Toxic People – Mind Toolset

People can be hard. It can be difficult to work out what who to trust and who to distrust. Some people need special care in handling, some people are just toxic. Here is a series of ideas that helps you to get from meeting with the assumption that they are decent, to a potential recognition that this person may need to be treated with lots of caution.

Principle of Charity: “Interpreting a speaker’s statements/actions in the most rational way possible and, in the case of any argument, considering its best, strongest possible interpretation.”


When you meet a person, or are not aware of all of the facts, assume they are trying to do the right thing with the information and abilities they have, that they are trying to say the right thing and don’t know how to say things better, and any ill consequence is hopefully ignorance.

Hanlon’s Razor: “Never attribute to malice that which is adequately explained by stupidity.” attributed to Robert J. Hanlon


Mallice is actually quite rare. When you are confronted by an anomolous (rare) situation that seems mallicious, in the absense of concrete evidence that this likely to be a stupid error.

Margaret Atwood ‘…the difference between stupid and ignorant was that ignorant could learn.”

Alias Grace Quotes by Margaret Atwood

If you’ve talked to the person about what went wrong and why that was a problem, then ignorant people will learn and not repeat the rationally explained and reasonably evidenced error. You shouldn’t have to explain too much or go into too much detail to be able to tell the difference between someone trying to learn what went wrong and someone refusing to engage (mallice), or incapable of engaging (limited capacity aka stupid) in the process.

Grey’s Law: “Any sufficiently advanced incompetence is indistinguishable from malice”, unknown author

[Gooden, Philip (2015). Skyscrapers, Hemlines and the Eddie Murphy Rule: Life’s Hidden Laws, Rules and Theories. Bloomsbury Publishing. p. 83. ISBN 978-1-47291503-0.]
While this is a useful idea, the original author is not known. It borrows both Clarke's Three Laws regarding sufficiently advanced science being indistinguishable from magic, and Hanlon's Razor from above.

At some point, it doesn’t matter if the person is mallicious or stupid, if they keep hurting you, they are toxic to you. Get away from them.

This sounds easy, but can be very hard – especially if the person is a parent or child and there is a dependent relationship between the two.

If you need some help to navigate if a situation is toxic or not, speak to a trusted friend, or see a therapist to help get a reality check. Therapists are also generally good at helping you find a way out of messy situations with toxic people, even families.

Autism is not Overdiagnosed

I’ve heard quite a lot of people state that they think that Autism is overdiagnosed, and a few stating we are in an Autism Pandemic.

No. This is not true.

Part of the problem lies in comprehending what a diagnosis actually means, because most people don’t understand what Autism actually is. The stigma is that Autism is a disability, an illness, a problem. While it is true that Autism can disable, is often comorbid (existing as well as) illnesses and can creates problems; Autism does not always disable, is not an illness, and doesn’t require problems to happen.

Being Autistic is not a bad thing.

People who assume that Autism is a medical label for a type of disability, illness or problem find it hard to understand why knowing you are Autistic if you don’t experience any of these is important. These people will argue against labelling people because labels are stigmatising, while ironically making the label stigmatising.

Knowing that you are Autistic is empowering. When you know that you are Autistic, it helps you understand traits that you live with, the traits that affect you, and that these traits are normal and okay; just different to people who are not Autistic. It helps you know that you can drop the mask when safe to do so, and it is relieving to doso. It enables you to comprehend why neurotypical people struggle to do some things, and why they do so many odd and illogical things. It helps you compensate for some of your own specific weak areas that you previously thought were failure or some kind of darkness.

You don’t need to have a “medically significant problem” to know your heritage and be empowered by that knowledge.

Chris from “Autistic Not Weird” surveyed many people to accumulate some very interesting statistics. Those who are diagnosed with Autism and the professionals who help diagnose both agree that Autism is not over diagnosed.

Survey indicating that most autistic and professionals agree that Autism is not over diagnosed
Source: Autistic Not Weird,

In my professional work as a therapist, I think that Autism is woefully underdiagnosed, and that under-diagnoses is blinding people to important information about themselves. That lack of information can be very harmful and lead to complications that just are not necessary.

Don’t let the stigma others carry block you from either getting your own diagnosis, self-diagnosing, or facilitating the diagnosis of a loved one.


Original text

[From the Facebook Group “Autistic Not Weird”]

Yes, there may be a striking difference in the level of disagreement, but the results are fairly unambiguous: both autistic respondents AND non-autistic professionals generally believe that autism is NOT over-diagnosed.

And honestly, it’s an idea that’s very damaging to autistic people (especially those who find diagnostic services inaccessible), so it’s encouraging to see the professional recognition of what most of us already acknowledge. -Chris

[Link to Full results and analysis]

Eye Contact is Overrated

When we look at an object, light reflects off that surface, strikes our eyes, goes through our lens, triggers photo-receptors on our retinas, triggers an ion cascade through nerve fibres to our brain, branches through our limbic early warning system and up through to our occipital region to paint an hallucination of the object within our mind that doesn’t exist.

To understand what this image is, elements of it go to various parts of our brain, a network to identify the base category [table]. Once identified, another network of brain parts starts to inform you of basic properties [sturdy but not strong, need a coaster, not a weapon]. For anything that is within your catalogue of known items and fits closely enough to things you’ve seen before, this process is so quick and automatic that you don’t even consciously think about what it is that you see, you just know.

When we look at someone’s face, we are supposed to pick up the cues of pupil location, changes in eye shape, colouring of the cheeks, muscle configuration, amount of teeth shown, wrinkling of the brow, wrinkling of the nose, flare of the nose, twitching of certain muscles, activity of the ears, orientation of the head, stiffness of the neck and so much more – to try to figure out both if we know this person, and also what is their internal state.

Many studies have shown that the amount of brain activity needed to determine if you recognise a face and identify a person – and the amount of brain activity to determine what the internal state of that human is – is very high.

For most people, determining faces and that person’s internal state is considered a priority task. Humans are tricksy beasts, often hiding what they are truly feeling, masking their moods and deceiving others. Often this deception is for their own protection, but enough of the time, it is to take advantage of or harm another. In this era where most of the wildlife has been tamed or killed, the predators that are actually dangerous to us are humans.

Additionally, to work together as a team, it is important to know what your team is doing without having to explicitly be told, and it is helpful for them to know your state without you having to tell them. This non-verbal communication not only avoids cluing in the prey animal we are hunting, it allows for communication in a noisy environment, at a range, or in a hostile situation.

So it makes sense that humans evolved an internal brain network that is not only good at detecting faces to recognise them as friend or foe, but also to register the internal state and intent of those we see, so that we can either brace for attack, or work more effectively as a team on collaborative tasks. For most, it only takes a few key signals to quickly and efficiently determine someone’s mood and intent. Each person viewing another’s face will use a different combination of cues, but it is enough to get there. Consider how much of a table you need to see to guess accurately at the rest.

It is a great pity that many autistic people have not got this automatic process (some do). Often it is “yes that is a face, that seems happy?” much like you would for a table. The process doesn’t have that extra nuance of “happy with the food, upset at something else – from the stiffness of their partner, I’d say they have a disagreement”.

Determining a person’s internal state and intent can be learned as a manual skill. Like all acquired skills, it is slow and cumbersome at first, and in time can be improved to the point of being an automatic process. In this regard, it is similar to learning any manual skill, such as tennis, judo or driving. We were not born knowing these manual skills, but we can acquire them after birth from manual learning, and get so good at them that we can be very proficient. Some people, though, are only ever mediocre.

It is important to recognise that even those who hone the skills to an expert level are doing a non-natural task, which makes it more taxing to the brain system than automatic tasks like breathing, or beating your heart. Consider when you’ve pulled over your car, turned the radio down so that you can look at the map, or missed a turn because the conversation was too distracting. How often have you forgotten to beat your heart?

Manually learned tasks are inherently inefficient. Determining internal states and recognising faces is already a highly taxing mental task in those who have the evolved automatic process; for those who manually had to learn it, it is even more taxing.

For many autistic people, eye contact is hard. It takes a lot of processing to “read a person”. Due to a history of errors, there are a lot of features the autistic person will use to try to gauge and error-correct an impression. Even so, doubt will exist as the differences between earnest and honest expressive people, nuances and deceptive people is subtle. A deceptive person who is bad at it won’t get very far.

If the autistic person has got good at this task and isn’t too stressed or fatigued, they can fake eye contact fairly well. Even so, there are likely to be lots of calculations in the background of “am I making too much eye contact?”, “am I making too little eye contact?”, “what does that twitch mean?” and “I think I’ve missed something”. As stress and or fatigue rise, eye contact becomes harder. If the person hasn’t got good and efficient at this manual task, it was already hard to begin with.

This hasn’t even yet included adding ensuring that your own face is conveying “I’m not a threat” and enough of your own mood to help them help you, or not help them harm you.

Many western cultures run under the practice of “eye contact is honest”. Too little eye contact implies “deception / disrespect / uncertainty / subservience / inattentive etc”. Too much eye contact can be read as “invasive / challenge / threat”. It can be a systemic enculturated discrimination of autistic people.

Many autistic people describe the feeling of forcing themselves to make eye contact as “uncomfortable / a pressure behind my eyes / disorienting / dumbifying”. Each of these describes the increased cognitive load trying to process a face and how that can reduce the resources to do other things, like hear what the person is saying, think of a response, still stims and other movements etc.

When an autistic person stops looking at your face, but continues to talk to you, especially engaging in your conversation or talking about a subject they are passionate about, they are conveying to you respect, affection and enjoyment. They have likely stopped eye/face visual contact to give you more attention, because they want to understand you and what you are saying and meaning. You can help them by adding in verbal descriptions about how you feel about what they have said, and being more explicit in verbally stating your intent and checking that you have both understood the other.

Eye contact is overrated.

Sensory Sensitivity

The standards to which we create things are based on the average wants and comfort levels of people. The biggest group is called “typical”, and since perception is about how your brain perceives things, we refer to their neurology as neurologically typical; shortened to neurotypical. Importantly, all people have a limit to what sensory they can process before their functional capacity declines.

Average is nice, but tends to exclude a good number of people.

For example, the loudest that electrical equipment can be is based on the average loudest dB that doesn’t cause pain or damage – which means that it does cause pain and damage for some. Additionally, domestic (home) equipment doesn’t sell well when it is too loud or sounds too obnoxious to people – you’d rather buy the brand that sounds less bad.

At some point in manufacturing, industries get lazy. For example, most vacuum cleaners sound about the same – that is, they are about the same loudness, and about the same pitch. It is the natural meeting point of “legal”, “sells well” and “cheap”. If you want to purchase a vacuum cleaner, and you aren’t very rich, you will settle on the least objectionable item – and they are all basically the same.

It is not uncommon for an autistic person to be more sensitive to some types of loud sounds and some types of pitches than neurotypical people. This sensitivity can be felt as physical pain, or mood pain such as anger, sadness or anxiety. Do you hear the electronic devices screaming in a super high pitch? Perhaps you hear the deep hum of the refrigerator and it irritates you. 

Too much sensory input

Not all autistic people will struggle with loud sounds, or with certain pitches. 

I’ve picked on audio as a place to start from. All of our senses have these issues, whether you are neurotypical or neurodivergent. There is a limit to how much or how little a phenomenon can be for any person to perceive. If you detect beyond the average range (eg very high sound, or very low sound) then you are hypersensitive; if you detect below the average range (eg can’t taste that food where others can) you are hyposensitive. You may note the phenomena, love the phenomena (philic response), or hate/fear the phenomena (phobic response).

I want to emphasise that being hyper or hypo sensitive isn’t necessarily a good or bad thing. Each are useful and hindering in the right context. I was supporting an autistic person to purchase a phone. They wanted to feel the texture of the phone before purchasing it, to minimise a sensory rejection of the item. When the sales assistant returned the phone to its cradle, they accidentally set off the burglar alarm. This was very, very loud and warbled at a particular pitch that was quite unpleasant. The store was emptied within seconds. The sales assistant was shaking as they tried very hard to focus enough to return the phone to the cradle properly and deactivate the alarm – the alarm was making it very hard for them to think. The autistic person I was supporting just stood there and waited, seemingly unperturbed by the sound. I checked to see if they were ok, and they responded that while the noise wasn’t fun, they were perfectly fine. We then held a conversation for a few minutes while waiting for the sales assistant to finally deactivate the noise, which confirmed that my person was not flustered or discombobulated. While the hyposensitivity to this particular noise wasn’t useful in this instance (beyond not having to run out of the store like all of the others), I can imagine a setting where it would be. This could have also gone the other way, where if my person was hypersensitive to that sound combination, I may have had a sobbing or aggressive person on my hands.

There is an excellent argument that if we, as a society, made some additional considerations of sensory sensitivities, then everyone would benefit. Imagine, being able to purchase a cheap and effective vacuum cleaner that was half as loud and less obnoxiously pitched. Imagine each room in the office building having their own climate control, so that the person in the room can pick the temperature that works best for them.

In my opinion, everyone would gain from society requiring more consideration to sensory limits, not just autistic people.

Rejection Sensitivity

Rejection Sensitivity is a strong reaction to perceived or actual rejection. It can often be triggered by fearing having done something tenuous wrong that another person will then act upon, or by the perception of negative feedback.

It often starts as a result to poor masking. Masking is a mechanism that neurodivergent people, such as autistic and adhders, use to seem like others, to fit in with the crowd and be accepted. The problem with this method is that neurodivergent person is not actually accepted, only their mask is.

When this fails and the person is rejected anyway, it triggers a spiral of “was it me”, “was it my mask”, “did they see the real me?” and “what do they want from me?”. Being seen behind the mask, not knowing how to fix the mask, and not understanding why you’ve been rejected is terrifying.

Image of male indicating rejection with the "thumbs down" hand sign
Being Rejcted

When it works, neurodivergent people can mistake themselves for the mask, or always feel empty, dishonest and false. Neurodivergent people can feel that they are what they produce and lose themselves in their identities such as work, rescuer and provider. These are all roles, and are not you.

When entering a group, the neurodivergent person wants to know what role they fulfil to “fit in”. What do you, the group, need? How will I be able to add value, so that you will value me? To decrease the risk of immediate rejection from the group, the neurodivergent person may bring gifts, services and work extra hard. It is not uncommon for the neurodivergent person to put so much work in, that they are doing the work of 2 or more people. Just don’t reject me!

Abusive people love to take advantage of this sensitivity and extra goods from the neurodivergent person.

Rejection Sensitivity is a thing. RSD aka Rejection Sensitivity Dysphoria, is not.

Rejection sensitivity comes with some cousins.
– Rejection sensitivity
– Imposter Syndrome
– Fear of Betrayal
– Fear of Abandonment
– FOMO (Fear of Missing Out)
– Fear of Failure
– Fear of Being Alone
– Conflict avoidance

To manage each of these, people form “People Pleasing” behaviours, avoid ever pointing out someone else’s mistakes and take on far, far, far too much responsibility. Until the neurodivergent person collapses in exhaustion and experiences burnout.

The central error in this is mistaking your worth as your product – gifts, services and sacrifice.

Your worth is in you as a person, not what you do for others. You are a Human Being, not a Human Doing.

This reorientation of worth allows the Human to make mistakes without being a mistake, and from those mistakes, learn, grow and change.

This allows you to produce a reasonable amount, instead of a superhuman amount. After all, the person in the team who does the least is still getting paid just as much as you are.

This makes it easier to spot those who are abusing your generosity and cutting them off. This allows you to walk away from that toxic situation.

When a neurodivergent person begins to arc up with extra sensitivity from any of the above trigger situations, they can query themselves – am I experiencing Rejection Sensitivity? Then take a pause and separate the feeling of personal failure from the situation. You haven’t changed – the situation has.

Sometimes the neurodivergent person has made a mistake, and if so, it will be clear and obvious. We don’t lose friendships over subtle problems, and a person who claims we made a subtle or illogical and non-evidenced error is someone to be aware of – they are likely toxic and may also be abusive (take the opportunity to get out of that relationship). Once we have identified the error, what can we learn from it? Can we adapt and adjust our actions, plans etc to factor in this new information? How can we grow?

We have turned a mistake into a growth opportunity.

Learning how to identify toxic people is very important. The odds are that if you have a high rejection sensitivity response and it is frequently triggered, then you are likely “surrounded by arseholes (TM)” [a ‘diagnosis’ I sometimes give my anxious people in hostile social situations].

I find the red, amber, green flag system useful for doing evaluations of the person/people who trigger the Rejection Sensitivity.

Red flags are “red alert” style behaviours (double standards, moving goal posts, claims of error without evidence, faulting you for not reading their mind).

Amber flags are “wake up and take a close look” behaviours, where something seems off, but it isn’t clearly a red flag, but it might be. This is the time to take the rose tinted filters off our eyes and take a cold hard look. Is this odd behaviour an anomaly, or is it actually a trend? Everyone has the right to a bad day.

Green flags are indications that our relationship (work, intimate, friend) is on the green – aka good. Things like “does what they say”, “informs you of the important bits in a timely fashion”, “asks for reasonable things”, “believes you”, “has a single standard”, “understanding”.

Once you’ve started to learn about how to spot the toxic people, and that their behaviour isn’t your fault or responsibility, you can start to yeet the toxic people.

Then, with a bit of retraining, your Rejection Sensitivity can calm down.

There is a strong caveat here. Even after internalising the above, you can still struggle with rejection sensitivity. Two main causes for that is past trauma – get some trauma counselling; and an adrenaline/mood problem – investigate medication.

If you want, I can go into those two in more detail. For now though, see a professional.

Anxiety – Part 1

Anxiety is a feeling of worry, nervousness, or unease about something with an uncertain outcome. At low levels it prepares us for an experience with low predictability in case the outcome is not good for us and we need to act quickly and decisively to become safe. This is a good thing.

Video link to the video this is a transcript for

Anxiety heightens our perception of change and harm so that we can better prepare for emergency action. That action is usually driven via the fear reflex – freeze, flight and fight.

Anxiety is supposed to be short term, and give us a clear idea about what we need to be cautious about, even if you can’t see it. Anxiety is generally about known situations that should pass.

Ongoing anxiety keeps you at a level of alertness all of the time. It drives hyper vigilance, hyper reactivity and can cause misperception of the circumstances, leading to poor decisions.  

At higher levels, anxiety can incapacitate one’s quality of life, as the anxious person is frequently enacting the freeze and flight fear response, and less commonly the fight fear response.

If you are responding to a simple problem, like a wild animal, then freeze, flight and fight are excellent responses. These often don’t work well with modern civilisation, where it is rare that you need to fight off animals or act in an emergency situation. In modern civilisation you need more nuanced and subtle solutions to life.

The difference between a fear response and an anxiety response is that with fear, the threat really is there and the consequences are that bad. An anxiety response is in the absence of a tangible threat, after the tangible threat has passed, or the response is in excess of the threat.

It is natural to feel anxiety when entering into a new situation, or where the outcome of an action is perceived to be very important to one’s future. It is not normal to feel anxious in the absence of such a situation. If someone is feeling anxious most of the time, there may be a disorder involved. 

The word “disorder” is a medical term we use to describe when something has got in the way of living your life.

We are going to take a whirlwind tour of a few different types of anxiety disorder.

General Anxiety

General Anxiety describes how someone can feel anxious in most places – whether it be the privacy of their own home, safely in their own room; or at work/school; or at a peaceful park. The feeling of anxiety is independent of the location. If this level of anxiety is a core component of your decisions to or not to do tasks, it is likely going to be called a disorder and be labelled General Anxiety Disorder, or GAD for short. It is frequently positively responsive to a class of medications called “SSRI”, which stands for Selective Serotonin Reuptake Inhibitors and generally benefits from talking therapies. If you experience general anxiety and it is interfering with your life, please talk to your doctor about this.

Social Anxiety

Social Anxiety describes how someone can feel anxious in the presence of strangers, acquaintances, friends and family. While not all people will necessarily trigger anxiety for a person with social anxiety, the feelings of anxiety diminish when alone and not thinking about other people’s judgments, reactions or negative experience of the person with social anxiety. In essence, in the absence of others, there is little to no anxiety. 

Social Anxiety is usually a side effect of some other category of problem and is commonly found with autism, ADHD, PTSD or trauma. For some of these, medication can help reduce the symptoms, for some talking therapies are more effective, often a combination of both. Once it has been established that the type of anxiety is social, the therapist should check to see if one of these other conditions (Autism, ADHD, PTSD or trauma) are also present and better explain the anxiety experience.


OCD stands for Obsessive Compulsive Disorder. Many people mistake OCD for other psychological traits. Let us debunk a few of those.

A person who can’t stand a tile being out of place in the bathroom, for example, or some other broken pattern has a keen Sense of Correctness or Sense of Pattern. While a Sense of Correctness is common in with Autistic people, it is not exclusive to Autistic people, and is quite helpful when accuracy is needed in your job. It is not OCD.

Someone who hyperfixates on a particular interest, or person, or object, can seem obsessive, but this is not OCD either. Again, this is not uncommon with Autistic people, and again this character trait is not exclusive to Autistic people. 

Ritualistic behaviour is a trait in common with OCD, but is not exclusive to OCD. Consider people who follow a particular religion that has specific set of rituals involved, or someone who just really likes the milk poured in their coffee first, not second, or maybe the other way around. Familiar patterns are commonly found with Autistic people, and again are not exclusive to Autistic people. 

I have mentioned autism a few times in connection to OCD. That is because in my experience, autistic people are frequently mistaken for having OCD. While it is possible to be Autistic and have OCD, the OCD diagnosis has to be carefully done by not assuming a sense of correctness, fixation on details or comfort in patterns/rituals means OCD.

OCD is a combination of Obsessive and Compulsive traits that are either beyond the control of the individual or very difficult to resist. Here, obsessive describes a thought or idea that seems to intrude upon the person’s mind and seems like it comes from elsewhere. It is not a pleasant thought or idea; and compulsive describes actions or rituals taken that are repetitive and perceived to prevent an unlikely or disconnected event, generally of a catastrophic nature. As mentioned before, it is a disorder because the thought intrusion and the requirement to do the action interfere in one’s life.

I have included OCD here because of the anxiety component involved. The person will feel very anxious about the future catastrophe and extreme anxiety and fear in the absence of doing the ritual that staves it off, or if the ritual is incomplete or no longer effective.

Some OCD is a learned behaviour, where a person fears an outcome that is generally beyond their control. They perform some kind of unusual action and in so doing, find a feeling of relief. As the fearful outcome has not actually been effected by this relieving action, the anxiety mounts again, so the action is repeated again with a soothing outcome. This cycle repeats and the training of the behaviour becomes stronger.

Most OCD has a neurological component and some medications are quite effective at relieving the symptoms. 

Generally a combination of talking therapies to address the perception of fear and find non-ritualistic methods to self sooth combined with pharmacological treatment are the best solution.


PTSD stands for Post Traumatic Stress Disorder. It is one of the best initialisms in the psychiatric part of medicine as it literally tells you what it is in plain language. This is the Stress one feels after a traumatic situation, where that stress has reached the level of a disorder – that is, it interferes with your quality of life.

One person’s bad experience can be another person’s trauma, and that other person’s bad day can be the first person’s trauma. What I am trying to say here is that trauma is personal. Most of us would agree on some common themes of what should be a traumatic experience for most people, such as war, death, pain etc; but not everyone will agree on uncommon themes, such as a long term adversarial experience with a parent, or workplace bullying, or being misnamed. 

PTSD is generally diagnosed after a person has had a reasonable time to process an experience and adjust, but hasn’t. PTSD is characterised by flashbacks, difficulties sleeping, avoidance of certain stimuli related to the traumatic event, decline in mood, hypervigilance, disassociation and a number of other traits. Not all of these need to be present in the person’s post trauma stress. 

I have included PTSD here as a common aspect of the condition is anxiety about when symptoms are going to occur, anxiety regarding a recurrence of the traumatic event and the avoidance of certain stimuli. 

PTSD can be exaggerated by untreated and undiagnosed ADHD, various Personality Disorders and/or anxiety disorder. Sometimes a traumatic event can exaggerate the symptoms of these and be mistaken for PTSD. For those who are assessing, it is important to do a careful investigation of when traits first appeared and not stop looking when a traumatic event has been identified. In my experience, it is not uncommon that behaviours and traits pre-date the traumatic event, and the traumatic experience has dysregulated a management method.

Treating PTSD requires talking therapy and is frequently supported by medications, especially if there is a background condition identified that was not previously being treated.


Phobia comes from the greek root word Phobos, meaning “fear” and is used to refer to an avoidance or running away from that which we irrationally fear. Most people have a thing that they are more uncomfortable around than most, and when that level of discomfort drives the individual to an action or makes other actions near the object of fear difficult, the discomfort is considered to have become a phobia. Generally there is little to no logic behind the source of fear. There are long lists of things that people irrationally fear and we are not going to list them.

Earlier I outlined that anxiety is a fear response to thing that is not present, but is anticipated to cause potential harm, and that an anxiety disorder is where that anxiety is either persistent, or disproportional to the event or object.

With phobia, the anxiety is disproportionate to the object that inspired fear. The person with the phobia will frequently try to justify their fear of the thing so that it seems reasonable and rational. However if no one else (or very few) fears it, even when comprehending it, then the likelihood is that the fear is disproportionate or misattributed to a thing that does not deserve it.

Sometimes the fear is secondary to a disgust reflex, where the individual has learned at some level that “that is wrong” and is thus disgusted in the presence or thought of the thing. This disgust is hard to reconcile, so the feeling is quickly changed to fear. This fear can then be hard to socially demonstrate, and so it is then transformed into anger. When we append the word “phobe” to the end of a noun describing a particular group of people, we are often referring to people that are aggressive about that group. When we look at the source of that anger, it is fear, and when we look at the source of that fear, it is disgust. This disgust is irrational and hard for someone to reconcile.

Phobias and phobes can be managed via talking therapies, which will frequently use various forms of exposure therapy after upskilling the person to manage their mood around the source of fear, and upskilling the person’s mind frame about the thing. This may include some careful use of sedatives to decrease the feelings of anxiety such that the lack of consequence from the thing is observed and internalised. Because the phobia is often based on a fundamental illogical disgust reflex, refreshers of exposure may be needed for many years.

It is important to note the difference between a phobic response to a stimulus and a pain response to a stimulus, such as what Autistic people experience. You can desensitise from the fear / aggressive response to a thing, but you cannot desensitise from a pain reaction to stimulus (such as loud noises). That pain response can trigger aggression and avoidance, and can easily be mistaken for anxiety or phobia. This pain response requires a different method of management, which may include some of the same tools as noted before – reframing and exposure, but will often implement sensory aids such as earphones, gloves and tinted glasses, depending on the source of the sensory overload.


While this is not an extensive list, we have covered some of the more common forms of anxiety, why they are different to each other and some of the common errors in diagnosis and treatment.

These forms of anxiety respond well to talking therapies and some benefit from medication. Most of the talking therapies will use similar methods to address the anxiety component.