“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.”
-Serenity Prayer
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.
References
1) Zombies, Theory of Mind and autism
2) Ludwig Wittgestein debunks Theory of Mind in autism
Cortical Chauvinism 
Manuel, I have to dissent here a bit. Yonks ago the antiinnatia theory of autism was published; an updated presentation can be seen at ref #1 below. According to that theory, all autism symptoms result from reduced expression of «innatons», that is, innately-programmed tendencies inherited in the genome. In the course of working up that paper, one (or more) of the innate tendencies was identified as «a predisposition towards forming of a conception of and monitoring of the mental state of others, of their intentions, assumptions, and points of view….» (page 228).
During the eleven years it took to get that theory through the anti-publication system, others at Cambridge/London (who’d probably been reading my submitted manuscripts) had published basically the same notion and given it the now famous «Theory of Mind» name (and also added some silly elaborations).
AND some of them started proposing it was the key essential characteristic of autism.
In respect of that latter, I agree with you. Autism does not *equal* a Theory of Mind deficit. But rather, the autistic syndrome has numerous primary brain atypicalities and behavioral atypicalities, of which Theory of Mind aspects are just one. And it is not an essential, necessary feature of autism – not all autistics necessarily have such deficits.
There is abundant evidence of ToM in (some) autism. The Sally-Anne experiment. The very telling reversing of «you» and «me». The «pragmatic» communication problems (page 228 of ref #1).
On page 235 is explained that autism researchers have tended to see one part of autism and get fixated on the notion that that is the whole of autism. This overhyped ToM = autism is just one example of such
error.
Ref 1: Chapter 7 at http://www.pseudoexpertise.com
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Theory of Mind as usually understood is a long way from the social anxiety I feel as a high-functioning autist. Markram and colleagues named it well – “intense world syndrome”: «In this view, the autistic person would be overwhelmed with emotional significance and salience. As a consequence, the subject would want to avoid this emotional overload and would have to withdraw from situations, such as social encounters, which are rich in complex stimuli.” Melvin Konner agreed, noting the Tinbergens (pioneers of autism research) detected fear in these children in social situations, and “reasoned that exceptionally timid children might be at risk for developing the disorder if they grew up in a sufficiently threatening – or perhaps for them, merely a very intrusive – social environment.”
Theory of Mind mistakenly believes autistic people ignore or don’t notice others, even family members. Maybe some do, notably Aspergers – but I’m very emotional, and recognize emotions readily – like most of us do, especially children. Gaze aversion might just mean the child doesn’t want to see your double messages.
Markram H, Rinaldi T, Markram K. The Intense World Syndrome – an alternative hypothesis for autism. Frontiers of Neuroscience 2007;1(1):77–96.
Konner M. The Tangled Wing. Biological Constraints on the Human Spirit. New York: Holt, Rinehart and Winston; 1982. (this edition only)
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«Theory of Mind mistakenly believes autistic people ignore or don’t notice others, even family members.»
Theories don’t have minds and consequently aren’t capable of believing anything. I guess Peter really means «Theory of mind implies that ALL….» or «Theory of mind presumes that ALL….».
But it doesn’t.
PS: Because the medical corporatocracy wish to pretend the autism increase hasn’t happened, many older people have been falsely «diagnosed» as autistic when they are more reasonably considered just introverted, socially-anxious, independent-minded, or perhaps in some cases, just total *@#»;!!’s (not with reference to any particular people here or anywhere, though some acquaintances do come to mind). I’ll have a bet that «Petergood» here doesn’t do much handflapping, spinning around, reversing «me» and «you», arranging things in rows. These are telling signs of the autistic syndrome. Being socially-anxious is NOT. I used to be VERY socially anxious but am certainly not now. Nothing whatsoever to do with being autistic. (Though fortunately my *@#»;-ness is incurable as I’m sure Manuel will confirm.)
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I believe there is a theory of mind deficit but it is a downstream result of autism’s deeper symptoms, in other words you have it because you have the autism, not the other way around. Unfortunately is has come to be defining for autism. It’s a preposterous as calling a mosquito bite a scratching disorder. The bump and itch lead to the scratching.
And not they even go as far as to claim autistic people lack emotions entirely. Yes, there are hundreds of websites and comments I’ve seen where they say so. There was a newstory where a child was raped but the principal of the school said of her «it’s good she is autistic, otherwise she would be traumatized.» Yes that happened!
Manuel, you won’t just be debating theory of mind, they will soon claim lack of feelings are part of autism too. Michael Fitzgerald for instance says so, ( a man who diagnosed Mark Twain, Hitler, and Ted Bundy as autistic….and written books pro neurodiversity ironically, have you heard of him?).
And I have seen some on the spectrum who are quite emotionally flat, but this I would reason is due to blunted affect (a disconnection between reaction and feeling) or childhood events shaping personality/ causing disassociation, not biological/organic.
I am curious, why do you think they now claim we can’t feel anything like that principal and the internet trolls/hate sites?
How did it go from this to that? Who is responsible?
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I read of a new drug by Roche which may be the first drug targeted for a core symptom. It’s designed to improve social ability. And maybe it will help, but this is all from the viewpoint of autism as a social disorder. They do not look at the relationship between a person with autism and interaction with REALITY, (of which social interaction is but a fraction of the whole picture and a result of the deeper problems), itself to find ways to design treatment. This lense they wear is an incredibly narrow one.
It’s like the myth antipsychotics are a magic cure for schizophrenia.
«It’s a just hallucinating disorder! He’s medicated and not seeing things so he must be normal now, why is he still unemployed and having so much trouble? He must be lazy!».
These narrow views of disorders contribute to stigma and comparisons to personality disorders.
https://www.psychologytoday.com/blog/resolution-not-conflict/201406/do-you-think-narcissism-autistic-spectrum-disorder
Except narcissists don’t have executive dysfunction, pronoun reversal, and learning impairments…but it’s an autism spectrum disorder?
http://www.ehbonline.org/article/S1090-5138(16)30010-1/abstract
Borderline personality disorder is a type of bipolar syndrome?
ARGH!
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For people who admire Asperger so much, his descriptions of his patients were quite… well,
He described them with words like degenerate, imbecile, automata, and said incapable of love. He highlighted their cruelty and considered calculated malicious behaviour as part of their condition.
Of course the environment at the time of authoritarian parenting in a Germanic Europe obviously had no effect (sarcasm), and he obviously didn’t cherry picked four specific boys who may have the worst behaviour (sarcasm). He said «the parents suffer from having such unloving children» or something like that. If you lived in a 1940s Nazi Germany society where you addressed your dad as «Herr Vater» and received caning from your teachers, I wouldn’t be surprised if anti-social personality characteristics would develop in children who are developmentally vulnerable and have difficulty interacting with their environment.
Now his words have become written in stone among how society views people on the spectrum, children being raised in such a way that doesn’t lead to a good character, childhood bullying, and lo, they say what bad and unkind people autistic people are.
A self fulfilling prophecy.
They say «what is the use of nurture and loving teaching methods on these little sociopathic creatures» and repeat the cycle leading to more criminal acts by people on the spectrum such as Sandy Hook because of this approach special education and intervention uses.
It’s paradoxical how neurodiversity could idolize a person who used such disparaging terms on his patients. Calling them «imbeciles, cruel, unloving». I think they never actually read what Asperger wrote! But the trolls and hatesite people have. The irony those who hate people on the spectrum and neurodiversity both seeing this man as the greatest source of information. And here I am saying «What about Kanner?», then both say «Who?». These approaches have made many people on the spectrum uncaring and anti-social and we claim that’s how they’ve naturally are.
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Hans, have you ever considered writing something similar but to be published as a blog in cortical chauvinism? Please think about it.
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Maybe you have to consider that Asperger was working in a system («regime» if you will) under which you had to choose your presentation carefully. Didn’t he at least suggest they might have some positive qualities and indeed not simply qualify for euthanising?
«It’s paradoxical how neurodiversity could idolize a person who used such disparaging terms on his patients.»
No more so than the way that Churchill is treated as some great hero in the UK, even having his face «proudly» (though cringeingly in my own case) on our banknotes.
My understanding is that in France the thinking on autism is mainly very backward, still in the Bettelheim era. I wonder what the general position is in German lands.
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I’ve been using a lot of your space in your blogs. I just fear backlash, I admire Jonathan for his bravery. How would it being part of Cortical Chauvinism work out?
Would I write then you put it on your blog, similar to Yuval’s articles?
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To Robin, (I don’t see a reply button, so this may be sent to Manuel),
True, he may have been a man of his time. I haven’t seen people admit that and people read his works without taking that into account for the haters/troll types.
I neither see the other side neurodiversity admitting «yes he did say those things».
Churchill, yes, the disaster at Gallipole, the Bengal Famine and firebombing half a million people dead even when the war was practically won.
I don’t know about France, but I hear they do deny ADHD.
I will avoid googling about it, don’t want to see anything more upsetting.
Inbetween the trolls/haters, neurodiversity, and anti vaccinators, or indifference in some countries, it’s hard to not feel abandoned.
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