Monday, July 23, 2007

True Lies: More thoughts on Autism and Schizophrenia

There is a fantastical article by Simon Baron-Cohen about how autistic children are more honest than the rest of us and how the neurotypical human brain is characterized by an ability to deceive.

As we all know, Autistic children have troubles with meta-representation, or believing that there could be two versions of reality- one that is factually correct, and which they themselves may hold; and another that is incorrect, but exists in the mind of another human being. Thus, they may not have any problem with knowing some fact about the world, but are greatly disadvantaged when it comes to knowing facts about other people's mind- as they cannot conceive that somebody can have beliefs that are different from the Reality- in other words that someone has 'false beliefs'.

As per Simon, the capacity to deceive involves the ability to know that one can have false beliefs; and also that one can manipulate the beliefs of another person, so that the person ends up with a false belief. I doubt whether the first ability is necessarily compromised in people with Autism. After all, they themselves may have had false beliefs about the world (say thinking that sun revolves around the earth) and thus may similarly conjecture that others can also have false beliefs. The trouble may lie elsewhere- they may lack the ability to discern that whatever beliefs they have (whether true or false), the other person might not necessarily have the same beliefs. That is they may confuse their own beliefs with that of another and would not have a higher level meta-representation, that someone can have a different belief set. Thus, the trouble is not with having beliefs- but with the ability to say and understand that "I believe that john believes this". They may not comprehend such a sentence or thought- as it is superfluous in their world, where their beliefs are consistent with Reality (or are false) and the other person's beliefs also being consistent with Reality are one and the same. Thus they never require , or are able to use, this recursive ability. I believe this deficit in recursive ability may to some extent explain their language difficulties too. coming back to point, as they themselves cannot comprehend that "I believe john believes X.", so also they are unable to comprehend that 'john believes I believe X". thus, in their innocent and simplistic world, their is no room for either manipulating others via deception; nor of not trusting and always being on their guard against what someone says or does. Thus, they would take sentences at their face value.

I came across this article via The Thinking Blog and there Mary makes some interesting points about whether all deception is bad and all honesty is good; and I concur fully with her that sometimes deception is needed and can be put to good purpose and sometimes truth is not desirable or even moral as per the situation. What is more instrumental is the motive with which the truth or lie is chosen. Thus, I personally am of the opinion that we do need an ability to deceive, but the character to keep the trait in check and to put in good use only.

Simon also makes a point that we treat Autistic traits like honesty as traits on a continuum and not as deficits and I agree with him there too. He treats the normal , social brain as the extreme end of the this trait on which the autistic are the other end; and here I differ. I have already made some strong cases for Schizophrenia to be at the other end; and I would like to support that position by drawing on Simon's analysis.

If we believe that one trait that Autistic lack is deception and meta-representation or ability to read minds, then the Schizophrenics are bound to be too good at it (as per my thinking they are two ends of a creativity spectrum).

  • The Schizophrenics may use so much meta-representation (thinking that goes 'I think he thinks that I think that Mary thinks ....') that they may not only get confused, but sound disoriented and disorganized as they may assume too much about what the other person believes. Much of the incoherence in a psychotic speech may be due to too much of shared context - or too much of' he-knows-what-she-knows-that-I-know' sort of thinking. Also keeping multiple perspectives or belief sets may tax their normal working memory capacities, making them sound incoherent.
  • Also as opposed to Autistics , who think people do not have an ability to mind-read- as they themselves lack it- the Schizophrenics may be marked by an increased propensity to consider that people can mind read and that too to a very great extent. This may underlie the frequently found delusion in schizophrenia that their thoughts are being broadcasted- that other can read their mind--or at least they want to read their minds using Gizmo's like satellites, headphones etc. The schizophrenic, after all, knows the advantages that can be obtained if one can mind read.
  • In its extreme, as the Schizophrenics have too much obsession with mind reading abilities- and the corollary ability to deceive- , they may think that people , in general, are deceptive and manipulators. This may explain why other people would like to insert thoughts or tamper with their thoughts/ memories etc. This may easily give rise to delusions of control.
  • the ability and propensity to deceive, would also explain the paranoia they feel- after all in their warped world view , all, like them, have immense capacity to deceive/ manipulate- and thus is a potential threat- an untrustable person. This gives rise to the paranoid delusions of schizophrenia.
  • Lastly, the obsession of schizophrenics with modeling other minds may lead to multiple personality syndrome (although I know this is not recognized by Psychiatry).

I , like Mary, am not taking sides on whether naive honesty is better or tendency to deceive/camouflage is better; I believe both have their utilities and one should be flexible enough to use both capacities at will. But as we know that much of Human evolution is driven by our capacity to deceive , I would classify schizophrenia as the cost we pay for human Evolution; and Autism as a developmental disorder- We humans are meant to be social and are meant to hide all our raw feelings/ beliefs / thoughts from other persons. Let us deceive, but let us keep that in check- or else be prepared for insanity.

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3 comments:

Anonymous said...

I have some pieces of information to think about. One is that there is a greater overlap between autism and an illness we call "schizophrenia", yet you say they are are two different extremes of a spectrum.

Another is that many people with a diagnosis of schizophrenia-related disorders do not have a problem with speech or disorganized thinking, a belief in thought broadcasting, mind-reading, etc. The daugnosis is so broad that there are probably 50 different illnesses getting lumped together under that diagnositic label. In fact, many cases of hypothyroid and hyperthyroid still get diagnosed as schizophrenia today.

Lastly - some children I know with schizophrenia-spectrum disorder DO NOT LIE. They may believe people are trying to poison them but that is based not on the recursive thoughts you are attributing to them, but rather, due to interpretation of false perceptions. i.e. it is the INPUT data that gets garbled.

Just another point of view from someone who sadly knows too much.

Sandy G said...

Hi Anonymous,

Thanks for commenting. I believe that the communicative problems and social ineptitude are traits that appear to be common to schizophrenia and autism, on surface; but I also believe that the underlying causes and mechanisms are very different.

I agree though that schizophrenia is a very broad term and my posts clubbing schizophrenics at one end and Autistics on other end may not apply to all the people who are now classified as 'Schizophrenics'. Delusions, though not necessary in all forms of the illness, are one of the prominent positive symptoms on the basis of which diagnosis is made. Disorganized behavior, thinking and speech is another prominent diagnostic criteria, clubbed under cognitive symptoms. Also prominent diagnostic criteria are negative symptoms like alogia, avolition etc. These diversity of diagnostic criteria , itself is testimony to the fact, that this is a spectrum disorder.

Also, I didn't mean to say that all people (children) diagnosed with schizophrenia lie; but my contention is that they may start confabulating earlier as their theory-of-mind module may develop earlier. In adulthood though,they may have a greater ability to deceive(sometimes using symbolic language and gestures), yet they may not necessarily use that ability to confabulate.

I know that people with schizophrenia have sensory gating problems and do interpret 'input' wrongly; but that doesn't exclude the possibility of paranoia arising from an advanced and dominant theory-of-module/ deception detection module.

Yet, all this is conjecture, but I believe these claims/ theorization can be tested using adequate experiments / longitudinal studies.

Anonymous said...

Except that all 4 women I know (2 with pediatric-onset - one being my own child), are completely honest and non-deceptive - a trait which I do not see in any "NTs".

All 4 are intelligent, and 3 are extremely so. All 4 are quite articulate - none with any problem speaking. None have disorganized thinking.

All paranoia they have have come from voices and other perceptions. My own child's psychiatrist initially had me read all about autism because there was so much overlap. But she is very socially aware.

She remains quite analytical and rational. In fact all have been very "sane" in their reactions to very distorted perceptions. If I had experienced what their brains experienced I myself would probably have reacted the same way and came to the same conclusions. I amend that - I am not sure I would have had the mental HEALTH my own child had to have remained "sane", and she has.

Perhaps one form of schizophrenia IS, as you hypothesize, a manifestation of a problem on the opposite end of the spectrum from autism.

Other forms, are simply sensory/hallucinatory/mood/psychtic/perceptual symptoms arising from various areas of the brain - different areas in different people with different underlying etyiologies. In my child's case, her hypothalamus is affected which causes not just symptoms of "schizophrenia" but a host of other neurological and endocrinological problems. Other people's "schizophrenia" are more frontal cortex. And the list goes on.

Sorry if I am saying anything I should not. You can blame it on my own autistic-spectrum traits (forgive me if I do not consider it a "disorder").