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Caetextia: a new definition of autism and Asperger's

Caetextia: a new definition of autism and Asperger's



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Supposing that, throughout the entire autistic spectrum generally, there is a phenomenon occurring that has not previously been identified? What if a remarkable mental capacity, one that came to the fore when mammals first appeared, is missing from people on the autistic spectrum? And what if this significant deficit is uniquely what is missing at the higher performing end of the Asperger's spectrum? It is the ability of mammals to read context, something all autistic people have difficulty with.

Caetextia = 'context blindness', a chronic disorder manifesting in the inability to adjust behaviours or perception to deal appropriately with interacting variables (i.e. context)
Supposing that, throughout the entire autistic spectrum generally, there is a phenomenon occurring that has not previously been identified? What if a remarkable mental capacity, one that came to the fore when mammals first appeared, is missing from people on the autistic spectrum? And what if this significant deficit is uniquely what is missing at the higher performing end of the Asperger's spectrum? It is the ability of mammals to read context, something all autistic people have difficulty with.

Caetextia = 'context blindness', a chronic disorder manifesting in the inability to adjust behaviours or perception to deal appropriately with interacting variables (i.e. context)

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Published by: Human Givens Publishing Official on Jun 02, 2009
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VOLUME 15, NO.4 – 2008
UTISTIC traits are generally recognised as occurring along a spectrum – with severe autism at one end and ahigher-functioning, ‘milder’ form (known as Asperger’ssyndrome) 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 andbehave flexibly; and over- or under-sensitivity to sensory infor-mation. Even people labelled as having Asperger’s syndromecan 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.
 Joe Griffin
Ivan Tyrrell
introduce caetextia: a new explanation for the wide range of behaviours spanned by the autistic spectrum – and beyond.
Parallel processing 
However, after many years of workingtherapeutically with male and female adults with Asperger’s syndrome, as well as interacting withthem socially and in business, we believe that theextreme male brain theory of autism, which doesat first seem persuasive, is an insufficient ex-planation for the various deficiencies seen in thissyndrome. It does not explain, for example, whymany otherwise extremely feminine women show Asperger’s traits but many men who are goodsystematisers don’t. It was this sense that thepuzzle of autism remained that led us to look backto our evolutionary past to search for new clues.The evolution of mammals and birds beganwhen they developed the ability to generate andmaintain a constant internal body temperature,irrespective of the external environmental temp-erature – popularly known as ‘warm-blooded-ness’. Reptiles regulate their body temperaturesby moving to different places in their environ-ment to get warm or cool down; they can movearound quickly only when their blood has heatedup and are sluggish when their blood is cold.In contrast, mammals can respond quickly andmove around whatever the external tempera-ture.
But this greater mobility, flexibility andfreedom of behaviour came at a high price: a stag-gering 80–90 per cent of a mammal’s energy isspent on maintaining its constant internal temp-erature. Compared with a similar-sized reptile,which controls its temperature by externalmeans, this means a fivefold increase in energyrequirement. Early mammals couldn’t afford togive way to impulses that would waste energyunnecessarily. So they had to evolve a mechanismwhich would make them more intelligent in theirreactions. Mammals had to develop a brain thatcould store memories of previous encounters anduse these to appraise future encounters moreefficiently. In effect, this enabled them to subjectevery arousing event to a risk analysis: “Does thatnoise signify potential food – or danger? Should Ihide? Am I likely to succeed in catching thatrabbit?” They had to make decisions based on thespecific circumstances or
that they foundthemselves in – and do so swiftly, as their survivalmight depend on it. Even if a rabbit was nearenough to chase, it would be wasted effort if arival could get there first – or fatal, if a biggerpredator appeared on the scene.
The brain and context
To see context, we need to be able to attach anddetach attention from different objects andIt seems remarkably odd to us that a personwho needs specialist help and assisted housingcan be included in the same category as a pro-fessor of physics, say, or a gifted poet or mu-sician, or a computer programmer who is mar-ried with a family – individuals who, despitehaving Asperger’s syndrome, have managed tomake an accommodation with the world andlearn enough of the ‘rules’ to function highlyefficiently and relate to people to some degree.We suggest that, by looking at the evolution-ary history of mammals and humankind, we canarrive at a more comprehensive way of viewingthe autistic spectrum than has been offered todate – and that this new understanding canhelp us help those who seek therapy for psycho-logical difficulties. We are going to put forwardthe idea that occurring throughout the entireautistic spectrum is a phenomenon that has notpreviously been identified; that a remarkablemental capacity, one that came to the fore oncemammals started to evolve, is missing from allpeople on the autistic spectrum; and that thismajor deficit, while it may be just one aspect of what is missing in autism, is
what ismissing at the higher performing end of the Asperger’s spectrum. It is the ability to readcontext.Professor Simon Baron-Cohen of CambridgeUniversity, one of the world’s leading authori-ties on autism, has suggested that there is asystemising brain (usually associated with themale thinking style) and an empathising brain(traditionally associated with female behaviour)and that we all have varying amounts of each.
He has provided much evidence for this claim,showing how these sex differences arise morefrom biological than cultural causes, and goes sofar as to support Dr Asperger’s suggestion thatthe syndrome is an extreme form of the male
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VOLUME 15, NO.4 – 2008
ing to take into account Jill’s possible reactionstoo. When you can do this easily, it is difficult toimagine not being able to do it. But caetexticpeople can’t. As a consequence, they also havedifficulties understanding complex metaphorsbecause they mainly rely on logical thinking andrandom associations.
Other theories
Leading researchers in the field of autism havealso linked the word ‘context’ to Asperger’s syn-drome. Cognitive psychologist Uta Frith, alongwith others, has put forward a theory of ‘centralcoherence’, which suggests that, when carryingout tasks, people with autism show a relativefailure to process information for context-dependent meaning.
For instance, it has beenfound that, if a high-performing person with Asperger’s syndrome is asked to retell a storywhich they have been told, they are likely tofocus intensely on the small details in it – wholesections of whatever they can recall, almost verbatim – but will completely miss the over-arching idea, meaning or metaphor. They fail toextract the main idea because they are not sens-ing context. Frith points out that, if you tell astory to someone who is not on the autistic spec-trum and ask him or her to retell it, they can in- variably give you the gist: its central meaning. Another theory to explain Asperger’s syn-drome and autism was developed by SimonBaron-Cohen, Uta Frith and their colleague Alan Leslie, while all were working at the Med-ical Research Council’s Cognitive DevelopmentUnit in London in the 1980s. It proposes thatpeople with autism lack ‘theory of mind’: what ismissing in autism is the ability to read otherpeople’s minds and, from that, to predict otherpeople’s behaviour.
 As Frith describes it,“Thinking about what others think, rather thanwhat is going on in the physical world outside, isessential for engaging in complex social activitybecause it underpins our ability to cooperate andto learn from each other. Our research hasshown that theory of mind is either absent orseverely delayed in autistic individuals and thatthis can explain their difficulties in socialcommunication.”
Frith is now looking for a way to relate thetheory of central coherence to the theory of theoryof mind.We propose that the theory we areputting forward does just that and also providesa much richer view of context than the theory of central coherence. To us, central coherence andtheory of mind are limited examples of the deep-er principle we are describing, which is the crip-pling inability to see the world from multipleperspectives and to recognise how sudden changecan 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 thefront of his hair, but never the back. The imagehe saw in the mirror didn’t show the back of hisevents and see them from different viewpoints.The early behaviourists believed that mammalsand birds simply responded mechanically tostimuli, but more sophisticated experiments re- vealed that there is a cognitive component in- volved in their response, which relates to priorexperience. One significant experiment demon-strated that there is a mammalian intelligencethat searches for and assesses relationships be-tween different events – some part of the brainhas reviewed the history of past experiences of asimilar kind.
Many subsequent experimentshave substantiated this finding. So, millions of years ago, mammals evolved, in effect, a bio-logical 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 uncon-sciously comparing similar, previous experienceswith each new one. It is something we take com-pletely for granted today but, millions of yearsago, it was the key to surviving and thriving.When we say that the profoundly disablingimpairment that runs across the whole autisticspectrum is the inability to perceive context, wemean this mammalian ability to maintainseparate streams of attention and switch effort-lessly between them to assess the relevance of each to what is currently happening. This can bedone only if the brain can dissociate: reviewwhat it knows about something it has comeacross before, while still paying attention to thatsomething in the here and now. Modern brainscientists have ascribed this function to the an-terior cingulate gyrus. As one neuroscientistputs it, “This region is active when we need con-trolled, distributed attention, such as listeningto our friend at the party while also watchingour colleague dance. It also tells us to forget bothof those people and pay close attention to theother side of the room when we sense that poten-tial combatants may start a fight.”
‘Context blindness’ – the inability to switcheasily between several foci of attention and trackthem – is clearly seen in autism (the child trans-fixed by spinning the wheels on a toy car has nosense of a car’s real purpose, for instance) but isthe most dominant manifestation of autisticbehaviour in high-achieving people with Asper-ger’s syndrome. We have therefore named it ‘cae-textia’, from the Latin
, meaning ‘blind’and
, meaning ‘context’. We are suggest-ing that caetextia is a more accurate and des-criptive term for this inability to see how one variable influences another, particularly at thehigher end of the spectrum, than the label of ‘Asperger’s syndrome’.If you can read context, it seems like the mostnatural thing in the world. You might be talkingto Maggie about something, for example, butanother part of your attention is aware that Jillis listening as well and could read implicationsinto what you are saying that you didn’t intend.So, straight away, because you have this aware-ness, you are able to alter the way you are speak-
VOLUME 15, NO.4 – 2008
why, she said, “My mother’s a Catholic”. Sheassumed that, if she went to visit her mother,she would have to tell her about her own changein religious belief, and that her mother wouldn'tbe able to cope with it. It didn’t occur to her thatpeople of different faiths
still know and loveone another, especially if they are family; or thatshe could choose to protect her mother fromwhat she thought would be devastating infor-mation for her, and just continue to go to Masswith her mother whenever she was home.Clearly, in such cases, people lack the inform-ation necessary to inform their judgementsabout the choices and actions available to themin different situations.
Struggling to cope
It is, therefore, easy to see why people withcaetextia experience high levels of frustration,anxiety and anger when other streams of infor-mation keep intruding into whatever they aretrying to do – especially when their needs forstructure, rules and rituals are transgressed.Because they don’t know instinctively thatmultiple factors affect any given situation, theymay be nonplussed even when just two simpleinteracting factors require attention. We sawthis clearly in the jerky way a colleague with Asperger’s syndrome would drive. Whenever hebecame aware that a gap between his car andthe one in front was closing or widening, he res-ponded by jamming on his brakes or speedingup inappropriately, instead of gently moderatinghis speed to accommodate what is, after all, acontinually fluctuating situation when driving.He found it difficult to negotiate varyingcircumstances smoothly – other drivers changingspeed, closeness to other vehicles, the curve of the road, weather conditions, etc – all of whichneed constant simultaneous attention.On one occasion, he was in the wrong lanewhen approaching a set of traffic lights. When itwas pointed out to him that he needed to moveover to the right lane, he refocused his attentionon this new task and was unable at the sametime to continue processing and prioritisingother relevant information – such as the factthat the light had changed to red and thatdriving through it could get him and his pas-sengers killed. Indeed, he proceeded to drive onthrough the red light, causing us much alarmand consternation! Although he was aware of this deficit, and described it as ‘straight-linethinking’, he was unable to do anything about it.
Dancing with horses
 A dream, by chance related to Joe by his teenagedaughter Liley-Beth, served to crystallise ourthinking about the role of context. In the dream,she went to a club with a horse; all the othergirls there were dancing with horses and she,too, started dancing with a horse; it seemed themost natural thing in the world. Then the horseasked her out and she was just wondering whe-ther to accept when she woke up. When Liley-head and, clearly, he was not relating the imagehe saw to a bigger ‘picture’ of his head as awhole. He was genuinely unaware that a humanbeing can be seen from all angles and that, there-fore, he should comb his hair back and front, if hewanted to make a neat impression. Clearly, therewas a major category of information missing inhis mind: being able to view a situation fromdifferent perspectives (context).Sarah, a woman with Asperger’s syndrome,was asked by a friend what she thought of an ex-pensive fancy handbag the friend had justbought. Sarah didn’t like the bag and was com-pletely nonplussed as to how to respond. Shecould 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 mindconflicting perspectives (not liking the bag,liking the friend) and choose an appropriate oneto communicate, on the basis of a wider know-ledge of the possible consequences (upsetting orpleasing her friend). She was unable to see, forexample, that an honest opinion is not alwaysrequired in such circumstances; she could havepretended to like the bag, complimented herfriend for buying it, or told her that it was abargain. In fact, she said nothing at all, whichtotally perplexed and unsettled her friend. (Thisinability of people with Asperger’s syndrome tobe tactful or diplomatic is often interpreted asfrank honesty.) A very intelligent man who had Asperger’ssyndrome used to come out in a rash wheneverhe was anxious, which bothered him. One day, heread in a health magazine that mustard wasgood for skin rashes and promptly bought anindustrial-sized pot of it, so that he could plastermustard over his face every day. It never occur-red to him that customers in the shop he man-aged would think it odd to see him walkingaround with a bright yellow face. Another man with Asperger’s syndrome, alsohighly intelligent, described to us how his wifegave him a little box of chocolates just beforethey went out to celebrate his birthday and said,“You can eat the whole box while I go upstairs toget ready”. When she came down a little later,dressed for their night out, she found him eatingthe cardboard box. She immediately got angryand shouted at him – but he had absolutely noidea why. After telling this anecdote, he said, “Itseems as though other people have a concept tofollow that I am missing. I just follow theinstruction.” If he had had instant access to theknowledge that humans are not expected to eatcardboard boxes, just the contents of the box, hewould not have engaged in this bizarre be-haviour. (Interestingly, such literalism can alsobe observed in people in deep trance.) Another example: a professional woman whocame to see one of us had decided to give up her job in a bank and go and live in a Buddhist med-itation centre. Although she was keen to do this,she was also very sad and upset because shewould never see her mother again. When asked
 Joe Griffin
is a psychologist and  psychotherapist. He isdirector of studies at MindFields College and co-founder, with IvanTyrrell, of the human givens approach.
Ivan Tyrrell
is principal of MindFields College and editorial director of 
Human Givens

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