Autism, Empathy & Theory of Mind

EmpathyPsychology is obviously a very complex business and looking at it under the lens of scientific scrutiny doesn’t make things any simpler. How do you quantify emotion or reason? How do you examine and analyze the inherently unpredictable? Well the answer is you can’t, not directly anyway.

Theory of mind is a term used to describe the understanding that other people other than yourself also have a mind and can experience the world around them in their own way, but more than that, it is the ability to, psychologically speaking, putting yourself in someone else’s shoes. Most adults have a good degree of “Theory of Mind” – their own mind can attribute desires, emotions and thoughts in others, they can predict other people’s intentions and understand their motives. This is an inherent social skill which is normally learned naturally during childhood.

People on the Autistic Spectrum tend to have a poor “Theory of Mind”. The myriad of social cues, facial expressions, body language and vocal clues that are subconsciously used to determine somebody’s intentions or motives can’t easily be read. Therefore it makes it difficult for someone with ASD to put themselves in somebody else’s shoes. Now if you study Autistic Spectrum Disorders you will read a great deal of literature which will explain that people with Autism are incapable of understanding people’s intentions or motives or understanding that other people have their own plans, needs, thoughts or point of view. This is a very academic view – and as is often the case, nothing is that black and white and nothing to do with complex psychology can be summed up so easily; having said that – typically the more severe the Autism, the poorer the “Theory of Mind”.

I have Aspergers Syndrome and I am perfectly aware that other people have their own needs, their own thoughts and their own points of view. Where my problem lies is in putting these things together in order to work out somebody’s intentions. For example, does someone want to get to know me or are they talking to me because they want something? Most of the time I can work simple things like this out for myself; but there are times where I miss very blatant clues which someone else would immediately understand. I think, looking back at my own experiences, it is fair to say that I look for the most obvious motives and intentions in others and assume I am correct, which would be fine if everyone always told the truth and people acted logically.

I naturally feel more comfortable with people who are on the same “wavelength” as me. I find having to explain things to people face to face a bit uncomfortable, as it is easy to offend. The difference between explaining something to someone and talking to them like they are an idiot isn’t always particularly clear, partly because I have a strange natural assumption that people automatically know pretty much what I know.

Another very common “fact” that you will come across in terms of Autism is that people with an Autistic Spectrum Disorder have no empathy. To some extent this is true in a very technical sense. Empathy is the capacity to recognise and share feelings with others. Recognise and Share – it is the first part that is the major problem. People on the spectrum experience emotion – we are not robots, but we do sometimes struggle to express them. I can’t look at somebody’s face and determine their emotional state – anything beyond assuming a frown is angry, tears are sad and a smile is happy – I get lost. I know things are not that simple, but knowing and having the capacity to do are very different things. For me, empathy isn’t as simple as that. You see the assumption here tends to be that people on the Autistic spectrum are unfeeling, when the truth is often very different.

Approximately 85% of people on the Autistic spectrum have Alexithymia – the inability to express emotion verbally and to some extent physically – difficulty crying for example. When observed by others I suppose it is perfectly reasonable for people to assume that ASD means poor emotional empathy, but inside those emotions are alive and kicking. Indeed it can be common for people on the spectrum to be Oversensitive, to the point where emotions need to be habitually suppressed in order to simply cope and when these emotions do escape – the mental and emotional feedback can be incredibly painful and even psychologically damaging.

Emotion, empathy and relating to others is a huge issue for people on the spectrum, but it is the worst kind of hubris to sum up the emotional abilities of an individual based on the diagnosis of an Autistic Spectrum Disorder. People are complex, and wonderful; they are kind and cruel very brilliant and incredibly stupid and emotionally messy – being on the Autistic spectrum doesn’t change that, in the end, we are just as human.


Aspergers Syndrome & Creativity

I have Aspergers Syndrome and I am not creative. I can’t paint or draw, I can’t sculpt or carve, and I have no musical talent whatsoever. In fact by the time you have finished reading this post I am quite sure you will agree that writing is a bit of a stretch! My complete lack of artistry makes me the worst example for the post I am about to write.

I often read various interpretations of the diagnostic criteria of Aspergers Syndrome, and one that is commonly listed is “A Lack of Imagination” or something very similar. Firstly, and let me state this categorically, the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not mention imagination, artistic talent, creativity, inventiveness or ingenuity. We have symptoms which are sometimes referred to as “The Impairment of Imagination”, but this a poor description which actually describes rigidity of thought processes, which I will come to in a moment.

Over the years I have encountered numerous people with Autistic Spectrum Disorders who have been incredibly talented individuals, and many of those where specifically diagnosed with Aspergers Syndrome.

creativityBeing imaginative is one thing, being truly creative, truly original is quite different. I think if pressed most people would say they were inspired by this or that, but true originality is really quite rare, but no rarer on the spectrum – quite the contrary in fact. There are many types of imagination and creativity and some don’t come easy to the Autistic Mind, but there are some, for which the Autistic mind is uniquely suited. Perhaps one of the few benefits of ASD is the ability to see the world around you in a different way and to make connections which would otherwise be missed. I am not saying that every Aspie is a potential prodigy, because that isn’t the case, but we can be every bit as imaginative as anyone else and in some cases far more so.

So where does this idea come from? I think it is numerous factors. Perhaps the main issue here is that there are many types of imagination. “Impairment of Imagination”, as mentioned earlier refers to poor “Social Imagination”, meaning that we usually find it difficult to put ourselves in someone else’s place, which is also where the misnomer comes from that we don’t experience empathy. We are capable of empathy; we simply sometimes lack the ability to appreciate someone else’s situation. In more serious cases of Autism, things can be taken very literally, which leads to yet another misnomer – no appreciation of humour (I will write more on this in the near future – it is a fascinating subject). Artistic or creative imagination is different again and although “Impairment of Imagination” may affect creative imagination, it doesn’t lessen it, but rather it alters it’s perspective.

Where creativity and imagination come from is a mystery. Perhaps it is one part nature one part nurture, who can tell? The brain chemistry involved with Autistic Spectrum Disorders often allows individuals to absorb almost everything they see & here. Senses can be heightened and largely unfiltered. Adopting these aspects of their condition into their special interests can be a way of coping with all this stimuli. If those interests involve art, music, science or mathematics, then truly astonishing things can emerge out of this turbulent mix.

There is plenty of speculation on which notable historic figures had an ASD and many seem to match the specific criteria for Aspergers Syndrome, but I am not interested in speculation. What I do know is that the Autistic mind has plenty to offer the world and it is time that we, as a society learned to embrace those possibilities.

Before I leave this post, I can’t resist putting in a link to one of my favourite Autistic Artists – Stephen Wiltshire, who draws much of his work from memory. I think his drawing style is simply amazing and I can look at his work for hours. Check out his Online Gallery:

Stephen Wiltshire – Online Gallery

ZenEmu X

depression & asd

ASD & Depression

depression & asdI have been writing this blog for sometime now and to be perfectly honest I think I have subconsciously avoided touching on the darker side of Autism, but a few days ago it occurred to me that I had been ignoring the elephant in the room: Depression.

There are no hard and fast statistics on depression related to Autism. I have spent the past few days looking online, scanning research and medical journals. I contacted every contact and no-one is aware of any substantive research on the subject, yet all agree on one thing – Depression and Autistic Spectrum Disorders are very common bedfellows. It seems that diagnosis of depression in people of all ages is substantially increased in ASD’s.

Not all people on the spectrum are depressed by any means. We are as unique and varied as anyone else. We come with our own hopes, quirks, desires, problems and eccentricities that have little to do with our condition. However, the unique challenges we face create an environment where depression can easily germinate.

For me as an adult Aspie, perhaps the greatest issue is just how aware I am of my own limitations and problems. I suppose the irony is that as you learn to come to terms with your own limitations, by necessity you need to explore those limits and learn where your problems lie and you become increasingly aware of the effort required to fit in or to try to comply with societies expectations of you, which is a taxing process, and one that doesn’t necessarily become easier with age and increased responsibility. I’m sure most Aspies have experienced more than there share of guilt, shame and regret over past meltdowns or misunderstandings or have been overwhelmed by strong emotions or thoughts. Feeling constantly like an outsider can be draining in its own right.

There are other factors too which are less obvious:

Many people on the spectrum have a truly excellent long term memory and can be obsessive. These two traits combined mean that often every mistake, argument, meltdown, embarrassing moment or social faux pas can be etched into memory ready to be relived at any given moment.

ASD often comes with a strong need for order, a sense of completeness, the comfort of predictability and the joy of patterns. It may seem obvious to say the world around us rarely, if ever works this way, it doesn’t change that inherent need, nor does it lessen the anxiety when that need is not met.

Just like everyone else, we have a need to communicate. Unfortunately, most of the time, we can communicate only with varying degrees of success and failure; especially when we need to convey emotions or emotional needs. We simply don’t have those social tools that allow us to easily express ourselves emotionally and when we do, it can be without filters and can seem disproportionate.  Renowned 19th century author, Christian Nevell Bovee once said “Tearless grief bleeds inwardly”. All human beings need an emotional outlet, but with ASD barriers are a natural defence against that which we are poorly equipped to regulate.

People on the spectrum tend to have one very unpopular characteristic: they are extremely poor at following the crowd. They often have unusual world views and differing paradigms which are inherited from seeing the world in a different way. These world views, although different aren’t necessarily wrong, indeed they can often be brilliant, but equally are rarely easily embraced by society. When you have a minority view and you are not adept at socialising or communicating, it is extremely likely your interpretation of the world around you will remain unknown and widely ignored regardless of its advantages or insights. Indeed it is often this aspect of autism which when acknowledged can occasionally change the world.

The autistic mind more than any other has an inherent need to analyze their environment, to rationalise and to make judgements based on coherent understanding of their circumstances. One of the cruellest things about depression is that it distorts the ability to reason and this above anything else is the most difficult obstacle to overcome.

Overcoming depression is a whole book in and of itself and much better minds than mine have written chapter and verse on the subject, most of which, unfortunately, is meaningless when you actually have depression. Depression on the spectrum means more hurdles to jump, but that doesn’t mean it is insurmountable, merely difficult, as is so much of life.

To strive against depression requires an immense amount of effort and for those who have over overcome depression, whether on the spectrum or not, you have my respect. For those who are facing that challenge, good luck, you have my best wishes. I am sure there are many people out there who have been through this experience and I am sure your insights would be valuable to those still going through this struggle, so please, if you have a few moments, share your story with us.


ZenEmu X

In Vitro Fertilization

Rumour of Autism Link to IVF Facts

In Vitro FertilizationJust a brief post today. I’ve had a couple of emails this week concerning a couple of news articles referring to research being undertaken to investigate possible links between In vitro fertilisation and Autism. I think they originatate from here: Quebec doctor probes possible autism, in-vitro fertilization link.

Obviously I am by no means an expert in this field, nor am I medically qualified to give an opinion, but I can shed a little light on the history, which has prompted the current investigation being undertaken in Canada at McGill University, Montreal.

Between 2009 – 2010, Sackler School of Medicine (University of Tel Aviv, Israel) undertook a study on 461 children who were born as a result of IVF. Of these children 10.5% were diagnosed as being on the Autistic Spectrum, with varying degrees of severity. Typically, the expected rate of Autism in Israel is thought to be somewhere around 3.5%.

Around the same time as the Israeli study, another more general study was being conducted in the US by the Harvard School of Public Health. At the time, a more general Health study was being conducted concerning women. During this study 111 women who had Autistic children were questioned about their fertility history, specifically concerning the use of drugs which induce ovulation. Of these 111 women, 34% had used these kinds of fertility treatment. As an interesting side note – 43% of the women questioned in this study had a history of some form of fertility problem.

Obviously these are very limited research groups, as is often the case, and although they raise some interesting questions, from a purely mathematical point of view they are hardly conclusive and require much more comprehensive investigation before any firm conclusions can be made. It is in this vein that the McGill University, in Montreal, Canada, is taking the lead in a national study involving 43 of Canada’s leading fertility experts.

So, there we are, those are the facts as they stand at the moment. If you are reading this with concerns about IVF treatment, discuss it with your Doctor, but I really must reiterate that there isn’t any concrete evidence one way or the other at the moment.

I will be monitoring the latest research as and when it is published, so please feel free to contact me for any updates. I will be posting any significant findings as and when they come up.