#title The Genius of Autism
#subtitle A new view of the mind and mental illness
#author Christopher Badcock
#date April 2020
#source <[[https://doi.org/10.13140/RG.2.2.26234.85448][doi.org/10.13140/RG.2.2.26234.85448]]>
#lang en
#pubdate 2023-11-30T14:02:24
#topics autism
** Preface
The origins of this book go back to the late 1990s when Charles Crawford asked me to contribute a chapter to a book on the applications of evolutionary psychology {1} which was pre-published on the Great Debate website in 2002 {2}. There I first developed the concepts of mentalistic and mechanistic cognition, but the few thousand words available to me were self-evidently too few to enable me to do more than sketch out the idea and its far-reaching implications, and so I immediately began work on something longer, which eventually became this book.
At the same time, it occurred to me that the striking antithesis that I had noted between the symptoms of autism and paranoid schizophrenia was reminiscent of that seen between those of Prader-Willi and Angelman syndromes: two developmental disorders not long before discovered to be due to oppositely transposed disorders in imprinting at the same site on chromosome 15. In 2002 I got into correspondence with Prof Bernard Crespi at Simon Fraser University in Vancouver, and repeated my suggestion. To my great pleasure and surprise, Prof Crespi—a leading geneticist, and not a complete amateur like myself—took up the idea and together we published two papers outlining the theory in scientific journals {3} {4} to be followed by a third by Crespi alone: {5}. In doing so, Prof Crespi convinced me that the pattern I had first noticed probably applied to most psychotic illnesses, and not just to paranoia, as I had originally supposed, and chapter 5 of this book summarizes this view (illustrated by diagram 5.1, originally devised by Prof Crespi and reproduced here with his kind permission). However, in writing that particular chapter I had cause to go back to a manuscript of mine originally entitled, The Maternal Brain and the Battle of the Sexes in the Mind, and the present chapter 5 also draws on the ideas of that earlier, unpublished work. But clearly, any progress I may have made here is largely thanks to Prof Crespi. Suffice it to say that the present book could not have been written without his input and inspiration, and will owe any success it has as much to him as to its ostensible author.
My experience of teaching some of the material covered here to students following my courses at the London School of Economics in recent years has convinced me that autism is a subject that resonates with many people in an often quite surprising way. I was certainly astonished to find how many of my students either had friends and relatives who were diagnosed with autistic spectrum disorders or had had personal experience of autism in other ways (such as helping out at special schools and camps). Indeed, following the LSE’s enlightened decision to recognize Asperger’s syndrome as a disability, I was delighted by the number of Asperger’s students who actually registered for my courses, and deeply impressed with the courage of those who openly admitted their so-called disability in class discussions. So I must thank all those students for their contributions, along with my sons, James and Louis, and my wife, Lenis. Additionally I must thank Abdallah Badahdah, Simon Baron-Cohen, Kingsley Browne, Vikas Chandra, Martin Conway, Charles Crawford, Tom Dickins, Diana Fleischman, Janet Foster, the late and much lamented Bill Hamilton, Anthony Holland, Ayla and Nick Humphrey, Satoshi Kanazawa, Nicola Knight, Alan Lloyd,
Alex and Marian Monto, Rebecca Sear, John Skoyles, Peter Sozou, Sarita Soni, Thomas Suddendorf, Andy Thompson, Richard Webb, and Andy Wells. However, responsibility for everything said here remains of course entirely my own.
Christopher Badcock
16th August 2006
** 1. Mentalism, Autism, and Aliens
Like many important developments in science, the disorder we now know as autism was discovered more or less simultaneously by two independent researchers. In 1943 Leo Kanner (1896-1981) published a book based on eleven children at Johns Hopkins University Hospital in Baltimore, and in 1944 Hans Asperger (1906-1980) independently described four similar cases in Vienna. Kanner called the condition early infantile autism and Asperger autistic psychopathy. The term autism was originally introduced by the famous Swiss psychiatrist, Eugen Bleuler (1857-1939) to describe the characteristic alienation from reality found in schizophrenia (itself another Bleuler coinage). He derived it from the Greek autos (autos) meaning “self”. However, this term is often rendered as “dereism” or “dereistic thinking” in translations of Bleuler’s writings, with the result that today autism is almost exclusively associated with the syndrome described by Kanner and Asperger {6}. Nevertheless, it is worth noting that from the very beginning autism and schizophrenia were linked—albeit purely terminologically—and with the benefit of hindsight you might wonder to what extent this reflected inklings about the possible connection between the two disorders which it will be a major theme of this book to explore.
Autism is a disorder which usually first becomes apparent in childhood, mainly as a result of failure to develop normally. As one account puts it, “You hear a great deal about children with autism, far less about adults. In fact, autism starts to be noticed in childhood, but it is not a disorder of childhood. Instead it is a disorder of development” {7}. A consensus panel of the American Academy of Neurology suggested recently that a child with any of the following symptoms should be evaluated for possible autism: no babbling by 12 months; no gesturing, pointing, or waving good-bye by 12 months; no single words by 16 months; no two words spoken together spontaneously by 24 months; and any loss of language or social skills at any time {8}. Nevertheless, children can develop normally up to a certain point, and then regress; while others can appear to have early delays in these respects which are later fully compensated and leave no lasting deficits {9}. Typical symptoms of autism are set out in text box 1.1 along with a number of other features often mentioned in connection with autism although not found in all cases.[1]
[1] For a fictitious, but remarkable insight into the world of a child with an autistic disorder see Mark Haddon’s novel, The Curious Incident of the Dog in the Night-time {10}. Haddon, M., The Curious Incident of the Dog in the Night-time. 2003, London: Jonathan Cape. 271.
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**Text box 1.1: Typical symptoms of autism**
- social deficits in non-verbal communication such as eye-contact, gesture, facial expression, and body language;
- self-absorption, egocentricity, and lack of awareness of and insensitivity to others, with difficulty in establishing relationships, friendships, or peer-relations;
- delay, or total lack of language competence, with communication deficits in speech, gesture, and conversation;
- routinized, repetitive, or stereotyped movements, with distress over change and insistence on routine, or a compulsion to carry out rituals;
- fragmented sensory perception with inability to generalize, and pre-occupation with parts rather than wholes;
- abnormal pre-occupation with or intensity of interest in one subject or activity, perhaps with isolated areas of expertise and/or exceptional rote memory alongside more general cognitive impairment.
**Additional symptoms often found in autism**
- unusual beauty, often looking younger than they are, with a characteristic “autistic look”; odd or unusual gait;
- insensitivity to pain, often combined with insensitivity to cold (and sometimes lack of fear of heights and an amazing ability to survive falls);
- synaesthesia (mixing of perceptual categories) with confusion between different senses; problems with depth-perception, “white-out” effects and other visual deficits, particularly in relation to moving objects, strange places, or novel situations;
- unusual sensitivity to smell, sound, or other sensory perceptions, sometimes with sensations of “sensory overload”;
- allergic or phobic reactions to specific foods, smells, or sensory perceptions, with resulting fastidious food preferences and avoidances;
- bowel disorders;
- sleep disorders;
- epilepsy;
- intolerance of itchy and/or tight clothing;
- chronic anxiety, often with excessive startle and fear reactions;
- fear of crowds and strangers, and dislike of socializing;
- panic reactions at being touched or hugged by people;
- a liking for being wedged in small, enclosing spaces, or tightly squeezed into corners;
- a fascination for machines, mechanisms, and gadgets of all kinds.
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An important aspect of diagnosis in autism is the extreme variability of the symptoms. For example, children diagnosed with autism within the same family can show some strikingly different symptoms {11}, and authorities point out that “None of the criteria exactly describes every individual with autism. Autism presents in a myriad of ways; every individual with autism is different and unique, and has features that would lead a person superficially examining them to say that this person can’t have autism” {12}.
According to the Fourth, Text Revision Edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the incidence of autism is five cases per 10,000 individuals, with reported rates ranging from two to 20 cases per 10,000 {13}. But a study of 788 pairs of twins investigating autistic tendencies using the Social Responsiveness Scale suggested that the point at which a person is considered autistic is somewhat arbitrary and that autistic deficits are continuously distributed in the population with an incidence of 1.4 per cent for boys and 0.3 per cent for girls {14}. Diagnosed autism, in other words, may just be an extreme point on a much wider spectrum that shades into normality, with milder forms of autism being much more common than previously supposed. According to a recent study of 56,946 children aged 9-10 carried out in South-East England, the prevalence of autism spectrum disorders varies between 25 and 116 per 10,000, depending on the exact diagnostic criteria used. This study concluded that the prevalence of autism and related disorders is substantially greater than previously recognised, and amounted to about one per cent of the child population. Whether the increase is due to better ascertainment, broadening diagnostic criteria, or increased incidence remained unclear, but the study added that a true rise in incidence cannot be ruled out {15}.
* * *
You cannot go far in reading what autistics say about autism before you come across aliens. You soon find them saying things like, “I felt like an alien, as though I had come to earth from somewhere else” {16}. Other autistics have called their disorder “wrong planet syndrome” {17}, and protest that they “don’t remember signing up for this planet” {18}. Another autistic author who entitled her book Through the Eyes of Aliens comments that “Many autistic people affectionately, humorously refer to themselves as aliens. They feel displaced on a vast planet, which has a code of life, and understanding they can’t ever quite subscribe to.” She calls them “mysterious Martians who don’t know the culture of the planet they have been misplaced on” {19}. One of the best-know autistic authors, Temple Grandin, has described herself in the title of a well-known book as An Anthropologist on Mars {20}, and the writer and political activist Simone Weil (1909-43) who has been posthumously diagnosed with an autistic disorder was called “my little Martian” by one of her professors {21}. Two other authors gave their account of their “lives in the universe of autism” the interrogative title, Women From Another Planet? {22}.
Contact with aliens is a staple of science-fiction, but if it ever happened in reality, the first reaction of those in authority would almost certainly be an attempt to protect the public by quarantining the extra-terrestrials. Certainly, the parallel with alien contact seems to have been borne out in what you might regard as the first phase of the human race’s encounter with autism, running from its discovery during World War 2 to the early 1980s. The symbolism of quarantine is apt here because at this time autism was seen largely as a childhood disorder featuring severe mental retardation. You never heard much about adult autistics, and the impression you got was that, for someone with autism, there was no such thing as adulthood. Many autistics lived out their lives in long-stay hospitals (“asylums” as they were called then), effectively in a state of institutionalized infantilism, sometimes under regimes of real cruelty (as we shall see in a moment). Although this may have been rationalized at the time as being for the good of the individuals concerned rather than to protect society as a whole, the fact remains that, like aliens from outer space, those diagnosed autistic during this period were likely to be incarcerated in institutions of various kinds, and certainly to have been regarded as seriously alienated in the psychiatric sense of the word.
One of the worst examples of this is found in the person of Bruno Bettelheim (19031990) who became associated with the claim that autism was an entirely mental illness caused notoriously by “refrigerator mothers”. In fact that term was first used by Leo Kanner to describe the frequently high-achieving, emotionally cold parents that he had noticed often tended to have autistic children {23}. As Uta Frith points out, “This caricature of bad mothering overlaps with the caricature of the career woman, in particular of the ‘intellectual’ type. An abnormally detached child—a child who is unable to relate lovingly—is a fitting punishment for the woman who neglected to be a full-time devoted wife and mother” {24}! Nevertheless, Kanner never blamed mothers for their children’s autism and in 1941 had even published In Defense of Mothers: How to Bring up Children in Spite of the More Zealous Psychologists {25}.
Bettelheim, however, was a different matter. As Director of the University of Chicago’s Sonia Shankman Orthogenic School, he successfully applied to the Ford Foundation in 1956 for a research grant for the then enormous sum of $342,500 to discover, besides other things, what the parents of autistic children had done “wrong” in raising them {26}. The result was a number of articles, films, and a widely- read and highly influential book, The Empty Fortress {27}. Bettelheim started with what he alleged were a dozen autistic children (six of each sex), and from the beginning claimed spectacular successes in treating them. The drawings of a girl called Mary and a boy called Dick were said to illustrate their improvement, and along with the case of “Joey, A Mechanical Boy,” were published in Scientific American {28}. According to Bettelheim, Joey was a child who had been robbed of his humanity by parents who completely ignored him, did not want to care for him, and punished him when he cried. The result was that Joey had become a robot who could only eat when he was connected to an imaginary power source, only defecate when holding vacuum tubes that powered his bowels, and only avoided saying the wrong things thanks to an internal “criticizer” {29}. In other words, if Joey had become something of an alien, it was not because he was from outer space but because his parents had made him into one.
Bettelheim had been incarcerated in the Dachau and Buchenwald concentration camps for ten and a half months in 1938-9 and believed that he saw a valid parallel between the prisoners known as “Moslems” in the camps, and autistic children. Moslem was the name for prisoners who had given up all hope, avoided all eye contact, often refused to eat, and became completely passive and zombie-like. If autistic children resembled them in their behaviour, it could only be because their homes were the equivalent of concentration camps, and their parents—mothers especially—that of the cruel, persecuting guards. As early as 1950 Bettelheim had claimed that “it is common knowledge that the difficulties of almost all emotionally disturbed children have originated in the relation to the parent” {30}. In The Empty Fortress Bettelheim stated his belief that “the precipitating factor in infantile autism is the parent’s wish that the child should not exist” {31}.
Bettelheim thought that he had found further evidence of this in the case of so-called “Wolf Children” found near the Indian city of Orissa. Two girls had been discovered in a wolf’s lair along with cubs in 1920. The girls were christened Amala and Kamala, and were believed to be aged about three and five respectively. Both ate only raw meat, growled if approached, and walked on all fours. Amala died within a year, but Kamala eventually began to play with other children and learnt about a dozen words, dying in 1929 {32}. Bettelheim believed that Amala and Kamala “were probably utterly unacceptable to their parents for one reason or another. This is characteristic of all autistic children, no matter of what age; the parents manage to disengage themselves from them by placing them in an institution (...), or by setting them to fend for themselves in the wilderness, or, the most likely, by not pursuing them when they run away” {33}. Bettelheim concluded that “feral children seem to be produced not when wolves behave like mothers, but when mothers behave like nonhumans” {34}.
In her classic study of autism, Uta Frith considers other cases of feral children, notably The Wild Boy of Aveyron and Kaspar Hauser. The latter was found in Nuremberg in 1828 with a letter addressed to the captain of the cavalry requesting that he should be allowed to serve as a soldier, and giving the date of his birth as 1812. His verbal ability was largely limited to the repetition of one rote-learned phrase to the effect that he wanted to be a cavalryman like his father, but he could nevertheless write his name and the letters of the alphabet. He was unable to walk, evidently through lack of practice, and appeared to have been kept in a cellar with a wooden rocking-horse for many years and fed only bread and water. Hauser grew two inches in a few weeks, began to have dreams, and learned avidly—eventually even mastering some Latin. He was found to have an excellent memory, despite almost complete amnesia about his past. Although his senses seemed unusually acute, he lacked perception of visual depth so that he was unable to correctly judge the size of objects seen at a distance. He was reported to have been “astonished at the discovery of an invisible inner world of the mind” and was eventually murdered by an unknown assassin on a second attempt in 1833 {35}.
The Wild Boy of Aveyron was found thirty-odd years earlier, scarred, naked and living wild in woods where he had been sighted for a couple of years before his capture. Believed to be aged about 12 at that time, he was found to be mute—but not deaf—and completely asocial. A local physician, Dr Itard, attempted to educate him with limited success and published a book on the case in 1801. Anticipating Bettelheim’s view of autism, Itard has been described as believing that “a human being was a social construct” and that the Wild Boy’s deficits were “due not to any inherent genetic failure, but simply to the fact that he had been excluded from human society at a vital stage in his development. His idiocy was thus due not to nature, but to the lack of nurture” {36}. Although the Wild Boy learned some sign language, he never spoke or developed any significant social skills or attachments. By contrast, Hauser developed so far and so fast in respects of language and social skills that some claimed he was a fraud, and had never in fact been incarcerated as he claimed {37}.
A careful analysis of both cases leads Uta Frith to conclude that the Aveyron boy perhaps was a case of autism, but that Kaspar Hauser probably was not. On the contrary, Frith deduces that Hauser was almost certainly a case of severe neglect and resembled the Romanian orphans who were brought to the UK for adoption in the 1980s. Most of these 165 children were under a year old (although some were well over) and all had suffered serious neglect in over-crowded orphanages. By the age of four most had recovered, but 11 children who were older than the rest showed symptoms reminiscent of autism, such as difficulties in forming normal relationships, deficits in speech and conversation, compulsive touching and smelling, and narrow interests in things like watches, vacuum cleaners, and plumbing. However, by age 6 most of these symptoms had vanished or ameliorated and Frith concludes that, contrary to what Bettelheim would have predicted, these children did not in fact have autism. Instead, she concludes that they suffered from a developmental delay in aspects of social and non-social development than can mimic autism. Evidence for this can be found in the remarkable fact that intelligence scores increased by 20 points in the group of eleven “quasi-autistic” orphans, compared to an average increase of only 7 points in the rest of the group {38}.
Despite Bettelheim’s often repeated claims of spectacular therapeutic success, objective evidence of it is hard to come by. Indeed, when challenged by a reviewer to produce real evidence in relation to his treatment of alleged autistic children, Bettelheim stated that “I wanted the reader to form his opinion on the basis of the clinical material. This he can evaluate by his own empathy, and in terms of its inner logic, and not by any reliance on figures which, however carefully checked by my associates, and against our records, would still have to be accepted on my say so” {39}. But according to the testimony of Jacquelyn Seevak Sanders, Bettelheim’s primary assistant and hand-picked successor at the Orthogenic School, “you couldn't believe anything Bettelheim said” {40}. Despite having only a single doctorate in philosophy without honours, Bettelheim claimed to have passed doctoral degrees summa cum laude in three subjects, adding psychology and art history. Additionally he falsely asserted that he had “training in all fields of psychology”, and even to have “studied with Freud”! In his application for the Ford grant and repeatedly throughout his life, Bettelheim claimed to have had two autistic children who lived with him in his home for many years, and whom he successfully treated. In reality, Patricia Lyne was the only child the Bettelheims took into their home in Vienna, and she was never diagnosed as autistic. Indeed, she later wrote that “Bruno did not play any role in bringing me up” {41}.
Clearly, Bettelheim’s “say-so” hardly inspires confidence, and certainly does not do so in relation to his controversial claims of therapeutic success, which systematic follow-up studies by others showed were characteristic mixtures of lies and exaggerations {42}. Indeed, even where his ostensible successes are concerned, Bettelheim’s talent for misrepresentation gives grounds for suspicion. William Blau, a “counsellor” (or, less pretentiously, a teacher) employed at the Orthogenic School in the late 1940s and who quickly came to regard Bettelheim as a bullying cult leader, said that in his experience none of the children seemed to him to be nearly as disturbed as Bettelheim proclaimed them to be. One explanation may be that Bettelheim told a colleague to be sure to admit some children whom he knew not to be too disturbed, adding that “You need to develop some credibility in the community, and the way to do it is to show some successes” {43}.
Bettelheim claimed that the regime at the Orthogenic School under his direction distilled therapeutic insights from his experience in concentration camps, and there certainly were some arresting parallels. At his insistence, children were separated from their parents for years at a time and often denied intervening visits {44}. As one former student put it in a recently published autobiographical account of his experiences at the school, “I was a prisoner as surely as any prince locked in the Tower or the Bastille” {45}. Indeed, many children under his care served longer sentences than Bettelheim himself had done in the concentration camps.
Although Bettelheim condemned corporal punishment in his public pronouncements, he used it regularly himself at the Orthogenic School, and encouraged others to do the same. Even though the writer from whom I have just quoted seems to have retained a remarkably positive attitude towards the man who everyone—himself included— called “the Big Bad Wolf”, even he admits in passing that he was regularly slapped a couple of times a month by Bettelheim {46}. But other children were not so fortunate. According to testimony given to one recent biographer,
Alida Jatich wrote that she lived in terror of the director, who, when she was fifteen, pulled her naked out of a shower and beat her in front of a room full of dormmates and counsellors. She said that he was angry because she was withdrawn and did not want to socialize with her peers and because she generally disapproved of him and the school. “He started slapping me over and over, dragging me out by the hair. I tried to grab a towel to cover myself but was not able to do that.” {47}
Other girls were routinely beaten with a belt, while boys were beaten for masturbating at times, then encouraged to do so at others. A number of other former students allege serious sexual assaults, and one reported going to bed with multiple layers of underwear on to try to protect herself from Bettelheim’s nocturnal groping. Bettelheim claimed that he fondled the breasts of girls after beating them “to show them he loved them”. Yet another former resident wrote that there was “always— always—a visceral, stomach-tightening ... terror in all when [Bettelheim] made his nocturnal and afternoon approaches” {48}. Bettelheim’s deputy and successor, Jacquelyn Sanders, later admitted that “we became abusers of abused children,” that “children who had aggressive tendencies identified with this aspect of our approach,” and that “we became actors in sexual-sado-masochistic fantasies” {49}. The biographer who published these findings concludes that “physical and emotional abuse was a part of everyday life at the Orthogenic School.” He adds that Bettelheim “did not hit or invade the privacy of every child... but everyone saw or heard about his frightening explosions, and no one was exempt from the anxiety they produced, an anxiety that in some cases did make the children feel like frightened prisoners” {50}.
* * *
If contact with extra-terrestrial beings were to occur in reality, quarantine would hopefully just be a preliminary to an effort to communicate with them and to find out who or what they really were. Science fiction often portrays alien beings as immediately able to understand and to communicate with humans—even to the point of speaking English and having excellent manners! But a moment’s reflection is enough to show that in reality things would probably be very different. Human technology and material culture might be pretty much self-evident to any intelligent being able to travel here or communicate with us, simply because material culture exploits principles of science and technology which are universal. But we have no way of knowing whether the fundamental principles of human behaviour would be as self-evident to an extra-terrestrial species which might be biologically very different from us. It might take some time and careful analysis for aliens to begin to understand what are self-evident realities to us, such as the self, consciousness, or personal moral responsibility. The very idea of the mind as an entity might be alien to the aliens, whose initial reaction to human beings might be wholly behavioural and completely lacking in the appreciation of mental factors such as intention, meaning, and emotion. In other words, extra-terrestrials might regard us as we might creatures very different from ourselves, such as plants, insects, or bacteria. And at the very least, actual extraterrestrials, like human anthropologists who visit foreign cultures, would have to learn our languages and understand our cultural conventions: they would be Martian anthropologists on Earth, if you like.
Admittedly, this is just speculation about something that will almost certainly never happen. But here again, there is a striking parallel with autism. By contrast to the incomprehension of the past, today many symptoms of autism are understood in terms of one specific deficit: that relating to the mind and an ability to understand and interpret your own and other people’s behaviour in purely mental terms. Here autistics show characteristic short-falls which go a long way to explaining their own feeling of being aliens from human society (not to mention the alienation and rejection that they commonly experience from other human beings who simply cannot understand them). Like real extra-terrestrials might be expected to be, many autistics are either totally mute or have serious verbal shortcomings, and even when they can speak they often interpret things said to them too literally, completely fail to understand metaphors, or show an inability to see what is funny in a joke. And again like any actual aliens you could realistically imagine and who would almost certainly be physically very different from ourselves, autistics are poor at recognizing and interpreting emotional expressions, gestures, and body-language.
Where social deficits are concerned, autism has been graphically described as “mindblindness” {51}. Originally, the equivalent German term, Seelenblindheit, was coined by the neurologist, Heinrich Lissauer (1861-1891) to describe blindness whose cause lay not in the eye but in the brain (what is today known as blind-sight {52}). Here I shall use the term exclusively in the modern sense and interpret it to mean figurative blindness to what is in another person’s mind—or indeed, even in your own.
It is certainly the case that autistic people can be distressed by their inability to understand what other people are thinking or feeling. For example, one young autistic man complained that he couldn’t “mind-read”. He explained that other people seem to have a special sense by which they can read other people’s thoughts and anticipate their responses and feelings. He knew this because they managed to avoid upsetting people whereas he was always “putting his foot in it”: not realizing that he was doing or saying the wrong thing until after the other person became angry and upset ( {53} quoting {54}). But this problem is not linked in any way to deficits in intelligence, education, or opportunity. The philosopher, A. J. Ayer (1910-89) for example, who has been posthumously diagnosed with an autistic disorder, once remarked that none of his philosophical preoccupations had given him “as much trouble as the problem of our knowledge of other minds” {55}.
A critical assessment of such deficits is the so-called false belief or Sally-Anne test. In the simplest version, a child is shown a tube of sweets and asked what they think is inside. Of course, the child replies, “sweets!” But the tube is opened to reveal a pencil. The child is then asked what another person, who has not yet been shown the tube and its unexpected contents, will think is inside it. Alternatively, a child is shown two dolls, Sally and Anne, each of which has a toy box. The child sees that Sally has a toy in her box, but Anne does not. Now the child is asked to imagine that Sally leaves the room, and while she is absent, Anne takes Sally’s toy out of Sally’s box and puts it into her own box, and shuts it again. Now Sally returns. The crucial question is: where does Sally think her toy is now? The majority of four-year old children can appreciate Sally’s false belief that her toy is still in her box despite the fact that they personally know that it is not, but autistic children even considerably older typically reply that Sally now thinks that her toy is in Anne’s box. Exactly the same happens with the tube of sweets: most four-year-olds realize that someone not shown the pencil inside would think it contained sweets, but autistic children typically fail to understand this. Such reactions are taken to indicate that those who fail the tests are answering on the basis of their own knowledge, and seem unable to appreciate others’ ignorance because they lack the ability to understand another person’s different state of mind {56} {57}.
The Sally-Anne/sweet-tube test may sound so elementary to most adults that they fail to see how anyone could fail it. But many people in the modern world have probably experienced at least one situation where they are likely to feel sure that another adult has in effect failed the test. This is in the common experience of finding that instructions provided for assembling flat-packed goods, or operating new gadgets, machines, or software fail in their intended aim. Frustrated users are likely to insult the intelligence of the authors of the instructions, or impugn their good faith in genuinely wanting them to succeed. But the truth is often likely to be that the instructions have been written by those who already fully understand the product whose use or assembly they are trying to explain to beginners.
Such failures in communication may often be attributable to the fact that the authors of the instruction manual understand the situation so well that they find it hard—if not impossible—to imagine how a complete beginner will feel, and allow their easy expertise to obscure their comprehension of the difficulties of their readers. Furthermore, the same reasoning probably explains why the most brilliant academics are often the worst teachers—particularly when it comes to teaching novices. It may simply be that they find the subject so easy and so obvious that they fail to appreciate the difficulties it holds for beginners who do not share their existing knowledge and habitual mastery of the subject. But clearly, teachers need to be able to understand what their students do not know before they can successfully teach them what they themselves know already. In short, understanding others’ state of awareness is the essence of the Sally-Anne/sweet-tube test, and the frequency with which printed or didactic instruction fails in its intended purpose is testimony enough to the fact that inability to appreciate false belief is certainly not confined to childhood and to autism but can be found throughout life and in otherwise perfectly normal people.
According to Premack and Woodruff, who originated the term, theory of mind describes the ability to infer that other people experience mental states like our own. They claim that such a capacity may properly be viewed as a theory because mental states are not directly observable, and can be used to make predictions about the behaviour of others {58}. Experiments like the Sally-Anne test described above suggest that normal children acquire a theory of mind between the ages of three and five, but that autistic children are notably lacking in this respect. Studies show that autistic children do not differ from others in their ability to understand the functions of an internal organ like the heart. Nor are they deficient in their knowledge about the location of organs such as liver or brain. However, whereas other children are able to understand that the brain has purely mental functions, autistic children tend to associate it only with behavioural functions, so that it appears that specifically mental, unobservable events are beyond their comprehension {59}.
Today a great deal of evidence of many kinds has accumulated in support of the view that theory-of-mind deficits characterize autism {60} {61}. Indeed, the latest research has even begun to reveal the brain structures that might be involved. In a recent experiment using brain-imaging, 10 autistic and 10 normal subjects viewed animations of two moving triangles on a screen in three different conditions: moving randomly, moving in a goal-directed fashion (chasing, fighting), and moving interactively with implied intentions (coaxing, tricking). The last condition frequently elicited descriptions in terms of mental states that viewers attributed to the triangles. The autism group gave fewer and less accurate descriptions of these latter animations, but equally accurate descriptions of the other animations compared with controls. While viewing animations that elicited mentalizing, in contrast to randomly moving shapes, the normal group showed increased activation in parts of the brain previously identified with theory of mind functions. The autism group showed less activation than the normal group in all these regions. As the researches comment: “The claim that individuals with autism spectrum disorders, regardless of general intelligence, have an impairment in the attribution of mental states, has been confirmed once again” {62}. According to another authority, “we can now take for granted that there is such a thing as ‘mentalizing,’ and that the probably innate physiological basis of this ability is at fault in autism. The neural network that supports mentalizing can already be seen through a scanner” {63}.
* * *
Although alien beings arriving on Earth might indeed reveal deficits in their ability to understand human minds comparable to those found in autistics, it is also possible that they might nevertheless understand things which we do not—perhaps precisely because of their limitations. For example, simply because they were not human, extraterrestrial visitors to the Earth might not make the sharp distinction that we make between ourselves and animals. On the contrary, they might take the wholly objective view that we were just one animal species among many, and perhaps appreciate as much about other species as they failed to understand about us. At the very least, they might be expected not to share our view of human pre-eminence and superiority over the rest of creation, and certainly, something very similar appears to be true of some autistics.
A case in point is Temple Grandin, one of the world’s best known—and certainly, most eminent—autistics. She recalls that as a two-year-old child she showed the symptoms of classic autism: no speech, poor eye contact, tantrums, appearance of deafness, no interest in people, and constant staring off into space {64}. The psychiatrist and writer Oliver Sacks, meeting her in adult life, reported that Temple Grandin seemed largely devoid of an implicit knowledge of social conventions and of cultural pre-suppositions which most normal people accumulate throughout life on the basis of experience and encounters with others. Lacking it, she had instead to “compute” others’ intentions and states of mind, to try to make formal and explicit what for the rest of us is second nature {65}.
But whatever her shortcomings where comprehension of the characteristically human mind is concerned, Temple Grandin’s expertise in understanding the animal mind is so great that her services as a consultant on animal behaviour are widely sought, and she has become an acknowledged international authority on the humane handling of cattle. Indeed, in the words of Marian Stamp Dawkins,
she has arguably done more than anyone else in the world to improve the welfare of animals in a practical way. Her major contribution has been to go into places that most of us would probably prefer not to think about—slaughterhouses—and imagine what it would be like to be an animal on its way to being killed. She has dramatically improved the welfare of these animals, not by making any expensive modifications to the slaughter plants but by suggesting simple changes that cost nothing, such as removing a yellow coat hanging over a grey fence, or altering the lighting to eliminate shiny reflections from a puddle. By removing stimuli that frighten cattle and cause them to stop and pile up on one another, the cattle move more easily, they don’t slip and fall, and the use of electric goads is almost unnecessary. These things are all very simple and effective. It’s just that no one had thought of them before. {66}
As Grandin herself puts it in her most recent book, “Autism made school and social life hard, but it made animals easy” {67}. Indeed, she remarks that “Autism is a kind of way station on the road from animals to humans...” {68}. Speaking of herself as an autistic, she adds that “We use our animal brains more than normal people do, because we have to. We don’t have any choice. Autistic people are closer to animals than normal people are {69} [author’s emphasis]. According to another autistic woman, “an autistic person regards her environment the same way as an animal” {70}. Certainly, in the following comments of Grandin’s recorded by Sacks about a cow that had been separated from her calf mental states are inferred and predictions made about them in just the way that Premack and Woodruff argued typify a true theory of mind:
“That’s not a happy cow,” Temple said. “That’s one sad, unhappy, upset cow. She wants her baby. Bellowing for it, hunting for it. She’ll forget for a while, then start again. It’s like grieving, mourning—not much written about it. People don’t like to allow them thoughts or feelings. Skinner wouldn’t allow them.” {71}
The reference to Skinner is, of course, to the behaviourist, Burrhus Frederic Skinner (1904-90). As an undergraduate, Temple Grandin met Skinner. Before the meeting she saw him as a divine being, indeed, “He was the god of psychology,” and visiting him was “like going to see the Pope in the Vatican. . But when I went into his office, it was a big letdown. He was just a normal-looking man.” Indeed, with characteristic autistic candour she recounts that the god-like psychologist revealed his feet of clay when he tried to grope his undergraduate admirer! But Grandin put him in his place, observing that while he might look at her legs, he was not permitted to touch them: an exercise in negative re-inforcement that seems to have worked as well on the great behaviourist as on any laboratory animal {72}.
Behaviourism derived its name from its dogmatic assertion that the mind was a “black box” that could not be opened and about whose internal workings science could not speculate. According to Skinner, words like “mind” and “ideas” were “invented for the sole purpose of providing spurious explanations”. And because “mental or psychic events are asserted to lack the dimensions of physical science, we have an additional reason for rejecting them.” Skinner’s fellow behaviourist, John B. Watson (18781958), proclaimed that “the time has come when psychology must discard all reference to consciousness” and be purged of “all subjective terms such as sensation, perception, image, desire, purpose, and even thinking and emotion as they are subjectively defined” {73}. All that could be studied objectively was what went into the brain in the form of stimuli and what came out of it as observed behaviour. Nothing else could be said. Behaviourism was the study of behaviour, not of the mind—mind-blind psychology, if ever there was.
At much the same time that Behaviourism was becoming dominant in the West, the teachings of the founding father of behaviourist psychology, Ivan Pavlov (1849-1936) were proclaimed official dogma in the Soviet Union, becoming in the words of one historian “hypertrophied to the point of absurdity” in the process. Anyone of a different mind was persecuted as an “idealist” and “deprived of normal opportunities to carry out scientific work” {74}. Pavlov’s fundamental discovery was of course conditioning, and the fact that you could condition dogs to salivate at the sight of a technician’s white coat or the sound of a bell suggested that all behaviour was learned. Indeed, Watson asserted that psychology no longer had any need of the term “instinct” because “Everything we have been in the habit of calling an instinct today is largely the result of training”. Even breathing or the beating of the heart was seen as “an unlearned act ... becoming conditioned shortly after birth” {75}. Watson boasted that with behaviourist conditioning he could mould a child to any desired psychological specification:
we no longer believe in inherited capacities, talent, temperament, mental constitution, and characteristics. Give me a dozen healthy infants, well formed, and my own specified world to bring them up in and I’ll guarantee to take any one at random and train him to become any type of specialist I might select—doctor, lawyer, merchantchief and yes, even beggar-man and thief, regardless of the talents, penchants, tendencies, abilities, vocations, and race of his ancestors. [Watson, 1970 #230 p. 104]
In like manner, Skinner claimed that “All behavior is constructed by a continual process of differential reinforcement from undifferentiated behavior, just as a sculptor shapes his figure from a lump of clay” {76}. Here the “sculptor” is a metaphor, but in reality behaviourism appeared to give enormous influence to persons who could mould the behaviour of others, such as parents, professors, and politicians. Perhaps it was the fact that behaviourism extolled the power of conditioning to an extreme degree and reduced the mind to little more than a blank slate that made the doctrine so appealing to totalitarian regimes like that in the Soviet Union. Clearly, the Marxist doctrine that consciousness originates in society fitted nicely with Pavlovian conditioning to suggest that that the mind of the individual could be discounted completely and moulded in whatever way that the higher powers of politics dictated.
But such a denial of the mind was not limited to behaviourist psychologists or Marxist thought-police. According to George Williams, one of the most eminent of twentiethcentury Darwinists:
only confusion can arise from the use of an animal-mind concept in any explanatory role in biological studies of behaviour. . Mind may be self evident to most people, but I see only a remote possibility of its being made logically or empirically evident
... I feel intuitively that my daughter’s horse has a mind. I am even more convinced that my daughter has. Neither conclusion is supported by reason or evidence. Only if it violates physical laws would mind be a factor that biologists would have to deal with. . There is no such evidence for mind as an entity that interferes with physical processes, and therefore there can be no physical or biological science of mind. . no kind of material reductionism can approach any mental phenomenon. {77}
Williams concludes that the “solution to the non-objectivity of mind” is “to exclude mind from all biological discussion”. Elsewhere Williams castigates what he calls “lubricious slides into discussions of pleasure and anxiety and other concepts proper to the mental domain” as nothing other than “flights of unreason” on the part of authors who “claim to have provided a physical explanation of mental phenomena” {78} Similar comments to those of Williams can be found in the work of the ethologists, Niko Tinbergen (1907-88) and Konrad Lorenz (1903-89). These writers concentrated on observed behaviour and mistrusted mental terms, which were often dismissed as “anthropomorphic” (that is, committing the error of attributing human thoughts and feelings to animals). Such views have been perpetuated and popularized by their pupils, such as Richard Dawkins, according to whom “Ethologists . do not permit words like ‘fear’, ‘anger’, ‘libido’ and even ‘hope’, but only as formally defined intervening variables or hypothetical constructs” {79}.
Such a conscious, intentional rejection of all things mental is certainly comparable to the involuntary and unintentional mind-blindness of autistics, but perhaps deserves a term of its own. My suggestion would be anti-mentalism. As such, the term designates a rational belief rather than a cognitive deficit—an anti-mind theory, if you like. But whatever you care to call it, such behaviouristic anti-mentalism was typical of most twentieth-century Darwinists and many students of animal behaviour. The result of such views was what you might call evolutionary, genetic, or ethological behaviourism: “explanations” of behaviour that went directly from the evolutionary, genetic, or ethological factors proposed to the observed behavioural result. Such an approach neglected the mental level of explanation altogether, and at times left you wondering why organisms should be regarded as possessing minds at all—so irrelevant did they seem to behaviour. Where human beings were concerned, evolutionary, genetic, or ethological behaviourism prompted understandable protests that such an approach was “reductionistic” and diminished people to the status of mindless robots, controlled by their genes or ethological programming to act in ways essentially no different from the ways in which an ant or an amoeba might behave. Indeed, wherever it was found anti-mentalism appeared to do exactly what Bettelheim accused the parents of autistics children of doing: dehumanizing people by treating them as if they were robots, animals, or aliens.
Another virtue of the concept of anti-mentalism is that it implies the existence of what it negates. Mentalism was a term that was originally used to describe stage acts in which the performer appeared to be able to read other people’s thoughts—a feat which was also called “mind-reading”. However, the term is also used in philosophy and psychology to describe what behaviourism attempted to rule out: the belief that the mind is real and that our subjective experience of it provides valid insights for these disciplines. This is the exact contrary of anti-mentalism and describes the essential deficit in mind-blindness: the tendency to infer, interpret and predict mental states in yourself and others—perhaps animals included—in other words, to mindread or to mentalize {80}.
An advantage of thinking in terms of mentalism is that it allows us to dispense with the cumbersome phrase “theory of mind” along with the misleading implications it carries with it, such as the impression it gives that people’s mentalistic abilities spring from a prior conceptual understanding of psychology. This is clearly not the case, because mentalism is an implicit, automatic, unconscious ability that comes as naturally to most normal people as walking or talking. And just as no one needs to study the grammar and syntax of their native tongue in school before being able to speak it competently, or learn anatomy and mechanics before being able to walk, so no normal person needs a course on theory of mind before they can interact socially with other human beings. Theory of mind, in other words, is not a consciously learnt body of propositions like the Special Theory of Relativity or theory of music.
Temple Grandin’s attempts to compensate for her mentalistic deficit by consciously thinking “algorithmically” about human social interactions is what you might call a true “theory of mind” because it is something she has had to learn, apply intentionally, and think about conceptually:
Since I don’t have any social intuition, I rely on pure logic, like an expert computer program, to guide my behavior. I categorize rules according to their logical importance. It is a complex algorithmic decision-making tree. There is a process of using my intellect and logical decision-making for every social decision. Emotion does not guide my decision; it is pure computing. ... Using my system has helped me negotiate every new situation I enter. {81}.
So, paradoxically, autistics like Grandin do have theories about the mind—or, at least, about other people’s minds—because this is the only way they can compensate for the lack of the implicit, automatic, unthinking ability to understand the mind that the phrase “theory of mind” was intended to describe. However, the term “theory of mind” is too well established in the literature to be avoided entirely. So from now on I shall treat it as a phrase equivalent to mentalism, and prefer mentalism and mentalistic as the noun and adjective that refer to the same fundamental concept: human beings’ ability to understand their own minds and behaviour and the minds and behaviour of others in purely mental terms. Indeed, to this extent mentalism can be seen as equivalent to “mind-reading”, “folk psychology”, “social intelligence”, “mentalizing”, {82} or “mindness” {83}.
More recently, empathising has been suggested as another alternative to theory of mind {84}. Clearly, this is intended to avoid exactly the same difficulties with theory of mind that we have just been looking at, and adds an emotional, implicit dimension to mind-reading understood in opposition to mind-blindness. But as Temple Grandin’s remarks above again show, it is not “empathising” as such that characterizes her autistic deficit, but her inability to empathize with human beings. As we saw, she has if anything an enhanced ability to empathize with animals and their feelings, but this seems to contribute little or nothing to her ability to understand people:
The work I do is emotionally difficult for many people, and I am often asked how I can care about animals and be involved in slaughtering them. Perhaps because I am less emotional than other people, it is easier for me to face the idea of death. . However, I am not just an objective, unfeeling observer; I have a sensory empathy for the cattle. When they remain calm I feel calm, and when something goes wrong that causes pain, I also feel their pain. I tune in to what the actual sensations are like to the cattle rather than having the idea of death rile up my emotions. My goal is to reduce suffering and improve the way farm animals are treated. {85}
Again, cases can be found where autistics empathize to an astonishing extent not merely with animals, but even with totally inanimate or even abstract objects as the following quotation from another autistic shows:
I remember being very upset about being introduced to the spelling concept of dropping the “e,” if one exists, at the end of a word when one adds the suffix -ing. My concern over the letter was so great that I talked about it during a counselling session with a psychiatrist I was seeing at the time. He drew the letter of concern on a piece of paper and let it fall to the floor. I had to go to rescue it. I truly felt bad for this letter that was cast aside and dropped to the floor. It was much easier for me at that time to imbue this inanimate object with feelings than people because humankind is full of unpredictable emotions that can be difficult to decode. It was [as] if the object had feelings of its own. Even now, when I see an object damaged I feel badly for it. {86}
All this suggests that it is the peculiarly human, psychological aspects of being able to empathize with other human beings’ mental experience that is lacking in autism, not simply empathy as such. To the extent that this is implied and assumed in the use of “empathising” in this context, it could be seen—along with “theory of mind”, “mentalizing”, and “folk psychology”—as an alternative formulation for what I would prefer to call mentalism. Admittedly, if mentalism were a concept purely appropriate to autism, there might be little point in advocating it in preference to the others we have already discussed. But as I hope to show in the course of this book, the concept of mentalism as introduced here has much wider ramifications than any of the alternatives suggested so far. At the very least, it has a merit as a single noun with an already-current adjective as an alternative to phrases like “theory of mind” and “folk psychology”, or verbs such as “mentalizing”. This alone might be a good enough reason for advocating the use of mentalism in preference.
Finally, the history with which we began suggests one last reason for preferring mentalism to “empathising”. This is that however empathic Bettelheim’s approach to autism may have claimed to be—and this is a claim inherent in all psychotherapy— the practical consequences were anything but empathic in reality. As the biographer from whom I quoted earlier observed, although Bettelheim pretended that he ran the Orthogenic School in a much more humane fashion, his readiness to strike and threaten the children—not to mention tyrannizing the staff much of the time—owed more to the behaviourism of Skinner than to the ideals of Freudian psychotherapy {87}.
Temple Grandin protests that “There’s so much psychodrama in normal people’s lives,” but there was vastly more at the Orthogenic School {88}. Indeed, life there was one long psychodrama for everyone. Emmy Sylvester, a leading assistant from the beginning described Bettelheim as follows: “He was a very bright guy, no doubt about it. But he was also a bad character, full of the lust for power, an absolute monarch, always manipulating people: the kids at the school, the staff, his collaborators” {89}. Staff meetings were used to dissect the counsellors as well as the students’ behaviour:
He saw the sessions “as instruments for challenging staff members to confront themselves He would get into your parents, your brother, your whole personality,” recalled Shelton Key, a counsellor and teacher at the school from 1953 to 1962, who was often so shaken after evening staff sessions that he could not sleep. Few of the staff meetings ended without at least one of the women in tears and several others fighting them back. “When there was a staff meeting before lunch,” recalled one former resident, “you would see many staff members come into the dining room with eyes red from crying.” {90}
On one occasion, Bettelheim suddenly started to slap a child across the face after a comment about her from her counsellor, Nina Helstein, who was deeply shocked. Later Bettelheim asked her about the child, and Helstein made a comment about the child’s behaviour. Bettelheim then replied with a remarkable interpretation even for a so-called psychoanalyst:
“That's right. So when a child is upset, why would you have me hit her?” Helstein was numb with dread at the prospect of challenging her world-famous employer, but somehow managed to say, “Dr B. you do not hit children because I tell you to, you did that.” She said he was enraged by her effrontery. “It was insane. A lot of what went on at the school was, and the staff members went along with it.” {91}
Insane it might have been, but quintessentially mentalistic it certainly was, and the reason that the staff went along with it was that such manipulation can be highly effective—especially when exploited by so ruthless, dishonest, and domineering a character as Bettelheim.
Bettelheim like other Freudians took a strongly pro-mentalistic stance in the sense that he extended the concept of the mind to include the unconscious, and shared the movement’s tendency to find hidden motives for anything and everything with a complete disregard for fact or physical foundation. For example, some critics pointed out that Bettelheim and his colleagues appeared to be extraordinary mind-readers. Bettelheim reports that one boy
picked up a sandwich at his first meal, bit into it and then put it down. Provocatively, he picked up another one, took a little bite, and put it down. And this he continued with another and another until he had bitten into eight altogether. By then, he began to wonder if we might not, contrary to his expectations, be more interested in allowing him the freedom to behave in line with his emotional need to waste food, than we were in saving food or in enforcing good manners at the table. {92}
But as a reviewer pointed out, this is a remarkable insight for an emotionally disturbed child to have at his first meal in a strange new institution [ {93} quoting Virginia Axline's review of Love is Not Enough in The Journal of Abnormal and Social Psychology, 46, #3 (July 1951) p. 449.] Indeed, psychoanalysis as a whole became notorious for such over-interpretation of peoples’ motives and intentions, and as we shall see in later chapters, mentalism can be as much of a menace to mental health if it is over-extended as autism shows it to be if it is deficient. In other words, although you can hardly have too much empathy, you most decidedly can overdo mentalism, and this in itself is a good enough reason for adopting the concept.
** 2. Asperger’s Syndrome, Savants, and Male Mentality
When extra-terrestrials are portrayed in science fiction, they are very often credited with superior intelligence, technology, or scientific knowledge. Indeed, this is more or less unavoidable if they are to be believed to have the ability to travel here from other planets. Such a challenging feat obviously implies an advanced intellect—at least where technical know-how is concerned—and alien intelligence might be expected to transcend many of the limitations of the human mind where basic functions like memory, mathematical or logical reasoning, or originality were concerned. And once again there is a striking parallel with autism. As we shall now see, some autistics at least approximate very closely to what we might imagine aliens to be like in this respect and sometimes show compensating strengths in precisely the same areas of expertise where we might suppose extra-terrestrial intelligence to excel: those related to mathematics, science, and technology.
Although both Kanner and Asperger are credited with the discovery of autism, Asperger’s original cases were different from Kanner’s in having well developed speech and even “talking like grown-ups” in early childhood. Reflecting this early difference in emphasis, the most recent edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM IV TR) distinguishes what is now widely known as Asperger’s syndrome from classical autism (sometimes called in contrast Kanner’s syndrome). Asperger’s syndrome shares the central deficits in mentalism and the restricted, repetitive patterns of behaviour, interest, and activity seen in classical autism, but is distinguished by the absence of delays or deficits in language and of obvious signs of cognitive impairment in childhood. Consequently, Asperger’s syndrome is sometimes described as high functioning autism {94}. Indeed, a recent study of a population of children aged 7 in South-East England found that only 35 per cent of those affected by autism or Asperger’s syndrome had IQs below 70—probably as a result of a greater awareness of autism in brighter children. As Uta Frith comments, “This new finding raises the possibility that learning disability may not be as strongly associated with autism as was once thought” {95}. Furthermore, the results of a postal questionnaire distributed to British members of Mensa (an organization for people whose IQ falls within the top 2 per cent of the population) found real associations between high intelligence and infantile autism (along with gout and myopia) {96}.
Although Asperger’s subjects have obvious deficits in many ways and have often been described as clumsy and uncoordinated in their actions, they are often notably better than average at performing spatial tasks, such as doing jigsaw puzzles. Unlike normal children or those with general intellectual impairment, whose performance on different cognitive tests tends to be similar, autistic children often show a more uneven pattern. Perhaps because of their mentalistic deficits, autistic children tend to do worst on subtests that demand a high degree of communicative competence and/or social intelligence, such as comprehension tests, which demand an ability to interpret the often implicit meanings, intentions, and understandings conveyed in a passage of writing. However, autistic children in general, and those diagnosed with Asperger’s syndrome in particular, do best—and sometimes better than normal children—at tests of spatial ability, such as the block design test. Indeed, if extraordinary facility with doing things like jigsaw puzzles is included {97}, the majority of people with autism would be classed as showing some specific talent {98}.
Again, compulsive concentration on a single subject need not always be counterproductive, as an autistic writer observes:
While most clinicians with expertise in Asperger’s syndrome would likely say that dwelling on certain subjects counts as negative, I must disagree. I have the trait of sticking to a project long enough to see it through to completion ... Since I can think about subjects repeatedly for long periods of time without getting bored, my mind has greater access to deeper thinking about those subjects. I find that with repeated tenacious thoughts, things that were initially difficult to figure out do eventually get figured out. {99}
In his original paper on autism, Hans Asperger remarked that,
To our own amazement, we have seen that autistic individuals, as long as they are intellectually intact, can almost always achieve professional success, usually in highly specialized academic professions, with a preference for abstract content. We found a large number of people whose mathematical ability determines their professions: mathematicians, technologists, industrial chemists, and high ranking civil servants. A good professional attitude involves single-mindedness as well as a decision to give up a large number of other interests. It seems that for success in science or art, a dash of autism is essential. . Indeed we find numerous autistic individuals among distinguished scientists. {100}
Autistic tendencies in general, and Asperger’s syndrome in particular, have been suggested as allied with the outstanding skills and even genius in scientists such as Sir Isaac Newton (1643-1727), Albert Einstein (1879-1955), and Paul Dirac (1902-84). Another example is Michael Ventris (1922-56), the cryptographer who deciphered the ancient Mycenaean script known as Linear B {101}. Temple Grandin adds Vincent van Gogh (1853-90); Charles Darwin (1809-82), Gregor Mendel (1822-84), and Bill Gates, founder of Microsoft, to the list {102}. Others who have been retrospectively diagnosed as somewhere on the autistic spectrum include the poet, artist, sculptor, and architect Michaelangelo Buonarroti (1475-1564) {103}; the philosopher Ludwig Wittgenstein (1889-1951); and the Indian mathematician, Srinivasa Ramanujan (1887-1920) {104}. Politicians and statesmen too have been added to the list of those suspected of having been Asperger’s cases: specifically Thomas Jefferson (17431826) {105}, Eamon de Valera (1882-1975), and perhaps most interestingly of all, Adolf Hitler (1889-1945) {106}. However, and as the last name might suggest, it would probably be wrong to assume that all of those with autistic tendencies who achieve fame or notoriety put their talents to the best uses. It has recently been suggested that Theodore J. Kaczynski, otherwise known as the Unabomber, is an Asperger’s case. Kaczynski’s engineering skills were diverted into bomb-making (astonishingly, often with wooden parts) and his social isolation resulted in a highly atypical career of lone terrorism. If this diagnosis is correct, the fact that the Unabomber occasioned the longest and most expensive manhunt in the twentieth century and was only caught when he attempted to communicate his ideas by publishing his Unabomber Manifesto is a indication of what a force for evil as well as good autistic tendencies can be {107}.
Recently Michael Fitzgerald published a book about what he terms Asperger’s savants: that is, “persons with high functioning autism or Asperger’s syndrome who produce works of genius” {108}. Despite the fact that, as Fitzgerald himself notes, “Persons with Asperger’s syndrome are often atheoretical”, he includes the philosophers Spinoza (1632-77), Immanuel Kant (1724-1804), and A. J. Ayer mentioned earlier (see above p. xx). Less surprising perhaps is his inclusion of several famous musicians, such as Wolfgang Amadeus Mozart (1756-91), Ludwig van Beethoven (1770-1827), Eric Satie (1866-1925), and Bela Bartok (1881-1945), and along with Van Gogh, the painters L. S. Lowry (1887-1976) and Andy Warhol (192887) {109}.
Understandably perhaps in the light of the on-going debate about the exact diagnosis of autism and Asperger’s syndrome, not all of these suggestions have been accepted by everyone. In particular, Oliver Sacks has questioned whether Wittgenstein, Einstein, and Newton, were “significantly autistic,” contrasting their cases with that of the chemist, Henry Cavendish (1731-1810), who he believes certainly was. Sacks thinks that, unlike most other “supposed autistic geniuses,” he showed “near-total incomprehension of common human behaviours, social relationships, states of mind, and money, as well as an almost obsessed attention to detail—which led him to the great generalizations he was later to erect” {110}.
But however that may be, the combination of outstanding skill or talent and autistic tendencies is not confined to a few, famous cases. Ten percent of autistics, but only one percent with other developmental deficits, show so-called savant skills: in other words, remarkable cognitive and memory ability found among more prevalent disability. Such talents are usually limited to music, art, maths and calendar calculation, mechanical and spatial skills, often featuring astonishing memorization feats; while the combination of blindness, autism and musical genius is unusually frequent {111}. For example, a pair of identical twin savants described by Sacks possessed calendar-calculating skills over an 80,000 year range; could not do simple arithmetic, but would calculate lengthy prime numbers for fun; could instantly count and factorize the number of matches that fell out of a box; and could remember the weather and the important political events on every day of their adult lives while having little or no memory of more personal events {112}. Kim Peek, the inspiration for the film, Rain Man, walks with a sideways gait, cannot button his clothes or manage many of the practical chores of daily life, has great difficulty understanding abstraction, and has an overall IQ of 87. Yet he has an encyclopaedic knowledge of history, political leaders, roads and highways in the U.S. and Canada, professional sports, the space program, movies, actors and actresses, Shakespeare, the Bible, Mormon doctrine and history, calendar calculations, literature, telephone area codes, major Zip codes, television stations, classical music, along with the detailed content of 9000 individual books at the time of writing {113} {114}.
Such feats are fairly easy to authenticate, but what of the claims sometimes made about musical savants? Blind Tom was purchased as a child at a slave auction in Georgia in 1850 along with his mother. A contemporary described him as “idiotic for any other purpose” and capable of nothing but “gyrations and melodies”. He did not speak and could barely walk by the age of five and “gave no other sign of intelligence” apart from an “everlasting thirst for music.” But despite having been blind from birth, he taught himself to play the piano by the time he was four, and by the age of 11 he was performing before the president at the White House, and later went on a successful concert tour to Europe. His vocabulary ultimately amounted to less than a hundred words, but although incapable of learning anything else, his musical repertoire eventually included over five thousand pieces, and he was said to be able to perfectly reproduce passages of unfamiliar music up to 15 minutes long {115}. His modern equivalent is Leslie Lemke, also blind from birth and afflicted with cerebral palsy, who now gives regular concerts and reproduces music from memory with such machine-like precision that members of the audience are asked to write down their requests rather than shout them out (because otherwise Lemke will insist on playing each and every one in the order in which he heard them, no matter how long it takes!) {116}. We saw just now that Mozart has been posthumously diagnosed as a so-called Asperger’s savant. At the age of 14, he is said to have written out the complete score of Allegri’s Miserere after a single hearing on a visit to St Peter’s in Rome. The Miserere is a complex antiphonal piece for multiple choirs culminating in nine parts, and copyright was kept exclusive to the Vatican choir under pain of excommunication. It is easy to imagine that such stories as these may have lost nothing in the telling, and perhaps gained much.
Nevertheless, some properly controlled experiments have been attempted. In one, Hermelin, and O’Connor compared the performance of a 19-year old musical autistic savant who had an IQ of 61 and almost total absence of spontaneous speech with that of an accomplished musician. Both listened to two pieces of recorded music that they had not heard before (Grieg’s “Melody”, opus 47 no. 3, and part of Bartok’s “Mikrokosmos”). The autistic savant gave an almost note-perfect rendering of all 64 bars of “Melody”, playing 798 notes of which only 8 per cent were wrong. By contrast, the professional pianist attempted to play only 354 notes, but in this much abbreviated version there were a total of 80 per cent wrong notes. Hermelin adds that after 24 hours during which he had not heard the piece again, the savant gave a second near-perfect performance. However, in the case of the less conventional piece by Bartok, the savant again played more notes (277 against 153), but got 63 per cent of them wrong as compared to only 14 per cent in the case of the professional musician. On a separate occasion, Leslie Lemke was asked to reproduce and improvise on the same two pieces and was compared with another professional musician. According to Hermelin’s account, “Having first played a few bars of Grieg’s ‘Melody’ note perfect, Leslie produced 215 bars of improvisation, which he played with enormous enthusiasm and verve. The professional pianist played 95 bars...” Then, in a manner reminiscent of Beethoven’s famous improvisations (and who, as we have already seen has also been diagnosed an Asperger’s savant), she continues, “the savant replaced Grieg’s rather thin musical texture with something much more dense and though he never lost sight of the main theme and returned to it often, he interspersed this with extravagant flamboyant expansions. In contrast to Leslie’s embellishments of Grieg’s spare texture, the professional musician tended to retain it, and his improvisations were simple, reflective and restrained, as indeed is Grieg’s own composition.” Where the Bartok was concerned, Hermelin recounts that “the two participants resembled each other much more closely than they had done in their improvisations on the piece by Grieg, although for the Bartok, too, Leslie also gave a much richer interpretation, mostly by putting in more chords” {117}.
These findings give credence to accounts of comparable (if less rigorous) tests carried out on Blind Tom. For example, because he could not read music, the top line of an original 14-page composition was played to him while he was asked to fill in the accompaniment. Having successfully performed this feat, he “proceeded to play the treble with more brilliancy and power than the composer”. Indeed, a panel of sixteen outstanding musicians of the day concluded that “in ... every form of musical examination” Blind Tom “showed a capacity ranking him among the most wonderful phenomena in musical history” {118}. Clearly then, musical savants do exist, and where an undoubted genius like Mozart is concerned, the story of how the Pope lost his monopoly on Allegri’s Miserere seems perfectly plausible.
So-called acquired savant syndrome can occasionally emerge after brain injury or disease in a previously normal person. For example, a nine-year old, who was deaf- mute and paralysed by a gun-shot wound to the left hemisphere, developed outstanding mechanical skills after the injury. But perhaps the most remarkable case is that of Daniel Tammet. Diagnosed with Asperger’s syndrome, Daniel developed an unusual combination of synaesthesia and savantism following a series of childhood epileptic seizures. Synaesthesia describes the mixing of senses so that in Daniel’s case, for example, every number up to about 10,000 is seen as a uniquely coloured and textured shape, occasionally also associated with a specific emotional feeling. By means of manipulating numbers visualized in this way, Daniel can perform calculations with the speed and accuracy of a computer, and currently holds the British and European record for the rote recitation of the places of pi from memory to 22,514 places—a feat achieved in just over five hours. His synaesthesia also extends to words, and following a challenge from a TV producer, Daniel learnt one of the world’s most difficult and distinct languages, Islandic, in one week sufficiently well to be successfully interviewed live in the language on Islandic televison. Indeed, and tellingly illustrating my opening remarks about autistics and aliens, one of the Islanders described Daniel’s linguistic skill as “not human” {119}.
But acquired savant syndrome need not only be acquired in childhood. On the contrary, fronto-temporal dementia in older people can sometimes release remarkable artistic skills while devastating normal functions {120}. Experimental evidence pointing to the same conclusion comes from a remarkable study in which eleven right-handed male volunteers underwent magnetic stimulation of the left fronto-temporal lobe of their brains before being asked to reproduce images of animals and faces by drawing. The magnetism had the effect of temporarily inhibiting this region, which is the same part of the brain where damage or degeneration is known to be associated with the spontaneous appearance of savant skills in previously normal people. Although some autistic savants excel in pictorial art, the output, be it drawing, painting, sculpture or modelling, is usually realistic, rather than abstract or conceptual {121}. Indeed, this is often how savant’s artistic skills are first recognized: even as children they show technical competence in representing things in their art that goes far beyond that normal for their age. The frontal-lobe magnetic-inhibition study found that some subjects showed a dramatic change of style towards a more life-like way of drawing, with more attention to realistic details and less of a tendency to caricature—but only after genuine stimulation, not after control sessions when no magnetism was applied. Indeed, one subject said that after the stimulation he was more “alert” and “conscious of detail,” and that the experimenters had “taught him how to draw dogs!” {122}.
Another study of five patients all diagnosed with fronto-temporal dementia noted that the creativity of these subjects was visual but never verbal. Similarly, the paintings, photographs, and sculptures were realistic copies lacking an abstract or symbolic content. The painters remembered realistic landscapes, animals or people, and seemed to recall images that were then mentally reconstructed as pictures without the mediation of language. Also, despite progressive cognitive and social impairment, they showed increasing interest in the fine detail of faces, objects, shapes, and sounds. The authors of this study also cite the case of a Polish painter who suffered a lefthemisphere stroke associated with aphasia (loss of speech) but lost only the ability to create the highly symbolic pictures that he had previously painted, while retaining an ability to paint realistically without a flaw {123}.
Brain-imaging shows left-brain abnormalities in savants along with changes to the corpus callosum, the thick bundle of nerve fibres that connects the two hemispheres (indeed, Kim Peek lacks this structure altogether). Language and other mentalistic skills are localized more on the left half of the brain than the right in most people. It is in the left hemisphere that the main speech centres are found, but in children with autism language develops much more on the right side of the brain than it does in normal children {124}. Exactly the same is found in the pattern of activity involving the prefrontal and parietal regions of the brain, which are normally correlated on the left in normal subjects, but on the right in high-functioning autistics {125}. On the other hand, typical savant skills such as artistic, musical, and mechanical abilities are found more on the right side of the brain. Taken together, these observations suggest that savant syndrome may result from compensation in the right hemisphere of the brain for damage in the left. This may go along with lower-level, “habitual” memory compensation for higher-level “cognitive” memory deficits. The 6-fold predominance of savant syndrome in males may be explained by the left hemisphere completing its development later than the right. This might make it more vulnerable to pre-natal influence from the male sex hormone, testosterone, which slows and impairs neuronal function. The result would be enlargement of the right hemisphere, perhaps with a shift towards the right hemisphere skills typical of savants {126}. Musical savantism often features perfect pitch (as it did in the case of Mozart, for example), and here it is worth noting that recent evidence suggests that a particular region of the auditory cortex in the right hemisphere is much more specialized for representing detailed pitch information than its counterpart on the left side of the brain. For example, tones that are close together in pitch seem to be better resolved by neurons on the right. {127}
Each cerebral hemisphere is in the main linked to the opposite side of the body. In other words, the left motor cortex controls the right side of the body, and right cortex the left. People normally show a dominance of one hemisphere over the other. Nine out of 10 people are right-handed, meaning that the left, verbal, more mentalistic hemisphere is normally dominant, but as the findings above might suggest, lefthandedness is more common in autism and Asperger’s syndrome, with 18-20 per cent of sufferers being left-handed.
Women activate more brain regions on difficult verbal tasks than do men, who by contrast to women only activate the right cortex on challenging spatial tasks {128}. At birth, the right hemisphere is normally larger in males, whereas the corpus callosum is larger in females, and its size is linked to verbal intelligence {129}. This may be why brain imaging of a rhyming task showed that men activated only the left hemisphere (specifically, the inferior frontal gyrus or Broca’s area), whereas women activated both left and right sides of the brain. Such differences in laterality between the sexes may also explain why men but not women usually suffer verbal deficits following left hemisphere stroke {130}. Again, women appear to be less lateralized than males: in other words, they show less differences between the two halves of the brain, and consequently a more balanced development than that normally found in males. In autism, by contrast, reduced cortical connections via the corpus callosum have been reported {131}. Compared to males, females are less likely to be left-handed, but lefthanders of either sex are more likely to score high on maths, musical, and drawing ability, and chess. And as the facts about brain laterality would suggest, left-handed people have on average better spatial ability, and are more common in visual arts occupations, and in architecture and engineering.
During gestation, hands develop early, at much the same time as sexual differentiation, and along with the brain and heart. The relative length of the fingers is fixed by 14 weeks, and reflects hormonal influences in the womb. In men, the ring finger or fourth digit tends to be longer than the index finger or second digit, but in women the lengths of these fingers tends to be more similar. A low ratio like that found in men correlates with masculinity, autism, left-handedness and musical ability, while a high ratio correlates with femininity, vulnerability to breast cancer, and high female but low male fertility {132} {133} {134}.
This suggests that early developmental influences, ultimately controlled by genes and mediated by hormones, may account for the development of both autism and savant syndrome. For example, a recent study of 29 normal girls and 41 boys carried out at the age of 12 months found that the girls made significantly more eye-contact than the boys and that the amount of eye-contact in both sexes was related to exposure to foetal testosterone—in other words, to the effects of the principal male hormone before birth {135}. In a further study, amniotic fluid, obtained from 87 pregnant women for routine amniocentesis was analysed for foetal testosterone level. Their infants (40 girls and 47 boys) were followed up 18 and 24 months after birth and their vocabulary was assessed. Girls were found to have a significantly larger vocabulary than boys at both ages, and this difference was related to foetal testosterone exposure, suggesting that it might be involved in shaping the neural mechanisms underlying communicative development in the cases of both eye-contact and language ability. {136}. More recently still, the mothers of 35 boys and 23 girls who were followed up to age four completed a questionnaire assessing language, quality of social relationships, and range of interests in their children. Higher exposure to foetal testosterone was found to correlate negatively with quality of social relationships (taking normal sexdifferences into account), and was also positively correlated with restricted interests in boys. In other words, these findings suggest that pre-natal exposure to male sex hormones is associated with poorer quality of social relationships and more restricted interests, particularly in boys {137}. And in adult men of course, testosterone is notoriously associated with increased aggression and irritability and with reduced feelings of empathy and concern for others {138}.
From the very beginning, both Kanner and Asperger noticed that what they were each independently describing as autism was much more prevalent in males than in females, and Asperger originally believed that his syndrome never occurred in girls before puberty {139}. Nor were such initial impressions entirely misleading. According to DSM IV TR rates of incidence of the disorder are four to five times higher in males than in females and higher still in Asperger’s syndrome {140}, and according to some estimates, males exceed females by 10 to one or more at the highest functioning end of the autistic spectrum associated with Asperger’s syndrome {141} {142} {143}. Indeed, in his original report Hans Asperger suggested that autism may represent an extreme development of the normal male brain: “The autistic personality is an extreme variant of male intelligence. ... Boys... tend to have a gift for logical ability, abstraction, precise thinking and formulating, and for independent scientific investigation. In the autistic individual, the male pattern is exaggerated to the extreme” {144}.
Experiments with babies only a day old show that from birth girls attend more to social stimuli, such as faces and voices, than do boys, who attend more to non-social, spatial stimuli, such as mobiles or traffic {145}. Babies with autism show an even more marked lack of interest in faces, and here it may be significant that autistics process visual information about faces in the same part of the brain normally used for objects alone, rather than in the specialized face-recognition and reaction region found in normal people {146} {147}. Normally girls develop social skills sooner than boys, and studies suggest average female superiority in language skills, social judgment, empathy, and co-operation. Most girls develop language earlier than most boys, and higher levels of the male hormone testosterone are generally associated with lower verbal ability {148}. By 18 months there can be a huge difference between boys and girls, with some children still not yet speaking and others with vocabularies of up to six hundred words {149}. Women on average perform better at verbal tasks than do men. For example, they can generally name twice as many synonyms for a word than can the average man, and women can usually generate longer lists of words beginning with the same letter. Furthermore, as one writer points out, “Simple thought and action are consistent with low verbal skill. A larger vocabulary encourages complicated thought, not speedy action. The less time spent considering possibilities, the easier it is to keep a positive frame of mind” {150}.
Reduced frontal brain volume is associated with anti-social and psychopathic behaviour, which are much more common in men, and claims have been made that temporal and frontal lobe brain volumes are larger in women {151}. Increased volume in these areas suggests superior abilities where pro-social and self-inhibitory behaviour is concerned, and according to one authority “affords us neurobiological evidence that women may have a better brain capacity than men for actually censoring their aggressive and anger responses” {152}. Indeed, according to a survey of the scientific literature, the single interpretation that best describes the research findings across a wide range of tasks is that women have greater inhibitory abilities than men on most tasks involving sexual, social, and emotional content {153}.
Women are also superior to men in perceptual speed as measured, for example in finding matching items; fine-motor co-ordination (such as that involved in needlework); pretend play in childhood; and arithmetic. Male superiority is normally found in mathematical reasoning, especially geometry and logic. Indeed, at the highest level male mathematicians outnumber female 13-to-one. Men also normally excel in embedded and rotated figure tasks {154} {155}. Interestingly in this respect, female-tomale transsexuals who receive testosterone injections in preparation for their sexchange operations have been reported to show large increases in rotational ability {156}. One such sex-change patient recorded the following impressions after three months of testosterone treatments:
I have problems expressing myself, I stumble over my words. Your use of language becomes less broad, more direct and concise. Your use of words changes, you become more concrete... I think less; I act faster, without thinking. ... The visual is so strong.when walking in the streets I absorb the things around me. ... It gives a euphoric feeling. I do miss, however, the overall picture. Now I have to do one thing at a time; I used to be able to do different things simultaneously. . I can’t make fine hand movements anymore; I let things fall out of my hands. . My fantasy life has diminished strongly. I would have liked to keep that. I am becoming clumsy, more blinkered. I didn’t ask for this; it just happens. . {157}
Another recent finding that may have a similar explanation is the fact that women carrying male foetuses improve their performance on difficult cognitive tasks involving working memory and spatial ability, but not on any other tests. Although the factor responsible could not be determined and is unlikely to have been foetal testosterone, some other similar product of the foetus/placenta is almost certainly the cause {158}. By contrast, androgen deprivation is a male sex hormone-reducing therapy sometimes used to treat prostate cancer in men. Subjects given cognitive tests after therapy showed slightly improved verbal fluency but reduced ability to recall images, suggesting that their skills in these respects had been shifted towards the female pole of cognitive ability {159}.
Males are generally superior in most (but not all) spatial skills, and in target-directed motor skills, irrespective of practice. Where navigation is concerned, recent experiments found that men travel about 20 per cent further in virtual mazes than women do. Furthermore, women take approximately 30 per cent longer to orientate themselves, and are more likely than the men to be wrong when they do. Out of an equal number of males and females using a virtual maze for real life navigation, only one of 17 subjects who got completely lost was male {160}. One possible explanation is that male and female brains simply do not work the same way in such situations. Brain imaging recently demonstrated that on exiting a virtual 3-D maze women activate the right parietal cortex and right prefrontal cortex, whereas men trigger the left hippocampus alone {161}.
In the case of geography, boys always win the National Geography Bee, which tests American children in grades four to eight on their knowledge of places around the world {162}, and male college students can locate almost twice as many countries on an unlabelled map of the world as female students can {163}. In general, men—but not boys—seem to navigate preferentially by vector (that is, directions and distances), whereas women—but not girls—normally prefer to use landmarks {164}. The fact that this difference only appears after puberty suggests that it is an evolved, innate one mediated by sex hormones. Furthermore, such evolved sex-differences in cognition would have made sense in our ancestral environment to the extent that vegetarian food of the kind typically collected by women in primal hunter-gatherer societies is indeed often best located by reference to fixed landmarks, whereas game that is being pursued by hunters can take off in any direction, and may well dictate a novel, crosscountry return to base, rather than one using well-known paths. Such cross-country navigation demands exactly the kind of spatial sense at which men excel, and studies of women’s greater ability to remember the location of objects closer to home also fits the predictions from the hunter-gatherer model {165}.
Again, tool-making and missile-throwing ability would certainly have benefited primeval males more than females in most instances, and such skills would probably have been critically involved with males’ success in conflicts both with other males and in hunting. According to an experimental archaeologist who has been making stone tools for 37 years, the basic skills needed for making stone tools are mainly visual, spatial, and manual: “Good hand-eye co-ordination, a good sense of geometry, patience and an ability to get the feel of a stone. An appreciation of angles and pressure points is crucial. You have to have to see inside the stone and predict how the stone will behave when you do something to do it” {166}. At the very least, this would explain why mechanical, manual, and throwing skills all seem to be aspects of male cognitive proficiency today—not to mention why they are also found in connection with superior vector-navigating ability and geographical expertise. Certainly, today the average man does better than the average woman on most—but not all—tests of mechanical skill, notwithstanding the fact that women generally appear to be more dextrous than men {167}.
Standard psychometric tests—so-called IQ tests—usually exclude any items that show large sex differences simply because they are designed to test populations of both sexes. The result, of course, is that sex differences in cognition are systematically ignored or underestimated by such measures {168}. However, some special aptitude tests are exceptions, and these show a very marked superiority in male performance where mechanical skills are concerned. For example, US Air force aptitude tests for mechanical comprehension show that the average male performance exceeds that of 80 per cent of females {169}, and in the top 10 per cent of mechanical reasoning ability males outnumber females by approximately 8-to-1 {170}. The relevance of this finding to Asperger’s syndrome is that it is sometimes called “the engineer’s disorder”. Indeed, authorities in the field comment that
it is hard to find a clinical account of autism that does not involve the child being obsessed by some machine or another. Typical examples include extreme fascinations with electricity pylons, burglar alarms, vacuum cleaners, washing machines, video players, trains, planes and clocks ... Showing an apparently precocious mechanical understanding, whilst being relatively oblivious to their listener’s level of interest, suggests that their folk physics might be outstripping their folk psychology in development. {171}
As another author puts it, “children with autism tend to relate to others as though they were machines rather than people” {172}.
According to a survey of 919 families of children with autism or Asperger’s syndrome which listed occupations of parents, fathers of children with autism or Asperger’s were twice as often employed in engineering as were fathers in any of four control groups of children with Tourette’s or Down Syndrome. The Autism-Spectrum Quotient or AQ Test consists of fifty questions covering social skill, attention switching, attention to detail, communication, and imagination. Fifty-eight adults with Asperger's syndrome, 174 randomly selected controls, 840 students at Cambridge University, and the 16 winners of the UK Mathematics Olympiad were each sent a questionnaire by post. Results showed that the majority of people with Asperger's syndrome scored above 32 (out of a maximum of 50). But interestingly, among the students at Cambridge University, those in the sciences and technology had a higher AQ score compared to those in the arts and humanities. Mathematicians scored the highest of all—around 20 out of 50—and were closely followed by engineers, computer scientists, and physicists. Among the scientists, biologists and medics scored the lowest, around 14 out of 50 {173}.
Another study of a mathematician, a physicist, and a computer scientist all diagnosed with Asperger’s tested them against controls on folk physics and folk psychology (Reading Eyes Test). Although all three equalled control subjects’ performance on sex judgments on the eye test, all scored more than one standard deviation below controls on folk psychology and more than one standard deviation above on folk physics (which is comparable to 85 per cent of Asperger’s subjects, who also score at or above this level). As the researchers comment, “These results strongly suggest that theory of mind (folk psychology) is independent of IQ, executive function and reasoning about the physical world.” They conclude, “There thus seems to be a small but statistically significant link between autism and engineering” {174}. Indeed, it is one that can be seen in a sample of Asperger’s original cases of “autistic psychopathy”. A recent study of these found that in 37 cases where the father’s profession was mentioned the most common form of employment was a technical one and that the most frequently seen profession was “engineer” or “electrical engineer” {175}.
With the benefit of hindsight, it may even be possible to disentangle the truth about the notorious “refrigerator mother’ (see above pp. xx-xx). Uta Frith points out that
As convincing evidence for the genetic causes of autism has now emerged, a new twist has been added to the story. Kanner’s and Asperger’s clinical intuitions about the often intellectual and detached parents of the children they saw were not mistaken. Well-controlled studies have shown that fathers as well as mothers may have some of the same traits as their children, often in very mild form. Of course, this does not mean putting back the blame on early interaction with parents. If anyone is to blame, it is indifferent Mother Nature. {176}
An astonishing example of the possibility that both fathers and mothers may contribute to the likelihood that a child will be diagnosed autistic can be found in the reported incidence of these disorders in Silicon Valley (Santa Clara County, California). In 1993 there were 4,911 diagnosed cases of classic autism. In 1999 the figure passed 10,000, and in 2001 there were 15,441 cases, with new ones added at 7 per day, 85 per cent of them children. Given that employment in Silicon Valley is primarily in electronic engineering and computing, and that equal-opportunity employment means that many children born there will have both parents in these industries, so-called assortative mating has been suggested as the most likely explanation. This is the idea that likes attract, and that people tend to marry partners who have much in common with themselves. In other words, it looks as if mentalistic deficits in people with engineering skills are being compounded in their children by inheritance of these deficits from both parents {177} {178}. Studies to confirm this finding are currently under way, and the first results suggest that mothers of children with autism are indeed more likely to have a more technological turn of mind than normal, along with interests more typical of men {179}.
Today there is certainly strong evidence that autism and Asperger’s Syndrome run in families. For example, there is a 90 per cent chance an identical twin of a sufferer will also be diagnosed autistic. The risk of a second child being autistic if one is already rises from 1-in-500 to 1-in-20, while the risk for a third being autistic after two children already are diagnosed is 1-in-3. Estimates of heritability of these disorders suggest that up to 90 per cent of the variation in symptoms is due to genetic causes and, as I mentioned earlier, there is now good evidence that autistic deficits in general are normally distributed throughout the population, with only the more severe incidence being diagnosed as classical autism or Asperger’s syndrome {180} {181} {182}.
Nevertheless, Temple Grandin remarks that
Aware adults with autism and their parents are often angry... They ask why nature or God created such horrible conditions as autism. However, if the genes that caused these conditions were eliminated there might be a terrible price to pay. It is possible that persons with bits of these traits are more creative, or possibly even geniuses. If science eliminated these genes, maybe the whole world would be taken over by accountants. {183}
But as we have seen, there is a small but statistically significant link between autism and engineering, and the researchers who discovered it continue:
The current result might also help to explain why a condition like autism persists in the gene pool: the very same genes that lead an individual to have a child with autism can lead to superior functioning in the domain of folk physics. Engineering and related folk physics skills have transformed the way in which our species lives, without question for the better. Indeed, without such skills, Homo sapiens would still be pre-industrial. {184}
Again, the link between autism and engineering may also be a factor explaining the frequently-encountered failings of instruction manuals mentioned in the last chapter. If such instructions are the work of engineers or designers, then their failings where consideration of the difficulties of potential users are concerned may not simply be a result of their authors’ expertise in understanding the product but may also lie in engineers’ and designers’ constitutional short-comings where mental skills such as understanding of others’ belief are concerned (see above pp. xx-xx). In the case of one otherwise “very competent computer analyst” who was also autistic, “his inability to
understand that they could not understand what was wrong made it almost impossible for him to explain the problems or help people to correct their errors” {185} [author’s emphasis].
Temple Grandin confesses that as a child she “was completely turned on by machines instead of people” and that even as an adult who regards herself as partly recovered from autism, she is still “turned on by machines, especially control mechanisms designed to interact with people” {186}. Grandin had a maternal grandfather who she describes as “a brilliant, shy engineer who invented the automatic pilot for airplanes,” and is herself a noted and very successful engineer to the extent that she has designed a third of all cattle and pig-handling equipment in the USA. She relates “better to scientists and engineers, who are less motivated by emotion” than other people {187}, and explicitly attributes her engineering success to her predominantly visual mode of thinking: “Every design problem I’ve solved started with my ability to visualize and see the world in pictures. ... I visualize my designs being used in every possible situation, with different sizes and breeds of cattle and weather situations. Doing this enables me to correct mistakes prior to construction” {188}.
Drawing on her extensive knowledge of autism and autistics, Temple Grandin speculates that
There may be two kinds of thinking—visual and sequential. Society needs to recognize the value of people who think visually. Misinterpretation of psychological test results could label a brilliant visual thinker as below average intelligence. Einstein was a visual thinker who failed his high school language requirement and relied on visual methods of study. {189}
She adds that “People with autism can develop skills in fields that they can really excel in. I’ve known people who are engaged in satisfying jobs as varied as elevator repair, bike repair, computer programming, graphic arts, architectural drafting, and laboratory pathology. Most of these jobs use the visualization talents that many people with autism have” {190}. This conclusion is underlined by a recent study which compared autistics with normal subjects on tests of comprehension that involved sentences which demanded both verbal and visualization skills such as The number eight when rotated 90 degrees looks like a pair of eye-glasses. As the researchers point out, in sentences like this the linguistic content must be processed to determine what is to be imagined, and then the mental image must be evaluated and related to the verbal meaning. Normal subjects only used mental visualization when necessary, but autistic subjects were found to use it even when it was not, and the researchers quote Temple Grandin to the effect they were probably “thinking in pictures” much of the time. Indeed, the study suggested that as a result autistics might be better at visualizing linguistic information than normal people are {191}. And we saw above that at least one autistic savant uses his remarkable synaesthetic ability to visualize numbers to perform calculations which would normally require a computer.
As I mentioned at the beginning of this chapter, it is certainly true that children with autism often perform above average for their mental age on embedded-figure or block-design tests which require the child to find hidden elements within a larger picture in the first case or to assemble a figure from parts represented on separate blocks in the second. However, prior segmentation of the parts of the block-design puzzle massively improves the performance of non-autistic children, whether normal or learning-disabled. Nevertheless, it has little effect on the performance of able children with autism, who are extremely fast even with un-segmented designs {192}. Brain-imaging reveals that autistics solve embedded-figure tasks using regions involved in object perception, whereas in normal controls the approach is more global and involves the use of working memory much more {193}.
One way of explaining such findings is to propose that autistics show greater fieldindependence defined as a lack of influence of context in both visual perception and in social interaction. So for example, breaking up the blocks in the block design test just mentioned could be seen as making the parts more independent of any context, and therefore easier for normal children to re-assemble correctly. However, because autistic children are much more field-independent to the extent that they are much less affected by any existing arrangement of the blocks, the finding that prior segmentation has little effect on them is explained. Indeed, it is possible that “Fielddependent people are easily swayed by others’ opinion and tend to take on the prevailing views of their group; field-independent people are unaffected by current crazes and don’t care so much about other people’s opinion. People with a high degree of social detachment tend to be good at spotting embedded figures” {194}.
[[c-b-christopher-badcock-the-genius-of-autism-1.jpg][Figure 2.1: The Ebbinghaus illusion]]
Such field-dependence has also been called central coherence, and Uta Frith points out that strong and weak central coherence map closely onto the terms field dependence and independence {195}. An example is provided by the Ebbinghaus illusion (figure 2.1). In reality, both black circles are exactly the same size, but they seem different because of the size contrast of the surrounding figures. Francesca Happe found that autistics are less prone to this illusion, presumably because their greater field-independence makes them go from specific to general and consequently be less likely to be fooled by the surrounding circles. According to a model proposed by Happe, central coherence/field-dependence (or the lack of it) can be found in visual, verbal, auditory and other domains, and varies from strong to weak in the normal population, with the autistics showing a similar range, but biased towards the less centrally-coherent/more field-independent extreme. She also suggests that normal mentalizing relies on field-dependence and in particular on the ability to place things in their context and relate them to their proper background. Children who score high on field-independence in cognitive tests also score low on social competence: for example, in 1,276 three-to-five year olds, those who were more field-independent showed more non-social play. Happe concludes that “individuals with weak central coherence and detail-focused processing are less successful in putting together the information necessary for sensitive social inference” {196} {197}.
Central coherence is certainly critical where normal understanding of speech is concerned because words owe their meaning to the way in which they are embedded within larger units such as phrases, sentences, or longer units of discourse. Again, field-dependence is particularly clearly seen in the way in which a listener discriminates words which have the same sound but different meanings by means of their verbal context, such as there, their, or they’re. But autistics will typically read sentences such as: “He took a bow from his violin case” with exactly the same pronunciation of bow as in “He took a bow and everybody clapped’; or will speak of “a big tear in her dress” in exactly the same way as if it were a “big tear in her eye” {198}.
According to a recent view, the male brain is predominantly hard-wired for understanding and predicting the behaviour of events and objects by building systems. Systemising is defined as the drive to analyse and explore a system, to extract underlying rules that govern the behaviour of a system; and to construct systems. The systemiser intuitively figures out how things work, or what the underlying rules controlling a system are. Systems can be as varied as a pond, a vehicle, a plant, a library catalogue, a musical composition, a cricket ball or even an army unit. They all operate on inputs and deliver outputs, using “if-then” correlation rules {199}.
As in the case of terms like theory of mind, folk psychology or empathising, I have no wish to deny the use of systemising as a characterization of extreme male/autistic cognitive style to those who prefer it. But, as in the case of those terms where I would favour mentalism for the reasons set out earlier, I would also like to suggest a corresponding alternative to “systemising”. And again like the case of mentalism, it would be useful to have a noun, rather than a verb or phrase, and one, furthermore that contrasted appropriately with it to denote male rather than female, and a non- mentalistic style of thought. My suggestion is mechanistic cognition {200} {201}. As we have already seen, there is a clear link between autism and engineering, and to my way of thinking mechanistic thinking describes most of the examples produced to justify it much more aptly than does systemising {202}.
Another virtue of mechanistic as a term for autistic thinking is that it is already current. People with rich experience of autistics comment that “Individuals with autism assign not an everyday but a more mechanistic significance to things” {203}. Certainly, the notorious insistence on punctilious repetition and regular routine by autistics of all kinds might be called “systematic”, but mechanistic catches its mechanical, mindless character better in my view. The same is true of the rigidly repetitive way that autistics often carry out instructions without any apparent thought about their meaning: of course this is systematic, but mechanistic is a much more apt term, and certainly explains the mechanical, robotic quality that is often attributed to such behaviour by others. Furthermore, mechanistic rather than systemising ability underlies many of the features listed earlier in which men normally excel, such as mechanical and target-directed motor skills. The mechanistic expertise of the former is self-evident, but accurate throwing-ability also demands an intuitive grasp of Newtonian mechanics (for example in realizing that a projectile follows a curving rather than a straight trajectory but does so more accurately if it is spinning around an axis directed at its target). Again, giving directions using landmarks as women tend to do can be just as systematic as using vectors, which men typically prefer. Where vector directions differ is that, like the path of projectiles, they combine direction and distance in a dynamic description which is essentially the same as that used in classical mechanics. If autism spectrum disorders are indeed extremes of normal male rather than female cognitive expertise, then describing them as mechanistic rather than systematic seems justified on these grounds alone—quite apart from the fact that many people with autistic tendencies do indeed have notable mechanical skills of various kinds, as we saw Temple Grandin observing earlier. Indeed, she herself exemplifies the point when she reveals that she became one of the first girls in her school “to be allowed to take wood-shop”—at least until she was forced “to return to the traditional cooking class” and become “a failure once again” {204}.
A further advantage of the term mechanistic as a characterization of the cognitive style of autism is that it avoids the implied contradiction between systemising and the weak central coherence found in autistics. In other words, if you describe something as “systematic” you imply that it is coherently consistent and does not have parts that are discrepant with or independent of the whole—that would obviously be unsystematic. However, describing something as mechanistic does not carry the same implications. On the contrary, a mechanistic approach to human behaviour or medicine for example is often described as “reductionist” because of the way in which it sees human phenomena as caused by lower-order processes such as genes or physiological mechanisms. To this extent, you could see the mechanistic approach as more concrete, and less conceptual. This certainly is the view of Temple Grandin, who characterizes autistic cognition as hyper-specific and claims that “autistic people don’t see their ideas of things, they see the actual things themselves. We see the details that make up the world, while normal people blur all those details together into their general concept of the world.” Indeed, she complains that “The problem with normal people is they’re too cerebral,” or what she calls “abstractified”. Grandin is emphatic that “When ... an autistic person is seeing the real world instead of his idea of the world that means he’s seeing detail. ... Visual thinkers of any species, animal or human, are detail-oriented {205} [author’s emphasis]. Finally, mechanistic seems a more apt term than systematic to describe the greater representational realism—not to mention proof-reading skills—described earlier in cases of experimentally- or stroke-induced frontal lobe inhibition.
Such devil-in-the-detail reductionism is often contrasted with a so-called holistic approach, which focuses instead on the overall configuration (or gestalt), and takes a top-down view which inevitably emphasizes central coherence. Furthermore, the holistic outlook is often much more conceptual or abstract because by definition it takes a much wider, more inclusive and field-dependent view (compare the difference between what you think of when you consider an English person as opposed to English people: the former is likely to be an actual person, the latter has to be much more of an abstract concept). Holism, in other words, sees the whole as an entity greater than the sum of the parts, whereas reductionism takes a bottom-up view which sees the parts as completely constituting the whole and therefore tends to ignore the larger, field-dependent perspective. In his apt and amusing book on autistic thinking, Peter Vermeulen points out that “the first axiom in systems theory” is “that the whole is more than the sum of its parts ... Systems theory regards the world in terms of the mutual relatedness and dependency of phenomena. The characteristics of a system, an integrated whole, cannot be reduced to its constituent parts.” By contrast, he adds that “individuals with autism live in a multi-universe: a world of unaccountable, incoherent details that are experienced as having only one meaning: the literal meaning. The world of people with autism is more like a world of different bits and pieces” {206}. At its worst, this leads to a highly disintegrated and chaotic view of life that is anything but holistic or systematic in its cognitive quality. Speaking of one particular autistic young woman, someone who knew her well described her as follows:
Kate knows and understands a great deal but seems to have very limited ability to structure. To use her way of putting things, her life is a heap of odd-shaped stones. Anything she tries to construct soon falls down, whereas other people build amazing structures, which often seem impenetrable and meaningless walls to her, hemming her in on every side. The more structured a subject, the less it means to her... (Hermelin 2001 p. 50)
Controlled scientific studies of autistic savants certainly suggest that their cognitive style is mechanistic, rather than systematic—and is anything but holistic. Consider the autistic savant with a measured verbal IQ of only 89 but a vocabulary score equivalent to an IQ of 121 who can understand, talk, read, write and translate from Danish, Dutch, Finnish, French, German, Greek, Hindi, Italian, Norwegian, Polish, Portuguese, Russian, Spanish, Swedish, Turkish and Welsh. However, he translates word by word like “an automaton”, with no concern for the meaning of whole sentences. When asked to take his time and look at the whole sentence first, he became distressed and said that he could not do it (Hermelin 2001 p. 71).You could call this “systematic”, but mechanistic seems a much better description. Indeed, this is precisely the way in which computer translation tends to turn out: fine for translating individual words, but weak on rendering the sense of the whole. Contrast this with the method used by Sigmund Freud (1856-1939) when translating: “Instead of laboriously transcribing from the foreign language, idioms and all, he would read a passage, close the book, and consider how a German writer would have clothed the same thoughts— a method not very common among translators” {207}. Perhaps not, but as a method of translation it was just as systematic as the one above in its own way, but was distinctly less mechanistic and much more holistic—not to say mentalistic.
Astonishingly, evidence of a strikingly mechanistic tendency can sometimes also be found in artistic savants—perhaps the last place you expect to find it, and particularly in connection with painting and drawing. Nevertheless, writing about Andy Warhol (who we saw earlier he considers to be an Asperger’s savant), Michael Fitzgerald observes that “One reason for Warhol’s success may have been that he represented the machine age. Romanticism was meaningless to him; the machine age was everything.” He goes on to quote Warhol remarking, “The things I want to show you are mechanical,” adding, “I would like to be a machine, wouldn’t you?”. Fitzgerald concludes that Wahrol “had the autistic mechanical mind”, and quotes other authorities who point out that Warhol “loved all sorts of machines and gadgets, embracing new techniques and technologies, working with tape recorders, cassettes, Polaroid, Thermofax, but the heart of all this experimentation had at its central focus photography and silkscreen for making a painting.” They add that “This was by extension his love for the machine because the screen process was very machinelike” {208}. Describing L.S. Lowry, who was another Asperger’s savant in his view, Fitzgerald comments that this “chronicler of industrial reality,” who looked on other humans as comical automatons, “habitually avoided any conversation that hinted at inner meaning in art, or one that looked as if it might lead to such conclusions.” Indeed, he was not above teasing his own friends in this respect, “in order to deflate pomposity or pretension” {209}.
In the experiment described earlier in which normal volunteers’ frontal lobes were inhibited by magnetic means, the same subjects who had shown the most notable change in their drawing style also showed the greatest improvement in a proofreading test. Proof-reading requires close attention to detail—the kind of bottom-up, word-by-word mechanistic approach seen in the linguistic savant described just now. But here again the improvement in proof-reading skill was only found after actual stimulation of the subjects’ frontal lobes, not after the placebo. As the experimenters comment, “These proof-reading results provide non-subjective evidence of the ability to switch on savant-like skill by turning off part of the brain in healthy individuals” {210}.
Earlier, I pointed out in passing that Leslie Lemke, the modern Blind Tom, reproduced a piece by Bartok much less impressively than he had one by Grieg, which he got almost note-perfect by comparison with the Bartok, which he got 80 per cent wrong (and much worse than a professional musician control who got the Bartok 76 per cent correct). An explanation may lie in the fact that such modern music is much less formally structured—and certainly much less predictable—than music of the classical or baroque periods, which could almost be described as much more mechanistic by comparison. Another autistic with a musical talent complained that even though some of his favourite music was from the Romantic era, he felt lost in a sea of non-harmonic tones and was unable to impose an analytic structure upon the music. He added that “The resultant muddiness in the demarcation of the structural borders along with the increased use of tones that are not part of a given chord make it more difficult for me to separate the foreground from the background in order to determine the harmony” {211}. At the very least, this suggests that, not only in memory and language skills, but in music also, autistic savants may be relying on a machine-like, field-independent, weakly centrally-coherent thinking ability to achieve their distinctive results.
Summarizing these and many other findings relating to autistic savants of different kinds, Beate Hermelin concludes that “Savant ability appears to take a route leading from the detail to the whole, thereby reversing our dominant tendency of information processing” {212}. Temple Grandin calls this specific-to-general thinking, and comments:
Looking at a lot of specific details and then piecing them together is how people with Asperger’s think. All my thinking goes from specific details to forming a general principle. I have learned from interviewing many people that most go from general concept to specifics. Their thinking is “top down” and my thinking is “bottom up.” {213}
According to another autistic author, autistics have a kind of brain that “zeroes in rather than zeroes out. It is ... a purer way of thinking that has advantages” {214}.
Weak central coherence, field-independence, and a specific-to-general cognitive style certainly seem to fit nicely with the recently proposed under-connectivity theory of autism. Functional magnetic resonance imaging of the brains of 17 autistics with normal IQ was compared with that of 17 non-autistic control subjects. The study showed that in both groups language functions were carried out by the same network of brain areas, but that in the autistic brains the network was less synchronized, and Broca’s area (which serves an integrating function in language ability) was much less active. However, Wernicke’s area, the other important speech centre that concentrates more on the processing of individual words, was more active in the autistic brains (perhaps explaining the word-by-word translation method of the autistic language savant mentioned above). Again, the sentence-visualization study I mentioned earlier which suggested that autistics do indeed think in pictures also supported the conclusion that this comes about in part thanks to reduced connectivity within the brain. These findings suggest that the neural basis of disordered language in autism entails a lower degree of information integration and synchronization across the large- scale cortical network for language processing—just as weak central coherence or a liking for specific-to-general thought processing would predict. Indeed, such a lack of integration within the brain might explain why some people with autism have normal or even superior skills in some areas, while many other types of thinking are disordered. It could be that the brain adapts to the diminished inter-area communication in autism by developing more independent, free-standing abilities in each brain centre. This might sometimes translate into the superior but isolated abilities typical of autistic savants {215} {216}.
Although there is also good evidence of denser connections than normal at a local level, another recent study points out that “Physically in the autistic brain, high local connectivity may develop in tandem with low long-range connectivity” {217}, much as it does to a lesser degree in the normal male {218}. Certainly, the remarkable synaesthetic savantism of Daniel Tammet described earlier in this chapter would fit this suggestion (despite being a very unusual condition). This is because synaesthesia in general has been seen as a result of overlapping and cross-talk between neighbouring brain areas—a theory which also seems to explain foot-fetishism (because the foot neighbours the genitals in the cortex) {219} {220}! But however that may be, it is certainly possible that communication between different centres within the brains of autistics retards processing in much the same way that a large number of users logged onto a computer network tend to slow it down. Certainly, excesses in local connections along with deficits in overall brain integration might explain why autistics sometimes show faster processing in certain cognitive functions but not others. An example might be so-called inspection time. This is the interval taken to correctly identify a visual stimulus, and has been found to correlate with IQ scores. People with higher intelligence seem on average to be more efficient in processing visual information when it is presented only briefly: “They can accurately tell what has been shown to them when others only see a blur” {221}.
However, this is not true of autistics. On the contrary, autistic children with average IQ of 83 have been found to have the same minimum inspection time as normal controls with average IQ of 118 (about 40 milliseconds). Indeed, autistic children with IQ of 68 had inspection time of only 42 milliseconds compared to 60 milliseconds for non-autistic but learning-disabled controls with IQ of 62. In other words, “This study proves that basic information-processing capacity is not necessarily reduced in autism” {222} citing {223}. If the information-processing involved in fast inspection time was bottom-up and local rather than top-down and global, it would certainly accord with the view that low-level processing in autistic brains might be enhanced, while overall connectivity might nevertheless be impoverished.
Such findings certainly tally with the fact that, unlike those of normal children, autistics’ scores on the many different sub-tests that are summed to produce an intelligence quotient are often highly uneven. Autistics appear to perform worst on tasks demanding holistic mental skills, such as tests of verbal comprehension or commonsense social reasoning. However, as we have already seen, they perform best on tasks demanding discriminatory spatial skills such as block-design, Seguin Formboard and Raven’s matrices tests. “All these tests aim to be independent of shared cultural knowledge, and they are all likely to tap basic processing efficiency independent of mentalizing ability” {224}. Indeed, where autistic savants are concerned, we have already seen that there can be staggering differences between their performance in their area of expertise and their overall IQ, which is usually well below normal.
Comparable findings to these studies of autistics have been reported when the sub-test scores of children diagnosed with Williams and Down syndromes have been compared. Williams syndrome has been linked to the deletion of at least 16—and possibly up to 30—genes on chromosome 7, whereas Down syndrome is caused by having an extra copy of chromosome 21. Sufferers from both syndromes have IQs of about 50, but Down children do better than Williams on measures of spatial IQ, and Williams do better than Down—indeed, often as well as the average person—on measures of verbal IQ {225}.
The contrasting findings from Down and Williams syndromes suggest that the fundamental reason for such remarkable unevenness in performance on sub-tests of different kinds may ultimately hinge on the fact that they relate to two distinctly different kinds of cognition: what I am distinguishing as mentalistic and mechanistic. If two different cognitive systems, rather than one unified one, underlie what IQ tests attempt to measure, then such findings are entirely to be expected, and indeed are significant precisely because they reveal the divided foundations on which intelligence may be based. A distinction between conventional IQ and social or emotional intelligence has already been suggested {226} {227}, but the true distinction may be one of mentalistic as opposed to mechanistic intelligence. However, it is also one that is likely to have been obscured by the tendency which I mentioned earlier to exclude tests that discriminate between the sexes from measures of standard IQ.
Because women averagely do better on mentalistic skills and men generally better on mechanistic ones, exclusion of measures revealing such sex differences also effectively rules out tests highlighting these two forms of intelligence, perhaps partly explaining why they have tended to escape notice until now.
** 3. Attention, Intention, Memory, and Mental Agency
From an evolutionary point of view, a plausible origin for what I am calling mentalism might be found in direction of gaze {228}. Primates (which include monkeys, apes and human beings) are typified by forward-rotated eyes, often to the extent that the visual axes are practically parallel (as in the human case). The benefit of this is excellent stereoscopic vision, which would have served their ancestors well in the arboreal habitat in which primates first evolved. However, the cost is a notable reduction in the visual field, particularly when compared with the almost panoramic view enjoyed by many mammals whose eyes are placed much more to the side of the head and whose visual fields may only overlap to a limited extent at the front. Indeed, prey animals like horses, cattle, and sheep have a small blind spot directly in front of them as well as one behind their heads {229}. When crossing a road for example, children have to be taught to look both ways, but most mammals would see both ways in such a situation without much need of head movements, thanks to their eyes being placed on the sides, rather than at the front, of the head. The result is that primates have become more social (and more vocal) so as to gain the advantage of many different pairs of eyes. Primates have also compensated for their restricted field of view by becoming sensitive to the direction of gaze of others. This is particularly important because, not only can it tell you where the others in the group are looking, it can also give useful clues about what they are seeing, their state of mind, and intentions. {230}
In other primates the outer surface of the eye is often the same colour as the rest of the face. In birds such as terns the whole eye is effectively camouflaged by being the same colour as the surrounding plumage (in the case of the tern, a black cap reaching down just far enough to hide the eyes). However, human beings have a white area— the sclera—surrounding the iris which may have evolved to reveal direction of gaze by giving the eyes a target-like appearance with their black pupils surrounded by a coloured iris surrounded in turn by the white sclera. Indeed, a recent series of experiments suggest that, along with the sclera we have evolved a dedicated expert brain system for monitoring direction of gaze using the whites of the eyes as the principal clues {231}.
Today a striking analogy for this evolutionary development exists in military technology. Radars function somewhat like eyes, and like them can be directed. Rules of engagement in some recent conflicts have allowed pilots to interpret a lock-on to their aircraft by an enemy radar as hostile, and to react immediately rather than wait for the missile-launch or gun-attack that might be expected to follow. Certainly, a precedent for this particular analogy can be found in recent brain-scanning experiments in which only the white of the eye was presented as a stimulus. These experiments showed that the more white of eye that was visible in fearful expressions, the greater was the response of the amygdalas. These almond-like organs lie deep within what has been called the emotional brain {232} and are implicated in fear responses, and as these experiments show, respond particularly to the eyes {233}. Indeed, a recent study of a woman with damage to the amygdalas which impaired her ability to detect fear on other people’s faces found that when instructed to look at the other person’s eyes, her recognition of fear became normal. Such findings suggest that normal people pay particular attention to the eyes when looking at others’ faces, and especially to detect a basic warning signal like fear {234}.
The primate researcher, Daniel Povinelli points out that “Appreciating the idea that others ‘see’ is, in some sense, foundational to the entire question of theory of mind— at least with respect to our human understanding of the mind”. He adds that “most of our social interactions begin with determination of the attentional state of our communicative partners, and from that point forward we constantly monitor their attentional focus throughout the interaction. Nothing can disrupt a social interaction more quickly than realizing that someone is no longer looking at you” {235}. Indeed, eyes are often called “the windows of the soul”, and detection of another person’s direction of gaze and shifts of attention have been described as “the linchpin of social cognition” {236}. It has been proposed that young children first experience the “meeting of minds” which epitomizes mentalism when they shift their attention to join that of someone else as indicated by the other person’s direction of gaze {237}. In other words, where the eyes lead, the mind follows, and what might at first have seemed an after-effect of social living, or a trivial detail in it—direction of gaze—now begins to take on the appearance of a central, fundamental, and strategic adaptation.
From the beginning it has been clear that autistics are notably lacking in awareness of direction of gaze, and are poor at interpreting its psychological significance. In his original paper on autism, for example, Asperger observed that “The characteristic peculiarities of eye gaze are never absent” in autistics. He went on, “From the first moment when an infant can properly ‘look’, that is, from the third month of life, and well before there is any verbal expression, the majority of his social relations are based on eye gaze. How the small child drinks in the world with his eyes!” But with autistic children,
there is a fundamental difference. Hardly ever does their glance fix brightly on a particular object or person as a sign of lively attention and contact. ... The disturbance is particularly clear when they are in conversation with others. Glance does not meet glance as it does when unity of conversational contact is established. When we talk to someone we do not only “answer” with words, but we “answer” with our look. A large part of social relationship is conducted through eye gaze, but such relationships are of no interest to the autistic child. Therefore, the child does not generally bother to look at the person who is speaking. The gaze goes past the other person or, at most, touches them incidentally in passing. {238}
Temple Grandin observes that the eyes of autistic children “seem to see everything except the one who is speaking to them” {239}, and recent research has wholly corroborated Asperger’s original finding:
Researchers have also realized that eye gaze can reveal children’s thoughts. Experiments have shown that normal children automatically gaze at the right place while being told a story along the lines of the Sally-Anne test. This is not the case with autistic children. Eye gaze turns out to be a better measure of mentalizing ability than the standard verbal response, and is even more discriminating between autistic and non-autistic mentally handicapped children. {240}
In short, if there is indeed a mental module or expert system specialized for gazemonitoring, it appears to be defective in the case of autistics.
Another deficit found in autism is an inability to judge and interpret others’ intentions towards oneself: so-called intentionality detection. Autistic people often fail to pick up cues directed at them in otherwise obvious and unmistakable ways, and are poor at interpreting body-language or judging the implications of others’ statements and behaviour. Indeed, autistic children notably make pronoun-reversal errors, referring to themselves as “you” and their mothers as “I” or “me’. However, language-impaired controls, such as sufferers from Down syndrome, do not make comparable errors, despite their poor speech competence {241}. Although autistic children are not confused about their own or others’ physical identity, and almost always use proper names correctly, they continue to use them long after non-autistic children of the same age have started to employ personal pronouns competently. Even normal adults can make errors with verbs like let/rent, or infer/imply in which the correct form depends on the relative status of the subjects to the objects concerned. Hence a speaker implies something which a listener infers, or a landlord lets accommodation which a tenant rents. In each case, the verb properly used defines who does what relative to whom. Again, whether you use the verb coming or going often depends from whose point of view you are describing the action: I may say I am going, but you may ask if I am coming. In such situations, whose point of view is considered is a matter of interpretation, and a common complaint is that a person may fail to see things appropriately from the other person’s angle. But people with autism have difficulty with the finer points of such negotiations of social roles and relative points of view. Indeed, all failures on their part which rely on these interpretive skills—including misuse of personal pronouns—have been described as failures in mentalizing {242}.
Many other deficits in autistics’ language and conversation skills have a similar origin. In large part, this is because human beings normally do not use language completely literally, and expect communications to be relevant to the speaker, their state of mind, knowledge, and beliefs—including, as we have seen, false ones (see above pp. xx-xx). Consequently autistic people tend to use language more literally than normal, and to misinterpret meanings which rely on understanding an expression relative to another person’s intention or point of view. For example, a young autistic woman is said to have actually painted the flowers at an art class rather than make a painting of them, and another became alarmed when told that she would be “sleeping on the train” rather than in a bed inside the train. Again, a young man with autism and a reputation for taking things said to him literally spent all day travelling to deliver a letter he had been asked to post to a friend. As Patricia Howlin remarks, “This literal response to language can also make individuals sound abrupt or even rude at times. A student called Eric, when asked what year his birthday was by his new tutor, looked at her in incomprehension and replied with scorn, ‘Well, every year of course!’” {243}.
Again, families with autistic children who have been taught to answer the telephone report that the child will reply to the inquiry of a caller, “Is so-and-so in?” with a simple “Yes!” but then replace the receiver, evidently thinking that a correct factual response is all that is required in such a situation {244}! Another common example is provided in this reminiscence from an autistic’s autobiography: “During the third grade I remember a classmate telling me that he felt like a pizza. I couldn’t figure out what made him feel like a pizza. Eventually I realized he meant that he felt like eating a pizza” {245}. Indeed, all failures to understand or respond to others’ feelings and expressions, verbal or otherwise, are failures to correctly interpret intention—at least if we assume that the basic intention of any expressive communication is to be correctly understood. To this extent, mentalistic deficits in autistics’ language and conversations skills could be seen as symptomatic of a fundamental shortcoming where interpretation of intention is concerned. Furthermore, if a plausible evolutionary origin of what I am terming mentalism might be found in direction of gaze, which we have seen is also deficient in autism, then detection, prediction, and interpretation of intention are an obvious second stage in the further development of mentalism.
As we have seen, direction of gaze normally reveals the current state of an organism’s attention: in other words, it reveals its probable current awareness. Furthermore, this can betray more than merely the direction in which it is looking, or even the exact target of its concern. Direction of gaze can also disclose much about an organism’s state of mind. A fixed, unblinking stare at an object can reveal a high level of concern, such as when a predator is stalking prey, or prey being stalked have seen the predator and are apprehensively monitoring it. By contrast, an unfocused, drifting direction of gaze which wanders over a large area can indicate a relaxed, unconcerned frame of mind, for example on the part of prey who have not yet spotted a predator or predators who are not looking for prey. Yet again, a probing, restless scanning of an area can reveal that the organism is searching for something in a state of anxiety or anticipation, as when prey know that a predator is near by but can’t tell exactly where it is, or when a predator has temporarily lost its prey but knows it to be in the immediate vicinity.
Such examples as these show what a short step it is to go from monitoring an organism’s attention to beginning to detect and even predict its intention: in other words, extrapolating from its current awareness to its next likely action. Furthermore, these examples also suggest the likely evolutionary forces that might have been at work in bringing about such a development. A prey animal that correctly anticipated the next move of a predator, for example in predicting where and when the predator would pounce, could easily owe its life to that ability. Such a development is an obvious candidate for so-called arms-race evolutionary escalation: a situation in which better prediction of predators’ intentions on the part of prey leads to predators having to become more resourceful in outwitting such anticipation, which leads to prey having to become even better at predicting intention, and so on, in principle ad infinitum—and in practice until both sides have become very good at monitoring and detecting the other’s intentions.
In human behaviour, an ability to correctly monitor others’ intentions is also sometimes a matter of life and death, particularly in modern towns and cities where traffic and pedestrians come into close contact. However, we are so habituated to reliably detecting and interpreting others’ intentions in the street that we seldom realize that just one or two steps often separate pedestrians and vehicles from potentially lethal encounters with each other. For example, people walking along a street parallel with the traffic may be no further away from it than a person wishing to cross, but it is the latter to whom drivers pay particular attention, usually on the evidence of no more than the person’s direction of gaze, posture, and general demeanour. In particular, drivers need to be able to distinguish between someone who is patiently waiting for a chance to cross safely, and someone who is in a hurry, and intent on getting across no matter what. Almost always their ability to make such distinctions will rely on their skill in interpreting intention and reading the signals that reveal it, and sometimes failure will result in severe injury or even death.
Recently brain-scanning has suggested that in order to predict others’ behaviour we probably put ourselves in their shoes and unconsciously run through the same processes in our own minds as they do in theirs. So-called mirror neurones are known to be excited in parts of the cortex involved with the action when someone sees someone else performing an act, and shortfalls in corresponding areas might explain some mentalistic deficits in autism [Chenga, 2006 #1988]. A sub-circuit known as the ventral pre-motor cortex appears to be involved with predicting others’ behaviour, while another area called the dorsal pre-motor cortex plans the actual execution of it. Some of the brain regions involved in prediction have been found to be abnormal in the brains of people with autism, suggesting where autistics’ difficulties with understanding others’ intentions and predicting their behaviour may be found {246}. Indeed, there is evidence that not only are autistic children poor at detecting, interpreting, and predicting the intentions of others, but that they also fail to conceptualise their own intentions as such {247}.
For example, in one study, three autistic young men with normal IQ who could pass tests of false belief (such as the Sally-Anne scenario) but nevertheless had varying degrees of mentalistic impairment were asked to record their thoughts at particular but unpredictable moments during a normal day (cued by a special device they carried with them). Each enjoyed participating, but only the least impaired boy quickly took to the idea of reporting his inner mental states; the second least impaired was only able to do so after four sessions; and the most impaired never satisfied the experimenters’ criteria for understanding the instructions. Instead, this individual persisted in only recording his purely physical actions, never his inner mental state. What struck the authors of this study about the boys’ reports was that all three described inner experience which was literal and visual, and appeared to lack verbal or other imagery. There was little or nothing in the way of introspective commentary on the events described which reflected the subjects’ own reactions. Such findings appear to be in line with other studies which suggest that when children are able to report their own mental states they are also able to report the psychological states of others, but that when they cannot report and understand the mental states of others, they do not report those states in themselves {248}. In the words of another authority,
“It is impossible to build up a sense of oneself without a good theory of other people’s minds” {249}.
Other writers observe that “Autobiographies of individuals with autism hint at disturbances of self-consciousness. Just as sleep-walkers can carry out many complex actions without being fully conscious of carrying them out, so children with autism go about their daily routines without full awareness of their own feelings and thoughts” {250}. Indeed, the following excerpt from a published autobiography of an autistic explicitly uses the symbolism of sleep-walking:
Autism had been there before I’d ever known a want of my own, so that my first “wants” were copies of those seen in others (a lot of which came from TV). Autism had been there before I’d learned how to use my own muscles, so that every facial expression or pose was a cartoon reflection identification... Like someone sleepwalking or sleep-talking, I imitated the sounds and movements of others—an involuntary compulsive impressionist. {251} quoting {252}
According to another account,
Whenever I get a very strong emotion and I am not clear as to where it comes from, I have to consider whether someone I am in communication with is displaying a similar emotion, and I am picking it up from them. Sometimes I feel as if I am fused with that other person’s emotions and can’t separate myself from them. One time when I was talking to my mother on the phone while at college, I got an overwhelming feeling of blackness when I talked to her and became very sad. Thinking about this, I realized that I didn’t have anything to be terribly sad about and perhaps had fused myself with an emotion from her. I called my mother back and found out that she was terribly sad. {253}
The following quotation from an autistic poet whose verbal IQ could not be established because she couldn’t understand the questions necessary to determine it, gives eloquent expression to the sense of autistic alienation :
I lost the me
It got under everything That was not poems {254}
A study of so-called Asperger savants mentioned in the last chapter (see above pp. xx- xx) observes that even so well-known and famous a writer as Hans Christian Andersen operated through a false self and had very little of a real or core self. The poet, William Butler Yeats, who has also been diagnosed as an Asperger savant, remarked that “My character is so little myself that all my life it has thwarted me. It has affected my poems, my true self, no more than the character of a dancer affects the movements of a dance” {255}. In the case of other famous people with autistic spectrum disorders, Fitzgerald observes that sometimes their sense of self depends on the admiration of others. The philosopher A. J. Ayer, for example, who Fitzgerald also cites as an Asperger’s savant, once remarked (parodying Descartes), “I am famous, therefore I must exist.” Ayer also asked whether he even had an image of himself, and answered that he did not think that he had an image of himself in the sense that he was much concerned with his own character {256}.
According to the autobiography of a woman diagnosed with Asperger’s syndrome at the age of 42, “One of the best ways of understanding what autism is like is to imagine yourself as a perpetual onlooker. Much of the time life is like a video, a moving film I can observe but cannot reach. The world passes in front of me shielded by glass” {257}. Temple Grandin comments that “Using my visualization ability, I observe myself from a distance. I call this my little scientist in the corner, as if I’m a little bird watching my own behaviour from up high.” She adds that this has also been reported by other people with autism and that Asperger noted that autistic children constantly observe themselves {258}.
The mother of two autistic boys reports that both her sons showed “an indifference or aversion to photographs or films of themselves.” Of the one called George she recounts that he “used to narrate the story of his own life as it was happening always in the third person.” Examples are: “He jumped into the bath with a tremendous splash; ‘Where can Daddy be?’ exclaimed George anxiously.” “He clutched his spoon tightly. The sausage bounced off the plate, but he caught it.” The mother adds that her all-time favourite was when he was eating a McDonald’s hamburger. “He pulled out the slimy, khaki slice of dill pickle and handed it to me, saying, ‘Mum, this is my conscience’” {259}.
Another autistic’s autobiography gives an account of being bullied and beaten by another child to the extent that she discovered on returning home that her face “was criss-crossed and bleeding from thousands of little scratches.” Her reaction, though, was “to stand in front of the mirror for a long time looking at my face” which she “thought ... looked interesting.” The same writer adds that “The vague sense of my body that I did have meant that I wasn’t particularly aware whether I was dirty, or how my clothes were sitting. I didn’t feel it.” {260}
An additional manifestation of a lack of awareness of their own intentions often seen in autistics is the ease with which others can influence their behaviour in certain respects. Furthermore—and again underlining a possible lack of sense of selfinvolvement in their own behaviour—such external influence can make autistics behave selflessly and co-operatively with others for both good or ill. A case illustrating good might be an autistic who even as an adult would carry groceries for his mother, assist in housework and cooking but “couldn’t ask a question, tell a joke, or respond except by repeating a few words of her last phrase.” Nevertheless, one of the few sentences he could produce on his own was “I’m being good!” {261}.
Autistics are not infrequently the victims of others’ mischievous suggestions when it comes to inappropriate, reckless, or deviant behaviour—in part perhaps because they lack the understanding of the conventional norms which would prevent another person agreeing to carry out the act. But a diminished sense of self-responsibility might be another important factor. Patricia Howlin observes that in mainstream schools it is not uncommon for children with autism to be deliberately led into trouble by other children who take a delight in exploiting this vulnerability. As the child with autism is frequently unable to appreciate the difference between children laughing with them and at them, they can be easily led into all sorts of outrageous behaviours {262}. A fascinating historical case of autism, that of Hugh Blair of Borgue (1708/965), shows that things were no different in the past: “Hugh was biddable by anyone including servants and schoolboys. He was often the source of crude amusement for others who provoked him into bad behaviour” {263}. For example, as contemporary witnesses quaintly put it, he “let even young boys [at school] lead him about and command him to do whatever they did ... the boys for their diversion passing and repassing him and taking off their bonnets ... by way of mock salutation . and he returning these salutations by taking off his hat to them” {264}.
* * *
Another important aspect of mentalism is memory. Without memory, people hardly have minds—or at least, have seriously diminished ones, as the tragic plight of those suffering the effects of progressive amnesia due to senile dementia or Alzheimer’s Disease shows. Indeed, we would scarcely have any kind of personal mental identity at all if we lacked an ability to recall our own past. And without an ability to remember others, we could hardly have much understanding of other people’s minds and would certainly not be able to form any sustained impression of them. Above all, appreciation of false belief—the litmus test of mentalism—is only possible if we can recollect the former state of knowledge that a later one replaces: to put it another way, you can only pass a Sally-Anne test as long as you can recall Sally, and what she did or did not know before Anne’s intervention (see above: pp. xx-xx).
Tulving suggested that there are a number of different ways of remembering, each with its own characteristic state of conscious awareness {265}. In so-called semantic memory there is generalized, impersonal knowledge about something. Examples might be knowing that Paris is the capital of France; knowing that there are 5280 feet in a mile, or that Columbus discovered America. However, so-called episodic memory refers to recollection of individual events which occurred in a person’s lifetime. Examples might be recalling a particular visit to Paris that you made, remembering giving the correct answer to how many feet there were in a mile when some particular person asked you, or recalling a specific book you read about Columbus’s discovery of America. Essentially the difference is that between knowing and remembering {266}.
According to a further elaboration of the concept suggested by Conway, a fundamental function of human memory is “to retain knowledge of the progress of personal goals.” Here episodic memory is seen as a system that contains recent experiences related to the self which are then consolidated into long-term autobiographical memory. Access to episodic memories rapidly degrades and most are lost within 24 hours of formation. Only those episodic memories integrated at the time or consolidated later—possibly during sleep—remain accessible and then become true autobiographical memories: “Autobiographical memory is, then, a type of memory that persists over weeks, months, years, decades and lifetimes, and it contains knowledge (of the self) at different levels of abstraction” {267}. Particular autobiographical memories are “dynamic transitory mental constructions generated from an underlying multilevel knowledge base which is under control of the ‘working’ self’” {268}. Indeed,
It seems then that autobiographical memory is dominated by the ‘force’ or ‘demand’ of coherence. A stable, integrated, self with a confirmatory past that yields a consistent and rich life story (...) constitutes a self that is able to operate effectively, achieve goals, and relate to others in productive ways (...). A coherent self will have high self-esteem and a strong positive sense of well being (.), both powerful predictors of physical health. Thus, the benefits of coherence may then be considerable. {269}
Semantic, factual memory needs to correspond to reality, so Conway concludes that memory as a whole may be something of a trade-off between the separate but competing demands of coherence with a person’s self-image demanded by autobiographical memory and correspondence with reality demanded by the recall of semantic memories {270}.
We have already encountered coherence in connection with the weak central coherence that is characteristic of the autistic style of thinking (see above pp. xx-xx), and another way of interpreting Conway’s remarks just quoted would be to say that episodic/autobiographical memory could be seen as inherently mentalistic, while semantic, factual memory was much more mechanistic. We have already seen that despite seeming to have an excellent memory after his discovery, Kaspar Hauser appeared to lack any kind of episodic memory from before that event (see above pp. xx-xx), and in laboratory tests individuals from the higher-functioning end of the autism spectrum show characteristic deficits in episodic/ autobiographical memory— those involving personal identification with the event. However, they show no such deficits in relation to semantic memory as tested in tasks such as rote memory, cued recall, and recognition memory {271}. In another study, although Asperger’s subjects were described as making significantly fewer remember responses (that is, episodic recollections) than did matched normal control subjects, they made more know responses (semantic recollections). Furthermore, we have already seen that remarkable rote memory can often be found in autism, and almost always in autistic savants, some of whom have amazing powers of recollection in connection with things like sports, history, or literature (see above pp. xx-xx). Yet despite such feats of semantic memory, “the main conclusion is that there is indeed episodic memory impairment in adults with Asperger’s syndrome” {272}.
Other writers describe autistics as being unable to remember themselves performing actions, participating in events or possessing knowledge and strategies, suggesting that the same is true of autistics’ autobiographical memory (Powell and Jordan, 1993 quoted by {273}. Indeed, with Conway’s perceptive comment quoted just now in mind, you could see this as yet another aspect of weak central coherence in autism: a mentalistic deficit in which autobiographical memory was much less coherent with the self than normal. Finally, a sense of your own central place in your own history allows not only mental time-travel into the past, but into the future too. If you can recall yourself as the principal actor in what has already happened to you, you can also easily imagine yourself as the author of actions yet to take place, and rehearse scenarios of as-yet-unrecorded autobiographical events. But just as we might predict, autistics also show characteristic deficits here: not only are they unlikely to travel mentally into their own past, they are if anything even less likely to travel into the future in this respect {274}.
These findings underline the point that episodic/autobiographical memory depends critically on a further aspect of mentalism that we have not discussed so far: what we might term the concept of agency. This is described by The Shorter Oxford English Dictionary as “the faculty of an agent, or of acting” and as “action personified”. Clearly, monitoring gaze, attention, intention, and interpreting motive in others all hinge on seeing others as independent actors, or agents, in interaction. But attributing independent agency or the ability to act to others implies that it is also possessed by the self, which is then seen as an internal agent, responsible for conscious behaviour. Normal episodic/autobiographical memory is characterized by this sense of mental agency: the recognition of your own role in your own remembered past. However, the ability to travel mentally into the future adds another important dimension to the sense of personal agency: that of free will and sovereign, self-determining consciousness.
To see how this comes about and how such a thing is related to mentalism, consider a simple scenario: that of a fugitive and his pursuers. Furthermore, we make the reasonable assumption that the pursuers have limited resources and cannot cover all possible sites for apprehending the fugitive, and that the fugitive can only be in one place at a time. The fugitive, by definition, is a free agent—indeed, he is determined to remain free. But the question is: how free? And in what sense is he a free agent?
In principle, the fugitive may seem completely free, but suppose the pursuers know that the fugitive is likely to resort to location A with the highest probability (his home, say), B with less probability (his family perhaps), or C with less likelihood still (for example, acquaintances), and so on, with decreasing probability for each subsequent suspected place of refuge. If the fugitive thinks for a moment, he immediately realizes that the pursuers will think this. In other words, he becomes conscious of what they might do, and in practice exercises normal mind-reading skills—something an autistic would not do at all, or only do with difficulty. What this means is that the fugitive instantly sees that, wherever he goes, he is not free to visit A, almost certainly not B, and probably not C either. However, knowing that his pursuers cannot cover all possible sites at one time, he might decide to go to some very improbable ones, say X, Y, or Z. But there again, he might reflect that, if he is sure his pursuers will foresee that he might think this, he might consider A, B, or C after all on the premise that, since he is expected to go there first, they will not look for him there if they anticipate his reaction to their reaction. Nevertheless, the fugitive cannot rule out his pursuers foreseeing this in its turn and therefore continuing to search for him at A, B, and C— which once again suggests somewhere like X, Y or Z...
Clearly, our fugitive is not a completely free agent, but is constrained by his pursuers—at least if he wishes to retain his freedom! The pursuers are certainly free to search for him wherever they wish, but they are also constrained by their expectations of where he might go. But neither has any more than very uncertain knowledge about the other, and knows that what each does in response to the other is constrained by what each thinks the other knows, and thinks the other knows about what they know, and so on, potentially ad infinitum. . .
Scenarios like this illustrate the fact that “freedom” is a relative, mentalistic term, meaning different things in different contexts: the fugitive by definition is “free” because he is no longer a captive, and also “free” to decide where to hide. Nevertheless, his freedom is constrained by his desire to stay free, and is to that extent determined by his situation. Moreover, what the fugitive is free to do is further limited by his consciousness of the situation: what he thinks his pursuers think—and by what he thinks they think that he thinks, and so on. This is essentially a Sally-Anne situation, one in which the fugitive and the pursuers’ actions are constrained by their beliefs about the other’s beliefs.
Of course, such fugitive-and-pursuer situations are the stock in trade of folk-lore, fiction, and mythology the world over, and one reason why they are so perennially popular may be that they so accurately portray the reality of mental interaction. This is because what I as a conscious mental agent can determine about others’ intentions and future actions is constrained, not only by what I think they know, but by what they might think I know about what they know, giving rise to considerations regarding what I know about what they know about what I know, and so on. The extra layers of complexity which taking into account others’ reactions to your own mental state introduces makes the prediction of others’ behaviour so difficult and so contingent that regarding them as mental agents with conscious free will is in practice unavoidable and in principle a welcome simplification. In short, if you cannot reliably predict another person’s behaviour because the causes are so complex, you might just as well regard it as unpredictable! But at the same time, you cannot simply consider others’ behaviour as random and meaningless, because this would be to ignore their mental states altogether and result in you behaving like an autistic in this respect. Instead, you have to both respect others as mental agents in their own right, and also allow them the freedom to act in ways which you can seldom completely control and often not completely predict or perhaps even understand. The result is that mentally you have to accord others conscious free will and respect them as independent agents of their own destiny. Our belief in human freedom is essentially a conclusion forced on us by the necessity of seeing other people’s behaviour as essentially unpredictable, but nevertheless motivated. And the role of the other person’s mental awareness of others in contributing to their behaviour confirms us in our justified view that we ourselves are conscious mental agents, able to choose an outcome knowingly, even if ultimately unpredictably. Indeed, this is why autistics often seem alien, childish, or robotic in their behaviour: thanks to their symptomatic deficits in mentalism, autistics do not take other’s reactions to their own behaviour sufficiently into account, and as a result their behaviour seems crass, unthinking, or compulsive to normal people.
To illustrate the contrast between mentalistic and mechanistic cognition in relation to the issue of agency, consider a surgeon operating on a patient. The surgeon treats the patient as an unconscious, material object on which the surgery is performed, rather as a mechanic might approach a piece of machinery that needed fixing—in other words, mechanistically. (Here autistic tendencies would not matter, indeed, to the extent that they helped the surgeon be detached and objective in operating on a patient, they might actually be beneficial.) But in a clinical interview, the same surgeon would treat the same patient as a conscious, self-determining subject, for example in negotiating a drug regime or program of post-operative care. In such contexts as this, the surgeon is obliged to respect the patient’s real freedom to choose, for example in agreeing or not agreeing to take medication or exercise in circumstances where, unlike the situation on the operating table, the surgeon does not have the power to enforce compliance on an unfeeling object. In this circumstance, the patient is being treated mentalistically (and in such circumstances of persuasion mentalistic skills would definitely pay off, while autistic tendencies would be a serious handicap.) Clearly, both the mechanistic approach to surgery and the mentalistic one to the clinical interview are appropriate and correct, and no one would criticize a surgeon for either. On the contrary, a surgeon who insisted that the patient should be conscious and freely choose for themselves each and every procedure during surgery would probably have as few patients as one who treated patients in interviews as if they were inert, unconscious bodies on an operating table!
It is important to realize that the differences here go much further than merely the context or setting of the interaction: they apply to the basic logic of causality. Suppose that during the operation the surgeon administers a drug to the patient which does not have the expected effect. The surgeon will have to consider what physiological, chemical, or other physical processes might account for it, and this would involve normal mechanistic, cause-and-effect thinking of the kind epitomized in medical science. But now imagine that in a clinical interview the patient refuses to take a drug which the surgeon wishes to prescribe, perhaps because of a fear of its possible sideeffects. The surgeon is now dealing with a quite different universe of cause-and- effect—the mental one—in which an event like taking or not taking a drug can be motivated by entirely psychological factors, such as beliefs, fears, or knowledge. Such factors may be considered causal, but the principles that govern them are completely different from those of the physical or even biological world. As a result, an entirely different system of cognition is required to understand and manipulate the world of mental reality, in a word: mentalism.
However, the fugitive/pursuer or surgeon/patient scenarios are notably one-sided to the extent that the pursuers or surgeon are the dominant agents and the fugitive or patient very much at the receiving end, so to speak. As such they fail to take into account the fact that in normal social interactions a person can play both an active as well as a passive role in relation to someone else, and can hope to have as much influence on the other’s behaviour as the other might hope to have on them. Certainly, where interpretation of intention is concerned, mentalism becomes a rich and powerful discourse because of the way in which it so readily takes on elements of evaluation, criticism, and even intimidation. This is because we commonly and regularly evaluate our own and others’ intentions as good, bad, or indifferent, and know that it we voice such evaluations, they are likely to influence other’s behaviour. So we praise intentions which lead to behaviour we would like to see repeated or reinforced, blame intentions leading to things we would want to prevent or avoid, and rate the rest as indifferent. In other words, you could say that mentalism provides us with means to name, blame, and shame (or alternatively to except, exonerate, and extol—something we are particularly good at when the subject is ourselves). Indeed, at the end of the first chapter we saw some examples of mentalistic manipulation at its most monstrous in the case of Bruno Bettelheim’s reign of terror at the Orthogenic School (see above pp. xx-xx).
If autistics have deficits in mentalism, then they should also show a deficit here: in other words, they should be less concerned with naming, blaming, and shaming than normal. I know of no scientific study that has ever investigated this, but the following quotation from the autobiography of one diagnosed autistic suggests that, at least in his case, the prediction is fulfilled:
A lot of things to me just are—not good or bad—they just exist. I often wonder why others seem to exert a lot of energy deciding whether others are good, bad, ugly or beautiful. This is a skill that I don’t seem to have nor care to cultivate. This does not mean I am unaware of the difference between right and wrong or bad and good... It just seems to me that a lot of what goes on in the daily judging of others and their actions is not worth the energy expended in doing so. {275}
Speaking about her two autistic sons, the mother I quoted earlier reports of her boys that
Many of the most aggravating habits of normal children are refreshingly absent. The boys have plenty of aggravating habits of their own, of course, but they don’t whinge, compete, squabble or blame other people for their own shortcomings. They don’t exaggerate minor injuries or try to get someone else into trouble. . I never hear those tiresome phrases like “It’s not fair” or “He started it” or “Are we nearly there?” . They may get cross with me when I thwart their desires, but they never criticize me, or anyone else. They never clamour for expensive treats or insist on their rights; they are unmoved by crazes and playground fashions. They haven’t the least notion of “cool”. They are immune to peer pressure. They are always completely themselves. {276}
One reason why autistics are almost always found to be wilful and recalcitrant in certain respects may be that their mentalistic deficits also make them less vulnerable to this censorious aspect of mentalism than others. To put it another way, you could say that autistics are not so easy to name, blame, and shame as people with normal mental sensitivities. For example, speaking of the original cases on which his diagnosis was built, a recent commentator points out that
Asperger often regarded the children as being “distracted from within/or by themselves”. Furthermore, half of the children displayed disciplinary problems, negativism or conduct difficulties, particularly at school; they did not listen to what the teacher said or only followed their own “spontaneous”, idiosyncratic ideas. They were described as disrespectful towards authority, and could come across as impudent and blunt because they would speak out freely without thinking while being quite unaware of the situation or the status of the person to whom they were speaking. {277}
Hugh Blair’s immunity to shame at least is suggested by the contemporary observation that “bid to uncover his nakedness . he did without seeming to know that there was any indecency therein” {278}. Today such behaviour might have landed Blair in court on a charge of indecent exposure, and we have already seen that one notorious criminal, the so-called Unabomber, Theodore Kaczynski, has been diagnosed as an Asperger’s case (see above: pp. xx-xx). An authority on autism in adults points out that “the vulnerability and honesty of people with autism can be to easily exploited or abused. They are the ones left holding the brick outside the video centre whilst the other youths have made off with the goods; it is they who may be used to shop-lift, or even drive a stolen car whilst other people wait in the background” {279}.
At present, autism does not figure prominently in forensic psychiatry or in pleas of mitigation in law courts, despite the passing comment of one authority that Asperger’s cases are found in “high numbers in secure prison hospitals” {280}. Nevertheless, the considerations touched on here suggest that, with greater understanding of the condition, the situation could change. After all, if a deficit in mentalism is indeed central to autistic spectrum disorders, and if as I am suggesting here, such deficits can have far-reaching implications for autistics’ social adaptation, then it is not hard to see that some individuals could become involved in behaviour that was not merely antisocial but actually criminal. Indeed, in some cases you can see how this could combine with autistics’ special interests and expertise in certain areas, such as the Unabomber’s engineering and wood-working skills, or another autistic’s interest in locks which led him to become an expert lock-picker (although, he assures us, never a thief {281}.
In his account of Temple Grandin Oliver Sacks comments on “the touching simplicity and ingenuousness of Temple’s writing” and “her incapacity for evasion or artifice of any kind” {282}. Temple Grandin herself remarks that
Autistic people tend to have difficulty lying because of the complex emotions involved in deception. I become extremely anxious when I have to tell a little white lie on the spur of the moment. To be able to tell the smallest fib, I have to rehearse it many times in my mind. I run video simulations of all the different things the other person might ask. If the other person comes up with an unexpected question, I panic. Being deceptive while interacting with someone is extremely difficult unless I have fully rehearsed all possible responses. Lying is very anxiety-provoking because it requires rapid interpretations of subtle social cues to determine whether the other person is really being deceived. {283}
As other writers have pointed out, successful lying requires not just competence in understanding false-belief situations, but real skill in exploiting and manipulating them, and this, as we have already seen, autistics notoriously lack (see above pp. xx- xx). Perhaps not surprisingly then, brain-imaging reveals that there is more brain activity when lying than when telling the truth. Areas activated when lying are predominantly left hemisphere ones involved in attention, error-detection, initiation, and voluntary movement (specifically, the anterior cingulated cortex and pre-frontal and pre-motor cortices) {284}. Indeed, Temple Grandin follows some leading neuroscientists in suggesting that
Normal people have an interpreter in their left brain that takes all the random, contradictory details of whatever they’re doing or remembering at the moment, and smoothes everything into one coherent story. If there are details that don’t fit, a lot of times they get edited out or revised. Some left brain stories can be so far from reality that they sound like confabulations. {285}
Here, Grandin seems to have Vilayanur Ramachandran’s remarkable findings in relation to anosognosia (meaning, ignorance of illness) in mind. This affliction accompanies a left-side/right hemisphere stroke and usually disappears within a few weeks, but on rare occasions can be permanent. Strokes often paralyse one side of a person’s body, but in anosognosia the paralysis goes with complete denial by the patient that the paralysis has occurred. A striking characteristic of anosognosia is the extent to which patients attempt to rationalize and not simply deny their disability. For example, when asked to perform an action with her paralysed left arm, one patient would usually rationalize her failure with statements such as, “My shoulder hurts a lot today; I have arthritis, you know,” or “I didn’t really want to point that time.” Although the patient could be induced to admit that she was paralysed after several such trials, just 10 minutes later, she not only reverted to denial—insisting that her left hand was fully functional—but also claimed that she had successfully used that hand during the preceding testing session! This was despite the fact that her memory for other details of that session was completely accurate. Ramachandran, who described this case, reports that it was almost as if she had “forgotten” or selectively repressed the memory of her failed attempts as well as her verbal acknowledgement of her paralysis.
An additional reason for thinking that anosognosic patients do indeed know somewhere in their brains that they are paralysed but cannot access the realization is the astonishing discovery that the condition can be temporarily cured by pouring icy water into the patient’s left ear. Given that anosognosia is linked to paralysis only on the left side of the body, it seems plausible to suppose that irrigation of the left ear with cold water stimulates the right hemisphere, and in particular the vestibular system, which is connected to the semi-circular canals of the ear and is concerned with maintaining balance and a sense of the orientation of the body. Irrigation of the left ear with resulting stimulation of the vestibular system’s links with the affected right hemisphere appears to temporarily restore whatever function of the right brain is compromised in anosognosia and to allow a remission during the treatment and for about 30 minutes afterwards. During this time, the patient not only openly admits to the paralysis, but shows evidence of having laid down episodic memories consistent with this realization throughout the previous period of denial. Ramachandran comments that it is almost as if the irrigation treatment had revealed two separate conscious human beings who are mutually amnesic: a “cold water” person who is intellectually honest and acknowledges the paralysis, and an anosognosic one who completely denies it {286}!
Of course, you could dismiss such findings as limited to cases of brain pathology like strokes, but Ramachandran is not so easily convinced. On the contrary, he suggests that “what one is really seeing in these patients is an amplified version of Freudian defence mechanisms caught in flagrante delicto; mechanisms of precisely the same sort that we all use in our daily lives”. Ramachandran concludes that “Contrary to the frequently expressed view that memory repression is not a real phenomenon, my findings provide compelling experimental/clinical evidence that it is indeed a robust psychological process” {287}.
Ramachandran also suggests that there is an unconscious “anomaly detector” in the right hemisphere whose sole purpose is to serve as a “Devil’s Advocate” that periodically challenges the left hemisphere’s “story”, and detects anomalies or discrepancies. He speculates that when the anomaly reaches a critical threshold, an interaction with the right hemisphere forces a complete change in your world view. Ramachandran adds that you could think of the anomaly detector “as a mechanism for preserving intellectual honesty or integrity. ... I might be willing to engage in some minor rationalization, i.e., make some small false assumptions to get on with my life, but when the false beliefs become too far removed from reality, my anomaly detector kicks in and makes me re-evaluate the situation” {288}.
Further evidence for this interpretation comes from an experiment in which an anosognosic patient’s paralysed left hand was put inside a box with hidden mirrors which allowed the experimenter to make it appear to move. This was done by having the patient wear a glove on the hand and contriving the mirrors in such a way that a hidden accomplice’s gloved hand looked as if it was the patient’s. The patient was first tested by being asked to clap, and proceeded to do so Zen Buddhist style, with only one hand, but claimed to be clapping normally! When asked to move her paralysed hand placed within the box to the sound of a metronome, the patient was not surprised to see it moving, despite the fact that it was of course the accomplice’s hand which she saw in motion. But when the accomplice’s hand was kept still like the patient’s real hand, the patient also nevertheless claimed to see it moving. According to Ramachandran,
When confronted with the contradictory information from her different sensory systems, her left hemisphere tries to impose consistency by simply inserting the required evidence, i.e., the visual appearance of a moving right hand. Since she has a malfunctioning anomaly detector in her right hemisphere, this bizarre delusion goes unchecked and, consequently, she reports that she can actually see her hand moving even though this belief is contradicted by the visual appearance of a stationary hand. {289}
What Ramachandran calls a striving to impose consistency is close to what we have already seen autism researchers defining as central coherence (see above pp. xx-xx). And we also saw earlier in this chapter that autobiographical memory is ideally coherent with a person’s self-image. Conway gives some illustrative examples of this—and indeed has suggested that it is impossible to induce false memories in people which disrupt such central self-coherence (although autistics’ characteristic weak central coherence and sense of self suggests that they may be exceptions) {290}. Again, Ramachandran’s right hemisphere “anomaly detector” recalls Temple Grandin’s “little scientist in the corner/little bird watching my own behaviour from up high” quoted earlier, and is strongly reminiscent of the flair for finding details and discrepancies that many Asperger’s subjects show, for example in their ability to solve hidden-figure puzzles, and as we have seen is otherwise described as field independence (see above pp. xx-xx). So to this extent you could certainly see the left hemisphere as more mentalistic/centrally-coherent and the right as more “autistic”/field-independent in the sense of being less mentalistic and perhaps more mechanistic.
Evidence that this left-hemisphere cognitive stance may also extend to purely mental matters and to memory is provided by a study which compared autistics with normal controls in memory tests which discriminated between true and false recollection of previously studied lists of words. To quote the experimenters:
the autistic spectrum disorder group showed significantly less false recognition of semantically related lure words than did the healthy controls. However, the autistic spectrum disorder group showed normal hit rates for previously studied words, resulting in greater discrimination between true and false memories than in the control group. The autistic spectrum disorder group appeared to be relying on a highly literal form of memory, missing out misattributions resulting in false recognition responses. {291}
We also saw that the savant syndrome found in 10 per cent of autistics and Asperger’s patients has been associated with right-hemisphere enhancement, skills, and developmental peculiarities, perhaps linked with left-hemisphere deficits and/or delays (see above pp. xx-xx). Ramachandran’s interpretation of the remarkable findings from anosognosia suggest that in everyone there may be a marked difference in mentalism between the two sides of the brain, with the left, normally dominant and conscious hemisphere being more mentalistic, verbal, and centrally-coherent than the right, which is more “autistic” by comparison—and certainly less verbal and less centrally-coherent.
The findings of so-called split-brain research point in the same direction. This term refers to a surgical procedure in which the corpus callosum—the connection between the two halves of the cortex (see above pp. xxx-xxx)—has either been wholly or partially cut, so that each half of the brain is even less connected to the other than normal, and consequently even more independent {292}. Nerves from one side of the body are, in the main, connected to the opposite side of the brain. Normally, we do not notice this because the two sides of the cortex communicate with one another. However, in split-brain patients the difference between left and right becomes dramatically apparent. The one extraordinary defect revealed by these studies, quite unlike anything seen in animals, is that subjects are unable verbally to describe experiences of the left half of the visual field or of the left hand. Though both hemispheres register awareness, only the left can write or speak {293}. If a stimulus-word like “laugh” is flashed up on a screen only seen by the left visual field (and therefore by the right hemisphere) one patient laughed and when asked why replied, “You guys come up and test us every month. What a way to make a living!” Patients will respond to similar left visual field stimulus-words such as “walk” and will provide various explanations when asked why they did so—such as wanting to go to get a drink. According to the experimenter, “However you manipulate this type of test, it always yields the same kind of result” {294}.
It is worth pausing for a moment to notice how “autistic” in some respects these experiments show the right hemisphere to be. As we have already seen, autistics are notoriously poor at many mental and verbal skills, and are often easily led, and in some situations highly suggestible. Here, the right hemisphere seems much the same: lacking in full conscious awareness and unable to verbalize the true reasons for its actions as we have seen autistics often to be, yet also very vulnerable to suggestion. At the very least, the right hemisphere seems to have notable deficits in mentalism by comparison to its much more competently mentalistic equivalent on the left, and so to this extent you could say that there was something of an autistic in all of us. For the normal majority, it appears to be limited to the right hemisphere, but in autistics evidently affects the left, normally more mentalistic hemisphere too. However, autistics’ left hemisphere’s deficits in mentalism and central coherence might make it all the more difficult for them to exploit false beliefs successfully in themselves and others. Certainly, Temple Grandin believes that “autistic people don’t seem to have repression. Or if they do, they have it only to a weak degree”. Speaking of herself, she remarks that she doesn’t think she has any of Freud’s defence mechanisms, and is “always amazed when normal people do”. Indeed, she claims not to have an unconscious at all {295}!
Of course, you could dismiss such denials as symptomatic of the characteristic hypo- mentalism of autistics—at least where insight into their own minds is concerned. In other words, if autistics can’t read other people’s minds, why should we expect them to be able to read their own? And if most of what goes on in the brain is unconscious as it is indeed known to be, is it any wonder that an autistic ends up knowing even less about their own unconscious than many less mentalistically-deficient people do? Nevertheless, you could also wonder whether the mentalistic deficits of autistics mean that their ability to deceive themselves is much less well developed than that of normal people. And given the deficit that we have already seen autistics show in a sense of self, this suggests that the fundamental motives for defence—self-protection, self-promotion and self-justification—are likely to be muted in autistics, and perhaps sometimes even absent altogether, further explaining their characteristic tendency to candour.
For reasons like those discussed in this chapter, people with autism spectrum disorders are in the words of one leading diagnostician very much “truth-seekers” {296}, and tend to be immune to many commonplace contemporary prejudices. Articulate autistics speak of themselves as defiant “in the face of orthodoxy” and as despising and loathing “the system of the world, with its fashions and trends and flimsy ideas and philosophies, its media and social conditioning”. Indeed, the same person reports that he would sometimes make the mistake of bringing this superficiality to the attention of odd individuals. “‘Have you noticed how false everyone is?’ I would start. ‘The way they change depending on whose company they are in? They talk one way when they are on their own, and a completely different way when they’re with their friends—sometimes even altering their feelings and beliefs to suit.’ He concludes, “It’s because they’re scared of being themselves, you see”— something that we have already seen autistics are not {297}. As a result, autistics represent a unique challenge to the rest of the human race: “Autism, with its indifference to cultural values, implies an existential critique of society. It questions some of its most valued concepts... Society is challenged and humbled by the sheer existence of people who are unmoved by values that it takes for granted” {298}. Like extra-terrestrials who have lived unsuspected on Earth, “These mysterious, impossible, enchanting beings will always be among us, unwitting yardsticks for our own moral behaviour, uncomprehending challengers of our definition of what it means to be human” {299}. Certainly, the combination of an alternative way of looking at life with unusual cognitive gifts and an inability to dissimulate or package the truth for popular consumption means that the insights of autistics represent the only genuinely alien intelligence about ourselves that we have had to date.
** 4. Hyper-mentalism, Schreber, and Psychosis
At the beginning of the last chapter we saw that monitoring of gaze is a plausible evolutionary origin for mentalism, and that such awareness of attention would lead naturally to intuition of intention and mental agency. We also noted that autistics were symptomatically deficient where sensitivity to gaze was concerned (see above pp. xx- xx). However, the same cannot be said of Rupert Sheldrake. In his recent book, The Sense of Being Stared At and Other Aspects of the Extended Mind, this writer reports that he often turns around to find “someone staring at me” {300}. He adds that, according to his own surveys of adults in Europe and in the United States, 70 to 90 per cent said that they had sensed when they were being looked at from behind. Indeed, it is the considered view of this author that such a sense of being spied on can even be derived from closer-circuit TV cameras and other types of remote imaging, and he provides many anecdotes which he believes illustrate the point. He also includes a lengthy discussion of the “evil eye” as an instance of “the fact that people do seem able to influence others by their looks” {301}.
As Sheldrake himself points out, people’s awareness of being looked at by others could be explained by sensitivity “to sounds, to movements in their peripheral field of vision, or to other subtle sensory clues, perceived subliminally. ... People may often turn around but only remember the occasions when someone was staring at them, and forget all the times they turned and no one was looking.” Indeed, he adds that “This illusion would be enhanced by the tendency for our visual systems to detect movement. As we turn around to look behind us, if someone behind us sees us moving, we are likely to attract their attention, and our eyes meet” {302}. In a series of experiments published after Sheldrake’s book, 40 subjects were repeatedly shown images for a fraction of second separated by blanks. Sometimes the images remained the same, but sometimes they were subtly different. In the latter case, about a third of the experimental subjects reported a feeling that the image had changed before they could identify what the change was; but in control trials the same people proved that they could reliably tell when no change had occurred. According to the researcher, “this explains a lot of the belief in a sixth sense” and he adds that “Our visual system can produce a gut feeling that something has changed even if we cannot visualize that change mentally” {303}.
But according to Sheldrake, there is not just a sixth sense, but a seventh also—one identified with what he calls “the extended mind.” Indeed, Sheldrake is prepared to challenge what he calls the “intromission” theory of vision and visual perception within the brain put forward by modern science as nothing more than “a dogma accepted on the authority of science”. In his view, “Educated people have been brought up to believe that their minds are located inside their heads, and that all their perceptions and experiences are somehow concentrated in their brains.” He goes on to “propose that vision involves a two-way process, an inward movement of light, and an outward projection of images” {304}.
Of course, there is much truth in the claim that vision—like most other perceptions, but probably much more so—involves a two-way process in the sense that what we see is demonstrably constructed by our brains somewhat in the way in which computers generate virtual images. Certainly, whatever we are conscious of seeing is not what appears directly on our retinas. On the contrary, retinal images are inverted, have a significant hole near the centre (the blind-spot) and are processed separately as left and right halves of the visual field in opposite hemispheres of the brain. Only in our subjective, mental perception are the two halves of the visual field seamlessly joined, put the right way up, and shown without any obvious sign of a blind-spot. Furthermore, there is evidence that some visual hallucinations definitely originate within the visual system itself, and represent artefacts of the visual processing mechanism projected out into the virtual reality that our brains construct {305} {306} {307} {308}.
But this is evidently not what Sheldrake means. He goes on to say that “This outward perception occurs within mental fields, which I call perceptual fields.” He adds that some may prefer to talk about “vibrations, energy flows, chi or non-local quantum effects” to his use of “field”, but concludes that whatever words are preferred, the sense of being stared at must depend on the influence of the looker on the person looked at, on a projection of influences outwards. This sense reveals that through the power of attention the mind is connected to the world beyond the body. If the sense of being stared at is real, it implies a sensitivity that goes beyond hearing, sight, touch, taste and smell—beyond the known senses. It could be thought of as a sixth, or even a seventh sense; alternatively as a form of perception beyond the known senses, in other words extra-sensory perception or psychic ability. Indeed, according to Sheldrake’s theory, “Mental fields that extend beyond the brain may also explain telepathy,” and he adds that “our own telepathic powers are generally poor compared with those of dogs, cats, horses, parrots, and other species of mammals and birds.” He speculates that “They may have a seventh sense that enables them to detect threatening intentions. The may be able to sense when a would-be killer is looking at them, even if they have not yet detected the predator through sight, smell or hearing” {309}. He adds that “This is a potentially dangerous thought. It would be much less disturbing to dismiss the sense of being stared at as an illusion—or even as a form of paranoia” {310}.
Certainly, feelings of being watched, stared at, or spied on remarkably similar to those reported by Sheldrake are common in paranoid schizophrenia—so much so that Harry Stack Sullivan (1892-1949), a psychiatrist famed for treating schizophrenics, advised his colleagues to sit at the side of such a patient rather than facing them, never to look them in the eyes (which he found created suspicion), and to address them in the third person. The most famous paranoiac in the psychiatric literature, Senatsprasident Daniel Paul Schreber (1842-1911), a German high-court judge who published an autobiographical account of his illness which was later the subject of a paper by Sigmund Freud, eloquently bears out Sullivan’s observation {311}{312}. Schreber’s book has been described as “the most written-about document in all psychiatric literature” {313}, and included a section in it entitled “Direction of Gaze” long before the subject had been introduced into discussions of theory of mind. Writing about his psychiatrist, Schreber comments: “I ... gained the impression that Professor Fleschig had secret designs against me; this seemed confirmed when I asked him during a personal visit whether he really honestly believed that I could be cured, and he held out certain hopes, but could no longer—at least so it seemed to me—look me straight in the eye” {314} [Schreber’s emphasis]. Recent laboratory experiments have provided the first direct scientific evidence that people with schizophrenia are indeed unusually sensitive to the direction of another person’s gaze. Indeed, the researchers point out that the social deficits seen in schizophrenia could be the outcome of such an over-sensitivity—particularly in preventing them making accurate inferences about what another person is likely to be thinking {315}. In other words, both excessive sensitivity and insensitivity can result in perceptual deficits. This clearly happens in the case of sensitivity to light causing visual deficits, and it can just as easily occur in relation to social inferences: too much sensitivity can be as bad as too little.
Nowadays paranoid psychotics often extend this morbid sensitivity about direction of gaze to modern technological surrogates for it, and become similarly pathologically pre-occupied with cameras, closed-circuit TV, and radiation-producing mechanisms of many different kinds (evidently sharing Sheldrakes’s belief that vision involves an outward projection of some kind even when it emanates from a machine). Such delusions might fit nicely under another of Schreber’s headings: “Egocentricity of the rays regarding my person”. According to Schreber, “Rays . continually want to see what pleases them, and these are foremost either female beings, through which their sensation of voluptuousness is stimulated, or their own miracles, which give them the joy of having created something (.). My eye-muscles are therefore influenced to move in a certain direction so that my glance must fall on things just created (or else a female being).” He explains that “The objective reality of this event cannot be doubted after thousand-fold repetition; why should I have the slightest wish to pay particular attention to any fly, wasp or butterfly etc., which happens to appear around me. One will in any case not dispute that I must know myself whether my eyes are pulled towards an indifferent object or whether I look at something interesting around me of my own will” {316} [Schreber’s emphasis].
This is not as absurd as Schreber’s characteristic mode of expression may suggest. Indeed, I myself have noticed something similar when reading in bed. Like many married couples, my wife and I share a double bed, and again like many people, we tend to read in bed before sleeping. Normally my eyes are fixed on what I am reading, but I have noticed that often when my wife is looking at the pages of a fashion catalogue or magazine illustrating women’s underwear, my eyes mysteriously begin to wonder over to her side (despite the bed being a double king-size)! Schreber would have described this as a miracle stimulated by the “nerves of voluptuousness”, but in more mundane terminology it is not difficult to see the explanation. Normally, we are not aware of what is in our peripheral vision, particularly when reading, which requires conscious attention to the centre of our visual field. But an unconscious awareness is always present, ready to claim our attention if it finds something which it may think more interesting or important. Yet conscious awareness lags behind this subliminal perception of peripheral vision, and so, like Schreber, we have occasion to wonder to what extent we consciously choose to look at what we see.
Schreber also often railed at the sun, which he saw as God’s eye or as a living being who spoke to him in human language. According to his psychiatrist, “the patient used to stand for a long time motionless in one place, staring into the sun, at the same time grimacing in an extraordinary way or bellowing very loudly at the sun with threats and imprecations, usually repeating endlessly one and the same phrase...” {317}. Although impossible before his illness, in the course of it Schreber believed he could look at the sun without blinking—indeed, the sun’s rays visibly paled before him when he did so. Nor was Schreber the only case to show this particular symptom. There are much more recent reports of retinal damage in sun-gazing paranoid schizophrenics {318} {319}. Indeed, one study suggests that Schreber’s claims may have had a factual basis in the finding that a sub-group of schizophrenic patients have an abnormality in retinal neurons which reduces sensitivity to light {320}.
At the very least, an interesting contrast emerges with autism where monitoring gaze is concerned. As we can now begin to see, where autistics have serious deficits in gaze monitoring and interpretation, paranoiacs show startling excesses. Indeed, Rupert Sheldrake’s book on the sense of being stared at suggests that even quite normal people can believe that they are supernaturally sensitive to direction of gaze. However, this striking pattern is by no means limited to gaze. Another deficit found in autism is an ability to judge and interpret others’ intentions towards oneself: what we discussed in the last chapter under the heading of intentionality detection—in other words, having a mental understanding of why people do things (see above pp. xx-xx). But as with sensitivity to gaze, detection of intention can go into overdrive in psychotics like Schreber. According to him “All human activity near me, every view of nature in the garden or from my window stirs certain thoughts in me; when I then hear ‘Why only’ or ‘Why because’ spoken into my nerves, I am forced or at least stimulated in immeasurably greater degree than other human beings to contemplate the reason or purpose behind them.” As a case in point, he mentions watching workmen in the asylum and adds that “I am unavoidably forced to give myself an account of the reason and purpose of every single job.” The result is that “Being continually forced to trace the causal relation of every happening, every feeling, and every idea has given me gradually deeper insight into the essence of almost all natural phenomena and aspects of human activity in art, science, etc., than is achieved by people who do not think it worth while to think about ordinary everyday occurrences.” Even being introduced to a “Mr. Schneider” arouses the question of
why he is called Mr. Schneider? This very peculiar question “why” occupies my nerves automatically—particularly if the question is repeated several times—until their thinking is diverted into another direction. My nerves perhaps answer first: Well, the man’s name is Schneider because his father was also called Schneider. But this trivial answer does not really pacify my nerves. Another chain of thought starts about why giving of names was introduced at all among people, its various forms among different peoples at different times, and the various circumstances (profession, origin, particular physical qualities etc. which gave rise to them. {321}
Although Schreber’s compulsion to ask “why?” was a characteristically exaggerated one, it was not pathological in itself. The ability to ask why someone did—or just as easily, did not—do something follows as a natural development of prediction of other people’s intention. Once we begin to predict what people may do next, we are also bound to ask why they fail to do what we expect, or do what we did not expect. This leads us into interpretation of intention, and such interpretations inevitably pose the question “why?” Schreber’s compulsive posing of the question is therefore only an exaggeration or overstatement of a normal, mentalistic response.
Interpretation of intention is quintessentially mentalistic because it suggests numerous purely mental factors that might account for a person’s behaviour. Such interpretations raise the issue of people’s motives, aims, and beliefs. In order to understand why someone did or did not do something, we need to be able to “get inside their heads” so to speak. By definition, what we think we see in people’s minds will be intrinsically mentalistic: we will be forced to consider their state of mind, their emotions, their beliefs, desires, and wishes. All manner of purely mental factors will become germane to the problem of predicting, interpreting, and understanding other people’s behaviour once we begin to go beyond the point of mere monitoring of others’ intention to true interpretation of it. Indeed, such a mentalistic concern with meaning, motive, and interpretation immediately suggests why the mother of a pair of autistic boys quoted in the last chapter reports that neither of them ever used the word “why” {322}. If this line of reasoning is correct, it was yet another manifestation of the characteristic mind-blindness of autistics and stands in striking contrast to the perpetual “whys?” addressed to himself by Schreber.
Schreber illustrates another very common symptom of paranoia in the voices which he continually heard. These frequently harangued him with insulting imputations, referring to him as “Miss Schreber” and enquiring “Is he not unmanned yet?” At other times he was called “The Prince of Hell” and subject to abuse too vile to be printed. Alternatively, the voices would constantly question him, not only with the constant “whys?” mentioned just now, but with comments that someone else might easily have made, such as “What do you really mean?” or “We have had this before!” {323}. Schreber nicely illustrates my earlier point above about mentalism being a means of constraint and control over others (see above pp. xx-xx) when he asks us to
Imagine a human being planting himself before another and molesting him all day long with unconnected phrases such as the rays use towards me (“If only my,” “This then was only.” “You are to,” etc.) Can one expect anything else of a person spoken to in this manner but that he would throw the other out of the house with a few fitting words of abuse? I also ought to have the right of being master in my own head against the intrusion of strangers. {324}
Perhaps so, but Schreber’s protest is only at the very extreme form of naming, blaming, and shaming to which his voices subjected him. It suggests that sensitivity to the comments of others is such an innate, evolved part of normal human mentalism that it can become pathologically sensitive, and operate without external cause, like pain reactions in phantom limbs, or tinnitis (ringing) in the ears, or phosphenes (patches of light) in the eyes. As such it would qualify as yet another symptom of psychosis which contrasts with the marked insensitivity to mentalism seen in autistics. Thanks to their deficits in mentalism, people with autistic tendencies not only fail to understand mental terminology in full, but are often remarkably immune to its intended effects, so that other people perceive them to be callous, self-centred, and insensitive to the wishes and needs of other people. Indeed, far from hearing imagined voices, a common complaint about autistics is that they often seem not to listen to real ones, with the result that autistics are often mistakenly thought to be deaf. According
to one autistic: “Autism makes me hear other people’s words but be unable to know what the words mean. Or autism lets me speak my own words without knowing what I am saying or even thinking” {325} quoted by {326}.
Paranoid hyper-sensitivity to voices recalls the similar sensitivity to direction of gaze mentioned just now. The researchers who first demonstrated the latter in the laboratory go on to suggest that people with schizophrenia may be “hyper-primed” to detect other people’s intentions, and clearly the same could apply to what people say to schizophrenics. They add out that this is consistent with several other lines of evidence that these individuals “over-perceive” other people’s intentions. For example, they note that patients with schizophrenia show an enhanced tendency to link perceived intentions with consequences, and to judge the movements of objects as more affected by the actions of people than do healthy controls {327}.
The evidence suggests that this over-sensitivity to intention can take two forms, depending on whether the intention detected is positive or negative. Positive overinterpretation of other’s intentions underlies erotomania (otherwise known as de Clerambault’s syndrome or, in the terminology of DSM IV, erotomanic type delusional disorder).[2] In this case, the subject delusionally believes that others are attracted to, or are in love with them, and most sufferers are female {328}. In his memoirs, the painter, Salvador DaH (1904-89) recounts a memorable case of erotomania on the part of a peasant woman from his native town in Spain, Cadaques. Named Lydia, at the age of twenty she had met the Catalan writer, Eugenio d’Ors, and soon afterwards become convinced that he was in love with her, but had to conceal his passion for her in his writings. When d’Ors ignored all her letters, Lydia became convinced that the texts of his daily column in a newspaper were coded replies. DaH reports that “She explains that this was d’Ors only recourse, for a lady whom Lydia had nicknamed ‘Mother of God of August,’ and other rivals, would with their perfidy have managed to intercept the correspondence.” And, wonderfully anticipating the concept of mentalism elaborated here, DaH adds that “Lydia possessed the most marvellously paranoiac brain aside from my own that I have ever known. ... She would interpret d’Ors’s articles as she went along with such felicitous discoveries of coincidence and plays on words that one could not fail to wonder at the bewildering imaginative violence with which the paranoiac spirit can project the image of our inner world upon the outer world, no matter where or in what form or on what pretext. elucidating it word by word in an interpretive delirium so systematic, coherent and dumbfounding that she often verged on genius!” {329}. Indeed, although Lydia was never formally diagnosed as paranoid, DaH reports that her sons were committed to an asylum, evidently suffering from delusions that they had discovered radium in Cadaques.
[2] See Ian McEwan’s novel, Enduring Love {330}. McEwan, I., Enduring Love. 1997, London: Jonathan Cape. and its useful appendices for some further striking examples to those given here.
However, negative over-valuation of intention is much more common and is seen in the delusions of persecution which are found in so many paranoid psychotics. We have already seen that Schreber entertained paranoid feelings about his psychiatrist, Professor Flechsig, remarking that “right from the beginning the more or less definite intention existed to prevent my sleep and later my recovery from the illness resulting from the insomnia for a purpose which cannot at this stage be further specified” {331} [Schreber’s emphasis]. But this was just the start of it. Much of Schreber’s memoirs is concerned with a much more elaborate delusion of persecution involving what he termed “soul-murder”: “a plot was laid against me (...) the purpose of which was to hand me over to another human being after my nervous illness had been recognized as, or assumed to be, incurable, in such a way that my soul was handed to him, but my body—transformed into a female body.—was then left to that human being for sexual misuse and simply ‘forsaken,’ in other words left to rot.” Schreber adds that the “most disgusting” part of this plot was “that my body, after the intended transformation into a female being, was to suffer some sexual abuse, particularly as there had even been talk for some time of my being thrown to the Asylum attendants for this purpose” {332}. Schreber believed that “God himself must have known of the plan, if indeed He was not the instigator, to commit soul murder on me, and to hand over my body in the manner of a female harlot. . All other conceivable methods were therefore tried in the course of time. Always the main idea behind them was to ‘forsake’ me, that is to say abandon me; at the time I am now discussing it was thought that this could be achieved by unmanning me and allowing my body to be prostituted like that of a female harlot, sometimes by killing me and later by destroying my reason (making me demented) {333}. Indeed, Schreber’s delusional system centred on a universal struggle of good against evil in which Schreber himself “had to fight a sacred battle for the greatest good of mankind,” and from which he says that “the picture emerges of a martyrdom which all in all I can only compare with the crucifixion of Jesus Christ” {334}.
So not just in relation to monitoring and interpretation of gaze and voice, but also in relation to imputation and interpretation of intention, paranoid schizophrenics like Schreber show a striking contrast with autistics. Whereas autistics often ignore intention to the point of seldom if ever asking why someone did or did not do something, and certainly consistently fail to interpret their own and other people’s intentions correctly, paranoid schizophrenics do the opposite. As we have seen, Schreber compulsively questioned people’s intentions with his unending “whys?” and showed the proverbial paranoid tendency to feel persecuted by all and sundry while erotomaniancs like Lydia manage to find hidden attentions to themselves where none was ever intended.
Yet another autistic deficit is found in shared attention mechanism. Autistic people typically do not become involved in group conversations or activities because they usually fail to understand the element of collective psychological activity that is inevitably involved {335}. Temple Grandin noticed
a kind of electricity that goes on between people. I have observed that when several people are together and having a good time, their speech and laughter follow a rhythm. They will all laugh together and then talk quietly until the next laughing cycle. I have always had a hard time fitting in with this rhythm, and I usually interrupt conversations without realizing my mistake. The problem is that I can’t follow the rhythm. {336}
Indeed, according to Rupert Sheldrake,
when individual animals or people are relating to each other through the normal senses, telepathy may play an essential role in the normal communication of intentions, images and thoughts. For example, when two people are sitting talking to each other, they are not only linked through the words that are said and heard, but through body language and visual contact, through the shared environment, and so on. If they know each other well, then they are also linked by the emotional bonds between them, and by shared memories. These are all favourable conditions for telepathy, and favour the transfer of feelings, images, concepts and ideas. {337}
Once again, paranoiacs are characteristically even more mentalistic and are given to imagining not mere telepathic communication, but concerted group activity often expressed as conspiracies against them, as the last quotation above from Schreber illustrates. To take another example, Schreber noticed that “as soon as I sit down on a bench in the garden and ... close my eyes, which would in a short time lead to sleep .., a fly, wasp or bumble-bee or a whole swarm of gnats appears to prevent me from sleeping.” Indeed, he goes on to add that he has “most stringent and convincing proofs of the fact that these beings do not fly towards me by accident, but are beings newly created for my sake each time!” {338} [Schreber’s emphasis]. Even more annoyingly, he also believed that, whenever he wished to go there himself, “some other person in my vicinity was sent (by having his nerves stimulated for that purpose) to the lavatory, in order to prevent me evacuating.” He assures us that “This is a phenomenon which I have observed for years and upon such countless occasions—thousands of them—and with such regularity, as to exclude any possibility of its being attributable to chance” {339}!
Paranoid delusions of conspiracy, in other words, can be seen as fantastic elaborations of the shared-attention mechanism that enables normal people to understand what goes on in groups, meetings, and social gatherings of all kinds. Although autistics find appreciating what goes on in a group difficult, and often give it little serious thought or attention, paranoid psychotics pay far to much attention to groups, and tend to see conspiracies everywhere and imagine everyone plotting behind their backs. Indeed, for paranoiacs like Schreber, life was one vast, cosmic conspiracy implicating not just other human beings both alive and dead, but God himself.
The same pattern of pathological exaggeration of a normal aspect of mentalism is found in relation to memory in paranoid psychotics like Schreber, who often fabricate complex and colourful autobiographical memories {340}. As we saw in the previous chapter, episodic/autobiographical memory is deficient in autistics (see above pp. xx- xx), but Schreber’s memoirs once again provide plenty of anecdotic evidence for excesses, both in episodic memory, and indeed in a sense of personal agency. Schreber’s very title, Memoirs of My Nervous Illness, immediately reminds us that the entire book is one long account of the episodic/autobiographical memories of one particular person. Furthermore, this is a person who finds no difficulty in remembering himself being involved in events. On the contrary, many of he bizarre details of the Memoirs derive from Schreber’s characteristically paranoid tendency to over-mentalize, and to exaggerate his own role, not only in his own history, but in that of the entire universe—central coherence with a vengeance (see above pp. xx-xx)!
One reason why Schreber wrote the book and thought it to be so important was that he believed that through his personal experiences he had gained unique insights into reality denied to others and had come “infinitely closer to the truth” than others had. His self-confessed aim was “solely to further knowledge of truth” and he believed himself “infinitely closer to the truth than human beings who have not received divine revelation.” Nor did he consider himself unduly credulous, remarking that he had belonged to the category of doubters where religion was concerned, at least “until divine revelation taught me better” {341}. Indeed, he adds that “Whoever knew me intimately in my earlier life will bear witness that I had been a person of calm nature, without passion, clear-thinking and sober, whose individual gift lay much more in the direction of cool intellectual criticism than in the creative activity of an unbounded imagination.” Not surprisingly then, he goes on to remark that “It seems psychologically impossible that I suffer only from hallucinations,” and adds that “I can claim two qualities for myself without reservation, namely absolute truthfulness and more than usually keen powers of observation” {342} [Schreber’s emphasis].
For a writer who owes most of his justly deserved fame to his beautifully-written account of his delusional system and its consequences for his life, this represents a very high level of self-deception. Indeed, you could see this as another striking contrast between autism and paranoia: namely, that where autistics are often pathologically literal and truthful (see above pp. xx-xx), paranoiacs are prone to extreme self-deception and wildly erroneous perception resulting in the bizarre delusional thinking that usually typifies the untreated condition.
Schreber gives us the full flavour of both rich autobiographical memory and time travel into the past which it allows when he begins the second chapter of his book by claiming that the “miraculous structure” of the universe “has recently suffered a rent, intimately connected with my personal fate. But it is impossible even for me to present the deeper connections in a way which human understanding can fully grasp. My personal experiences enable me to lift the veil only partially...” {343}. Indeed, Schreber came to believe that his encounter with his psychiatrist, Dr Flechsig—definitely a real episode in his past—had historical precedents reaching back much further: “I therefore concluded that at one time something had happened between perhaps earlier generations of the Flechsig and Schreber families.” and goes on to name the individuals involved, some of whom he imagined to have lived in the previous century {344}. Here not just autobiographical memory, but history itself is transformed in a manner that is wholly and centrally coherent with Schreber’s beliefs about himself and his role in the greater scheme of things.
Nevertheless, it would be wrong to think that all Schreber’s ostensible memories were as false or completely fantastic. On the contrary, much of Schreber’s book is taken up with a harrowing account of his incarceration in a number of mental institutions and of the frightful experiences he had in them. In other words, Schreber’s memories may be pathologically elaborated, but they are not necessarily factually inaccurate in all their details. Intermingled with Schreber’s delusions, there is clearly much truth. According to this way of looking at it, Schreber’s written recollections of his mental illness enshrine a bizarre exaggeration of normal mentalism, rather than a completely different, or alien mode of thought. Here, perhaps the most striking example is Schreber’s extreme embellishment of the normal mentalistic ability to include yourself in episodic/autobiographical memories which shows itself in his delusion that he was the only real human being alive, and that others were “fleetingly improvised”—mere allusions to human beings: “During the latter part of my stay at Flechsig’s Asylum I thought . that I was the last real human being left, and that the few human shapes whom I saw apart from myself—Professor Flechsig, some attendants, occasional more or less strange-looking patients—were only ‘fleetingly improvised men’ created by miracle” {345}. Many if not most of these people were clearly real persons whom Schreber encountered, but their reduction to mere ciphers for persons underlines the central role that Schreber’s own self always plays in the Memoirs. Others may be remembered, but they are recalled only in reference to Schreber himself, and appear to have little other significance apart from their connection with him. Where autistics typically fail to include themselves in their episodic memories (see above pp. xx-xx), paranoiacs like Schreber appear to fail to include anyone but themselves.
Finally, as we have already seen, autistic people are generally deficient in theory of mind. Indeed, the most general expression of the characteristic mind-blindness of autistics is that they fail to attribute mental states to others and to react to them appropriately). But here again, paranoia shows the opposite tendency. The evolutionary psychiatrist, Randolph Nesse, notes that “those who have worked with schizophrenics know the eerie feeling of being with someone whose intuitions are acutely tuned to the subtlest unintentional cues, even while the person is incapable of accurate empathic understanding” {346}. Furthermore, there are grounds for believing that such subjective impressions are by no means inaccurate. Experiments on schizophrenics’ mind-reading abilities have seldom been carried out, and might be open to question in relation to the often very effective drug therapies to which such patients nowadays are normally subjected. Nevertheless, at least one carefully controlled study suggests that paranoid patients even when on medication are demonstrably better than normal controls in interpreting non-verbal cues—at least where the resulting expressions are genuine and where the situation is one of expectation of an electric shock. With simulated expressions, normal subjects performed better than paranoid ones, but as the experimenter herself points out, this is just what you would expect if you thought that paranoiacs have a special sensitivity to non-verbal cues {347}.
Indeed, this is much as the term is used in everyday speech: we are likely—perhaps jokingly, perhaps not—to suggest that someone is being “paranoid” if we think that they are being over-sensitive to someone else’s behaviour or expressions and consequently finding motives or meanings where there are none. In other words, you could say that in such instances we are suggesting that whoever is being “paranoid” is reading too much into someone else’s mind, rather than too little, as autistics typically do. In genuine paranoia such excessive mentalizing means that although paranoid schizophrenics may indeed be more sensitive to expressions of others’ states of mind in certain respects, they are nevertheless as likely to over-interpret them erroneously as autistics are likely to under-interpret them.
In Schreber’s case this tendency, which we have already noted in relation to direction of gaze and interpretation of intention and shared attention, went with a readiness to attribute minds—or what he actually called “bemiracled residues of former human souls”—to birds and trees and generally to mentalize—he would have called it to “spiritualize”—the whole world. According to the language of the souls he heard speaking to him, Schreber was called “the seer of spirits,” and he saw them everywhere, not merely in animals and plants, but in the heavens. The Sun’s rays were by turns the “nerves of God” or “God’s spermatozoa,” and according to Schreber, “it appeared that nerves—probably taken from my body—were strung over the whole heavenly vault” {348}.
Indeed, not merely in the external world, but in his own self, Schreber found other minds. This was graphically portrayed by his delusion that “on one occasion 240 Benedictine Monks under the leader of a Father whose name sounded like Starkiewicz, suddenly moved into my head to perish therein.” Among other souls who invaded Schreber’s head was a group which consisted mainly of former members of the Students’ Corps, Saxonia, from Leipzig, not to mention relatives, friends, former colleagues and doctors who had treated him in the past {349}. And it was not just in his mind, but in his body too that he felt the presence of these other minds. He noticed that “friendly souls always tended more towards the region of my sexual organs (of the abdomen etc.) where they did little damage and hardly molested me, whereas inimical souls always aspired towards my head, on which they wanted to inflict some damage, and sat particularly on my left ear in a highly disturbing manner” {350}. Schreber underlines the essentially human character of these presences within him and the mentalistic quality of his interpretation of them when he adds that “I saw ... ‘little men’ innumerable times with my mind’s eye and heard their voices.” And just in case anyone should think him incapable of distinguishing the mental from the physical he adds in a footnote to this sentence: “Of course one can not see with the bodily eye what goes on inside one’s own body, nor on certain parts of its surface, for instance on the top of the head or on the back, but— as in my case—one can see it with one’s mind’s eye...”—or, as I would prefer to put it, mentalistically {351} [Schreber’s emphasis].
Another way of describing this tendency to mentalize to excess is what has been called magical ideation. The Magical Ideation Scale developed at the University of Wisconsin presents a questionnaire asking the respondent to agree or disagree with a list of statements. These range from what you might call commonplace superstition (such as “Horoscopes are right too often for it to be a coincidence”) to some with a distinctly delusional tone, themselves ranging from the erotomanic (“I sometimes have the passing thought that strangers are in love with me”) to the more conventionally paranoid (“I have sometimes sensed an evil presence around me”). Also included are many sentiments endorsed by conventional religions (“I have wondered whether the spirits of the dead can influence the living”); belief in the paranormal (“I think I could learn to read other people’s minds if I wanted to”); or even extra-terrestrial life (“The government refuses to tell us the truth about flying saucers”) {352}. Students who scored high on the scale also showed more psychotic symptoms than students with lower scores, and in a study of psychiatric patients those with schizophrenia had a higher magical ideation score than non-schizophrenic patients or normal controls. A longitudinal study of 7,800 students revealed that students who scored high on magical ideation in college showed more symptoms of so-called schizotypal personality and other schizophrenia-related disorders a decade later, and also reported more psychotic experiences than others. Ten years later, the number of people who had developed some form of psychosis was significantly greater in the group that had scored high on magical ideation. {353}.
These findings make complete sense if you consider the fact that mentalistic thinking, although perfectly true and applicable in its own, proper psychological setting, inevitably becomes delusional if substituted for mechanistic cognition of the physical world. We have already seen how easily even erstwhile scientific writers like Sheldrake can begin to credit ideas like the Evil Eye and sixth—or in his case, even seventh—senses in relation to vision and attention, and I will mention more examples in a moment. However, intention can even more easily be extended beyond its proper, purely mental domain. Another of the statements from the Magical Ideation Questionnaire reads, “I have felt that I might cause something to happen just by thinking about it too much”. Schreber illustrates the extreme culmination of this kind of thinking when we find him vastly overstating his own influence on things, for example in his claim that “the weather is now to a certain extent dependent on my actions and thoughts; as soon as I indulge in thinking nothing, or in other words stop an activity which proves the existence of the human mind such as playing chess in the garden the wind arises at once”. He concluded that “everything that happens is in reference to me” {354} [Schreber’s emphasis ].
Such delusions of reference as they are often called can be seen as an exaggeration of the normal belief in yourself as responsible for your own intentions. They result from extension of the fundamental mentalistic sense of your own responsibility for your conscious acts outwards onto acts and events which in reality cannot be caused by your own mind, intention, or behaviour. Furthermore, such interpretations of intention have a foundation in reality. A case in point might be to inadvertently distract someone’s attention so that they do something they did not intend, say drop something, or bungle something that they would normally do perfectly well. In these circumstances you may not have directly intended the accident, but mentalistically you feel responsible because you know that your intervention—albeit quite innocent—probably contributed to the outcome. And from real situations like this it is but a short step to begin to think as Schreber evidently did that just about everything that happened around him did so in some way or another in connection with himself. Looked at from this point of view, Schreber’s delusions of reference are—as with so many of his symptoms—not so much pathologically unprecedented as extreme exaggerations of normal mentalism.
But of course, intentions can also be retrospectively regretted, and repudiated, particularly if the outcome was less than or contrary to what was intended. For most people, such miscarried intentions become the subjects of private recrimination, personal sorrow, and ultimately perhaps selective amnesia—or at least some degree of self-vindication. We tend to say things like, “I didn’t really mean to do it,” “That wasn’t what I actually intended,” or “I would never have wanted this to happen”. But here again Schreber shows the process of self-excuse in an extreme form when he asserts that, where he is concerned, “Plates simply break in two without any rough handling, or objects which the servants or others present or even I myself hold (for instance my chessmen, my pen, my cigar-holder etc.) are suddenly flung to the floor, where those that are breakable naturally break into pieces. All this is due to miracles; for this reason the damage caused is made the topic of conversation by people around, usually some time afterwards” {355}.
This appeal to miraculous intervention to explain his own clumsiness or contrariness illustrates the extent to which magical, mentalistic thinking can produce bizarre fantasies and severe alienation from reality—something all the more noticeable when the delusions in question lack the fig-leaves of conventional credulity or the vestments of traditional religious belief as they so starkly do in the Schreber case. And by contrast to autistics, whose sense of personal agency is often severely diminished as we saw, agency in paranoiacs sometimes becomes true megalomania. It certainly did in the case of Schreber, who believed that he “became in a way for God the only human being, or simply the human being around whom everything turns, to whom everything that happens must be related and who therefore, from his own point of view, must also relate all things to himself” {356}. Schreber, in other words, was not merely the centre of his own little world, he believed himself to be crucially central to the entire cosmos. Delusions of grandeur seldom get much grander, and megalomania could hardly be much more megalomanic than this!
* * *
We have already seen that you could describe autistics as characteristically hypo- mentalistic, or as having a theory of mind ability limited to animals and basic, “desire psychology”, rather than fully extended to human beings and mentalistic thinking in general. However, my discussion of the case of Schreber suggests that paranoia in particular and perhaps psychosis in general could be correspondingly seen as characteristically hyper-mentalistic—in other words as having too much theory of mind, and excessive mentalistic tendencies. This in turn would suggest that mentalism as such—the ability to attribute minds to others, and to interpret and understand mental states—is not an all-or-nothing phenomenon of human psychology, but covers a continuum stretching from the extremes of hypo-mentalism in severe autism to hyper-mentalism in cases of psychosis like Schreber’s.
At the very least, the concepts of hypo- and hyper-mentalism would neatly explain why autism is a disorder with an invariable onset in childhood, whereas classical schizophrenia is very much an adult-onset (or at the very least, a late adolescent) one. The reason could simply be that no one could develop the characteristic hyper- mentalism of a psychosis without first developing a more normal level of mentalism—evidently something which usually takes the whole of childhood and the greater part of adolescence to achieve. But if autistics are symptomatically hypo- mentalistic, this would imply that they had never completed the normal process of mental development, but stopped short long before at some point in childhood (or perhaps regressed back to it). In any event, autistic symptoms would show in childhood and psychotic ones would not be seen fully developed until later—which is exactly what we find. In other words, here would be the reason why in the past at least people thought of autism only in relation to childhood, and of schizophrenia and other psychoses mainly in relation to adulthood.
Rupert Sheldrake’s concept of what he calls “the extended mind” is another instance of what I would prefer to term hyper-mentalism. According to him, “Our minds are extended into the world around us, linking us to everything we see.” This leads him to believe that “unexplained human abilities such as telepathy, the sense of being stared at and premonition are not paranormal but normal, part of our biological nature. ... Instead of thinking of minds as confined to brains, he suggests that “they involve extended fields of influence that stretch out far beyond brains and bodies” giving credence to reports of remote viewing, psychic spying and clairvoyance {357}. He adds that in another of his books, Dogs That Know When Their Owners Are Coming Home, he showed that these unexplained powers are widely distributed in the animal kingdom. Such extensions of mental activity to other species, and such belief in “mental fields” extending out from the mind in time and space eminently portray the concept of hyper-mentalism as clearly as the behaviourist’s denial of the mind illustrates that of anti-mentalism (see above pp. xx-xx). Indeed, as schools of psychology, behaviourism and parapsychology stand at opposite ends on the continuum of mentalism: behaviourism at its hypo-mentalistic extreme and parapsychology at its hyper-mentalistic one.
Furthermore, you could see religion along with magic and superstitious thinking in general as the normal, socially-acceptable expression of hyper-mentalism in human culture. Magic invites credulity for miracles and supernatural intervention in the form of the belief that prayers, rituals, or spells can affect physical reality and bring about the fulfilment of wishes—or in other words, that mere mental factors such as intentions and words can change the real world. Superstition is based on the belief that things are not what they seem, and that behind apparent chance events or manifest appearances lurks a deeper, more psychologically-significant reality that can be interpreted in typical mentalistic terms like intention, meaning, guilt, or justice. Fundamental to religion and magic is the belief that beyond the purely physical, tangible, and mundane there is a different, higher, or parallel reality which believers would call “spiritual”, “super-natural,” or “extra-sensory”. All such thinking goes beyond the immediate appearance of the physical world and attributes souls, spirits, essences, or other mental realities to the universe, and there is always an occult but psychologically-perceived truth beyond the immediately-obvious perceptions of the senses.
Religion applies mentalistic thinking to the world and maintains that beyond immediate appearances life has a moral and ethical dimension often represented in divine judgement and retribution in an after-life, heaven, or hell. As a result, reality as a whole—and not just social reality—becomes peopled with divine agents who can be influenced in mentalistic ways analogous to those in which ordinary humans can be: through supplication (prayer), flattery (praise), generosity (sacrifice), apology (confession), restitution (penance), personal visitation (pilgrimage) and lobbying (intercession via saints, angels, and other deities). Accommodation for deities is provided in temples, and entertainment added in the form of sacred music, dramas, and precessions. Indeed, some religions even claim to have quasi-legal, mutually- binding contracts with their deity, such as the Old and New Covenants of Judaism and Christianity respectively—and several regard God as the author of their sacred book and guarantor of their claims to territorial sovereignty and racial integrity. In this way, all manner of personal and collective fears, failings, and frustrations beyond the remedy of mere mortals can be redressed, and a mentalistic adaptation could become the foundation for the evolution of religion. As Schreber perceptively commented, “the legends and poetry of all peoples literally swarm with the activities of ghosts, elves, goblins, etc., and it seems ... nonsensical to assume that in all of them one is dealing simply with deliberate inventions of human imagination without any foundation in real fact” {358}.
In his Natural History of Religion David Hume (1711-76) observed that
There is an universal tendency among mankind to conceive all beings like themselves, and to transfer to every object, those qualities, with which they are familiarly acquainted, and of which they are intimately conscious. We find human faces in the moon, armies in the clouds; and by a natural propensity, if not corrected by experience and reflection, ascribe malice or good-will to every thing, that hurts or pleases us. Hence... trees, mountains and streams are personified, and the inanimate parts of nature acquire sentiment and passion. {359}
Indeed, Hume adds that even “philosophers cannot exempt themselves from this natural frailty; but have often ascribed. to inanimate matter the horror of a vacuum, sympathies, antipathies, and other affections of human nature” {360}. Much more recently, the primate researcher, Daniel Povinelli commented that “For over three centuries, philosophers and scientists alike have, to greater and lesser degrees, assumed that when we see animals behave in ways that look very similar to ours, they must be thinking in ways that are similar to ours” {361}, and nowhere is this more true than in relation to our nearest primate relative, the chimpanzee. But following a long series of carefully controlled experiments carried out with exemplary scientific method Povinelli concludes that chimpanzees do not interpret the pointing-like gestures of themselves or others in the manner that we do; that although they are quite sensitive to the behaviour of others, chimpanzees do not interpret behaviour in mentalistic terms; and that chimpanzees do not draw on underlying intentions in judgements of accidental as opposed to deliberate actions. Furthermore, he concludes that chimpanzees are unable to represent others as agents with false beliefs: what we have already seen has been called “the acid test of theory of mind” (see above pp. xx- xx). In other words, Povinelli concludes that chimpanzees have evolved neither what I have termed mechanistic nor mentalistic cognition as they are found in human beings. These, in his view, add up to “a specialization of the human species—a specialization that was woven into our brain right alongside a much older set of psychological systems, leaving us in the awkward position of being uncertain about which mechanisms are at work at any given time” {362}.
But however that may be, the question remains of why human beings should so compulsively and routinely mentalize nature. A recent suggestion is that “We see apparent people everywhere because it is vital to see actual people wherever they may be.” And not just people: “it is better for a hiker to mistake a boulder for a bear than to mistake a bear for a boulder” {363}. In other words, to the extent that hyper- mentalism means attributing human-like minds to objects or organisms that in reality lack them, it is entirely normal, and the occasional false alarms, so to speak, are more than compensated for by the importance of not missing a real occurrence:
when we see something as alive and humanlike, we can take precautions. If we see it as alive we can, for example, stalk it or flee. If we see it as humanlike, we can try to establish a social relationship. If it turns out not to be alive or humanlike we usually lose little by having thought it was. This practice thus yields more in occasional big successes than it costs in frequent little failures. In short, . “better safe than sorry.” {364}
Exactly the same reasoning explains other pathological mental states such as anxiety attacks or phobias. In these cases too, the better-safe-than-sorry principle applies and explains why, even though there may be so many false alarms, the fear/phobia system is nevertheless more useful if set for too much sensitivity than it would be if set for too little. For some individuals at the extreme end of the sensitivity setting this may mean chronic, disabling anxiety or irrational phobias, and much the same could be true of mentalism. It may be that paranoid schizophrenics like Schreber represent only the extreme end of a normal distribution, with everyone having some tendency to over-mentalize in some situations but few taking it to such lengths as he did. Mentalism, in other words, like anxiety or phobias, may be a naturally-selected tendency that would only become pathological in cases like Schreber’s where it far exceeded its normal bounds. And if anyone wanted to know why natural selection should have endowed human beings with such supernumerary mentalism, so to speak, they have only to consider the plight of autistics to see what happens to those without it.
But the mention of autism reminds us that if paranoiacs like Schreber are hyper- mentalistic in this respect, autistics ought to show the opposite tendency and be much less likely to believe in magic and religion. Certainly, the issue of autistics’ attitude to religion and belief in God is also raised by the case of Hugh Blair of Borgue mentioned earlier (see above pp. xx-xx). In their retrospective analysis of the legal proceedings which provide much of the evidence on which the diagnosis of Blair’s autism is based, Houston and Frith comment that “It follows that a lack of theory of mind restricts a religious sense... For this reason the question posed by the judges: ‘Did Hugh Blair have a sense of God?’ can be interpreted as analogous to the question posed by modern psychologists: ‘Did Hugh Blair have a theory of mind?’” Their answer:
Clearly, the behavioural signs suggested that Hugh appreciated religious feelings and participated in the proper religious activities. Nevertheless, the final verdict of the court implies that the judges did not believe that Hugh had the same sense of God as other members of the community. This matches our interpretation of Hugh having a diminished awareness of mental states. {365}
Up to the present, there have not been any systematic studies of autistics’ religious feelings or beliefs, but one paper has been published which considered the evidence in autobiographical accounts like those I quoted in the last chapter. The author concludes that
One gets the distinct impression by reading such descriptions that religion in autism consists of entirely different processes than the normative experience. Namely, in these passages, God, the sine qua non of Western religious experience, is perceived more as a principle than as a rich psychological agent. God is perceived as a force in the universe that is directly responsible for the organization of cosmic structure— arranging matter in an orderly fashion or treating entropy—or has been reduced to the conceptualisation of scientific logic altogether. {366}
She adds that “What is noticeably absent in the autistic accounts is a sense of interpersonal relations between the worshipper and the deity, a sense of emotional dependency on an intentional agent who has control over the experiences and existence of the individual.” She concludes,
Because people with autistic spectrum disorders have difficulty interpreting the meaning attached to social behavior and therefore probably cannot rely on a theory of mind to explain their experiences, their religious beliefs cannot affix to core representations of psychological agency. The religious beliefs of people with autism could therefore be envisioned as sliding into conceptual slots provided by the folk physics system, even those, such as supernatural agent concepts, that are traditionally relegated to the slots of the folk psychology system. Thus supernatural agents, such as God, are perceived as behavioral rather than intentional agents. {367}
Indeed, the mother with two autistic sons who I have cited before remarked that her boys “don’t turn to God as a way of navigating life’s difficulties”, adding that when one of them “was (inappropriately) attending a mainstream primary school, his report simply said, ‘Religious Knowledge: not applicable’” {368}.
Autistics’ religion, in other words, is generally speaking more mechanistic and less mentalistic than that of normal believers. Nevertheless, the question of superstition still remains. Surely, this is highly mentalistic, and not something you would expect to find in autistics—at least if a deficit in theory of mind is believed to underlie many of the symptoms of the disorder? Nevertheless, the fact that no less a behaviourist than B. F. Skinner once published a paper entitled, “Superstition” in the pigeon {369} suggests that the situation may be more complicated. The irony of this is of course the fact that in this paper—and despite the inverted commas around the word superstition—Skinner appears to attribute a highly mentalistic attribute to a laboratory animal which is supposed to lack any kind of mind, at least according to the anti- mentalistic nostrums of behaviourism (see above, pp. xx-xx).
Skinner used the term “superstition” to describe the widely replicated finding that laboratory animals can become spontaneously and accidentally conditioned by otherwise random or freak stimuli that might occur in association with a reward. For example, if a hungry pigeon is placed in a cage and receives a food reward at random intervals unlinked to any particular behaviour, the pigeon is likely to become conditioned to keep repeating whatever it happened to be doing when the first reward arrived. In other words, this is conditioning similar to that of Pavlov’s salivating dogs, and indeed recalls the fact that Pavlov had first noticed the dogs making this conditioned response to the white coats of the lab technicians who came to feed them. The bell came later as a contrived confirmation of the effect, and of course it need not have been a bell: any suitable stimulus would have had the same effect. In the case of the superstitious pigeons a fortuitous activity of the experimental animal itself which just happened to occur when the reward appeared became linked in the animal’s mind—behaviourists would say behaviour—with the reinforcing reward. And of course, once this apparent link was established and the animal began to repeat the reinforced behaviour more frequently, the more likely would it be to become even further reinforced by subsequent rewards occurring in connection with it. Indeed, Skinner’s experiments showed that an interval between reinforcements of about 15 seconds was the optimal one and that one as long as a minute was much less so {370}.
It was of course the apparently compulsive repetition of the reinforced behaviour that made Skinner think of superstition—along with the fact that the experimenter knew that there was in reality no connection whatsoever between the behaviour and the reward that had occasioned it. Indeed, the superstitious pigeon was so intuitively appealing to audiences that Skinner frequently used it as a classroom demonstration which was—and apparently still is in the words of one authority—“a consistent crowd-pleaser” {371}. In terms of the concepts being developed in the course of this book, you could see the pigeon’s superstition as mechanistic, rather than mentalistic: it would be purely behaviourally superstitious—superstition without any mental content whatsoever. But equally, whatever could happen in a pigeon in this respect could just as easily—perhaps even more easily—occur in a human being. Indeed, as Skinner himself pointed out
There are many analogies in human behavior. Rituals for changing one’s luck at cards are good examples. A few accidental connections between a ritual and favourable consequences suffice to set up and maintain the behavior in spite of many unreinforced instances. The bowler who has released a ball down the alley but continues to behave as if he were controlling it by twisting and turning his arm and shoulder is another case in point. These behaviors have, of course, no real effect upon one’s luck or upon a ball half way down an alley, just as in the present case the food would appear as often as it does if the pigeon did nothing—or, more correctly speaking, did something else. {372}
In other words, if a pigeon can exhibit what I would call mechanistic superstition, then so too can a human being, and the sporting or card-playing examples cited immediately above underline the mechanistic aspect because they relate to mechanical actions carried out on objects or imagined to influence them. The mother of the two autistic boys I quoted above on the lack of religious feeling in her sons adds that
Autistic children ... don’t collude in magic because it involves the use of mentalizing skills they simply don’t possess.. To appreciate magic, you need a firm grasp of what’s normal, what’s expected. Autists, who see the world in disconnected detail rather than as a coherent whole, lack that overview of normality. {373}
To the best of my knowledge, no one has ever investigated the superstitions of autistics in any systematic way, but we have already seen that impressions of their religious beliefs suggest that they fit the pattern we might predict and are less mentalistic and much more mechanistic than normal. Again, we saw in the previous chapter that many autistic people lack a sense of personal agency and as a result fail to connect events that happen around them to their own internal mental states (see above pp. xx-xx). As a result, autistics might be predicted to be even more likely to exhibit superstitious behaviour than normal people—or what I would term mechanistic superstition. Indeed, to the extent that an autistic might be severely hypo-mentalistic, they might be as prone to superstitious behaviour as one of Skinner’s pigeons.
The reason for this would be that, whereas a normal person might be able to relate events around them to their own and others’ motives, knowledge, state of mind, skills, and abilities, an autistic might simply observe them happening without reference to themselves or others, rather as we saw exemplified by the three young men mentioned in the last chapter (see above pp. xx-xx). Lacking an ability to interpret such events in terms of their own or others’ mental states, an autistic person might be all the more likely to attribute them to luck, God, or any other arbitrary factor that seemed credible. For example, Uta Frith comments that autistic children often do not understand the difference between justified knowledge and a mere guess, and recounts the following case as an apt illustration:
Milton is an intelligent autistic boy of 12 who took part in our experiments on reading. He read—fluently—selected passages of text and we asked various questions to test his text comprehension and general knowledge. After he had given a particularly good answer we asked him quite casually, “Oh, how did you know that?”
His matter of fact reply was, “By telepathy.” We repeated the question on several other occasions, and he always answered in the same way. He never said, “I just read it,” or “My teacher told me,” or “It’s obvious, isn’t it?” {374}
Belief in—or perhaps it would be more accurate to say invocation of—telepathy, is thus not necessarily evidence of what I am calling hyper-mentalism. In this case it looks more like a convenient excuse, much as a child might explain a mess they had intentionally made as being the result of an “accident”. Indeed, high-functioning Asperger’s cases in particular might be particularly prone to attribute certain events to such external agencies and to try to close the gap, so to speak, between their own minds and those of others by use of socially-accepted symbolism, such as that of conventional religion, traditional superstition, or parapsychology.
A final implication of this line of reasoning is that, if autistics are hypo-mentalistic even when they are religious or superstitious, psychotics might be correspondingly hypo-mechanistic. In other words, if there are indeed two parallel cognitive systems— what I am calling mentalistic and mechanistic cognition—and if deficits in mentalism sometimes go with remarkable mechanistic skills in autism, you might wonder to what extent hyper-mentalistic psychotics also tended to show mechanistic deficits. Of course, you could argue that anyone with a tendency to magical ideation and credulity for the supernatural would have to be lacking in a more down-to-earth, mechanistic style of thought, and that to this extent the observation was fairly obvious. But however that may be, there is indeed evidence that schizophrenics and others with milder schizotypical tendencies also have impaired visual-spatial and arithmetic abilities, relative to their verbal abilities. Furthermore there is evidence that carriers of a genetic tendency to psychosis in their near relatives show impairments in verbal memory and in visual and spatial skills. Indeed, a separate study concludes that a relative superiority of verbal to spatial skills—or what I would call mentalistic to mechanistic cognition—represents a cognitive asymmetry characteristic of schizophrenia {375} {376}.
** 5. Selfish Genes and the Battle of the Sexes in the Brain
If human beings ever established contact with aliens, the question would immediately arise: how do they see us? Once we had got over the shock of knowing that we were not the only intelligent beings in the universe, we would inevitably see the alien consciousness as a mirror reflecting back a uniquely new and different view of ourselves. We might not like it, but we would have to know what it was because it would represent the only opportunity our species ever had to see itself totally objectively: literally as other intelligences would see us. And of course, such an extraterrestrial view of human nature might reveal fascinatingly original insights into things about ourselves which we would otherwise never have noticed.
Obviously, this is just science-fiction, but with the parallel with autism in mind, we could nevertheless make one or two very well founded predictions about how such an alien view might portray us. We have already noted that extra-terrestrials could be counted on not to share human vanity about our place in nature, and so might see our species as just one among many (see above pp. xx-xx). In all probability (and particularly if they were a DNA-based species like all those on Earth) the aliens would have already taken what is often called the selfish gene view of life after the title of the well known book by Richard Dawkins {377}.
The Selfish Gene is a popular-science account in large part based on the insights of the person who many would see as the Darwin of the twentieth century, William D. Hamilton (1936-2000). Anticipating my distinction between mentalistic and mechanistic styles of thought, Hamilton made a telling discrimination between what he called people people as opposed to things people. He observed that “people people just need people to interact with, not necessarily the understanding of them: They tend to be conformist and are seldom more than superficially critical of any ethos of their time” {378}. But Hamilton himself was obviously one of the things people. Indeed, he described himself as “almost idiot savant” and rated himself “fairly good at woodwork as at other handicrafts” to the extent of having carpentry as a “reserve life plan” in case his theory proved un-publishable {379}{380}. Like the Unabomber—who as we saw was also a skilled woodworker—Hamilton experimented with explosives as a child, in his case losing parts of three fingers and gaining some pieces of shrapnel permanently lodged in his lungs. And like Temple Grandin—who as we have also seen was another keen if frustrated carpenter (see above pp. xx-xx)—Hamilton had a family background which also conformed to the typical pattern of someone with autistic tendencies: his father was a well-known engineer (designer of the Callender-Hamilton bridge) and was followed into engineering by one of Hamilton’s brothers, while a geriatrician sister had mechanical skills to the extent that she developed an improved pressure mattress for the treatment of bed sores {381}.
Hamilton also described himself as possessing “notably a trait approaching to autism about what most regard as the higher attributes of our species”. He went on to portray himself as “a person who ... believes he understands the human species in many ways better than anyone and yet who manifestly doesn’t understand in any practical way how the human world works—neither how he himself fits in and nor, it seems, the conventions.” Indeed, he added that “It is known now how autists, for all that they cannot do in the way of human relationships, detect better out of confusing minimal sketches on paper the true, physical 3-D objects an artist worked from, than do ordinary un-handicapped socialites.” He concluded—evidently with himself in mind—that “so may some kinds of autists, unaffected by all the propaganda they have failed to hear, see further into the true shapes that underlie social phenomena” {382}
What Hamilton saw underlying social phenomena was to become the foundation for modern Darwinism and the revolution in thinking associated with Sociobiology and Evolutionary Psychology. Dawkins’s selfish gene metaphor expressed Hamilton’s realization that, from the ultimate point of view of evolution, organisms are the vehicles—or bio-degradable packaging—of their genes. Those organisms that deliver their genes safely copied into future generations have been selected, those which fail have not: evolution is as simple as that.
The selfish gene view, if we may call it that, is self-evidently mechanistic to the extent that it makes the transmission of genes the ultimate factor in evolution. People often misunderstand it to think that Hamilton’s essential insight also puts genes in the driving seat, so to speak, but the truth is that organisms which move need brains to control their movement because genes as such could never do it on their own. Another analogy is to see organisms as acting as the agents of their genes. Looked at from this perspective, genes build bodies and brains to act for and on behalf of them. But they have to give those agents the necessary independence and expertise they need to complete their mission. In the human case, mentalistic skills are foremost among the expertise that people need, and as we saw in the last chapter, endow us with real freedom of choice in situations where one person’s actions are constrained by another person’s beliefs about them (see above pp. xx-xx). Genes alone could not solve the difficult problems that such complex situations pose, and so they build brains with mentalistic and mechanistic abilities to solve the problems for them. Like passengers on a plane, genes sit quietly in their sex-cell precursor seats and leave it to the aircrew on the cerebral flight-deck to do the skilful part by delivering them safely to their destination: the next generation {383}.
Evolution could probably be counted on to act this way anywhere in the universe, suggesting that an alien intelligence would also see itself this way. In this chapter I want to take a look at autism and psychosis from this unusual point of view. As we shall now see, it is one which reveals some astonishing insights, not only into the most bizarre of all Schreber’s delusions, but also into the genetic logic that appears to underlie both autism and psychosis and to explain the strange symptoms of each.[3]
[3] In what follows I am deeply indebted to my fellow researcher and co-author, Bernard Crespi, whose work in evolutionary genetics is very much a continuation of the tradition established by Hamilton.
* * *
With Hamilton’s words about discerning underlying patterns quoted above in mind, we might return to the last chapter and, looking at things autistically so to speak, note that a remarkable pattern has begun to emerge. We saw that many of the most striking symptoms of psychotic illnesses like paranoid schizophrenia could be seen as the exact opposite of those seen in autism. The clear implication is that, rather than being totally unconnected, autism and psychosis now begin to look as if they could represent poles of a continuum of mentalism stretching from the extreme hypo- mentalism of autistic mind-blindness to the bizarre hyper-mentalism of paranoid psychotics like Schreber.
A further notable antithesis which I have not mentioned so far is in relation to reading. Dyslexia describes difficulty in learning to read despite adequate intelligence and opportunity, and is found in about 1-in-20 primary-school age children, with a prevalence in boys about four times that in girls. As many as 70-80 per cent of schizophrenics were found to exhibit a significant number of dyslexic language traits in one study, and the neuro-anatomical and cognitive correlates of dyslexia are similar to those found in both schizophrenia and schizotypal personality disorder [Crespi, In preparation #1909]. Hyperlexia is essentially the opposite of dyslexia. The term describes the spontaneous and precocious mastery of reading in children, usually before the age of three, and in conjunction with impairments of verbal communication. Hyperlexics typically can read more or less anything, but cannot necessarily understand what they are reading. Hyperlexia is a rare condition, found almost exclusively in conjunction with autism, and we have already encountered one famous hyperlexic in the person of Kim Peek, the savant role-model for the film Rainman (see above pp. xx-xx). Like Kim Peek, hyperlexic children often show significant impairments in reading comprehension, especially in relation to the more mentalistic aspects of langue, such irony, metaphor, or humour. Indeed, to the extent that reading words is a purely mechanistic skill now performed by computers but that understanding what they mean is a mentalistic one only fully developed in normal human beings, you could see hyperlexia as representing an extreme of the pattern of preserved mechanistic but impaired mentalistic cognition seen in autism as a whole. And as this association would lead you to expect, hyperlexic children show enhanced visual-spatial abilities like those typically found associated with autism[Crespi, In preparation #1909]. In other words, whereas autistics are sometimes hyperlexic, schizophrenics are more likely to be dyslexic: another diametrically-opposed set of symptoms to add to the list (see table 5.1).
Autism/Asperger’s syndrome
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Psychosis/Paranoid schizophrenia
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gaze-monitoring deficits
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delusions of being watched/spied on
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apparent deafness/insensitivity to voices
|
hallucination of and hyper-sensitivity to voices
|
intentionality deficits
|
erotomania/delusions of persecution
|
shared-attention deficits
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delusions of conspiracy
|
theory of mind deficits
|
magical ideation/delusions of reference
|
deficit in personal agency/episodic memory
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megalomania/delusions of grandeur
|
literalness/inability to deceive
|
delusional self-deception
|
early onset
|
adult onset
|
hyper-mechanistic: visual/spatial skills
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hypo-mechanistic: visual/spatial deficits
|
some hyperlexic
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some dyslexic
|
local brain over-connectivity with global underconnectivity
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local brain under-connectivity with global over -connectivity
|