REJECTION AND ASPERGER'S SYNDROME
by Scott Hoge
(Click here to download this essay)
Despite the rich and luxurious technological advancements we've made in the last century -- television, computers, spacecraft, computer software, video games, digital effects in movies, and wireless devices, not to mention treatments and cures for diseases and advances in theoretical knowledge -- an alarming degree of negative popular attention has been given to so-called 'nerds,' 'geeks,' and 'dorks' who pioneer these advancements and make life comfortable for their attackers, even if only for being slightly awkward in appearance or manner. The style of thinking of many of these bright individuals is formalized and intellectual, and there is even a label given to those who show patterns of social isolation and intense absorption in developing a skill: Asperger's Syndrome.
In this essay, I will suggest that Asperger's Syndrome can be caused by rejection alone, no matter who you are, and expound on some of the positive traits associated with it. There is no true mark of the person with Asperger's Syndrome. Whether or not someone 'has it' is entirely a matter of opinion, and throughout the essay, I will therefore say people diagnosed with Asperger's Syndrome rather than people with Asperger's Syndrome to give respect to this important fact.
I, myself, have been told I have Asperger's Syndrome by two clinicians, though I have come to expressly disagree with them. As I will propose, being diagnosed say little about you other than that you may have been ostracized, even out of fear or jealousy. Later, I will offer a rationalization of the 'geek' stereotype. While I have rejected the label itself, I will still say 'we' to refer to the diagnosed and expect that no misunderstanding will take place. (I'm somewhat averse to being told I 'have' it.)
In 1944 (one year before Adolf Hitler died), Hans Asperger published a syndrome he called 'autistic psychopathy' after studying the behaviors of a group of children, some of whom exemplified the traits mentioned above. Over time, the diagnostic criteria have been revised, and today we have in the DSM-IV what is called Asperger's Syndrome. It may be that 'psychopathy' was just not considered an appropriate term to describe the collection of relatively harmless behaviors observed in the children he studied. Even today, people diagnosed with Asperger's Syndrome have committed very few crimes.
There has been some suspicion that excessive permeability of the intestinal wall is indirectly responsible for the syndrome and its traits, and that consumption of wheat and dairy products allows certain peptides ('gliadomorphins' and 'casomorphins') to leak into the bloodstream from the intestines and enter the brain, where they act as extremely powerful opioids that alter social behavior. Although I have been a lifelong lover of many of these foods, I got checked for this condition and my lab results came back negative with my peptide assessments in the normal range.
I will now show with a diagram that social rejection by itself might be able to create the symptoms of Asperger's Syndrome, and explain how a diagnosis, even when done at random, can encourage rejection.
THE DSM-IV DIAGNOSTIC CRITERIA FOR ASPERGERS SYNDROME *     *     * To conclude the essay, I will give a brief summary of everything I've discussed.
(A) Qualitative impairment in social interaction, as manifested by at least two of the following:
(D) There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)
(E) There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.
(F) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.
How can a diagnosis lead to rejection? For one, children and their parents have already expressed frustration with namecalling and bullying. It seems that 'ass burger' is the most frequent insult, and there are others. Second, when a social group learns that a member has been diagnosed, it can inspire wariness and mistrust. Finally, the syndrome and its stereotypes have been depicted in characters ridiculed in the media.
On a side note, what else can lead to rejection? It could be anything: glasses, motor clumsiness, a slightly unusual appearance or voice characteristic, introversion, bold nonconformity, high intelligence, an interest in advanced subjects, or a willingness to challenge social norms with new ideas. The likelihood of anyone's being rejected also varies between social groups. A team of enlightened scholars will respond differently to someone than a gang of hoodlums. Medieval plays will attract different audiences than rock concerts. A diagnosis of Asperger's Syndrome can say just as much about the group to which one belongs -- and sometimes inevitably belongs -- as the patient.1
How can rejection lead to a diagnosis? The answer is shown in the diagram: by the combination of criteria A2, A3, and B1. Rejection, we may suppose, leads to failure to develop peer relationships ('appropriate' to developmental level, something the clinician gets to decide) and a lack of desire to share one's interests with those who rejected him or her, meeting two criteria of group A and thus the first requirement in one fell swoop. Finally, if rejection inspires one to compensate by specializing and developing a talent or skill in one area, then the final requirement is met through the satisfaction of one criterion of group B.
So if you're cast out -- or even just choose to be alone -- and you decide to pick up a hobby, then they can diagnose you with Asperger's Syndrome. It's that easy.
Though clinicians have been quick to call specialization 'abnormal,' the decision to specialize may be seen as a natural, positive, and intelligent reaction to separation from one's peer group. In fact, specialization is important to economics itself, as we trade our best service for another's. Surely there's nothing psychologically defective about being good at something!
Now, I'm not at all denying that there could be differences in brain structure that lead to these traits. I'm simply pointing out that the DSM criteria are so vague that all it takes is rejection, or even just an introverted personality, to be diagnosed with Asperger's Syndrome. As I will explain later, clinicians tell us that they are specially trained to make competent judgments in these cases, but the vagueness in the criteria can be plainly seen and we must be wary of hidden factors like company greed. I'm not saying that everyone who has Asperger's Syndrome is rejected, either -- only that rejection in particular can cause one to fulfill the criteria. Giving someone Asperger's Syndrome might even in some cases be seen as a form of social abuse.
1However, I must disagree with Temple Grandin's remark that dressing differently will cause you to be teased 'absolutely and always' (The Unwritten Rules of Social Relationships, p. 312), which, in my opinion, could provide bullies with the incentive to tease in order to justify the claim.
Other Traits Associated with Asperger's Syndrome
Over the years, we've built up a 'geek stereotype.' While tendencies toward pedantry, black-and-white thinking, preference for order, and Theory of Mind deficits are not mentioned in the DSM criteria, they are nevertheless associated with Asperger's Syndrome. And while many of these personality traits can result from social isolation, not all of them are negative. Some of them even coexist with high intelligence. In what follows, I will offer explanations for what they amount to.
A common trait associated with Asperger's Syndrome is a formal and pedantic style of speaking. Colloquialisms and figures of speech are more often avoided, and the speaker adopts a plain and grammatically correct way of expressing his or her thoughts. A plausible explanation for this is a fondness for textbooks. When one spends more time acquiring knowledge or developing a talent by reading books than interacting with others face-to-face, he or she may learn to speak 'like a textbook' and handle grammar extraordinarily well, even in an informal social setting. This may be seen as a positive quality: good grammar allows one to express oneself with greater depth and clarity.
A tendency not to use figures of speech could arise from a lack of in-group knowledge of them (due to rejection, for instance), an acquaintance with textbooks as suggested above, or a distaste for obscurity and a preference to be explicit.
Another associated trait is 'black-and-white thinking.' There are several definitions of this term:
As an example of good black-and-white thinking, consider sense (4). Scientists draw up their theories according to mathematical principles and, even in the case of quantum mechanics, arrive at a logical framework of the universe in which statements about the world are 'definitely true' or 'definitely false.' According to relativity, for instance, it is definitely true that energy and mass are related by the equation E = mc2 and that a freely-falling projectile follows a geodesic curve through spacetime. As one advances to contemporary physics one finds that waves are governed by laws of probability, and while statements about the outcomes of events in the world may lose their certainty, claims about their likelihood may still remain true or false. It is even suspected that these probabilities arise from actual world-splitting (see another essay of mine, Many-Worlds and the Origin of Life in the Universe). Theories of the universe may, of course, be refuted, but they have been so useful and have advanced our technology so marvelously that one might exercise caution before challenging the scientific mode of thinking.
As another example, consider sense (5). In standard mathematics, statements are either true or false. No statement can be true and false at the same time, nor are there statements with gray-area truth values, except as artificial constructs within standard mathematics -- such as in probability or fuzzy logic -- and even they can be reduced to true-or-false statements. For instance, although sentence S might have a truth value of 0.47, the statement "Sentence S has a truth value of 0.47" is still true with a truth value of 1. Excitingly enough, there is debate over whether certain statements that cannot be proven or disproven in standard mathematics, like the Continuum Hypothesis, are actually true or false. The truth status of the liar statement, "This statement is false," is still under discussion. Additionally, some have challenged the validity of the Law of the Excluded Middle. Is there gray area in mathematics? The controversy has not yet settled.
Science and mathematics still leave room for gray area in matters of opinion. In fact, the holding of an opinion is expressible in a true statement, as "Ice cream tastes good" in "Jim likes ice cream." Some believe that there is gray area in moral judgment as well. Morality deals with a wide range of ethical systems, each with its own strengths and weaknesses: utilitarianism, duty-based ethics, virtue ethics, and religious ethics are a few examples. Just as in mathematics, there is still controversy over whether gray area truly exists in the realm of morality.
The proclivity to think mathematically may be a positive adaptation brought about in part by the sudden burst in technological progress . If so, then the genes of those lucky enough to be born with the skills to understand and use the technology would proliferate more quickly, and the notable talents associated with Asperger's Syndrome may have arisen through the recombination of these traits.
Need for Sameness
A preference for organization and routine can also, in many cases, be seen as a positive trait. The greatest philosophers and scientists of history -- Newton, Kant, Einstein -- including the earliest Greek philosophers, have admired orderliness, attributing it even to divine intelligence. Orderly perfection today is sought in the crafting of jewelry, in the manufacture of technology, in the formation of scientific theories, in neatly-kept households, in dance, in artwork, in music, and perhaps even in the universe itself.
Given all this admiration for the splendor of natural beauty, it may, again, be questioned whether 'need for sameness' is even a defective trait. Diagnosed children might line up their toys out of the same appreciation for orderliness as brilliant scientists invent their theories and master composers write their music.
Social Skills and Theory of Mind
People diagnosed with Asperger's Syndrome are sometimes accused of breaking 'unwritten rules' and having Theory of Mind deficits. A Theory of Mind is supposed to be the feature of our cognition that allows us to understand everything that makes another person who he or she is: beliefs, values, knowledge of facts, attitudes, feelings, emotional states, likes, dislikes, and so on.
Understanding is one thing, but practice is another. How do you use a Theory of Mind? Your own traits, including the way you look, your voice characteristics, your likes and dislikes, and your overall mood, affect your social status and others' reaction to you. The decision of your social group to accept or reject you depends not only on your Theory of Mind or absence thereof, but also on your own traits. Being disliked by a group for your traits doesn't mean you lack a Theory of Mind. In such cases, an absence of empathy or social intelligence must not be inferred.
It is rather unusual that victims of rejection and bullying are charged with a Theory of Mind deficit, rather than the bullies themselves. Perhaps even more importantly, accusing someone of having a 'lifelong Theory of Mind deficit' could call into question whether that person is even capable of understanding the value of other's happiness. We would like to think that when we see couples together, we can be happy for them, even if we ourselves are single. To be told that one is unable to comprehend the value of the relationship and 'stuck in jealousy,' so to speak, could be taken as a great insult. There is even a kind of intellectual terrorism in the phrase, 'eternal recurrence as only oneself,' a subject dealt with in philosophy.
Now, onto rules of etiquette: What are unwritten rules? In our context, a rule is a guide for what to do or what not to do in a social situation. At a formal dinner, "Don't spit on another's food" might be a rule. Another might be, "If you are in charge and you see someone spit on another's food, escort him or her out of the room." These rules have the advantage of being useful to the person who might otherwise break them.
But what kind of rule is, "Don't break the unwritten rules"? In what way can this rule be interpreted or used? In what way should it affect us, and for what purpose do we announce that someone has broken it? I'm going to give an answer that will likely be considered controversial. To the person who is allegedly in the habit of breaking it, the prohibited action is an unknown action whose decision supposedly results from bad judgment. But because the rule is unwritten, he or she is unable to discern whether the rule is something innate or something that ought to be inferred from good sense, and thus known beforehand, or something arbitrarily made up by the group-in-power, whose violation is decided on a case-by-case basis.
Because of this, even the concept of an 'unwritten rule' is open to abuse. The group-in-power might make an unwritten rule that no fat people are allowed, or that boys with glasses shouldn't talk to girls. We see, therefore, that even a group's intolerance of someone's appearance can masquerade as an unwritten rule.
Neither Aliens, Nor Machines, Nor Snakes
In addition to the 'geek stereotype,' people diagnosed with Asperger's Syndrome are occasionally given the surreal stereotype of the 'alien.' Temple Grandin once called it, 'Oops, Wrong Planet Syndrome,' and a highly popular website called WrongPlanet, based on her remark, features a little green alien on its title.
This stereotype might be seen as cute by many, but we must be careful not to scapegoat the diagnosed as evil, uncaring people, even on the partial basis of the terrifying depictions of aliens in movies and in other media. In general, we, the diagnosed, are not the kind of people who would actually perform gruesome experiments upon innocent captives, and in fact, we are surely more often than normal the victims of medical malpractice ourselves.
Occasionally, the diagnosed are compared to machines. We say things like, "He's having a meltdown," or, "He thinks like a computer." Unlike machines, however, human beings have specific needs. We need food, entertainment, social encouragement, and intimacy. To marginalize the human component of a person diagnosed with Asperger's Syndrome, or for that matter, with any autistic condition, would be to commit a grave fallacy.
Nor should we unduly make comparisons of the diagnosed to snakes based on the sound of the label, or accuse the diagnosed of being 'evil sinners,' especially on the basis of the DSM criteria given earlier. We are not minions of Satan, nor should we be thought of as such. Further -- and I say this with foresight -- any hostile reaction of ours to torture or oppression by Christians would not justify the oppression itself or "mean that we are snakes," as in the first place such an argument would rest on the Fallacy of Circular Cause and Consequence.
Asperger's Syndrome: Who 'Has' It?
There has been a lot of talk about whether someone, living or dead, 'has' or has had the syndrome, as if Asperger's Syndrome were some mysterious lump in the brain that you could measure and say, "Yep, he has it," or, "No, he doesn't." As we observed very early on, the DSM criteria for Asperger's Syndrome are highly opinionated -- so much so, in fact, that every single criterion is opinionated. What is 'abnormal'? What is 'appropriate'? What is a 'marked impairment'?
Hearing these questions, clinicians will get wise and try to tell you that their educational background and medical training justify the diagnosis. They'll make probability assessments and tell you that they're "90% sure you have it," or "99.9% sure," or whatever figure sounds cute and relevant to them, when in fact, two clinicians can disagree. In truth, it's entirely a matter of opinion whether or not you 'have' it.
Here is my advice to the diagnosed: if you don't like being told you lack a Theory of Mind, or the 'ass burger' joke, or the stereotypes, or the presumptuousness and finickiness with which people might treat you, then you don't even have to tell people you have Asperger's Syndrome. Because the criteria are all opinionated, any judgment that you have Asperger's Syndrome is opinionated. If you choose to say that you have it -- perhaps to give people an impression of your talents -- that's fine. But if you choose to reject the label, you may. All you have to say is, "They tried to diagnose me, and that was that."
Medical companies are like any other company. They sell products and services to their customers and make a profit. As companies, they are vulnerable to the same Machiavellian temptations of deceit and trickery as almost any other. Think of fast food commercials that exaggerate the tastiness of their meals, weight loss advertisements with cleverly-worded phrases and loads of fine print, or any service that hides their hidden fees, flaws, and imperfections until the very last minute. In a similar way, telling you that you have Asperger's Syndrome could simply be someone's way to convince you that there's something wrong with you, and that you need their product.
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To conclude the essay, I will give a brief summary of everything I've discussed.