Dawn Barker explains Autisim and the book
First of all, thank you for having me on your blog today. I’m very excited that More Than Us is out now!
Thank you also for asking me to explain a little bit about some of the mental health conditions that are central to the characters in More Than Us. For those who haven’t read it yet, More Than Us tells the story of a family who must make drastic decisions about the mental health treatment of their son, and then deal with the fall-out for their family, and particularly their children, when the parents have completely opposing views about his psychiatry treatment.
One of the main characters in More Than Us is a teenage boy named Cameron. Cameron has always been different to his sister, and different to the other children around him. He was harder to manage as a baby and toddler, with behavioural issues and struggles at school. His mother is sure there’s something wrong with him; his father thinks he’s just a child and shouldn’t have to be the same as everyone else.
I chose to write about this issue in the book as when I’m not writing, I work as a child psychiatrist here in Perth, Australia. I therefore see every day that diagnosing behavioural and emotional difficulties in children is not as straightforward as diagnosing a medical illness: there’s no blood test or scan that can tell us what’s ‘wrong’ and we depend on information and observation from many places to help formulate a diagnosis and tailor treatment, both psychological and sometimes, medication, if appropriate. Also, children are developing and changing all the time, and so are their symptoms.
In More Than Us, Cameron doesn’t fit neatly into any box. He has features of an Autistic Spectrum Disorder, and he also has features of Obsessive Compulsive Disorder. Over many years, other symptoms appear that seem to relate to ADHD, or anxiety, or depression. This again, is not uncommon in my day to day work.
In child psychiatry, symptoms often overlap. For example, an Autistic Spectrum Disorder involves symptoms of not only social difficulties, but also restricted and repetitive interests and behaviours. Obsessive Compulsive Disorder involves, amongst other symptoms, repetitive compulsive behaviours that may appear to parents, or teachers, as restricted behaviours. The two conditions, however, are very different, as is their treatment. To complicate things, children may have both conditions, and in fact many mental illnesses commonly co-occur with others.
I see children with social difficulties all the time in my practice, and Cameron in More Than Us struggles to relate to his peers at times. It had been suggested when he was younger that he may have an Autistic Spectrum Disorder, which, by definition, involves difficulty in social communication. However, he doesn’t quite fit in that box.
Other mental health disorders can create social difficulties too: someone with OCD may be so preoccupied with their worrying, obsessional thoughts and completing their compulsions that they can’t concentrate on social interactions; someone with ADHD may struggle to control their impulses or their attention on conversations; someone who is depressed will be so flat in their mood that they don’t have the energy or motivation to relate to others.
I wanted to explore in the book how all of our behaviours exist on a spectrum, from what we would class in our society as ‘normal’, social and confident children, to those people whom we see at work or school every day who don’t fit the norm. They may be ‘quirky’ or a little odd, or avoid social interactions, or just seem to not understand social communication. That’s not necessarily an illness or mental health condition and diagnosis depends on a really careful and thorough history and observation of a child and family over time. Not every child who has social difficulties has an autistic spectrum disorder, and diagnosing children is complex.
I hope that readers of More Than Us can put themselves in the place of Cameron’s mother and father, and consider what they would do in that situation, if Cameron was their child. After writing the book, it has become even clearer to me that there is no right or wrong answer, and no right or wrong way to raise your own child, but even if parents disagree about treatment, or any aspect of parenting, they mustn’t forget that the most important thing is to ensure that their child is happy and thriving, regardless of their own views.
Thanks again for having me on your blog today and I hope your readers enjoy More Than Us.
Links to Book:
Dawn Barker is a psychiatrist and author. She grew up in Scotland, then in 2001 she moved to Australia, completed her psychiatric training and began writing. Her first novel, ‘Fractured’, was selected for the 2010 Hachette/Queensland Writers Centre manuscript development programme, was one of Australia’s bestselling debut fiction titles for 2013, and was shortlisted for the 2014 WA Premier’s Book Awards. Her second novel is ‘Let Her Go’. Dawn lives in Perth with her husband and three young children.