The SPC model as a heuristic tool to better understand autism spectrum disorder and other structural diagnosis in psychiatry and psychotherapy

Both autism and the broader autism phenotype represent stable mental features over time that often lead to typical psychosocial problem patterns such as bullying, interpersonal conflicts at work and at home, or social withdrawal. These patterns may in turn cause specific temporary medical conditions such as states of tension, agitation, mutism, depression, or psychosis. When presenting to psychiatry or psychotherapy patients generally do not complain about autism, but rather about depression, interpersonal conflicts, and psychosocial difficulties. They may also complain about maladaptive behaviors such as social withdrawal, gaming etc. They often have difficulty understanding themselves, generating a clear sense of self and identity, and understanding other people’s behaviors. The SPC model presented here is a heuristic tool to provide clarity on this complex interplay of different ontological entities. The model analyses life phenomena and developments according to their degree of situational freedom and modifiability. Mental structures are considered to be fateful, fundamental physical phenomena, similar to body height, IQ, and ametropia. Problems and problematic behaviors are not core phenomena of the autistic structure, despite developing in typical psychosocial dynamics and patterns in the biographies of autistic individuals. Examples include bullying, social withdrawal, and dysfunctional communication patterns. Unlike autistic structures, these should not be accepted, but changed. Conditions are understood as specific psychobiological and physical states. Affected persons are not free to intentionally alter such conditions. Unlike bodily structures, they have a beginning and an end, and are transient by nature. Examples include states of tension, depressive episodes and psychotic states. Such conditions should be treated with all available medical and psychotherapeutic means, or endured until they naturally pass. In individual situations, people are not free with respect to their own structure and biological conditions. They cannot manipulate these phenomena voluntarily. They can only compensate or cope. Problems and problem behaviors, however, can and should be solved. These phenomena fall within the realms of freedom and responsibility. Such a comprehensive understanding of one’s own body, mental structure, and psychodynamic mechanisms, as well as the typically evolving interpersonal dynamics, is of utmost importance for the development of a valid and functional self, particularly in autism.