A 28 year old female comes into my office telling me that she has been diagnosed with Asperger's Syndrome. She states that she has an IQ of 150 and that she was an excellent student until the 11th grade at which point her father had a sudden death. Since then, she has done poorly academically and she cannot graduate college. By her report, " the wheels came off". In a matter of fact manner, she describes that she has problem "re-setting" herself, but when her father was alive, he helped her with that.

I understood her to be saying that she struggles with issues of self-regulation, meaning that she felt that she was missing the part of personality which copes with stress so she can function in the world. When her father was alive, he provided an external regulator which guided her feelings in the world. In other words, when a friend disappointed her, she would feel lost, but her father explained to her that sometimes friends are disappointing, and then she could cope and resume her work. Without her father, she could not put a framework on upsetting events. She could not concentrate on school since her subjective stress overwhelmed her ability to think. The tragedy of her father's death was profound. Her mother was around and available, but she did not know how to provide this regulatory function. She speculated that her mother might have Asperger's Disorder as well.