An informal rant about individual differences in autism and why the extreme male brain theory should be axed;




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I think the fundamental problem of why we cannot understand the difference between males and females with autism is because we look at the condition as a overriding layer of a person’s self, and do not consider that whilst this does colour a lot of our thinking and behaviours, there is still the influence of personality, external inputs such as society, gender, past experiences, birth order, star signs, past lives (too far!?).

The point is we are all individual and unique already, and the autism mixes in with that. For example, when you see two people experiencing depression they may appear nothing alike. One may be bed bound, refusing to eat or talk, they have completely given up on life. Another may be found sobbing loudly at work as soon as anything goes wrong, telling people she’s just met about the Prozac her Drs recently prescribed her and how her therapist thinks it’s due to her mother’s emotional neglect. Yet there are also people who you wouldn’t even know had depression, they externally have not changed in the slightest. What makes people react so differently to the same illness? It is unfair to say it is due to severity, often those who commit suicide from depression are the ones you did not even suspect had any problems at all.

What it comes down to is individual personalities and experiences.  The extravert who loves to be around people and who has never experienced rejection may be more likely to sob in public and not fear being seen, whilst the introvert who has been rejected in the past may keep their illness completely hidden, believing they are stupid to feel this way. Whilst we consider conditions like depression an illness, there is a similar affect with all psychiatric, developmental, and neurological conditions. This is why we become stuck with the very strict criteria of what autism is and what it looks like. We have a set off core symptoms that should be found in anyone with autism (social communication problems and restricted and repetitive behaviours), our mistake is to believe that these should look the same in everyone. It would be a much easier diagnosis if they did, but can we say that just because someone makes good eye contact they cannot be autistic? No, because there are many factors that make people more or less prone to make eye contact. The impairment is with social communication as a whole, and this may be something a person struggles with internally more than externally. For example someone with autism may really struggle to make small talk with another individual, but may have learnt ways to introduce themselves and keep a conversation going. It may be painfully awkward inside but outside not noticeable, that doesn’t mean the impairment isn’t there. What happens if you get an extremely extraverted autistic person? Will this look the same as an extremely introverted autistic person? What if you have an autistic person who has 5 brothers, compared to one who is an only child? Are they able to socialise better with their peers and be less rigid and self-orientated? The point is that impairments can be expressed in hundreds of different ways depending on an individual.

So when we compare males to females with autism, are we really looking at individual differences and how these play a role? If we take the Extreme Male Brain Theory, which attempts to summarise autism as an extreme form of the male brain, whereby individuals on the spectrum are quite low empathisers and high systemisers, we see a very set way or viewing autism which does not allow for individual differences. Instead of viewing autism as an extreme form of the male brain I would argue that autism is more a extreme hyper focussed selective brain. If you test mainly males for an extreme male brain, then of course you will find many have an extreme form of maleness, because they become hyperfocussed in their interests, and as they are men these will mostly be male orientated. So if more males are systemisers who like physics, then for sure autistic males will be even stronger systemisers who obsess about physics. If we look at the common obsessions females with autism have, they look completely different to males. Females with autism often obsess over soap operas, books, animals and psychology. It could therefore be said that autism is an extreme form of the female brain too, when actually autism is just an extreme brain. I am often surprised by just how different two people on the spectrum can be, and in my field of research and work come by a really diverse mix of people with autism. What binds them all is their similar difficulties in socialising, and the extremeness of their obsessions and sensory stimulations.

It is not helpful to keep trying to box autism more than it already is. No two people’s brains with autism look exactly the same, just as no two people’s without autism do. When we assess for autism we must look beyond the physical manifestations of the disorder and stereotypes we have all been fed to make our lives and work easier. We all respond to the world differently, and just because a person has autism doesn’t mean they don’t have their own personality and experiences too.

 

 

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Autism - Autism Diagnosis - Autism research - gender - Mental Health - sexism
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16 Comments
  1. This is a very clever and sophisticated analysis! I tend to hang out with visual artists and poets/writers, many of whom (in your broader sense) seem to show signs of Asperger’s and are not in the least systematizers.

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  3. This is the first time that I will comment on your blog, but I want to say that I always appreciate your articulations that combine your own subjective experiences as well as your academic knowledge and research experience. (I myself went to university to study neuroscience, and often struggle to bridge the gap between my own mental health struggles and what I have read in research and textbooks, but have never been able to verbalise this as you do so eloquently).

    I hope it is okay for me to reblog this and comment, as it encapsulates some of the my frustrations that I will probably not receive a diagnosis (on the NHS, at least), and therefore, not be counted in the statistics. There are many like me (I tick the boxes of two categories that often go undiagnosed: adults, and females), who get missed off the numbers, perpetuating this myth that women “are not susceptible”, this vicious circle, and confirmation bias that comes along with this. To add to your points about individual differences and also a past post you did on CBT, I am recently learning through my counsellor at the moment, that my past attempts at CBT were unsuccessful, perhaps due some traits of me possibly being on the spectrum (such as the fact that I find it difficult to distinguish what detail I am meant to prioritize, or some alexithymic traits that I have).

    (Sorry for the long comment! To sum it up, I just want to say that you’re great, and I really really appreciate your writing!)

  4. I appreciate this post so much. I am a self-diagnosed Aspie who identifies with many of the traits I’ve read about, but also not with many others. I have my extreme obsessions, I have my own world in my brain that I prefer to live in rather than the real world, and I have a hard time connecting with people because I hate talking about myself and don’t really know how to.

    Still, many people look at me and think I can’t possible be an Aspie because I make good eye contact (before I read up on it, I had WAY too much eye contact; I had to read up on the proper amount to do it), I can have regular conversations (though they’re mostly one-sided as I prefer listening), and I can function fairly well.

    To be honest…I’m happy in my little bubble. I can get lonely sometimes, but for the most part I’m happy. I wish others could see that instead of forcing me into uncomfortable social situations to make friends with all their friends.

  5. Hi Hannah,
    somehow this morning, I managed to stumble upon your “Changing the Face of Autism” video and now I’m here. I’m 23 years old and for at least the past 5 years have had this feeling in my gut that I might be on the autistic spectrum. But, as the case seems to be with most late diagnosis female autism cases, any time I’ve brought this up to someone, they tell me I’m way too normal for that. I’ve struggled with a lot of anxiety and depression in the past two years because trying to fit in has gotten so exhausting. I want to seek help and get a proper diagnosis but to be honest I’m really terrified of not being taken seriously. If you have the time, I’d love to chat with you about your experiences and maybe get some advice.

    Justine

  6. I’m just beginning to check out what may have been going on with me. Very early on, I realized I was “the forgotten one.” If I won an academic effort, there was no mention that I had been the winner. I was grouped in with others who were good, as if I was nothing special. And when I worked for weeks on decorating for school dances, I’d be the one whose name wasn’t on the list, and when I mentioned that I’d been there everyday, the one managing the effort would say “oh, that’s right. I remember seeing you.” When everyone else started dating, I realized I didn’t know how to interact with guys. I became completely confused on how to act or what to say. I was physically attractive enough, so eventually guys who had met me through some activity would ask me out. But it was never like I saw it was with other girls. I had so many communication issues. I was too good at some aspects of school, and probably would have been great at other aspects if I only knew how to ask for guidance. I still lack the ability to ask for help. And when I have a serious physical condition, I hide it for months, simply not showing up for events until people think I’m not interested. I don’t know if that’s Asperger’s or not (I think the old language was more accurate, so I’ll use it here). I had very serious separation anxiety as a toddler. And as an adolescent I considered suicide. I’m older now, and I’ve made peace with all of it. I was able to overcome much of it by pouring myself into over-achievement and then my work. I married an extremely introverted man who doesn’t ask a lot of time or attention from me. We meet on breaks from doing whatever geeky stuff each of us is into at the moment. I am definitely obsessive about my hobbies. No health professional has ever suggested I might be on the spectrum. But something has never been quite right, and I’ve hidden it well. In fact, I’ve only told my husband very superficial things about it, but I’ve never shared the reality of it with anyone. Except a glimmer of it here, to you.

  7. I completely agree that the ‘extreme male brain’ theory is pretty poor. Loved your alternate theory of it tho – in terms of ‘hyperfocus’. In general I just I don’t think we know enough about the brain to give good behavioural based diagnoses. No one would have ever guessed I have Aspergers, simply because I came up with some really good coping strategies (i.e. was good at hiding it)

  8. On the spectrum.

    All humans are on the neural diversity spectrum so visualising a Gaussian curve is a sound way to contemplate how diversity is distributed.

    There is the ‘normal distribution’ which almost every human is clustered around and then there is the rest of the curve stretching off into a type of infinity (in this example).

    Every single person inside or outside of the ‘normal distribution’ expresses a unique neural diversity. In my opinion there is little value in establishing a definitive nomenclature for neural diversity in our clade given the complexities of analysing everybody. Every single human would need to be measured to establish a meaningful definition.

    I feel that all the people whose neural diversity exists outside of the normative, neural typical, distribution can be empowered by understanding they occupy a unique position along an infinite spectrum.

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