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The Autistic Tug of War

I have ideas. So many ideas. Goals. Dreams. And yet...

Living life as a self-identified (probably) autistic person means I've come to accept some truths about myself.

I have limitations just like everyone else. But mine are uniquely colored by my neurotype. And because I'm in the minority in my neurotype, the world rarely understands the reality of those limitations.

Three Intersecting Traits and a Couple of Co-Morbidities

My greatest limitation lies that the intersection of 3 personal traits.

  1. I have an overabundance of compassion and empathy. I connect very quickly to others' emotional struggles.

  2. My social cup is finite. No matter how present I want to be for others, I can only handle so much interaction before I collapse.

  3. I have a profound sense of social justice. Fairness and equity are core to my personal ethics.

These traits interact and create their own dynamics. Compassion and empathy plus a need for fairness create a desire to help others. But my finite social capacity and need for justice give me very low tolerance for barriers and obstacles. And my compassion for others and desire to help are taxed easily because I can only handle so much social contact. Three things pulling me in different directions, like the most complicated tug o' war ever.

And then, add in some ADHD traits and a little Rejection-Sensitive Dysphoria to spice it up. I have a touch of time-blindness, struggle with routines, and respond badly to perceived rejection.

And that, my friends, is how you create burnout.

What I Can Do and What I Want to Do are Different

Somewhere along the line, I internalized the idea that I can do anything I put my mind to. I think a lot of parents try to instill this idea in their kids. But I've come to understand how damaging that belief really is. Because we can't do anything we want to. And we shouldn't try to do everything, even when we want to.

We are human. Finite. Limited. Some of us are more obviously limited than others. But all of us have limits. Physical limits. Financial limits. Limits in capacity, ability, and skill. And we only have so much time every day. Trying to do everything means that we may not give our best work to each of our goals. That's not going to leave us fulfilled. In fact, it will just leave us feeling more empty than when we started.


A colleague once gave me great advice. She said "Saying no to things that don't interest you is easy. What is hard is saying no to things that you'd love to do if you had all the time and energy in the world." Oof. That one hits hard.

So I'm in the midst of doing some hard choosing. Picking my battles. Setting priorities. And most importantly, acknowledging my limitations. Which means I'm saying no a lot. No to out-of-state patients, in part because I would have to get another medical license in their state (which is both a lot of work and would never be cost-effective for my practice.) No to speaking engagements that don't serve my interests. No to committees, boards of directors, and partnerships. Because I want to get this right. I can't be all things to all people, but I can be the right thing for the right person. And that's enough.

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