Autism, Empathy & Theory of Mind

 

Autism.

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, or perhaps more commonly, lack of intentions. For example:

Does someone want to get to know me or are they talking to me because they want something?

Is somebody not speaking to me because they are annoyed at me, or are they simply lost in their own thoughts? 

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 not on the autistic spectrum would immediately understand. Does this mean I lack empathy?

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.

Empathy.

Empathy?Empathy is the capacity to understand and share feelings with others. It is difficult to understand something when you simply aren’t aware it is there.

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 and anything more subtle and I am likely to miss it completely. The part of my brain which interprets facial expressions – the posterior superior temporal sulcus, doesn’t function as well as it should.

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 over sensitive, 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.

It is easy to assume then, that someone on the Autistic Spectrum is unfeeling or insensitive when they say things or behave in a way which is inappropriate to a situation, but when you are wearing an emotional blindfold, sometimes it is unavoidable. Does that count as a lack of empathy?

Theory of mind.

Psychology 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, to put 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.

By definition, 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 anothers shoes.

There is a great deal literature explaiing 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 or feelings. Typically, the more severe the Autism, the poorer the “Theory of Mind”.

Theory of mind is however a very academic concept – a useful diagnostic tool. In the real world, nothing is so black and white. A human being cannot be summed up so easily.

Emotion, empathy and relating to others can all be challenging to Autistic people to varying degrees, but it is the worst kind of hubris to sum up the emotional range of an individual based on the diagnosis of an Autistic Spectrum Disorder. People are complex, and wonderful; they are kind and cruel and they can be 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 and just as flawed. We just struggle to show emotion sometimes, and other times we struggle to see it, and occasionally we struggle to control it. In the end, we are just a part of the human spectrum, like everyone else.

“And now here is my secret, a very simple secret: It is only with the heart that one can see rightly; what is essential is invisible to the eye.”
― Antoine de Saint-Exupéry, The Little Prince

Autism & Vaccines – My View.

The problem with the community.

Vaccines are probably the biggest area of contention within the Autism community and there are some very strong opinions on either side.

I don’t have a child with a severe disability. I don’t know what it is to devote my life to a child who may, for the rest of their lives require around the clock care, nor do I know what it is to devote my entire life to their well being. I don’t know that anger, that sense of helplessness or the moment of grief that comes with learning that your child might not have the future you wished for them.

On the flip side, it is not uncommon for people with my form of Autism to resent being thought of as disabled. For many, the idea that we should be ‘cured’ is offensive. Many are very gifted and find their own unique niche, contributing remarkable things to society.

It is easy then to see why this argument swings back and forth, and why views on both sides get so heated.

Me & My Autism

In many ways, I am very lucky. I have an “mild” form of autism. I’m not entirely locked away in my own mind. I can for the most part look after myself and I can interact with others. My form of Autism comes with catches as much as symptoms. Sure I struggle with using the phone, and social situations are difficult self conscious affairs. but for the most part, I manage. Yes,  it can be difficult, but it is for the most part manageable.

For myself, I believe my Autism gives me some very unique traits, and some interesting gifts. If I could take a pill to cure myself, most days I would say no. But there are days… I think if even the most passionate high functioning Autistic people are honest with themselves, I am sure they would feel the same way.

My view.

It is very easy for me to form a light-hearted opinion as someone who didn’t receive childhood vaccinations, but went on to develop Aspergers Syndrome. I am not severely autistic, and I am not the parent of a child who is, I’m not a parent looking for answers.

I have read countless vaccine related studies over the years and I have often written about the subject. I have publicly given stated my opinion on Andrew Wakefields’ deplorable actions with regard to his claims in 1998 and the methodology he used.  In my opinion, his claims were unsupported, biased by greed and his methodology was obscene.

It is also difficult to ignore the simple fact that vaccines have made a huge difference to child mortality. In all good conscience, I don’t believe I could deny any child the possibility of immunity to diseases which can kill and are easily transmitted, especially among children.

Here is the thing though – the Autism community spends so much time on this debate, that sometimes I feel we are missing the bigger picture. We spend more time debating this one issue than we do at looking at treatment for those suffering severe Autistic symptoms. We need to work together as a community to highlight the positives and treat the negatives and to raise awareness on the practical issues around Autism. Early diagnosis, easing symptoms, and appropriate and practical therapies that give Autistic children the best possible chance need to be discussed, researched and heavily funded.

My conclusion after all these years is that Autism to some extent is a natural aspect of humanity and has probably been present throughout our history. It is, however very much on the increase, the numbers are difficult to argue with. The research on the whole seems to  indicate that Autism has both genetic and environmental factors. Whether those factors are vaccines, pollution, smoking, alcohol, dietary or simple evolution throwing the dice, I am not sure it matters much. What is vastly more important is acceptance within society and a practical approach to dealing with the practical issues at hand. That is what is important and should be the focus of medical science and the community. I am not talking about curing autism, I am talking about making it manageable and reducing the suffering it all too often causes.

So there you have it, that is my view. I am sure some will take issue with it, but hopefully we can open up debate on other subjects other than cause and create discussion about more practical matters.

Zen