Theory of Mind (ToM) . People with ACC, in my experience, have a great deal of difficulty objectifying our thoughts and emotions. Because we have difficulty with executive function skills, we also have issues with regulating our thoughts and our emotions, they are either "full on" or "full off" regardless of what they are (happy, sad, angry, peaceful, depressed, bored, etc...) and why they arose in us in the first place.
It is my experience that "it is so crowded in there" that there is no space, no room for our cognitive process to work with and regulate, and know the appropriateness of both thoughts and emotions.
While it appears that those with ACC fall along a spectrum, this is more or less true for all of us. I have met ACCers with well developed ToM, with none, and everything in between. I imagine the ability to work on and develop ToM also falls along a spectrum. As I have mentioned in other posts, there are exercises that can evoke ToM in an individual...As mentioned above, often those with ACC find no "space" between themselves and their overwhelming thoughts and emotions, yet there are methods possible to create breathing room in the psyche. It is this breathing room itself that evokes ToM.
I found personally, that I could not identify my thoughts and emotions accurately, nor express them, until I first related to how they made me feel in and as my body. What I mean is "I'm feeling this 'emotion', how does it make my body feel? Do I feel it in my chest, my stomach, my head maybe? Is it pain, is it nausea, butterflies?" You see, another issue with our ToM is that we can be very unaware that emotional states are felt in the body...yet identifying these feelings in our bodies is a first step in being able to cognitively identify and be able to describe/relate these thoughts and emotions. Once we have identified how it makes us feel, this gives us a "handle", it gives us something to work with in a concrete manner.
For example, I get anxiety attacks. I could not always tell you that what I was feeling was anxiety, to me it was just "emotions" and any tags I would put on them, wouldn't be accurate, they would likely be only what I think you wanted to hear. I began to work with my anxiety, and I discovered that this feeling I had was a pain in my chest and that I could hardly breath. My breaths, I discovered were very shallow and rapid. I felt like my stomach was this large unprotected vulnerable area, and I was afraid of anyone going near it.
So, the next step for me was not a cognitive approach, decidedly not psychotherapy. The next movement in my process after identifying how this felt in my body was to do its opposite. I "could not breath", so instead I made my focus my breath. Instead of shallow rapid breaths into my chest, I would take long slow breaths, in and out, all the way to my belly. I would not force myself to do this versus the other, but I would treat myself gently. Every time that impulse of anxiety would move me back up into my chest and my breath would want to become shallow again, I would gently redirect my attention into my belly, and long, slow, deep breaths, in and out.
What happens to me is that there becomes a "space." A space between the bad feeling in my body (anxiety) and the feeling of relaxation. There becomes a realization between "this feeling" and "that feeling." The space between these two things is where I exist. I begin to understand, that I am neither the bad feeling or the good feeling, but I am something other than that.
I began to realize that I had these feelings in the body, instead of feeling that I was those feelings in the body. This step, in my opinion, is extraordinarily important. It is an objectifying of the physical effects of our emotions felt in the body.
Once I was able to objectify how these emotions felt in my body, I was able to push them away slightly at "arms length." After I'd gained a lot of practice doing this, my cognitive processes began to latch onto these sensations in the body and label them "anxiety" vs "peace and relaxation."
This is a very simple if dumbed down version of the process I have used that has helped me develop Theory of Mind. I have been taught even more refined versions of this that have improved my quality of life greatly. I practice a form of meditation, that in itself evokes this process very quickly and distinctly with my thoughts and emotions. It has not been an instant fix or easy process, but remains a steady discipline I have embraced that continues to produce useful changes in my cognitive and emotional life.
I'm convinced that almost everyone with ACC is capable of some level of this process in development. I would think the only barrier to such development might be someone who is profoundly intellectually disabled.
I would add, that this process continues to go on within me, and will likely never "end" or complete. This is as it should be, (I feel) as human beings are meant to continue and develop, grow, and change throughout a lifetime of experiences, not just "once and your done." In times of extreme stress or emotional upset, I can and still do appear to "lose" ToM momentarily. I will get so caught up in the thought or emotion and its feeling in the body that I have no "room" to maneuver, no space to think about it objectively. When this occurs, I go back to basics, and begin the process all over again, as described in this post.
I hope this post has given ACCers and parents of ACCers something to think about, ponder and explore. I have not gone into any great detail about this process, as it really needs to be tailored individually to the person who experiences it, there is no such things as one size fits all.
Should you have any questions or comments, you can leave them here, or contact me via Facebook in one of the ACC groups. I would be happy to help in any way possible.