“God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.”
In my book review last week on The Autistic Buddha I commented that Thomas’ introspective ruminations made it clear that he was deeply aware of the feelings and emotions of others. This cognitive ability, also known as Theory of Mind (ToM), is presumed to be abnormal in autistic individuals. Some researchers go as far as to propose ToM as a core deficit of autism and offer it as a putative explanation to their inability to relate socially and to communicate. I have written several blogs underlining the fallacy of Theory of Mind in autism (see references); however, as noted on the comment section of my previous blog, there are still some unanswered questions.
It is always a dangerous temptation to play the role of an armchair psychiatrist and offer opinions about the mental health of an individual without the benefit of a one-on-one mental status examination and revision of his/hers medical records. While acknowledging the limitations of such an uninformed opinion, I would like to proffer my impression regarding Thomas’ tribulations and how they relate to ToM.
Stress is your body’s response to a perceived threat. To have stress is to care about something that may be taken away from you or that you stand to lose. In a simplistic way, to have stress is to have ToM. In The Autistic Buddha, Thomas didn’t care about being autistic, his stress came from knowing that the emotions of others (his parents) were at stake. In Thomas’ mind, his parents valued education. A college degree would provide them with a much-anticipated diploma for display. Thomas’ stress spoke volumes about his values and how he perceived the world around him. He ruminated about his problem in a way typical of an autistic individual. He just couldn’t let go.
Neurotypicals have a finite capacity to pay attention to things. Autistic individuals, on the other hand, seem to have an attention tunnel that allows them to focus and intensify a given perception or thought process. In many instances, this attention tunnel can procreate a negative state of arousal or anxiety. Although only a personal opinion, I do believe that some autistic individuals may hang on to the pain of a given experience for much longer than the average neurotypical.
Decartes said that we are human because we think. Autistic individuals are then very human as they tend to overthink their own emotions and those of others around them. This innate “thought perseveration” essentially shatters the beliefs of ToM/autism proponents. I would dare to counter Decartes proposal and say that we are humans because, rather than to think, we have the capacity to choose. How we react or adapt to our environment allows us to control difficult situations.
Thomas’ stress festered and his environment didn’t match his needs. He didn’t enjoy social support in a foreign city, wasn’t getting any exercise, and apparently did not investigate possible communal activities at school. He had no good choices or outlets for releasing his energy. Instead of compartmentalizing his stress, and making it manageable, his stress and depression generalized to other areas of his life. He wasn’t taking care of his apartment, his hygiene, or his health. His ruminations took him to a distant place, far away from the present, where he created a mental construct of the world. This mental construct opened the door to depression and dissociative symptoms. In this mental construct he lacked choices, self-control, and compassion for himself. He believed that he was his own thoughts.
Thomas was institutionalized and gradually improved. Time was the best healer. He took solace in establishing friendship with an inmate and in knowing that things would pass. There was no magic nor immediate fix to his recovery. Although he had talk therapy, it almost seemed as if nobody was listening to him. Later on, when he realized that his parents only wanted him to be happy, the perception of the stress changed and allowed him to move forwards. Thomas experienced posttraumatic growth when he confronted his own understanding of the world. He realized that how he reacted or adapted was under his control. Viktor Frankl once said, “Everything can be taken away from man but one thing- the last human freedom, to choose one’s attitude in any given set of circumstances.”
For many individuals stress is about having fear of fear itself. Stress management helps you to make choices about who you are or want to get out of life: the core beliefs you may have and that you may not have ever thought about. Living in the present stops your mind from wondering into a false reality. Indeed, living in the present allows you to engage life to the fullest.