Tuesday, November 10, 2009

The Existence of Asperger's

Simon Baron-Cohen complains about the possible removal of Asperger's Syndrome from The Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. Asperger's is not regarded as sufficiently different from classic autism. The APA book defines mental illness for the world and, crucially, for insurance companies. This has always been an alarmingly subjective business. As Baron-Cohen points out, it is not yet possible to define a mental illness in terms of its causes, only in terms of its symptoms and symptoms, especially mental ones, are slippery things. I am not, to my knowledge, mentally ill. But I have just been reading Melanie Klein - brilliant - and she seemed to nail me on a number of counts. In fact, I suspect she nails most of us. That amounts to a character study, not a diagnosis, and no treatment is required, certainly not prolonged encounters with Gabriel Byrne. Yet, doubtless, I could get hold of the APA 'bible' and find something wrong with me. At the other end of the spectrum, however, lies Asperger's, a real and terrible condition. But there it is, symptom-defined like everything else and subject to the kind of re-ordering to which Baron-Cohen is objecting. Mental illness remains a curiously weightless conception.


  1. A lot of people talk about Asperger's being one end of a continuum, on which all people (or just men?) sit. My brother-in-law was diagnosed with Asperger's when he was at primary school (he's now in his mid-thirties), and sometimes it does seem like he's just a sort of extremely shy man, but at other times he's clearly in different category and the continuum idea falls down. Which, as you say, illustrates the inherent difficulty in trying to label mental illnesses.

  2. Pinker, in the lecture Mark linked to yesterday, discusses briefly why such horrible tortures and punishments were extant in medieval times often for quite trivial crimes. He puts it down to Singer's circle of empathy being smaller because of limited communications and therefore fewer chances to walk in another's boots. Personally, I don't think this is sufficient.

    However, without going all the way down the road of Foucauldian antinomianism, my point is that a decent number of people from the pre-modern era might well be considered to exhibit psychopathic behaviours.

    Isn't one of the implications of Baron-Cohen's argument (which I believe he accepts) that the increase in diagnosis in Aspergers may be a product of less tolerance today for the extreme male brain?

    The socially determined definition of mental states is a fascinating topic, which I think deserves a lot more work, probably multi-disciplinary. There's a lot of mystery as to why people thought differently in different times as is suggested by the inadequacy of some of Pinker's explanations.

    Not a lot seems to be happening in the arts and social sciences on this topic, at least that I'm aware of (though Hilary Mantel's recent Wolf Hall is a terrific imagining of a great historical alteration in mentalities). It's mostly the scientists and futurists who are doing the work. Foucault fouled the nest, it seems!

  3. I posted on Pinker's lecture here (and re-posted the lecture itself). It's all very heartening, albeit fundamentally mysterious. Well worth watching.

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