Consequences of automatic behaviour events

In many cases, automatic behaviour was described as resulting in an unsuccessful activity. Individuals reported that they could often carry on doing a task successfully, and it wasn’t until they were interrupted or an unexpected event arose that the errors in their behaviour occurred. This involved errors in sequencing, item/ environment intrusions, perseverations leading to nonsense and behaviours that were successful but context inappropriate.

4.1.2.1 Sequencing errors

Automatic behaviour often resulted in sequencing errors, which typically involved omission of a step in a sequence. This included not only missing a step in a behaviour, but also mixing up the order of the act.

“I boiled the water up to make spaghetti… I wanted to stir the spaghetti in the water and I actually put my hand in it!” [Participant B].

4.1.2.2 Item/ environment intrusion

For all participants, automatic behaviour often was associated with putting objects in the wrong places. This appeared to be associated with individuals wanting to place an item somewhere and continuing with the act of ‘putting something away’, but mistaking environmental stimuli. For example, if an item was to be put in a cupboard the item often ended up in a place where a door opened, such as the fridge. Similarly, objects to be placed in drawers would be found in another drawer.

“I could perhaps find a saucepan in the freezer, or really weird things like that. See your brain keeps working when you’re in automatic behaviour. It says put your saucepan away in your cupboard. But you get it a bit wrong, so you put it in the wrong cupboard, which happens to be your freezer. It’s really quite weird, that your brain carries on dong something, but it can’t get it quite right.”

[Participant D].

“Anyway after the meal I put the lamb in the blinking um dishwasher instead of our fridge! And then I couldn’t find it, and I didn’t even think to look in the dishwasher. I mean why would you?” [Participant B].

“It’s not unusual to find the kettle in the fridge and the milk sitting where the kettle should be.” [Participant C].

There were however isolated examples of when items were put in places that were not associated with the desired environmental stimuli. This differed from the above example, in that individuals appeared to have a place that items were consistently placed inappropriately.

“The family’s gotten in the habit of asking ‘have you looked in your ugg boots’… on more than one occasion I have lost something and later found it in my ugg boots.” [Participant C].

4.1.2.3 Perseverative actions leading to nonsense

Individuals operating in automatic mode were also found to be perseverative in their actions. That is, participants reported continuing on with the actions of a task in a very specific manner, such as typing the same letter on a computer over and over again. Therefore, this often resulted in nonsense behaviour. At times it appeared to others that the individual was functioning appropriately, however once the product of the behaviour was examined it became clear that the individual had been in automatic mode. Participants noted that this most frequently occurred during conversations in which they perseverated on letters, words and topics of conversation.

“I was a legal secretary…so I went along and had to take down the case short hand… and at one stage the magistrate asked me: ‘What did so and so say a few minutes back?’ and all I had was just scribble and I wasn’t able to answer them.”

[Participant J].

“At dinner table… spoke gibberish… fighting to regain composure and apologised to company”. [Participant J - Journal]

4.1.2.4 Context inappropriate behaviours

Participants reported that automatic behaviour did not always result in making errors in behaviour or nonsense. At times individuals were able to carry out a successful behaviour while in automatic mode, however actions were sometimes context inappropriate. This most often occurred when writing or in conversation with others.

“Very often I join in the conversation and say something completely different to what [pause] to the person I’m talking to was talking about”. [Participant J]. “I mean the whole letter made sense but it just didn’t happen….. and I was so embarrassed and I had to pretend that I was writing to someone else. To this day I don’t know who it was I was talking about!”[Participant C].

It may be speculated that the last quote may have been a mixture of automatic behaviour and a dream like state. Although not reported by this participant (Participant C), another participant noted that automatic behaviour and hallucinations occurred together. Other participants did not report this.

“I was at a restaurant with my husband and I poured lemonade into my plate, instead of pouring it into a glass. But I was hallucinating. And I remember distinctly thinking that that was the glass… so I think I hallucinate at the same time or nearly the same time as the automatic behaviour.” [Participant J]

4.1.2.5 Successful actions

Individuals with narcolepsy reported being able to perform successful actions while in automatic mode. That is, participants reported that they were able to complete an action successfully and it was only by retrospectively looking back and noting that they could not recall a period of time that they became aware that they had been in automatic mode. This type of automatic behaviour was often reported when driving.

“There’s many a time I’ve pulled up in this driveway and thought ‘I cannot recall anything of the last 2 or 3 kilometers’ but I’ve driven and I’ve come home without having an accident.” [Participant C].