当に様々です。
 子どもに多いのは、思ったことをすぐ口に出してしまう事によるトラブルです。例えば、スーパーに買い物に行き、レジで並んでいるときに、前のおばさんを指さして、「あの人の鼻の穴大きいね」などと、見たまま思ったままを言ってしまうというようなことです。

 アスペルガー症候群の人は、語彙数がむしろ豊富なこともあります。一見流ちょうで筋が通っているように思えることも少なくありません。文法も助詞などの使い方を除いては大体合っていることがほとんどです。しかし、以前にも少し触れたように、話し方が回りくどく言葉の引用の仕方が独特で、杓子定規な印象をうけることが多いです。話し方は丁寧なことが多いのですが、その場に合わないことがあり、親しい関係の人に丁寧すぎる言い方をして、逆に相手がよそよそしさを感じたりすることはよくあるようです。

 また、親しさや相手との距離をうまく理解できない時に、それほど親しくない人にまるで普段から知っている人のようなフランクな言い方をしてしまったり、名前を呼び捨てにしたり命令口調になって、相手に不快感を与えてしまうことがあります。

 アスペルガー症候群の人にも、たまに独語が見られることがあります。一つは強迫観念と関連した、不安を打ち消すための呪文のような働きをするもので、周囲に奇異な印象を与えますが本人にとってはどうしてもそうせざるを得ず、それが周りにどのような反応を与えるかということが分かっていてもやめることができないことが多いです。

 もう一つは、思ったことをそのまま口に出してしまうための独語であり、奇異さはありませんがその場の状況には合わないので、何でこんな時にひとりぶつぶつと言っているのだろう、と周囲が理解に苦しむことがあります。独語が本当に困るのは社会に出たときで、そのために仕事を失った人も少なからずいるのです。

 アスペルガー症候群の人たちには、決まった場面ではほとんど問題なく話せる人と、場面に関係なく話すこと自体が苦手な人たちがいます。アチャモさんのように、決まった営業トークならほとんど問題なくできるのに、普段の会話が苦手な人もいます。また話すことが苦手でも書き言葉による表現ならば十分にできる人もいます。中には文章を書く才能に非常に恵まれるアスペルガーの人もいるのです。

 また、話すのも書くのも苦手な人もいます。頭の中には言いたいことがいろいろと思い浮かんで来るにもかかわらず、それを言葉にする段階でどうすればいいか分からないために起こると言われています。高機能自閉症の場合、どちらかというと会話も書くのも苦手という人が多いように思います。

 さて、言葉の理解の問題ですが、大きく分けると、自分の使っている言葉の理解の仕方に関するものと、相手の使う言葉の理解の仕方に関するものに分けられます。

 アスペルガーの人に多いのは、自分の使っている言葉の意味が、文脈やその場の状況に合っていないことが分からないという問題です。知能の高い人で、自分の知っている法律や経済、医学などの専門用語を頻繁に引用して話すことがありますが、十分に意味を理解しないで使っている場合が案外多いです。言葉には複数の意味があって、状況に応じて使い分けられている事への理解が不十分なことから生じる問題や、言葉の単純な意味は合っているけれども文脈の前後とつながらない使い方になってしまうことから生じる問題があります。

 話題が少しずつずれたり、急に変わったりするのもアスペルガーに時々見られる特徴です。まるで連想ゲームみたいだな、と思うこともあります。

 「この前TV番組を見ていたら、ある政治家が日本の経済はこれから良くなるって言ってましたが、経済と言えば失業率ですよね。仕事がなくて、ハローワークに行っても適当にあしらわれて、面接の予定を先方にキャンセルされたこともあって、なかなか思うようにいかないですね。…で、TVのニュースで(福知山線の)脱線事故のことをやっていて、ああいうのを見ていたら今の社会って信用できないなって思うんですよ…」

 社会性にもまたがる問題ですが、アスペルガー症候群の一つの特徴として、相手が自分の言葉をどう受け止めているかに無頓着な場合と、逆に必要以上に過敏になる場合があるように思います。小学生まで仲良くしていた友達と急にうまくいかなくなった、というアスペルガーの中学生の話を聞いていたら、そのきっかけが、相手に親しみを込めていったつもりのある一言に、相手がキレてそれ以後無視されるようになった、というのです。

 そしてその一言は、明らかに相手の気にしている身体の特徴に関する言葉だったので、第三者から見れば確かに相手は怒るだろうと思えるようなことでした。しかし、言った方は、自分と同じように相手が受け止めていないということがどうしても理解できませんでした。

 アスペルガー症候群の人は、言葉を額面通りに受け止めてしまうために、相手の意図が伝わりにくいとよく言われます。しかし、それだけでなく、額面通りでない極端な受け止め方をしてしまうために起こる問題も多々あるように思います。特に言い方が曖昧でどちらにでも意味がとれそうな時に、自分の裁量で判断する過程で極端な意味づけをしてしまうことがあるようです。

 子どもたちのグループで集まって、誰かが映画を見に行こう、と言い出したとします。他の子どもたちは行っても行かなくてもどっちでもいいよ、という意味で「そうね、行ってもいいよ」と言います。しかしアスペルガーの子どもは「行ってもいい」というのを「行くと決定した」と受け止めるか、「私もみんなと一緒に行ってもいいと許可された」という受け止め方をしたりします。他の人はどっちでもいいわけなので、中には今日は行かない、と言い出す子どもが出てきたりするわけですが、そうすると、みんなで行くって決めたのになぜ行かない?となるわけです。

 アスペルガー症候群の人は自分の分かるようにしか相手の言葉を受け止めることができないため、何かを言付けるときに、他の人とは全く違う伝わり方をすることがよくあります。文章全体の意味を捉えられずに、自分がキャッチした部分的な言葉から全体を組み立てようとするところがあるから、というのも一つの理由です。特に自分が気にしていることに関する言葉には敏感で、その部分だけを捉えてしまうため、「そんなつもりで言ったわけではないのに、なぜこの人はこんな受け止め方をするんだろうか」と周囲が不思議に思うこともよくあります。

 最後に、自説として付け加えておきたいことがあります。

 アスペルガー症候群のコミュニケーションの問題には、「言えない」のと「言わない」のと両方があるように思います。言葉でどう表現していいか分からないから言えない、あるいは慣れない環境で頭が混乱してしまい、言いたいことが吹っ飛んでしまうから言えない、と、いろんな理由で言葉での表現ができないことはよくあります。

 しかし同時に、本当は言えないわけではないのに言わないこともアスペルガーには時々見られます。とくに次に述べる社会性の障害が軽度で、周囲の変化を察知できる能力がある人たちは、自分の言うことが他人を不快にしそうだと思うときに、だんまりを決めてしまうことがあるのです。家では普通にしゃべるのに、学校では絶対にしゃべらないし自分を出さないと決めてしまった子どもの例もあります。言わなければ自分が不利になると分かっていても、絶対に話さない場合もあり、そのような極端さがアスペルガー症候群に特有のものかもしれない、と思うことがよくあります。

 非言語コミュニケーションの問題は、ひとことで言うと表情や仕草を読み間違うということです。アスペルガーも伝統的な自閉症のように、表情に乏しいかというと必ずしもそうではなく、よく笑う子もいます。ただし皆がしんみりしているときに急に大声で笑い出すという、その場にそぐわない行動として出てくることもあり、相手の表情、とくにあいまいなものに対する理解が乏しいほど、社会性の障害も重くなる傾向があります。非言語コミュニケーションの問題は、コミック会話の活用が効果を発揮します。

 言葉の使い方・理解の仕方は、苦手な分野とそうでないところは人により違います。非言語コミュニケーションの問題はほとんどは言語の問題とセットになっていて、あとはそれぞれの障害がどの程度なのかという判断になります。言葉の理解は、その人の体調によっても変わるので、気分と同じようにいいときと悪いときが必ずあります。全体的に程度が重いほど伝統的な自閉症(カナータイプ)に近づくことになり、軽いと定型発達の人に近づくということになるでしょう。

 誰にでも誤解や思い違い、話しの食い違いは起こります。しかしアスペルガー症候群の人たちは、そのような行き違いに対して適切に対応することが苦手で、そのためにお互いにストレスを与える結果となることがよくあります。こういう場面でどうすればいいのか、予め説明しそのときは理解できていても、いざ現実の場になるとどうしていいか分からないということも少なくなく、社会性の障害とも合わせて、本人へのアプローチに様々な工夫を必要とします。

 また、明らかに嘘と分かる言い訳や、不快な相手をさらに不快にさせるような言動が見られる場合に、それを指摘されると余計に反発することもあります。ある学校の先生が、「人に傷つけられることには敏感だが、人を傷つけることには全く反省がない」と言っていたように、感情的になると相手に激しい言葉をぶつけることもあり、コミュニケーションの問題、とひとことで言っても、聞く方がこのくらいならまあ受け入れられるかなという限度を超えることも、現実にはいろんな場面で見られます。


 長くなりましたので、このあたりで一端やめて、次の記事で社会性の障害について書きます。

 

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Comments

 いつも読ませてもらっています。奥が深いですね。
 私も今まで何人もの臨床心理士に出会ったり、お世話になったりしましたが、発達障害という面から、アプローチのできる臨床心理士のは出会いませんでした。
 自分も自閉症スペクトラム上の人であり、それによって生きにくさがあるということが、発達障害の子たちへのよりよいケアにつながっているような気がしています。
 また次の記事を楽しみにしています。

Posted by: aikidonotatujin | 2005.07.10 at 05:39 PM

 アスペルガー症候群には、3つのタイプがありますね。積極奇異型、受動型、孤立型、それぞれ全くタイプが違います。
 私の長男は、アスペルガー症候群の診断がされており、典型的な積極奇異型です。母は食べるために、父は移動するために必要だと言っています。
 次男はアスペルガー症候群ではないですが、アスペルガータイプです。典型的な受動型です。
 私は、完璧な受動型です。同じアスペルガー症候群でも、コミュニケーションの取り方にもそれぞれの特徴がありますね。

Posted by: aikidonotatujin | 2005.07.10 at 06:44 PM

どうもはじめまして。
たびたび拝見させていただいておりますが、初めて書き込みさせていただきます。
自分の話し方についてここまで的確に説明された文章を初めて見て非常に感銘を受けました。こうして形にしていただくと自分が抱えている問題もクリアーになってきて対処の糸口になると思いました。ありがとうございます。
それでは失礼いたします。

Posted by: sandman | 2005.07.11 at 02:47 AM

>aikidonotatujinさん

>私の長男は、アスペルガー症候群の診断がされており、典型的な積極奇異型です。母は食べるために、父は移動するために必要だと言っています。
 次男はアスペルガー症候群ではないですが、アスペルガータイプです。典型的な受動型です。
 私は、完璧な受動型です。同じアスペルガー症候群でも、コミュニケーションの取り方にもそれぞれの特徴がありますね。

…そうですね、同じアスペルガーといっても家族でタイプが違うことはありますね。それぞれの特徴は、ある意味個性と受け止めてもいい部分も含まれているのかもしれません。

>sandmanさん、

 書き込みありがとうございました。
少し細かいかなと思いましたが、理解していただけてとてもうれしいです。
 これからもよろしくお願いします。

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時折、貴ブログを拝見させていただいております。
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