As I did the reading for this week, I found myself feeling very protective of Sacks. I remember, early in the semester, when we were reading Awakenings, my cursory Google search of Sacks revealed that there was great hostility toward him, among book reviewers and medical professionals, and their criticism always had a weird personal quality to it, a whiff of undignified animosity. Alexander Cockburn is an example of this, and so is Tom Shakespeare. Although--to be honest--I find their criticism thoughtless and hard to take seriously, I do want to be sensitive to the real ethical complications and questions of Sacks’s work (notably, these are not the issues that Cockburn and Shakespeare address; they are dismissive rather than critical).
There are basically three ethical concerns that Sacks has raised for me personally. The most significant difficulty I’ve had with Sacks--and this is something I’ve spent a lot of time thinking about--is the fact that he consistently chooses the most extreme and rare cases, rather than trying to elucidate the more common varieties of neurological difference and/or damage with his warmth and erudition and depth of insight, so as to make his work of practical benefit. It’s the deliberate seeking out of impressive and unusual cases that, to me, has a faint suggestion of freak show. Another thing I find problematic about later Sacks is the ambiguity of his role: I felt much more comfortable with the cases in which Sacks was present primarily as a doctor, the best example of this being Awakenings. There, his presence is clearly justified. But with Temple Grandin I was very unclear about what exactly his stated reasons for being with her were. I was curious how he had explained the situation to her, since she didn’t seem to find his presence strange. With Temple Grandin, as with several others, he was in the role of voyeur, primarily. My third concern has to do with his films specifically. I sort of tense up when I notice that Sacks is talking about the patient or subject as if he or she weren’t in the room. That feels like a kind of dehumanization, when you talk about people like museum pieces. But the matter Sack’s ethics is trickier than my criticisms suggest. A lot of what I’ve highlighted is defensible.
As we’ve discussed, there can be some benefit to looking at the extreme cases. They have a way of revealing general principles about the brain. I can see how his writing about Parkinson’s could really alter, for the better, how physicians and lay people understand the condition. Moreover, he is to some degree a creative writer; he is to some degree an entertainer, he is to some degree an educator; he is a public intellectual. A former fiction teacher of mine would ask of a story the Passover Seder question: Why is this night different from all other nights? Or, what is the conflict here? Why is this story of all possible stories worth telling? Why should we care? This is to say, stories are about exceptional happenings. Even stories that claim not to be--like Mrs. Dalloway--can’t help transcending the mundane. If we view Sacks as a short story writer, as I most certainly do, it is perfectly understandable that he would choose the extreme cases.
The ambiguity of his role is problematic, not because I think he ought to take on an especially rigid role for its own sake, but because I think it creates confusion for the person about whom he is writing. I would feel awkward for that reason if he were writing about me. I wouldn’t know how to relate to him or what to expect from him. I wouldn’t be sure whether he was there to help me, or whether he was there to look at me and study me for someone else’s benefit or his own. When he puts on his doctor cap, this problem mostly goes away. A lot of the ethical muddiness dries up. But, on the other hand, stepping out of the doctor role gives him a little more latitude, which can reveal aspects of a condition that are otherwise hard to get at. He can be more flexible in the way he interacts with his subjects. He can see them in a wider variety of contexts. He can elicit different reactions. We can learn some subtle things if he isn’t strictly in the doctor role.
What I don’t find defensible is his habit--albeit occasional--of talking about subjects and patients as though they are not there or cannot hear or cannot understand. Some of his commentary, even if it’s astute, is painful to hear directly and could be better received in final essay form, with necessary qualification. It’s not that the content of his remarks is wrong; it’s that he, in these instances, treats people like objects, and this goes against his project.
Okay, I’m tired.
Wednesday, April 29, 2009
Tuesday, April 28, 2009
Boundaries, eh?
I found the articles dissecting Oliver Sacks’ anthropo-literary style very intriguing. Throughout this semester, I have been struck by the boundaries I would normally assume to exist between patient and doctor being blurred and, in some instances, nonexistent as regards Sacks and his subjects. For the most part, I was happily surprised at the manner by which Sacks seeps into the lives of his patients and, comparatively, he he allows them to seep into his life. This reaction was especially prominent when reading sections from An Anthropologist on Mars, wherein he traveled to Pontito with his eidetic memory patient, Franco. In turn, seeing Sacks zonked out (for lack of a more apt term) on kava juice (?) as he explored Micronesia during The Island of the Colorblind. Indeed, Sacks provides his readers not only with a portrayal of his subjects, but also (as Couser points out in reference to Sacks’ films) “Sacks himself enters the frame; he, too, is available for visual inspection, as is his interaction with his subjects.” His presence is also repeatedly felt throughout his writing, wherein he continually analyzes how he feels about his patients, their dispositions, and his philosophical ideations.
There is also a part of me, however, that wonders about how much blurring of the boundaries between a patient and a doctor is appropriate. Should there be fine lines of demarcation? I know, in situations I’ve been involved in, there has always seemed to be somewhat of a dichotomy (involving power levels) between my status as a patient, seeking “treatment,” and the doctor’s status as the treatment provider. [I have, however, been known to foster somewhat dichotic views, and so perhaps more of my own perception may account for these ostensibly clear-cut delineations].
I wonder also, however, especially in light of all our readings for this semester (especially Joseph LeDoux’s), whether it is indeed better to have less rigid boundaries. In fact, when I call the Echo Maker to mind, it seems that conceiving of boundaries as fixed and inflexible entities is absolutely false—and one would be pathological to assume this as truth.
Indeed, as LeDoux asserts in our final reading of his “Synaptic Self,” though different brain regions are distinct in a cytoarchitectonic and organizational sense, to conceive of our neural structures as distinct, isolated entities is inaccurate. Each depends upon another to carry out its function, and thus illustrates the fluidity of perceived distinction.
Overall, then, it’s difficult to decide what my stance is on Sacks and his dealings with his patients. In no way do I agree with the authors who deem his interactions violating or reminiscent of freak shows. However, I think that his style of patient-doctor relationship certainly transgresses conventional lines. That said, I do believe this method helps bridge the gap between the pathological and the non-pathological. So much of Sacks’ work, I feel, results in a clearer image of what it might be like to be one of his patients. Indeed, a more integrative and holistic perspective is provided by all of his publications, wherein the reader (unless, like Cockburn, s/he decides to hate the man for no good reason) gleans a novel perspective, free from typically binary modes of thought (i.e. seeing a disorder only for its diagnostic criteria). And so, in conclusion, I would say that there’s a great deal of ambiguity here, which parallels the ambiguity Sacks introduces into his work. In turn, I feel that this ambiguity is a more accurate reflection of reality, in that conceived boundaries are, well, conceived. Changing. In flux. Not entirely solid or stable.
I appreciate this perspective, and recognize that it is not one to which I have generally adhered. Thus, as a result of reading Sacks, Powers, Skloot, LeDoux, and others (who have, in particular, seemed to promote the notion of flexibility rather than rigidity in their perspectives) my synapses seem to have done a little readjusting. Thanks, guys!
There is also a part of me, however, that wonders about how much blurring of the boundaries between a patient and a doctor is appropriate. Should there be fine lines of demarcation? I know, in situations I’ve been involved in, there has always seemed to be somewhat of a dichotomy (involving power levels) between my status as a patient, seeking “treatment,” and the doctor’s status as the treatment provider. [I have, however, been known to foster somewhat dichotic views, and so perhaps more of my own perception may account for these ostensibly clear-cut delineations].
I wonder also, however, especially in light of all our readings for this semester (especially Joseph LeDoux’s), whether it is indeed better to have less rigid boundaries. In fact, when I call the Echo Maker to mind, it seems that conceiving of boundaries as fixed and inflexible entities is absolutely false—and one would be pathological to assume this as truth.
Indeed, as LeDoux asserts in our final reading of his “Synaptic Self,” though different brain regions are distinct in a cytoarchitectonic and organizational sense, to conceive of our neural structures as distinct, isolated entities is inaccurate. Each depends upon another to carry out its function, and thus illustrates the fluidity of perceived distinction.
Overall, then, it’s difficult to decide what my stance is on Sacks and his dealings with his patients. In no way do I agree with the authors who deem his interactions violating or reminiscent of freak shows. However, I think that his style of patient-doctor relationship certainly transgresses conventional lines. That said, I do believe this method helps bridge the gap between the pathological and the non-pathological. So much of Sacks’ work, I feel, results in a clearer image of what it might be like to be one of his patients. Indeed, a more integrative and holistic perspective is provided by all of his publications, wherein the reader (unless, like Cockburn, s/he decides to hate the man for no good reason) gleans a novel perspective, free from typically binary modes of thought (i.e. seeing a disorder only for its diagnostic criteria). And so, in conclusion, I would say that there’s a great deal of ambiguity here, which parallels the ambiguity Sacks introduces into his work. In turn, I feel that this ambiguity is a more accurate reflection of reality, in that conceived boundaries are, well, conceived. Changing. In flux. Not entirely solid or stable.
I appreciate this perspective, and recognize that it is not one to which I have generally adhered. Thus, as a result of reading Sacks, Powers, Skloot, LeDoux, and others (who have, in particular, seemed to promote the notion of flexibility rather than rigidity in their perspectives) my synapses seem to have done a little readjusting. Thanks, guys!
Sunday, April 26, 2009
Shakespeare the Ideologue & Sacks' Ethics
I began this week’s readings feeling unsure about the moral purity of Sacks’ work, but the three critiques — coupled with “A Surgeon’s Life” — have helped me toward a clearer position in favor of Sacks, though not necessarily because I agreed with what I read.
My most significant disagreement is not with an arguement we read directly, but with one that was paraphrased and deconstructed for us: Tom Shakespeare’s. I do not know much at all about Tom Shakespeare*, yet the (what seemed to me) strangely misdirected ire that he targeted at Sacks immediately placed him in an unfortunate category for me. He became akin to Michael Moore and Ann Coulter: an ideologue who makes exaggerated, misleading, or even deliberately false statements in order to further a cause. To my mind, this behavior undermines rather than supports the cause in question because it presents a detrimentally simplistic perspective. My impression from reading Couser’s quotations and paraphrases is that Shakespeare is more interested in drawing focus to the persistent marginalization of the disabled by the medical community than in the ethical strength of Sacks’ writing. He makes accusations that seem to have no bearing on Sacks’ actual writing. Shakespeare asserts that Sacks is interested primarily in profiting from his patients’ stories (qtd. in Couser 7), which, if sincere, seems like shallow guesswork made by a poor judge of character.
Sacks is clearly a kind-hearted and generous doctor. Nearly everything in Sacks’ writing has pointed toward a patient-first attitude that is not only willing but eager to find a living, relatable person in even the most severely disabled patients and subjects. In spite of Shakespeare's accusation that he writes to make us "marvel" at his "expertise," Sacks humbly admits his mistakes where he sees them: “Some things, one might think, would be completely out of the question [for someone with Tourette’s] — above all, perhaps, the intricate, precise, and steady work of a surgeon. This would have been my belief not so long ago” (Sacks 79). Admittedly, he is not always successful: his dismissal of Heidi's complaint in the department store shows some methodological coldness (Couser 5).
Fortunately, Sacks is constantly examining and re-evaluating his own perspective and assumptions about disease, and this is perhaps no more apparent than in the chapter from the book that we read for today, the same book that Shakespeare supposedly reviews. I agree with Couser that Shakespeare quite possibly “formed a negative opinion of Sacks on the basis of the earlier volume [The Man Who Mistook His Wife for a Hat] and was unable or unwilling to qualify it in reviewing a subsequent book that is far more ambitious and accomplished” (Couser 8). Shakespeare judges Sacks only on his most sensationalist book, which would not look so much like that "high-brow freak show" (Couser 2) for which the likes of Alexander Cockburn despise him. This hollow attempt at an argument, which Couser generously calls "succinct" (Couser 2) is so glib and moronic that I am tempted to make fun of the Nation columnist's name in like fashion.
Shakespeare also complains that Sacks is monological in his presentation and fails to give the patient perspective sufficient space on the page. But I am more inclined to agree with Anne Hunsaker who says, “To compare Awakenings to the conventional [monological] medical history is to trace a movement away from "authoritative discourse" and toward dialogism.” Shakespeare’s complaint presumes an niche perspective of a general-audience writing; that is, he is preoccupied with his own idea of how many personal testimonials he would have liked to see. He is interested in the unfiltered perspective of the sick, not their doctor's attempt to synthesize patient and physician. Perhaps in Sacks, Shakespeare was looking more for direct quotations, but it seems that more generally he wanted a journalist to document the diseased or disabled perspective, not a neurological interpreter to weave a narrative case study, however humanist the tone.
* I do know that Tom Shakespeare is himself disabled, and I guiltily wonder if his own sense of marginalization (probably not a real word) or his affinity for the chronically ill gives him a distorted or instinctively confrontational perspective on the work of a doctor writing about his patients. I am guessing that this is an offensive idea to some, especially since I am presuming to psychoanalyze a person I have never met, but it is the only explanation I can think of for such a respected voice in the scientific community (I did a little internet research) voicing such irrational outrage against a man who has done much for a cause he also promotes (that being the social acceptance of the neurologically atypical or handicapped).
P.S. I have noticed that I have a habit of misspelling “Sacks” as “Sachs.” Perhaps this is from seeing “Goldman Sachs” in the news too many times. Please forgive the error.
A Retraction of my "wrong", and further thoughts
At the end of our last class I threw around the word "wrong" a lot. I'd like to further clarify what I meant. I don't think of what Sacks does as "wrong", explicitly--rather something about reading narrative case studies feels wrong to me personally. Voyeurism and exploitation of others are things I try ardently to avoid, as a scholar, artist, and human being in the world; and I know that the work of Sacks is sometimes read for those purposes.
I found Cassuto's analysis of Sacks' work thoughtful and fascinating, though I also discovered some holes in his argument. In his metaphor of the freak show, Cassuto neglects to reflect on the charlatanism rampant in that tradition. Of course, of course, many of the "ringmasters" did travel the country, seeking out (and even trading amongst themselves) people with medical oddities. But they also would use makeup, props, and sleights of hand to create the illusion of a freak where there was really only an out-of-work actor. Somehow this knowledge shifts Cassuto's metaphor for me, and slightly invalidates it, though I understand his use.
Secondly, I objected to a specific evaluation he made: "Sacks is writing narratives of wonder at a time when wonder is hard to come by. These wonder narratives wind up creating a uniquely collaborative space within which disabled people can express themselves--rather than closing one off" (329).
Now, I would argue that the people represented in Sacks' narratives are not "express[ing] themselves". What is expressed is Sacks' own perception of their self, which is an entirely different beast. I also think the degree to which this process is "collaborative" necessarily depends a great deal on the abilities/lucidity of the individual patients. Someone like Temple Grandin, for instance, has a deep understanding of how she is being portrayed and is participating actively in shaping Sacks' narrative of her (as well as writing her own, of course). Someone like Jessy Park, on the other hand, doesn't have the same kind of grasp on what it means for her to be in Sacks' documentary. I wouldn't call her a "collaborator". This is a term Cassuto returns to often, and I question his choice.
To go back to this idea of "wrong". I really appreciated Hawkins' comments on Sacks' project--and I agree wholeheartedly that his approach is novel and commendable. To be as a doctor a "traveler into the world of the patient" is brave, difficult, and compassionate. I do support the work. Sacks clearly comes across, both as a writer and a man, as a compassionate, thoughtful, respectful, curious, engaging individual. I understand how his work has broadened the public's mind to ideas of difference/the neurotypical, living with disease, etc... and honestly, his work also entertains, titillates, and provides scintillating stories. The problem for me only lies in the extremely public display of other people's lives, because you can't control how it will be received. As someone who has lived through an array of medical emergencies and strange conditions, I personally am concurrently very open and very protective of those details. I feel no shame when relating a story from my medical history, but at the same time, *I* want to be in control of that information, *I* want to be able to present it and myself. Therefore, I feel a sense of guilt when reading Sacks' work, alongside the intellectual interest and pleasure in his writing style. This is what feels "wrong". Does anyone else feel this way, or is it particular to me?
I found Cassuto's analysis of Sacks' work thoughtful and fascinating, though I also discovered some holes in his argument. In his metaphor of the freak show, Cassuto neglects to reflect on the charlatanism rampant in that tradition. Of course, of course, many of the "ringmasters" did travel the country, seeking out (and even trading amongst themselves) people with medical oddities. But they also would use makeup, props, and sleights of hand to create the illusion of a freak where there was really only an out-of-work actor. Somehow this knowledge shifts Cassuto's metaphor for me, and slightly invalidates it, though I understand his use.
Secondly, I objected to a specific evaluation he made: "Sacks is writing narratives of wonder at a time when wonder is hard to come by. These wonder narratives wind up creating a uniquely collaborative space within which disabled people can express themselves--rather than closing one off" (329).
Now, I would argue that the people represented in Sacks' narratives are not "express[ing] themselves". What is expressed is Sacks' own perception of their self, which is an entirely different beast. I also think the degree to which this process is "collaborative" necessarily depends a great deal on the abilities/lucidity of the individual patients. Someone like Temple Grandin, for instance, has a deep understanding of how she is being portrayed and is participating actively in shaping Sacks' narrative of her (as well as writing her own, of course). Someone like Jessy Park, on the other hand, doesn't have the same kind of grasp on what it means for her to be in Sacks' documentary. I wouldn't call her a "collaborator". This is a term Cassuto returns to often, and I question his choice.
To go back to this idea of "wrong". I really appreciated Hawkins' comments on Sacks' project--and I agree wholeheartedly that his approach is novel and commendable. To be as a doctor a "traveler into the world of the patient" is brave, difficult, and compassionate. I do support the work. Sacks clearly comes across, both as a writer and a man, as a compassionate, thoughtful, respectful, curious, engaging individual. I understand how his work has broadened the public's mind to ideas of difference/the neurotypical, living with disease, etc... and honestly, his work also entertains, titillates, and provides scintillating stories. The problem for me only lies in the extremely public display of other people's lives, because you can't control how it will be received. As someone who has lived through an array of medical emergencies and strange conditions, I personally am concurrently very open and very protective of those details. I feel no shame when relating a story from my medical history, but at the same time, *I* want to be in control of that information, *I* want to be able to present it and myself. Therefore, I feel a sense of guilt when reading Sacks' work, alongside the intellectual interest and pleasure in his writing style. This is what feels "wrong". Does anyone else feel this way, or is it particular to me?
Tuesday, April 21, 2009
Studying the relationship between emotion, memory, and perception in Autism
Losh and Capps' paper brought to my attention many ideas about the relationship between emotion, memory, and perception.
In one instance, they cite other studies that suggest "experiences rendered through narrative are more likely to be consolidated in memory". Typical children developed the narrative form of response when recounting emotional incidents, and L&C believe that this supports the "prospect that narrative activities may be integrally involved in emotional appraisal and that autistic individuals' noted difficulties with narrative, could, in part, inhibit their capacity for appraising emotional experiences and constructing emotion concepts and memoryies"
This presents an interesting relationship between formation of a narrative, and appraisal of emotions. It suggests that emotions are determined after the formation of a narrative, rather than the reverse. Yet we often address other individuals' emotions and seek reasons / create a narrative afterward.
L&C address this, and acknowledge that autistic individuals certainly posess less elaborate memories of emotions, (as Grandin suggested), and that formation of narrative is not cognitive bottleneck. They believe that memories of emotional events create a "knowledge base... on the causes, consequences and subjective meaning of affectively charged happenings, and that Lacking such a repository could render autistic individuals disadvantaged"
Still, the question remains as to why this knowledge base is not created. This leads me to believe that a core question in autism is studying the relationship between perception and emotion, or perception and creation of narratives. L&C point out the autistic group's tendency to point out the visual elements of emotions (angry faces, sad faces, etc). This leads us to believe that the understanding of emotion that this individuals have, is based more in visual-word association than some 'deeper' emotional understanding or empathy.
It seems that understanding social interaction, requires the need to process emotional information, which seems to be a consolidation or 'essentialized' form of information. As was emphasized in the Rage for Order film, the brain of an autistic individual is structured in such a way that it appears to prefer processing closed, predictable, and physical systems.
This reminds me of a hypothesis for Autism called, The Intense World Syndrome. As it proposes: "...the core pathology of the autistic brain is hyper-reactivity and hyper-plasticity of local neuronal circuits. Such excessive neuronal processing in circumscribed circuits is suggested to lead to hyper-perception, hyper-attention, and hyper-memory, which may lie at the heart of most autistic symptoms. In this view, the autistic spectrum are disorders of hyper-functionality, which turns debilitating, as opposed to disorders of hypo-functionality, as is often assumed."
This in does seem compatible with what the University of California researcher in the Rage for Order film was talking about --a deficit in that kind of coordinating ability that is apparent in the cerebellum. It may be that a dysfunction in this area is what allows hyper-sensitivity to perceptual information., or that hyper-activation of those circuits is what causes disfunction in the cerebellum, as researchers of that theory might propose.
As a side note, I just wanted to say/complain:
Reading Understanding of Emotional Experience in Autism: Insights From the Personal Accounts of High-Functioning Children With Autism, gave me a new found appreciation for the writing of Oliver Sacks and other narrative-neuro writers.
Take for example, this idea of understanding autism through a "discourse analytic framework", or, the great phrase, "personalized causal-explanatory narrative frameworks". I can't imagine anyone who doesn't have an hour to read the paper understanding this. Thankfully, we have writers who address the general public, letting us know that what the authors really mean to describe are, "recorded conversations" and "personal stories" respectively. Some fields are much worse, but this paper reminded me of the great need for popular science writers who can convey specific ideas in more accessible ways.
In one instance, they cite other studies that suggest "experiences rendered through narrative are more likely to be consolidated in memory". Typical children developed the narrative form of response when recounting emotional incidents, and L&C believe that this supports the "prospect that narrative activities may be integrally involved in emotional appraisal and that autistic individuals' noted difficulties with narrative, could, in part, inhibit their capacity for appraising emotional experiences and constructing emotion concepts and memoryies"
This presents an interesting relationship between formation of a narrative, and appraisal of emotions. It suggests that emotions are determined after the formation of a narrative, rather than the reverse. Yet we often address other individuals' emotions and seek reasons / create a narrative afterward.
L&C address this, and acknowledge that autistic individuals certainly posess less elaborate memories of emotions, (as Grandin suggested), and that formation of narrative is not cognitive bottleneck. They believe that memories of emotional events create a "knowledge base... on the causes, consequences and subjective meaning of affectively charged happenings, and that Lacking such a repository could render autistic individuals disadvantaged"
Still, the question remains as to why this knowledge base is not created. This leads me to believe that a core question in autism is studying the relationship between perception and emotion, or perception and creation of narratives. L&C point out the autistic group's tendency to point out the visual elements of emotions (angry faces, sad faces, etc). This leads us to believe that the understanding of emotion that this individuals have, is based more in visual-word association than some 'deeper' emotional understanding or empathy.
It seems that understanding social interaction, requires the need to process emotional information, which seems to be a consolidation or 'essentialized' form of information. As was emphasized in the Rage for Order film, the brain of an autistic individual is structured in such a way that it appears to prefer processing closed, predictable, and physical systems.
This reminds me of a hypothesis for Autism called, The Intense World Syndrome. As it proposes: "...the core pathology of the autistic brain is hyper-reactivity and hyper-plasticity of local neuronal circuits. Such excessive neuronal processing in circumscribed circuits is suggested to lead to hyper-perception, hyper-attention, and hyper-memory, which may lie at the heart of most autistic symptoms. In this view, the autistic spectrum are disorders of hyper-functionality, which turns debilitating, as opposed to disorders of hypo-functionality, as is often assumed."
This in does seem compatible with what the University of California researcher in the Rage for Order film was talking about --a deficit in that kind of coordinating ability that is apparent in the cerebellum. It may be that a dysfunction in this area is what allows hyper-sensitivity to perceptual information., or that hyper-activation of those circuits is what causes disfunction in the cerebellum, as researchers of that theory might propose.
As a side note, I just wanted to say/complain:
Reading Understanding of Emotional Experience in Autism: Insights From the Personal Accounts of High-Functioning Children With Autism, gave me a new found appreciation for the writing of Oliver Sacks and other narrative-neuro writers.
Take for example, this idea of understanding autism through a "discourse analytic framework", or, the great phrase, "personalized causal-explanatory narrative frameworks". I can't imagine anyone who doesn't have an hour to read the paper understanding this. Thankfully, we have writers who address the general public, letting us know that what the authors really mean to describe are, "recorded conversations" and "personal stories" respectively. Some fields are much worse, but this paper reminded me of the great need for popular science writers who can convey specific ideas in more accessible ways.
Nothing new under the sun
Sachs' investigation of Stephen Wiltshire's drawing and Temple Grandin's discussion of her visualization-based drafting process challenge the conventional understanding of what it means to be an artist. We take for granted that an artist (I will, for the sake of simplicity, stick to visual art) renders an image from his imagination, and that art, therefore, is a product of imagination. Certainly, most of the art that fills the world's galleries is taken from life, inspired by or modeled on a scene that took place in reality. But art is not an automatic reproduction. It is created with style and intention. Art speaks; it has a message. Even photography can be more than pure journalistic record-keeping. A photographer frames an image and makes it his own. He manipulates his instrument to emphasize what he judges to be the salient features of a scene. Through the enumerable choices made in shooting and developing, a photographer communicates, and documentation is turned into art. But is Stephen capable of more than documentation? Is he an artist?
I argue he is on both counts, and there are a couple of reasons for this. First of all, he is driven to draw. His compulsion seems to stem, in the most general terms, from a need to make order out of what he perceives and, in rendering it, to communicate that order. I don't mean that Stephen is trying to reach out to the larger public — Emily Dickinson wrote the vast majority of her poems without any apparent intention to publish them; they were a way of communicating with herself — but he is solidifying his perception of the outer world into something tangible. Second, he interprets. He adds details and ornamentation to buildings for both aesthetic (the chimney on Sachs' house) and symbolic (the flagpole in his yard) purposes. Jessy Park's psychedelic coloration is similarly interpretive and has an individualized style that parallels the warm lines of Stephen's later drawings.
The additional perspective we get from Grandin is problematic. Her mode of piecing visual images together to make something new seems to be echoed in Stephen's creative alterations and additions. Is it truly art if he is only mechanically stacking visual images like building blocks? I think this is a false distinction. Grandin's process merely literalizes the common method of all human creative output. Nothing comes from nothing. An artist takes in what is pre-existing and makes a new pattern out of the old pieces. The pieces themselves are eternal, though we add new meanings to them as our memory of associations grows. So to strip Stephen of his artistic mantle would be an act of supreme arrogance on the part of the neurotypical. It would require belief that the neurotypical artist can make something out of nothing in a manner beyond the ken of an autistic one.
Monday, April 20, 2009
"a scientist trying to figure out the ways of the natives"
I'm going to start, if I may, with a personal anecdote. Trying to write this response has been uncommonly difficult for me, because the subject matter is so personal and so difficult for me to relate to people. I was diagnosed with high-functioning Asperger's syndrome when I was sixteen and, despite the fact that there has been a good deal of research demystifying Asperger's and the autism spectrum, it really something isn't something that I like talking about. Immediately following my diagnosis, my mom reacted very negatively, trying to find any alternate diagnosis to explain the experiences and symptoms that I described and that were noted to my psychiatrist, maybe because she was a concerned parent still operating with a set of beliefs like the "views" noted by Capps and Losh "that individuals with autism do not experience or express emotions (e.g., Bettelheim, 1967)" or "that autism involves an absence of emotional expression and indifference to others (e.g., American Psychiatric Association, 1994; Bettelheim, 1967; Kanner, 1943; 1971)".
Of the conditions we've studied, the disorders on the autism spectrum strike me as being among the most subjected to negative social stigma, along with epileptic disorders, which I also had the privilege to write about. I feel a bit hypocritical for this, but while I find the stigma surrounding epilepsy to be rather outdated and highly motivated by superstition -- the experiences of epileptics are such a radical break from neurotypical people that one of the most logical ways to explain them without using neuroscience are through falling into the realms of the unscientific and unrealistic -- I honestly can understand the stigma against autism spectrum disorders. As LeDoux made a point of discussing in last week's reading, emotions are exceedingly difficult to explain through the same methods in which neuropsychologists describe other phenomena, but they are too inherent to the human experience to ignore.
Considering this, the notion of someone's brain being so neurologically atypical that they have marked difficulty understanding and relating to their own emotions and those of other people, experiencing deep a 'disconnection' between themselves and the rest of the world, naturally seems foreign, strange, and even impossible to understand. Even living with it myself, I don't understand much of my own experiences and my family has even greater difficulty doing so, though having the context of Asperger's gives us a framework within which to work. Reading the selections for this week has been difficult for me to sort through and, thus, respond to because so much of it is simultaneously familiar and alien. For example, while, I could empathize with Temple Grandin on many counts -- her experiences with finding the right course of medications, for example, struck a chord, albeit for different reasons -- other parts of her descriptions of her experiences were so far removed from how I understand things. Her early notion of "thinking in pictures," for example, was strikingly other.
The otherness of autism spectrum disorders is, though, what I think makes them inherently essential to an understanding of the human mind and the neurotypical experience. As we've come back to time and time again during the course, understanding how a neurologically atypical brain works highlights the functioning of the brain in general, so that we can better learn how a neurotypical brain crafts and contributes to our experiences. In our readings about autistic spectrum disorders, we've had the perspectives of the neurotypical (Clara Claiborne-Park, Lisa Capps and Molly Losh, and our friend Oliver Sacks, in both An Anthropologist on Mars and his introduction to Exiting Nirvana), the autistic (Temple Grandin), the Asperger's (Tim Page), and the neurotypical writing as autistic (The Curious Incident of the Dog in the Nighttime), and this synthesis, this meeting different aspects of similar experiences, even more than the experiences themselves, is where we can really find an understanding of the material. The relationship between a neurotypical brain and an autistic one could be seen as this idea, written in synapses and chemicals rather than in words.
Of the conditions we've studied, the disorders on the autism spectrum strike me as being among the most subjected to negative social stigma, along with epileptic disorders, which I also had the privilege to write about. I feel a bit hypocritical for this, but while I find the stigma surrounding epilepsy to be rather outdated and highly motivated by superstition -- the experiences of epileptics are such a radical break from neurotypical people that one of the most logical ways to explain them without using neuroscience are through falling into the realms of the unscientific and unrealistic -- I honestly can understand the stigma against autism spectrum disorders. As LeDoux made a point of discussing in last week's reading, emotions are exceedingly difficult to explain through the same methods in which neuropsychologists describe other phenomena, but they are too inherent to the human experience to ignore.
Considering this, the notion of someone's brain being so neurologically atypical that they have marked difficulty understanding and relating to their own emotions and those of other people, experiencing deep a 'disconnection' between themselves and the rest of the world, naturally seems foreign, strange, and even impossible to understand. Even living with it myself, I don't understand much of my own experiences and my family has even greater difficulty doing so, though having the context of Asperger's gives us a framework within which to work. Reading the selections for this week has been difficult for me to sort through and, thus, respond to because so much of it is simultaneously familiar and alien. For example, while, I could empathize with Temple Grandin on many counts -- her experiences with finding the right course of medications, for example, struck a chord, albeit for different reasons -- other parts of her descriptions of her experiences were so far removed from how I understand things. Her early notion of "thinking in pictures," for example, was strikingly other.
The otherness of autism spectrum disorders is, though, what I think makes them inherently essential to an understanding of the human mind and the neurotypical experience. As we've come back to time and time again during the course, understanding how a neurologically atypical brain works highlights the functioning of the brain in general, so that we can better learn how a neurotypical brain crafts and contributes to our experiences. In our readings about autistic spectrum disorders, we've had the perspectives of the neurotypical (Clara Claiborne-Park, Lisa Capps and Molly Losh, and our friend Oliver Sacks, in both An Anthropologist on Mars and his introduction to Exiting Nirvana), the autistic (Temple Grandin), the Asperger's (Tim Page), and the neurotypical writing as autistic (The Curious Incident of the Dog in the Nighttime), and this synthesis, this meeting different aspects of similar experiences, even more than the experiences themselves, is where we can really find an understanding of the material. The relationship between a neurotypical brain and an autistic one could be seen as this idea, written in synapses and chemicals rather than in words.
Sunday, April 19, 2009
A jumble of thoughts
Oliver Sacks is one of my favorite writers, in general, and certainly my favorite among the authors we’ve read for this class. I was pleasantly surprised (though not actually surprised) to find Sacks’ forwards in some of our recent readings. In Exiting Nirvana he perfectly sets up the following text, and provides a historical context in terms of prior research on the autism spectrum, and an emotional context by providing certain details of the family portrayed in this book that the author did not provide. Additionally, I appreciate how he sees the benefits, as well as drawbacks of each disorder he studies. He includes some of this insight in his forwards. As we’ve discovered, especially after reading “Prodigies,” among other chapters from our reading, and watching films such as Rain Man, etc., there are many remarkable individuals with autism. The level of artistic and other skills in the cases we’ve encountered are staggering- not simply considered in the realm of individuals with certain deficits, but among “healthy” children and adults.
Exiting Nirvana discusses “theory of mind” at length, and how people with autism are characterized as not being able to see from another person’s perspective. Immediately upon reading the first few pages of Thinking in Pictures, I was stunned by Grandin’s ability to create such effective designs mostly due to her ability to see through the eyes of the livestock (both emotionally and literally- creating humane ways to move these animals by thinking about their emotions and physical comfort, and literally seeing through their eyes with the aid of her vivid visual mind). This raises a lot of questions for me. First, if humans are animals, why then can certain individuals with autism see from only certain animals’ perspective, and not humans? Why is there a disconnect here? If a person with autism possesses an innate ability to empathize with livestock, can this person learn to empathize with other humans easily? Additionally, as Katie mentions in her post, is there a link between autism and sociopathy (“given that a lack of empathy is also a hallmark of the antisocial personality disorders, the connotation feels a bit negative.”)?
A picture is worth a thousand words...
Cliche, I know, but after reading "Thinking In Pictures? that saying is so much more powerful. The thought of thinking in pictures is mind-boggling to me. I am an extremely verbal thinker -- everything I imagine comes up as a series of words strung together, or placed in its representative spot. For example, I once was asked to describe my favorite place to be in the world. This happens to be my best friend's bedroom, since I virtually grew up there -- we've known each other for sixteen years and her bedroom has hardly changed. She has a queen sized bed with no frame in the left upper corner, a dresser about three feet in front of that with a tv and a dvd player. To the right of the dresser is a brown book shelf stacked completely with CD's, and to the left is the door. n the adjacent wall, another brown bookshelf, a tall white floor lamp, and her coral colored closet doors. On the wall directly behind her bed, a large window with white sills and mini blinds. When I visualize this picture, however, I don't see those things. I see the word bed, and clumped around it I see 'green, white, purple' for the colors of her bed sheets. The word 'dresser' is in front of that, with the words 't.v.' and 'DVD player' stacked on top of it. The shelf shows as 'shelf' in very large letters, and the word 'CD' is packed over and over very tightly in between the letters. It is impressive and amazing that someone can not only fully visualize an object, but even rotate and see it from all sides. I have never once visualized an object in its entirety.
Grandin addresses the fact that being a visual thinker has the downside of not being able to comprehend words with which there is no concrete image to associate. But what I am curious about is what happens for words that have multiple meanings. I imagine that the first image associated with the word would be the most widely recalled, but is it possible to file the word away again with a second image? For example, the word 'leech'. From older days it means physician or surgeon, and it's also a blood sucking annelid. As a verb it is the act of using an annelid to suck blood, or more generally to drain or exhaust something. Is there such a way for a visual thinker such at Grandin to remember each of these definitions in conjunction with the same word? Can slight alterations to the word affect how she visualizes? I'm reminded of some of the work I do as a computer technician. Occasionally, work orders are lost before they can be completed and I have to create new ones. however, the system won't allow me to create multiple work orders for the same serial number. I avoid that situation by putting in the serial number with a period behind it. I wonder if the same concept could be applied to Grandin's visualization process.
To better understand the mind of the visual thinker, I took Grandin's suggestion and used Google Images. I typed in a few random nouns that came to mind and sorted through he first few pages of results. Simple nouns such as 'leech' yielded pictures of the animal, but after a few pages I started to see boots, which are worn to prevent leeches from attaching to the ankles or getting into pant legs, and vials of blood because that's what leeches eat. Upon searching 'liberty', I got a plethora of pictures of the Statue of Liberty, the Liberty Bell, and a Jeep Liberty. My final word was 'symbiotic' for which I received a bunch of pictures of different animals that have symbiotic relationships with other organisms. It was a great representation of the associative way people on the autistic spectrum think.
I am fascinated by this system and have many questions. Do all of the visual thinkers have memories that are inexhaustible? if only a percentage of visual thinkers have Grandin's ability to modify information, is there a point where those without that skill are "maxed out" on their ability to associate a word with something? Do visual speakers excel at word games such as anagrams and scrambled words? Grandin offers a lot of insight on the visual mind but I suspect that she is right when she says that it works in ways forever incomprehensible to the non-visual person.
Grandin addresses the fact that being a visual thinker has the downside of not being able to comprehend words with which there is no concrete image to associate. But what I am curious about is what happens for words that have multiple meanings. I imagine that the first image associated with the word would be the most widely recalled, but is it possible to file the word away again with a second image? For example, the word 'leech'. From older days it means physician or surgeon, and it's also a blood sucking annelid. As a verb it is the act of using an annelid to suck blood, or more generally to drain or exhaust something. Is there such a way for a visual thinker such at Grandin to remember each of these definitions in conjunction with the same word? Can slight alterations to the word affect how she visualizes? I'm reminded of some of the work I do as a computer technician. Occasionally, work orders are lost before they can be completed and I have to create new ones. however, the system won't allow me to create multiple work orders for the same serial number. I avoid that situation by putting in the serial number with a period behind it. I wonder if the same concept could be applied to Grandin's visualization process.
To better understand the mind of the visual thinker, I took Grandin's suggestion and used Google Images. I typed in a few random nouns that came to mind and sorted through he first few pages of results. Simple nouns such as 'leech' yielded pictures of the animal, but after a few pages I started to see boots, which are worn to prevent leeches from attaching to the ankles or getting into pant legs, and vials of blood because that's what leeches eat. Upon searching 'liberty', I got a plethora of pictures of the Statue of Liberty, the Liberty Bell, and a Jeep Liberty. My final word was 'symbiotic' for which I received a bunch of pictures of different animals that have symbiotic relationships with other organisms. It was a great representation of the associative way people on the autistic spectrum think.
I am fascinated by this system and have many questions. Do all of the visual thinkers have memories that are inexhaustible? if only a percentage of visual thinkers have Grandin's ability to modify information, is there a point where those without that skill are "maxed out" on their ability to associate a word with something? Do visual speakers excel at word games such as anagrams and scrambled words? Grandin offers a lot of insight on the visual mind but I suspect that she is right when she says that it works in ways forever incomprehensible to the non-visual person.
The Uncertainty of Autism
Apart from the obvious separation between fiction and memoir, Exiting Nirvana and The Curious Incident of a Dog in the Night-Time are two books about autism, separated by view points. Haddon gives the perspective of Christopher, an autistic boy whereas Park gives her own, neurotypical perspective on her autistic daughter, Jessy. Something that struck me after reading Park’s memoir was the constant and very detailed search for an answer to her daughter’s differences and the
realizations and perceptions that come from the perspective of an outsider.
Exiting Nirvana is written in such a way that allows the reader to work through the same process that Clara experienced when trying to understand or at least grapple with her daughter’s autism. The anecdotes are usually coupled with Clara’s attempts to reason and come to grips with the fact that Jessy meant to ask a question rather than make a statement, or that she has a sudden obsession with clichés, or that the sky suddenly has so much power over her emotions. Through deduction and reasoning, much like the way Jessy solves math problems, Clara comes to the conclusions that Jessy’s “clichés help her express herself, but their real advantage is far more fundamental. They help her give structure to chaos” (37) and “ ‘Jane’s house is in New Jersey.’ It sounds like a statement…Yet she doesn’t know where Jane’s house is, and the statement is false. But she has no reason to mislead me, and she is incapable of a convincing lie, so I’m able to guess: this is one of her odd assertions that function as a question” (55). These efforts to understand do not always end in success, however.
Jessy’s need to keep everything constant and in perfect order and her inability to comprehend change and abstraction is difficult for any outsider, including her mother, to decipher. “Jessy loves charts: they too reduce an untidy world to order” ( 36). In spite of all her efforts to understand Jessy, for Clara, there will always be a void. When recalling the anecdote where Jessy had eight pieces of bacon, Clara states, “Though it would make for a neater narrative, I won’t reinvent the words of the question I didn’t record. My question mark, floating in the blankness, is a truer rendition” (26).
The math that Jessy employed as a child didn’t have any real rhyme or reason to an observer and although it seemed that “gradually, numbers lost their magic” and Jessy’s “emotions seemed independent of the weather” (82), a meeting with Oliver Sacks twenty years later proved these theories to be only somewhat true. Something that I was very taken with after reading both, Mark Haddon’s novel, and Clara Claiborne Park’s memoir, is the world of total “bewilderment” that comes with autism. Not only does it come from the observers of the autistic, like Clara Claiborne Park, but it most certainly comes from the person housing the illness, like Jessy and Christopher.
realizations and perceptions that come from the perspective of an outsider.
Exiting Nirvana is written in such a way that allows the reader to work through the same process that Clara experienced when trying to understand or at least grapple with her daughter’s autism. The anecdotes are usually coupled with Clara’s attempts to reason and come to grips with the fact that Jessy meant to ask a question rather than make a statement, or that she has a sudden obsession with clichés, or that the sky suddenly has so much power over her emotions. Through deduction and reasoning, much like the way Jessy solves math problems, Clara comes to the conclusions that Jessy’s “clichés help her express herself, but their real advantage is far more fundamental. They help her give structure to chaos” (37) and “ ‘Jane’s house is in New Jersey.’ It sounds like a statement…Yet she doesn’t know where Jane’s house is, and the statement is false. But she has no reason to mislead me, and she is incapable of a convincing lie, so I’m able to guess: this is one of her odd assertions that function as a question” (55). These efforts to understand do not always end in success, however.
Jessy’s need to keep everything constant and in perfect order and her inability to comprehend change and abstraction is difficult for any outsider, including her mother, to decipher. “Jessy loves charts: they too reduce an untidy world to order” ( 36). In spite of all her efforts to understand Jessy, for Clara, there will always be a void. When recalling the anecdote where Jessy had eight pieces of bacon, Clara states, “Though it would make for a neater narrative, I won’t reinvent the words of the question I didn’t record. My question mark, floating in the blankness, is a truer rendition” (26).
The math that Jessy employed as a child didn’t have any real rhyme or reason to an observer and although it seemed that “gradually, numbers lost their magic” and Jessy’s “emotions seemed independent of the weather” (82), a meeting with Oliver Sacks twenty years later proved these theories to be only somewhat true. Something that I was very taken with after reading both, Mark Haddon’s novel, and Clara Claiborne Park’s memoir, is the world of total “bewilderment” that comes with autism. Not only does it come from the observers of the autistic, like Clara Claiborne Park, but it most certainly comes from the person housing the illness, like Jessy and Christopher.
Bridging the Gap (With Empathy).
Losh and Capps point to a critical and widely accepted notion in proper emotional and social development. In a neuro-typical individual, “advances in emotional understanding occur as children are increasingly able and inclined to locate emotions within causal–explanatory frameworks and evaluate their significance in relation to self and other.” The authors go on to argue that “the development of such evaluative skills has been argued to be a key factor in the enabling of children to penetrate the psychological and sociocultural dimensions of complex affective encounters.” Thus it is the acquisition of these increasingly complex abilities that is lacking in autistic individuals.
Though this would seem to encompass the lack of empathy long assumed to be a hallmark of both Kanner’s and Asperger’s autism, such a definition circumvents the slightly caustic ring of former classifications. I use the word caustic here, because to claim another individual lacks empathy sounds (at least to me) somewhat accusatory.
Perhaps this is a case of cue distortion on my party, but given that a lack of empathy is also a hallmark of the antisocial personality disorders, the connotation feels a bit negative.
I find it preferable, therefore, to conceive of the undeniable emotional barriers faced by autistic individuals not as an absence of the very emotion that renders us human, but as a snag in his or her emotional development. Or, as Temple Grandin might put it, a short-circuit in the computer wires.
In reference to this, I think the work of Martin Hoffman is an appropriate parallel. In Hoffman’s view, empathetic ability increases as a direct function of developing cognitive awareness of others (Hoffman 1984). In simpler terms, as more complex mental capacities develop, so too does the capacity to engage in and experience empathy. In infancy (0-1 years of age), for example, only a rudimentary form of empathy exists, wherein a basic imitation of adult gestures—or, motor mimicry— is observed (Meltzoff 1977), as well as what Hoffman terms the “primary circular reaction” wherein newborns reactively cry upon exposure to other crying infants (Sagi and Hoffman, 1976). By contrast, in later childhood and early adolescence, “person identity” (the realization that others’ identities, opinions, personal experiences and emotions are not solely dependent upon oneself—and that they exist outside of immediate, observable situations) enables a more advanced (and abstract) understanding of others. Only when person identity is acquired, Hoffman argues, can individuals “take the other’s role and asses their reactions in particular situations [while] also generaliz[ing] from these situations and construct[ing] a concept of the other’s general life experience” (Hoffman 1984). By transcending early childhood fusions of self and other, and by refining the resulting perceptions of separate entities, a more complex and mature form of empathy is engendered.
In its entirety, Hoffman’s model of empathy comprises four distinct stages (of which primary circular reactions and person identity acquisition are associated with the first and last, respectively). As for the second stage (1-2 years of life), sympathy (in absence of the ability to put oneself in another’s shoes, as mandated by empathy) is made possible by the attainment of person permanence (the notion that people do not disappear when, say, they leave the room). Following this is the stage lasting from 3 to 10 years of age, wherein role taking (the ability to assume another’s perspective) develops, and thus empathy takes its first roots.
If this model is to be applied to autistic individuals, one might argue that—dependent upon the severity of their symptoms—they are prevented from progressing to the third and fourth stages of empathy acquisition, based on neurological hindrances. In other words, from a developmental standpoint that carries a hint of psychoanalytic theory (inasmuch as this might be mistaken to parallel Freud’s psychosexual stages—and this is by no means my intention), autistic individuals may be neurobiologically incapable of engaging in role taking, which is necessary for the more complex forms of empathy.
To me, this correlates with the “complex attributional processes hinging on later developmental achievements, such as the capacity for reflecting upon experiences
and evaluating them in relation to sociocultural norms and expectations, as well as the appraisals of others” that Losh and Capps refer to. In that sense, though it may seem somewhat tangential, Hoffman’s approach to empathy development might shed a more humanistic light on cases of autism. Not that I find them to elicit the negative connotations associated with antisocial personality disorder. But I do believe that there is a want of empathy in the neuro-typical population and their reactions to autism.
Not only is there a disconnection on the autistic individual’s part—as they can engage only limitedly in the emotional currency upon which otherwise normal individuals rely. There is also a critical lack of understanding on the parts of non-autistic individuals who, say, observe their neuro-developmentally impaired counterparts and cast them off as retarded or burdensome. Perhaps, then, if empathic connections are fostered on more basic, more rudimentary or earlier forms of empathy (as one would attempt to cultivate in youngsters who have not yet developed a person permanence or person identity), a greater communication between the two seemingly opposite worlds could be achieved.
Though this would seem to encompass the lack of empathy long assumed to be a hallmark of both Kanner’s and Asperger’s autism, such a definition circumvents the slightly caustic ring of former classifications. I use the word caustic here, because to claim another individual lacks empathy sounds (at least to me) somewhat accusatory.
Perhaps this is a case of cue distortion on my party, but given that a lack of empathy is also a hallmark of the antisocial personality disorders, the connotation feels a bit negative.
I find it preferable, therefore, to conceive of the undeniable emotional barriers faced by autistic individuals not as an absence of the very emotion that renders us human, but as a snag in his or her emotional development. Or, as Temple Grandin might put it, a short-circuit in the computer wires.
In reference to this, I think the work of Martin Hoffman is an appropriate parallel. In Hoffman’s view, empathetic ability increases as a direct function of developing cognitive awareness of others (Hoffman 1984). In simpler terms, as more complex mental capacities develop, so too does the capacity to engage in and experience empathy. In infancy (0-1 years of age), for example, only a rudimentary form of empathy exists, wherein a basic imitation of adult gestures—or, motor mimicry— is observed (Meltzoff 1977), as well as what Hoffman terms the “primary circular reaction” wherein newborns reactively cry upon exposure to other crying infants (Sagi and Hoffman, 1976). By contrast, in later childhood and early adolescence, “person identity” (the realization that others’ identities, opinions, personal experiences and emotions are not solely dependent upon oneself—and that they exist outside of immediate, observable situations) enables a more advanced (and abstract) understanding of others. Only when person identity is acquired, Hoffman argues, can individuals “take the other’s role and asses their reactions in particular situations [while] also generaliz[ing] from these situations and construct[ing] a concept of the other’s general life experience” (Hoffman 1984). By transcending early childhood fusions of self and other, and by refining the resulting perceptions of separate entities, a more complex and mature form of empathy is engendered.
In its entirety, Hoffman’s model of empathy comprises four distinct stages (of which primary circular reactions and person identity acquisition are associated with the first and last, respectively). As for the second stage (1-2 years of life), sympathy (in absence of the ability to put oneself in another’s shoes, as mandated by empathy) is made possible by the attainment of person permanence (the notion that people do not disappear when, say, they leave the room). Following this is the stage lasting from 3 to 10 years of age, wherein role taking (the ability to assume another’s perspective) develops, and thus empathy takes its first roots.
If this model is to be applied to autistic individuals, one might argue that—dependent upon the severity of their symptoms—they are prevented from progressing to the third and fourth stages of empathy acquisition, based on neurological hindrances. In other words, from a developmental standpoint that carries a hint of psychoanalytic theory (inasmuch as this might be mistaken to parallel Freud’s psychosexual stages—and this is by no means my intention), autistic individuals may be neurobiologically incapable of engaging in role taking, which is necessary for the more complex forms of empathy.
To me, this correlates with the “complex attributional processes hinging on later developmental achievements, such as the capacity for reflecting upon experiences
and evaluating them in relation to sociocultural norms and expectations, as well as the appraisals of others” that Losh and Capps refer to. In that sense, though it may seem somewhat tangential, Hoffman’s approach to empathy development might shed a more humanistic light on cases of autism. Not that I find them to elicit the negative connotations associated with antisocial personality disorder. But I do believe that there is a want of empathy in the neuro-typical population and their reactions to autism.
Not only is there a disconnection on the autistic individual’s part—as they can engage only limitedly in the emotional currency upon which otherwise normal individuals rely. There is also a critical lack of understanding on the parts of non-autistic individuals who, say, observe their neuro-developmentally impaired counterparts and cast them off as retarded or burdensome. Perhaps, then, if empathic connections are fostered on more basic, more rudimentary or earlier forms of empathy (as one would attempt to cultivate in youngsters who have not yet developed a person permanence or person identity), a greater communication between the two seemingly opposite worlds could be achieved.
Tuesday, April 14, 2009
To Take Away What is Unnecessary, You Must First Define What Is Necessary
Through the fictional autistic narrator, Christopher, author Mark Haddon introduces a vital theme, not only apparent throughout The Curious Incident of the Dog in Night-time, but also evident in the non-fictional accounts of autism provided by Oliver Sacks (throughout his Anthropologist on Mars). The theme is that of Occam’s razor, which (in Christopher’s translation from latin) states, “no more things should be presumed to exist than are absolutely necessary” (Haddon 90).
There is certainly evidence enough to argue that Christopher’s mental state is an illustration of this tenet. For one, he (like other autistic individuals) considers the non-goal-oriented chit-chat that so greatly comprises human interaction as unnecessary: “I didn’t reply to this either because Mrs. Alexander was doing what it called chatting, where people say things to each other which aren’t questions and answers and aren’t connected” (Haddon 40). [As Feinberg describes this phenomenon, albeit rather bluntly: individuals with Asperger’s (the less-severe and more functional form of autism), “…cannot see the point in social chit-chat. They do not ming having a discussion…on a particular issue in order to establish the truth of the matter…But just a casual, superficial chat? Why bother? And what on earth about? How?...it is both too hard and pointless” (Feinberg 172). Perhaps a more neutral and reflective tone is found in Oliver Sacks’ description of the same sentiments (or lack there of) in Temple Grandlin: “By professional standards, she is extraordinarily successful, but other human interactions—social, sexual—she cannot ‘get’” (Sacks 260). Indeed, the emotional understanding and communication that serves as the basis for such social interactions (be it chit-chat or deep empathic exchange) rests on an individual’s ability to share the emotions of the other person, an ability that is also lacking in Sacks’ other true-life character, Stephen: “He seemed not to understand different emotions and would laugh if one of the children had a temper tantrum or screamed” (201).
In turn, Christopher’s direct, simplistic thinking is another example of the reductionist motif. He does not waste time in mincing words or thoughts, but states and attends to things without the presumed prefrontal cortical inhibition that causes otherwise neuro-normative individuals to hold their tongues: i.e. when Christopher explains to Mrs. Alexander why he does not feel sad about his mother’s (supposed) death: “I don’t feel sad…because mother is dead. And because Mr. Shears isn’t around anymore. So I would be feeling sad about something that isn’t real and doesn’t ecist. And that would be stupid” (Haddon 75). Or, when Christopher shows up at his mother’s house and genuinely asserts to Mr. Shears that “I’m going to live with you because Father killed Wellington with a garden fork and I’m frightened of him” (192). Likewise, Oliver Sacks’ depiction of Temple’s lack of “…diffidence or embarrassment (emotions unknown to her)” (Sacks 262) while displaying her bedroom and squeeze-machine “…with a complete absence of inhibition or hesitation” (265). Thus the regular tentativeness, humbleness, or self-consciousness that might be expected of a non-autistic individual is not apparent. Such is the case, as well, with Steven Wiltshire who “…seemed to have no sense of either vanity or modesty, but showed [Oliver Sacks] his drawings, commented on them, in an ingenuous way and with total absence of self-consciousness” (Sacks 205).
A further embodiment of the theme present in Occam’s razor is the presumed “hypertrophy of a single mental faculty” (Sacks 193) to the exclusion of all others that characterize savant talents. Inherent in this distinction is a cleavage of all (or most) other mental faculties that unrelated (and thus unnecessary to) the hypertrophized faculty—i.e. verbal/communicative skills, emotional competence, etc. Christopher compares this to the otherwise normative state of mind, wherein “most people are almost blind and they don’t see most things and there is lots of spare capacity in their heads and it is filled with things which aren’t connected and are silly, like ‘I’m worried that I might have left the gas cooker on” (Haddon 144). Thus, at least to Christopher, such non-autistic minds to not cleave the unnecessary or surperfluous.
It is crucial to note, however, that to define “necessary” or its counterpart, “superfluous” is entirely subjective. Indeed, Christopher sees what others may deem necessary as silly, or stupid (in his words); while most non-autistic individuals would deem his retention of every detail when looking at a farm field, for instance, as equally unnecessary—disadvantageous, in fact. Thus it can be argued that perspective is inherently correct.
This, of course, leads into the discrepancy over whether savantism is a deficit or a gift. Most would see it as a disadvantage, if it is to be accompanied by social deficits and interpersonal dysfunctional; however, as Temple asserts, “If I could snap my fingers and be nonautistic, I would not…Autism is par of who I am” (Sacks 291); “It is possible that persons with bits of these [autistic] traits are more creative, or possible even geniuses…If science eliminated these genes, maybe the whole world would be taken over by accountants” (292).
In summation, then, one individual’s take on Occam’s razor may be entirely different than another’s: unnecessary and necessary (and the removal of and/or implementation of each) are highly dependant upon perspective—which, itself, is colored by an individual’s predisposition, emotional interior, exterior, and cognitive capacities. The very insistence that deficits such as autism are unnecessary can even be lumped into this discrepancy.
There is certainly evidence enough to argue that Christopher’s mental state is an illustration of this tenet. For one, he (like other autistic individuals) considers the non-goal-oriented chit-chat that so greatly comprises human interaction as unnecessary: “I didn’t reply to this either because Mrs. Alexander was doing what it called chatting, where people say things to each other which aren’t questions and answers and aren’t connected” (Haddon 40). [As Feinberg describes this phenomenon, albeit rather bluntly: individuals with Asperger’s (the less-severe and more functional form of autism), “…cannot see the point in social chit-chat. They do not ming having a discussion…on a particular issue in order to establish the truth of the matter…But just a casual, superficial chat? Why bother? And what on earth about? How?...it is both too hard and pointless” (Feinberg 172). Perhaps a more neutral and reflective tone is found in Oliver Sacks’ description of the same sentiments (or lack there of) in Temple Grandlin: “By professional standards, she is extraordinarily successful, but other human interactions—social, sexual—she cannot ‘get’” (Sacks 260). Indeed, the emotional understanding and communication that serves as the basis for such social interactions (be it chit-chat or deep empathic exchange) rests on an individual’s ability to share the emotions of the other person, an ability that is also lacking in Sacks’ other true-life character, Stephen: “He seemed not to understand different emotions and would laugh if one of the children had a temper tantrum or screamed” (201).
In turn, Christopher’s direct, simplistic thinking is another example of the reductionist motif. He does not waste time in mincing words or thoughts, but states and attends to things without the presumed prefrontal cortical inhibition that causes otherwise neuro-normative individuals to hold their tongues: i.e. when Christopher explains to Mrs. Alexander why he does not feel sad about his mother’s (supposed) death: “I don’t feel sad…because mother is dead. And because Mr. Shears isn’t around anymore. So I would be feeling sad about something that isn’t real and doesn’t ecist. And that would be stupid” (Haddon 75). Or, when Christopher shows up at his mother’s house and genuinely asserts to Mr. Shears that “I’m going to live with you because Father killed Wellington with a garden fork and I’m frightened of him” (192). Likewise, Oliver Sacks’ depiction of Temple’s lack of “…diffidence or embarrassment (emotions unknown to her)” (Sacks 262) while displaying her bedroom and squeeze-machine “…with a complete absence of inhibition or hesitation” (265). Thus the regular tentativeness, humbleness, or self-consciousness that might be expected of a non-autistic individual is not apparent. Such is the case, as well, with Steven Wiltshire who “…seemed to have no sense of either vanity or modesty, but showed [Oliver Sacks] his drawings, commented on them, in an ingenuous way and with total absence of self-consciousness” (Sacks 205).
A further embodiment of the theme present in Occam’s razor is the presumed “hypertrophy of a single mental faculty” (Sacks 193) to the exclusion of all others that characterize savant talents. Inherent in this distinction is a cleavage of all (or most) other mental faculties that unrelated (and thus unnecessary to) the hypertrophized faculty—i.e. verbal/communicative skills, emotional competence, etc. Christopher compares this to the otherwise normative state of mind, wherein “most people are almost blind and they don’t see most things and there is lots of spare capacity in their heads and it is filled with things which aren’t connected and are silly, like ‘I’m worried that I might have left the gas cooker on” (Haddon 144). Thus, at least to Christopher, such non-autistic minds to not cleave the unnecessary or surperfluous.
It is crucial to note, however, that to define “necessary” or its counterpart, “superfluous” is entirely subjective. Indeed, Christopher sees what others may deem necessary as silly, or stupid (in his words); while most non-autistic individuals would deem his retention of every detail when looking at a farm field, for instance, as equally unnecessary—disadvantageous, in fact. Thus it can be argued that perspective is inherently correct.
This, of course, leads into the discrepancy over whether savantism is a deficit or a gift. Most would see it as a disadvantage, if it is to be accompanied by social deficits and interpersonal dysfunctional; however, as Temple asserts, “If I could snap my fingers and be nonautistic, I would not…Autism is par of who I am” (Sacks 291); “It is possible that persons with bits of these [autistic] traits are more creative, or possible even geniuses…If science eliminated these genes, maybe the whole world would be taken over by accountants” (292).
In summation, then, one individual’s take on Occam’s razor may be entirely different than another’s: unnecessary and necessary (and the removal of and/or implementation of each) are highly dependant upon perspective—which, itself, is colored by an individual’s predisposition, emotional interior, exterior, and cognitive capacities. The very insistence that deficits such as autism are unnecessary can even be lumped into this discrepancy.
Welcome to My World
What strikes me the most about Mark Haddon’s The Curious Incident of the Dog in the Nighttime is how evidently blunt the writing it is and where the bluntness comes from. Because we are reading the story from the perspective of a young boy with Asperger syndrome, we receive a very straightforward narrative with very little description or speculation. Christopher, because of his condition, is extremely deliberate in anything that comes across his mind. He doesn’t like yellow and brown. He likes red. Different types of food on the same plate cannot touch one another. There is no real designation for why he likes these things those ways. There is even a chapter about why Christopher doesn’t like yellow and brown, but it provides no true reason for why he hates yellow and brown, but creates more of a list of yellow and brown things. The idea behind this is that Christopher believes that when the reader notices his “list” they will automatically realize why yellow and brown are terrible.
The clear-cut decisions and thoughts bring up an interesting style of narrative. Some would argue that it waters down the true quality of the prose, but in the case of Mark Haddon, that fact is almost the idea behind the novel. Everything is very frank to Christopher, thus making things like finding out about his mother and Mr. Shears just seem to be something that happened, instead of the horrible affair that is truly behind the discovery. The lack of adjectives helps to make frightening sections of the novel, like Christopher’s father becoming very angry unfold in a slow motion style. They are occurring with no real emotion and because of the lack of emotion, the narrative becomes extremely powerful.
Although the subject matter is entirely different, I couldn’t help being reminded of The Road by Cormac McCarthy. The same style of writing is employed, giving the narrative a blunt side that takes away from the beauty of writing but enhances the experience of the novel. Horrible moments become that much more terrible because of their exposure to the reader. Each sentence is naked, creating a strong piece of writing.
I believe that the experience that the reader has when moving through the narrative of The Curious Incident is the important part of the novel, and the idea that Mark Haddon is looking for. He presents it to the reader very obviously in Christopher’s perspective, but also through his actions and thoughts because he forces the reader not only into seeing the way Christopher sees, but also the way he thinks, and the affect that it has on the reader. One cannot help reading The Curious Incident and being shocked at some points in the novel, and if you are shocked then Mark Haddon has achieved his goal.
Tuesday, April 7, 2009
On Part One: I am No One
On page 59 Mark has his first post-accident recognition of another patient’s sadness when he overhears someone sobbing in a room near his. This “feat of intellect” as Karin calls it seemed to be so much more to me at that moment. Every now and then while reading Powers’s novel I stop and have that moment of questioning: is he the echo-maker? Is he simply echoing what his interrupted mind grasps, words or actions that instigate a connection, a memory? It cannot be this simple. Mark recognizing sadness seemed pivotal to me in the unorganized, time-warped narrative. So much of him seems to still be present and what is missing is baffling because it seems to be so little he is not capable off. He shoots the shit with his two buddies and they recognize his progress but he gets overwhelmed. “When they’re near, he can’t hear himself think. Too much happening at once for him to see what’s wrong.” (67). He receives necessary, pseudo-romantic attention from Bonnie and then becomes captivated, infatuated by Barbara. He is able. He can walk and talk. Tracking his progress is confusing because of the parallel narrative of his sister, that at times overshadows his deficits and puts the reader’s focus on Karin. The self—our self, knowing who one is through memory and self-preservation—is not only taken from Mark but to an extent more so from Karin by her brother’s Capgras syndrome. “You think I’m just a symptom?” (92), she asks Daniel. Her sense of self, the idea of the life she has created and thought she knew and could hold on to, is taken away by the accident and Mark’s recovery and misidentification delusions send Karin deeper and deeper into the chase, the struggle. I cannot imagine what it must be like to be talking to your sibling, the closest genetic organism to you, knowing that they do not recognize who you are. I ask a completely unanswerable question: Why does Capgras manifest itself in this way? Why do patients not recognize loved ones especially? The mysterious note only adds to the delusion and shattering of the self. I am No One. To bring back someone else? Is Karin the one who needed bringing back? The obvious answer seems to me to be Mark but it is his challenge to bring back that other.
The pages are filled with cryptic lines about identity, life and death. Mark realizes on page 64 that he doesn’t even know where the dead are. For some reason this line and so many others seemed to make my mind pause and think and then blank. On the next page, he has another realization that seems so wise, so natural for someone who has had their world flipped inside out and upside down from one millisecond to the next. While asking his sister/actress to get him some sort of identification Mark seems to grasp something that at this very moment seems beyond me. They can operate on your brain without you even knowing it. In this thought Mark at once comes to terms with his accident and current situation and surrenders his body to the technology that, without his consent, has kept him alive.
I found myself struggling with the unannounced switch from Karin’s point of view to Mark’s. I definitely enjoyed reading the Mark sections more. Knowing his thoughts, the way they are presented and the way they expose his personality, made me understand the entire narrative better. “Nobody’s quite what they say they are, and he’s just supposed to laugh and play along.”
The pages are filled with cryptic lines about identity, life and death. Mark realizes on page 64 that he doesn’t even know where the dead are. For some reason this line and so many others seemed to make my mind pause and think and then blank. On the next page, he has another realization that seems so wise, so natural for someone who has had their world flipped inside out and upside down from one millisecond to the next. While asking his sister/actress to get him some sort of identification Mark seems to grasp something that at this very moment seems beyond me. They can operate on your brain without you even knowing it. In this thought Mark at once comes to terms with his accident and current situation and surrenders his body to the technology that, without his consent, has kept him alive.
I found myself struggling with the unannounced switch from Karin’s point of view to Mark’s. I definitely enjoyed reading the Mark sections more. Knowing his thoughts, the way they are presented and the way they expose his personality, made me understand the entire narrative better. “Nobody’s quite what they say they are, and he’s just supposed to laugh and play along.”
Capgras + Our Sense of Self
For me the most intriguing part of Capgras syndrome is the profound implications this disorder has with regard to how we define our sense of self. The Hirstein and Ramachandran article details the multiple brain functions that are involved in the process of recognizing a face. Part of our neurology allows us to consciously interpret what we see in front of us as another person, while another part is responsible for triggering the emotional arousal that results from our associations with a face that is familiar to us. The authors suggest that in the case of Capgras patients, the limbic section of the brain fails to enact this emotional response to the faces of loved ones, thus forcing the patient to conclude that the person they are encountering is not the really the relative they know and love, but an imposter.
In The Echo Maker, Richard Powers creates a vivid picture of the impact this kind of neurological disconnect can have on the lives and relationships of an affected person and his loved ones. Our sense of self is defined by our connection to others. The relationships we create anchor us in our surroundings and give meaning to our place in the world. In the novel, Mark’s conception of one of his most important relationships becomes wrapped in distrust and suspicion. Once he no longer has the grounding link to the person he loves most, his sense of self is profoundly shaken. The syndrome deeply impacts Karin as well, since much of her understanding of herself relies on the role she once inhabited in Mark’s life. She knows herself as his protector, his caretaker, his sister, and she has shaped a significant part of her identity around this version of herself. Mark’s accident changes all of this. His brain can process her face intellectually, but can no longer elicit the warm emotional reaction that would allow him to accept Karin as his sister. She is stripped of a role that she has long relied on to define herself.
In his interview with Terry Gross, Powers suggests that although Capgras is a rare phenomenon, the theme of the novel may resonate with readers because we may experience this “decoupling of intellectual recognition and emotional recognition” in small ways in our everyday lives. He gives the example of someone professing their love to another person, only to later admit that they no longer have those passionate feelings toward them. In that example, the person would recognize their lover as the same familiar face, but no longer feel the emotional arousal that their partner used to bring forth. In neuro-typical people, this decoupling would lead the person to conclude not that their lover is a fake, but that some change has taken place within themselves or the other that has caused the initial feelings to fade. Powers also emphasizes that the self is a kind of novelist, in that it has an amazing ability to revise its view of the world. Our environment, our relationships, our place in society – all these factors that make up our lives are constantly shifting, and as a result we must constantly reconstruct the narrative of our experience. Whether it’s a brain malfunction like Mark’s that interrupts our understanding of a relationship, or the more common reality of falling out of love, life demands that we are flexible in how we view ourselves and organize the world around us.
In The Echo Maker, Richard Powers creates a vivid picture of the impact this kind of neurological disconnect can have on the lives and relationships of an affected person and his loved ones. Our sense of self is defined by our connection to others. The relationships we create anchor us in our surroundings and give meaning to our place in the world. In the novel, Mark’s conception of one of his most important relationships becomes wrapped in distrust and suspicion. Once he no longer has the grounding link to the person he loves most, his sense of self is profoundly shaken. The syndrome deeply impacts Karin as well, since much of her understanding of herself relies on the role she once inhabited in Mark’s life. She knows herself as his protector, his caretaker, his sister, and she has shaped a significant part of her identity around this version of herself. Mark’s accident changes all of this. His brain can process her face intellectually, but can no longer elicit the warm emotional reaction that would allow him to accept Karin as his sister. She is stripped of a role that she has long relied on to define herself.
In his interview with Terry Gross, Powers suggests that although Capgras is a rare phenomenon, the theme of the novel may resonate with readers because we may experience this “decoupling of intellectual recognition and emotional recognition” in small ways in our everyday lives. He gives the example of someone professing their love to another person, only to later admit that they no longer have those passionate feelings toward them. In that example, the person would recognize their lover as the same familiar face, but no longer feel the emotional arousal that their partner used to bring forth. In neuro-typical people, this decoupling would lead the person to conclude not that their lover is a fake, but that some change has taken place within themselves or the other that has caused the initial feelings to fade. Powers also emphasizes that the self is a kind of novelist, in that it has an amazing ability to revise its view of the world. Our environment, our relationships, our place in society – all these factors that make up our lives are constantly shifting, and as a result we must constantly reconstruct the narrative of our experience. Whether it’s a brain malfunction like Mark’s that interrupts our understanding of a relationship, or the more common reality of falling out of love, life demands that we are flexible in how we view ourselves and organize the world around us.
To Take Away What Is Unnecessary, You Must First Define What is Necessary
Through the fictional autistic narrator, Christopher, author Mark Haddon introduces a vital theme, not only apparent throughout The Curious Incident of the Dog in Night-time, but also evident in the non-fictional accounts of autism provided by Oliver Sacks (throughout his Anthropologist on Mars). The theme is that of Occam’s razor, which (in Christopher’s translation from latin) states, “no more things should be presumed to exist than are absolutely necessary” (Haddon 90).
There is certainly evidence enough to argue that Christopher’s mental state is an illustration of this tenet. For one, he (like other autistic individuals) considers the non-goal-oriented chit-chat that so greatly comprises human interaction as unnecessary: “I didn’t reply to this either because Mrs. Alexander was doing what it called chatting, where people say things to each other which aren’t questions and answers and aren’t connected” (Haddon 40). [As Feinberg describes this phenomenon, albeit rather bluntly: individuals with Asperger’s (the less-severe and more functional form of autism), “…cannot see the point in social chit-chat. They do not ming having a discussion…on a particular issue in order to establish the truth of the matter…But just a casual, superficial chat? Why bother? And what on earth about? How?...it is both too hard and pointless” (Feinberg 172). Perhaps a more neutral and reflective tone is found in Oliver Sacks’ description of the same sentiments (or lack there of) in Temple Grandlin: “By professional standards, she is extraordinarily successful, but other human interactions—social, sexual—she cannot ‘get’” (Sacks 260). Indeed, the emotional understanding and communication that serves as the basis for such social interactions (be it chit-chat or deep empathic exchange) rests on an individual’s ability to share the emotions of the other person, an ability that is also lacking in Sacks’ other true-life character, Stephen: “He seemed not to understand different emotions and would laugh if one of the children had a temper tantrum or screamed” (201).
In turn, Christopher’s direct, simplistic thinking is another example of the reductionist motif. He does not waste time in mincing words or thoughts, but states and attends to things without the presumed prefrontal cortical inhibition that causes otherwise neuro-normative individuals to hold their tongues: i.e. when Christopher explains to Mrs. Alexander why he does not feel sad about his mother’s (supposed) death: “I don’t feel sad…because mother is dead. And because Mr. Shears isn’t around anymore. So I would be feeling sad about something that isn’t real and doesn’t ecist. And that would be stupid” (Haddon 75). Or, when Christopher shows up at his mother’s house and genuinely asserts to Mr. Shears that “I’m going to live with you because Father killed Wellington with a garden fork and I’m frightened of him” (192). Likewise, Oliver Sacks’ depiction of Temple’s lack of “…diffidence or embarrassment (emotions unknown to her)” (Sacks 262) while displaying her bedroom and squeeze-machine “…with a complete absence of inhibition or hesitation” (265). Thus the regular tentativeness, humbleness, or self-consciousness that might be expected of a non-autistic individual is not apparent. Such is the case, as well, with Steven Wiltshire who “…seemed to have no sense of either vanity or modesty, but showed [Oliver Sacks] his drawings, commented on them, in an ingenuous way and with total absence of self-consciousness” (Sacks 205).
A further embodiment of the theme present in Occam’s razor is the presumed “hypertrophy of a single mental faculty” (Sacks 193) to the exclusion of all others that characterize savant talents. Inherent in this distinction is a cleavage of all (or most) other mental faculties that unrelated (and thus unnecessary to) the hypertrophized faculty—i.e. verbal/communicative skills, emotional competence, etc. Christopher compares this to the otherwise normative state of mind, wherein “most people are almost blind and they don’t see most things and there is lots of spare capacity in their heads and it is filled with things which aren’t connected and are silly, like ‘I’m worried that I might have left the gas cooker on” (Haddon 144). Thus, at least to Christopher, such non-autistic minds to not cleave the unnecessary or surperfluous.
It is crucial to note, however, that to define “necessary” or its counterpart, “superfluous” is entirely subjective. Indeed, Christopher sees what others may deem necessary as silly, or stupid (in his words); while most non-autistic individuals would deem his retention of every detail when looking at a farm field, for instance, as equally unnecessary—disadvantageous, in fact. Thus it can be argued that perspective is inherently correct.
This, of course, leads into the discrepancy over whether savantism is a deficit or a gift. Most would see it as a disadvantage, if it is to be accompanied by social deficits and interpersonal dysfunctional; however, as Temple asserts, “If I could snap my fingers and be nonautistic, I would not…Autism is par of who I am” (Sacks 291); “It is possible that persons with bits of these [autistic] traits are more creative, or possible even geniuses…If science eliminated these genes, maybe the whole world would be taken over by accountants” (292).
In summation, then, one individual’s take on Occam’s razor may be entirely different than another’s: unnecessary and necessary (and the removal of and/or implementation of each) are highly dependant upon perspective—which, itself, is colored by an individual’s predisposition, emotional interior, exterior, and cognitive capacities. The very insistence that deficits such as autism are unnecessary can even be lumped into this discrepancy.
There is certainly evidence enough to argue that Christopher’s mental state is an illustration of this tenet. For one, he (like other autistic individuals) considers the non-goal-oriented chit-chat that so greatly comprises human interaction as unnecessary: “I didn’t reply to this either because Mrs. Alexander was doing what it called chatting, where people say things to each other which aren’t questions and answers and aren’t connected” (Haddon 40). [As Feinberg describes this phenomenon, albeit rather bluntly: individuals with Asperger’s (the less-severe and more functional form of autism), “…cannot see the point in social chit-chat. They do not ming having a discussion…on a particular issue in order to establish the truth of the matter…But just a casual, superficial chat? Why bother? And what on earth about? How?...it is both too hard and pointless” (Feinberg 172). Perhaps a more neutral and reflective tone is found in Oliver Sacks’ description of the same sentiments (or lack there of) in Temple Grandlin: “By professional standards, she is extraordinarily successful, but other human interactions—social, sexual—she cannot ‘get’” (Sacks 260). Indeed, the emotional understanding and communication that serves as the basis for such social interactions (be it chit-chat or deep empathic exchange) rests on an individual’s ability to share the emotions of the other person, an ability that is also lacking in Sacks’ other true-life character, Stephen: “He seemed not to understand different emotions and would laugh if one of the children had a temper tantrum or screamed” (201).
In turn, Christopher’s direct, simplistic thinking is another example of the reductionist motif. He does not waste time in mincing words or thoughts, but states and attends to things without the presumed prefrontal cortical inhibition that causes otherwise neuro-normative individuals to hold their tongues: i.e. when Christopher explains to Mrs. Alexander why he does not feel sad about his mother’s (supposed) death: “I don’t feel sad…because mother is dead. And because Mr. Shears isn’t around anymore. So I would be feeling sad about something that isn’t real and doesn’t ecist. And that would be stupid” (Haddon 75). Or, when Christopher shows up at his mother’s house and genuinely asserts to Mr. Shears that “I’m going to live with you because Father killed Wellington with a garden fork and I’m frightened of him” (192). Likewise, Oliver Sacks’ depiction of Temple’s lack of “…diffidence or embarrassment (emotions unknown to her)” (Sacks 262) while displaying her bedroom and squeeze-machine “…with a complete absence of inhibition or hesitation” (265). Thus the regular tentativeness, humbleness, or self-consciousness that might be expected of a non-autistic individual is not apparent. Such is the case, as well, with Steven Wiltshire who “…seemed to have no sense of either vanity or modesty, but showed [Oliver Sacks] his drawings, commented on them, in an ingenuous way and with total absence of self-consciousness” (Sacks 205).
A further embodiment of the theme present in Occam’s razor is the presumed “hypertrophy of a single mental faculty” (Sacks 193) to the exclusion of all others that characterize savant talents. Inherent in this distinction is a cleavage of all (or most) other mental faculties that unrelated (and thus unnecessary to) the hypertrophized faculty—i.e. verbal/communicative skills, emotional competence, etc. Christopher compares this to the otherwise normative state of mind, wherein “most people are almost blind and they don’t see most things and there is lots of spare capacity in their heads and it is filled with things which aren’t connected and are silly, like ‘I’m worried that I might have left the gas cooker on” (Haddon 144). Thus, at least to Christopher, such non-autistic minds to not cleave the unnecessary or surperfluous.
It is crucial to note, however, that to define “necessary” or its counterpart, “superfluous” is entirely subjective. Indeed, Christopher sees what others may deem necessary as silly, or stupid (in his words); while most non-autistic individuals would deem his retention of every detail when looking at a farm field, for instance, as equally unnecessary—disadvantageous, in fact. Thus it can be argued that perspective is inherently correct.
This, of course, leads into the discrepancy over whether savantism is a deficit or a gift. Most would see it as a disadvantage, if it is to be accompanied by social deficits and interpersonal dysfunctional; however, as Temple asserts, “If I could snap my fingers and be nonautistic, I would not…Autism is par of who I am” (Sacks 291); “It is possible that persons with bits of these [autistic] traits are more creative, or possible even geniuses…If science eliminated these genes, maybe the whole world would be taken over by accountants” (292).
In summation, then, one individual’s take on Occam’s razor may be entirely different than another’s: unnecessary and necessary (and the removal of and/or implementation of each) are highly dependant upon perspective—which, itself, is colored by an individual’s predisposition, emotional interior, exterior, and cognitive capacities. The very insistence that deficits such as autism are unnecessary can even be lumped into this discrepancy.
Monday, April 6, 2009
I'm glad I don't have Capgras.
In Kim Ferguson’s Intro to Cognitive Science class last semester, we watched a documentary about a man suffering from accidental Capgras, that is, arising from physical injury to the brain. I believe it was a car accident, making his case very similar to Mark’s. In the short video, the man (whose name escapes me) is living with his parents in his old house, and has been for several months. He says that although he is not convinced that the people living with him are his real parents, he is no longer difficult or hostile to them because they seem like good people and they take good care of him. He says the same of his house, which he no longer recognizes as his own. His parents say they are taking baby steps, and that their relationship has much improved from the earlier days. This video was extremely haunting, in a way that was different from the coldness exhibited by Mark towards Karin, in that this man was simply coexisting with his parents because it was convenient and posed no threat to him. All of his past relationships and memories with his parents had evaporated on his end, and he had simply accepted that. While Mark often puts up some sort of fight towards Karin, acknowledging her presence and significance if not as her sister as a caretaker, the other man does not even feel the need to do that. He lives in his fake house because it is shelter, and cohabitates with his fake parents because they cook for him. And while the omnipresent narrator of the video insists that he is making progress and that there is hope that his emotional connections will be restored, it is hard to believe when watching the video.
In the same class, we briefly covered what happens in the brain that causes Capgras. It is speculated that the reason Capgras sufferers may recognize loved ones and simultaneously not recognize them is that connection between emotion and face recognition and memory is damaged (Please tell me if this is not right…my poor memory has suffered over the many months). Therefore, when Mark looks at Karin, he recognizes her face but does not feel the flood of emotion one might feel towards one’s sister; love, affection, irritation, etc. Mark’s brain then rationalizes that since it doesn’t emotionally react towards his sister, then she cannot logically be his actual sister. It is this reason also that Capgras patients hardly ever believe it is themselves who are the cause of it. This is a prime example of both the fragility of the brain and it’s amazing prowess, in this case occurring at the same time.
I enjoyed The Echo Maker. Powers is obviously a very skilled writer; utilizing many literary tools and layered narrative to tell the story. The balance between fiction and disorder was even, in that though the plot was centered around Mark’s Capgras, there were other elements interwoven into it that made it an interesting read without relying solely on the disorder. Powers was informed and respectful and chose a syndrome that lent itself well to fiction writing. While the book itself could have been a more exciting read--the smoothness of the flow became a bit tiring--I think Powers successfully relayed both a story and a course on Capgras.
In the same class, we briefly covered what happens in the brain that causes Capgras. It is speculated that the reason Capgras sufferers may recognize loved ones and simultaneously not recognize them is that connection between emotion and face recognition and memory is damaged (Please tell me if this is not right…my poor memory has suffered over the many months). Therefore, when Mark looks at Karin, he recognizes her face but does not feel the flood of emotion one might feel towards one’s sister; love, affection, irritation, etc. Mark’s brain then rationalizes that since it doesn’t emotionally react towards his sister, then she cannot logically be his actual sister. It is this reason also that Capgras patients hardly ever believe it is themselves who are the cause of it. This is a prime example of both the fragility of the brain and it’s amazing prowess, in this case occurring at the same time.
I enjoyed The Echo Maker. Powers is obviously a very skilled writer; utilizing many literary tools and layered narrative to tell the story. The balance between fiction and disorder was even, in that though the plot was centered around Mark’s Capgras, there were other elements interwoven into it that made it an interesting read without relying solely on the disorder. Powers was informed and respectful and chose a syndrome that lent itself well to fiction writing. While the book itself could have been a more exciting read--the smoothness of the flow became a bit tiring--I think Powers successfully relayed both a story and a course on Capgras.
The Echo Maker
I want to apologize, first, for this tardy write-up. The truth is, I’ve been struggling to think of anything very insightful to say about The Echo Maker. But, after a lot of hemming and hawing, I think I may have something at least vaguely interesting. It has to do with the omnipresence of the brain and brain science and how some of the material, including The Echo Maker, has proposed implicitly, thrown into doubt, reconfigured, or destabilized fundamental notions of who we are. Explaining how I got onto this line of thinking will require some anecdotes.
There’s an odd experience we have when we’re reading about a topic that is novel to us, as much of neuroscience is novel to me. It’s the same thing we experience when we learn a new word. We start to see it everywhere. Now that I know a bit more about Parkinson’s, now that I know a bit more about autism, now that I know a bit more about epilepsy, synaesthesia, Capgras syndrome, agnosia, etc., examples of atypical brain development and of brain damage appear in news stories constantly; they come up in my conversations with friends and relatives; books relating to them seem to materialize out of nowhere; the reading assignments in other academic courses bring them up; my own short stories begin to swirl around related themes. In the past two or three weeks, this has been uncannily true for me, and it’s gotten me to think in new ways about some of what we’ve read.
An acquaintance--Jeremy--who’s becoming a friend and whom I met through another acquaintance had, I noticed shortly after we’d been introduced, some habits in his conversation and in his Web correspondence (e-mail and instant messages) that could be construed as rude or, at the least, bizarre. For instance, in the middle of an IM conversation, he would disappear abruptly, while still ostensibly signed on, and come back forty minutes later, saying he’d gotten so involved in his music (he’s a composer) that he’d forgotten we were talking. This happened more than once. I also noticed, while I was with him in person, that, if I said anything ironic or sarcastic, he would pause and look blankly at the floor for a moment, then register the joke and laugh. He wasn’t big on prolonged eye contact either--which was fine by me, initially, since I think intense eye contact can easily become more creepy than polite. But his eye contact was so brief and so rare that I started to think something in this social situation was awry. I was beginning to take some offense, privately, to these various gestures, but didn’t say anything because I knew I was construing them as rude when, conceivably, no disrespect was intended. Then one time he mentioned in passing “having A.S.,” but didn’t elaborate, either assuming I knew what he was referring to, or testing whether I did, and the context gave me no clues, other than that it was a medical issue. The only “A.S.” I could think of on the spot was Ankylosing spondylitis, a rare form of arthritis--how I know of that A.S., I couldn’t say. Anyway, when I responded with something about Ankylosing spondylitis, he looked at me as though I had just broken into a foreign language that sounded funny to uninitiated ears. “No,” he said, “Asperger’s syndrome”--which I did in fact know some rudimentary information about. Suddenly, all the potentially offensive ambiguities in our interactions were explained. And of course I felt like a serious, serious idiot. A psychology student in neuropsychology class, I should have known. And Ankylosing spondylitis was a comically absurd guess. It struck me how much and how concretely our everyday interactions are shaped by the vicissitudes of the brain, and how a knowledge of the brain casts a different and brighter light on those interactions, bringing clarity as well as new questions when previously indistinct details are revealed, as in a picture moved to a different and better lit setting. And not just our everyday interactions but the big stuff too. We can see a similar phenomenon in The Echo Maker, where an alteration in a single brain has amazingly widespread effects, altering in turn whole sensibilities, whole relationships and families, whole lives.
Not long after the awkward and embarrassing incident above, it was announced on the news that the actress Natasha Richardson--daughter of Vanessa Redgrave, wife of Liam Neeson--had died because of a seemingly--but really only seemingly--minor head injury, which she sustained when she fell during a skiing lesson, after which she was talking and laughing and refused medical help. She died of apparently serious brain damage, which I won’t bother to explain here, two days later. That evening, when two American parents heard of her death and the circumstances surrounding it, they thought of their seven-year-old daughter, who had had a head injury, seemed to be fine at first, but had after two days, when they went to see her to bed, begun to complain of a headache--a pattern almost exactly like Richardson’s last days. Making the connection, the parents called their pediatrician, the girl was transported by helicopter to a hospital equipped to deal with the injury--which was the same as Richardson’s after all--and she survived basically unscathed. Then I heard on the news about a lawyer in the Midwest who was using the possibility that his client had Asperger syndrome as a defense in a murder case, claiming that his client was “laboring under it” so that he “didn’t know the nature of his actions or that they were wrong.” Wisely, the judge rejected this defense. Still, knowing what I know about Asperger’s, I found the lawyer’s attempt outrageous. When I mentioned the story to Jeremy, he explained much more precisely that such a defense wouldn’t make sense with this particular form of autism, but could make more sense--he said this with an air of caution--with other forms, although it would be a controversial argument even then. He spoke, moreover, about the dangers of conflating neurological and psychiatric phenomena and the misuse of neuroscience--this surely rings a bell with members of our class. The brain, with both its power and its vulnerability, shapes our lives in real ways, on the individual level, and our world, on a societal level.
These coincidences and parallels reached a peak this afternoon when I was having lunch with a friend, who’s a novelist and professor. He mentioned, apropos of something else, having been on the committee that voted to give the National Book Award to Richard Powers for The Echo Maker. My friend, however, was the only person not to vote in favor of Powers’s book, which he said he hated. He said, furthermore, that he sees psychology currently and increasingly replacing philosophy and making it irrelevant, and he sees neuroscience replacing psychology; and this made him nervous, deeply nervous. When you study literature, it is sometimes said, philosophy is always right around the corner; but more and more it is psychology and neuropsychology that are around the corner, as Richard Powers unquestionably knows. Given my friend’s age and education, I should think that The Echo Maker violates fundamental ideas he holds about what literature is and ought to be. My friend, when we were discussing another thing entirely, mentioned that he’d recently met Oliver Sacks at a lecture and that they’d been e-mailing since, planning eventually to get together. They’d been talking about what “apprehension” means, from the perspective of a writer and that of a neuropsychologist. My friend said, fittingly, “I think I may be afraid of Oliver Sacks.” The brain, brain damage, brain science--they are omnipresent and to some people a major threat, a threat to aesthetic, intellectual, moral, legal, and philosophical views. I will admit, I felt a twinge of anxiety when reading The Echo Maker, because it gets at such visceral and deeply embedded fears and destabilizes some of our smug sense of safety, constancy, comfort, and so on.
There’s an odd experience we have when we’re reading about a topic that is novel to us, as much of neuroscience is novel to me. It’s the same thing we experience when we learn a new word. We start to see it everywhere. Now that I know a bit more about Parkinson’s, now that I know a bit more about autism, now that I know a bit more about epilepsy, synaesthesia, Capgras syndrome, agnosia, etc., examples of atypical brain development and of brain damage appear in news stories constantly; they come up in my conversations with friends and relatives; books relating to them seem to materialize out of nowhere; the reading assignments in other academic courses bring them up; my own short stories begin to swirl around related themes. In the past two or three weeks, this has been uncannily true for me, and it’s gotten me to think in new ways about some of what we’ve read.
An acquaintance--Jeremy--who’s becoming a friend and whom I met through another acquaintance had, I noticed shortly after we’d been introduced, some habits in his conversation and in his Web correspondence (e-mail and instant messages) that could be construed as rude or, at the least, bizarre. For instance, in the middle of an IM conversation, he would disappear abruptly, while still ostensibly signed on, and come back forty minutes later, saying he’d gotten so involved in his music (he’s a composer) that he’d forgotten we were talking. This happened more than once. I also noticed, while I was with him in person, that, if I said anything ironic or sarcastic, he would pause and look blankly at the floor for a moment, then register the joke and laugh. He wasn’t big on prolonged eye contact either--which was fine by me, initially, since I think intense eye contact can easily become more creepy than polite. But his eye contact was so brief and so rare that I started to think something in this social situation was awry. I was beginning to take some offense, privately, to these various gestures, but didn’t say anything because I knew I was construing them as rude when, conceivably, no disrespect was intended. Then one time he mentioned in passing “having A.S.,” but didn’t elaborate, either assuming I knew what he was referring to, or testing whether I did, and the context gave me no clues, other than that it was a medical issue. The only “A.S.” I could think of on the spot was Ankylosing spondylitis, a rare form of arthritis--how I know of that A.S., I couldn’t say. Anyway, when I responded with something about Ankylosing spondylitis, he looked at me as though I had just broken into a foreign language that sounded funny to uninitiated ears. “No,” he said, “Asperger’s syndrome”--which I did in fact know some rudimentary information about. Suddenly, all the potentially offensive ambiguities in our interactions were explained. And of course I felt like a serious, serious idiot. A psychology student in neuropsychology class, I should have known. And Ankylosing spondylitis was a comically absurd guess. It struck me how much and how concretely our everyday interactions are shaped by the vicissitudes of the brain, and how a knowledge of the brain casts a different and brighter light on those interactions, bringing clarity as well as new questions when previously indistinct details are revealed, as in a picture moved to a different and better lit setting. And not just our everyday interactions but the big stuff too. We can see a similar phenomenon in The Echo Maker, where an alteration in a single brain has amazingly widespread effects, altering in turn whole sensibilities, whole relationships and families, whole lives.
Not long after the awkward and embarrassing incident above, it was announced on the news that the actress Natasha Richardson--daughter of Vanessa Redgrave, wife of Liam Neeson--had died because of a seemingly--but really only seemingly--minor head injury, which she sustained when she fell during a skiing lesson, after which she was talking and laughing and refused medical help. She died of apparently serious brain damage, which I won’t bother to explain here, two days later. That evening, when two American parents heard of her death and the circumstances surrounding it, they thought of their seven-year-old daughter, who had had a head injury, seemed to be fine at first, but had after two days, when they went to see her to bed, begun to complain of a headache--a pattern almost exactly like Richardson’s last days. Making the connection, the parents called their pediatrician, the girl was transported by helicopter to a hospital equipped to deal with the injury--which was the same as Richardson’s after all--and she survived basically unscathed. Then I heard on the news about a lawyer in the Midwest who was using the possibility that his client had Asperger syndrome as a defense in a murder case, claiming that his client was “laboring under it” so that he “didn’t know the nature of his actions or that they were wrong.” Wisely, the judge rejected this defense. Still, knowing what I know about Asperger’s, I found the lawyer’s attempt outrageous. When I mentioned the story to Jeremy, he explained much more precisely that such a defense wouldn’t make sense with this particular form of autism, but could make more sense--he said this with an air of caution--with other forms, although it would be a controversial argument even then. He spoke, moreover, about the dangers of conflating neurological and psychiatric phenomena and the misuse of neuroscience--this surely rings a bell with members of our class. The brain, with both its power and its vulnerability, shapes our lives in real ways, on the individual level, and our world, on a societal level.
These coincidences and parallels reached a peak this afternoon when I was having lunch with a friend, who’s a novelist and professor. He mentioned, apropos of something else, having been on the committee that voted to give the National Book Award to Richard Powers for The Echo Maker. My friend, however, was the only person not to vote in favor of Powers’s book, which he said he hated. He said, furthermore, that he sees psychology currently and increasingly replacing philosophy and making it irrelevant, and he sees neuroscience replacing psychology; and this made him nervous, deeply nervous. When you study literature, it is sometimes said, philosophy is always right around the corner; but more and more it is psychology and neuropsychology that are around the corner, as Richard Powers unquestionably knows. Given my friend’s age and education, I should think that The Echo Maker violates fundamental ideas he holds about what literature is and ought to be. My friend, when we were discussing another thing entirely, mentioned that he’d recently met Oliver Sacks at a lecture and that they’d been e-mailing since, planning eventually to get together. They’d been talking about what “apprehension” means, from the perspective of a writer and that of a neuropsychologist. My friend said, fittingly, “I think I may be afraid of Oliver Sacks.” The brain, brain damage, brain science--they are omnipresent and to some people a major threat, a threat to aesthetic, intellectual, moral, legal, and philosophical views. I will admit, I felt a twinge of anxiety when reading The Echo Maker, because it gets at such visceral and deeply embedded fears and destabilizes some of our smug sense of safety, constancy, comfort, and so on.
Tuesday, March 31, 2009
Inherent Instability
One of the major themes throughout Richard Powers’ Echo Maker is that of “the self” as a fluid and constantly changing entity. Each character challenges the assumption that members of our species—biologically endowed, as we are, with the prefrontal cortical advantage of self-concepts and self-awareness—are inherently coherent, consistent, or predictable. In Mark’s case, his very disorder (Capgras) is a direct reversal of such supposition, as are the unravelings of Karin’s and Weber’s respective personalities, David’s stoic and tolerant perspective, and Barbara Gillespie’s personal history (morphing from high-functioning journalist to mysterious nurse’s aid). Frequently, in fact, Powers addresses the notion that it may be delusional to believe in the constancy of self, or the qualities that define us as individuals. As Weber reflects, “our sense of physical embodiment [does] not come from the body itself. Several layers of brain [stands] in between, cobbling up from raw signals the reassuring illusion of solidity” (Powers 258). Or, as Karin sums it up: “the whole race suffer[s] from Capgras” (Powers 347).
Interestingly, each character’s “self” seems to be primarily determined by its relation to others (either another person or another thing). Mark, for instance, gains his identity as his sister’s brother, as his father’s son, as an accident victim, as a sufferer of Capgras, as an employee at IBP, as a buddy of Rupp and Cain, etc. Karin, likewise, gains her identity as Mark’s sister, as the daughter of Marks’ parents (her parents), as a caretaker, as someone who has been unfaithful in relationships, as a former smoker, and so on. Weber’s, in turn, is based upon his research, his publications, his relation to his wife (Sylvie), his holistic stance in neuroscience, and his role as a father (amongst other things). Thus whenever any of these external or “other” entities change, so the “self” that is reliant upon them for its definition changes. In the broadest and most apparent situation, Mark’s accident alters not only his perception of reality and his functional capabilities, but also alters his sister’s perception of reality and her functional capabilities. The latter alteration is a direct byproduct of Mark’s personal alteration—which, ultimately (as the reader discovers) has been precipitated by the entrance of Barbara Gillespie (an “other”) into an element of Mark’s self (in this case, his extended peripersonal space, just beyond his car on a highway in Nebraska). Simply put, the “self” is interdependent upon the “other.”
This notion fits in quite well with Nancy Cantor’s and Hazel Markus’s concept of a “working self,” as outlined by Ledoux in Synaptic Self. As the author summarizes, the working self is “…a subset of the universe of possible self-concepts that can occur at any one time—it is the subset that is available to the thinking conscious person at a particular moment, and is determined in part by memory and expectation, and in part by the immediate situation” (Ledoux 256). In turn, the manner by which certain motives are acted upon (and the manner by which certain goals are pursued) contribute to this sense of self, inasmuch as they endow a person with agency—or the free will to direct his/her actions. (As a mundane example, a person with a preference for dark chocolate is a separate individual from a person who dislikes dark chocolate and prefers hard candy, inasmuch as each—when a craving arises—pursues a different entity: the one with the relative incentive salience. Given some conditioning, however, such tastes are surely subject to change: if the dark chocolate, say, is mixed with ipecac, a taste aversion may develop that steers the former chocolate-lover in the opposite direction. Likewise for the hard candy fan)
Another similarity between Ledoux’s and Powers’ takes on the self is the acknowledgment of innate mechanisms that seem to underlie the more fluid and changeable personal identity. As Ledoux explains, one neural correlate of behavior is rooted in the dopaminergic pathways that exist in organisms whose brains possess an amygdala, tegmentum, accumbens, pallidum, and motor cortex. At the presentation of a novel conditioned stimulus (in this case, one that seems threatening—i.e. a tone associated with a painful shock), the lateral nucleus of the amygdala is activated, “…which, in turn, activates the central nucleus of the amygdala…[whose outputs] initiate the expression of species-typical defense responses (like freezing and associated autonomic changes) as well as activate arousal systems in the brain stem” (Ledoux 248). These structures, and their neurotransmitters (dopamine being the most important here) are universal, much like the postulated primary incentives and the respective drives to acquire them (i.e. food, sex, water—in no particular order). Thus, in contrast with the inconsistency of the less concrete self (i.e. the personality, labels one adopts, one’s individual preferences or secondary incentives like fame, money, or dark chocolate), the system that gives rise to basic responses and evolutionarily conserved functions (i.e. defensive reactions or defensive actions is quite consistent. Thanks to the central and basal amygdalar nuclei (amongst other structures), there exists an innate, unchanging response system, regardless of the personality built on top of, in reaction to, or as a byproduct of its functioning.
This notion of an inherent sameness or consistency as the basis upon which fluidity is constructed is also apparent in Powers’ writing. Most obviously, it is evident in his depiction of the Cranes’ migratory patterns: “Something in the birds retraces a route laid down centuries before” (Powers 4), wherein he underlines the innate (yet unconscious) tendency to return to some sort of root or home base. This is also apparent in his human characters, as Karin (for one) constantly complains of Nebraska’s inescapability and her futile efforts to escape her homeland (while also acknowledging her repeatedly unfaithful endeavors with David and Robert). In fact, Powers seems to point out benefits of a slight reversion to this earlier, ingrained, and unconscious behavior, frequently noting the advantage of losing the gauze of identity. Often, he casts Mark’s ostensible reversion in a positive light: “with an animal precision [Karin’s] had lost, his ears picked up stray pieces of surrounding conversations and wove them together” (Powers 37); “Damage had somehow unblocked him, removing the mental categories that interfered with truly seeing. Assumption no longer smoothed out observation…The lower the brain, the slower the fade. Love, in an earthworm, might never extinguish at all” (Powers 198). Perhaps this viewpoint is best expressed in Weber’s conclusion that “older creatures still inhabited us, and would never vacate” (Powers 231).
Both Ledoux and Powers point to several aspects of personhood: the malleability of the self, its inexistence without an “other,” and the innate, implicit basis upon which this fragile structure is seated. Thus individuation, in the human sense of personal identity, is not negated; rather, our uniqueness—our senses of self—seem to rest upon a firm and consistent base. This base, our innate evolutionarily conserved mechanisms (i.e. fear reaction and action, incentive sensitization, etc.) provides us with a secure jumping off point from which we can construct the less reliable and inherently unstable (yet explicit) selves—selves that we strive to establish continuity in, against all odds (even if that means confabulating from time to time).
Interestingly, each character’s “self” seems to be primarily determined by its relation to others (either another person or another thing). Mark, for instance, gains his identity as his sister’s brother, as his father’s son, as an accident victim, as a sufferer of Capgras, as an employee at IBP, as a buddy of Rupp and Cain, etc. Karin, likewise, gains her identity as Mark’s sister, as the daughter of Marks’ parents (her parents), as a caretaker, as someone who has been unfaithful in relationships, as a former smoker, and so on. Weber’s, in turn, is based upon his research, his publications, his relation to his wife (Sylvie), his holistic stance in neuroscience, and his role as a father (amongst other things). Thus whenever any of these external or “other” entities change, so the “self” that is reliant upon them for its definition changes. In the broadest and most apparent situation, Mark’s accident alters not only his perception of reality and his functional capabilities, but also alters his sister’s perception of reality and her functional capabilities. The latter alteration is a direct byproduct of Mark’s personal alteration—which, ultimately (as the reader discovers) has been precipitated by the entrance of Barbara Gillespie (an “other”) into an element of Mark’s self (in this case, his extended peripersonal space, just beyond his car on a highway in Nebraska). Simply put, the “self” is interdependent upon the “other.”
This notion fits in quite well with Nancy Cantor’s and Hazel Markus’s concept of a “working self,” as outlined by Ledoux in Synaptic Self. As the author summarizes, the working self is “…a subset of the universe of possible self-concepts that can occur at any one time—it is the subset that is available to the thinking conscious person at a particular moment, and is determined in part by memory and expectation, and in part by the immediate situation” (Ledoux 256). In turn, the manner by which certain motives are acted upon (and the manner by which certain goals are pursued) contribute to this sense of self, inasmuch as they endow a person with agency—or the free will to direct his/her actions. (As a mundane example, a person with a preference for dark chocolate is a separate individual from a person who dislikes dark chocolate and prefers hard candy, inasmuch as each—when a craving arises—pursues a different entity: the one with the relative incentive salience. Given some conditioning, however, such tastes are surely subject to change: if the dark chocolate, say, is mixed with ipecac, a taste aversion may develop that steers the former chocolate-lover in the opposite direction. Likewise for the hard candy fan)
Another similarity between Ledoux’s and Powers’ takes on the self is the acknowledgment of innate mechanisms that seem to underlie the more fluid and changeable personal identity. As Ledoux explains, one neural correlate of behavior is rooted in the dopaminergic pathways that exist in organisms whose brains possess an amygdala, tegmentum, accumbens, pallidum, and motor cortex. At the presentation of a novel conditioned stimulus (in this case, one that seems threatening—i.e. a tone associated with a painful shock), the lateral nucleus of the amygdala is activated, “…which, in turn, activates the central nucleus of the amygdala…[whose outputs] initiate the expression of species-typical defense responses (like freezing and associated autonomic changes) as well as activate arousal systems in the brain stem” (Ledoux 248). These structures, and their neurotransmitters (dopamine being the most important here) are universal, much like the postulated primary incentives and the respective drives to acquire them (i.e. food, sex, water—in no particular order). Thus, in contrast with the inconsistency of the less concrete self (i.e. the personality, labels one adopts, one’s individual preferences or secondary incentives like fame, money, or dark chocolate), the system that gives rise to basic responses and evolutionarily conserved functions (i.e. defensive reactions or defensive actions is quite consistent. Thanks to the central and basal amygdalar nuclei (amongst other structures), there exists an innate, unchanging response system, regardless of the personality built on top of, in reaction to, or as a byproduct of its functioning.
This notion of an inherent sameness or consistency as the basis upon which fluidity is constructed is also apparent in Powers’ writing. Most obviously, it is evident in his depiction of the Cranes’ migratory patterns: “Something in the birds retraces a route laid down centuries before” (Powers 4), wherein he underlines the innate (yet unconscious) tendency to return to some sort of root or home base. This is also apparent in his human characters, as Karin (for one) constantly complains of Nebraska’s inescapability and her futile efforts to escape her homeland (while also acknowledging her repeatedly unfaithful endeavors with David and Robert). In fact, Powers seems to point out benefits of a slight reversion to this earlier, ingrained, and unconscious behavior, frequently noting the advantage of losing the gauze of identity. Often, he casts Mark’s ostensible reversion in a positive light: “with an animal precision [Karin’s] had lost, his ears picked up stray pieces of surrounding conversations and wove them together” (Powers 37); “Damage had somehow unblocked him, removing the mental categories that interfered with truly seeing. Assumption no longer smoothed out observation…The lower the brain, the slower the fade. Love, in an earthworm, might never extinguish at all” (Powers 198). Perhaps this viewpoint is best expressed in Weber’s conclusion that “older creatures still inhabited us, and would never vacate” (Powers 231).
Both Ledoux and Powers point to several aspects of personhood: the malleability of the self, its inexistence without an “other,” and the innate, implicit basis upon which this fragile structure is seated. Thus individuation, in the human sense of personal identity, is not negated; rather, our uniqueness—our senses of self—seem to rest upon a firm and consistent base. This base, our innate evolutionarily conserved mechanisms (i.e. fear reaction and action, incentive sensitization, etc.) provides us with a secure jumping off point from which we can construct the less reliable and inherently unstable (yet explicit) selves—selves that we strive to establish continuity in, against all odds (even if that means confabulating from time to time).
Sunday, March 29, 2009
The Illusion of Normalcy and the Mercurial Self
Before I started writing my post, I read Tina’s, and her closing questions got me started on a train of thought traveling back through the landscapes of The Echo Maker and other portions of this course’s material, and I came upon an idea that took me by surprise: In neurological medicine, there is no such thing as going back to normal.
In class discussions, we’ve made an effort to avoid the implied value judgment of the word “normal” by using “neuro-typical” or its synonyms. I think that the difficulty we have experienced of cutting this bias out of our language reveals how deeply ingrained that assumption of the superiority of normalcy is. The goal of normalcy applies to several levels of human organization. Culturally, the norm is the status quo, and any group that follows the biological imperative of self-preservation will probably recognize maintaining the norm as necessary for its survival. We can see this in our own governmental process: setting Liberal and Conservative labels aside, all but the furthest fringe elements of our political system take the preservation of the vast majority of the Constitution for granted; we trustingly follow the traditions of law and procedure that have accumulated for two centuries – and why not? To abandon the norm would be to take on unknowable risks. The same instinctual fear of the unknown that helps sitting politicians remain in office - sometimes regardless of popularity and competence compared to their competition – is part of what inspires the infamously impenetrable social unit, the clique. People group together with others that remind them of themselves, and in those groups, surrounded by friends more identical than family, they are normal. They cling to each other as naturally as drops of oil in water. Types and genres (goth, geek, jock, prep, mods, rockers…) of people are coagulated from a sea of formerly solitary uncategorized persons, allowing for each group to establish its own us-against-them dichotomy and to create a localized sense of normality, of sameness, coexisting simultaneously with an expression of rebellion, individuation, or exclusivity. On a personal level, it is natural to distinguish what is familiar or relatable from what is alien or surprising as normal and abnormal, respectively. Neurologically and psychologically (these two fields seem to be on a collision course towards unification), the normal brain can appear almost indistinguishable from the ideal brain. If we allow the easy layman’s conflation of brain and identity, it follows that to be normal is ideal. If normal is best, shouldn’t everyone want a normal brain, and isn’t it medicine’s responsibility to strive to give the gift of normalcy to all?
Of course this issue is much more complicated. Two problematic variables that immediately spring to mind are the issues of degree of abnormality and its danger to the patient, and whether a condition is damaged-induced or inborn. Regarding the first, if the condition is life-threatening, medical intervention is not going to encounter nearly as many moral hang-ups. But under physically non-threatening circumstances, as Tina suggests, the right path is increasingly difficult to discern. And whose choice is it to make whether a surgical or pharmaceutical measure is to be taken? As with a lethal abnormality, a lucid patient able to understand her condition and step outside of its influence to make an informed decision on whether to normalize herself, as with Sister John of the Cross, is a moral Get Out of Jail Free card from the medical perspective. But what about Mark, who understands that something is wrong, but is unable to step outside his delusion, or Weber’s “David,” who, like so many of the people we’ve read about, has incorporated the products of gradual brain damage into his personality (Powers 363)? For me, it is becoming increasingly difficult to differentiate self and personality from neurology and brain structure. A change to one is a change to the other, and neither is ever constant. There is no "true" self for each brain, only a multitude of ever-changing potentialities for what that self might be.
What I am realizing, and what I learned from The Echo Maker, is that there is no going back to normal neurologically. We cannot approach the health of the brain like we do the health of the rest of our bodies. There are some overt parallels, but also important distinctions. We could think about purely psychological dysfunction (although I am starting to think it doesn’t exist in isolation) as physical fitness. By thinking the right way and following the right routines, we can work ourselves out of a bad mood much like we can exercise ourselves into better shape. But neurosurgery and neurochemical medication are much more complex and dynamic than putting a scalpel to another part of the body or taking a fiber pill to help with digestion. The brain is not a machine that can have parts replaced. To borrow from the principles of physics, we cannot modify one aspect of the brain without inspiring an unpredictable change in the brain as a whole. Weber muses, “Always the water changed, but the river stood still. The self was a painting, traced on that liquid surface” (Powers 382). If a neurosurgeon takes out a piece of the brain, a bucketful of the water, how can he control the shifting of the surface where the self is manifested? Or if a nurse gives an injection of a neurotransmitter, drops in a pebble for the sake of the ripples, how can the change be reversed, the ripples recollected or the pebble plucked from the bottom without greater disruption? The pebble, the chemical addition, is incorporated into the river. Deliberate changes evolve, and the brain outpaces us in our ability to modify it. The water of the river is always new, and the surfaces that patterned the self yesterday cannot be recreated by modification just as a person with a bucket can reverse the direction of the river. So when we try to restore some kind of familiarity to the deep and wildly dynamic structures upon which the ever-changing self is borne, we cannot hope to recreate what was, only to guide what is in the right direction, and even that is uncertain.
Karen had to come to terms with this principle regarding her brother’s condition. We all know that experiences change us, but the profundity of structural changes that occur on a daily basis is hard to comprehend. Karen learns that she must approach neurological change seeking not restoration but reconciliation and adaptation. Mark could not return to the same person he was before his accident, but he could, with the right pebbles tossed in the river, move toward a more recognizable pattern of self less muddled by delusion.
Personal Melodies in Dissonance
How was everyone's break? I hope you all had a good rest and got some work done and traveled safely and all that. My break went a little awry right at the top--I was greatly enjoying the Echo Maker. I started reading it before break, and in the first week took it on my plane ride back home--and promptly left it in the seat pouch after I'd landed in Austin. Over the next couple of days, as I waited for my dad to pick up another copy at the bookstore, I found myself thinking a lot about recognition and homecomings, some of the themes in the book, if only because I no longer spend a lot of time in my hometown (which, being somewhat sheltered from the recession, is still vibrantly and rapidly changing all the time). I was struck by niggling feelings that something was wrong as I drove down the street where I lived after high school--and then realized the new owner of my old studio apartment had the door open, and she'd painted, and the color was different. Or I'd I find myself searching for an old friend in one of the enormous crowds sweeping the city for South by Southwest, and recognizing her from afar by the way she flicked her cigarette. As Karin does in the novel, I was instantly "at home" again both physically and psychologically, in an emotional and geographical place I'd left long ago--and it reminded me that mapping is still ever-present in my mind.
I'm not sure I ever wrote about this, but I was captivated a few weeks ago when we read a Sacks article online and someone referred to a patient's "motor melody" being disturbed. I think that is one of the most comprehensible metaphors I've come across to explain these altered states of being, altered relationships of mind to body. In the novel, the entire melody of Mark's life had been disrupted by the accident, and yet he didn't see himself as different, but the whole world, and most specifically, his sister, or her impersonator.
Because there's simply no way to comprehend inhabiting a Capgras mind, I kept reaching for strange metaphors to explain it to myself. For instance, when Richard Powers was talking to Terri Gross about the artificiality of typing and composing at once, I turned that into a way to understand the artificiality--or mechanicalness, I suppose is more correct--of how we recognize and represent the outer world to ourselves. I tried to imagine what it would be like to not simply know my sister, but to have most of the elements there and then have others ask me to convince myself that she was really the one. This problem that Capgras patients simply don't "feel" like the person is their loved one is awful. Few people, in other circumstances, have to consciously construct their most intimate relationships, they simply are.
Powers eloquently describes the effects of this emotional brain-damage on the bystanders. It seems that Mark makes everyone doubt themselves (except perhaps Barbara, who is in her own way shaping a double identity)--or perhaps not doubt, but re-examine the way they are positioned against other people. As Dr. Weber's mid-life crisis (for lack of a better term) creeps over him, he has the added uncertainty of this young man who for all intensive purposes seems functional--and yet is very, very damaged. Karin slowly becomes convinced, and begins to voice her belief, that Mark is right, that she can't be his real sister. Her pain in dealing with this disconnect is haunting. We've seen other spouses, siblings, and parents dealing with a loved one who is taken from them by a malady or condition--but never before someone who loses *themselves* because of another's illness.
Reading this novel just after Lying Awake brings us again to the issue of a patient's role and involvement in their treatment. Sister John, though she went through turmoil in the process, was actively involved in planning the course of action and had a great deal of input into how her illness was going to be viewed. Mark, on the other hand, because of the very nature of his deficit, was unable to productively participate in treatment and actually effectively blocked people from helping him. So would it have been right or wrong of Karin to have left him to his own devices, to wash her hands of the matter because this new, strange brother before her believed he was fine and the rest of the world was crazy? It's hard to say, especially because she needed him to "recover" to regain her own sense of self, so in a way her actions were almost as selfish as those Dr. Weber was punishing himself for. How do you treat someone who thinks they don't need treatment? And who is to say that a nonlife-threatening condition must be corrected?
I'm not sure I ever wrote about this, but I was captivated a few weeks ago when we read a Sacks article online and someone referred to a patient's "motor melody" being disturbed. I think that is one of the most comprehensible metaphors I've come across to explain these altered states of being, altered relationships of mind to body. In the novel, the entire melody of Mark's life had been disrupted by the accident, and yet he didn't see himself as different, but the whole world, and most specifically, his sister, or her impersonator.
Because there's simply no way to comprehend inhabiting a Capgras mind, I kept reaching for strange metaphors to explain it to myself. For instance, when Richard Powers was talking to Terri Gross about the artificiality of typing and composing at once, I turned that into a way to understand the artificiality--or mechanicalness, I suppose is more correct--of how we recognize and represent the outer world to ourselves. I tried to imagine what it would be like to not simply know my sister, but to have most of the elements there and then have others ask me to convince myself that she was really the one. This problem that Capgras patients simply don't "feel" like the person is their loved one is awful. Few people, in other circumstances, have to consciously construct their most intimate relationships, they simply are.
Powers eloquently describes the effects of this emotional brain-damage on the bystanders. It seems that Mark makes everyone doubt themselves (except perhaps Barbara, who is in her own way shaping a double identity)--or perhaps not doubt, but re-examine the way they are positioned against other people. As Dr. Weber's mid-life crisis (for lack of a better term) creeps over him, he has the added uncertainty of this young man who for all intensive purposes seems functional--and yet is very, very damaged. Karin slowly becomes convinced, and begins to voice her belief, that Mark is right, that she can't be his real sister. Her pain in dealing with this disconnect is haunting. We've seen other spouses, siblings, and parents dealing with a loved one who is taken from them by a malady or condition--but never before someone who loses *themselves* because of another's illness.
Reading this novel just after Lying Awake brings us again to the issue of a patient's role and involvement in their treatment. Sister John, though she went through turmoil in the process, was actively involved in planning the course of action and had a great deal of input into how her illness was going to be viewed. Mark, on the other hand, because of the very nature of his deficit, was unable to productively participate in treatment and actually effectively blocked people from helping him. So would it have been right or wrong of Karin to have left him to his own devices, to wash her hands of the matter because this new, strange brother before her believed he was fine and the rest of the world was crazy? It's hard to say, especially because she needed him to "recover" to regain her own sense of self, so in a way her actions were almost as selfish as those Dr. Weber was punishing himself for. How do you treat someone who thinks they don't need treatment? And who is to say that a nonlife-threatening condition must be corrected?
Monday, March 9, 2009
Becoming a Part of Her
A theme that has surfaced in our readings and discussions has been, in some cases, the concept of a mental illness becoming an all-consuming, self changing part of the affected human being. It has the potential to become an actual part of the person rather than something outside of them. It can make a person who they are. There is no longer a differentiation between the self and the disease. In Mark Salzman’s Lying Awake, Sister John lived years with migraine-like headaches that gave her “a wonderful experience, but it’s spiritual, not physical” (47).
I found that the decision to place this story in a cloister with a nun who is affected by epilepsy is a very deliberate decision. Epilepsy is a disorder which can make the patient feel that they are “becoming so drawn into the altered world created by the disorder that one loses interest in everything else” (68). The days spent in the cloister are used for the purpose of becoming closer to God. The goals are to be as selfless as possible and to put oneself “in [God’s] hands completely” (125). In the cloister, the nuns are meant to lose themselves in religion. There no longer is a material world. Epilepsy, just like religion, is impalpable. Sister John experiences her epilepsy so that her spiritual world and physical world become undifferentiated. According to Sister John, Epilepsy is a disease of the will of God. She gives God full power over this illness and loses her will to cure her epilepsy. She questions her surgery because surgery used to cure epilepsy would mean questioning God. The narrator states that for Sister John, “leaving the enclosure made her feel uneasy, like being caught in an open field with a storm approaching” (38). The cloister and her place in it has been what defines Sister John. Everything that she experiences within the cloister whether it be physical or emotional becomes entangled within her identity as a whole.
Something that was quite striking in Lying Awake, was Sister John’s reaction to her diagnosis. It seems as though she was very much aware of her life, pre-epilepsy. She knew there was difference between her pre and post epileptic life and must have believed that it was due to some sort of religious awakening rather than a physical cause. The epilepsy actually improved Sister John’s emotional life. She states that “if the surgery were to take my dream away, everything I’ve gone through up to now would seem meaningless. I wouldn’t even be able to draw inspiration from the memory of it…” (138). In this moment sister John begins to separate her illness from her religious life, admitting that the epilepsy has made her religious self, a more meaningful self. She comes to the conclusion that the medical world and the religious world might be separated and that her doctor may not understand her “take” on her condition.
To Sister John, epilepsy is something that was given to her by God, a condition that was designed for her. To the medical world, her way of life seems like “hyperreligiousity” and “the choice to live as a celibate: hyposexuality. Control of the will through control of the body, achieved through regular fasting: anorexia. Keeping a detailed spiritual journal: hypergraphia” (153). Many of the mental illness that we have studied in class so far have seemed like an exaggeration of a neurotypical mind. In this case,however, Sister John contradicts the idea that what she experiences is “hypertypical”. She sees her epilepsy and her way of life as being normal and different from the material world, but not an extension of the “norm”. To Sister John, epilepsy is who she is, her conception of “neurotypical”.
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