Thursday, April 20, 2006

Tonal agnosia, Asperger's syndrome, high-functioning autism

It seems that psychiatric science is gradually finding a convergence between a number of phenomena and disorders that have to do with social functioning. What was once seen as a "disease" -- so you either had it or you didn't -- is now being seen as a point on a spectrum. At the far end are people who might need to be institutionalized, but as you progress towards the median of "normalcy", you will encounter people who are impaired, or just quirky, or simply who have a personality type of some sort, all of which are being understood as degrees of the same proclivity.

The natural tendency for language to drift during this process can be tricky. If you take a condition which is so debilitating that it requires special care or institutionalization, do those people have a right to feel offended or upset when the name of that condition is later used for what could barely be called a mild neurosis? People who suffer from clinical levels of obsessive-compulsive disorder certainly have a good claim on being annoyed to find people using the same term to refer to an uncle who simply likes all his tools to face left on his pegboard, while they can't even go out without soul-numbing, health-impairing medication.

That's why I'm hesitant to call my own mild disability by any of the names sometimes foisted on it, listed in the title of this post. Each of those terms refers to a clinical condition which can render someone incapable of functioning without assistance in society. Yet advances in psychiatric science are rendering them variations on one common spectrum of behavior, a spectrum on which I fall more than a few sigmas from the median, but still nowhere near clinical levels.

My condition is not easy to describe because I lack something most people don't realize they have. They say that non-verbal communication comprises some very large percentage of interpersonal communication (most sources say 80% or more). This largest part of the bandwidth of human interaction is something that I perceive only dimly and incompletely.

It's tricky, because even if someone tells you the dry "80%" fact, and even if you believe it, and even if you're trying to see the process at work in your own life, you usually can't see it. It's too subconscious -- so much so that becoming consciously aware of it seems to impair it, so most people do not and perhaps cannot sense themselves doing it. Which means they are often incredulous at the idea that I have any kind of real disability when I talk about it, because they can't shake the idea that what I'm missing is "no big deal". They know there's a gulf between words and meanings, but they so hugely underestimate it that they can't take seriously that it matters.

People sometimes get a vague glimpse of this when they're forced to resort to email or text chat media. Everyone pays lip service to the fact that so much gets lost when you can't see the other person, so it's easy to misunderstand, or to have inappropriate emotional reactions. Entire classes of social behavior are attributed to this phenomenon. But if I tell someone "that's what I'm like all the time" they usually still don't get it.

There's a sublime irony in this, though. Since I don't directly perceive a lot of the "tone of voice" and similar things that make up the majority of human communication, I have had to learn by a conscious process how to pick up on these cues. As a result, sometimes I understand those cues better because I see them consciously while others don't, and in many cases can't. I sometimes do better in understanding people on text-only media because, essentially, everyone else is dragged down to my level. In a chat room, I'm the one-eyed man in the kingdom of the blind. And sometimes I better understand the way people think. If you had to build the engine for your car from scrap parts, it would never run anywhere near as well as your neighbor's off-the-lot car, but you'd understand how engines work a lot better than he does.

It's nigh-impossible to convince people to literally say what they mean, because they think they already are. And if you start poking at the fiddly details of the actual words they're using, they just feel attacked. What's even more frustrating is people back-translating what I say. They're reading cues I don't know very well how to give off, which are therefore inconsistent and unreliable, and using them to translate back from what I said to what they'd have meant if they'd said that, which is not what I meant at all. When they react to that, I'm often flabbergasted -- "but that's not what I said!" whereupon they might insist that I did, indeed, say that, or at least mean it. "Don't be coy, don't play stupid, you know perfectly well what it means when you say that," someone might say. I sometimes wish I could pull out some kind of ID card or medalert tag and say, "No I don't, and here's proof!"

As this is better understood, it's becoming clear that it's just a facet of the classic "geek" personality -- the socially awkward, literalist tone many nerd-types have. In a way it means I'm just a geek to an exaggerated, but not clinical, degree. But this revelation does not help any, because alluding to socially-inept geekhood still gives people miscalibrated expectations of my abilities to understand subliminal cues. Plus, it doesn't come off as much of an answer since so many people still think the geek mindset is a voluntary affectation, not a reflection of something that's either learned early or hardwired or both, but in any case, not readily changed.

The worst part of this, though, is when my inability to understand what other people are feeling or what they're really saying causes them to be hurt. In the social dimension I can be like a clumsy buffoon -- when I trip and fall, someone else is as likely to get hurt as I am. And that in turn pains me greatly. Sometimes the impossibility of avoiding that makes me almost paralyzed with anxiety.

But most of the time I can remember that, while I may be more whatever-you-call-it-like than your average geek, enough for it to have a real impact on my life, I'm nowhere near as bad as those with clinical levels of these disorders, who find social interaction almost entirely impossible, and who cannot, therefore, choose and pursue a life they might wish. I can do most everything I want to do, and I'm doing all right at it. I have friends and people who care about me, who can withstand a few unintended social fumbles now and then. I've got it good.


litlfrog said...

Dealing with Aspys can be a little challenging, but I found it much easier once I understood the condition. As a species, we say obvious / polite / technically unnecessary things all the time; I can't imagine what it's like to not have the instinct of when those phrases are appropriate.

HawthornThistleberry said...

An interesting discovery reported in today's news:

The typical brain activity that occurs when most people are resting or daydreaming is impaired or absent in individuals with autism, new research suggests.

The activity in this so-called "resting network" normally aids in the processing of emotional and social cues, "the very things that are abnormal in autism," lead investigator Daniel P. Kennedy noted in comments to Reuters Health.

The resting network is known to be highly active when an individual is at rest.

When someone is asked to perform a mentally demanding task that is not of a social or emotional nature -- like a math problem -- the resting network shuts down or is deactivated, "most likely reflecting a reduction in these unconstrained resting thoughts," explained Kennedy, a graduate student in the neuroscience PhD program at the University of California at San Diego in La Jolla.