What does Maryana Bezusla think? Psychiatrist on Asperger’s syndrome: its origins and whether it can be cured

Friends, hello.

Today we are meeting with you at an unusual time, but there is a topic that has sparked very heated discussions in society.

So we're here to help you figure it out.

On July 26, MP Mariana Bezugla revealed that she has Asperger's syndrome, or, quote, neurotypical thinking.

For the first time, she announced this under a post on Facebook by the head of communications at the Institute for Economic Research, Olena Shkarpova.

On July 27, the deputy communicated this once again on her own page.

This caused a flurry of discussions on social media, where Asperger's syndrome is called a mental illness, a non-existent diagnosis, a condition that imposes certain professional restrictions, including inadmissibility of state secrets.

This issue is not dedicated to the figure of Maryana Bezugla.

Moreover, we remind you that each of us is protected by medical confidentiality and should not report our health conditions publicly.

Your health is your personal matter.

Instead, our conversation today is designed to remove the stigma of Asperger's syndrome.

The behavior, statements, or actions of different people with the same health conditions should not be standardized.

Ms.

Bezugla's decisions are not equal to the decisions and actions of other people with Asperger's syndrome.

Moreover, in a world where the struggle for tolerance and inclusion continues, it is important to use words, terms, and names of disorders correctly to prevent any discrimination based on health status.

And psychiatrist and psychotherapist David Tsybenko will help us understand the topic of times and Asperger's syndrome.

David, congratulations. Thank you very much for joining us. Congratulations.

Today we will talk to you about Asperger's syndrome, which has been so much discussed on social media in recent days.

And I would like to first of all understand what it is, because people have started to incorrectly use phrases like mental disorder, mental illness, stigmatizing people who have and live full, professional, and absolutely simple lives, without any restrictions.

So let's start with what this syndrome is and how it manifests itself.

It is now called the spectrum, autism spectrum, or autism spectrum disorder.

And this is a neurodevelopmental disorder.

It's not a mental disorder in the sense that people probably want to hear, but it's definitely a neurodiverse.

And this is part of the very concept of neurodiversity.

Why do we talk about autism spectrum disorders and not Asperger's syndrome? If we look at the history of this development, the development of this disorder in general, then we look at the year 43, uh, this is when Kanera begins.

Well, there is a psychiatrist Kaner, who, uh, studied children with uh-huh disabilities.

And he studied, uh, specifically children, uh, and called their disorder autistic.

Uh, and he researched that they have certain, uh, developmental delays.

Well, and he was investigating complex cases, not really cases that would be, uh, typical of, for example, Asperger's, which we'll talk about now.

But he investigated complex cases.

There were developmental delays, for example, or he studied children at a much older age who had, uh, narrow interests or who had, uh, poor understanding of emotions, poor understanding of social context, poor adaptation to society and who had, uh, narrow certain interests in life or certain strange interests that would be strange to others.

or, for example, sensitivity to certain sounds, certain textures, or, conversely, they really liked certain sounds and certain textures, certain patterns, repetitive movements, such as rocking, or, for example, how they can soothe themselves with different, certain movements.

For example, he should want to constantly hold some kind of, uh, thing, some kind of toy in his hands or, uh, make certain repetitive movements with his arms, legs, neck, or whole body.

And in 1943, and this continued until 1990, the syndromes and symptoms of autism described by Kaner were used in most cases.

But now it will sound strange, in the year 44, it would not be so obvious and uh uh different, but a German pediatrician already described exactly this problem, and he called it Asperger's syndrome.

And this Asperger's is a German psychiatrist, a German pediatrician, who, uh, described this very Asperger's disorder.

He showed milder cases, milder in the pubes.

Okay, so we can't say easy or difficult, but on the spectrum, if it's the autism spectrum, we see that these are easier cases of children who had problems with social skills.

They had very big problems with social skills.

Also, narrow interests, certain strange interests that only interested them there, for example, collecting certain things.

Uh, because collecting, well, for example, it may sound completely strange, there, collecting, uh, train signs, for example, some certain ones there, for example, and some children liked it.

Well, that's the same as one child.

This is a very narrow interest that would, well, not be general.

He saw this kind of social autism.

And he saw that these children did not have impaired intelligence, some kind of impaired intelligence or, for example, reduced intelligence.

Sometimes there was even high intelligence, on the contrary.

And they had a tendency to really think more analytically, more structuredly, and to isolate more of the context, they isolated more of certain details, very small details, that they could see and wouldn't be overlooked by other, uh, people, for example, who see a broader spectrum, a broader picture.

Well, later it was called Asperger's syndrome.

And, unfortunately, since I think it's related to 1944 or because not all psychiatrists in the US or other parts of the world could speak German, Asperger's, Asperger's syndrome was included in the International Classification of Diseases or the Diagnostic and Statistical Classification of Disorders in the 1990s.

uh, only in the 90s, in 92, yes, and in 2000, it seems, it was already the eighth, and in 2013, sorry, in 2013, they already reduced everything to one spectrum of consideration of the autism spectrum.

And as I said, this is a spectrum related to society, that is, social maladjustment and behavioral maladjustment.

If we look at Asperger's itself and what we say is Asperger's syndrome, it means mild manifestations or milder manifestations on this spectrum of autism.

They will be more related not to intellectual disabilities, not to some kind of e.

g.

how people can think with mental disorders, but rather to how a person processes emotions, that is, they feel emotions, but they can process them in their own way.

For example, she may not understand the social context of emotions, she may internalize some emotions that are not typical for this social context.

for example, laughing where it would not be necessary to laugh, or crying where it would be appropriate to cry, and so on.

Or, for example, uh, they might feel them more deeply, but, again, not express it socially, if other people would.

They also have a certain lexicality, a misunderstanding of other people's emotions as their own.

Well, and if they can understand emotions, again, they feel them, but they have a hard time understanding them at the level that neurotypical people feel.

So what this means is, uh, that we feel sadness and we feel this sadness.

But for example, they need to intellectualize this sadness.

For example, they need to understand: "Yeah, there are these physical symptoms, I feel this, this, this, so this is sadness.

" And it works like that somewhere, because they need to really examine, describe, and understand what it is.

on an intellectual level.

Please tell me, does this depend on the fact that their brains developed differently? That is, it is a congenital condition.

But this is a congenital condition.

That is, there is currently no clear etiology of where the autism spectrum comes from, but there is a very, very high probability that there is a genetic component to it.

That is, 90% of this etiogenesis is genetic.

It could also be a problem of intrauterine development.

So what does that mean? These are physical disorders of intrauterine development, infections, uh, uh, for example, the use of narcotic substances or certain pharmacological, uh, substances during a woman's pregnancy.

And this can affect and may be a problem in neurodevelopment.

What does it mean? This means that the child is not developing in a neurotypical style.

That is, it can be from the very beginning, as soon as the child is born, or it can be, uh, uh, it can be after the child had, for example, normal development for the first year and then the normal development fades, for example, regression.

Well, these are two such specific styles that we immediately see that neurodevelopment is impaired or we see regression.

But, of course, it is possible to make a diagnosis closer to school age, but, uh, it must be detected and suspected at an early stage.

It's been one and a half to two years.

Well, it is desirable to identify according to certain criteria.

For example, there is no eye contact, well, specifically eye contact, uh, specifically between the child and the parents or, uh, the child does not accept certain games, for example, like hide and seek and some kind of hide and seek or I mean some kind of grimaces.

She doesn't perceive, she doesn't laugh at them, she doesn't react to the face of her mother or father, for example, she doesn't understand, for example, what her mother's hand is and starts to touch it and use it as a tool.

And the point is that at this stage we can see, okay, that there are most likely some developmental problems here and we need to start doing behavioral therapy.

Not medication, but behavioral therapy for these children.

The earlier it starts, the better this outcome.

It's just that they have more social skills, more ability to learn, and their intellectual abilities improve.

Well, in principle, even if the specialist is wrong, for example, and there is no neurodevelopmental disorder, such therapy, namely behavioral therapy, there is, for example, ABA therapy or similar ABA-based therapies, of which there are a lot now.

then they can be very useful even for healthy children for intellectual development.

Therefore, there is nothing wrong with making a mistake and sending your child to this therapy, it will be very useful.

So, I understand correctly that you and I have essentially just debunked that myth.

I would even say the stigma that is currently spreading all over social media is that Asperger's syndrome requires some kind of treatment.

Since it is a syndrome, it is simply a condition, not a disease.

The disease requires treatment.

A syndrome is simply a condition that a person is born with and lives with.

Well, somehow supporting yourself.

having certain characteristics, for example, as we have already said, in communication, yes, with society.

And they also discuss the issue of empathy in this matter.

You talked about how people with this syndrome, well, and people in general, perceive the emotions of others a little differently.

I understand correctly that in principle, these people do not have as developed empathy as neurotypical people.

Did you say that correctly? I'm not talking about empathy here, I'm talking about perspective here.

It's about taking another person's perspective. Well, it depends on the spectrum itself.

Again, what spectrum are we on and exactly what spectrum are we talking about.

If we are talking specifically about Asperger's and specifically about the milder types of this spectrum, then we see that there is not a problem with empathy itself, but a problem with putting yourself in the shoes of another person.

For example, understanding another person's emotions, understanding another person's social context, understanding another person's perspective.

And this is problematic.

But essentially, uh, exactly, uh, when looking at the autism spectrum, this can be learned, intellectualized, actually, and, uh, it's not a problem that can't be solved.

Well, for example, social skills, even if the child has not had any training, well, at an early age, for example, working even in adulthood with social skills, well, shows that their social skills and understanding of other people improve a lot, even if it is intellectualized, and not somehow felt as if it is instinctive or, well, intuitively, it is meant.

Well, that will be okay, because they will simply understand it on a different level, but they will understand and empathize just a little differently.

But the point is that they will then be able to put themselves in their place.

Another person just needs to develop it.

This happens to us more often in neurotypical people.

Again, this is not always the case. And neurotypicals can be completely unempathetic. This is normal.

But the point is that we can put ourselves in the shoes of another person and even twist it and put ourselves in the shoes of a third person and so on.

Well, that is, we have, uh, this is the ability of the brain.

Well, we don't have to learn this here.

And for neurotypical people, this is a task that is not easy, but can be learned.

Research shows that these can be learned. You're talking about learning.

Do I understand correctly that this learning occurs precisely during the therapy process? And most often this happens either in the process of life or in the process of therapy.

Of course, this learning can happen, and a lot of, again, behavioral therapies now focus on taking the other person's perspective, because that's an important part of social skills.

I will now read to you how Mariana Bezugla described her condition.

I would like to know if, well, this really describes Asperger's syndrome.

Our thinking is really a bit different. I think in structures, algorithms, verification.

Certain facts and observations are superimposed on each other in a single database, like in a computer.

And then the result is displayed, which consists of all, in my opinion, taken into account variables.

I feel emotions, but in a slightly different way.

And for the most part, this is the result of conscious socialization.

I have a high threshold for fear, etc. We also find it very difficult to lie.

I'm not actually lying, but of course I can make mistakes in judgment.

Okay.

This is what we were talking about, right? Uh, the intellectualization of emotions, in essence, and the ability to understand emotions at the level of intelligence is not at the level of such an innate such an innate such an understanding of emotions.

Of course. Emotion is a concept. Good. And we call them sorrows and so on.

Just because we've learned to call it that, but it's easier for us to do it.

Well, it needs to be intellectualized for them too.

And we see this precisely at, uh, the level of what you read.

Plus, analytical thinking is like that.

This sometimes doesn't depend on whether it's simply a developed autism spectrum disorder or whether the person simply has analytical thinking.

But yes, it can also be, as we said, with the autism spectrum disorder itself, especially if we use the old term Asperger's syndrome, there are highly intelligent people there and that's absolutely okay.

And with Asperger's syndrome, a lot of people achieve great success, but that doesn't mean it's a disorder.

geniuses.

Yes, we can cite many examples of people who had autism spectrum disorder, who achieved something, but that doesn't mean it's a genetic disorder.

This means that it is quite widespread.

And, uh, according to some data, now for every 36 children, approximately one child may be on the developmental spectrum, especially a mild autism spectrum disorder.

Therefore, this is a fairly common species, because if we take the Soviet system, then the Soviet system simply did not see it.

For a while, they either called it atavisms like prop schizophrenia, which they called something like childhood schizophrenia or something like that.

And sometimes they could call autism or autistic psychopathy, unfortunately, that way.

Or, and then they often called it, translated it into schizophrenia or schizoid type, or something else.

They simply did not see this difference, because the Soviet system was not aimed at all at helping the patient, but rather at isolating him and putting a stigma on the person, yes, so there is definitely a stigma here, yes, but in this it has a certain resonance, because the post-Soviet countries, they don't even look at them.

They have a very low percentage of autism spectrum disorder.

While in developed countries it is becoming more common.

And this is not, again, this is not some kind of autism spectrum disorder.

It's not because we use any vaccines there or anything.

Well, it's just that its detection is greater, because there are still some debates about its genesis, but this is a highly genetic problem.

It is at the level of its genes that there are the most problems here, or at the level of intrauterine development, there are certain bright things that still lead to teratogenesis.

Well, it means a certain negative impact on the fetus.

This, again, as I said, it could be certain medications, uh, for example, for example, Valproate, uh, in psychiatry or, for example, uh, certain, uh, drugs or alcohol, or, uh, some very severe stress, or some very severe experiences in the mother, or physical, uh, physical injuries in the mother during pregnancy.

This can lead to developmental disorders.

When I was preparing for our conversation, I looked up what myths are spread about, uh, Asperger's syndrome.

And, uh, they wrote very often in Treats that the most common myth is that, uh, children or adults who have this syndrome or this autism spectrum disorder are called geniuses.

They have some professional super achievements there.

Well, this is often associated with Elon Musk for some reason, because he probably just communicated it openly.

He immediately said he had Asperger's syndrome.

And there, too, Anthony Hopkins, the actor, once said that he too was diagnosed as an adult.

This is also the singer Sia has autism spectrum disorder syndrome Greta Thunberg.

That is, more and more people are starting to talk about it publicly.

Well, people actually think that this somehow just equals some kind of genius.

Despite this, we have debunked one of the most common myths.

However, I would like to talk here about issues of the profession and the impact on the profession and activities.

Because when Mariana Bazugla published, uh, this comment, they started discussing her access to state secrets, which supposedly dates back to 2002, when an order was issued by the SBU and the Ministry of Justice, if I'm not mistaken, that supposedly people with RA and, in particular, Asperger's syndrome do not have access to state secrets.

Despite this, in fact, the commentators didn't read very carefully that there are two more asterisks there, which indicate that they may actually be allowed, but it must be after a certain conclusion from a psychiatrist.

Well, today they are already discussing another order, by the way, a recent one, from June 2025.

And there, uh, they expelled people all at once.

And inclusively, we are already talking about Asperger's syndrome today, it is included in the autism spectrum disorder and people have access to state secrets.

Well, actually, can we even talk about the fact that autism spectrum disorder can somehow affect the professional lives of people who have it? If we are talking about Asperger's syndrome, again, if from the consideration of the autistic spectrum, then these are the milder manifestations or the continuum where there is the very aspergy that we are talking about, then it does not affect intellectual development in any way.

And it's not some kind of disease or something else that can affect the very involvement in the mysteries or whether a person can become a doctor or a healer, but something else, something else, something else.

So, uh, these are echoes, again, of the Soviet system.

It's actually, well, a very vivid echo, because, uh, well, there really aren't any contraindications here.

This is the first.

Even, uh, if we continue talking about all these things, we will say that, uh, a lot of people have some kind of disorder.

And then, in order to prevent all people from accessing state secrets, they themselves must be healthy.

Although this is, well, nonsense really.

And the type of autism spectrum disorder does not affect judgment in any way, which is very important.

The fact that a person may not understand certain social contexts will in no way affect his processing of information, certain state secrets, and so on.

Moreover, a person who has a place on such a spectrum will already understand the social aspect, because he has reached certain heights of power or something else.

That is, if she is building a career, then she has the abilities to do so, then she has certain intellectual abilities that can enable her to maintain this career, move on, and so on.

Uh, so there are definitely social skills here, they've definitely already, uh, been acquired and so on.

And, uh, certain character traits that can be found in people with Asperger's syndrome should not be a reason to, uh, not allow secrets.

This is exactly the stigma we were talking about. And there are actually a lot of such places.

And this is not okay, because in our system, not only the state system, but I notice in some patients that they are exposed to this disease.

But they face stigma for bipolar disorder, for schizophrenia, for depression, for example, for OCD, or for other disorders.

they may be exposed to this strain. And this is not okay.

And this is exactly what needs to be changed at the legislative level, at the level of human consciousness.

Well, because, well, these people are just like us.

Good.

Well, nothing changes if they intellectualize emotions or something.

Please tell me how it is diagnosed? In particular, if we are talking about Asperger's syndrome, as an initial or, well, maybe this is a rough word, a milder form, how is it diagnosed and who diagnoses it? This is a psychiatrist.

And can they, for example, diagnose it in adulthood, when it was not diagnosed in childhood, for example? They can, uh, they can in adult, they can in children.

Well, this is diagnosed by a psychiatrist.

If it's a child, then we have a child psychiatrist in Ukraine, if it's an adult, then an adult psychiatrist.

But the distances are a team of specialists.

Well, the distance is precisely a clinical examination by a psychiatrist, an examination using semi-structured interviews, an examination by a psychologist who is also competent in this.

This is testing these children or also collecting a history from their parents about their disorders, genetic predisposition, about how the child developed, and so on.

So, uh, in this direction, if we say, I'm not a child psychiatrist, I'm an adult psychiatrist, then if we're talking about adults, then, uh, what, uh, what I do, what uh is it's always uh most likely teamwork or it's certain then, if it's if I'm the only one to diagnose, it's a clinical diagnostic interview, clinical interviewing, uh, simple review and separation from other uh disorders that can be both together with this disorder, or how can mask this disorder, or uh can create the appearance of an autistic spectrum disorder.

And here's an important thing, that we not only rely on clinical experience, but also on semi-structured interviews, on conversations, again, with the patient's relatives.

uh, we collect objective data, an objective history, uh, of the patient.

And against this background, we can then create a certain conclusion about, ah, about the diagnosis itself, uh, the patient itself, that there may be a type of autism spectrum disorder here.

Well, you mentioned that people mask, so how do they do that? It's not, uh, being specially disguised or anything.

This means that, for example, the development of autism spectrum disorders can often occur together with generalized anxiety disorder.

And then it's hard to separate what's what.

And the best option then is to treat the generalized anxiety disorder and see if the autism spectrum disorder persists, if it's a mild one, again, a type of autism spectrum disorder, especially if we're talking about Asperger's, because if it's a severe autism spectrum disorder, it's still easier to diagnose than its milder manifestations.

And they can disguise themselves as depression.

For example, many people with autism spectrum disorder who have high intelligence or normal intelligence, uh, they, uh, often have depression, they often have comorbidities.

There are many comorbidities, uh, with psychiatric, uh, problems like depression, anxiety, health anxiety, uh, obsessive-compulsive disorders, uh, that is, there is a certain comorbidity, uh, sleep problems, and there are frequent companions of autism spectrum disorder.

And so it's worth differentiating this here, again, and for this, there is a certain kind of painstaking work that is not done there, for example, one visit to a psychiatrist.

One visit to a psychiatrist is difficult to accurately determine whether someone is on the autistic spectrum, especially if it is a mild manifestation.

Good. And especially when it's not so noticeable.

when there are certain other disorders that can either mask or create a type of athetistic spectrum disorder.

And this is a certain peculiarity of diagnostics.

To wrap up our conversation, uh, I'd like to ask you from my own experience or maybe just, you know, from my own observations as a person.

What stigmas and myths do you observe regarding people with Racial and Asperger's syndrome? I now see fewer signs of autism spectrum disorder.

More than anything, I'm noticing that these disorders, I don't know if that's a good thing or a bad thing, are becoming more common knowledge among people who come to me, and they might ask, "Do I have an athetoid spectrum disorder?" Well, there is a certain boom now in diagnosing autism spectrum disorders.

And sometimes they divide, sometimes they don't, but I'm very happy because it's happening now, because it will now be corrected and doctors will understand better where the autism spectrum is developed and where it isn't.

And there will be a higher percentage of detection of this disorder, because unfortunately it is currently significantly low or sometimes there is a risk that this development of the autism spectrum is not placed where it should be.

And here is the question of this diagnosis, the question of how Ukrainian doctors will process information and new research on autism spectrum disorder, because here you need to know not only the diagnostic components and not only have a semi-structured interview, but also look at new research that shows, uh, certain data about them, certain, uh, things about whether it would be possible to better identify these, uh, uh, this autism spectrum disorder.

That's why I don't see much stigma around autism spectrum disorder now.

Well, but I hope she won't be there, uh, now.

Well, but there is one and only problem, which is that there is a stigma among, uh, psychiatrists, which is a very big problem.

This is both with Rdug and with the autism spectrum.

I just have n't seen it for a long time, but, well, I remember from two years ago that in state hospitals, uh, if you're 18 years old, you've turned 18, that's it, you don't have autism, you don't have an autism spectrum disorder or you don't have autism spectrum disorder, it went somewhere and you can't put it, as if adult psychiatrists for some reason give completely different diagnoses for autism spectrum disorder or autism spectrum disorder.

not those at all. It's often personality disorders they pose. And this is not okay.

This is just another Soviet atazm, that it has to grow somewhere or something.

No, that's not how it works.

If a person has a mental illness, if a child has attention deficit hyperactivity disorder, or if a child has a developed autism spectrum disorder, he will not outgrow it.

He will intellectualize emotions.

He will improve his skills, but he will have an autism spectrum disorder.

And this is very important to remember and not to put some other disorders, because the head doctor said: "It doesn't put such a good thing.

" Therefore, uh, I think the new generation of psychiatrists and doctors in general is more focused on a more, uh, European system in this regard.

And I think it will be much better.

And do n't you notice that these are all different, well, let's say, I'll combine it with the word diagnoses, because this applies not only to once, but also to other certain mental diagnoses, that they have become popular and are used where they shouldn't be.

For example, well, it's fashionable to say, "I have depression when you're in a bad mood or you're tired.

I have anxiety disorder when you're, well, just worried.

" The same could be true with Asperger's syndrome, now that, well, so many people have started talking about it publicly.

I'm a little worried that this could become a new fad, like bipolar disorder, as it was rudely called, or depression.

Ugh.

And it's not certain whether it will become, uh, fashionable.

I think some of the fear that I have an autism spectrum disorder is coming from people or trying to understand themselves through diagnostic labels.

And this is a common part of the practice that I see that every year some diagnostic tricks become more popular and people try to find out whether I have it or not.

But it's very important here that it's not bad on the one hand, because if a person comes and says that they want to be tested for autism spectrum disorder or other disorders, well, then, well, it's already good that the person comes and we can talk.

On the other hand, of course, I wouldn't want it to be devalued, because people who actually have autism spectrum disorder, or as you said, bipolar disorder - people with bipolar disorder, they sometimes feel anger or frustration when they hear someone make fun of it, because it's hard to actually have something like that and hear them make fun of it.

But I see a trend that we now have less of this stigma, and younger people now have more understanding of the condition.

And they try to explain their condition with various diagnostic tricks.

The problem is that the diagnostic label, whether it will be there or not, is one thing.

But it is very important to understand what a person really wants in life and how they want to fix the problems in their life.

If it's developed on the autism spectrum and it helps, great, but it still takes a lot of work.

And there are no magic pills here.

I think that in principle, our conversation today will dispel a little of these discussions and myths surrounding Asperger's syndrome and the condition itself.

And I think we were definitely useful to you in this direction.

David, I am very grateful to you for joining us, for having this conversation and explaining everything so clearly and clearly.

Thank you. Thank you, friends.

I hope you found this video useful and that you improved your knowledge on the topic of autism spectrum disorders and Asperger's syndrome.

And let's not forget that there is a dictionary of tolerance, where you have to use terms correctly and call people with autism spectrum disorder.

Let's not forget that the person comes first, and then all other health features.

Thank you for being with us. Until next time. [music].