If you lack sleep or if you are bored you may find yourself half conscious while reading this blog. Freud would say that many of our personal problems lurk in the unconscious mind. A neurologist may examine a patient that has lost consciousness due to a stroke. We read in the newspaper a story about the positive effects of meditation or the negative ones provided by mind-altering drugs. All of these ideas jump into our mind when we talk about consciousness. Today I would like to emphasize one such idea, the relationship between consciousness, Theory of Mind (ToM), and autism.

Theory of Mind is the human ability that allows us to identify our own mental states as well as to characterize the mental states of others. Based on observable behaviors ToM allows us to attribute beliefs and feelings in others and to conceptually predict their future behaviors. ToM in this regard is closely linked to our ability to attribute causation to events in our lives. It is based on inferential beliefs (themselves solidly grounded on past experiences), developed conceptions on the laws of nature, and abstract reasoning.

Figure legend: Too much ToM may be a bad thing.

Many individuals have argued that there is no dissociation between the capacity for self-knowledge and for other-knowledge. According to Thomas Hobbes to be conscious is to understand what is in common. It is only instantiated in a relationship between the individual and the collective. John Locke in “An Essay Concerning Human Understanding” used the term in a similar way. Indeed the word conscious is derived from the Latin roots cum and scio meaning with and knowledge respectively. Consciousness as used by Locke was to know what was shared by the community.

Uta Frith, who introduced the concept of Theory of Mind in autism, has said that, “Experimental studies of normal and abnormal development suggests that the abilities to attribute mental states to self and others are closely related. This inability to pass standard “theory of mind” tests, which refer to other’s false beliefs, may imply lack of self-consciousness. Individuals who persistently fail these tests may, in the extreme, be unable to reflect on their intentions or to anticipate their own actions” (Frith and Happe, 1999).

What is it to live a life without consciousness? Consciousness is directly related to awareness, which in turn is directly related to alertness. A computer may perform intelligent tasks without having consciousness. We could envision a similar state by aggregating a series of prosthetic limbs and making a robot. In psychiatry fuge states like multiple personality disorders (now known as dissociative identity disorder) would not be pertinent to the discussion. These mental states confer the individual with a fractured or dissociated personaility but no alteration of consciousness.

Philosophers interested in understanding the mind usually use the example of zombies when pondering consciousness. Zombies in B movies are soulless creatures; however, zombies in philosophical arguments are thought experiments that tests mental life.In this regard zombies are defined as hypothetical human beings that lack conscious experience and thus have no ToM. Although zombies do not exist, in real life we have a close analogue. We call this zombie-like state somnambulism.

Sleepwalking is usually seen in children 6 to 12 years old with episodes diminishing in frequency with aging. The episodes themselves usually last only seconds or minutes. Behaviors during sleepwalking are rather simple, often repetitive. Individuals may sit on the edge of their bed or walk around their house. In some cases they may get dressed and even drive a car. Although having their eyes open the sleepwalker bears a dull expression. Because of the altered state of consciousness a somnambulist does not know that he is sleepwalking during an incurred episode. When awake and conscious the person does not recall what happened while sleepwalking.

Is autism akin to somnambulism? Can autistic individuals differentiate right from wrong? Can they set goals and carry them to completion? These activities would be impaired in someone who is sleepwalking just as well as somebody who lacks ToM.

The simplistic proposals provided by ToM proponents usually face difficulties in the cluttered environment of real life. Lack of ToM would render life useless within society. There would be no empathy, art or spirituality without ToM. Without this ability an individual would lack competence and would thus be excluded from any criminal prosecution. Indeed our being or self is the composite of our experiences gained through perception, emotions and thoughts. We may conclude that without ToM there would be no self. According to George Berkely, to be is to be perceived.

To say that autistic individuals lack ToM is irrational. Tests like Sally-Anne attempt to offer an objective grasp of what is by nature a subjective phenomena. Whatever objective test I use in trying to prove that Ludwig van Beethoven is a better composer than Johann Sebastian Bach will always be criticized. In the case of Sally-Anne-ike tests finding faults is easy. Most studies lack appropriate controls (e.g., language) and explanations as to what is expected during testing have usually not been properly conveyed to participants. In finding an empathic autistic individual, or one with emotive artistic abilities, or one who is a stand-up comedian (I am aware of autistic individuals with all of these qualities) Samuel Johnson would have cried, “Thus I refute the ToM theory of autism”.

Autistic individuals do have a perception of an external world that is independent of them. I do not need to objectify this observation. It is self-evident. Autism offers a graveyard to psychological theories each buried and superceeded by others that were thought to be better. Thus far they reflect our ignorance and lack of understanding about the biological underpinnings of the condition. The serendipitous meanderings brought about by psychological theories such as ToM have held hostage our knowledge of autism rather than driven us to a better understanding of the same.

I will end with a quote from the rationalist character of Sherlock Holmes:

“It is a capital mistake to theorize before one has data. Insensibly one begins to twist facts to suit theories, instead of theories to suit facts.”

References

Fith U, Happe F. Theory of Mind and Self-Consciousness: What is it like to be autistic? Mind and Language 14(1):1-22, 1999.