WRT 2, what changes do you want to see in him> Are they realistic for a sick, autistic person?
Most urgent priority is I want him to understand his PTSD better and learn to relate it to some of his behavior and hopefully begin treatments for it. That would be really helpful for everyone. It was really obvious to everyone (including his doctor) that he had a complete nervous breakdown a few months after the end of the A and he was, until very recently, in total denial about that.
But the kind of PTSD he has is the kind you read about war veterans having. He can never, ever feel relaxed. He is always waiting for something bad to happen. He struggles with terrible flashbacks. He can't stand almost any noise. He gets really angry for no reason at all, at inanimate objects. This is, on it's own, a very big strain on a relationship even without the A!
He has struggled with understanding what's happening to him and why, and so I need to see him connect the dots with it. Yes, he is capable of doing that. He has already made great progress. As a family full of autistics we are used to certain adjustments around everyone's sensory things - but autism and PTSD are not the same thing, and he needs to get help.
I don't think it's a questions of realistic or not. Severe PTSD is no joke. It is also causing so much anxiety that he is in an almost permanent Lupus flare which is a truly horrible illness. The last six months before I left I would basically have classed him as disabled. So he just has to deal with it. He has to. It's that simple. He can't continue like this.
WRT 3, my W worked on herself. That meant she didn't cater to me. I wanted her to work on the A. She and her therapist - who was also our MC - worked on the more basic motivations that enabled W's general screw-ups. She became less co-d, for example. I became OK with that, in part because I couldn't change it and in part because I am pretty well convinced that work on root causes is more effective, especially for the long term, than work on symptoms.
But W's work on R was indirect. I was OK with it, but would you be OK with indirect work?
Yes. I honestly believe he is not the same person he was when he made the choices he did. I honestly believe he has already done a lot of "the work" internally, but he just hasn't shared it with me. I don't need huge changes in him as a person - I think those have been happening organically on their own.
What I need from him is:
a) Understanding on why he has to stop being defensive when we talk about things he finds shameful
b) Showing more empathy (even if it doesn't come naturally) when I am dealing with a trigger rather than jumping to shame
c) To be able to talk to him about everything that happened and ask any questions I have remaining without fear I will make him sick
d) For him to stop the self-loathing and start to like himself again
That's pretty much it. To be honest, his untreated PTSD and medical problems are probably the biggest problem. If I can see sensible, reasonable action to try and get better then I think there's a very good shot at R but he's been sitting on it and just getting sicker and sicker and sicker.
An autistic person can't do some of the things neuro-typicals can do, but that's not necessarily relevant to your decision. You are free to decide you don't want to deal with autistic behavior - but you'll make a better choice for yourself if you figure out what specific behaviors you will and will not accept.
I am an autistic Mother :) I love autistic behavior - it's one of the things I love best about him. It just makes complex emotional situations very hard and it means his tolerance for emotional strain or demands is a lot lower. Things need to be explained really directly, he doesn't get hints or suggestions. I know how to handle it, it just makes it a bit harder to get certain things like reassurance.
A neurotypical person can understand a subtle hint they are being asked for reassurance. They understand because they kind of imagine how the other person might feel. My WS can't do this very well. I need to literally spell it out. "I am feeling insecure or triggered about X and I need you to provide me with X please".
Otherwise he will kind of fumble in the dark and give me a hug or tell me I am beautiful because he can't intuit the words I need very easily. You can see how hard he is trying because he really panics that he is going to say the wrong thing and when he says something right and I acknowledge that he kind of makes a mental record so he knows what to do next time.
I know that probably sounds weird to people not used to living with autism (which is different in every person) but it's kind of endearing. My autistic loved ones are probably the most genuine, loving, kind people I know so I generally see "living with it" as a privilege :) Sorry, being mother there - mum pride :)