Laura James (1)

Books by people with autism about their condition are a dime a dozen. We don't need more.

And yet, I'm inclined to recommend this book -- if you'll allow me a preface. When I started reading this, a lot of it was routine to the point of boredom -- a chronicle of anxiety and rigidity. Standard autistic traits. Some insights from researchers on the topic -- yes, women with autism typically are better at hiding their condition than men, because they're better at mimicking "normal" behavior. But this really isn't news, any more. I was reading this book in dribs and drabs, without much enjoyment and without learning much.

Then, on about page 185, I realized what James's real problem is. She has (Big Heavy Word Alert) alexithymia, which is a fancy Greek way of saying that she has no words for her emotions -- she doesn't know what she's feeling. She says herself that she doesn't really have the ability to distinguish pleasant from unpleasant emotions -- all she can tell is strong or not strong. She has enough self-consciousness to know whether things are "in control" or "out of control," but she can't really self-regulate because, other than that, she can't recognize what is going on. She writes rather wistfully about her partner's ability to sum up his emotions in one or two words. Hers, she thinks, are too complex for that. It doesn't seem that way to me; truly, what she keeps describing is the Big Two of rigidity and anxiety plus some sensory problems. So why is it so hard for her to know what is going on? Because her ability to analyze herself is affected.

Suddenly, that made the book more significant. Roughly half of people with autism -- including highly intelligent ones like James -- have alexithymia. This helps explain some of the problems James has had in therapy (although a lot of it may just be that she ran into the wrong types of therapists -- a Freudian turned loose on a person with autism is effectively guaranteed to do more harm than good, e.g.). But most people who can't describe their emotions can't describe their lives, either. James is a good writer and a good researcher; she can.

A autistic person with alexithymia is at a significant handicap compared to those who can identify their feelings. She finds it harder to understand others, or to understand the ways they use to control their behavior; she has no way to connect others' feelings with her own. Autism is defined in terms of social problems and repetitive behaviors, but emotional problems are also high on the list -- I, for instance, suffer from excessive loyalty, excessive susceptibility to rejection, and "emotional contamination" (the ability of others to inflict emotions on me). James, in particular, suffers from the second of those. But she hasn't really learned how to deal with it.

It's a rather heart-rending tale. You may not enjoy it. But if you read this book with the goal of understanding what it is like to experience feelings you cannot identify, it can be the source of very deep insight.… (más)

I love this idea.

The book itself could perhaps use a little, well, help. The idea here is to take famous characters from children's books, movies, etc., and assess what psychological condition each would have if actually diagnosed. Since many fictional characters are one-dimensional, and that one dimension is often psychologically distorted, it's a really cute notion.

The execution sometimes lacks a little. All the chapters follow the same format -- "Name," "Physical presentation," "Diet," "Family background," "Patient notes," description of the disorder, description of treatment, and a much-too-facile checklist for suggesting whether someone has the disorder. This frankly gets to be a little wearing after a while. Some of the articles are brilliant (that Tigger from Winnie-the-Pooh had Attention Deficit/Hyperactivity disorder is obvious, and because it's so straightforward, the article flows quite well). But some plod; you'll feel you've read almost the same text again and again.

And some of the diagnoses simply aren't right. For example, author James suggests that the Tin Woodman in The Wizard of Oz has schizoid personality disorder. (A diagnosis will almost certainly vanish in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, as will the Histrionic Personality Disorder that James incorrectly assigns to Cruella de Vil.) The Tin Woodman, by her case notes, used to feel love strongly, then gave it up because he thought he would be rejected. That's not schizoid personality disorder, that's avoidant personality disorder -- a diagnosis which exists and will continue to exist. Similarly, psychopathy is not a disorder -- it's a proposed subtype of Antisocial Personality Disorder that has not been approved. James admits this but still uses the diagnosis for Bluebeard.

Similarly, we read that Mad Hatter and March Hare have "shared psychotic disorder." But that diagnosis was so rare that it has simply been dropped from the newest edition of the Diagnostic and Statistical Manual. Nor, I would suggest, do the Hatter and Hare share their disorder; they're just both very odd ducks. (Or lagomorphs, as may be.)

And since we're on Alice in Wonderland: Alice's address is not "Rural England." It's the Dean's Residence, Christ Church College, Oxford, England. Oy. And Alice was extremely intelligent -- the brightest child in a family known for its very high intelligence; she didn't merely have "age appropriate" intelligence. Growf.

Also, James picks on the residents of the Hundred Acre Wood for all living alone, claiming this is disordered. But they're all animals, mostly mammals. Other than humans, almost no mammals form pair bonds. This is normal.

Finally, has James ever read any versions of the folktales (Cinderella, Beauty and the Beast, etc.) other than those by Charles Perrault? (Or maybe by Walt Disney?) Those versions of the tales don't give a good match for the young women of, say, the Grimm version Cinderella. It's perfectly legitimate to analyze Disney's Cinderella (at least in the context of analyzing the Wizard of Oz or Willy Wonka or Peter Rabbit), but it needs to be clear that it's Ms. Cinderella Disney, not Ms. Cinderella Grimm.

And this book was written in 2007. How about a section on Harry Potter and his Intermittent Explosive Disorder and possible Conduct Disorder? That could turn out very badly indeed....

I don't want to criticize too much. This is a clever idea, and I commend Laura James. But readers will probably want to take this book in small doses (not more than one or two cases a day), and they need to be aware that this isn't even close to an adequate diagnostic manual.

At least for human beings. If you ever have to analyze a Tigger, it probably provides all the information you'll ever need.… (más)

After wondering all her life why she seemed different from other people, in her mid-forties Laura James was diagnosed with both Ehlers-Danlos and Asperger’s (and I suspect she may have synesthesia, too, although she doesn’t say so). Over the course of a year, she learns all she can about these disorders, and things start making sense to her- and to her husband. It’s not that she’s been a failure- she was highly successful, with four children and a career as a journalist. But there had always been situations that caused extreme discomfort, sometimes even leading to a meltdown. Crowds, uncomfortable clothing, sensory overload- even some colors- are all things she tries to avoid.

Highly intelligent, she and her second husband created a life that allowed her to succeed and still be protected from things that stressed her. Getting her diagnosis explained so much about her, but she’d already gone a long way towards accommodating her problem. The diagnosis meant she could find out how other people dealt with having autism and allowed her to be in contact with people who faced the same problems.

The book follows her over a little over a year’s time, with sections of current time alternating with her past. It’s a really interesting read, but I could never quite get invested in her story. There is a dryness to her prose that seemed somehow stand-offish, even though she talks about some really painful events. Perhaps part of being autistic, perhaps part of being a journalist, used to presenting facts. A four star read; I recommend it to anyone with a person with autism in their circle, because it might really help them to understand that person.… (más)