Autism Unexpected: How Do People With Autism Experience Pain?


I find it interesting how my autistic son Jack reacts to injuries. He gets them often enough, because he’s pretty clumsy and because he has two rough and tumble brothers. But while those neurotypical brothers are oh-so-dramatic about their minor pains, Jack is incredibly matter of fact about the whole thing.

My oldest son is kind of a drama king. The smallest injury—sometimes even an imaginary injury brought on by a brotherly assault he doesn’t care for—merits a full-on screaming fit and the demanding of multiple apologies.

The youngest takes incredible, acrobatic tumbles and usually pops up with a cheery, “I’m okay!” Brotherly injustices will send him down the drama king path as well, though. He has already learned that getting hurt can sometimes lead to extra cuddles or a special privilege to make him feel better, so he will often try to manipulate me into turning his pain into a treat.

Jack, on the other hand, has a very straightforward reaction to getting hurt. Just as he is the least whiny of my three children, he is also the least dramatic about perceived pain. When he does react, I know that he is really hurt, and I need to take some action. For him, big hugs usually do the trick.

In fact, even more than pain, the sight of blood causes Jack the most distress. He will often be fine after an injury until he looks down and sees red. Then he starts to scream: “BLOOOOOOD!” Usually the instant a bandage is put over the blood or I clean him up, he is completely fine again.

I know that people with autism often feel pain differently that typical folks. I know some people would say that autistic people don’t feel pain, but I don’t believe that to be true. I do believe that some of them probably experience it differently, maybe as sensation instead of pain. Or maybe communication problems lead to stoicism in the face of pain. Or maybe, just as in the general population, some autistic individuals just have a high tolerance to pain.

As someone with tendencies similar to Jack, I know that I would much rather experience sharp pain than listen to some of the noises that trigger my sensory processing difficulties. I can deal with pain. I cannot deal with hearing someone’s low, loud bass emanating from their car stereo. The latter is far worse for me. I wonder if there is a similar thing going on with my son.

Of course, there is pain and then there is pain. Severe pain is going to affect everyone in a pretty terrible way. My son experienced such an injury the other day. He ended up at the ER with my husband. He is fine now, but based on the injury in question, I’m sure the pain was intense. Still, he seemed more concerned about having my husband answer his questions about what was going to happen. Even in this extreme case, Jack’s anxiety over the unknown trumped the physical pain.

I find my son’s reaction to pain, like so many of the manifestations of his autism, to be fascinating. I also find it fascinating that the way he deals with injury is so much easier than the way my other children deal with it. His straightforward way of being is sometimes a true blessing.

Originally published at Autism Unexpected on June 24, 2010.