San Francisco Chronicle autism blogger Laura Shumaker today presents this quote from Dr. Susan Ashely's 2006 book The Asperger’s Answer Book: Professional Answers to 275 of the Top Questions Parents Ask as an authoritative, neutral statement on theory of mind:

Theory of Mind (ToM)is the ability to make attributions. Attributions are the thoughts we create about others in order to explain what happens in our interactions with and observations of them. No one actually teaches us to make attributions; we just do it automatically. For the most part, we can make good guesses at someone’s intentions. From these inferences, we determine how to react to them.

Children and teens with Asperger’s are deficient in ToM. They do not comprehend that others have thoughts and feelings that are different from their own. They cannot stand in someone else’s shoes.

What's wrong with that?

Laura presents one point of view on a controversial subject as fact.  I recommend anyone seriously interested in theory of mind visit Rachel Cohen-Rottenberg's site Autism and Empathy and this essay she wrote on the topic:

Now, I will readily admit that I cannot infer a person’s mental state by reading nonverbal cues. And while I can reflect endlessly upon the mental processes of neuro-typical people, I find certain of their characteristics unfathomable. Why do people enjoy socializing? What do they get out of it? Why are most people put off by discussion about serious matters? I haven’t a clue.

But let’s turn the tables for a moment. Let’s look at how unfathomable autistic people seem to the vast majority of neuro-typical folk. For many decades, scientists had no ToM regarding the mental processes of an autistic person. Guess how they found out? An autistic person wrote about it. She put it into words. She had to, because your average human being could not infer the mental state of an autistic person by translating his or her nonverbal cues.

The Sally-Anne test which Simon Baron-Cohen uses to support his theory relies on complex verbal instructions which autistic people may not understand.  When a similar test is presented through drawing, autistic children may do slightly better than other children.

Ashely's explanation is especially problematic because she uses exclusive language.  Even if one embraces the theory of mind deficit as a core component of autism, it would be more accurate and professional to write this:

Children and teens with Asperger’s may be deficient in ToM. They may have trouble comprehending that others have thoughts and feelings that are different from their own. They may find it harder than their peers to stand in someone else’s shoes.

Autism is a spectrum.  Having a child on one part of the spectrum does not mean that you are an expert on people on another part of the spectrum.  If someone asks you questions about what things are like for people with Asperger's syndrome, it's not okay to use neurotypical experts and other neurotypical parents experts as your only source if you are answering for a major publication.  If you're not willing to take the time to actually get some input from someone who has Asperger's syndrome, you should probably just not answer the question. 

Ariane Zurcher goes beyond rejecting Simon Baron-Cohen's bigoted ideas about autism and "theory of mind."  She explains with brilliant simplicity two insights that should replace them.

1) Autistic people communicate differently, and that impacts almost everything we do.

Zurcher describes the infamous "Sally-Anne" test, then explore the fallacies in the conclusions SBC draws from it:

From the test results Simon Baron-Cohen concluded "that the core problem in autism is the inability to think about other people or one's own thoughts" according to the blog, holah.co.uk. Except that his test did not take into consideration the challenges many autistic children have in sequencing, language problems, misunderstandings of prepositions, the level of anxiety or stress levels of the autistic participants at the time of testing. Nor did it take into account literal thinking, something many autists have, all of which made the test and the questions asked that much more challenging.

My 10-year-old autistic daughter, Emma, when asked what her doll's name is, will reply, "Doll" or "Girl." This is just one example of Emma's literal mind at work. She is not wrong -- her doll is a doll and yes, the doll is a representation of a girl. If I say to Emma while she is in the shower, "Em, wash the soap off," she will take the bar of soap and hold it under the water, even though what I meant was she should wash the soap off her body -- she understood my request literally. Was she wrong? No. To draw some other conclusion from her answers would be. When the child, during the Sally-Anne test, was asked, "Where will Sally look for her marble?" a literal-minded thinker, who also has trouble with prepositions would have difficulty arriving at the "correct" answer.

2) Many autistic people often experience overwhelming emotions or sensations that can cause us to appear to be disconnected:

When Emma was diagnosed I came upon the "Theory of Mind" paper early in my research. At the time I thought this explained why, when any of us were upset, Emma seemed oblivious. But as I continued along the road of educating myself, coupled with observing my daughter, I began to question his theory. I read about autistics who avoided looking in people's eyes because it was too intense. One autist described it as akin to seeing into a person's soul. Others talked about how they could sense immediately upon entering a room the various occupants' emotional state and became so overwhelmed they would seek refuge in a corner, try to leave or would stim as a way to counter the intensity of what they were experiencing.

There are times when Emma will, with outstretched arm, put her hand out in front of her face like a shield. Often it is done when she's very happy and having a good time. I believe it is in response to the intensity of feelings, either hers or others or both. Or as Jessy Park, Clara Claiborne Park's autistic daughter, was quoted as saying, "It's too good."

Essential reading.

Do autistic people have empathy?  Yes.

Note: This piece has been on the site for a few months, but it's one of my favorites.  I was going to write something new to go with these images that I posted to my Facebook last week, but finally decided that is still the best I can do with the topic.

It's well known that most people with autism have difficult emotional lives, but the nature of those difficulties is profoundly misunderstood. They are usually described as "a lack of empathy" or "difficulty reading social cues."  In other words, the discussion usually focuses on the problems we have understanding the feelings of other people.  But those problems arise first from how hard it is to understand our own emotions.

"How are you?"
"How do you feel?"

For me, these are not easy questions to answer.  I have intense difficulty both identifying my own emotions and understanding why I have them.  I think the reasons for that have to do both with my neurology and my experience.  

In the first part of this series, I explained my belief that autism is at root a tendency for the brain to make connections, and therefore to develop, in unusual ways.  There seems to be at times almost no connection at all between the parts of my brain that feel things and the parts of my brain that are supposed to analyze those feelings.

Click here to keep reading.

What my emotions look like, sometimes.

It's well known that most people with autism have difficult emotional lives, but the nature of those difficulties is profoundly misunderstood. They are usually described as "a lack of empathy" or "difficulty reading social cues."  In other words, the discussion usually focuses on the problems we have understanding the feelings of other people.  But those problems arise first from how hard it is to understand our own emotions.

"How are you?"
"How do you feel?"

For me, these are not easy questions to answer.  I have intense difficulty both identifying my own emotions and understanding why I have them.  I think the reasons for that have to do both with my neurology and my experience.  

In the first part of this series, I explained my belief that autism is at root a tendency for the brain to make connections, and therefore to develop, in unusual ways.  There seems to be at times almost no connection at all between the parts of my brain that feel things and the parts of my brain that are supposed to analyze those feelings.

The stronger my emotions are, the harder it is for me to understand them.  When I am heading for a meltdown, all I know is that I feel bad and that that bad feeling is more than I can deal with.  Later, I am usually able to go back and figure out what the emotion I felt was and why I felt it, but at the time?  No.  

I become increasingly confused, frustrated, and agitated.  I feel under attack.  I feel stupid and incompetent.  And because most people do not seem to have these problems to the degree I do, I also feel increasingly isolated, lonely, and sad.
But none of those are the root emotion that caused me to become overwhelmed in the first place.  They are simply layered on top of it, making it even more difficult to identify.

My emotional problems begin, then, with a brain that makes some connections that are too weak and others that are too strong. They are compounded by living a world which expects people to have emotions that I don't.  

Children learn to identify their emotions by seeing them modeled by the people and stories that surround them.  We learn that hugs make people feel connected and happy.  If they make us feel constricted and desperate instead, it's deeply confusing.  That makes it very hard for us to learn to understand our own emotional lives.

We learn that our emotional reactions are somehow wrong, and that things are easier if we pretend that we feel the same way about things that other people do.  So there does not seem to be much value in going to the difficulty of understanding our emotional lives.  They confuse us and the people around us so much, isn't better to just pretend they aren't there at all?

No, it isn't.  

And if you have autism, the most important work that you need to do is to learn to understand your own emotions.  If you don't know how you feel, you cannot know what you want or what you need at the time that you want or need it.  If you cannot learn to recognize your feelings, you cannot learn to express them in ways that help other people to understand and care about you.

It frustrates me to no end that people seem to think that the only problem people with autism have regarding emotions is with recognizing the emotions of the people around us.  Neurotypical people do not not understand our emotional lives better than we understand theirs, and they have none of the disadvantages that I've been describing up until now.

Some of the problems that people with autism have with emotions, originate with what I affectionately call "faulty wiring."  For an interesting discussion of one element of this that someone who isn't an expert in neurology, see John Elder Robison's discussion of mirror neurons in his book Be Different.

But some of the problems we have with emotions have to do with lack of education and modeling.  The idea that autistic people have emotions that are different, but no less real and important, than those of the people around us is controversial,  but it is the most important thing I have to say to you about autism.

And, again, because autism is this tendency to make unusual connections in our brains, and those connections effect how we experience emotions, people with autism have a much wider range in our feelings than neurotypical people do.  Two people with autism are not only unlikely react emotionally to an event in the same way a neurotypical person would; they are also unlikely to experience the same emotions as each other.

Of course, it needs to be said that two neurotypical people are also very likely to have different emotional reactions to the same event.  But NT people don't tend to have the experiences of overstimulation that make interacting with others so treacherous for people with autism, and which make our reactions to such basic building blocks of relationships as eye contact and parties so unusual.

There are a few generalizations about the emotional lives of people with autism that I feel comfortable in making, with the caveat that they are tendencies, not rules.

1.  In general, our emotions are simpler than those of neurotypical adults.  They are more like those of children and animals.  However, this tends to be a delay rather than a deficit.  People with autism can learn greater emotional sophistication when they are taught, especially when everyone recognizes how slow and difficult progress will be.  

2.  Because of our tendency to be overwhelmed by the physical and emotional presence of other people, we experience mixed emotions when interacting with others more often that not.  Because of our simpler emotional systems, we find these mixed emotions overwhelming as well.  This is ultimately the root of most meltdowns.

3.  People with autism usually have a harder time dealing with things that are extremely important to us than things that do not matter.  When something matters very much, it's importance becomes something that we need to worry about, and can become overwhelming.  When I want something too much, working toward it can become impossible because the experience of need and desire is too painful.  This is an area where it is very possible for us to support each other, but for the most part we have yet to learn how to do so.

In closing, a few words on theory of mind, the thing that I'm supposed to lack since saying I have no empathy sounds mean.  It's the idea that people with autism have a hard time understanding the thinking of other other people.  It should be clear be now that I think a lot of this comes from the fact that our actual emotional experiences are different from those of most people.

But I think people with autism often have a difficult time with the concept of causality-- understanding how one event results from another.  This is because our brains develop in ways that tend to make relationships between events hard to observe.  This is true for me, whether or not I am trying to guess what someone else would think.