The Imprinted Brain

How Genes Set the Balance Between Autism and Psychosis

Christopher Badcock

• Publisher: Jessica Kingsley Publishers
• Year: 2009
• Print ISBN:
  9781849050234
• eBook ISBN:
  9781846429507
• Topic: Psychology
• Subtopic: Autism Spectrum Disorders
• Index: Psychology

The Imprinted Brain sets out a radical new theory of the mind and mental illness based on the recent discovery of genomic imprinting. Imprinted genes are those from one parent that, in that parent's interest, are expressed in an offspring rather than the diametrically opposed genes from the other parent. For example, a higher birth weight may represent the dominance of the father's genes in leading to a healthy child, whereas a lower birth weight is beneficial to the mother's immediate wellbeing, and the imprint of the mother's genes will result in a smaller baby. According to this view, a win for the father's genes may result in autism, whereas one for the mother's may result in psychosis. A state of equilibrium - normality - is the most likely outcome, with a no-win situation of balanced expression. Imprinted genes typically produce symptoms that are opposites of each other, and the author uses psychiatric case material to show how many of the symptoms of psychosis can be shown to be the mental mirror-images of those of autism.

Combining psychiatry with insights from modern genetics and cognitive science, Christopher Badcock explains the fascinating imprinted brain theory to the reader in a thorough but accessible way. This new theory casts some intriguing new light on other topics as diverse as the nature of genius, the appeal of detective fiction, and the successes - and failures - of psychoanalysis.

This thought-provoking book is a must-read for anyone with an interest in autism, psychiatry, cognitive science or psychology in general.

Chapter 1

Autism and Its Compensations

Once, autism was thought to be a condition with few if any positive aspects, but today a more balanced view has emerged. In this chapter I aim to show that autism is not simply a combination of deficits as was once supposed, but is associated with some remarkable sensory and cognitive compensations. As we shall see, research into autism suggests that human beings have evolved two parallel ways of thinking. One, which you might call people-thinking, mentalistic cognition—or more simply mentalism—is wholly concerned with understanding human beings, their minds, motives, and emotions; the other, which by contrast you could call things-thinking or mechanistic cognition is concerned with understanding and interacting with the physical, non-human universe of inert objects. It is to the latter that we owe our technological, scientific, and material mastery of the world, and we shall see that although autistics symptomatically have deficits in mentalistic peoplethinking, they are often superior where basic sensory sensitivity is concerned, and can sometimes show extraordinary abilities in mechanistic things-thinking. Furthermore, this way of looking at autism suggests that the exact opposite cognitive configuration—superior mentalistic skills with deficits in basic senses and in mechanistic cognition—could also exist. Later I shall argue that it indeed does in psychotic disorders such as schizophrenia and that what passes for normality is nothing but a more or less stable balance of both tendencies. The fundamental insight is that autism is part of a much bigger picture which includes both psychosis and sanity, and lies at the heart of human genius, as I shall argue in my conclusion.

But this is to anticipate. First, let me set the scene with a brief historical summary of what we have come to know about autism.

Autism, schizophrenia, and Asperger’s syndrome

The word autism was originally coined by one of the founding fathers of modern psychiatry, Eugen Bleuler (1857–1939), to describe a style of thinking found in schizophrenia (itself another Bleuler coinage).1 He derived it from the Greek

(autos) meaning “self,” and defined it as “detachment from reality, together with the relative and absolute predominance of the inner life.”2 In 1936 the paediatrician, Hans Asperger (1906–1980), gave a lecture at the Vienna University Hospital in which he described the characteristics of “autistic psychopaths,” and in 1938 and 1944 published details of more such cases.3^,4 Meanwhile, in 1943 the psychiatrist, Leo Kanner (1896–1981), also published an account of 11 children at Johns Hopkins University Hospital in Baltimore who were suffering from what he called “early infantile autism.” He concluded that “Profound aloneness dominates all behaviour” in the autistic child, adding that “We must, then, assume that these children have come into the world with innate inability to form the usual, biologically provided affective contact with people, just as other children come into the world with innate physical or intellectual handicaps.”5a

It is not known whether Asperger’s discovery influenced Kanner or even if he knew of its existence. In any event, Asperger remained largely unknown to the English-speaking world until the 1980s6 and his name was not so much as mentioned in one of the most well-informed and wide-ranging reviews of the autism literature published in the 1960s.7 Recently an account of six cases diagnosed in 1926 as various types of “schizoid personality disorder” has been translated from the original German. Some of these subjects were also described as “autistic” by its author and bear striking similarities to the type of high-functioning autism now associated with Asperger.8^,9 However, even earlier accounts certainly exist.7a^,10 Indeed, there is evidence of a five-year-old autistic boy having been admitted to Bedlam in 1799. The case was described in a textbook of 1809 by John Haslam, the Apothecary of Bethlehem Hospital, and this may well be the earliest description of autism in the psychiatric literature.11 Nevertheless, authors such as Jane Austen (1775–1817) and Sir Arthur Conan Doyle (1859–1930) appear to have had an implicit awareness of features of autism and to have been able to portray autistic characters in their fictional works quite independently of science and psychiatry12 (for more on Conan Doyle, see pp. 196–198).

Today autism and schizophrenia are thought to be separate disorders, and Bleuler himself later substituted dereistic for autistic as a description of schizophrenic thought that was less likely to be misunderstood.13 However, a major theme of this book will be to argue that there is indeed an important link between them. Later I shall suggest that autism and psychoses such as schizophrenia could be seen as extremes on a single line of development—with normality balanced precariously in between. Just as both over-sensitivity and under-sensitivity to light or sound will cause visual or hearing short-comings, so we shall see that both over- and under-sensitivity to your own and other people’s minds can cause the contrasting mental deficits seen in autism and psychosis. If this is so, you might wonder to what extent the early association of the two disorders in psychiatry was an anticipation of what is now beginning to look like a profound connection ultimately explicable in terms of genetic findings that are only now coming to light.

Autism is a disorder that usually first becomes apparent in childhood, mainly as a result of failure to develop normally. A consensus panel of the American Academy of Neurology recommends that a child with any of the following symptoms should be evaluated for possible autism: no babbling, gesturing, pointing, or waving good-bye by 12 months; no single words by 16 months; no two words spoken together spontaneously by 24 months; and any loss of language or social skills at any time.14 As the last item suggests, children can develop normally up to a certain point, and then regress; while others can appear to have early delays in these respects that are later fully compensated and leave no lasting deficits.15 Typical symptoms and signs of autism are set out in the box above along with a number of other features often mentioned in connection with autism although not found in all cases (for a more exhaustive discussion see 16.)

Typical symptoms and signs of autism

•deficits in non-verbal communication such as eye-contact, facial expression, and body language

•self-absorption, egocentricity, and lack of awareness of and insensitivity to others, with difficulty in establishing relationships, friendships, or peer-relations

•delay, or total lack of language competence, with communication deficits or peculiarities in speech, gesture, and conversation

•repetitive and/or stereotyped movements (such as handflapping), with distress over change and insistence on routine, or a compulsion to carry out rituals

•fragmented sensory perception with inability to generalize, and pre-occupation with parts rather than wholes

•abnormal pre-occupation with or intensity of interest in one subject or activity, perhaps with isolated areas of expertise and/or exceptional rote memory alongside more general cognitive impairment

Additional features often found associated with autism

•mental retardation (found in about 75% of cases)

•unusual beauty, often looking younger than they are, with a characteristic “autistic look” described by Kanner as “beatific serenity”

•odd or unusual gait

•difficulties with hand-writing

•insensitivity to pain, often combined with indifference to cold (and sometimes lack of fear of heights and an amazing ability to survive falls)

•synaesthesia (mixing of perceptual categories) with confusion between different senses

•problems with depth-perception, “white-out” effects and other visual deficits, particularly in relation to moving objects, strange places, or novel situations

•unusual sensitivity to smell, sound, or other sensory perceptions, sometimes with sensations of “sensory overload”

•allergic or phobic reactions to specific foods, smells, or sensory perceptions, with resulting fastidious food preferences and avoidances

•bowel disorders

•sleep disorders

•epilepsy (25–35% of cases)

•intolerance of itchy and/or tight clothing

•chronic anxiety, often with excessive startle and fear reactions

•fear of crowds and strangers, and dislike of socializing

•panic reactions at being touched or hugged by people

•a liking for being wedged in small, enclosing spaces, or tightly squeezed into corners

•a fascination for spinning objects

•enthralment with machines, mechanisms, and gadgets of all kinds

An important aspect of diagnosis in autism is the extreme variability of the symptoms. Autistic children within the same family can have strikingly different autistic traits,17 and authorities point out that “None of the criteria exactly describes every individual with autism. Autism presents in a myriad of ways; every individual with autism is different and unique, and has features that would lead a person superficially examining them to say that this person can’t have autism.”18a

Another factor that has bedevilled diagnosis is confusion of autism with schizophrenia and other mental disorders, despite the fact that almost from the beginning some writers could see that they were antithetically different in many respects.7 What we would now call autism was often given labels such as “schizoid personality disorder” or even “childhood schizophrenia” in the past, and more recently there was also a tendency to diagnose children as autistic but to substitute “schizophrenic,” “psychotic,” “borderline,” or some similar diagnosis for the same symptoms when they grew up. Indeed, I shall argue in a later chapter that even today it is easy to confuse autism with psychotic disorders, and that although the symptoms might seem very similar, closer examination shows them to have completely different causes. Nevertheless, mis-diagnosis—principally of autistics as suffering from various forms of psychotic illness but also psychotics mis-diagnosed as autistics—has been a major factor in confusing autism with psychosis. This has certainly been true in forensic psychiatry where, despite the high numbers of autistics in secure prison hospitals,18b autism has tended to be regarded as a much less convincing plea of mitigation in the courts than has schizophrenia. A case in point is that of Theodore J. Kaczynski, otherwise known as the Unabomber, who has recently been diagnosed as a high-functioning autistic, but who was prevailed upon to plead insane on account of schizophrenia at his trial by his lawyers. Kaczynski’s autism and associated social isolation resulted in a highly atypical career of lone terrorism which occasioned the longest and most expensive manhunt in the twentieth century, and was only brought to an end when he attempted to communicate his ideas by publishing The Unabomber Manifesto.19 The result is that a classic case of autism has gone down in legal history as one of schizophrenia, and there is no way of telling how many other similar cases there may be.

Despite the fact that Kanner specifically remarked in his original report that “Even though most of these children were at one time or another looked upon as feebleminded, they are all unquestionably endowed with good cognitive potentialities,”5b Kanner’s name has become associated with a more severe degree of disability. One reason may be that 8 out of...

Table of contents

• Cover
• Of Related Interest
• Title Page
• Copyright
• Contents
• Preface
• Introduction
• 1 • Autism and Its Compensations
• 2 • Deficits in Mind
• 3 • From Gaze to Grandeur
• 4 • Cancers of the Mind
• 5 • The Battle of the Sexes in the Brain
• 6 • Sex and Psychosis
• 7 • Beyond the Balanced Brain
• Notes
• References
• Index