Category Archives: Autism

Ursula Le Guin (1929-2018), autism and neurodiversity

It was announced today that Ursula Le Guin died on the 22nd of January 2018. She was my favourite author in my late teens and early 20s whilst I put her in my top three today. I first read my favourite Le Guin novel, The Left Hand of Darkness, aged 18 and it probably had quite an influence on my thinking and views. To my knowledge, Le Guin never wrote about autism or neurodiversity but many of the themes in The Left Hand of Darkness seem very relevant.

The basic idea is a man from a western philosophy culture visits a world where the inhabitants are meant to be symbolic of eastern philosophy. The visitor sees things in contrastingly binary terms, such as light vs dark, society vs nature and male vs female. The world he visits has an eastern philosophy approach where different elements are in balance with one another, they do not form a sharp contrast. The strongest example is gender, since the inhabitants of this planet are genderless, so there is no binary contrast between male and female. However, the visitor, with his western philosophy, cannot help but put the inhabitants into binary terms of male and female, he struggles to shed his inbuilt preconceptions and see the inhabitants of the planet for how they truly are. The visitor constantly fails to read the motives of the inhabitants of the planet and often does not realise this is happening. However, during a political crisis which he also misreads he is eventually forced to cooperate with one of the inhabitants and, through a long and difficult process, eventually gain some insight into the inhabitants.

I read the novel as an exploration of the challenge of understanding others, be it people you have known all your life or people from cultures you are unfamilar with. I take Le Guin as thinking we often interpret people, especially people from other cultures, in unhelpful, simplistic, binary terms. She was influenced by her interest in anthropology and, writing in the late 1960s, the feminist movement which she made a major contribution to. These notions seems very important lessons for today given the existence of Donald Trump who characterises Mexican migrants as ‘rapists’ and African nations as ‘shitholes’ whilst ex-Daily Mail columnist Katie Hopkins describes migrants as ‘cockroaches’.

I think Le Guin’s general approach is also applicable to some of my interests in psychiatry. The problem of how to accurately understand someone who is different is quite central to philosophy of psychiatry. There has been a long history of negative connotations being associated with psychiatric patients and those in mental distress. As this articles shows, disability has often been associated with deviance and immorality. Whilst hopefully this situation is improved today, with more people talking about mental health, Le Guin’s insights are also important in a world which tries to be tolerant of those who are different. In relation to autism, modern science suggests autistic individuals often have unusual ways of thinking, unusual ways of perceiving the world and unusual ways of understanding others. Thus it is very easy for a non-autistic person to apply their non-autistic expectations to an autistic individual, think they have understood them but fail to. On the other hand, autistic people are not simply defined by the symptoms of autism, each one is a unique person with many unique traits and views. So there is an equal danger that a non-autistic person interprets an autistic person solely in terms them being autistic and thus again fail to understand who they are.

Additionally, all this is applicable from my perspective as an autistic person. Autistic people often struggle to pick up on social nuances or see the perspective of others, and these are certainly true of me. Additionally, my default position for many years was to assume people think and feel as I do but, in my experience, this just leads to typically failing to understand others without realising it. Of course, some autistic people go to considerable efforts to try see things from the non-autistic perspective but, in my experience at least, this is really difficult to do. Non-autistic people also have many diverse traits and views so this approach can easily lead to painting those around me with a big, rather inaccurate, brush.

Le Guin’s concerns over binary categories and importance of balance seems important here. She shows how, in relation to gender, we can find a helpful middle ground, a balance with more harmony if (primarily though not exclusively) men can make more effort to not hold unhelpful gender stereotypes and if both genders see that gender roles are a product of wider socio-cultural forces rather than how men and women truly are. Similarly, both autistic people and non-autistic people can try and find a helpful middle ground, that more harmonious balance. Even if most the problems are caused by the larger of two groups (the non-autistic) and even if many of those problems are caused by wider socio-cultural factors (such as misleading narratives from the media, expectations about what constitutes acceptable socialising or expectations that useful work must follow specific uniform procedures), I believe the best way to find that harmony is for both autistic people and non-autistic people to challenge the ways they perceive the other and where required make changes. This image of what neurodiversity should aim for is different to some notions of neurodiversity I have encountered which desire that only non-autistic people make changes. A mutual change towards more harmonious understanding feels to me more in line with the lessons of The Left Hand of Darkness, my favourite novel of the recently departed Ursula Le Guin.

Philosophical analysis of Neurotribes

My article, ‘Putting the Present in the History of Autism’ has been published in Studies in the History and Philosophy of the Biological and Biomedical Sciences (a pdf of the uncorrected proofs can can be found here). Though the article title mentions history, there is much philosophical content in article.

I focus upon Silberman’s extremely positive message about autism, discussing his portrayal of the past as being mistaken about the diagnostic criteria for autism and how the modern diagnostic criteria for autism has effectively got it right. I felt strangely conflicted about Silberman’s argument. One on hand, I thought he was unfair to many historical diagnostic criteria for autism. On the other hand, I still broadly agreed with his position. I agree with Silberman with that autism is getting something right about the world, being a worthy scientific concept and describing the world to at least a reasonably degree of accuracy. On this basis I significantly share Silberman’s positive message. However, as much as I believe in modern autism, I might believe even more in an alternative diagnostic approach to autism (whether it be one similar to one used in the past or something new), such as one with a greater number of subtypes or one with slightly altered boundaries. I felt Silberman’s positive message unfairly downplayed such alternatives. I think we need do research and consider our values to decide if the current diagnostic approach is superior to alternative diagnostic criteria and possible subtypes. We need study alternative approach and subtypes to see if we can make autism get even more right about the world or, alternatively, become more confident about modern autism by showing it works better than possible alternative views. So whilst I share Silberman’s positive views, I felt they risked reducing interest in scientifically investigating alternative approaches to autism, hence I both agreed with Silberman yet was critical of his position. I outline my views fully in the article.

Reviewing Peter Hobson’s The Cradle of Thought

Peter Hobson’s The Cradle of Thought is a philosophically and scientifically informed discussion of how thought develops in early life. Hobson’s main argument is that “interpersonal engagement contributes to the development of the mind – and [that] disordered interpersonal relations affect development of thinking” (p.143). He discusses many scientific studies which show how the level and nature of interpersonal relationships can impact the capacity for thought, suggesting deficient interpersonal relationships can lead to impoverished thinking.

Hobson highlights this through discussing individuals who are often not as capable of interpersonal interactions as most humans. He primarily discusses autism in detail, suggesting the usual thinking of autistic individuals (such as theory of mind differences) arise from lack of normal social and emotional interactions in early life. He heavily emphasizes that autism has a genetic component which results in biological differences (rejecting notions of poor mothering causing autism which some psychoanalysis used to believe) but argues the abnormal thinking itself is not primarily just due to biological difference. Rather, the biological differences result in difficultly interacting normally socially and emotionally, and this abnormal social and emotional experience results in abnormal thinking.

One might ask, why not just say the biological differences are responsible for both the abnormal interactions and for the abnormal thinking? Hobson uses a novel strategy to answer this question, primarily by looking at other types of individuals who also can face difficulties interacting normally. He considers individuals who are blind from birth and individuals who had very little social or emotional interaction in early life when raised in Romanian orphanges. These individuals often could not relate to other people in early life in the same way as most children. He then shows that these individuals sometimes develop some symptoms of autism, at substantially higher probabilities than would occur at random. Autistic individuals have biologically abnormal minds, blind individuals lack sight and Romanian orphans presumably have no major biological differences, yet all can exhibit some similar behaviour we associate with autism. Therefore, Hobson argues, some autistic behaviour is not directly the product of the biologically abnormal mind, but the biologically abnormal mind sets up abnormal interpersonal relationships and those interpersonal relationships result in symptoms associated with autism. Hobson also provides some evidence from how mothers with boarderline personality disorder interact with their children and how chimpanzees lack some parts of human socialising, suggesting both these cases can contribute to less than fully developed thinking.

Even though considered a developmental disorder, there is often a suggestion within scientific literature that the psychological development purely follow biological developments, rather than biological development resulting in psychological developments which then result in further psychological developments. I think a simple biological leading to psychological approach often present in modern science is far too simplistic, but I am unsure whether I think Hobson is correct or if I prefer a middle ground between Hobson and that modern science picture. Reguardless, the book is highly recommended for raising some important questions, presenting a solid evidence basis (often from very diverse sources which are not usually discussed in the context of autism) and for being highly accessible, being effectively popular philosophy and popular science.