One of THOSE Discussions / God, Free Will and Absurdities

This post has gained momentum from having one of those “late night” discussions with a friend – the type that is popular when one is in college, a bit drunk (or otherwise deranged) and which, as one gets older and wiser, one vows to never again participate in. The gist of the argument was:

Determinism (God) is totally compatible with Free Will (The Declaration of Independence), so we have both.

I could stop right here, because this “set up” is thoroughly American “wacky” thinking. It demonstrates the absolute belief that “America” is a special case = exemption from reality, that was/is made possible by American Democracy (in case you weren’t aware, democracy is not a political creation of human origin) which came about by an Act of God. “Freedom” is a basic American goal: Free Will is therefore a mandatory human endowment (by virtue of the word Free appearing in both “concepts”). God created everything, so he must have created Free Will. Jesus is a kind of “sponge” that suffices to “soak up” all those bad choices Free Will allows, that is, if you turn over all your choices, decisions and Free Will to Jesus.

The irony is that this absurd, pointless discussion “cleared the air” over previously unspoken conflict with a dear friend, like blowing up the Berlin Wall; getting it out of the way, and establishing that friendship is not “rational” at all, but an agreement about what really matters; good intentions carried into actions, loyalty and a simple “rightness” – agreement on what constitutes “good behavior” on the part of human beings and a pledge of one’s best effort to stick to that behavior.

This entire HUGE neurotypical debate is nonsense.

God has nothing to do with Free Will, the Laws of physics, or any scientific pursuit of explanations for “the universe”. The whole reason for God’s existence is that He, or She, or They are totally outside the restrictions of “physical reality”. That’s what SUPERNATURAL means. So all the “word concept” machinations over “God” and “science” – from both ends of the false dichotomy – are absurd. Free Will is also a non-starter “concept” in science: reality proceeds from a complex system of “facts” and mathematical relationshipsthat cannot be “free-willed” away.

Total nonsense.

If one believes in the “supernatural” origin of the universe as a creation of supernatural “beings, forces and miraculous acts” then one does not believe in physical reality at all: “Physics” is a nonexistent explanation for existence. One can only try to coerce, manipulate, plead with, and influence the “beings” that DETERMINE human fate. Free Will is de facto an absurdity, conceived of as something like the Amendments to the U.S. Constitution, (inspired by God, after all – not really by the intelligence of the people who wrote it). In American thought, (political) rights grant permission to “do whatever I want”. The concept of responsibility connected to rights has been conveniently forgotten. Free Will in this context, is nothing more than intellectual, moral and ethical “cheating”.

So, the immense, complicated, false dichotomy of Determinism vs. Free Will, and the absurd 2,000+ year old philosophical waste of time that has followed, and continues, is very simple (at least) in the U.S. 

Whatever I do, is God’s Will: Whatever you do, isn’t. 





Who’s Safe With a Gun? Don’t Ask a Shrink

The Daily Beast, May 2013 Background Checks


Forget any guidance from psychiatry’s bible, the DSM-5, when it comes to background checks for gun buyers, writes the psychotherapist author of The Book of Woe. (Gary Greenburg)

Many years ago, a man I was seeing in therapy decided he wanted to take up a new hobby: high explosives. The state he lived in licensed purchasers of dynamite and other incendiaries only after a background check. He wanted to know: Would I write a letter declaring him fit to blow up stuff in his backyard for fun?

Aside from the fact that this was how he wanted to pass the weekend, I didn’t have any reason to think otherwise, so I gave him the note. He got the license. A few years after he stopped seeing me, I had occasion to visit him at his office. He had all his digits and limbs and, to my knowledge, had committed no antisocial acts with his legally obtained explosives. My note attesting to his mental health was framed on his wall.

I’ve been thinking about this guy recently, ever since our politicians’ imaginations have fastened upon background checks as the solution to our gun problems. I’ve also been thinking about a couple of other patients. One of them, a middle-aged professional, a ramrod-straight retired Marine, father of a little girl, faithful husband, the kind of man who buys a special lockbox just for transporting his weapon between home and gun club. The other: a 27-year-old hothead, an absentee father who never met a drug or a woman he didn’t like. His idea of fun was riding his motorcycle between lanes on the interstate at 100 mph, and he was the proud owner of (by his count) 37 guns. In the three years prior to arriving at my office, he’d been fired from four jobs, arrested for six or seven driving offenses and a few drug charges, and helped to bury three of his friends who met untimely and violent ends.

No one asked me which of these two men I’d rather was a gun owner, let alone which one ought to have a firearms license. But I know what my answer would have been. Or I would have known until about a year ago, when the ex-Marine, inexplicably and without warning (although he’d just been put on an antidepressant as part of a treatment for chronic pain), sat at the base of the tree holding his favorite deer perch and shot himself in the mouth. Meantime, the hothead has cooled down. He’s been with the same woman for two years and the same job for one. He sees his son faithfully twice a week. He’s sold his motorcycle and more than half of his guns, and become obsessed with bodybuilding and responsibility. The transformation is not complete—he’s still dead certain the government wants to come to his house and confiscate what’s left of his arsenal, for instance—and I can’t take too much credit for it. He’s pursuing the pleasures of self-control with the same manic intensity as he once chased adrenaline. But I’m not all that worried about his guns anymore, and I’m really glad no one asked me if he should have them.

Because one thing they don’t teach you in therapy school: how to tell the future. Clinicians can assemble a story out of the ashes of a person’s life; we might even be able to spot what we think are the seeds of catastrophe, but we generally do that best in retrospect. And that’s why, if one of us insists he or she knows for sure what’s coming next, you should find another therapist. It’s also why, to the extent that background checks involve people like me, it wouldn’t do much more than reassure politicians that they are doing something about gun violence without simultaneously threatening their National Rifle Association ratings.

But wait a minute, you may be saying. Don’t mental-health workers have a whole huge book of diagnoses to turn to that can help you assess a person’s fitness to own a gun? No, we don’t. We have the book, of course, the Diagnostic and Statistical Manual of Mental Disorders, which is about to come out in its fifth edition. But while some of those disorders seem incompatible with responsible gun ownership, even a diagnosis of a severe mental illness like schizophrenia or bipolar disorder isn’t a good predictor of who is going to become violent. Indeed, only about 4 percent of violent crimes are committed by mentally ill people. We are not going to diagnose our way to safety.

There’s a reason for this. A diagnosis of a mental disorder is only a description of a person’s troubles. A neurologist presented with a patient suffering loss of coordination and muscle weakness can run tests and diagnose amyotrophic lateral sclerosis or a brain tumor. They can explain the symptoms and predict with some accuracy what will happen as the disease takes its expected course. The 200 or so diagnoses in the DSM, on the other hand, explain little and predict less. Until the book contains a diagnosis called Mass Slaughter Disorder, whose criteria would include having committed mass slaughter, it’s not going to offer much guidance on the subject, and, obviously, what guidance it provides is going to come too late.

With the mentally disordered, as with all of us (and let’s remember that in any given year, something like 30 percent of us will meet criteria for a mental disorder, and 11 percent of us are on antidepressants right now), there is no telling what will happen next. No matter how many diagnoses are in the DSM, and no matter how astutely they are used, they will not tell us in whose hands guns are safe. The psyche is more unfathomable, and evil more wily, than any doctor or any book.




American Pop Chart Toppers / 1940-2016 WEIRD!

What a strange trip! Pretty damn “kitschy” 

I think Americans are the weirdest people on the planet, but in our own estimation, we set the standard for NORMAL. Aye, yai, yai!


SHY? / Be prepared for predatory rage…

To be “shy” in the U.S.A. is a social crime.

Shy people are relentlessly attacked. Note the implications:

You have a genetic defect; you’ve experienced child abuse; you have a social anxiety or a social phobia; you’re a narcissist; you have “negative thoughts”; you have low self-esteem; you’ll never have a boyfriend or girlfriend; you’re a bad person; you stutter; you’re ugly; you can’t win: (either you don’t talk enough or you talk too much). And on, and on.

Shyness is a deficit that one must overcome, otherwise life is not worth living: 

You probably hate people and must be anti-social:

Shyness carries a life sentence of social exile and failure:

Some weak links found. Shy 3 yr-olds become cautious teens. Difficult 3 yr-olds remain difficult. Well-adjusted 3 yr-olds also. Current research. Temperament and Big 5 related. May carry-over into adulthood.

And if that isn’t enough, let’s detail the social horrors:

How much more depressing can it get?

Propaganda: Shyness is pathologic. Your life is a mess; buy this crap.

Dear World: Be afraid; be very afraid. American psychology is coming for you…


A culture in flux

— Kirsten Weirm 2014, Vol 45, No. 10

When Heather Henderson, PhD, a psychologist at the University of Waterloo, lectures to students about her shyness research, she often shows videos of young kids playing. The response is predictable. “People laugh and smile at outgoing kids, and they become uncomfortable watching shy kids,” she says.

Were she to show that same video in rural China, she might get a very different response. In any culture, there’s a range of temperaments from very reserved to more outgoing. But culture strongly affects how those temperamental differences are judged.

In the 1990s, Xinyin Chen, PhD, a psychologist at the University of Pennsylvania, showed that while shy behaviors were linked to problems such as anxiety in North America, they were associated with positive school adjustment outcomes in China. Behaviorally inhibited students in China were held up as leaders in the classroom and rated as more likable by peers, says Robert J. Coplan, PhD, a psychologist at Carleton University in Ottawa who has collaborated on cross-cultural studies with Chen and colleagues in China.

But China has changed dramatically since the 1990s, with rapid modernization and strong influences from the West. Correspondingly, in large urban areas, shyness is starting to be seen as a detriment. “The same behavior, in a very short period of time, seems to have done an about-face in terms of its perceived adaptiveness in Chinese culture,” Coplan says.

While social inhibition is still praised in many rural areas, he says, “assertiveness and independence have now become more positively valued in the big urban centers.” The rapid turnabout could have major implications for Chinese society. Whereas an older teacher might admonish an outgoing child, the younger teacher down the hall might offer praise. Children born in cities versus rural villages may receive very different messages about how to behave.

For psychologists interested in the influence of culture on behavior, the change is astounding. Little more than a decade ago, Chinese teachers wished more children would act more reserved, Coplan says. And now? “On my latest visit, they were talking about setting up intervention programs to help young shy children.”

Neurotypical Dichotomies / Basis of Social Structure, Judgment, Behavior

This follows up on a previous post:

The prime contention of that post is that the “estrangement” of mankind from the natural world, which was the consequence of a new survival strategy, agriculture,  forced a fundamental evolutionary change in Homo sapiens. The concentration of large numbers of “wild humans” into close quarters, and the fact that many would be strangers to each other, was a greater challenge than we recognize, thanks to our fantasies about agriculture, myths about “happy peasant life”on the farm and convenient loss of memory as to what “hand farming” is like. (Remember slavery?)

The evolution of a “complex of domesticated (neotenic) species” was the result, with humans being “part of” that domesticated stock, and not “Masters over Nature” – a concept that is a narcissistic misunderstanding of what occurred.

The “point is” that not only did this break with nature occur, “Nature” became a hostile beast; grudgingly providing crops one season and destroying them in the next. The dichotomy of Good vs. Evil, became the subjective judgment of farmers, a radical departure from the previous relationship of “Homo sapiens” to nature, as a creature within the “web of life”. Natural forces were indeed powerful; those powers were respected as being much more powerful than humans, and used carefully. The perception was that “power” is both positive and negative in its potential for human use; power cannot be divided “against itself”.

Modern humans live today with the unfortunate, and perilous division of the universe, as a subjective creation of the agricultural mind, into Good and Evil and the endless application of this principle, as conceptual word dichotomies to divide what is in reality an undivided natural system. 

di·chot·o·my / noun
plural noun: dichotomies – a division or contrast between two things that are or are represented as being opposed or entirely different. “a rigid dichotomy between science and mysticism”
synonyms: contrast, difference, polarity, conflict; gulf, chasm, division, separation, split; “the great dichotomy between theory and practice”

The following article on false dichotomies explains why Modern Social Typical BLACK or WHITE THINKING drives Aspergers BATTY!

What kind of conversation results from the modern social typical (American) addiction to dichotomy? Pointless reinforcement of racism, political stalemate, “the blame game” and the inability to solve important questions around global warming, the education of children, where and how money is spent and invested – (military, infrastructure, human services, healthcare, and ALL THINGS personal, social, governmental, economic, and behavioral.

Two of the issues stalled in the “false dichotomy” belief system are:

It’s the “guns” or “mental illness” false dichotomy that prevents actual analysis of mass gun violence and attempts at prevention. This leaves us with “gun violence – mass shootings” are the NEW NORMAL. Prevention is impossible because 1. Only total removal of “all guns” from citizens is the answer. 2. You can’t take away my guns; it’s in the Constitution. 3. The “middle ground” is conceived of as “chipping away” at these absolute positions. 4. Give Up. 

Immigration Reform: Enough false dichotomies to keep the U.S. from ever establishing a “sane” policy. 1. Let everyone who can get in, get in. It’s the American Way. (Not really; The U.S. has always had immigration restrictions, many quite severe). This categorizes all immigration as “good.” No one is here illegally; in fact, all immigrants are “good, not evil” people. Illegal immigrants who commit heinous crimes “magically don’t exist” (poor misunderstood people) and cannot even be mentioned as a public safety problem. The current extension of this belief is that (illegal) immigrants are BETTER CITIZENS than native born Americans, and ought to be “rewarded” for coming to the U.S. What a propaganda accomplishment! Since Americans are dichotomy thinkers extraordinaire, this of course, makes “perfect sense”. 2. Thus,  the “good or evil” false dichotomy has become the most important question in immigration policy. 3. Another false dichotomy is the Christian immigrants are Good vs. Moslems (and any of those other not-Christian religion people) are Evil – Exemptions considered if the applicants bring lots of money. 4. The “middle ground” requires some sort of legal sorting system that could distinguish between which immigrants will both flourish and contribute to the “good of the nation”, but this is an impossible and inconceivable task, given sole reliance on false dichotomy judgments based on categories of Good vs. Evil people. 5. It is impossible therefore to prevent crime and terrorism: Give up. 


False Dichotomies 

by Joseph Rowlands Note: “RAND” refers to AYN RAND (And I’ve lost the link: keep getting, page does not exist.)

In studying the ideas of Objectivism, it’s hard not to notice how often the term ‘dichotomy’ comes up. There’s the is/ought dichotomy. There’s the mind/body dichotomy. There’s the moral/practical dichotomy. The list is a long one.

A dichotomy is defined as “division into two usually contradictory parts or opinions”. It’s when you classify things into two mutually exclusive categories. Dichotomies are a useful conceptual tool. If properly used, they divide things into two groups. They’re mutually exclusive, meaning something can be in only one group or the other. But the categories are also exhaustive. If something is not in one, it must be in the other.

Objectivist literature mentions dichotomies frequently, but usually in a negative sense. The dichotomies mentioned above and many others are false dichotomies. This means that the two categories are either non-exhaustive, or they overlap some. Either case can lead to conceptual mistakes. You count on something fitting in one, and not fitting in another. If the groups are not mutually exclusive, you might see that an idea fits in one group, and falsely assume that it doesn’t fit in the other. Similarly, if it’s not exhaustive, you may see that an idea doesn’t fit in one, and assume it must fit in the other.

An example of the non-exhaustive categorization occurs in the false selfish/altruist dichotomy. In this sense selfish is meant to be actions that benefit yourself and hurt others. Altruism is hurting yourself to benefit others. If you believe this is a real dichotomy, then you only get to choose who to hurt. Rand attacked this false alternative by showing that it’s possible to act in your rational self-interest, which doesn’t require hurting others, and might even benefit them.

An example of a dichotomy that isn’t mutually exclusive is the moral/practical dichotomy. This is the belief that an action is either morally praiseworthy, or it is useful, but not both. If you run a business, it’s practical, but not morally praiseworthy. If you give until it hurts, it’s morally praiseworthy, but not practical. Again Rand attacked this as a false dichotomy, showing that not only can the moral and the practical overlap, but that they should.

So the question is, why are there so many false dichotomies? Why did Rand spend a lot of time debunking them? Why do these false dichotomies trick philosophers and laymen alike? What accounts for the prevalence?

I believe the answer lies in the fact that the dichotomies seem to present the full range of possibilities. You’re given a choice between two options that are presumed to be exhaustive. And often one of the options is obviously bad. This explains why these dichotomies can stand the test of time. It’s not just a bad idea accepted without merit. The ideas are seen as the only possibilities, and you just need to pick the best of the two. Altruism wouldn’t have survived if it wasn’t believed that the only other choice was brutish selfishness. Communism wouldn’t be as appealing if the other choice hadn’t been enslavement by the wealthy few.

This also means that these dichotomies are often self-reinforcing. If one of the categories is particularly bad, people will avoid leaving the safety of the first category so they don’t get labeled as part of the other group. For instance, few people would want to speak up against altruism when they’ll be immediately labeled as a selfish brute who thinks nothing of anyone but themselves.

Think of other examples. A reason/emotion dichotomy would make everyone either cold, calculating and heartless on one hand, or compassionate and loving on the other. If you try to argue using logic, they can dismiss you as a heartless, cruel person. A common view of capitalism vs. communism is a system supporting the rich versus supporting the poor. The choice only seems to be who is the beneficiary of the looting. If you don’t support communism, you must want poor people and children to die! There are many more examples.

This shows the power and the survivability of a false dichotomy. These false alternatives are difficult to challenge. If you assume they’re true dichotomies, you may never question the hidden assumptions. And once accepted, they have mechanisms that reinforce them. Fortunately, once the dichotomy is clearly seen as a false one, it’s can be easy to convey that information. The strength of these ideas is in them being viewed as exhaustive and mutually exclusive. Once that assumption is challenged, the house of cards can come tumbling down. And that’s a good reason to remember to check your premises.


Enhanced Perceptual Functioning / Patterns, Structure, Creativity

Note that savants are discussed, but the “mechanisms of perception” also apply to Asperger types. Some definitions inserted, and comments about personal experience!

Enhanced perception in savant syndrome: patterns, structure and creativity

Laurent Mottron, Michelle Dawson, Isabelle Soulières

Published 12 April 2009.DOI: 10.1098/rstb.2008.0333


According to the enhanced perceptual functioning (EPF) model, autistic perception is characterized by: enhanced low-level operations; locally oriented processing as a default setting; greater activation of perceptual areas during a range of visuospatial, language, working memory or reasoning tasks; autonomy towards higher processes; and superior involvement in intelligence. (I’ll have to “decode” this group – very specific terms) EPF has been useful in accounting for autistic relative peaks of ability in the visual and auditory modalities. However, the role played by atypical perceptual mechanisms in the emergence and character of savant abilities remains underdeveloped. We now propose that enhanced detection of patterns, including similarity within and among patterns, is one of the mechanisms responsible for operations on human codes, a type of material with which savants show particular facility. This mechanism would favour an orientation towards material possessing the highest level of internal structure, through the implicit detection of within- and between-code isomorphisms. A second mechanism, related to but exceeding the existing concept of redintegration, (!!) involves completion, or filling-in, of missing information in memorized or perceived units or structures. In the context of autistics’ enhanced perception, the nature and extent of these two mechanisms, and their possible contribution to the creativity evident in savant performance, are explored.

atypical mechanisms: enhanced detection of patterns; redintegration.  Redintegration refers to the restoration of the whole of something from a part of it. In cognitive psychology the word is used in reference to phenomena in the field of memory – a small part of a memory can remind a person of the entire memory. Yes, certainly familiar in the “visual memory” domain. One “piece” of an image “leads to” a repository of non-verbal memories. Picture a “wormhole” opening to other dimensions. 

It’s as if sensory memories are connected to each other by wormholes.

1. Enhanced perception: from autism to savant syndrome

Autism is characterized by enhanced perceptual processing (Happé & Frith 2006; Mottron et al. 2006a). The superiority of autistics in low-level cognitive operations (e.g. discrimination) (Discrimination, in psychology, the ability to perceive and respond to differences among stimuli. It is considered a more advanced form of learning than generalization, the ability to perceive similarities, although animals can be trained to discriminate as well as to generalize.) is a widely replicated finding in both the visual and auditory modalities (Dakin & Frith 2005; Samson et al. 2006). At least at the group level, this advantage can be observed in most operations involving perceptual material. For example, superior discriminative performance co-occurs in the same autistic individuals with enhanced abilities in a variety of target detection tasks involving mnemonic, attentional or visuospatial operations (Caron et al. 2006). In the auditory modality, superior pitch discrimination, labelling and memory also co-occur (Bonnel et al. 2003; Heaton 2003). Mechanisms involved in these perceptual skill superiorities are not yet fully understood, but a more extensive and atypical involvement of primary and associative perceptual areas during perceptual tasks (Gaffrey et al. 2007; Manjaly et al. 2007; Milne et al. 2009), atypical lateral inhibition in both modalities (Bertone et al. 2005; Vandenbroucke et al. 2008) and functional autonomy of perceptual operations from top-down processing influences (Caron et al. 2006) are complementary and promising physiological explanations.

The collection of empirical findings and associated putative partial mechanisms related to autistic perception has been combined under the label of enhanced perceptual functioning (EPF), a behavioural and physiological model that has recently been updated in the form of a short list of principles (Mottron et al. 2006a). These principles can be considered variously as descriptive and/or explicative. For example, one principle is that top-down influences on perceptual systems are optional in autism and mandatory in non-autistics. This assertion may act not only as a unifying description for the dominant and extended role of perception in autistic strengths, but also as an explanatory mechanism for the autonomy of perception with respect to various higher level cognitive processes.

The wide variety of atypical mechanisms involved in EPF principles suggests that autistic cognitive atypicalities are more accurately described as an entirely different processing system, rather than as a collection of negative cascade effects resulting from one or many major impairments (excesses or deficits) impeding typical processing and development.


The extensive support for EPF in autism is strongly suggestive that perception as a whole should be viewed as an integral part of the mechanisms of savant abilities, in as much as these unexpectedly strong skills are intrinsic manifestations of autistic behaviour, learning and intelligence. However, it is not yet clear to what extent basic perceptual mechanisms are associated with autistic ability peaks and a fortiori with savant abilities. Multiple intervening variables (e.g. nature, age and intensity of exposure to relevant material) may intercede between superior low-level processing and superior visual and auditory cognitive abilities, impeding any affirmation that, for example, enhanced visual discrimination directly produces visuospatial ability peaks, or that enhanced auditory discrimination produces superior musical ability in savant or non-savant autistics.

The key role of atypical perception in savant syndrome is not an entirely new story (see Heaton & Wallace 2004, for a review). For example, Treffert (1989) proposed that eidetic memory may be important in savant syndrome, but this view is contradicted by the transformations that savants consistently perform on their material of expertise. While Snyder & Mitchell (1999) elaborated on a privileged access to typical low-level perceptual processes, these authors do not explain why savant syndrome is so prevalent in autism or why particular abilities (e.g. calendar calculation) are disproportionately represented. Neither do they specify the details of the low-level operations responsible for savant performance. The aim of this paper is therefore to further explore the role of these aspects of perception and memory in the materials and cognitive operations commonly encountered in the investigations of savant syndrome.

2. Savant abilities entail structured material

Materials involved in savant syndrome consist mainly of human codes (e.g. written language for hyperlexia and list memorizers, music for savant performers and composers, numeration for savant mathematical and calendar calculators, and complex three-dimensional graphic representations for savant artists). Human codes share the property of being structured and predominantly non-arbitrary. Emphasizing the role of pattern recognition is therefore in strong contrast with the idea that unstructured, eidetic-type, memory is a major mechanism underlying savant ability. A structured sequence (as opposed to noise) can be phenomenally defined by the recurrence of a finite list of elementary constituents (letters or ideograms, phonemes, digits, notes and geons). These constituents are spatio-temporally stable, in the sense that the shape of a letter, for example, remains roughly equivalent across its various occurrences. The constituents are also relatively simple forms, generally presented in homogeneous series (letters with letters or digits with digits).

The units composing most human codes are embedded in a hierarchy of recurrent patterns of increasing scale. In the case of written language, a finite series of letters forms a larger number of words, and these words are arranged in phrases and sentences with syntactic regularities. Each level contains elements that are intrinsically more similar within that level than they are across levels. Resemblance within letters defines the alphabet, resemblance among words defines lexicon and redundancy in the arrangement of words defines syntax. A similar structural regularity characterizes music (Jackendoff 1987), and could be used to encode the complexities of the three-dimensional perceptual world (Biederman 1987). Phenomenal resemblance or isomorphism is therefore at the centre of what describes a code, and the structured material composing human codes can be described as embedded organizations of isomorphisms, each class of isomorphism defining a particular level (e.g. phonological, lexical). We contend that the phenomenal redundancy of human perceptual and cognitive codes, in as much as they are processed by autistic perceptual mechanisms, grounds the key role these codes play in autistic strong interests and savant abilities.

I would suggest that this attention to structure is what “freaks out” neurotypicals, who do not “believe in facts or boundaries” as concrete parameters in nature – or in the Laws of Physics. Physical reality impinges on, and threatens, their magical supernatural social universe. 

3. Pattern detection in savant cognition

Structure being defined by the presence of repeating basic patterns (this is real in nature – and is described by mathematics; it is not “just” in our “defective” autistic heads), one possibility would be that pattern detection mechanisms are especially active in autism. (Or in visually dominant brain organization) This would explain the unique relationship between what phenomenally defines a structure, and perceptual mechanisms in autism. By especially active, we mean essential in achieving a high level of performance, guiding behaviour, detecting smaller or larger scale units, and being more independent from the influence of non-perceptual cognitive processes. Following this hypothesis, the detection of perceptual similarity between spatio-temporal recurrences of a pattern, whatever its scale, could result in the creation of a lexicon of units—and provide the perceptual root of savant ability. More generally, the detection of regions of the world possessing a high density of similarity among perceptual patterns would orient savants towards their principal materials of interest, i.e. towards commonly available human codes. For example, letters and digits presented in printed material belong to a finite list of visual patterns sharing overall shape and features, with multiple recurrences in the world, and are associated by largely non-arbitrary rules maximizing their salience as stimuli. In calendar calculation, the target information is commonly presented in the form of matrices where digits and letters occupy consistent places in the structure. Three-dimensional geometrical regularities (e.g. geons) are presented and available as two-dimensional representations structured and ruled by linear perspective, while pitches may be presented as locations on keyboards.

The same mechanism that detects intrinsic similarity among simultaneously presented units, or between presented and memorized units, could also detect higher scale isomorphisms by analysing the recurrent structures formed by redundant arrangement of these units, as well as their extrinsic similarities, i.e. recurrent figure–ground relationships between these structures and their context of occurrence. An enhanced role for pattern detection would therefore parsimoniously account both for the heightened interest in codes (characterized by their high level of structural redundancy), and for the detection of within-code, large-scale isomorphisms such as arithmetical structure, calendar structure, syntax and three-dimensional perspective rules.

That is, our attention to structure allows us to identify “layers” of similar / identical structure within and across hierarchies of “coded” information. For an Asperger of “my type” – not a strict math thinker or speaker – this focus on structure manifests as pattern discrimination in “knowledge systems” across scale, from detailed observation to “big picture” analysis. It’s what I refer to as discovering “coherent or incoherent” systems. (Is it isomorphic across scale?) Yes, the structural reference is natural systems which are the templates for reality. Sorry, neurotypicals, but science is not another form of “magic”. Magic is narcissistic; the focus is on “personal power” as the driver of phenomenon!    

At a still higher scale level, we propose that many savant abilities involve a one-to-one mapping process between two isomorphic series of elements, a veridical mapping between different codes involving the detection of structural similarity between the two series of units (e.g. written code/oral code). Accordingly, a significant proportion of savant ability involves between-code mapping: hyperlexia maps graphic and oral codes (this would seem to apply to me); absolute pitch maps pitch labels or keyboard locations and pitches of the chromatic scale; calendar calculation maps days of the week with dates; and prime number detection maps series of numbers with their factor composition. In all cases, the mastering of these mappings is implicit, both in the way they are learned, and in the frequent difficulty or impossibility that savants have in verbalizing the strategies used to produce answers relying on these mappings. (This is not only true of “savants” but “regular” Asperger types)

A beneficial consequence of enhanced pattern detection is that it allows stabilizing associations between labels and precise values within continuous dimensions, which non-autistics are poorly able to memorize. In a significant number of savant abilities, the equivalent ability in non-autistics is only poorly or rarely, if at all, represented. This may be because one series of representations cannot be anchored on the other, as in the example of relative rather than absolute pitch. For pitch perception, non-autistics are able to easily discriminate two distinct pitches as well as to maintain an absolute pitch value in short-term memory, but the pitch is generally lost in long-term memory. Similarly, the three-dimensional regularities of the real word are easily manipulated in three-dimensional visual perception but cannot be maintained even in short-term memory and a fortiori cannot be accessed through high-level processes. Recently, we have described prodigious abilities in weight estimation (Mottron et al. submitted), which are achieved through the stabilization of a veridical mapping mechanism. GT, who estimates the weight of objects below 500 g with a precision within approximately 5 per cent, proceeds by mentally comparing each object to a 35 g reference unit (the weight of a cereal bar).

Pattern recognition cannot be dissociated from grouping processes. Accordingly, pattern detection could be defined as the capacity to detect (not imagine!) organization in the phenomenal aspects of the world. This may be done within the perceptual field, by the detection of relative properties of a series of features (e.g. proximity), or between two series of features (e.g. symmetry and similarity). It has been proposed that in autistics, some mechanisms involved in detecting relational feature properties such as grouping are less efficient (Dakin & Frith 2005). However, as demonstrated in Caron et al. (2006), grouping process are, at least under some experimental conditions, intact or even superior, but not mandatory in autism. Likewise, locally oriented graphic construction, resulting from the non-mandatory nature of grouping principles, produces a global figure that respects the relative proportions of each of its elements—demonstrating the integrity of these principles, as has been repeatedly demonstrated in autistic graphic arts (Selfe 1983). Similarly, musical performance in savants encompasses both superior local perception (absolute pitch) and the ability to perceive, perform, transpose, improvise on and enhance global aspects of musical structure (Sloboda et al. 1985; Hermelin et al. 1987, 1989; Miller 1989; Young & Nettlebeck 1995). Finally, autistics’ more independent cognitive processes result in regularities within and among patterns being detected, manipulated and generated at the scale of very large structures (e.g. the 28- or 400-year regularity in calendar calculation)—while still retaining their perceptual nature.

4. Pattern completion at a different scale

We have proposed elsewhere (Mottron et al. 2006a) that the concept of redintegration, as applied to pattern completion tasks, may play an important role in the enhanced cognitive operations characterizing savant syndrome. Redintegration in its current use (Schweickert 1993) consists in completing a cue identical to a part of a larger configuration previously encountered. This completion is multidirectional, such that any part of a configuration can prompt recall of its missing parts. In the case of words, the recalled parts have been encountered as such and the cue and response form a unit in long-term memory. This concept is therefore close to that of pattern completion or of multidirectional cued recall, i.e. the ability to recognize an incomplete figure, a well-documented function of implicit memory (e.g. Toth et al. 1994). Its application to autistic production is related to the task support hypothesis first put forward by Bowler et al. (1997), in which cues perceptually identical to a part of the remembered material disproportionably aid autistics during recall. Redintegration-related mechanisms could describe savant abilities that are characterized by providing an answer to a closed question (e.g.: what day of the week was…; what is the square root of…; can you sing a C flat…), as well as bidirectional access to some calendar information, which allows the autistic savant DBC to answer with the same facility questions, such as ‘what are the months beginning by a Friday?’ and ‘what day of the week was the 30th of April, 1998?’ (Mottron et al. 2006b). In addition, with some latitude, this account may help explain the ability of savant artists to complete three-dimensional representations starting from any part of a figure, if one considers the state of the drawing at time 1 as a cue for its completion at time 2 (e.g. Mottron & Belleville 1994, fig. 2).

However, a more general concept of pattern or information completion is required in order to encompass the creative scope of savant performance, which clearly exceeds memory and the limitations of redintegration in non-autistics. In addition, autistics’ atypical perception would result in pattern or information completion occurring both at a more local level, as well as within structures much larger, than those used to demonstrate the equivalent mechanism in non-autistics. A greater independence among encoded levels of information would also be involved. For example, a non-autistic expert musician with absolute pitch is far more limited than DP, an autistic savant musician, in disembedding and reproducing (that is, completing or filling-in the pattern of) the individual notes in large chords (Pring 2008). Pattern or information completion may also act in combination with typical, conscious cognitive processes. In the case of a response to a question such as ‘is this a prime number?’, the limited concept of redintegration would be unable to account for factorization of never-encountered numbers or the detection of primes within very large numbers. It is therefore conceivable that the rapid decomposition of the target number into multiple subcomponents can return it to a state of memorized equivalence (e.g. 4×3=12) where pattern completion can occur. A similar mechanism could participate in the production of future dates, as in the case of the autistic calendar calculator Donny (Thioux et al. 2006) who exhibited a distance effect for future dates, implying the use of some kind of computational procedure.

5. Savant creativity: a different relationship to structure

Savant performance cannot be reduced to uniquely efficient rote memory skills (see Miller 1999, for a review), and encompasses not only the ability for strict recall, requiring pattern completion, but also the ability to produce creative, new material within the constraints of a previously integrated structure, i.e. the process of pattern generation. This creative, flexible, albeit structure-guided, aspect of savant productions has been clearly described (e.g. Pring 2008). It is analogous to what Miller (1999, p. 33) reported on error analyses in musical memory: ‘savants were more likely to impose structure in their renditions of musical fragments when it was absent in the original, producing renditions that, if anything, were less ‘literal’ than those of the comparison participants’. Pattern generation is also intrinsic to the account provided by Waterhouse (1988).

The question of how to produce creative results using perceptual mechanisms, including those considered low-level in non-autistics, is at the very centre of the debate on the relationship between the nature of the human factor referred to as intelligence and the specific cognitive and physiological mechanisms of savant syndrome (maths or memory, O’Connor & Hermelin 1984; rules or regularities, Hermelin & O’Connor 1986; implicit or explicit, O’Connor 1989; rhyme or reason, Nettlebeck 1999). It also echoes the questions raised by recent evidence of major discrepancies in the measurement of autistic intelligence according to the instruments used (Dawson et al. 2007).

A combination of multiple pattern completions at various scales could explain how a perceptual mechanism, apparently unable to produce novelty and abstraction in non-autistics, contributes in a unique way to autistic creativity. The atypically independent cognitive processes characteristic of autism allow for the parallel, non-strategic integration of patterns across multiple levels and scales, without information being lost owing to the automatic hierarchies governing information processing and limiting the role of perception in non-autistics.

An interest in internal structure may also explain a specific, and new, interest for domains never before encountered. For example, a savant artist newly presented with the structure of visual tones learned this technique more rapidly and proficiently than typical students (Pring et al. 1997). In addition, the initial choice of domain of so-called restricted interest demonstrates the versatility of the autistic brain, in the sense that it represents spontaneous orientation towards, and mastering of, a new domain without external prompts or instruction.

Independence of action is interpreted by neurotypical parents, teachers etc. as a “defect” or even as “disobedience” because independent learning leaves them out of, or bypasses, the social hierarchy’s control of information being filtered and transferred to “lesser humans” (social indoctrination) – especially to young children. This irrational “fear of toddlers” necessitates, for some authority figures, the abuse of “non-conforming” children. 

How many such domains are chosen would then depend on the free availability of the kinds, amounts and arrangements of information which define the structure of the domain, according to aspects of information that autistics process well. Generalization also occurs under these circumstances, for example, to materials that share with the initial material similar formal properties, i.e. those that allow ‘veridical mapping’ with the existing ability. In Pring & Hermelin (2002), a savant calendar calculator with absolute pitch displayed initial facility with basic number–letter associations, and was able to quickly learn new associations and provide novel manipulations of these letter–number correspondences.

The apparently ‘restricted’ aspects of restricted interests are at least partly related to pattern detection, in that there are positive emotions in the presence of material presenting a high level of internal structure,(it is exceedingly pleasant to indulge in this activity) and a seeking out of material related in form and structure to what has already been encountered and memorized. Limitation of generalization may also be explained by the constraints inherent in the role of similarity in pattern detection, which would prevent an extension of isomorphisms to classes of elements that are excessively dissimilar to those composing the initial form. In any case, there is no reason why autistic perceptual experts would be any less firm, diligent or enthusiastic in their specific preferences for materials and domains than their non-autistic expert counterparts. However, it must also be acknowledged that the information autistics require in order to choose and generalize any given interest is likely to be atypical in many respects (in that this may not be the information that non-autistics would require), and may not be freely or at all available. In addition, the atypical ways in which autistics and savants learn well have attracted little interest and are as yet poorly studied and understood, such that we remain ignorant as to the best ways in which to teach these individuals (Dawson et al. 2008). Therefore, a failure to provide autistics or savants with the kinds of information and opportunities from which they can learn well must also be considered as explaining apparent limitations in the interests and abilities of savant and non-savant autistics (see also Heaton 2009). Thank-you!

6. Structure, emotion and expertise

While reliable information about the earliest development or manifestations of savant abilities in an individual is very sparse, biographies of some savants suggest a sequence starting with uninstructed, sometimes apparently passive, but intent and attentive (e.g. Horwitz et al. 1965; Selfe 1977; Sacks 1995) orientation to and study of their materials of interest. In keeping with our proposal about how savants perceive and integrate patterns, materials that spontaneously attract interest may be at any scale or level within a structure, including those that appear unsuitable for the individual’s apparent developmental level. For example, Paul, a 4-year-old autistic boy (with a presumed mental age of 17 months), who was found to have outstanding literacy, exceeding that of typical 9-year olds, intently studied newspapers starting before his second birthday (Atkin & Lorch 2006). It should not be surprising that in savants, the consistent or reliable availability of structured or formatted information and materials can influence the extent of the resulting ability. For example, the types of words easily memorized by NM, proper names, in addition to being redundant in Quebec, share a highly similar structural presentation in the context where NM learned them, including phone books, obituaries and grave markers (Mottron et al. 1996, 1998). However, a fuller account of why there is the initial attraction to and preference for materials with a high degree of intrinsic organization, and for specific kinds of such structured materials in any particular individual, is necessary. (Suggest visual thinking as clue) 

Positive emotions are reported in connection with the performance of savant abilities (e.g. Selfe 1977; Sloboda et al. 1985; Miller 1989). Therefore, it is possible that a chance encounter with structured material gives birth to an autistic special interest, which then serves as the emotional anchor of the codes involved in savant abilities, associated with both positive emotions and a growing behavioural orientation towards similar patterns (Mercier et al. 2000). Brain structures involved in the processing of emotional content can be activated during attention to objects of special interest in autistics (Grelotti et al. 2005). So-called repetitive play in autism, associated with positive emotions, consists of grouping objects or information encompassing, as in the codes described above, series of similar or equivalent attributes. In addition, in our clinical experience, we observe that repetitive autistic movements are often associated with positive emotions. (And are viewed with horror by neurotypicals) 

One possibility worth further investigation would be that patterns in structured materials, in themselves, may trigger positive emotions in autism (pattern recognition contains an aesthetic component) and that arbitrary alterations to these patterns may produce negative emotionsa cognitive account of the insistence on sameness with which autistics have been characterized from the outset (Kanner 1943).

“Sameness” is a loaded social word based on ignorance of “things seen by autistics, but unseen by neurotypicals”. Its use betrays a total blindness to “content” in objects, patterns, and to the power of aesthetic comfort.

Individuals who excel in detecting, integrating and completing patterns at multiple levels and scales, as we propose is the case with savants, would have a commensurate sensitivity to anomalies within the full array of perceived similarities and regularities. (e.g. O’Connell 1974). In Hermelin & O’Connor (1990), an autistic savant (with apparently very limited language skills) known for his numerical abilities, including factorization, but who had never been asked to identify prime numbers, instantly expressed—without words—his perfect understanding of this concept when first presented with a prime number. The superior ability of autistics to detect anomalies—departures from pattern or similarity—has accordingly been reported (e.g. Plaisted et al. 1998; Baron-Cohen 2005).

I would add that autistic “bullshit detection” in social communication and behavior – lies, dishonesty, injustice and manipulation of other humans, and the rejection of these behaviors, is included under this sensitivity to anomaly, and demonstrates a highly negative reaction to “aesthetic violation of human codes” that exist prior to domestication of modern social Homo sapiens. 

Overexposure to material highly loaded with internal structure plausibly favours implicit learning and storage of information units based on their perceptual similarity, and more generally, of expertise effects. Savants benefit from expertise effects to the same extent as non-autistic experts (Miller 1999). Among expertise effects is the recognition of units at a more specific level compared with non-experts and the suppression of negative interference effects among members of the same category. Reduced interference has been demonstrated between lists of proper names in a savant memorizer (Mottron et al. 1998). Another expertise effect is the ‘frequency effect’, the relative ease with which memorization and manipulation of units, to which an individual has been massively exposed, can be accomplished (Segui et al. 1982). For example, Heavey et al. (1999) found that calendar calculators recalled more calendar-related items than controls matched for age, verbal IQ and diagnosis, but exhibited unremarkable short- or long-term recall of more general material unrelated to calendars. These two aspects of expertise would favour the emergence and the stabilization of macrounits (e.g. written code in a specific language, or set of pitches arranged by harmonic rules), which are perceptually the spatio-temporal conjunctions of recognizable patterns related by isomorphisms. Conversely, pattern detection may be unremarkable or even diminished in the case of arbitrarily presented unfamiliar material (Frith 1970).

Hence the totally “blank” state produced by neurotypical social demands to answer unimportant rhetorical questions like, “What are you wearing? It looks stupid…” and to respond with “hyper-emotional displays of excitement” when encountering a person one sees a dozen times per day at home, work, or in the hallway at school.

Identifying savant syndrome as aptitude, material availability and expertise, combined with an autistic brain characterized by EPF, is also informative on the relationship between savant syndrome and peaks of ability in non-savant autistics. Perceptual peaks are largely measured using materials with which the participant has not been trained, whereas savant syndrome encompasses the effects of a life spent pursuing the processing of specific information and materials. We therefore forward the possibility that the range and extent of autistic abilities may be revealed only following access to specific kinds, quantities and arrangements of information. However, we do not expect savant abilities to differ from non-savant autistic peaks of ability in their basic mechanisms. According to this understanding of differences between savant and non-savant autistics, the fact that not all autistics are savants is no more surprising than the fact that not all non-autistics are experts.

7. Behavioural and brain imaging support for enhanced perception in savant syndrome

The proposals in this paper lack sufficient empirical support from savant studies, but are consistent with the well-established role of enhanced perception in autistic cognitive abilities. This is evident in a large variety of tasks studied in non-savant autistics, ranging from visuospatial peaks of ability such as the hidden figure task (Manjaly et al. 2007) to high-order tasks such as the N-back task (Koshino et al. 2005). In the latter study, the authors report that whereas non-autistics exposed to series of letters that can be either linguistically or perceptually processed exhibit activation of left frontal regions, consistent with the occurrence of mandatory linguistic processing, autistics exhibit mainly extrastriate activation, consistent with their optional use of a more perceptual mechanism. The ability to engage perception in this task did not disadvantage the autistics who performed as well as their controls, and were more flexible in rapidly adjusting to different N-back conditions. Nor does the optional ability of autistics to perceive letters as images hamper their ability to comprehend sentences, a task in which a group of autistics performed dramatically faster than typical individuals (Just et al. 2004).

Similarly, hyperlexic children display ‘acute visual registration mechanisms for written language’ (Goldberg & Rothermel 1984, p. 759; see also, Cobrinik 1982), but this superior perceptual ability does not impinge on their skill in reading visually distorted words or pseudowords (Goldberg & Rothermel 1984; Atkin & Lorch 2006); and these children are not impeded, as are typical children, by the notorious complexity and difficult orthography of written English (Seymour et al. 2003). An extrastriate pattern of activation has also been observed in a 9-year-old boy with limitations in oral skills in the presence of decoding skills 6 years in advance of his chronological age (he began his interest for printed material at 13 months). He showed greater activity than reading age-matched controls in the right posterior inferior temporal sulcus, an extrastriate region belonging to the right ventral stream known to be important in visual form recognition. This area is activated in early stages of reading acquisition, but its activity disappears with age. Interestingly, these areas were activated in addition to typical left hemisphere phonological decoding systems (Turkeltaub et al. 2004), which is indicative of an important role for perception in exceptional reading ability in autistics.

Future research should explore the role of enhanced perception across the development of expertise, as well as in the entire range of exceptional abilities in savants and autistics. Particular consideration should be given to domains in which, given the opportunity, these individuals perform with proficiency, flexibility and creativity.

Yes, DO NOT try to “cram us” into what for us are “alien restrictions” on what the human brain can do. It’s cruel, and counterproductive; a huge waste of human potential, not only in what “autistics” can contribute, but in what “typical” children can accomplish and enjoy. 




Medical Alexithymia / An Extensive Paper

My question for ASD / Asperger people: does this paper (Assessment of Alexithymia in medical settings) actually describe our “subjective” experience of interoperception?

What is that?

SEE: Interoception and emotion

Influential theories suggest emotional feeling states arise from physiological changes from within the body. Interoception describes the afferent signaling (in the direction of the central nervous system), central processing, and neural and mental representation of internal bodily signals… more

How is this physical phenomenon “different” in Asperger people? Don’t expect to find the answer here! 


 J Pers Assess. (Click for full paper) Author manuscript.
Some nips and tucks for length…it’s a long paper. And yes, I loose my tolerance for nuttiness hallway through…

The Assessment of Alexithymia in Medical Settings: Implications for Understanding and Treating Health Problems

History and Definition of the Alexithymia Construct

The term alexithymia literally means “lacking words for feelings” and was coined to describe certain clinical characteristics observed among patients with psychosomatic disorders who had difficulty engaging in insight-oriented psychotherapy (Sifneos, 1967). Alexithymic patients demonstrate deficiencies in emotional awareness and communication and show little insight into their feelings, symptoms, and motivation. When asked about their feelings in emotional situations, they may experience confusion (e.g., “I don’t know”), give vague or simple answers (“I feel bad”), report bodily states (e.g., “my stomach hurts”), or talk about behavior (“I want to punch the wall.”). Such patients in psychodynamic psychotherapy have been described as unproductive, unimaginative, boring, and stiff. Therapists often have difficulty establishing working alliances with them, and such psychotherapy appears to lead to little benefit.

The alexithymia construct was originally conceptualized by Nemiah, Freyberger, and Sifneos (1976) as encompassing a cluster of cognitive traits including difficulty identifying feelings, difficulty describing feelings to others, externally oriented thinking (concrete), and a limited imaginal capacity. This original view of alexithymia has been the most influential in contemporary theory and research (Taylor, Bagby, & Parker, 1997). An alternative conceptualization, that alexithymia is a global impairment in emotional processing resulting in limited emotional expression and recognition (Lane, Sechrest, Riedel, Shapiro, & Kaszniak, 2000), has been less influential thus far. Yet, both definitions agree that alexithymia is a deficit, inability, or deficiency in emotional processing rather than a defensive process, and this deficit view is gaining increasing support from basic laboratory research. (more)

Other psychological constructs seem similar to alexithymia and may be confused with it. Although a full presentation of these other constructs is beyond the scope of this paper, we briefly describe several and contrast them with alexithymia. Some constructs represent emotional skills, abilities, or strengths, rather than deficits or limitations. For example, emotion regulation is broader than alexithymia and refers to a wide range of processes, including being aware of emotions, accessing and expressing emotions, and monitoring and controlling emotions (Dahl, 2003). Emotion regulation is so broad that it is difficult to define, and there are no assessment devices that capture the full range of emotion regulation processes. Emotional intelligence also is broader than alexithymia, and the leading theorists propose four characteristics: perceiving emotions in others, using emotions to facilitate thought, understanding emotions, and managing emotions (Mayer, Salovey, Caruso, & Sitarenios, 2001). Whereas alexithymia refers to basic emotion processes, emotional intelligence refers more to the application or implications of such basic emotional abilities. Other constructs are narrower in scope than alexithymia, including emotional awareness (Lane & Schwartz, 1987), emotional approach coping (Stanton, Danoff-Burg, Cameron, & Ellis, 1994), and meta-mood skills (Salovey, Mayer, Goldman, Turvey, & Palfai, 1995). These constructs typically exclude the cognitive aspects of alexithymia, (limited imaginal ability and externally oriented thinking), are newer on the psychological landscape than alexithymia, and have generated little literature relevant to their assessment in medical or mental health settings. (These two “aspects” are now part of alexithymia, the psychology version, with obvious negative prejudice as to what constitutes “imagination” – imagination=neurotypical magical thinking – and  the judgement that “concrete thinking” is pathological.) 

Several other emotion-related constructs are sometimes confused with alexithymia. Emotion suppression, inhibition, isolation, denial, and repression—like alexithymia—imply limited emotional insight and expression. Yet these constructs refer to active, defensive processes that reduce the experience or expression of emotion, whereas alexithymia is considered to be a deficit or deficiency rather than a defense. Defenses have long been the focus of psychodynamic and experiential psychotherapies, which attempt to lower or bypass them in order to facilitate emotional awareness and expression. Finally, low psychological mindedness overlaps with alexithymia (Shill & Lumley, 2002), but psychological mindedness places less emphasis on emotion than does alexithymia. The current review article will focus only on alexithymia, for which a very large literature has been generated, particularly in medical and psychiatric contexts.

The Assessment of Alexithymia

The most common approach to assessing alexithymia in applied settings is clinical judgment, and the two cases presented above were judged to be alexithymic during the course of psychotherapy. Yet, this time-worn clinical practice is of dubious psychometric quality, given that the interactions with the patient and the observations are not standardized, there are no criteria to define alexithymia and distinguish it from other constructs, and interrater reliability is unknown. Advancements in both research and clinical practice call for a more psychometrically sound approach.

Note: History of assessment tools follows – (bypassed here for the sanity of reader) 

We present measures according to the type of assessment method used—interview-based, collateral informant, projective testing, verbal responses, and self-report—and provide information on their psychometric status and utility. At the end of the article, we revisit alexithymia measurement as we explore several controversial and emerging issues…

…By far, self-report is the most widely-used approach to assessing alexithymia.

Although there is ongoing debate about the comparative validity of various alexithymia assessment approaches, the vast majority of studies have used only the TAS or TAS-20. Thus, as we evaluate alexithymia assessment in medical and mental health settings, a debate over specific measures is largely moot. Instead, we turn to our primary goal of this article, which is to answer these applied questions: What does knowing that a patient is relatively alexithymic tell the medical or mental health practitioner about the patient? Of what utility is the assessment of alexithymia in health care settings

The Utility and Validity of Assessing Alexithymia in Medical settings

Alexithymia was first described in people with classic psychosomatic disorders, and subsequent research has confirmed elevated levels of alexithymia in people with rheumatoid arthritis, essential hypertension, peptic ulcer, and inflammatory bowel disease (Taylor et al., 1997). Yet, studies have found elevated alexithymia in patients with a range of other conditions, including irritable bowel syndrome, cardiac disease, non-cardiac chest pain, breast cancer, diabetes, morbid obesity, chronic pain, eating disorders, substance dependence, pathological gambling, kidney failure, stroke, HIV infection, fibromyalgia, panic disorder, post-traumatic stress disorder (PTSD), erectile dysfunction, low sperm counts, chronic itching, and more. The growing recognition that alexithymia is not specific to psychosomatic disorders has led to the view of alexithymia as a risk factor for those medical, psychiatric, or behavioral problems that are influenced by disordered affect regulation (Taylor et al., 1997). Alexithymia is associated with a failure to use adaptive affect regulation processes such as modulating arousal, appropriately expressing or suppressing emotions, employing fantasy, obtaining and using social support, tolerating painful emotions, cognitive assimilation, and accommodation. (That is, screwed up emotional response and control, which probably applies to almost every human being , under specific conditions and at various and numerous times during one’s life?) By hindering these processes, alexithymia is hypothesized to be one of several factors that contribute to various physical and mental health problems, including undifferentiated negative moods such as depression and anxiety, compulsive or addictive behaviors, heightened or prolonged physiological arousal, physical symptoms, and potentially somatic disease (Taylor et al., 1997).

How did we get from “lacking words for feelings” to any and all human “problems”?

In an earlier article Lumley, Stettner, and Wehmer (1996) described several processes or mechanisms by which alexithymia may influence health and illness, including changes in physiological systems (e.g., autonomic, immune, endocrine), health behavior, cognitive processes (e.g., attributions, appraisals), and social relationships (e.g., social support, social models). The current paper complements and updates that earlier review.

In this article, we examine five domains of clinical interest that may be informed by the assessment of patients’ level of alexithymia: pathophysiology and somatic disease, symptom presentation, maladaptive behavior, response to treatment, and the possibility of reducing alexithymia. In the following sections, we critically examine the literature of each domain. Table 1 summarizes our interpretations of the literature for these five domains along with limitations of those interpretations. (see paper)

Does Alexithymia Contribute to the Etiology or Pathology of Somatic Disease?

A leading theory is that the alexithymic person’s (Hmmm… shift to alexithymic “aspects” become the person’s identity) failure to regulate negative emotions results in altered autonomic, endocrine, and immune activity, thereby producing conditions that are conducive to the development of somatic disease, although the specific disease that develops is determined by other factors (Taylor et al., 1997). What is the evidence for this theory? Studies of alexithymia and physiological processes are of two types—immune function and psychophysiologic activity (Guilbaud, Corcos, Hjalmarsson, Loas, & Jeammet, 2003).

Lab data here…

There are a number of limitations of these studies, however. The studies are limited to laboratories, and we do not know how alexithymia is related to psychophysiological activity in the natural environment. (Radically more important than lab results, since most humans don’t live in a lab) Also, it is possible that elevated resting sympathetic or cardiovascular arousal could result from adjustment to the novelty of the laboratory environment, or even to factors such as poorer aerobic conditioning or the use of arousing substances (caffeine or nicotine), which most studies do not assess or control. Also, the laboratory stressors that have been studied vary widely, and many are passive or contrived (e.g., viewing videos) rather than personally relevant stressors, which may yield different responses. Finally, different physiological measures yield different response patterns, particularly in response to different emotions, thus complicating interpretation of these studies further. (Mind-boggling “ditch-digging” that undermines the whole “shebang”)

Note: We still don’t have a clear medical definition of Alexithymia anywhere in this discussion so far. What the hell are we talking about? Another mysterious label that is so extended and diffused as to mean nothing!

In summary, although the literature has limitations and the findings are not entirely consistent, there is some evidence that people with alexithymia have more resting sympathetic and cardiovascular arousal as well as impaired immune status than people without alexithymia. (more)

Does Alexithymia Contribute to Symptom Reporting and Health Care Utilization?

Although there has been much interest in the possibility that alexithymia contributes to somatic disease, an alternative mechanism is that alexithymia influences illness behavior, particularly the experience and reporting of physical symptoms and seeking of treatment. The prolonged or heightened physiological arousal experienced by an alexithymic person might be experienced as aversive physical symptoms and reported as such. Relatedly, alexithymia may prompt a person to report only the undifferentiated physiological aspects of emotion but not the emotional label or the subjective, feeling aspects of emotion. Finally, alexithymia may prompt lead to somatosensory amplification, or the tendency to notice and be concerned about one’s body, which can be intensified by the low-level negative mood that often accompanies alexithymia. All of these processes are sometimes considered aspects of “somatization.” (The ubiquitous “It’s all in your head” diagnosis – and the classic presumption that children are just trying to get attention by pretending to be sick.)

Many studies have found positive associations between alexithymia and symptom reports. (data here)

Increased symptoms in alexithymic people would be expected to prompt health care utilization, and several studies support this proposal. (more)

The proposal that alexithymia drives the experience of symptoms and seeking of care rather than somatic disease may explain why some studies find similar levels of alexithymia among different patient groups, or between patients with “explained” versus “unexplained” symptoms … (more)

Does Alexithymia Contribute to Unhealthy Behavior?

Alexithymia also may contribute to poor health by prompting maladaptive or unhealthy behavior. Although behavior is influenced by many factors (e.g., environmental contingencies, modeling, attitudes), poor emotion regulation also may contribute to unhealthy behavior. For example, drug use and other compulsive actions may serve to modulate aversive arousal. Even behaviors such as safety, nutrition, or hygiene may be impeded by the failure to experience or recognize potentially adaptive feelings such as fear, guilt, or even self-pride.

Are the authors describing “neoteny”? That is, Alexithymia as the “inability to establish adult emotional stability” …another expansion of a “symptom” into a majority condition in Americans, as is now claimed for autism and mental illness? Hmmm…

There is consistent evidence that alexithymia is elevated in people with eating disorders, problematic gambling, and alcohol and drug abuse or dependence although perhaps not cigarette smoking and nicotine dependence. One comprehensive study found that, compared with controls, patients with eating disorders or alcohol- or drug-related disorders had similar, high levels of alexithymia, and a path analysis suggested that alexithymia predicted depression which predicted the addictive behavior in these disorders (Speranza et al., 2004). In addition, alexithymic people were found to have poorer nutrition and a sedentary lifestyle (Helmers & Mente, 1999) and a greater body mass index (Neumann et al., 2004). Alexithymia also is associated with a history of childhood maltreatment and subsequent self-injurious behavior (Paivio & McCulloch, 2004). Interestingly, alexithymia is related to less frequent sexual intercourse among women (Brody, 2003), thus possibly decreasing the risk of sexually transmitted diseases, although likely signaling interpersonal difficulties. Finally, an impressive, 5.5-year longitudinal study of 2297 middle-aged men found that alexithymia predicted increased risk of all-cause mortality, and the effect was even stronger for the risk of death due to injuries, suicide, or homicide, which suggests the importance of alexithymia-associated maladaptive behavior in these outcomes (Kauhanen, Kaplan, Cohen, Julkunen, & Salonen, 1996).

I’m sorry – this is why Aspergers simply give up and say, “bat-crap-crazy” neurotypicals…again.

There is a compulsion on the part of neurotypical “magic word thinkers” to take the most specific “aspects of thought and behavior” in human beings and to suddenly be possessed by the “demon of cognitive diarrhea”. Concrete thinking is utterly lacking. Analysis is unknown mental territory. Intellectual self-discipline is an “unimaginable” skill.

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The construct of alexithymia is, in our opinion, a welcome addition that broadens our understanding of emotions, affect regulation, and the etiology and treatment of medical and psychological disorders. There is now a voluminous literature on alexithymia, and it is time that the construct makes inroads into clinical practice. The assessment of alexithymia in medical and mental health settings is both feasible and recommended, multiple measures of alexithymia using different methods are currently available, and the literature supports a number of useful clinical inferences when elevated alexithymia scores are found. Knowing a patient’s level of alexithymia guides our understanding of health status, clinical presentation, behavior, and responses to treatment. Although there remain various interpretive and conceptual limitations, we encourage readers to translate empirical and theoretical knowledge about alexithymia into clinical practice.


Preparation of this article was supported, in part, by a Clinical Science Award from the Arthritis Foundation and NIH grants AR049059 and AG009203.