«Susan Teresa Ruggeri A Thesis submitted in fulfilment of the requirements of the University Of Wolverhampton for the degree of Doctor of Counselling ...»
1.7.7 Supercharged Brain This approach adopts a neurological explanation of the difficulties encountered in Asperger s syndrome. It suggests that the brain is hyperactive. Szalavitz (2008) describes a supercharged brain that allows for excessive information processing which gives rise to an exaggerated perception that is difficult to integrate into a whole. In her account colours are brighter, detail more defined and every sensation overwhelming. Perception is therefore fragmented, which leads to withdrawal from the world or only paying attention to a small part of it. In order to make sense of all the information that is received it is necessary to narrow down focus and concentrate on a small section. Although this account affords with many of the experiences attributed to people with autism, it is difficult to comprehend how anyone experiencing these extreme sensations could function in the everyday world and not everyone with a diagnosis of Asperger s syndrome has the same experiences.
Baron-Cohen (2008 a) also describes how children with autism go through a period of brain overgrowth in the first few years of their life with their head and brain growing faster than average. He states that at post mortem, on average, the brain is both bigger and heavier in children with autism and suggests that the there is an overgrowth of grey matter which is involved in neuronal computation. The causes of this overgrowth are unclear, although, it may reflect the presence of too many nerve cells but this is not substantiated. He also acknowledges that the differences do not apply to every individual with the diagnosis and that further research is required as these differences are not found in adult brains.
Baron-Cohen (2008 a) also notes that the amygdala, which is a key structure in the brain, is involved in emotional responses and recognising emotions in others, is smaller than average in adolescents but larger than average in young children with autism. The amygdala theory is linked to the Kulver-Bucy syndrome a possible animal model of autism. However Baron Cohen (2008 a) also suggests a credible animal model of autism may not be possible as communication and empathy are far more complex in human beings than other animals.
Work on animal models also provides the basis for the claims of Szalavitz (2008) where the work undertaken by the Swiss Federal Institute of Technology was on rats.
This is an interesting area of investigation but findings made on other animals may not link across species. There is no biological marker for autism or Asperger s syndrome at present and Baron-Cohen (2009) urges caution when interpreting current research findings. Caution must be enacted when considering any of the research that has been undertaken so far into the biological and neurological aspects of Asperger s syndrome as the evidence is far from convincing. It has yet to be demonstrated conclusively that the brains of people with autism are different to people without the condition.
Although people are biological entities their experience is reflective, As Smith, Flowers and Larkin (2009) describe if we adopt a phenomenological philosophy we view a person as being not only embodied but also immersed in the world, interacting with their environment. There is an interaction between biology and environment that helps form and shape human experience.
1.7.8 Extreme Male Brain (Empathising/Systemising) This hypothesis which focuses on the single minded, goal orientated underlying basis of a personality may explain some of the difficulties with humour that could be faced regarding intentionality and the unexpected. According to this theory people with a diagnosis of Asperger s syndrome are average or above at systemising, a drive to analyse or construct systems and below average at empathising, or having an appropriate emotional reaction to another persons thoughts and feelings. Baron-Cohen (2008) suggests the strength of this theory (Extreme Male Brain, Empathising/Systemising,) is that it can account for the social and non social features of Asperger s syndrome. The narrow interests and repetitive behaviours are explained by systemising, with a drive to follow rules and impose structure. A lack of empathy helps explain some of the social, communication difficulties experienced as interacting with others may be difficult if social clues are not attended to.
This theory allows for a reconceptualisation of Asperger s syndrome for rather than it being viewed as something undeveloped or missing, it is thought of as the result of intelligent behaviour. It allows for a different way of thinking and learning, with attention to detail occurring for a positive reason, understanding a system.
The empathising-systemising theory has been extended into the Extreme Male Brain theory of autism. The Extreme Male Brain was an explanation given by Asperger in his 1944 paper that has been followed up by Baron-Cohen (2002). Asperger suggested the autistic personality was an extreme variant of male intelligence. Baron-Cohen, (2002) states there are clear sex differences in empathising and systemising, females perform better on empathising tests and males perform better on systemising tests.
This view of a difference between the way men and women think is common in popular culture but there is no conclusive evidence that men think any differently than women. This view of the Extreme Male Brain has been challenged by Rivers (2006), who claims that Baron-Cohen s (2002) study was not well designed and lacked critical controls against experimenter bias and has not been supported by subsequent research.
According to Baron-Cohen (2009), there may be some biological support for his theory as there is a correlation between babies exposed to high levels of testosterone in the womb and those that go on to develop an autistic trait. The Extreme Male Brain hypothesis may account for some of the clinical manifestations of Asperger s syndrome and also for the fact that the overwhelming majority of people with this diagnosis are male (9:1) but it does not account for all the difficulties experienced by people with a diagnosis of Asperger s syndrome. Further research is required in this area before Baron-Cohen s (2009) suggestions are accepted.
Baron-Cohen (2009), in the recent debate on pregnancy screening for autism describes how autism is often linked with talent and how extraordinary abilities in areas such as mathematics can be demonstrated by people with Asperger s syndrome.
It must be remembered however, that not all savants have Asperger s syndrome. In our society there is a tolerance for people who are good at tuning in to other peoples thoughts and feelings but have difficulty understanding machines as systems. It is hoped therefore that people with autism will enjoy the same forbearance especially as research is putting a more positive slant on the skills and talents of people with Asperger s syndrome.
Extreme male brain theory, again only gives a partial explanation of the difficulties with humour that may be faced by a person with a diagnosis of Asperger s syndrome.
It does however allow for the idea that not all people with a diagnosis have a similar experience and that difficulties, like talents, may be on a continuum. Not all people with the diagnosis are mathematical geniuses neither are they all Mr Bean and that is why it is important to investigate their actual experience rather than make predictions about possible outcomes.
All the hypotheses that focus on the possible cognitive difficulties experienced by people with a diagnosis of Asperger s syndrome provide a partial explanation, either positive or negative, of problems that may be encountered but in many instances they are conflictual. None give comprehensive account of the difficulties that are experienced. Like humour where there have been many theories put forward, none of the theories of the underlying causes of Asperger s syndrome give a full account of the many difficulties experienced. This could be because the explanation has to be multifaceted to match the condition. What this literature review has demonstrated is that although difficulties are acknowledged, these do not appear to be insurmountable.
What is required therefore is focussed research which looks at the real life, lived experience of individuals with a diagnosis of Asperger s syndrome, to investigate their actual experience. By looking at particular people in particular contexts, we can demonstrate the existence of the phenomena and in looking in detail at their accounts we can develop an insight into their actual experiences, highlighting the embodied, cognitive, affective and existential elements of this experience.
1.8 The Current Study At present there is no research that investigates humour from an insider perspective except a single case study (Werth et al 2001). This exposes a gap in our understanding for it is important that we develop knowledge of their actual experience if we are to work towards improving the lives of our clients. Humour plays an important role in our social interactions; it helps secure friendships and alleviates stress. Difficulties with social interactions are a defining category in the diagnosis of Aspergers syndrome. If we are to develop a better understanding of the problems encountered by people with this diagnosis we need to gain an insight into their experience.
The website of the institute for the study of the neurologically typical, written by people with a diagnosis of autism, questions the judgements made about their capabilities. It parodies the idea that some people are hardwired to understand social interaction and others are not and questions whether one way of being is superior to the other. In regard to humour Bauer (2002, p.1) states The common belief that persons with pervasive developmental disorders are humourless is frequently mistaken. If we are to gain a better understanding of the experience of people with Asperger s syndrome we should pay more attention to what people with the diagnosis have to say.
As a counselling psychologist my aim is to ally myself with the needs and views of my clients, developing an understanding of their experiences and working alongside them to bring about positive changes in their lives.
In this literature review I have discussed the triad of impairments associated with a diagnosis of Asperger s syndrome and how this diagnosis is based on behavioural reports: an outsider s perspective. I have questioned the validity of the diagnosis and maintained throughout how important I feel it is to recognise the individuality of people and not make assumptions about their abilities. Humour is a phenomenon that has an impact in many areas of our lives and its complex multifaceted nature has led to difficulty with trying to establish a theory that covers its many aspects. A similar problem has been encountered with trying to establish an underlying theory that covers the many difficulties experienced by people a diagnosis of Asperger s syndrome. What theories have been produced to date of both humour and Asperger s syndrome only give partial explanations. This is why I feel it is important not to make sweeping statements that people with Asperger s syndrome do not have a sense of humour. What is needed is research that examines real life lived experiences, that does not make assumptions and predictions about what will be found but allows actual experience to emerge.
There is a wide gap in the research looking at humour in people with a diagnosis of Asperger s syndrome from an insider perspective and if we are to develop a good understanding of what it is actually like for the individual we have to investigate this area from the inside. Only then will we be able to develop an understanding of what it is really like and from this we should be able to calculate what is actually required to improve the quality of life of our clients. As Moncrief (2007) suggests the way forward for psychologists is to offer help that is useful and empowering.
It is hoped that through this research a better understanding of their experience can be developed and without predicting the outcome it is anticipated that the information it reveals will prove useful in helping bring about new ways of working with people with a diagnosis of Aspergers syndrome.
1.9 References American Psychiatric Association (APA) (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington D.C.: American Psychiatric Association.
Aristotle, (1984) Rhetoric, II, 1389b, 10-11; Nicomachean Ethics, IV, 1128. In J.
Barnes (Ed.) The complete works of Aristotle. New Jersey. Princeton University Press Asperger, H. (1944). Autistic psychopathy in childhood. In U. Frith (Ed) Autism and Asperger syndrome. Cambridge: Cambridge University Press.
Attwood, T. (2000). Strategies for improving the social integration of children with Asperger syndrome. Autism, 4, 85-100.
Attwood, T. (2006). The Complete Guide to Asperger s Syndrome. London: Jessica Kingsley Publishers.
Baron-Cohen, S. (1988). An assessment of violence in a young man with Asperger s syndrome. Journal of Child Psychology and Psychiatry, 29, 351-360.
Baron-Cohen, S. (1989). The autistic child s theory of mind: A case of specific developmental delay. Journal of Child Psychology and Psychiatry, 30, 285-297.
Baron-Cohen, S. (2002). The extreme male brain theory of autism. Trends in Cognitive Sciences,6(6), 248-254.
Baron-Cohen, S. (2008 a). Autism and Asperger s syndrome. New York: Oxford University Press.
Baron-Cohen,S. (2008 b). Mind Reading: The interactive guide to emotions.
www.jkp.com/mindreading Baron-Cohen, S. (2009) Autism test could hit maths skills. Retrieved January 10, 2009, from http://news.bbc.co.uk/1/hi/health/7736196.stm.
Baron- Cohen, S., Wheelwright, S., Robinson, J. and Woodbury-Smith, M. (2005).
Adult Asperger Assessment. Journal of Autism and Developmental Disorders,35(6), 807-819.
Bauer, S. (2002) The Institute for the Study of the Neurologically Typical. Retrieved January 10, 2009, from http://isnt.autistics.org/.
Bauminger, N. and Kasari, C. (1999). Brief report: theory of mind in high functioning children with autism. Journal of Autism and Developmental Disorders, 29, 81-86.
Boyd, B. (2004). A Play Theory of Humor Philosophy and Literature. Laughter and Literature: Volume 28, Number 1, 1-22.
Boyle, M. (1999). Diagnosis. In C. Newnes, G. Holmes, and C. Dunn (Eds). This is Madness, pp.75-90. Ross on Wye: PCCS Books.
Brownell, H., and Gardner, H. (1988). Neuropsychological insights into humor. In J.