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Book ChapterDOI

Disruption to embodiment in autism, and its repair

TL;DR: In this article, the authors explore an affective neuroscience understanding of autistic experience and how to work creatively with its impulses for health and personal development, with a focus on insights of Penelope Dunbar (Pum) who has lived with autism for decades.
Abstract: This paper offers a neuroscientific explanation of life with autism which recognizes that human behavior and experience is by nature both personal and interpersonal. With a focus on insights of Penelope Dunbar (Pum) who has lived with autism for decades, we explore an affective neuroscience understanding of autistic experience and how to work creatively with its impulses for health and personal development. Pum describes her autistic disruptions to the intrapersonal coherence of her basic states of being, moving-with-feeling in self-awareness, and how this disturbance to her internal subjective coherence of mind challenges her capacity to self-regulate arousal, and communicate with others. By examination of the source of her problems in childhood and ways of working with them, Pum has clarified fundamental elements in the development of her capacity to regulate self-care in creative efforts that facilitate both affective embodiment and sensory-motor coherence in growth of understanding in her mind and body. With her advice we explore how current neurobiological insights in autism as a disruption to the regulation of affective embodiment and sensory-motor integration leads to new recommendations for therapeutic care to relieve autistic distress and restricted modes of being. Although particular to her circumstances and cultivated habits of autistic expression, this analysis offers insight into the fundamental nature of autism, and ways of positive working with one’s autistic nature for creative gains.

Summary (4 min read)

Autistic Experience as a Disruption of the Primary Affective Self, and its Coherent Integration with Secondary and Tertiary Processing

  • In this paper the authors examine lived autistic experience to reveal its nature in light of the vertical organisation of mental processing.
  • Therefore, the experiences and conclusions drawn from these are relevant for this one particular autistic individual, and the authors can guarantee their accuracy as reported.
  • Autism is not a simple variation of normal motivation and intelligence.
  • It is recognized as a very varied state of personality and in each case manifests its spectrum of conditions idiosyncratically (Hobson, 1993; Gillberg, 1992; Hobson & Hobson, 2011).

A Brainstem Sensorimotor Disruption in Autism

  • The authors account of autism emphasises a disruption to efficient primary processing of sensorymotor information, and the self-related affective processing that mediates arousal regulation and coherence of motivation within Panksepp’s Core Self .
  • The authors account recognises and appreciates the fundamental contribution to conscious thought, feelings, and awareness the brainstem complex provides, not only in terms of organising information, but in terms of organising one’s subjective awareness.
  • As the autistic community points out, “if you’ve met one person with autism, you’ve met one person with autism”.
  • An intra-personal coherence between levels of processing appears disrupted, which prevents the development of the innate function of the core self in regulating affective states, and that disrupts efficient agency and inter-personal communication recognised in formal clinical autistic symptomology.

Autistic Challenges of a Disconnected and Incoherent Core Self

  • In Pum’s experience, she felt a distressing disjunction between her rational, reflective self and her inability to manage her affective states of arousal.
  • Further, this habitual disassociation into a performed script damaged her ability to manage her basic functioning, and manifested in, for example, eating and sleeping disorders and entrenched mental health problems in her early adult life.
  • The language of the core self is non-verbal, affective and aneotic (Vandekerckhove & Panksepp, 2009).
  • And she worked hard to learn speech, reading and writing through copying particular demonstrations of these, and with obsessive attention to detail of politeness and needs of others.
  • It was only many years later in adult life, after ongoing therapy and some decades of self-reflection and analysis that she came to understand that she had developed a disjunction between what the authors now know as her Core Self – her core affective, perceptual, and embodied Self – and her more artificial, rational, and reflective Tertiary Self.

Meaning, Coherence, and the Challenge of Incoherence

  • The authors are a social species that demands meaningful social interaction, even in autism (Jaswal & Akhtar, 2018).
  • Similarly, disconnection within oneself can be painful.
  • Left unattended to in childhood, this lack of depth of meaning created despair and anxiety that became the standard in her adolescence and early adulthood.
  • Johnson and Lakoff teach us how ‘being in the body’ grows into language (Lakoff & Johnson, 1980, 1999), a feature missed or reduced in Pum’s development.
  • The expressive language of the emotions and body come first in development, on which the language of words bears depth of meaning, and purpose.

Implications for Self-Improvement and Therapeutic Support of Autistic Disturbance to the Core Self

  • If their account of the disruption to the coherence of core experience of self and its communication with higher level processing is correct, then focussing therapeutic intervention on overt behaviours and conventional speech production may miss the mark, - 9 - over-shooting a coherent integration of feelings and impulses of the affective Core Self.
  • Ontogenetically one must work to develop and substantiate the primary levels of processing first, before extending to more advanced forms such as social regulation, speech production and verbal communication.
  • Without support for routines, feelings and self-agency may be inaccessible, blocked by executive function difficulties in planning, preparation, and organisation.
  • The human organism must come to terms with the innate complexity of its own movements, expressions, and desires, and able to experience these as self-expression of ‘Me’, before one can differentiate him or herself from the actions of another.

Getting into a Routine

  • There is an anxiety specific to autism provoked by the beginning of any new act (Robledo, Donnellan, and Strandt-Conroy, 2012), and it takes time for the individual to feel safe and allow arousal levels to settle.
  • This can be debilitating, and prevent wilful transition into the activity.

How Emotional Arousal can be Understood, and Managed.

  • States of happiness and surprise are especially triggering, and stressfully disorientating.
  • Pum dissociate and become over-stimulated, which often results in an inevitable shift to meltdowns and anxiety, leading to disorientation, confusion and a grief-stricken state.
  • The practitioner’s actions need to be predictable and consistent for the person with autism to feel accepted, safe and their needs appreciated.
  • Then they can begin to become aware of what those needs are, safe in the knowledge that the other is able to foster trust and lower arousal.
  • From this foundation in mutual regulation of self-awareness and trust, the more creative organic platform of communication for the self through structured, repetitive activity can be developed.

Co-opting Compulsions for Repetitive Behaviours, and Transforming Them into Productive, Creative, Self-sustaining Action for Personal Growth

  • Self-expression is built and shared in efforts of sport and art, but their aesthetic and moral power in shared vitality can be devalued and often overlooked in Psychology, even as music has been by Stephen Pinker, follower of Noam Chomsky’s theory of the rational formality of language (Chomsky, 1957), on ‘the language instinct’ (Pinker, 1994).
  • Pum has shown that the power of two routines she has developed over many years can coopt her autistic needs for repetition and regularity, but also her needs for body movement to feel alive in the body and in her mind.
  • Regular, repetitive sensory-motor loops of arm, leg, head, and body posture in synchrony are paced and forced with direction in space and time to produce fluid movement of the whole body through the water.
  • Swimming builds up individual and relational awareness and creates a safe exploration in rhythms of movement for the experience of Self, to appreciate it is intact and truly inhabited with an ambitious will to live.
  • Exercise of repetitive body movement can liberate thought.

2 Interestingly, this stands in contrast to the lateral thinking released for enhancement of the creative imagination in people without autism, and suggests that while some common mechanism is at work, its effects

  • Differ in their quality between autistic and non-autistic experience.
  • It involves intention for regular cycles of repetitive sensorimotor activity – sorting of the paper, selection of images, cutting of fragments – all actions that demand integrated action across the body, stabilising posture and maintaining coherence of attention and coordinated action.
  • As with her swimming, Pum has found collage-making to be a calming activity that allows an integration of the whole self from across the vertical levels of mental processing, allowing thought of the experience to flow from its perceptual elements to recollections of their embodied resonances on combination.
  • This process of composing an integrated picture can be cathartic, easing her internal tension which arises out of an autistic confusion of fragmented parts and contexts.
  • It is in such sustained activity that she begins to synthesise thoughts, feelings, and ideas working below the level of conscious reflection to solve problems, and that is when she begins to feel an intuitive, integrated and coherent sense of self.

Sensitive Care for the Primary Self of a Companion with Autism: Supportive Structures for Routines of Practice

  • And while this may yield some benefit for the family and community by creating an apparently adapted individual with socially normalised behaviours, that individual may very likely remain internally stressed deeper in the body, because performative communication can remain disconnected from personal motives, and remain meaningless or empty.
  • By understanding the individual’s autism’s needs for clear, transparent expectations with explicit prompts, a caring supporter can facilitate management of the individual’s growing anxieties about the change-to-come.
  • Preparing the swimming costume and towel, packing the bag, wearing the right clothes for the outside, leaving the house, and travelling to the pool, also known as Each step is important.
  • This will promote a growing sense of self-control, self-confidence, and selfempowerment.

Supporting an Integration of the Self, for Self-Awareness and Self-Empowerment

  • The experience of feelings and motives for action and interaction of the Core Self can be very different from that of the higher-order, Conceptually-Oriented Self.
  • This can lead to “difficult”, “disruptive”, or “challenging” behaviours.
  • This is why the authors advise support for them to become more happily self-aware, ready and able to ask for help and therefore to manage their autism better, in friendship.
  • The Core Self is non-verbal, expressive in the language of body movement, gesture, and intonation of the voice.
  • It may be that to emphasise verbal language acquisition in some children – ‘to get them to talk’ – may miss the fact that they don’t speak because they are not ready for that level of abstract, verbal narrative and sense-making, and must rely on intuitive non-verbal elements of self-expression.

All Behaviour is Communication

  • Parents as custodians of mental and emotional life can often be overly concerned with what their child ‘can’t do’, overlooking what their child ‘can do’.
  • And at the same time it’s activity in action is creating life experiences at a cognitive and sensory level, creating new neural pathways.
  • Thus, the best caregiver support is attentive and observant to the opening, to where the child is going to be able to channel communication with their self and body.
  • This is fundamental learning for self-care and self-development.
  • The authors identify means that caring persons can deploy to help the person with autism become more complete, embodied and coherent, and to help them express their individuality ready to share an integral meaning in life’s movements and what they discover.

10. Expiration the cloud of breath, or speech bubble of chromosomes, the complex strands

  • Which hold and fold their genetic mysteries.
  • Pum believes that the branch of science epigenetics is showing up just how important lifestyle choices (how the interactions with their environment shape their being, and the expressions of their genes) are.
  • Autism aetiology is complex, involving both genetic and environmental factors (Hallmayer, Cleveland, Torres, & et al., 2011)(Sandin et al., 2014).

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Papaneophytou & Das (Eds.) Delafield-Butt, Dunbar, & Trevarthen
- 1 -
Disruption to Embodiment in Autism, and Its Repair
ACCEPTED AUTHOR MANUSCRIPT
To be published in N. Papaneophytou & U. Das (Eds.), Emerging Programs for Autism
Spectrum Disorder. Academic Press.
The full copy-edited manuscript will be available at:
https://www.elsevier.com/books/emerging-programs-for-autism-spectrum-
disorder/papaneophytou/978-0-323-85031-5
Please cite as:
Delafield-Butt, J., Dunbar, P., & Trevarthen, C. (2021). Disruption to Embodiment in
Autism, and Its Repair. In N. Papaneophytou & U. Das (Eds.), Emerging Programs for
Autism Spectrum Disorder. Academic Press.
Jonathan Delafield-Butt
Professor of Child Neurodevelopment and Autism
Director, Laboratory for Innovation in Autism,
University of Strathclyde, Glasgow, Scotland.
E-mail: jonathan.delafield-butt@strath.ac.uk
Penelope Dunbar
Independent Artist and Creative Researcher, Glasgow.
Colwyn Trevarthen
Professor (Emeritus) of Child Psychology and Psychobiology,
School of Philosophy, Psychology and Language Sciences,
The University of Edinburgh, Edinburgh, Scotland.
E-mail: c.trevarthen@ed.ac.uk

Papaneophytou & Das (Eds.) Delafield-Butt, Dunbar, & Trevarthen
- 2 -
Disruption to Embodiment in Autism, and Its Repair
Abstract
This paper offers a neuroscientific explanation of life with autism which recognises that
human behaviour and experience is by nature both personal and interpersonal. With a focus
on insights of Penelope Dunbar (Pum) who has lived with autism for decades, we explore an
affective neuroscience understanding of autistic experience and how to work creatively with
its impulses for health and personal development. Pum describes her autistic disruptions to
the intra-personal coherence of her basic states of being, moving-with-feeling in self-
awareness, and how this disturbance to her internal subjective coherence of mind challenges
her capacity to self-regulate arousal, and communicate with others. By examination of the
source of her problems in childhood and ways of working with them, Pum has clarified
fundamental elements in the development of her capacity to regulate self-care in creative
efforts that facilitate both affective embodiment and sensory-motor coherence in growth of
understanding in her mind and body. With her advice we explore how current
neurobiological insights in autism as a disruption to the regulation of affective embodiment
and sensory-motor integration leads to new recommendations for therapeutic care to relieve
autistic distress and restricted modes of being. Although particular to her circumstances and
cultivated habits of autistic expression, this analysis offers insight into the fundamental
nature of autism, and ways of positive working with one’s autistic nature for creative gains.
Keywords: autism, affective neuroscience, embodiment, self-regulation, art, movement

Papaneophytou & Das (Eds.) Delafield-Butt, Dunbar, & Trevarthen
- 3 -
Introduction
In the human mind, consciousness of ‘the self as agent’ (Macmurray, 1957) is not a singular,
homogenous phenomenon, but is a layered set of systems integrated by a hierarchy of
phylogenetic principles of brain growth and animated activity that give rise to sympathetic
actions and reactions that connect ‘persons in relation’ (Macmurray, 1961). Comparative
neuroscientist of emotions, Jaak Panksepp (Panksepp, 1998a; Panksepp & Biven, 2012).
identified three levels of neural processing in mammals, each generating an awareness of the
Self made in relation to internal and external environments, and mediating between the two.
His view advanced by detailed comparative neuroanatomy with penetrating observation of
affective expressions and responses common to rodents and primates gave psychology
improved description and richer evolutionary understanding of the basic notion of a ‘triune’
brain of Paul MacLean (1990) – the idea that evolution of vertebrate ecology in social groups
toward the human cultural intelligence incorporated three distinct, but inter-connected levels
of processing. First of the reptilian brain stem, then the palaeo-mammalian midbrain limbic
system, and finally the complex neo-mammalian powers for acquiring adaptive experience
recorded in what is known as the neocortex of the forebrain.
What a human person experiences in healthy activity of the body and brain with awareness
as a singular coherent conscious Self (Sherrington, 1906) is the result of efficient composition
of action in the layers of neurobiological processing working in synchrony (Buzsáki, 2006).
Regulations of energy in internal embodied well-being of an integrated person is maintained
by an affective system linked to the autonomic visceral organs (Panksepp, 1991; Panksepp,
1992), and this is coupled with all voluntary and imaginative neuromotor control of the
skeleto-muscular system of the body in purposeful movement (Bernstein, 1967). This inner
life’ from which all arts, mathematics and philosophies grow (Langer, 1942; Lashley, 1951) is
both graceful or aesthetic in its efficiency (Turner, 1991), and gracious or moral in inter-
subjective social cooperation (Trevarthen, 2015).
Efficient communication between all the elements of the intentional and self-conscious
nervous system in one rhythm of time (Buzsaki, 2006) is critical. The animal brain evolved as
an integrative organ to bring the experiences and activities of all parts of the body into one
composite awareness. In human beings the fingers, hands, elbows and feet move the body in
ambient and focal awareness to exploit what the outside world affords for use (Gibson, 1977).
Inner vitality coordinates functions of the stomach, liver and heart, and the information-
seeking assertions of neck, head, mouth and eyes that become powerful media of
communication of individual impulses and their effects in social partnerships (Reed, 1006).
Every movement acts as a coherent and coordinated whole with its own, singular purpose in
transformations of the body made in movement with prospective imagination of the effects
(Bernstein, 1967). The innate coherent rhythmic ‘musical’ composition of all wilful agency of
the individual is elaborated within each body as the common code for shared cultural
awareness and understanding (Malloch & Trevarthen, 2009b; Trevarthen, Gratier, & Osborne,
2014).
At the anatomical centre of this integrative system of neurons in all vertebrates is the
brainstem. At the anterior end of the spinal column it brings together information from the
visceral organs on maintenance of inner life, and information from the moving muscles of the
skeleton together which sense information about the surrounding world from the distance

Papaneophytou & Das (Eds.) Delafield-Butt, Dunbar, & Trevarthen
- 4 -
receptors, the eyes, ears, and nose for sight, sound, and smell. This brainstem ‘head ganglion’
(Coghill, 1929), has access to all of the information from outside and inside the body required
for prospective conscious awareness along the intended course of locomotion. It’s basic
anatomy and neural function is shared across ‘vertebrates’ – all animals with a spine; reptiles,
amphibians, birds and mammals. As the most ancient phylogenetic layer of this neural system
it is the site of rapid integration and evaluation of information across the body and brain, in
what Panksepp calls the ‘Core Self’, the first ‘centre of conscious awareness’ (Northoff &
Panksepp, 2008; Panksepp, 1998b).
Interestingly, and importantly, this Core Self can operate on its own in humans, cats, and rats,
without the addition of information from the phylogenetically more recent neocortex the
large, voluminous convoluted brain mass that fills the skull and that most educated people
(including cognitive neuroscientists) think of as ‘the brain’ (Bjorn Merker, 2007; Penfield &
Jasper, 1954). In fact, we can be conscious without a cortex, as surgical decortication
experiments have shown, and as is proven by children born with rare congenital total loss of
neocortex (Shewmon, Holmse, & Byrne, 1999). This simple fact is lost in most contemporary
neuropsychology sources, but it is critical to our understanding of autism. The brainstem is
the site of coherent integration of information about the world outside in consciousness, and
also of the state of the world inside, rich with vital needs of the body, which are afforded
opportunity for satisfaction in active appreciation of benefits, and apprehension of dangers,
in contacts with the world outside.
Second, above the brainstem sits a complex of pathways and larger nuclei that hold special
abilities to store memories and appraise these as benefits or risks of harm. These store and
organise past experience so it can be recalled and deployed to help organise action in the
present moment, and in service of future goals. The accumulated memories of the past serve
understanding of the consequences of actions in the present, and set goals for a desired and
imagined future of purposeful life.
In the third level of organisation experiences grow with our expanded cognitive or ‘knowing’
capacities, and with tools of symbolic abstraction that enable defined experiences to be held
‘off-line’ in memories and manipulated in our imagination. This third level of processing
occurs across the vast array of brain space we recognise as the cortex. It’s unique format
presents layers of neurons stacked as vast, broad sheets of integration that can process the
rich variety of experiences near-simultaneously. This new element of the brain provides
capacities of enhanced perceptual discrimination, memory, abstract reflection, conceptual
organisation, planning, and evaluation. These ‘cognitive tools’ become the structures that
build our human intelligence, knowledge, and technical mastery (Gigliotta, Pezzulo, & Nolfi,
2011; Pezzulo & Castelfranchi, 2009). It is the seat of our post-industrial rational human mind
and reflective pragmatic intelligence recorded symbolically in manufactured media.
Our conscious experience in each moment varies and shifts, contingent on changing needs
and circumstances. It is a single point in what William James called ‘the specious present’
(James, 1890), a unique moment in time that slips ever forward, its experience structured by
the remembered past and anticipated future. We now understand its structure is the product
of deep evolutionary layering, adapted for an adventurous animal life that expands our ability
to anticipate and prepare for the organic needs of growth, sustenance and learning especially
highly developed in humans. It enables an exceptional capacity to project the imagination
into the future, to make plans in the present moment based on a remembered past, for a
desired future (J.T. Delafield-Butt & Gangopadhyay, 2013) (Figure 1).

Papaneophytou & Das (Eds.) Delafield-Butt, Dunbar, & Trevarthen
- 5 -
Jaak Panksepp’s three levels of conscious processing demonstrate that what we have
traditionally considered ‘unconscious’ is in fact the core of our conscious experience it is a
primary, pre-reflective consciousness that is evident in, and that structures, everyday actions
of the animal. As Solms and Panksepp (2012) put it in their title, “The “Id” knows more than
the “Ego” admits.” We accept this as the hierarchy of human motor intelligence , and how it
grows between the intuitive invention of activity in awareness of the body, and the articulate
record and interpretation of thinking with semantic codification of foci of interest in gestural
and linguistic syntax with affective prosody (Delafield-Butt & Gangopadhyay, 2013; Delafield-
Butt & Trevarthen, 2015; Malloch & Trevarthen, 2009a; Trevarthen & Delafield-Butt, 2017).
Figure 1. Schematics of the nested layers of the Self showing (A) their nested organisation
(reproduced from Solms and Panksepp, 2012) and (B) their integration and contribution to
experience over time. The primary, core self is the most phylogenetically ancient and
therefore ontogenetically primary self a site of integration of integrative, evaluative
experience and agency. This is brainstem mediated. The secondary self stores with greater
precision the memories with greater powers of discrimination for evaluation, but finally the
tertiary self is empowered with the cognitive tools built on abstraction from primary
experience through its secondary process and considered ‘offline’. Cortically mediated.
These layers of processing are reflected in the artwork, “Profile of a collaged mind, finding
sense through fragment and movement autism as sensory motor disruption to core self”,
shown in Figure 2b.
Autistic Experience as a Disruption of the Primary Affective Self, and its Coherent
Integration with Secondary and Tertiary Processing
In this paper we examine lived autistic experience to reveal its nature in light of the vertical
organisation of mental processing. We build on self-reflection, scholarship, and dialogue
between Penelope Dunbar (Pum) and Jonathan Delafield-Butt, made in recorded interviews
about Pum’s life with autism over a period of five years, and placed into context of a

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Journal ArticleDOI
TL;DR: It is concluded that shared rituals of culture and practical techniques develop from a fundamental psycho-motor structure with its basic, vital impulses for action and generative process of thought-in-action that express an integrated, imaginative, and sociable Self.
Abstract: Narrative, the creation of imaginative projects and experiences displayed in expressions of movement and voice, is how human cooperative understanding grows. Human understanding places the character and qualities of objects and events of interest within stories that portray intentions, feelings, and ambitions, and how one cares about them. Understanding the development of narrative is therefore essential for understanding the development of human intelligence, but its early origins are obscure. We identify the origins of narrative in the innate sensorimotor intelligence of a hypermobile human body and trace the ontogenesis of narrative form from its earliest expression in movement. Intelligent planning, with self-awareness, is evident in the gestures and motor expressions of the mid-gestation fetus. After birth, single intentions become serially organized into projects with increasingly ambitious distal goals and social meaning. The infant imitates others' actions in shared tasks, learns conventional cultural practices, and adapts his own inventions, then names topics of interest. Through every stage, in simple intentions of fetal movement, in social imitations of the neonate, in early proto-conversations and collaborative play of infants and talk of children and adults, the narrative form of creative agency with it four-part structure of 'introduction,' 'development,' 'climax,' and 'resolution' is present. We conclude that shared rituals of culture and practical techniques develop from a fundamental psycho-motor structure with its basic, vital impulses for action and generative process of thought-in-action that express an integrated, imaginative, and sociable Self. This basic structure is evident before birth and invariant in form throughout life. Serial organization of single, non-verbal actions into complex projects of expressive and explorative sense-making become conventional meanings and explanations with propositional narrative power. Understanding the root of narrative in embodied meaning-making in this way is important for practical work in therapy and education, and for advancing philosophy and neuroscience.

88 citations

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Q1. What are the contributions mentioned in the paper "Disruption to embodiment in autism, and its repair abstract this paper offers a neuroscientific explanation of life with autism which recognises that human behaviour and experience is by nature both personal and interpersonal. with a focus on insights of penelope dunbar (pum) who has lived with autism for decades, we explore an affective neuroscience understanding of autistic experience and how to work creatively with its impulses for health and personal development. pum describes her autistic disruptions to the intra-personal coherence of her basic states of being, moving-with-feeling in self- awareness, and how this disturbance to her internal subjective coherence of mind challenges her capacity to self-regulate arousal, and communicate with others. by examination of the source of her problems in childhood and ways of working with them, pum has clarified fundamental elements in the development of her capacity to regulate self-care in creative efforts that facilitate both affective embodiment and sensory-motor coherence in growth of understanding in her mind and body. with her advice we explore how current neurobiological insights in autism as a disruption to the regulation of affective embodiment and sensory-motor integration leads to new recommendations for therapeutic care to relieve" ?

This paper offers a neuroscientific explanation of life with autism which recognises that human behaviour and experience is by nature both personal and interpersonal. Although particular to her circumstances and cultivated habits of autistic expression, this analysis offers insight into the fundamental nature of autism, and ways of positive working with one ’ s autistic nature for creative gains. 

Pum dissociate and become over-stimulated, which often results in an inevitable shift to meltdowns and anxiety, leading to disorientation, confusion and a grief-stricken state. 

In the sensory-motor realm of psychological functioning, the motor life embeds and supports the awareness of the senses, physically yolking them to the sensory, giving structure to and learning of selfconsciousness from sensory perceptions. 

Done well, the body’s physiological homeostasis can be maintained for many tens of minutes with the benefit of a constant, regular repetition of action and its felt sensory effects. 

Familiarity with this routine is paramount to reducing anxiety, and maintaining consistency in the patterns is extremely helpful. 

Her practice developed from a need to explore, express and, inter-relate ideas and concepts from her own personal research and scholarly work. 

In the activity of ‘doing’, the sensory and motor system embeds, supports and physically yolks experience to the active sensory-affective self. 

Then they can begin to become aware of what those needs are, safe in the knowledge that the other is able to foster trust and lower arousal. 

The authors identify means that caring persons can deploy to help the person with autism become more complete, embodied and coherent, and to help them express their individuality ready to share an integral meaning in life’s movements and what they discover. 

When over-done, their beneficial effect is lost to a detrimental, sometimes damaging form of loss of control, such as in compulsive eating, biting, or extensive habits that cause damage to the body. 

From this knowledge the authors advance the hypothesis that increased strength of the brainstem integrative signal excited for swimming generates a coherence of conscious experience by its regular repetition with the improved vigour of simultaneous, all-body sensory and motor signals. 

The other important feature of collage is that it captures one’s interest in the little fiddly movements some individuals with ASD are compelled to repeat, normally with little product or enjoyment to be shared. 

It was only many years later in adult life, after ongoing therapy and some decades of self-reflection and analysis that she came to understand that she had developed a disjunction between what the authors now know as her Core Self – her core affective, perceptual, and embodied Self – and her more artificial, rational, and reflective Tertiary Self. 

By analysis of Pum’s personal experience and collaboration with her perspective and insights of her experience of autism, the authors consider the benefits from two energetic and demanding sensorimotor activities, swimming and collage, which she knows to be beneficial for the integrative access between higher and core levels of her Self, and that she believes can be made beneficial for individuals with autism.