"Caetextia
Joe Griffin and Ivan Tyrrell introduce caetextia: a new explanation for the wide range of behaviours spanned by the autistic spectrum – and beyond.
Parallel processing
A
UTISTIC traits are generally recognised as occurring along a spectrum – with severe autism at one end and a higher-functioning, ‘milder’ form (known as Asperger’s syndrome) at the other. The core areas affected, to varying degrees, are ability to understand and use non-verbal and verbal communication; ability to understand social behaviour and behave in socially appropriate ways; ability to think and behave flexibly; and over- or under-sensitivity to sensory information. Even people labelled as having Asperger’s syndrome can vary in the severity and number of traits they display, ranging from severe learning difficulties and low IQ to high IQ and a talent for learning that brings acclaim.
It seems remarkably odd to us that a person who needs specialist help and assisted housing can be included in the same category as a professor of physics, say, or a gifted poet or musician, or a computer programmer who is married with a family – individuals who, despite having Asperger’s syndrome, have managed to make an accommodation with the world and learn enough of the ‘rules’ to function highly efficiently and relate to people to some degree. We suggest that, by looking at the evolutionary history of mammals and humankind, we can arrive at a more comprehensive way of viewing the autistic spectrum than has been offered to date – and that this new understanding can help us help those who seek therapy for psychological difficulties. We are going to put forward the idea that occurring throughout the entire autistic spectrum is a phenomenon that has not previously been identified; that a remarkable mental capacity, one that came to the fore once mammals started to evolve, is missing from all people on the autistic spectrum; and that this major deficit, while it may be just one aspect of what is missing in autism, is uniquely what is missing at the higher performing end of the Asperger’s spectrum. It is the ability to read context. Professor Simon Baron-Cohen of Cambridge University, one of the world’s leading authorities on autism, has suggested that there is a systemising brain (usually associated with the male thinking style) and an empathising brain (traditionally associated with female behaviour) and that we all have varying amounts of each.1 He has provided much evidence for this claim, showing how these sex differences arise more from biological than cultural causes, and goes so far as to support Dr Asperger’s suggestion that the syndrome is an extreme form of the male
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brain.1 However, after many years of working therapeutically with male and female adults with Asperger’s syndrome, as well as interacting with them socially and in business, we believe that the extreme male brain theory of autism, which does at first seem persuasive, is an insufficient explanation for the various deficiencies seen in this syndrome. It does not explain, for example, why many otherwise extremely feminine women show Asperger’s traits but many men who are good systematisers don’t. It was this sense that the puzzle of autism remained that led us to look back to our evolutionary past to search for new clues. The evolution of mammals and birds began when they developed the ability to generate and maintain a constant internal body temperature, irrespective of the external environmental temperature – popularly known as ‘warm-bloodedness’. Reptiles regulate their body temperatures by moving to different places in their environment to get warm or cool down; they can move around quickly only when their blood has heated up and are sluggish when their blood is cold. In contrast, mammals can respond quickly and move around whatever the external temperature.2 But this greater mobility, flexibility and freedom of behaviour came at a high price: a staggering 80–90 per cent of a mammal’s energy is spent on maintaining its constant internal temperature. Compared with a similar-sized reptile, which controls its temperature by external means, this means a fivefold increase in energy requirement. Early mammals couldn’t afford to give way to impulses that would waste energy unnecessarily. So they had to evolve a mechanism which would make them more intelligent in their reactions. Mammals had to develop a brain that could store memories of previous encounters and use these to appraise future encounters more efficiently. In effect, this enabled them to subject every arousing event to a risk analysis: “Does that noise signify potential food – or danger? Should I hide? Am I likely to succeed in catching that rabbit?” They had to make decisions based on the specific circumstances or context that they found themselves in – and do so swiftly, as their survival might depend on it. Even if a rabbit was near enough to chase, it would be wasted effort if a rival could get there first – or fatal, if a bigger predator appeared on the scene.
The brain and context
To see context, we need to be able to attach and detach attention from different objects and
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Caetextia events and see them from different viewpoints. The early behaviourists believed that mammals and birds simply responded mechanically to stimuli, but more sophisticated experiments revealed that there is a cognitive component involved in their response, which relates to prior experience. One significant experiment demonstrated that there is a mammalian intelligence that searches for and assesses relationships between different events – some part of the brain has reviewed the history of past experiences of a similar kind.3 Many subsequent experiments have substantiated this finding. So, millions of years ago, mammals evolved, in effect, a biological form of what computer buffs today call ‘parallel processing’: a mechanism capable of gauging risk by processing multiple streams of current information, at the same time as unconsciously comparing similar, previous experiences with each new one. It is something we take completely for granted today but, millions of years ago, it was the key to surviving and thriving. When we say that the profoundly disabling impairment that runs across the whole autistic spectrum is the inability to perceive context, we mean this mammalian ability to maintain separate streams of attention and switch effortlessly between them to assess the relevance of each to what is currently happening. This can be done only if the brain can dissociate: review what it knows about something it has come across before, while still paying attention to that something in the here and now. Modern brain scientists have ascribed this function to the anterior cingulate gyrus. As one neuroscientist puts it, “This region is active when we need controlled, distributed attention, such as listening to our friend at the party while also watching our colleague dance. It also tells us to forget both of those people and pay close attention to the other side of the room when we sense that potential combatants may start a fight.”4 ‘Context blindness’ – the inability to switch easily between several foci of attention and track them – is clearly seen in autism (the child transfixed by spinning the wheels on a toy car has no sense of a car’s real purpose, for instance) but is the most dominant manifestation of autistic behaviour in high-achieving people with Asperger’s syndrome. We have therefore named it ‘caetextia’, from the Latin caecus, meaning ‘blind’ and contextus, meaning ‘context’. We are suggesting that caetextia is a more accurate and descriptive term for this inability to see how one variable influences another, particularly at the higher end of the spectrum, than the label of ‘Asperger’s syndrome’. If you can read context, it seems like the most natural thing in the world. You might be talking to Maggie about something, for example, but another part of your attention is aware that Jill is listening as well and could read implications into what you are saying that you didn’t intend. So, straight away, because you have this awareness, you are able to alter the way you are speaking to take into account Jill’s possible reactions too. When you can do this easily, it is difficult to imagine not being able to do it. But caetextic people can’t. As a consequence, they also have difficulties understanding complex metaphors because they mainly rely on logical thinking and random associations.
Other theories
Leading researchers in the field of autism have also linked the word ‘context’ to Asperger’s syndrome. Cognitive psychologist Uta Frith, along with others, has put forward a theory of ‘central coherence’, which suggests that, when carrying out tasks, people with autism show a relative failure to process information for contextdependent meaning.5 For instance, it has been found that, if a high-performing person with Asperger’s syndrome is asked to retell a story which they have been told, they are likely to focus intensely on the small details in it – whole sections of whatever they can recall, almost verbatim – but will completely miss the overarching idea, meaning or metaphor. They fail to extract the main idea because they are not sensing context. Frith points out that, if you tell a story to someone who is not on the autistic spectrum and ask him or her to retell it, they can invariably give you the gist: its central meaning. Another theory to explain Asperger’s syndrome and autism was developed by Simon Baron-Cohen, Uta Frith and their colleague Alan Leslie, while all were working at the Medical Research Council’s Cognitive Development Unit in London in the 1980s. It proposes that people with autism lack ‘theory of mind’: what is missing in autism is the ability to read other people’s minds and, from that, to predict other people’s behaviour.6 As Frith describes it, “Thinking about what others think, rather than what is going on in the physical world outside, is essential for engaging in complex social activity because it underpins our ability to cooperate and to learn from each other. Our research has shown that theory of mind is either absent or severely delayed in autistic individuals and that this can explain their difficulties in social communication.”5 Frith is now looking for a way to relate the theory of central coherence to the theory of theory of mind. We propose that the theory we are putting forward does just that and also provides a much richer view of context than the theory of central coherence. To us, central coherence and theory of mind are limited examples of the deeper principle we are describing, which is the crippling inability to see the world from multiple perspectives and to recognise how sudden change can alter a current situation.
Examples of context blindness
A friend of Joe’s, who had Asperger’s syndrome, used to stand in front of a mirror and brush the front of his hair, but never the back. The image he saw in the mirror didn’t show the back of his
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Caetextia head and, clearly, he was not relating the image he saw to a bigger ‘picture’ of his head as a whole. He was genuinely unaware that a human being can be seen from all angles and that, therefore, he should comb his hair back and front, if he wanted to make a neat impression. Clearly, there was a major category of information missing in his mind: being able to view a situation from different perspectives (context). Sarah, a woman with Asperger’s syndrome, was asked by a friend what she thought of an expensive fancy handbag the friend had just bought. Sarah didn’t like the bag and was completely nonplussed as to how to respond. She could see only two possibilities: to tell the truth, which was that she disliked it, or to say nothing. She was unable effortlessly to juggle in her mind conflicting perspectives (not liking the bag, liking the friend) and choose an appropriate one to communicate, on the basis of a wider knowledge of the possible consequences (upsetting or pleasing her friend). She was unable to see, for example, that an honest opinion is not always required in such circumstances; she could have pretended to like the bag, complimented her friend for buying it, or told her that it was a bargain. In fact, she said nothing at all, which totally perplexed and unsettled her friend. (This inability of people with Asperger’s syndrome to be tactful or diplomatic is often interpreted as frank honesty.) A very intelligent man who had Asperger’s syndrome used to come out in a rash whenever he was anxious, which bothered him. One day, he read in a health magazine that mustard was good for skin rashes and promptly bought an industrial-sized pot of it, so that he could plaster mustard over his face every day. It never occurred to him that customers in the shop he managed would think it odd to see him walking around with a bright yellow face. Another man with Asperger’s syndrome, also highly intelligent, described to us how his wife gave him a little box of chocolates just before they went out to celebrate his birthday and said, “You can eat the whole box while I go upstairs to get ready”. When she came down a little later, dressed for their night out, she found him eating the cardboard box. She immediately got angry and shouted at him – but he had absolutely no idea why. After telling this anecdote, he said, “It seems as though other people have a concept to follow that I am missing. I just follow the instruction.” If he had had instant access to the knowledge that humans are not expected to eat cardboard boxes, just the contents of the box, he would not have engaged in this bizarre behaviour. (Interestingly, such literalism can also be observed in people in deep trance.) Another example: a professional woman who came to see one of us had decided to give up her job in a bank and go and live in a Buddhist meditation centre. Although she was keen to do this, she was also very sad and upset because she would never see her mother again. When asked
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why, she said, “My mother’s a Catholic”. She assumed that, if she went to visit her mother, she would have to tell her about her own change in religious belief, and that her mother wouldn't be able to cope with it. It didn’t occur to her that people of different faiths can still know and love one another, especially if they are family; or that she could choose to protect her mother from what she thought would be devastating information for her, and just continue to go to Mass with her mother whenever she was home. Clearly, in such cases, people lack the information necessary to inform their judgements about the choices and actions available to them in different situations.
Struggling to cope
It is, therefore, easy to see why people with caetextia experience high levels of frustration, anxiety and anger when other streams of information keep intruding into whatever they are trying to do – especially when their needs for structure, rules and rituals are transgressed. Because they don’t know instinctively that multiple factors affect any given situation, they may be nonplussed even when just two simple interacting factors require attention. We saw this clearly in the jerky way a colleague with Asperger’s syndrome would drive. Whenever he became aware that a gap between his car and the one in front was closing or widening, he responded by jamming on his brakes or speeding up inappropriately, instead of gently moderating his speed to accommodate what is, after all, a continually fluctuating situation when driving. He found it difficult to negotiate varying circumstances smoothly – other drivers changing speed, closeness to other vehicles, the curve of the road, weather conditions, etc – all of which need constant simultaneous attention. On one occasion, he was in the wrong lane when approaching a set of traffic lights. When it was pointed out to him that he needed to move over to the right lane, he refocused his attention on this new task and was unable at the same time to continue processing and prioritising other relevant information – such as the fact that the light had changed to red and that driving through it could get him and his passengers killed. Indeed, he proceeded to drive on through the red light, causing us much alarm and consternation! Although he was aware of this deficit, and described it as ‘straight-line thinking’, he was unable to do anything about it.
Joe Griffin is a psychologist and psychotherapist. He is director of studies at MindFields College and co-founder, with Ivan Tyrrell, of the human givens approach.
Ivan Tyrrell is principal of MindFields College and editorial director of Human Givens.
Dancing with horses
A dream, by chance related to Joe by his teenage daughter Liley-Beth, served to crystallise our thinking about the role of context. In the dream, she went to a club with a horse; all the other girls there were dancing with horses and she, too, started dancing with a horse; it seemed the most natural thing in the world. Then the horse asked her out and she was just wondering whether to accept when she woke up. When Liley-
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Caetextia Beth described the dream over breakfast, she said that what astonished her most about it was her unquestioning acceptance, in the dream, that humans can go out with horses. Everyone who remembers dreams will recognise this feeling of accepting as perfectly natural a phenomenon that is actually distinctly odd: it is the same as that described by the man who had felt it was natural to eat the cardboard box – except that he was awake. So why did Liley-Beth unquestioningly accept, as we all do in dreams, such bizarre happenings? The reason has to be that in dreams we have access to emotions and metaphor but not context because, while dreaming, the prefrontal cortex, which the right hemisphere draws on for background information, is switched off. The context missing in this dream was the information that humans do not go on dates and dance with horses; horses can’t walk around on two legs and speak like humans. Because, in the dream, Liley-Beth was cut off from the background information usually available to her, she was totally accepting of the validity of the dream imagery. Exactly the same thing appears to be happening in the experience of people with Asperger’s syndrome (caetextia). They accept absurdities as true and make judgements about them, without the background information to apply to the context they find themselves in. For those of us not permanently suffering from caetextia (it can be a temporary phenomenon, too, induced by stress and anxiety and depression), our minds can unconsciously draw on a vast hinterland of information that informs different aspects of any situation we find ourselves in. People with caetextia cannot do that because, although they may have collected millions of individual ‘facts’ in their memories, they are missing the ability to scan instantly for patterns in that rich background of information. Consequently, when something changes, they can’t evaluate the importance of the change and how it affects what is going on in the wider environment. They can no more do a reality check while awake than anyone else can while dreaming. on the autistic spectrum experience is because of their inability to process within themselves the changes going on around and within them. As they struggle to moderate their feelings, the only hope they have of reducing the pain that this sensory overload causes them is to try and control the environment and other people as much as possible. ..."
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