Saturday, October 27, 2007

Perspectives on Autism

Though all the reading for this week was interesting, I made an immediate connection between the novel “Banishing Verona”, and Dr. Sack’s chapter of “An Anthropologist on Mars” by the same name. There seemed to be a profound understanding in both pieces of how autism can fit into the broader life of an affected individual. And I was moved by the underlying story in both accounts of a person living with autism, in contrast to an account of how an autistic person is forced to live life.
Years ago I had an English teacher who insisted that everything human beings said and did was motivated by a desire to be emotionally close to one-another. Parties, sex, drugs, music, television; she insisted all of these were attempts to share something. In her opinion human sentience was such a lonely existence that part of our “drive” as a species was to achieve some kind of connection with another person.
I’ve always thought she was over-simplifying things. I know there are times in my life (perhaps most of the time) when I want to be close to others, to be on the same page and have a kind of mutual understanding. But there are also times (definitely less often, but equally as distinct) when I want the opposite. Sometimes I don’t feel the need, for whatever reason, to form an artificial connection with someone I really don’t like, or I find myself in one of those moods in which I’d much rather be by myself for a while then surrounded by lots of other people.
When Dr. Sacks asks Temple if, when she looks up at the stars, she does not “get a feeling of grandeur” I was moved by her simple response. “I intellectually understand its grandeur”, she tells him wisely. This struck me as an incredibly honest and perceptive thing to say. I know I occasionally have the experience of being moved intellectually, rather then emotionally, by a sight such as the night sky. It is rare for an individual to always see things in terms of grandeur and awe; we’d wear ourselves out if everything around us produced such wonder.
Though I can’t possibly know the kind of isolation and feeling of being inherently different that some people with autism describe, I can sympathize with the feeling of not always being entirely in touch with my own emotions or those of the people around me.
Thus, I was pleased to find a fair amount of optimism and empathy in both Dr. Sack’s case study involving Temple Grandin, and the pages of “Banishing Verona”.
When Oliver Sacks describes Temple Grandin he includes his own account of the way in which she goes about her life; her dedication to her work, her own opinions about the way in which her mind is different from other’s, and her level of compassion and almost supernatural ability to empathize with herd animals. But included in his account there is also a marked understanding of the role that human interaction and emotional understanding play in Temple’s life. Sacks seems to understand that Temple’s mind isn’t merely a hallow shell, filled pitifully by her work and her logical reasoning, but is instead the hopes and confusions of a complicated and evolving human being. As always, Sacks seems optimistic in his description, continuously emphasizing both the ways in Temple is unique, and the ways in which she is striving to understand her own different.
Like Sacks, Livesey is in many ways compassionate in her description of an individual affected by Aspergers. For what does Livesey emphasize if not the idea that we’re all a bit in the dark when it comes to relationships and human interaction? What does Zeke portray if not the sort of difficulties in communication understanding that we all have to lesser extent? At one point in the book Zeke points out that sometimes, when it is socially expected of him to offer a greeting, he just doesn’t feel like it. Can’t we all sympathize with this on some level? We smile at someone even though we’re not really fond of him or her, or we stop to make small talk even if we’re in a rush to get somewhere. I know there are moments when I follow social conventions not because I feel the desire to do so, but merely because I know they are expected.
Thus, I found both Sack’s and Livesey’s perceptions of autistic patients to be refreshingly open-minded. Both chose to see human life as something broader then merely the connections we form with others; chose not to define a person’s existence merely by the ease with which they connect emotionally. Rather then seeing a high-functioning autistic individual as someone who will never be able to function in certain ways, shouldn’t we view them instead as demonstrating just how difficult communication and understanding can be for all of us? If we choose to see autistic individuals as sharing somewhat accentuated aspects of our own personalities, rather then seeing their limitations and deficits, perhaps we can better understand the mindset of those affected.


Lauren S said...

I thought "An Anthropologist on Mars" was one of the most compelling case studies we've read by Sacks. Perhaps it was because of his subject, Temple, and her ability to articulate her experience of autism. It seemed to prove what I think was at the heart of all this week's material, that autism is not something to be cured, but what's needed are more doctors like Sacks, people who strive to make the difficult parts of autism and Asperger's easier to manage, while nurturing all that is positive. The sufferers don't need to be changed; they need to be understood.

I did worry a bit about Stephen, though, and other autistic savants, that they are treated a bit like freak shows to fascinate, amuse, or entertain. At one point, as a child, when his art teacher left, he stopped drawing unless he was reminded to do so ("Stephen seemed to lack the initiative to do much drawing on his own. It seemed as if he needed another person to get him going, to 'facilitate' his drawing," ANTHROPOLOGIST, p. 207). Is Stephen happy to be drawing on command? And is Temple lonely? I don't think she would give up who she is just for romantic--and platonic--companionship, but it does make me sort of sad to think about her chosen life of celibacy.

On the back of BANISHING VERONA there is a blurb from the NEW YORK TIMES that says "Livesey is interested not in medical conditions but in the human condition.... [she] expands ... our notion of what being human can mean." I think this is also Sacks's mission in presenting his case studies as such richly detailed stories. In VERONA, Zeke rarely struck me as having something wrong with him, whereas I'd say something was very wrong with his parents, Toby, and Henry. Based on the Sacks readings and the NEW YORKER essay I'm not sure Livesey completely captured in Zeke what it's like to live with Asperger's, but I appreciate the mission of her novels.

Hilary said...

The most interesting thing about the aspects of autism as encountered in the reading is that, unlike the other symptoms we've studied where there is clearly a deficit, they only seem to function differently, not necessarily wrongly. Autism is highly mechanistic instead of emotional, which gives those afflicted with it (and Temple, for instance, would disagree that it is an illness) a differing perspective on the world. They are able to see patterns with stark clarity, disregarding the interchange and emotional taxation we place on each other, and by not engaging themselves in society's games, they are able to take a look at it in such a distinct way that it becomes a "deficit" to us.

Of course, it helps that Temple is so able to articulate what it is like for her -- not all autistic people are able to adapt themselves into our society; it's rather as if they have their own. Stephen and the other savants are clearly mentally crippled, at least by our distinctions, but have the ability to do one thing marvelously well. As they are so involved in the mechanistic aspects of function, however, it seems almost silly to force autistics to conform to our idea of society and emotional roots; it makes as little sense to them as being told to think entirely like a computer, taking no account of emotion, would to us.

I agree with Lauren that Zeke didn't seem to be the most "afflicted" character in the book; the other, purportedly "normal" people seemed much more dysfunctional, which I think might have been a purposeful choice on Livesey's part. I got the sense early in the book that something was off with him (reminding himself about greetings and emotions) and it was, as I noted in relation to Hazel in the Missing World, probably as accurate as somebody who does not have the condition and is not a neurologist can relate it. What I found the most touching was how the mechanistic and emotional divide was bridged, and Zeke had the ability to fall in love. Maybe Temple can eventually too...

Stephanie said...

I agree about the similarity between Sacks' and Livesey's approaches. I also think that this approach can have a huge impact on someone who has been labeled "unreachable." I know this was fictional, but Zeke was able to get on an airplane because of a connection with another person. Stephen responded to Margaret's encouragement, and he even declared that he would stay by her side when she had an asthma attack. If some autistic people's lives are "vivid, isolated moments, unconnected with each other... and so devoid of any deeper continuity or development," as Sacks suggests, then it would be even more important for him to establish a positive, attentive, genuine presence in their lives. Even if there was no hope of "healing" to the point of a continuous narrative, I imagine that it would still be meaningful to have positive interactions in the isolated moments. Sacks later says that "it is not affect in general that is faulty but affect in relation to complex human experiences." I just glanced at Lauren's comment to the left and noticed that she pretty much said what I'm trying to say, albeit more articulately: that putting care and effort into helping someone might not be the means to an end. It might be the end itself. Instead of focusing on how to change and "cure" a person, Sacks focused on how to help them live a meaningful life, given their particular set of surpluses and deficits (which we all have, anyway, to a certain extent.) It makes me think of the scene in Awakenings (the film, though I'd imagine it's in the book as well) where Robert DeNiro's character is consumed by twitches and tics. They are exacerbated when staff in the hospital forcibly try to calm him. However, when his friend takes his hand and begins to dance with him, and his whole body relaxes, lost in the dance. He wasn't cured - the tics started again once he finished dancing - but he was given the gift of that dance.