Autism Self Diagnosis: The Seinfeld Syndrome

A few months ago, during an interview with Brian Williams of NBC’s “Nightly News”, Jerry Seinfled proclaimed that on a very drawn-out scale he fell on the autism spectrum. When asked to explain, he said that he was very literal, occasionally could not understand the expressions of other people, and that social engagement was a struggle for him. Although Seinfeld was very careful in wording his thoughts, he then added that these traits didn’t make him dysfunctional; rather he saw them as the expression of an alternate mindset. Members of the Neurodiversity movement, especially Ari Ne’eman president of the Autistic Advocacy Network, hurriedly jumped into the spotlight and commended Mr. Seinfeld for his expressions. Mr. Ne’eman incautiously took the casual comments prima facie and saw in Seinfeld a banner child with whom the public could identify and thus acquire greater tolerance for autism. A few days later Jerry Seinfeld backtracked during an interview with “Access Hollywood” and said, “I am not on the spectrum”.

Self-diagnosis is not a new phenomenon but is one seen more and more often in autism. People like Seinfeld making a self-diagnosis unknowingly play down on the pain and suffering of real autistic individuals. Their expressions do not acknowledge how autism confers on the affected individual a disability or a handicap and, rather, closely associate themselves with romanticized characters like “Rain Man”. Although these expressions are to be expected from uninformed people, I am more concerned when individuals with personality disorders self-diagnose themselves as autistic.

People with personality disorders have extremely rigid behavioral patterns that interfere with their ability to function within society. They regard their behavior as correct and blame society, and the world around them, for their problems. They are manipulative and, as such, many of their actions and expressions denote self-centeredness and a lack of empathy towards others. You may recognize many of these traits in certain exponents of the Neurodiversity movement who not only attempt to deny treatment and research for their own conceived condition, but also for every other autistic individual. In their minds, seizures, sensory problems, and mood disorders are not pertinent to autism because they themselves don’t experience the same. They will publicly display their ignorance in an assertive manner in internet forums and will try to impose their point of view by bullying and always having the last word.

Deviance (in the sense developed from social since, -not a pejorative term) serves a function of defining boundaries within a given society. To use the term autism inappropriately is to tear down these boundaries. In this particular case the perceived benefits of receiving the label of autism appears to outstrip the stigma associated with the condition. This is a type of operant behavior defined by reinforcement. By claiming autism as your cause celebre you can immediately jump into the spotlight and attract attention. In addition, you may not condone the irascible behavior of a person with a personality disorder but look for explanations to accommodate maladaptive behaviors from an autistic individual. Such instances force us to review and debate the assumptions of society’s collective moral sense.

Some sort of behaviors are eccentric enough to deserve attention, this is because there is a social sense of what is acceptable and what is not. In many cases, social norms are judged as deviant in judicial trials. In terms of medicine, problematic behaviors are judged to be maladaptive by professional boards of health-related professionals. For medical purposes problematic behaviors are due to actions, not dependent on a persons’ profession, how they live, or religious beliefs. A person with borderline personality disorder and another who is autistic may both be judged to fall outside of established norms, both may have achieved a certain status of controversy, and yet differ greatly between themselves. Who defines the boundaries and our shared moral sense?

There tends to be a scarcity of absolutist norms for judging mental disorders by health related professionals. They are not based on commandments or proposed imperatives that apply across different cultures. In this regard mental disorders may bear the judgment of both physicians on the one side and society on the other. Behaviors in medicine fall under a normal distribution, but this is not necessarily the case for behaviors judged by society. In effect, medical conditions are often glamorized by society based on case reports or romanticized single exponents that seem to go against the grain and buck the system. According to society, great leaders are almost by definition deviants. These are individuals with unique character traits or abilities that break social morays. Society demands no hypothesis or empirical formulations for these individuals.

The fact that society is always rooting for the underdog is well understood by people with personality disorders. Individuals like Victor “The Wild Boy of Aveyron”, whom some believe was autistic, never socialized or acquired language. Still our societal mind believes in Tarzan who after being rescued in his teens becomes a proper Englishman and thus escapes his atavistic traits. We dream that people can change social classes if the world around them changes and accommodates for their eccentricities. Accommodation is thus the rallying cry for the uninformed.

Medical criteria usually lack the glamour attached to societal deviance. Medicine is about providing labels that give the health related professional the illusion at least that they understand a condition and are able to treat the same. Much to the discomfort of those with personality disorders everybody in medicine starts at a level playing field. The mindset of a physician can’t be changed by unsubstantiated verbiage. Autism and its comorbidities still remains a medical condition deserving of research and treatment when necessary. Romanticizing autism denotes lack of knowledge in some cases; however, the lack of empathy in other cases may denote a disturbed individual.

9 responses to “Autism Self Diagnosis: The Seinfeld Syndrome

  1. I have a question for Dr. Casanova,or anybody else who might be reading this.Why are so few things considered criteria for an autism diagnosis?

    It seems to me that given the very small number of criteria considered for an ASD diagnosis,that it would be very easy to get such a diagnosis.Or to make a self diagnosis.There are definitely too many people diagnosed with autism,whose main problem is one of social anxiety.This is just those who have an actual diagnosis,not the self diagnosed.

    Why is it things like learning disabilities,self abusive behaviours,wandering,motor coorination problems,or developmental delays in addition to those involving speech and language are not factored into an autism diagnosis?

    I think we could even make a case for childhood onset psychiatric disorders being factored into an autism diagnosis.

    If autism was a more broad spectrum condition,where every single aspect of brain function and neurodevelopment were considered for a diagnosis,you might not have the self diagnosis phenomena in the first place.I don’t see an equal amount of people going around who are self diagnosed with something like Cerebral Palsy,for example.

    The other problem I see with the Jerry Seinfeld incident,is it condones the idea of self diagnosis in the first place.Ari Ne’eman of ASAN came out and praised Mr. Seinfeld for his “courage” soon after he made his initial comments.This,in itself,is shameful.It takes much more courage for an adult to actually seek out an autism diagnosis,and be tested for it.A number of bloggers have suggested there are those in ASAN who may,in fact,be self diagnosed.It might be interesting to find out for certain.

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  2. The best solution to this issue is the development and deployment of reliable biomarker tests for autism. That may or may not change the diagnosed numbers, but it will eliminate the speculation. Blood type is no longer a matter of opinion. Nor are the distinct biomarkers for many other neurological conditions.

    Imagine if our treatment options for MS and other neurological diseases were entirely and exclusively based on behavioral observation.

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  3. John Robison, the best solution for the problem would be a cure, but, like a biomarker that does not exist either. I do agree, it would be nice if we had biomarkers (including different biomarkers for different types of autism) but at the current point in time, that does not exist.

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  4. It would be nice to have a biomarker. At least that is the idea spewed by the federal government under its Precision Medicine initiative. As presented it is very misleading and probably will make things worse for ASD (see http://bit.ly/1EGp0B6 ). There are many ways to pursue biomarkers and severity indices in autism; unfortunatley, the initiatives from the federal government are likely to steer research efforts away from them.

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  5. If any of you (Roger, John, Jonathan) are attending IMFAR we should make a point to meet and discuss issues related to self-diagnosis and putative biomarkers.

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  6. I will be at IMFAR. I’m doing a workshop at the pre conference, and then we have a talk, poster session, and SIG. And we have the community lunch. So I’m happy to meet anyone around those events.

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  7. Pingback: Munchausen Syndrome, Autism, and Self-Diagnosis | Cortical Chauvinism·

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