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The Curious Incident of the Dog in the Night-Time

Article  in  Journal of the American Academy of Child & Adolescent Psychiatry · March 2016
DOI: 10.1016/j.jaac.2016.01.002

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 BOOK FORUM
Schuyler W. Henderson, MD, MPH
Assistant Editor
Atypical
W hat do other people think? What do other
people say? What do other people feel? Our
job is not just to ask these questions, but to listen
to the answer. Listening can be hard. I get a twinge of gut-
twisting anger when pundits and editorialists assume that
other people are complacent about atrocity to the point of
complicity. Instead of asking people what they think or say
or do, or listening to them when they answer, it’s much
easier to assume that people believe something. In this day
and age, with something called the Internet, it is not hard to
find examples of, say, “moderate Muslims,” and yet pundits
can still go on television to cry, “Where are the moderate
Muslims? Why aren’t they speaking out?”1,2 They are; the
pundits just don’t bother to listen, and they know that their
listeners will parrot them rather than check the facts.
An assumption that a particular group of people has a
homogenous, uncontroversial belief system is a staple of
bigotry. Like most behaviors, bigotry serves a purpose. In
addition to being spiteful and condescending, it relieves the
bigot of the burden of addressing actual complexities posed
by the answers. One of the bigotries we face is that people
say we blithely or arbitrarily determine who is normal and
who is not. This view can be held only by those who choose
to ignore how our field is rife with debates about the nature
of “normality,” developmental trajectories, origins, etiol-
ogies, sensitivities and specificities, and cutoffs; the claim
also elides real questions posed by complicated answers:
What should we do when typical (or atypical) behaviors are
associated with suffering? When and how do we intervene?
Diversity is typical, difference is normal. In this spirit, in
this month’s Book Forum, we comfortably deviate from the
typical. Kidd, Hershman, and Accordino review a play
adapted from a popular novel, and then we return to
“normal” with Cohen’s review of a popular science book by
a child psychiatrist.
REFERENCES
1. Shneier M. Why don’t more moderate Muslims denounce extremism?
Washington Post. http://www.washingtonpost.com/posteverything/
wp/2015/01/02/why-dont-more-moderate-muslims-denounce-extremism/.
Published January 2, 2015. Accessed May 14, 2015.
2. Shah B. The myth of the moderate Muslim. The New Statesman.
http://www.newstatesman.com/religion/2014/10/myth-moderate-muslim.
Published October 2014. Accessed May 14, 2015.
246 www.jaacap.org Downloaded from ClinicalKey.com at Massachusetts General Hospital on March
For personal use only. No other uses without permission. Copyright ©2016. Elsevier Inc. All rights reserved.
The Curious Incident of the
Dog in the Night-Time. The
Barrymore Theatre, New York;
October 5, 2014eindefinite.
A
nyone who is interested in being challenged to think
deeply about what it means to be an outsider—of
any kind—should see the Broadway import of
Britain’s National Theatre production The Curious Incident
of the Dog in the Night-Time, based on the best-selling novel of
the same title by Mark Haddon. Briefly, the novel and
adapted play are about what happens when Christopher
Boone, a sensitive, awkward, but strong-willed 15-year-old
adolescent, finds his neighbor’s dog, Wellington, stabbed to
death with a pitchfork. Christopher, who has a pet rat
named Toby and is a lover of animals, finds himself aghast
and tormented by the cruel manner of Wellington’s death
and goes on a quest to find the murderer.
The play is narrated in Christopher’s voice for the most
part, with some intervening dialogue between Christopher
(played with amazing power and nuance by Alex Sharp)
and his parents and teacher. In a skillful maneuver on
director Marianne Elliott’s part, Christopher’s narrative is
read by his teacher, allowing Christopher to act out his
emotions in an expressive, physical way. When Wellington’s
owner calls the police because she suspects Christopher of
the murder, we see Christopher crouching in a ball on the
ground, covering his ears, and making loud rhythmic
movement and noises after the policeman tries to grab him.
At the same time, the play’s compelling sound effects
enable us to enter into and understand Christopher’s
overwhelming, dissonant sensory experience of the world.
One of the first thoughts in the mind of a clinician is that
Christopher’s behavior could be explained in part by a
diagnosis of autism spectrum disorder (ASD).
Of note, no diagnosis is ever discussed or referenced
during the play, an intentional omission on the author Mark
Haddon’s part (more on this later). That said, throughout the
play are poignant insights into what the life of an adolescent
with ASD and his family might be like. Early on Christopher
explains that people often communicate without words, a
skill he lacks. Without it, life is challenging because, as
Christopher says, gestures “like raising an eyebrow can
mean multiple things” from skepticism to flirtation.
Christopher also explains how for him “metaphors are lies,”
adding to the obfuscating nature of communication.
JOURNAL OF THE AMERICAN ACADEMY OF C HILD & ADOLESCENT PSYCHIATRY
VOLUME
17, 2016. 55 NUMBER 3 MARCH 2016

The thought-provoking and poignant aspects of the novel
are enhanced by its translation to the stage and the oppor-
tunity to make use of aural, physical, and visual theatrical
effects. The stage adaptation is accomplished with unparal-
leled creativity and power by director Marianne Elliott and
her creative team: scenic and costume designer Bunny
Christie, lighting designer Paule Constable, video designer
Finn Ross, sound designer Ian Dickinson, movement
directors Scott Graham and Steven Hoggett, and music by
Adrian Sutton. The set of the play appears part of the time as
a box with square-shaped grids covering the back and lateral
walls. Christopher uses the grids to aid and calm himself:
they help him negotiate directions on his search for
Wellington’s murderer and, later, on an even more compli-
cated search taking him to London. The grids also function
as a backdrop onto which confusing language is projected
when Christopher is upset and where mathematical equa-
tions appear, which Christopher uses to help calm himself.
The grids become a metaphor for the audience—not for
Christopher!—to understand the purely, uncompromisingly
logical way Christopher’s mind works.
The audience sees most clearly how overwhelming an
excess of sensory stimulation can be for Christopher when
he is trying by himself to negotiate the London tube
(subway) for the first time. He stands on the subway plat-
form trying to make sense of the multiple directional signs
while trains roar into and out of the station and people rush
into and out of the train cars. This scene of the play calls to
mind the times when many of us have felt overwhelmed
trying to get somewhere in a loud, crowded foreign city,
but for Christopher, the feeling of being overwhelmed
is exponentially greater and paralyzing. The scenes in
the London tube contrast artistically with Christopher’s
statement that he wants to be an astronaut, where he can
be alone, quiet, in a seeming infinity of space. We see
Christopher being carried across the stage while observing
the many constellations of stars projected on the grid walls.
Christopher’s relationship with his parents is tumultuous
as they try to care for him and deal with his outbursts. For
example, while Christopher and his mother are Christmas
shopping, he becomes overwhelmed and breaks some
china on a shelf by mistake. In this scene, we feel Christo-
pher’s inconsolable agitation and his mother’s frustrated
embarrassment about her son’s behavior.
One of Christopher’s emotional anchors is his teacher at
school. Whenever he is talking with her, he also is working
with his train set, lining up and stringing together railroad
tracks, and the repetitive behavior calms him. The scenes with
Christopher’s teacher convey the essential role she plays in his
life, helping him acquire skills to regulate his own emotions,
whether by organizing tasks in steps or reciting mathematical
equations in his head when he is upset. His teacher is an
anchor for him because she is willing to enter fully into his
world, exemplified structurally by the fact that she is the one
reading his narrative in the play.
The relationship between the play as a work of art
and the play as a portrait of an adolescent struggling with
ASD is a complicated one. The character of Christopher, if
analyzed diagnostically, fulfills criteria for ASD. Even more
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BOOK FORUM
meaningfully, the play enables the audience to enter the
minds of Christopher, his parents, and his teacher and to
enter into the experiences of the world each character has in
a way that is sympathetic to all viewpoints, although they
are often conflicting. The play communicates what ASD is
like perhaps better than any textbook or other educational
tool could. By no means does it encompass all the kinds of
behavioral and emotional difficulties that individuals with
ASD face; for one play to do that would be impossible.
No diagnostic language is ever used in the play or
the book. The question of how to approach Christopher’s
diagnosis in the context of the play as a work of art also is
a complicated one. Mark Haddon, who studied English
literature at Oxford University and worked briefly with
people with conditions such as multiple sclerosis and ASD,
did not intend Christopher to have a particular psychiatric
or medical diagnosis. In an interview in London’s The
Sunday Times, Haddon described the novel as “about a kid
called Christopher with behavioral difficulties living in
Swindon with his dad who is a plumber.”1 For Haddon,
the novel is “not an issue novel or thought of as some
educational guide about [autism], the novel is really about
difference . about being an outsider.”1
The Sunday Times article noted that Haddon regularly
turns down offers to be a spokesman for those with ASD.
According to Haddon, “As soon as you start using those labels
you clump people together and it’s a spectrum disorder—for
some people it’s not a disorder at all, but a part of who they are
as human beings.”1 It is clear that part of what Haddon is
trying to do, and what the play is trying to do, is to ask us to
see Christopher first and foremost not as someone with a
diagnosis but as a human being, as someone who shares more
in common with the rest of us than as one who exists as
someone different. This attitude is a particularly challenging
one for clinicians—whose job it is to make diagnoses and help
treat symptoms—to take up. However, it is arguably one of the
clinician’s most important tasks: to respect the dignity of the
human being before treating the patient.
Christen L. Kidd, MD
New York-Presbyterian Hospital
and Weill Cornell Medical Center
New York
clk9018@nyp.org
Susan Hershman, EdM
New York University
New York
Robert E. Accordino, MD, MSc
Massachusetts General Hospital
and Harvard Medical School
Boston
http://dx.doi.org/10.1016/j.jaac.2016.01.002
REFERENCE
1. Landesman C. Mark Haddon: on the curious curse of my hit novel. The
Sunday Times. April 21, 2013.
www.jaacap.org 247