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アスペルガー症候群:最も分かりにくい障害(9)

 社会性の障害については、さらに述べておかなければならないことがあります。

 アスペルガー症候群がいわゆるカナーの提唱する自閉症に比べ理解を得にくいのは、その多様性にあります。

 社会性という観点からは、アスペルガー症候群にはいくつかのサブグループが存在するものと思われます。

 まずウイング博士の提唱する「孤立型」に相当する、人との接触をあまり好まず、他人への関心をあまり示さないグループがあります。カナーの自閉症に近く、情緒的な交流の難しい人たちです。しかし、興味を中心とした人との関係を持つことはでき、ある程度の社会スキルが育っていけば、社会的な自立が可能なグループです。集団の中で、協調性がない、孤立していると評価されながらも、マイペースを保っている人たち、と言ってよいでしょう。

 彼らにとって最もストレスなのは、「みんなと仲良くする、周囲に合わせて行動する」ことです。したがって、集団の中ではこのような協調性を求めるよりは、自分の役割を理解し、それを果たせるような援助が必要であり、彼らがときどき一人で過ごす時間や空間を持てることが大切だと思います。

 次に、他人への関心や接触をある程度持てる人たちのグループがありますが、これは3つに分けられると思います。

 1)他者への感受性が低く、自分に対する感受性の高いグループ
 2)自分と他者に対する感受性が極めて高いグループ
 3)他者への感受性が高く、感情刺激に爆発的な反応を示すグループ

 1)は、いわゆる「積極奇異型」に似ています。人と関わりたい動機は十分で、それなりに接触もするのですが、相手の立場や気持ちへの感受性が低く、状況に合わない、あるいは相手を不快にするような言動を繰り返すため、対人関係でしばしばトラブルを起こすグループです。彼らの行動が目立ちやすいため、いじめの標的になりやすく、また相手がなぜ不快感を示しているかが十分に理解できず、自分勝手と誤解されやすい人たちです。

 彼らは相手の気持ちを本当には理解していないことが多く、また自分の都合で相手を動かそうとすることがあります。さらに、相手の言って欲しくないことを言ったり、して欲しくないことをしていることを理解できずに、相手がなぜ不快感を示すのか、その理由がなかなか分かりません。それなのに相手のしたことに敏感に反応しやすいところがあり、周囲からは悲劇のヒロイン(ヒーロー)と捉えられてしまうこともあります。

 カウンセリングの現場では、コミック会話など構造化された方法で問題の起こった状況や相手の立場を考えていくという方法をよく用います。しかしここで前述の内省力が育っていないと、常に相手に問題があり、自分は被害者であるという感情を持ちやすく、他罰的になってしまうという問題が生じます。

 2)は私が勝手に「敏感型」と呼んでいるグループで、ある程度他人への気遣いを示し、自分自身を振り返る能力も持ち合わせていますが、相手の反応やそれに対する自分自身の反応に極めて敏感で、特に感情刺激に過剰に反応する特徴を持っています。このグループに属する人たちは、非常に傷つきやすく、トラウマになりやすい一面を持っています。

 感情コントロールがあまり良くないと、うつになりやすいのがこのグループの特徴です。1)に比べると他者へ合わせようとする力はあり、また人前では感情をあまり出さず自分のふるまいにも過剰なほど注意を払うので、一見社会性の障害が軽度とみなされることがよくあります。しかし、対人関係に強い不安(自分が人に迷惑をかけているのではないか、などといった)を持ち、1)とは反対に自分を責めやすいところがあります。

 敏感型のグループに対しては、「ほどほどの自分を受け入れる」ための援助を行います。またうつと自傷行為に対する予防あるいは早期介入が必要です。このグループに属する人たちについては、目立った社会的な問題が生じていなくても、見えないところで非常に苦しい思いをしていることを治療者は十分に理解する必要があります。

 3)はこれも勝手に「激情型」と呼んでいるグループです。1)と同様、他者とは積極的に関わろうとしますが、1)よりも他人の気持ちや立場には敏感です。しかし、相手に合わせたり思いやるというよりは、相手がどう反応してくるかに敏感と言った方がいいでしょう。激情型グループに属する人たちはさらに相手の言動に極端な反応を示します。1)グループはどちらかというと愚痴っぽく自分が満足するまで同じ事を何度も繰り返し話す人が多いですが、激情型は、自分に嫌なことをした相手を直接攻撃し、それも怒りの感情や激しい言葉(ホントに身も蓋もないような)をぶつけ、感情が高ぶると手も足も出てきて、収集のつかない状態になってしまうこともあります。そうかと思うと逆に、冷たく無視することもあります。

 激情型グループの人たちは感情や行動への自制が困難で、一度爆発してしまうとその後はまったく静かになり、何故こんなことをしたのか分からないということが多いです。他人を傷つける危険性だけでなく、自傷の危険性も高く、医学的診断上、人格障害、双極性障害(そううつ病)と診断されることもあります。

 このグループに対する心理的な支援は非常に困難です。感情コントロールの方法を身につけるには、自分自身の感情と向き合い、それを表現する力がある程度必要ですが、彼らにとってはこれが最も難しいからです。さらに彼らは、相手の感情や態度を適切に把握しないうちに衝動的に反応してしまいます。相手の態度が本当は彼らをバカにしたものではなくても、彼らが「こいつはオレをバカにしている」と認知してしまうと、次の瞬間、相手を罵倒したり暴れたり、という行動に出てしまうのです。おそらくこのグループに属する人たちのほとんどはADHDの診断基準も満たしており、内省力を育てるのがもともと困難なのではないかと考えています。

 最後に、育ちの問題について触れておきます。

 アスペルガー症候群は発達障害であり、養育者が適切な養育を行っても上記のような様々な情緒・行動の問題を抱えてしまう人たちがいます。しかし、適切な養育が行われなければ、さらに問題が悪化することを念頭に置かなければなりません。1)のように相手の立場が十分に理解できずに積極的に関わるグループや3)の激情型グループの人たちは、養育者にとって非常に対応が難しく養育者が彼らの問題をきちんと理解していないと虐待が起こりやすくなります。また、非常に過敏な2)のグループの人たちは、家族関係のトラウマを持ちやすく、それが後に様々な精神的・身体的な症状をもたらします(特に不安障害やうつが多いことに注目すべき)。

 アスペルガーの人たちは、周囲が適切に関わることができれば遅れながらも愛着を形成し、また自分や相手の感情を理解し適切に表現するスキルを身につけることができると、ある程度安定した対人関係を作ることができます。内省力はほとんどは対人関係の体験を通して身につくもので、自我の形成に必要な愛情や肯定的な体験をある程度持っていることが条件になるのです。したがって、自分を振り返る力を育てるには、早期に障害を発見し、子どもの抱える問題に応じた根気強い対応が必要になります。…といっても、彼らが状況を理解し適切にふるまう工夫をすることを覚えるための援助であって、相手の感情や葛藤の理由を定型発達の人たちと同じように理解できるようにならなければならないということではありません。ただ、その工夫ができるようになることで、いじめをはじめとする人間関係のトラブルを可能な限り防いでいくことはできるでしょう。

 アスペルガー症候群の社会性の障害は、彼らの生きにくさの土台にあるものですが、彼らだけの問題というわけではありません。育てる側に、ある程度の知識や彼らの抱える問題を適切に理解できる力、そして彼らの良い点を伸ばし、うまく彼らをサポートする姿勢が必要です。したがって、養育の責任を、単に保護者だけに求めることは適切ではありません。コミュニケーション同様、基本は家庭にありますが社会性を育てるには第三者、しかもいろんな人たちが介入していかなければならないのです。

 極めて孤立的でない限りは、アスペルガーの人は他人に理解され、受け入れられることを望んでいます。自分の事をある程度理解できる人であれば、自分の言動が他人に与える影響についても理解し、それ故に他人に受け入れられるために様々な我慢をしてしまうのです。しかし、理解された経験を持つことができれば、それは大きな安心となり、自分自身への肯定的な感情へとつながります。

 最も彼らにとって不幸なのは、ネグレクトの状態に置かれることです。感じ方・考え方が違っていても、必要なものは同じです。単に保護者だけでなく周囲との交流が乏しく、かつ彼らが求めるものがほとんど満たされなかったまま成長する過程で、多くの人は他人から注目されることで必要を満たすことを覚えていきます。それが良い行動での注目ではなく、反社会的な行動、あるいは周囲が予想しない行動であっても、彼らにとってそれが唯一他人から注目される手段になってしまえば、彼らはそれを繰り返します。

 ネグレクトの状態で成長した人のほとんどは、情緒的に極めて未熟であり、内省力も育っていないため、自我が極めて脆く、触法行為があった場合に通常の方法で矯正することが困難だということは前述の通りです。さらに自分の思考や感情を他人に鏡のように映し出し、あたかも自分でなく他人がそれを持っていると考えることで脆い自我を守ろうとする傾向が強く、第三者の声が最も届きにくく、援助者に対しても攻撃性を示す危険性があります。

 このように、アスペルガー症候群は、ある部分では育ちの影響を非常に受けやすいと考えておくことが必要だと思います。

 次は…来週かな?

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Comments

はじめまして。記事、とても興味深く拝見しました。
アスペルガー症候群当事者で、一児の母です。
※子どもは知的障害重度判定を伴う自閉症児(小2)です。
私は2の“敏感型”ですね。記述にピッタリです。
確かに思春期には自傷行為等もありました。
社会生活を送るうえで日々疲労困憊します。
一方で、家庭内では基本的には快適です。
幸いにも娘と私は共通点が多くあり、楽しく過ごせます。
相互リンクは可能でしょうか? 
ご判断にお任せしたいと思います。
もしよろしければ、お願いいたします。

Posted by: メラニー | 2005.08.13 at 05:54 PM

 私は、受動タイプです。まさにこの通りです。幸い私の生育歴の中で、両親からは、あまりよい育て方をされませんでしたが、叔母、祖母、塾(母が経営していた)の兄さん姉さんにとてもかわいがってもらい、今の人格が形成されました。「三つ子の魂百まで」といいますが、これだけアスペルガー症候群にとってはよい環境でありながらも、現在はOCDです。いかにアスペルガー症候群が、育て方や環境に敏感かが自分の生育歴を基準にするとよく分かります。
 私は、研修会などの折りに、各校から出されるアスペルガー症候群の子の指導について、sanaさんがここに記載されているようなことを主張するのですが、ただの一教師の発言としてしか受け止めてもらえません。
 もっと有名な人になれば、それなりに受け止めてもらえるかもしれませんが。
 
 また、次を楽しみにしています。

Posted by: aikidonotatujin | 2005.08.14 at 08:28 AM

こんにちは。
自分や友人たちの子どもの将来を考えると、
また、アスペルガー症候群傾向があるように思える友人と話す時、
どうしていったらいいのか判らないことがよくありました。
今回の記事、とても参考になりました。どうもありがとうございます。
次回も楽しみにしています。

Posted by: 蜜柑母 | 2005.08.14 at 11:32 PM

我が家には、アスペルガー症候群の旦那がいます。
旦那のタイプは、今回記事に出ていた3)激情型だと思います。
行動パターンがそっくりです。
なので、とても勉強になりました。ありがとうございます!

旦那があまり良くない生育環境だったので、それがとても気になっていました。
ですが、私が相談している人は、環境は関係ないという一点張りで話しをしていて…。
でも、今回の記事で私の胸のもやもやが取れた気がします。
ウチの旦那は、私に母親のような存在を、心なしか求めているような気がします。
それは、生まれて初めて自分のことを私が理解してくれたから…という信頼のような感情が伝わってくる行動をするからです。
正直しんどい時もありますが、診断された今は、家族のためにも、旦那のそんな現状も受け入れ頑張ろうと考えています。

もしよろしければ、私も相互リンクをお願いしたいです。
よろしくお願いします。

Posted by: moon_babe86 | 2005.08.17 at 05:38 AM

>メラニーさん、moon_babe86さん、

 はじめまして。コメントをありがとうございました。
リンクはどうぞご自由にお願いします。こちらからもリンクを張りたいので、リンク先のURLをお教え下さい。

>aikidonotatujinさん、

 有名でなくても、教師以外の第三者、たとえばスクールカウンセラーや学校心理士など専門職の意見なら受け入れてもらえるかもしれませんね。

 来週私も、中学校でアスペルガー症候群をテーマに教職員の研修会を予定しています。中学校は反応が鈍いですが、3年生の先生方を中心に、進路や社会性の発達について特に力を入れて講義します。

>蜜柑母さん、

 いつも記事を楽しみに拝見しております。
お友達との関係でお役に立てるようであれば、うれしいです。こちらが少しでも理解できることがあれば、よりよい関係を作っていく可能性も高まるでしょうね。

Posted by: Sana | 2005.08.20 at 02:15 PM

Sanaさん、少しは休養できましたか?私もよく疲労困憊します。最新記事、拝見しました。
Sanaさんのおっしゃりたいこと、伝わってきます。辛い想いをなさったのでしょうか…。
相互リンクありがとうございます。URLはこちらです。よろしくお願いいたします。

Posted by: メラニー | 2005.08.20 at 06:59 PM

初めまして。
27歳・男・大と言います。
最近自分が周囲の人と違い変だと思い
鬱、LD、アスなどの体験本等をみて調べて
自分に当てはまる点が多く自分もアスと鬱に近い人物です。
あくまでも自己診断です。

1部例として↓
人の話を理解してるようで理解していない。
言葉のキャッチボールが出来ない。
(自分の意見を完結的に終わらせる様な発言で話が続かない等)
計画表を作ってもうまくその通りに出来ない。
友達が出来にくい。
虐めやDVが幼少時から高校卒業まであった。
相手の気持ちがあまり理解できない・しにくい。
ほかなどです。


とりあえず
自分自身でここまで自分の注意点がみつかりましたが
自分だけではこれらを治すのはとても無理です。
ので、こう言った体験談に書き込まれたコメントなどを参考にしたいと思います。

コメントがこのような内容ですいません。

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