Not sure how trustworthy the source is, though. And short-sightedness is caused by behaviour (not getting sunlight), so it would be really hard to prove that vision problems lead to autism, and not the other way round.
Mirrors-- and, especially, common availability of mirrors-- are a relatively modern invention. They can't be a fundamental part of how people evolve a sense of self, though I wouldn't be surprised if they have an influence on modern people.
"Psychotics (schizophrenics) arises when this entrance into the linguistic field fails, and the psychotic ends up identifying too closely with language"
Psychotic is a particular condition of being, not a type of person, and even people with schizophrenia whose illness is relatively poorly managed do not inhabit an undifferentiated state for their entire existence. Nor is their internal state always blatantly visible to others, as it is in a crisis.
What I think you are referring to as "psychotic speech" is an extreme overflow of associations, where the mental activity is overloading the capacity to filter and communicate. Psychoanalyzing it is like psychoanalyzing a seizure.
You’re in good company. I remember waking my mom up at midnight one night after shining my dad’s brightest light in my eye me for long enough that I thought I’d gone blind, although I think I turned out slightly less autistic than my brother so maybe light therapy is the next big thing in autism therapy.
They have to test *variation* of the stimuli. A constant never-changing light might be useless, disco flashes or highly varied movie frames might work.
This agrees with common wisdom that autistic people try to minimize sensory perception. I think this is not restricted to sudden flashes, it also includes bright light and loud sounds in general.
How strong is the qualifier? If you're born with vision and go blind at six months.... how many people meet that criterion, anyway? Enough to do a study?
The first study, when scihubbed, says that sensory deprivation rooms improved schizophrenics. But given it’s a clinical report at a mental institution, idk how much to trust either the relevance (maybe they got better because even a sensory deprivation room is better than a mental institution) or the interpretation.
I think there is really something to the fundamental axis of autism vs schizophrenia being understimulation vs overstimulation. Autistics are understimulated and so never get used to high levels of stimulation and are easily overwhelmed by them, but on the other hand have a quiet working environment inside their heads that's useful for intellectual work. Schizophrenics are overstimulated and so learn to pull complex patterns out of noisy data, but then end up also finding a lot of patterns that aren't really there.
I'm not sure if this is what you were getting at, but both schizophrenics in a normal environment and other people in solitary confinement would have a lower level of stimulation than their body expected, so by the stimulation theory both would experience classic schizophrenia symptoms, e.g. hallucinations.
And autism - at least the sort of smart people with autism - “detect a lot of patterns” in the course of being very smart - despite not being schizophrenics, so I don’t think this is quite right
Yeah, but being blind to social patterns but “”finding lots and lots of patterns” in those and other areas suggests that it’s not a question of too many or too few patterns
I don’t think so, but even more I have no clue. Not a neuroscientist so I don’t really know what a mirror neuron is beyond the likely entirely wrong pop science thing, but (smart) autistic children still talk and can imitate the way other people move and stuff so it’s not like they don’t
Is there such a thing as debilitating congenital schizophrenia?
Not blind. Noticing different things, in different ways, but I really wish this “autistics are socially blind” thing would die off.
The number of times people have ridiculed me for noticing social patterns that they did not, saying “whatever, you're autistic, how would you even know”, is not a small number.
I wonder if having Aphantasia, having no mind's eye, pushes one to autism. Aphantasia would clearly seem to reduce levels of stimulation within ones brain. I have autism and Aphantasia.
I don’t think so tbh, as I discussed in an open thread I think the idea of aphantasia is given way too much weight by a lot of popular Reddit style ideas
>but then end up also finding a lot of patterns that aren't really there.
I do wonder if instead of overstimulation vs understimulation in the traditional sense, it has something more to do with how much sensory stimuli are processed.
Like, schizophrenics may experience sensory stimuli more deeply and in more detail, and as such find patterns much more often and over-assign meaning to sensory inputs. Whereas autistics don't tend to 'notice' or deeply consider sensory inputs (including physical social cues etc) unless something draws attention to them and they focus really hard.
I suspect you're reading a motive into the question, and feel like you're defending ASD people by responding thus, but if you're not going to actually respond to the question, I personally (as a diagnosed autistic who has suffered greatly due to misconceptions, to the point of being locked up drugged against my will for months a year ago) feel that you're doing more harm than good.
Different communities have different norms, and one of the norms here is to bend over backwards to assume good faith.
Congenital blindness has a wide variety of indentified causes. The 50%+ of blind kids with higher rates of autism is greater than share of heritable congenital blindness
I have no intelligent insights into any of these phenomenon. I just want to say they are very interesting and I intend them a topic of conversation among smart people at dinner parties soon.
1) A lot of ASD symptoms are secondary or tertiary from "real ASD genes/phenotypes" - specifically, they are the end of a chain of dominoes emanating from some other thing 'directly caused' by the ASD-causing genes.
2) Congential blindness, via a different pathway, tends to knock over such an early domino, and thus ends up propagating outward into the symptoms knocked over
Like, to throw out a random sounds-good-story to illustrate perhaps what I might mean - suppose that not making eye contact in some critical range makes some brain-development thing go wonky in a small set of ways.
Someone with ASD might find not make that eye contact because (like myself) looking at someone's eyes feels overwhelming (it's... sensorily overwhelming in a similar way to looking at the sun, except without that particular searing eye-pain).
Someone born unable to see doesn't get the same eye contact because they can't see the eyes in the first place.
Both would then end up with the same brain-effects of not having that eye contact.
Well 1 is almost tautologically true - what isn’t downstream from a complex multifaceted causality involving hundreds or more genes we don’t understand lol
Autism isn't purely social either, is it? My understanding is that they're bad at intuition in general, and dealing with other people involves a lot of intuition.
That doesn't really line up with my experience. More along the lines of having more explicit access to the machinery, able to plug in different interpretations to run different scenarios, and _much_ more likely to end up emotionally overloaded as a result, vs blithely (I'm being a bit cheeky here, but I'm not convinced I'm wrong :p) blundering ahead with an confident understanding of a situation that is "intuitive", but also (sometimes/often/occasionally depending on the situation) wrong.
Random thoughtless and unqualified guess but: could the "axis" just be some parameter of how(finitely?) the world model gets divided into separate representations? In schizophrenia I'd guess all concept representations begin to overlap too much, so the model of the world starts to take the shape of a single pattern to react to(hence extra brain tissue loss due to not needing the extra processing capacity to distinct separate models and having extra affect over them?), while in autism distinct parts of the world model get fragmented into their own, poorly overlapping but individually "rich" sub-models(maybe the local weights are too much so the sub-models barely communicate globally?) which causes fixation on specific detail and a difficulty in grasping the overall tone?
Utterly anecdotally, someone I knew with schizophrenia once told me that smoking helped him separate his ideas better from one another, so maybe whatever nicotine does as a stimulant is somehow connected to strengthening the cues that distinguish the cellular level representations of those sub-models from one another or maybe just increase the local representations' "weights" in the network...
And two last thoughts, I'm sorry for the triplepost but the lack of an edit feature here is grating: the tissue loss is actually probably the causal root for conceptual merging and not the reverse for schizophrenia. And I'd then assume that blind people don't get the sensory "unification" vision tends to grant and focus on individual sounds and sensations more so then the sub-models might naturally end up having fewer points of overlap...
[Repeated post for great offense-taking :D HaHaJustSerious :p]
Not blind. Noticing different things, in different ways, but I really wish this “autistics are socially blind” thing would die off.
The number of times people have ridiculed me for noticing social patterns that they did not, saying “whatever, you're autistic, how would you even know”, is not a small number.
But seriously, I'll try to think of some concrete examples that aren't betraying confidences (ie, the reason I know that I wasn't wrong in the memorable cases).
I can try to help fill this in. I don't look at peoples faces very much at all. Often that's because I'm just staring off into space thinking about abstract ideas, but equally often I am looking at *people*, just not at their *faces*. This means I notice a lot of details about how they hold and move their bodies. I spot subtle shifts in their weight as they lean a tiny bit forward or backward, unconscious or aborted small hand movements, and tension or relaxation in the arms and shoulders. Sometimes people point their bodies in the direction of somewhere they want to go, or repeatedly start lean in while psyching themselves to say something, or tense their arms in time with the pulses of chronic pain. I also fix these things in my memory and can return to them later.
Fairly often I'll say "you look like you ____" (wanted to say something about a certain topic/weren't feeling well/didn't like something that happened/were thinking about going to the kitchen/etc." This can visibly startle people and lead them to question how I could know or accuse me of being a "mind reader." I suspect that people expect to be able to modify their perceived affect by manipulating their facial cues and are unnerved by people who aren't thrown off by this.
Whereas I find I tend to be more hyper-aware of tells from phrasing and terminology, how carefully avoidant people are of saying particular things and how that translates to an outsize importance of the thing they always happen to avoid ever going anywhere near.
Though I've never been formally diagnosed with Asperger's, I suspect I'm on the spectrum — so take this for what it's worth. For me I seem to be OVER-reading and OVER-thinking social queues. I've come to believe that most people just don't really spend much time observing other people's facial expressions and body language — or rather they get a gestalt of what they're observing, and either respond accordingly or shrug their mental shoulders and move on to the next phase in the social interaction.
Also, I'm hyper aware of the emotions of cats (and dogs) — I guess because I've been around them all my life. The standard Ethological theory is that cats and dogs can't really display facial expressions except in extreme stress (hissing, pulling back the jowls to expose teeth, etc.). But up close (at least with my cats) I can read some emotional states from their "neutral" expressions. Cat jowls hide some very delicate lips, and if you look close enough those lips can display very human expressions.
I am a fan of the model of autism as a disorder of prediction, especially since recently Pawan Sinha measured some features which haven't been looked at before of motor impairment and sensory habituation impairment, are very much like his model predicted 6 years ago.
I feel it can be combined with Scott's and others' writing into a picture that autism and schizophrenia may be both disorders of "how much weight to put on top down priors", with autism defaulting to "too little" and schizophrenia to "too much".
Going on this model, it makes sense that vision during early childhood development is super important for calibrating your prediction machinery. If you literally can't see sensory input coming, you'll accept that the world is entirely unpredictable. That will lead to both 'passive' symptoms of autism (e.g. motor or sensory overload problems), and adaptive symptoms (like stimming or echolalia, which according to the prediction model are simply ways in which the child can create predictable sensory input in an otherwise scarily unpredictable world).
That said, this is a post-hoc justification and I don't know what I would have said if you asked me in advance whether blind kids are likelier to have ASD, so I will try hard to not update on this evidence.
> I am a fan of the model of autism as a disorder of prediction
I think it's neat too, but can't escape the feeling that it all smells a bit too much like Ancient Greek medicine for my liking.
The ancients noticed "Hey, there's a lot of weird fluids in the body, and they seem to be pretty important", so they speculated that maybe all the diseases were caused by imbalances between different bodily fluids, and eventually built an entire bullshit theory of physiology out of it. Nowadays we of course understand a little more about physiology and know that bodily fluids are one part of something more complicated.
The idea that everything wrong with the mind is some kind of predictive processing gone wrong smells to me a bit like the idea that everything wrong with the body is an imbalance of the four humors.
"The more I read about history, the more I realize that it was made up of people just like us. They didn’t always have the same tools we do, and they made some weird mistakes, but they weren’t any less intelligent than we are. Some of them were pretty smart.
I’m also concerned that this criticism doesn’t pass the sniff test. If Galen was really a moron, why did he have such a lasting impact? Most philosophers, including great ones, aren’t even known in their own time. There must have been something about Galen’s works that kept them around for thousands of years.
All this makes me very suspicious. Was Galen actually a dope? Or did someone pull an intellectual hit job on the guy? If so, why? What was he actually like, and why did he have such a huge influence?"
I accept it's a strawman, for the purposes of fitting the entire field of ancient medicine into about twelve words in the service of an analogy picking on something else.
But I think it's fair to say the following about ancient medicine:
1. They had a few of the basics right
2. They had vast gaps in their knowledge (e.g. cells, germs, chemistry) which prevented them from understanding a lot of what's going on
3. They leaned heavily on the few things that they did vaguely understand in order to explain all the things that they didn't, which resulted in a model of human physiology which wasn't all that true and wasn't all that useful for treating disease either.
And sometimes it feels to me, as a non-expert, like the study of the human mind in 2021 is roughly at the same point as the study of the human body in 400 BC.
3 not necessarily being true is precisely the point being raised by the book review:
"""
In fact, I was surprised by how modern Galen’s reasoning seems. At one point he discusses magnets, and argues against an atomic explanation of their action. Before you laugh, remember that the modern explanation is electromagnetic fields, which look a lot more like one of Galen’s natural faculties (a tendency for mutual attraction over distance) than they do Epicurus’ view that “the atoms which flow from the stone are related in shape to those flowing from the iron, and so they become easily interlocked with one another”.
In making this argument, Galen first points out that the idea that nature has “powers which attract” is sufficient to explain the observations. Next he says that since the proposed entanglement can’t be observed, it’s not clear why anyone would prefer this explanation to another. Even if we do allow it, he says, it doesn’t explain why a piece of iron that has previously touched a lodestone will then go on to attract other pieces of iron. The atomic explanation predicts that this shouldn’t happen!"
""
Certainly, there were a lot of gaps, but there was also recognition of those gaps, rejection of explanations due to contradiction, empirical testing, and cross pollination with other schools of thought.
Further, the nature of the textual record in an age with limited literacy practically requires that that record be distorted: from the acoup.blog link:
"""
One example I like to turn to is about medieval leprosy. Throughout the medieval world, people with leprosy were often removed from society, placed in leper colonies or leprosaria, and approached with a combination of fear and awe. But for a long time, and arguably even still, medical historians have questioned whether medieval peoples could actually distinguish Hansen’s Disease (the modern name for the disease that causes leprosy) from other skin conditions. Because medical texts don’t make it clear that they could. Just describing the symptoms of leprosy in these limited texts, it sounds a lot like late-stage syphilis. But studies of grave sites in leper colonies show that almost everyone buried there indeed had advanced Hansen’s Disease, which is apparent in the bones, particularly the bones of the face, which develop distinctive pitting on the upper jaw and degradation of the nasal cavity. This suggests that medieval understanding of these diseases in practice was a lot more sophisticated than theoretical writings suggest.
"""
I'm not arguing that they know everything (and by analogy, so do we), but that we do seem to have a foothold that makes actual useful predictions that can be falsified. It's incremental progress, but so is climbing a sheer mountain face, once you know how to find the footholds.
That was my take, but it turns out leprosy is much less contagious than you'd think (so not contagious that I don't understand how anybody gets it), and also a lot of people are genetically immune and can't catch it under any circumstance.
I get what you're saying, and I'm wary of it 'explaining everything' too (hence my hedging on "what would have I predicted if I would've had to guess"), but the model is more constrained than "everything wrong with the mind is some kind of predictive processing gone wrong".
It does not explain everything wrong with the mind (e.g. depression or mania or various psychoses), just the seemingly unconnected symptoms of autism - social deficits, sensory (and sometimes emotional) overload, motor impairments (e.g. walking on uneven ground or catching a ball), stimming and echolalia, adherence to strict patterns and routines etc.
Musings on schizophrenia are mine and mine alone, going off of Scott's writing.
Here's why I do like it:
1) Most importantly to me as a scientist, it already made new predictions about the details of some symptoms that weren't known before and were borne out by experiment. A model that makes new predictions gets a lot of points in my book.
Specifically, that severely autistic patients (unlike NT's) don't look ahead of the trajectory of something moving, only trail after it, and their motor response when catching a ball looks exactly like someone who can't predict where it will land until the last moment. Also, that they have much weaker sensory habituation to constant stimuli (the way we can 'tune out' a smell or noise) at the most basic neurological levels (of immediate sensory processing/prefrontal cortex).
Some of these experiments I don't know if they've been published yet, I heard them at a seminar that Prof. Sinha gave a few months back.
2) It really does tie together very elegantly symptoms that are really weird and unconnected, in a way no other model did before. And it focuses on the more basic neurological symptoms and less on the social aspect, which I appreciate. It's hard to imagine what does inability to register sarcasm have to do with stimming, and then it all clicks together as the result of living in a scarily 'magical' unpredictable world.
3) It ties into the PP framework nicely, and fits with some personal observations (e.g. that much of my experience on LSD was similar to the day-to-day experience of my partner, who has a bunch of autistic symptoms).
I really recommend the review I linked. Can send a file if paywall's an issue.
These comment threads on this post are making me wonder if I'm actually schizophrenic instead of ASD. Which is weird because I would not have thought that before.
Maybe my brain is just twitched in some completely different third way...
Huh. Do you mind elaborating why (i.e. what does your brain do that you) were diagnosed (or self-diagnosed) with ASD but think it might be schizophrenia instead?
I wouldn't be surprised if the space of "brain can't assign prediction weights properly" is mostly bimodal with tendency to settle either on ASD-like brains or SCZ-like, but with some people outside of the bimodal, as always.
Okay, now I'm wondering about links between colour-blindness and such. Gotta be a coincidence of the dna encoding multiple things, otherwise what on earth should a pigmentation failure have to do with anything neurological 😵 (I'm very colour-blind FWIW)
Contrary to what I expected from spectrum news . Org, they cite a “systematic review and meta analysis” https://pubmed.ncbi.nlm.nih.gov/30284394/ with “ The meta-analysis of the prevalence of schizophrenia in individuals with ASD encompassed 1,950,113 participants and 14,945 individuals with ASD.”. Interesting!
Yeah, this is part of what I'm trying to explain away with the paragraph "In theory you could use this kind of thing to help figure out what causes both conditions. In practice, it’s a lot more complicated. Autism and schizophrenia also resemble each other in a lot of ways, a lot of the genes for one also increase risk for the other, and some people even get diagnosed with both. I try to make sense of this conflicting information by speculating that autism has at least two components, which are correlated and anticorrelated with schizophrenia respectively (see here for guesses about what these might be), but still - all speculation and trivia."
So to test this, you’d want to see at higher IQs if schizophrenia and autism separate, or at least correlate less? Sounds like the sort of thing it’d be tough to find a good and large enough sample for
bored-anon: Ugh, copy/paste broke while fixing a typo; if you have the comment I typed out in a notification email, would you mind recovering my comment for me?
If you’re trying to dox me via hidden email metadata the copy will carry, nice try ;) (I doubt that’s doable exactly as it’s probably text only, and obviously you aren’t but it does gesture towards possibilities. Also it probably wouldn’t work as i segregate identities online)
FWIW, I'm very high IQ, diagnosed ASD, not at all schizophrenic (uot-patient psychiatrist agrees), but with a way of describing the world that for some reason convinces in-patient psychiatrists that I am in fact schizophrenic, which… is not a fun place to be. My out-patient psychiatrist has been giving me advice on this dilemma that amounts to “you probably should talk less and be really careful about how you phrase what you do say to mental health professionals if they don't know you really well”
As it happens, my comment contains an exploit for a fault in many mail servers that results in encoding ip addresses in the form of varying the unicode spaces used between words.
That is vaguely plausible-ish techno-babble tho I think bored-anon's concern might have been exposing their email address.
I can't think of any way that any email body data would encode metadata that could identify the recipient. I don't _think_ any (at all commonly used) email clients run JavaScript and, aside from convincing a reader to download and execute a file, you'd have to exploit something like a JPEG decoder/viewer library/program vulnerability (which _have_ existed).
The more prosaic 'attack', and one that's probably still common, is to link to an image on a server you control. When the recipient's email client downloads the image, your server can log/record the IP address for the host that initiated the download. That _could_ be the recipient's IP address, tho I think almost all of the popular web email services download images on their own services. But this wouldn't alter the email on the recipients end regardless. And IP addresses aren't particularly sensitive, or at least I don't think they are.
FWIW, I'm very high IQ, diagnosed ASD, not at all schizophrenic (my long-time out-patient psychiatrist agrees), but with a way of describing the world that for some reason convinces in-patient psychiatrists that I am in fact schizophrenic, which… is not a fun place to be. My out-patient psychiatrist has been giving me advice on this dilemma that amounts to “you probably should talk less and be really careful about how you phrase what you do say to mental health professionals if they don't know you really well”.
[Thank you bored-anon for helping me recover this comment from a copy-paste screwup!]
Honestly, I can really only make guesses (I have a significant degree of memory loss from last year, including much of my time in the hospital). Knowing a bit about myself, probably trying to explain existential angst to a doctor (or a nurse, and therefore to the doctor via an extra stage of telephone-game) while in the middle of a sensory meltdown episode.
Given some of your other comments about making inferences from details of people's verbal behavior that neurotypical people don't anticipate or follow, maybe you make assertions about what other people are feeling or thinking that the inpatient doctors interpret as paranoid or delusional?
I'm kind of curious how this interacts with aphantasia. It may be too hard to study, or I don't know how to look for studies about it, but anecdotally, I have total aphantasia, and I've worried on numerous occasions that my mind indulges in bouts of paranoia and "magical thinking" of the kind that is described by diagnostic criteria for schizophrenia. But ultimately, it seems like my ability to "roll to disbelieve" these things like intrusive thoughts, delusions, paranoid suspicions about conspiracies against me, etc, is pretty strong. They show up, I sometimes get tripped up by them briefly, but I notice it and dismiss the thoughts as "crazy" or "nonsense" rather than believe them strongly.
And then also, I notice that there's a really weird split between whether people immediately peg me as autistic. I've never been formally diagnosed, but seem to have a number of incidental traits (difficulty "tuning out" stimuli, preference for direct and explicit communication more than is considered "normal" or even "socially appropriate" in some contexts) that would seem to indicate being at least mildly fitting the description. I especially seem to have trouble intuitively grasping social norms about framing information in a way that will upset people, and I notice that the way people describe this to me (especially the people who get the most upset) sounds a lot like what I feel like when I notice intrusive thoughts. People have told me that I've said something that gave them really terrible imagery they can't get out of their heads, which I have a hard time understanding, not just because I don't literally get visual imagery, but also because it's easy for me to dismiss upsetting thoughts when they're not tethered to an unpleasant reality I actually have to deal with, much like I can disbelieve thoughts I come to think are delusional. I don't think people are just being overly sensitive, this really does seem to be a significant difference in how we process information, which is most stark with people who describe their mental processes as involving a lot of vivid visualization
This leads me to wonder whether a visual processing mode is just kind of inherently harder to dismiss. If your brain went to all the trouble of producing some imagery for you, it seems to me from the outside that this might make those thoughts associated with the imagery "stickier" in a way, harder to treat as meaningless or not change other beliefs to accomodate
DnD “roll to disbelieve” suddenly makes much more sense as a roleplay mechanic. Still not convinced people can create and throw fireballs with their mind though :D
I don't think this is true. From the account of someone suffering from schizophrenia - which I think I read in a previous post here - is that you don't just get rid of delusions by disbelieving in them. The writer of the account in question knew he was having a psychotic break and that he needed help, and at the same time being convinced that his friends and family were conspiring against him. I'm not sure how aphantasia plays into that - maybe it does intensify the delusions - but it's definitely not a case of "Just say no to psychosis."
Well that's exactly what I'm saying. I've read that and other first-hand accounts of schizophrenia, and understand that a lot of people who suffer psychotic breaks are fully aware that they're experiencing delusions. I also know that I've had delusional thoughts that sound extremely similar, including very complicated social conspiracies, and including auditory and even once or twice visual hallucinations that persisted for at least a couple of hours in some cases. But this nonetheless fails the diagnostic criteria outlined by the DSM, because like most pathologies, that requires rising to the level where it interferes with your life in some significant way, and as I described before, I seem to be able to ignore this sort of thought until it goes away, tell what's real and what isn't, etc. I've always wondered if this was just normal variation on some general spectrum of schizophrenic delusion on which I'm simply "very mildly delusional" or if there's some way in which this pattern of noticing delusions happen, and then being able to dissolve them more readily than people with the diagnosed malady seem to be able to is different from the delusions simply being "less delusion-y" in the first place. That's why when I read stuff like "blind schizophrenics don't exist", I start to wonder if there's something about persisting visual information that just makes it harder to dismiss information your brain is insisting to be true. I do find that for example, if I know that I am visually hallucinating, I can often clear it by closing my eyes for a few seconds
Suzette Haden Elgin wrote about assuming she would be able to tell that hallucinations were too implausible to believe, but then she had delusions (from steroid withdrawal, I think) of the CIA having an office in her hospital room, and she didn't doubt it when it was going on.
The ability to doubt hallucinations might be a very different thing than the ability to not have hallucinations.
Historically, it's been noticed that sensory deprivation helps bipolar mania as well. Here is a short story from 110 years ago mentioning this in passing
> He awoke at night. Everything was still; from the large neighboring room could be heard the breathing of the sleeping inmates. Somewhere from afar sounded a strange, monotonous voice. It was that of a patient conversing with himself in a dark room; and from the top floor—the women's department—a hoarse contralto was singing a wild song. The patient listened to these sounds. He felt a terrible weakness in all his organs; his neck pained him frightfully.
> "Where am I? What is the matter with me?" were the thoughts that came into his head, and suddenly, with an unusual vividness, there appeared before him the events of the past month, and he understood that he was ill and the nature of his illness. A whole row of disconnected thoughts, words and actions came into his memory, causing him to shudder in his entire body. "But this is ended, thank God, this is done," he muttered, and fell asleep again.
> Sometimes, as on the first night, he would awaken amidst the stillness, after a whole day of turbulent motion, feeling rheumatic pains in all his organs and a terrible heaviness in the head, but nevertheless in full consciousness. Perhaps this effect was produced by the absence of sensations in nocturnal stillness and dusk; or perhaps it was due to the weak efforts of a suddenly awakened brain, enabling him to catch, during these few moments, a glimpse of reason, and to understand his condition as if he were in a normal state. With the approach of day, however; with the reappearance of light and the reawakening of life in the hospital, the other mood would seize him again; the sick brain could not cope with it, and he would become mad once more.
Perhaps sensory deprivation can help both over-sensitive and under-sensitive people by serving as a "turn it off, then turn it back on again" fix for the brain? There's always a certain amount of filtering to perception - noticing smaller and smaller sensations when they're the only things happening, or becoming numb to things in an active, crowded environment - like turning a volume dial to the comfortable level. When moving from no stimulation to a normal amount of stimulation, the brain might naturally "turn the dial" to a neurotypical level, and then whatever makes you autistic or schizophrenic gradually changes the dial to a different number.
Think of somebody with a messed-up sleep schedule. They're stressed out and exhausted, but in spite of being exhausted still can't sleep at a regular time! Then they go on a nice, relaxing vacation in an isolated valley off the grid, with sunset and sunrise their only clock. Their sleep schedule heals and they start to feel normal again. Emerging back to regular life, they're still well-rested and happy for a while, but it doesn't last - daily stress, a cup of coffee in the afternoon, late-night Netflix - gradually they become the same exhausted insomniac as before the vacation. If the things that make you autistic or schizophrenic work like caffeine and stress in this metaphor - gradual damage that builds up until you're in a maladaptive state - then "autism" and "schizophrenia" could be attractor states in the machinery of sensory processing. Sensory deprivation tanks are like the off-the-grid vacation, completely cutting you off from the damaging influence. There's no sensory processing failure with no senses to process. It doesn't matter whether you were going to process it too much or not enough, as long as the "reset" puts you substantially closer to normal - in the same way that the off-the-grid vacation fixes the insomniac's sleep schedule whether they were sleeping too soon in the day or too late before leaving for the valley.
I can't tell you how valuable it is for someone like you to discuss these issues with so much humility. I don't have to tell you how often people online promote themselves as experts while the real experts are the first to say that the answers aren't always clear. I have two kids with psychiatric issues and we love their doc because she is so transparent about how difficult it can be to find successful approaches to their issues.
I'm not a doc myself but I have picked up a lot from the parental sidelines, and I can't name a more informative site than yours.
I'm hoping the genes from my schizophrenic father are sorta balanced out by the high functioning autism-ish genes from my mother. So far so good. I'm in the richest 1% and never hallucinated anything.
So, a common-to-the-point-of-there-being-tiktok-videos-about-it talking point is that we autists notice _different_ things in social settings, and that this often violates expectations about what knowledge/information about mental states is public knowledge.
This makes people deeply uncomfortable, consistently. Which makes us uncomfortable, and prone to doing odd things to try to… not cause that.
Obviously there are a multitude of different ways it can play out, but this resonates with me.
And it makes a lot of sense to me that someone with a dramatically different weighting of available sensory information would tickle this discomfort in others.
The diametrical model of autism and schizophrenia is complete nonsense. I can't say I'm surprised, because autism research has suffered from a truly appalling lack of rigor for the last eighty years, but I'm disappointed to see Scott fall for it. A few counterarguments:
Autism becomes apparent in early childhood. Schizophrenia rarely becomes apparent before adolescence. And yes, I know there are certain personality traits that appear much earlier and can increase the risk of schizophrenia. A Slate Star Codex article I'm too lazy to look for linked to the experience of recovered psychotic Peter Chadwick, who described his "problematic hardware tendencies": narrow attentional beam, poor context processing resulting in social awkwardness, little ability to integrate thought and feeling, chronic anxiety and threat sensitivity. I would hardly describe those traits as the opposite of autism.
Some of the genes that increase autism risk also increase schizophrenia risk. I recently read "Hidden Valley Road," about a family with twelve children, six of whom were schizophrenic. Every member of the family who was tested had a gene associated with schizophrenia, autism, and bipolar disorder. One of the neurotypical family members went on to have a child with sensory processing disorder.
Schizophrenia can in some cases be medicated. There is no medication that can treat autism. Taking antipsychotics won't make a neurotypical autistic, and taking hallucinogens won't make an autistic neurotypical. (Source: I once hallucinated vividly as an uncommon Ativan side effect, and remained autistic the entire time.)
Not all autistics are oversensitive. Some are undersensitive. Some - probably the majority - are oversensitive and undersensitive in different areas. I'm sure you've heard of autistics who scream when touched, but barely react to actual injuries.
Also, this is a bit of a digression, but I'm sick of seeing autism described as a social disorder. People only think that because of a combination of the double empathy problem - empathizing with people who are different from you is hard, and if everyone is different from you, your inherent human shittiness will be more obvious - and terrible research that involves putting kids through highly artificial lab situations and assuming they'll react to real-world situations the same way. There's the Sally-Anne test, which trips up autistic kids and non-native speakers alike with its confusing sentence structures (and which a significant minority of autistic kids pass, but neurotypicals never mention that because it would get in the way of their sweeping generalizations). The "Reading the Mind in the Eyes" test, which ignores the minor detail that real people aren't static black-and-white photographs of actors' eyeballs with multiple choice options floating around them. Various tests that involve making kids watch a cartoon of a square shoving a triangle, or whatever, and treat the child as socially defective when he correctly states that squares don't have motives. Meanwhile, I'm part of the minority of autistics who actually do lack empathy, but I'm good enough with language and familiar enough with acting and storytelling conventions to pass most of these tests with flying colors. When will people realize that genuine empathy isn't something that can be tested in a lab?
I more or less agree with the frustration expressed in this comment, and the expressed reasons for it, although I waot to personally emphasize that my frustration is more with society et al than with “Scott trying to figure it out while starting from a non-ideal starting point”
[the lack of editing has caused me to lose a comment when trying to do the copy-delete-paste dance once today already, so please excuse my inability to spell: I'm on a phone with a non-traditional keyboard that makes a different set of typos common, not an idiot 😜]
And here I was thinking you were an idiot. Just kidding. I cringe at my phone app typos too. Those auto correct errors look rely bizarre. Someone should really add a ducking edit feature.
(Hilarious anecdote from just now, I had *intentionally* and correctly typed out "ducking" for the joke... and autodefect corrected it to "fucking". Which presumably days something about how frequently I engage in profanity. ;-) )
I miss for a lot of reasons the fact that the 'like' button was apparently removed from this blog for some reason, including that I now need to type out a whole "Yes, all of this" comment rather than expressing "Yes, all of this" in a way that also doesn't detract from more complex conversations in the comment chain.
It annoyed enough of the commentariat here that Substack let Scott remove it.
If there was a way to turn off email notifications for likes but not replies it would probably have been fine - I like knowing that someone has something to say in response, but it's really annoying to be emailed every time someone clicks the like button.
I find getting an email of "Someone thinks you're wrong" much worse than getting an email of "Someone thinks you're right", and people are generally a lot more driven to leave comments when they think someone's wrong than when they think someone's right.
That's a matter for community norms and rules though. Such as the recent "content free disagreement is grounds for a banning" rule Scott mentioned.
I personally am far too prone to seek out the quick fix of writing comments to acquire internet points if the place I'm writing them is at all points oriented, and that's really toxic for an environment like this.
I think "people do stuff because they want recognition from their peers" is wired far deeper than anyone can solve by removing a like button, and also not a problem to be solved in the first place. There are environments (imageboards, mostly) that strive to avoid doing that, and they're interesting places in their own right, but they're even further from ACX-comments-intended-norms than "ACX comments, but with a like button". It's really something you have to go all-in on -- just the shape of human psychology is that any environment where there isn't a way to quickly say "I see you and I see what you're saying here" is one that's suddenly shifted to working on a completely different ruleset. The pre-like-button solution was "+1"/"this"/etc in actual replies, but post-like-button internet norms shift to considering this a net negative, so it's something you'd need to explicitly encourage in turn if you wanted it.
If the complaint is "when people have access to like buttons I feel more incentivized to make mindkilling quick political takes and less incentivized to make effortposts", the coordination problem there is that people should stop clicking it for mindkilling quick political takes and start clicking it for effortposts. My general experience is that rat-adj types are reasonably good at this compared to most communities where discussing politics is a thing.
Sure but we also, it would seem, want reasoned discussion and informed contrarianism here, and prefer that to likes. And the reason they were disabled is probably seeing the like numbers on all posts rather than just yours
Entirely disagree. I love knowing how and why someone disagrees, but could not care less for individual reminders for every person in the expected x% that agrees with something
> Not all autistics are oversensitive. Some are undersensitive. Some - probably the majority - are oversensitive and undersensitive in different areas. I'm sure you've heard of autistics who scream when touched, but barely react to actual injuries.
I can't stand the feeling of my skin after I've showered, I'm basically unable to function for a while after if anything at all is also wrong (extraneous sounds, smells, etc).
On the other hand, when I shattered my wrist, the hospital didn't give me any pain medication for the first several hours because I didn't appear to be in any pain. Although I was asked "Have you had anything to eat today? You look quite pale" at least 3 times during that period.
Obviously, it's impossible to compare subjective experiences, but when I was growing up, many people remarked about my apparently undereaction to injuries.
On the other hand, I've never experienced the shower thing you describe.
"Also, this is a bit of a digression, but I'm sick of seeing autism described as a social disorder."
Yeah. On the one hand, my lack of social ability has probably handicapped me in life. On the other hand, I don't like people - or rather, I don't like interacting with people. I don't have a 'social life' and I don't want one.
Imagine that somebody holds your head down beside a road drill for three hours, all the time going "Isn't this great? Aren't you enjoying yourself? I could do this all day!" and then afterwards, when you said that in fact you did not have fun, the attitude was "Well, the problem is with *you*, not with our fun-having drill!" That's my attitude towards parties and other fun! social! activities!
(And for roadworkers and others who do have to operate drills for more than three hours in a day, you have my sympathies).
I like it here under my rock. Stop trying to drag me out and shine bright lights in my eyes.
Well, for a self proclaimed misanthrope you seem to be pretty well loved around these parts. I guess you’ll just have to learn to live with that affection. :)
You are all very kind to me. I can handle things at a distance, and since most of you are about four thousand miles away from me, that's manageable 😀 If you lived down the road, it'd be a completely different manner.
I would like to second the kind thoughts. I've always liked your contributions.
You present your views eloquently, interestingly and in such a way that it's not grating to people with other, different views (such as myself, some of the time).
I know that feelings as well; still I don't like to socialise when sober. About the power tools, it was different. I was pretty happy when I was once allowed to handle a jackhammer all day.
Part of it is just wanting different things in friends and sociability. I for one supremely enjoy your comments, and would be delighted to have more friends who did nothing but digress at length about similarly interesting things
If you talk about schizofrenia, know that these are people with halucation problems (chronic psychosis) AND are treated with poison, see for example zyprexa here: https://pubchem.ncbi.nlm.nih.gov/compound/Olanzapine The symptoms you see are not of schizofrenic people but of schizofrenic people treated with poison.
How can I put this in line with the large number of schizophrenics or bipolars that I know who claim their “disease unmedicated made them unable to work or do anything meaningful and destroy all their relationships with friends and family” and that “only on the drugs, even though they are awful and poison, can they have something resembling a fulfilling and normal existence”? I do wish less people would take such drugs, but it is harder than it seems. And a lot of people have schizophrenia or bipolar for many years before the hard drugs? They obviously should meditate and self overcome it our, and the few that do are better for it, but they are maybe .1%?
1a. The blindness-SZ thing is much less clear than it's popularly reported. The actual papers on it will freely shrug and say "Yeah, our evidence for this is pretty weak and heavily supplemented by anecdata". That's not to say it's not true -- it's probably at least adjacent to truth, because the "this should be a common enough comorbidity that the anecdata would be much less certain" argument is pretty strong (but see 1b). The big thing that gives pause here, though, is that much of both the data and anecdata is from parts of the world where two things are true: congenital blindness is very rare, and SZ is generally a disabling chronic illness causing lifelong medical dependency. In the parts of the world where congenital blindness is much more common, the association between SZ and long-term contact with medical frameworks is much weaker, and a lot of people can easily be "lost to follow-up".
1b: No one at all has bothered to look at (though one group, as far as I can tell, has bothered to complain that no one is looking at) by far the single most important thing you would want to look at for this hypothesis: whether blind people are less *schizotypal* than the general population. There's little good excuse at this point to look at SZ as a random thing that Just Happens Sometimes in neurotypical young adults rather than as a semi-common [progression/adaptation] in a common neurodivergence that may or may not be clinically relevant before, but, well, here we are. Whether blind people are less schizotypal or not is the absolute core of the blindness-SZ speculation, and it has completely different consequences for whether this is likely to be a real effect, what it theoretically means, what it might clinically mean, etc.
2a. "Some people are diagnosed with both schizophrenia and autism" is one way of saying it. Another way of saying it is that about 8-15% of autistic adults fit SZ criteria in meta-analyses and as many as 40% in some individual studies. That is, that the risk is about the same as having an SZ parent (and in some samples to having *two* SZ parents). When I corner imprinted-brain/diametrical types and ask them to explain this, I tend to get some stammering about how high-functioning autism is akshully super misdiagnosed and none of those people were ever autistic at all. I am very sympathetic to explanations of weird shit that just look like "yeah, autism diagnosis is atrocious" (see below), but I think this requires much more bullet-biting than any of those parties actually think through; if you assume as in genpop that there are 2-3 people fitting schizotypal PD criteria for each person fitting schizophrenia criteria, you quickly ring up numbers where you'd just have to shrug and go "Yeah, high-functioning autism basically doesn't exist and it's all misdiagnosed schizotypes". I don't think this accurately represents the schizo-autistic spectra range -- even if I bite the bullet on myself and go "those can't overlap, I was always just schizotypal and there's some purely schizospec explanation for my autism-specific characteristics", I've certainly met people who are clearly and entirely on the other one. If you *don't* force yourself to bite really bad bullets for thought experiments just because they're common in pop-psych, I am definitely confident in the existence of distinct spectrum edges *and* their overlap.
2b. Has anyone sat down and read the schizotypal PD criteria? Or talked to a schizotypal person? I can't imagine doing that and coming away with the takeaway that these are unimaginably different, mutually exclusive conditions. Imprinted-brain/diametrical claims about the schizospec consistently strike me as written by people who have no clue at all what the schizospec is and how people on it act, especially when those people are not floridly schizophrenic. (There is still not much better excuse for a "schizospec but only full-blown SZ and everything else is vaguely backfilled" model than an "autism but only the most severe forms of autism and everything else is vaguely backfilled" model.)
2c. The autism-SZ associations are even stronger in childhood-onset SZ, which is generally conceptualised as a more "core" form of the neurotype that digs more directly at the neurological things going on underneath. Most children with COS fit PDD criteria premorbidly, and a substantial proportion fit full autistic criteria.
3. Routing around to the opposite end of Screwy Diagnosis: I've read a lot on autism diagnosis with pre-existing substantial disability in other fields, whether sensory, cognitive, motor, or otherwise. I've come to the conclusion I don't trust any such study as far as I can throw it. The children fitting ASD criteria here were more disabled on just about every axis, which is the case in ~every such sample; as long as ASD continues to essentially supplant intellectual disability alone as the diagnosis of choice for people fitting the latter criteria, I can't look at the sample characteristics here and go "Yes, this is clearly, obviously getting at a neurotype more complex than 'people with low birth rates, cerebral palsy, more signs of underlying brain damage, and lower socioeconomic status are more disabled than people without those characteristics'".
4. Until earlier this year, the Wikipedia article for the imprinted brain hypothesis -- that is, the first thing any random reader was likely to encounter researching this topic -- was a glowing hagiography with a fuckoff-huge table correlating random primary studies that didn't say the things they were represented as saying at all to the hallowed hypothesis cast down by angels, and featuring huge positive block quotes about this revolutionary new theory that was extremely true and about to rewrite psychiatry from the ground up. It looked like that for ten years. It no longer looks like that. I'm looking forward to seeing the long-term consequences.
Good ideas. I have been thinking, schizotypics and high functioning autists could not be mixed up because of the childhood sensory things, jactations and the like. Have to look things up.
Anyway, the guy in my secondary school class who later got schizophrenic was as weird as me but I found him boring, liked a few others more and made friends with at least one.
This convinced me. I now think schizophrenia and autism are at least as related as (and probably more related than) they are different, and that either or both are also really complicated and multi causal and presentational so as to make such a statement about two related descriptions for a wide variety of disabilities quite difficult to interpret and support.
Unrelated, and I don't have access to the article, but couldn't the low prevalence of smoking in autistic people also be caused by the effects of lower ability to socialize, not just (or even necessarily) biology?
I was born with one eye. I also believe I am slightly autistic. I am a schizoid personality but the relationship between schizoid and schizophrenia is not conclusive. I can relate a lot to this post and the comments. For me it is a chicken and egg thing as in are some of the things mentioned in the post and comments biology i.e. a result of my partial blindness and other genetic issues or did my lack of socialization due to my self consciousness of having a prosthetic eye as a child contribute to my schizoidness, autism, sensitivities, etc. As a child it was obvious that I had a prosthetic eye so I was teased and bullied a lot. Also my parents both worked in the evenings so I was not socialized much as a child. Fully adult it is much less obvious as my prosthetic eye, eye lid, etc look no different than my good eye. Even without my birth defect I have always felt different. So did my partial blindness contribute to my autism and schizoid personality? Yes but having studied a considerable amount of neuroscience I believe it is also in my innate biology not necessarily hereditary. I also think it is partially due to birth trauma and prenatal environment as my mother had a difficult pregnancy. So again genes and environment. Like the rest of us it is a combination of factors that made me who I am. Thanks again for this post it help me understand myself a bit more even at 62 years old.
Just spit-balling, but I wonder how schizophrenics, autistics and the blind experience inner speech the same or differently. Might the inner voice as a focal point be probative?
About schizophrenics' heavy smoking: Knew some researchers 20 yrs ago who believed the smoking was actually driven by one of the med side effects of the drugs most commonly given then for schizophrenia -- akasthisia. Nicotine apparently gives some relief from akasthisia. Don't know whether this theory has held up, though.
wonder if its possible that autism is at its core a kind of sensory overactivation. That the brain dedicates too much effort to processes most automate away. This for me would explain the pathological rationality, as well as the correlation with blindness (as blindness would require a heightened sensitivity of the remaining senses).
Epistemic status: speculative (as in: I'm a mechanical engineer and read papers on predictive processing as a hobby, let's wait for some sane people to weigh in on this)
We don't know what autism actually is, but predictive processing (PP) offers some theories. Yon and Frith 2021 explain that "characteristics of autism (e.g., a preference for stable and repetitive environments) can be cast as an consequence of overly-strong beliefs about the precision of incoming evidence - where every fluctuation in our sensory system seems to signal the need to change our models of the environment (i.e., the world seems unstable)." (1). The causal direction is not really clear to me, maybe high expected sensory precision leads to bad generalization capabilities and strong reliance on bottom-up sensory input, maybe it's the other way around? Beren Millidge's master thesis (2017) has a theory on a potential neural basis for Autistic Spectrum Disorders: "It argues that the observed pattern of long-range underconnectivity and local overconnectivity observed in ASD, when instantiated in a predictive processing framework, will lead to impoverished high level regions and lower-level regions which down-weight prior information coming from above and prioritise incoming immediate sensory information. This pattern is hypothesised to result in many behaviours recognised in autism such as sensory hy- persensitivity, a local, detailed-oriented processing style, and a preference towards predictable behaviours and routines." (2)
I'm even more confused on the schizophrenia side of the story. The best discussion I've seen so far is (3), which ties PP and the diametric model together and compares schizotypy to an underfitting strategy in machine learning: "One of the downsides of the generalization function of positive schizotypy is apophenia. It is considered the predisposition to false positives: if you have noisy data and you want to see a pattern in the data, you need to be giving a low weight to sensory input - that's the only way you're going to find the line of best fit. The downside: well, you're also going to sometimes see patterns that aren't actually there. You're essentially imposing your assumptions onto the data and you're imposing your model onto the world." (I'm not so happy with this source here, I just don't have anything better right now)
Now I don't see any way of looking at the theory above and coming up with a prediction of low schizophrenia and high autism rates for blind people. So let's push our luck and see if we at least in retrospect fit this together and come up with a few follow-up predictions.
I'd be really surprised if autism leads to blindness. Let's try to reverse the causal arrow: could blindness lead to autism? I'm not sure either, but to get the ideas started: there's an ongoing discussion of how exactly the brain learns in young children. Think of it as a nature vs nurture question: either you provide a genetically encoded brain for an infant (e.g. for animals who can walk right from day one) or you only provide some brain infrastructure and have the system learn on it's own (e.g. cats that fail to see horizontal stripes if they don't encounter them in the first weeks of life). There's some plausibility the human brain might be similar, especially when brain regions are missing at birth with the brain routing around this issue. Soooo maybe, by being blind, the brain reuses the area intended for visual processing and this kinda shifts the whole brain balance to a higher-autism structure?
You can find both links to the source papers and some discussion on r/predictiveprocessing:
My very humble opinion: the over/underfitting aspect is difficult and may depend on implementation details in a more intricate manner than in ML. Plausible stories can be told linking both disorders to either side of over/underfitting. I believe Autism represents over-sensitivity to present-moment input, not an experience vs priors weighting, and this largely changes the conclusions drawn in 3. There are good reasons for these being orthogonal algorithmic choices, which are obscured when you simply do ‘training’ then ‘testing’. The concept of precision is pretty robust though. Very intuitively, lacking the most informationally dense perceptual modality massively reduces prediction confidence.
Scott sez: “Maybe blindness makes children seem more autistic in some boring, mechanical sense? Like maybe if you can’t read other people’s body language or even consistently know where they are, it’s hard to be social and so you don’t interact with other people and that seems autistic to people trying to diagnose you?”
Here’s a proposal for how blindness could make children actually be more autistic in a real and interesting sense: Their inability to see what other people are doing, and especially their inability to see faces, results in their having a very substantially impoverished feed of information about people and the rest of the world. They suffer from a sort of cognitive malnutrition that causes autistic-like stunted and abnormal development in many areas; or produces full-on autism.
Babies are wired to pay attention to faces: Even as newborns they are especially attentive to faces, and they become able to recognize their caregivers very early, at about 2 months I believe. The responses they see on faces are crucial data to them, and if their caregiver suddenly goes deadpan they become desperate and disorganized (Still Face Experiment, https://www.youtube.com/watch?v=apzXGEbZht0). As they learn to navigate the world, the facial expressions of observers are important data for them (Visual Cliff Experiment, https://www.youtube.com/watch?v=p6cqNhHrMJA). The approval, disapproval, fear or even just friendly interest they see on the faces around them gives them information and probably also makes the explorations more satisfying. And of course babies and toddlers don’t just see faces looking at them with various expressions, they also see people with faces they recognize doing all kinds of stuff. Maybe the interpersonal data about visually recognizable people — what the people did, how they looked at me when I did this and that — even forms the framework on which hangs all the rest of the what people learn about how things work. Even if it does not, it must be very important.
Consider the situation of a blind baby: She lives perpetually in the Still Face Experiment. She navigates life’s visual cliffs without being able to see whether her caregiver is enthusiastic or terrified. She toddles around without the benefit of seeing smiling and interested faces observing her. She never gets to see anybody else do anything at all. It doesn’t seem terribly surprising to me that growing up with this very impoverished feed of info about one’s own actions and about life in general leads to social deficits and also deficits in using the body, using objects, activity level, flexibility, adaptability etc. Of course, caregivers can mitigate the damage by staying in touch with the young child via other channels — touch, speech, etc. Still, if we are born wired to tune into faces and to use them as a portal to learning everything else, it may not be possible to make up the visual-interpersonal shortfall via other channels. That shortfall could account for the high-frequency of autistic-like traits even in blind kids who are not actually autistic.
What does this theory have to say about sighted babies who develop into autistic children? Well, maybe they are born with something wrong with the face-processing parts of their brain. Maybe they are born without the wiring that makes them interested in faces, good at recognizing different people, naturally predisposed to be highly responsive to affective displays on the faces of others, naturally interested in the activities of facially recognizable others.
And about that Hobson and Bishop paper: Yeah, it’s really blurry-minded. My theory, above, may or may not have been what they were trying to get at. I did wonder, after reading it, why they had not examined the literature on the development of infants blind from birth. There must be a substantial body of research, and also a bunch of stuff out there, not all of it wrong-headed, about how to foster the development of blind babies. For them not to have incorporated any of this info into their study seems sort of — well, impoverished and rigid, if not frankly autistic. We should not make that mistake ourselves.
Autism is primarily sensory, motor, and cognitive. The social difficulties are a side effect. Wondering if blindness causes autism by stunting social development is like wondering if pollen causes the flu by making people's noses run - the underlying causes are completely different.
I don't think my theory is like saying maybe pollen causes flu by making people's noses run. It think it's like saying maybe being unable to chew due to a jaw malformation as a child causes thinness and short stature by making the chlld chronically malnourished.
And I'm not saying blindness causes autism by stunting social development. I'm saying it could cause autism by greatly impoverishing the feed of information about the world that babies and small children get. Sensory and motor and cognitive skills develop on a poorer information base. Much of the information small children get originates in a social context, because it is coming from interaction with and observation of the people that are around them. But what they are getting is not just social information, it is information about EVERYTHING. It's the impoverishment of the info about everything that leads to impaired sensory, motor and cognitive skills.
Maybe I partly misunderstood your comment. I can definitely buy that growing up in the different sensory world of blindness could cause an infant to develop autism. But I really disagree with the part about sighted babies developing autism because they can't read faces properly. I mean, babies take a lot of cues from other people, but not enough to rewire their entire nervous system!
===But I really disagree with the part about sighted babies developing autism because they can't read faces properly===
I do not think sighted babies "develop" autism because they can't read faces properly but I think the social difficulties is more than a "side effect". There is a test called The Reading the Mind in the Eyes Test which is very popular for assessing the ability to read faces especially eyes. Overall women score higher, Men score poorly, and people on the Autism Spectrum score the worst. As I mentioned in my comment above I am half blind from birth and my high functioning autism/social difficulties were not "caused" by my half blindness. BUT I truly believe that without being half blind at birth and all the consequences of that including how I was parented, teased and bullied in school, and many of the things that Eremolalos and Scott mention above, I would have not have some of my autistic traits. I was a very awkward child (because of my inability to perceive, sense, and see the same way a fully sighted person can) which was partially a result of my half blindness and how my brain dealt with the limited information it was getting. By nature I am an introvert, cerebral, intellectual, high IQ, so if I had complete sight in both eyes I still would lean into what is now called the Twice Exceptional 2e gifted realm of which high functioning autism is a part. But did my half blindness increase my autism or social difficulties with traits and behaviors that Eremolalos/Scott mentioned? Hands down, no question. So as I said my comment above it is always a chicken and egg thing. Everything in context. Genes/Biology and Environment in constant complex interaction. I hope that helps.
I'll take your word for it that being half-blind may have increased your autistic traits, but I have to say, the Reading the Mind in the Eyes test is, like so many autism-related tests, fatally flawed. Here's a lengthy blog post that explains some of the test's many problems:
The tl;dr is that real people aren't static black-and-white photographs of an actor's eyeballs with multiple choice options floating around them. There are some autistics who can read real people's body language with a startling degree of accuracy, but fail the test because it excludes so much of the information a real person gives out. On the other hand, there are people like me who are hopeless at reading real people but still pass the test because we've seen enough movies to be familiar with acting conventions.
"...the consequences of that including how I was parented, teased and bullied in school..."
I'm really glad you mention that - it's something I really wish autism researchers would take into account. Autistics tend to have such abnormal upbringings that it's hard to tell which symptoms are autism and which are trauma. For example, I was an affectionate kid until bullies kicked it out of me. Now I can't stand to be touched. Some other autistics are pathologically passive, which is always assumed to be an inborn deficit even if it comes after years of compliance training.
Wow. Too much new information for me. One silly question. Is someone working on a drug/thing that replaces smoking for schizophrenics so they don't incur the downside cancer risk of smoking? (As a x-smoker, cigs are both a drug and a thing to do. I sometimes miss the 'thing to do' part of smoking.)
The brain has "nicotinic" receptors, but obviously they didn't evolve for cigarettes, any more than our noses evolved to support glasses. Therefore something must stimulate them in the absence of smoking, but it seems as if people with schizophrenia somehow have too little of that stimulus and therefore often self-medicate.
It's also a well known pattern that drugs that mess with your brain build tolerance. Blocking a receptor makes it more sensitive, and overloading it makes it less.
So, as an alternative to smoking for schizophrenia, or obtaining nicotine some other way, why not take a drug that is intended to help *quit* smoking? By *blocking* the nicotinic receptors, they should become more sensitive to the environment that exists.
This theorizing was motivated by how well bupropion worked for me. It has a dual approval, as an aid to quit smoking and an antidepressant.
But now, my mind jumps, what if a drug that blocks *opiate* receptors also might make them grow and help with symptoms?
As it happens, such a drug, called naltrexone, exists in combination with bupropion, but it is only recognized as a weight loss drug.
Thank you for reminding me about that. I want to quit smoking and also switch antidepressants, so I'll suggest bupropion the next time I talk to my psych.
I found wellbutrin highly effective for smoking cessation. It really does greatly reduce the craving. Even with the help of wellbutrin you still have to work hard at becoming a non-smoker, though. You have to break the smoking habit and deconstruct the belief that you NEED cigarettes to concentrate, to relax, to enjoy life -- to do whatever the addiction made you believe you need them for. I was very very hooked on cigarettes, and got off them, and do not miss them one bit. You can do it too. Good luck!
"You have to break the smoking habit and deconstruct the belief that you NEED cigarettes to concentrate, to relax, to enjoy life -- to do whatever the addiction made you believe you need them for."
Allen Carr's Easy Way to Stop Smoking was a great help for me in doing that.
More trivia from what I'm currently reading: 'Visually impaired people usually have more sensitive photoreceptors, which react very sensitively to every slight change in light. This is also one reason why depression (seasonal affective disorder, or SAD), a condition that is linked to, among other things, disturbed melatonin production, affects them three times as often.'
Scott, are you aware of Dehaene's theory that schizophrenia is caused by an impaired consciousness? More precisely, because the threshold for perception to become conscious is higher than in neurotypicals? The difference is ridiculously strong, e.g. here:
Perhaps cutting away a large part of perception makes it easier for other perceptions to propagate to consciousness, because there are less competitors.
I am not sure how this relates to an axis schizophrenia-autism, but Clark's theory from "Surfing Uncertainty" is that autism is caused by too much error signal propagating upwards. Or rather, by too low thresholds for error signals to propagate upwards, so that it happens all the time.
Oversimplifying, perhaps schizophrenics are people with too little consciousness, while autistics are people with too much consciousness.
"the threshold for perception to become conscious is higher" - could you explain how someone who is paranoid is less sensitive or conscious of perceptions? By definition, wouldn't it be the opposite?
It's not a theory that this threshold is higher. One can measure this. For example, in masking experiments a picture is shown for x milliseconds before another picture (the mask) is presented. If x is below a threshold, then this picture does not enter consciousness, if x is larger, then it does. For neurotypicals, the threshold x is about 50-60 ms. For schizophrenics, it is about 90 on average. That is a really big difference, much higher than the variation among neurotypicals.
It is much less understood *why* this is different in schizophrenia. But one theory is the following: when some perception or thought is propagated to consciousness, then this involves the whole brain. So when the brain makes a Bayesian update, it can take into account all sort of knowledge; also knowledge from brain areas that say "this is dumb, don't believe it".
When something does not enter consciousness, then learning still takes place, but it is a different mode of learning. It is bilateral associative learning between small subregions of the brain.
According to the theory, you get paranoid when this second mode of learning is dominant over the first one, because you just learn some random associations without the "wait a minute, this does not make sense"-inhibition from other brain areas.
If you want to know more, I have written a review of Dehaene's book on consciousness:
"you just learn some random associations without the "wait a minute, this does not make sense"-inhibition from other brain areas"
Ok, but you said the difference is 30 milliseconds. That is obviously not the timescale on which paranoia and evaluating any situation rationally occurs on. Schizophrenia is not about failing to make the correct judgement of every situation in under 1/10th of a second. That's not a thing anyone does in the first place.
There are two different times involved: One is the threshold that is needed to spark a conscious perception. This threshold is 50-60 ms. But the conscious perception itself takes much long, about 500 ms. It's just that if the stimulus is presented longer than the threshold, then the conscious perception takes place, and otherwise it does not take place.
There are also other thresholds for conscious perceptions. For example, if you don't vary the time, but you vary the contrast from the background, then there is a minimal threshold for seeing something consciously.
The theory now assumes that in schizophrenic people, those threshold are not crossed so often in everyday life. So they have fewer conscious moments throughout the days. So less moments in which the whole brain cross-talks which each other. And more moments in which only some specific brain areas bilaterally talk with each other.
And the implication is not: "paranoia lower your thresholds". The (assumed) implication is "if your threshold is permanently lowered, then you start learning wrong/weird associations, because the association-learning is now based on bilateral learning between parts of your brain."
If you have a conscious perception, you first integrate the knowledge from all parts of the brain, and then learn the result. That's not cognition or something fancy, it's something automatic that happens in half a second. In unconscious moments, you only integrate the knowledge of two or three brain areas, and learn the result of that.
Adding a neuroscience viewpoint on sensory deprivation:
One effect of the day/sleep cycle is that synapses become on average stronger during daytime, and become weaker (go back to baseline?) during sleep. The homeostatic theory of sleep says that this is one of the reasons for sleep.
Sensory deprivation has the same effect. Your synapse strengths become weaker during sensory deprivation. At least some studies claim that.
There are lots of theories of autism and schizophrenia where signal strengths play a role, so this invites endless speculations on the interplay between sleep/sensory deprivation/signal strength/autism/schizophrenia.
"The homeostatic theory of sleep says that this is one of the reasons for sleep"
Wondering if you've seen this, apparently an astonishingly clear cut demonstration of the function of sleep and that it's not fundamentally about the brain:
I think that there are a lot of functions of sleep. I buy the story about Reactive Oxygen Species (ROS). But your brain also starts to show strange behaviour when you are tired (large and intense waves travelling through your brain and killing your thoughts), and I doubt that this is due to ROS damage.
If you don't sleep, you start malfunctioning in many places, probably for different reasons. But it might well be that ROS is what kills you first.
I see a lot of comments here about blindfolding, sleep, sensory deprivation. Has anyone ever tried anesthesia? There is no clearer analog of just turning if off and back on again for the human brain. Is it considered too dangerous to be used outside of surgery where it is absolutely necessary? Surely, it isn't more dangerous than electroshock therapy. Is it just no history of collaboration between psychiatrists and anesthesiologists?
I don't nearly have the means in terms of domain knowledge or journal access to do a real lit review, but a web search seems to indicate there are potentially dangerous interactions between anesthesia and antipsychotic drugs. I can't quickly find any indication of whether anyone has ever tried to use anesthesia as an actual treatment *before* the patient has a lifelong history of taking antipsychotics. I suppose one problem is this would be extremely expensive compared to things like electrocuting or blindfolding a person.
I have taken antipsychotic medication for a long time, and had no problem with anesthesia for a sigmoidoscopy or for wisdom teeth removal. I believe it was the kind where it removes your ability to form memories. So it's hard to tell just what the experience really *is*. But I don't think it is an analog of "turning your brain off". Sometimes I have dreams that I think may be flashbacks to experiences under anesthesia, so I am not totally sure that all memory formation is blocked either.
What does seem to be correlated with an altered mental state for me is electrolyte imbalances, going back to low potassium when I was originally hospitalized on suspicion of schizophrenia.
Insulin coma therapy was used as a treatment for schizophrenia in the 30's, 40's and 50's. Was thought to be efficacious, and was discarded not because it was proven not to be, but because antipsychotic drugs came into vogue.
I have a relative who experiences Intense Imagery Movements (IIM; https://pubmed.ncbi.nlm.nih.gov/26561043/). Because of frequent stimming, he was checked out for autism by a neurologist as a toddler. He's definitely not on the spectrum and actually is quite empathetic and insightful about others' emotional states. Nevertheless, as he's grown older, we've noted many autism-adjacencies and similar sensitivities. For instance, he has deep sensitivities to various sounds and tactile experiences.
The idea that there are constellations of related neurological conditions that manifest differently makes a lot of sense IMHO.
Also I wonder if the congenitally deaf have higher rates of schizophrenia. I had 3 deaf patients on decanoates at our clinic, and none just there for depression/anxiety. Though maybe deaf people with depression/schizophrenia go to places staffed with people who use sign language.
Actually, quick check reveals Usher syndrome is syndrome of congenital deafness and 'schizophrenia-like psychosis,' and is a common cause of congenital deafness.
As an autistic person, this is possibly relevant: Until I was fifteen or so, I would walk around the house blindfolded (or with my eyes shut tight) quite often, as a way to relax. I never knew any other autistic people to ask if they did something similar, but I'd be interested to find out!
On a related note - I've thought about the possibility of treating auditory hallucinations in schizophrenia patients using some sort of sensory substitution (see https://eagleman.com/science/sensory-substitution/ - he even has a TED talk!). Maybe having something vibrate when speech is recognized would help patients recognize hallucinated speech as such, and eventually something something predictive coding would lead to having weaker beliefs regarding inner speech. It might also be interesting to think of utilizing some form of sensory substitution in autistic people
The levels of melatonin depend strongly on the visual cues, that blind people lack. I wasn't able to get a full picture of how melatonin levels fluctuate in blind vs non-blind people, but there surely is a difference, that's probably most pronounced when it comes to rare, non-standard situation: let's say staying in a brightly lit room long past sunset would create a strong deviation in melatonin cycle in non-blind person but not in a blind person.
The dopaminergic theory of schizophrenia is far from a complete explanation. In fact it can be posed that D2 antagonists simply mask the disease as they largely don't revert schizophrenics to normal functioning.
The alternative theory of schizophrenia involves glutamate receptors. Now, there is a multitude of interactions between melatonin and glutaminergic system in the brain and it's hard to tell which interaction, if any, would explain the lack of schizophrenia in patients that aren't strongly affected by light, ie. for example blind people.
One potential link is that melatonin is a potent neuroprotector in cases of glutaminergic excitotoxicity. So one hypothesis here can be that non-blind people are at risk of being exposed to bright light and consequently having low levels of melatonin. And then in the case of increased glutamate secretion they wouldn't be protected from excitoxicity and subsequent death of certain neurons.
I'm far for claiming that this particular hypothesis has much chance of turning true. But I have a fairly strong belief in that melatonin and glutamate are strongly implicated in the biological basis of schizophrenia.
Intuitively, it looks to me (someone with zero expertise in the matter) like schizophrenia is a deficit of recursive processing in the brain relative to the amount of sensory input, and autism is an excess of the same. Consider what we might expect for different amounts of recursive processing versus sensory input:
(1) Too little recursion: inability to stay on topic (which looks like disorganized thought and lack of concentration), inadequate processing of thoughts (which looks like failure to distinguish between thoughts, impressions, and reality) and too direct translation of sense data into action (which looks like lack of internal motivation in unstimulating environments but flighty, compulsive behavior in stimulating ones)
(2) Low-ish but healthy amounts of recursion being handled well: somewhat reduced processing of thoughts (which looks like an intuitive or artistic style), reduced constraints the brain is trying to satisfy (which looks like uninhibitedness, confidence, and creativity), relative quickness changing topics in a conversation, relatively more effort put into finding or creating a stimulating environment
(3) Normal amounts of recursion - most folk (the baseline for comparison)
(4) High-ish but healthy amounts of recursion being handled well: somewhat increased processing of thoughts (which looks like an analytical or rational style), increased constraints the brain is trying to satisfy (which looks like inhibitions, awkwardness, and uncreativity), relative slowness moving on to new topics in a conversation, relatively less effort put into finding or creating a stimulating environment
(5) Too much recursion: leading to cyclic bodily motions, getting stuck on a topic obsessively, sometimes failing to respond to external stimuli, and sometimes experiencing painful sensory feedback analogous to a microphone screech.
I'd expect sensory deprivation to help people at (5) mainly by preventing the painful sensory feedback, maybe also thereby letting them relax and spare thought to control their other symptoms, and to help people at (1) mainly by making internal motivation the "loudest" remaining input, giving them a chance to focus.
A big chunk of the brain is dedicated to processing vision, so maybe congenitally blind people can re-purpose enough of that they all have enough processing capacity to spare, keeping them out of group (1).
TBH, the reason this account comes to mind is because of the effects of cannabis. Google tells me cannabis probably helps autists and definitely makes schizophrenia worse. From a (4)-ish starting point, cannabis makes me feel like much of my working memory has been turned off, and as a result I get reduced ability to concentrate, a more intuitive/less rational style, fewer inhibitions and more creativity, and even twinges of paranoid ideation that feel like my insecurities getting a free pass to invade my brain instead of being quashed as obviously unjustified.
Go away scammer
Apparently both, "Recent studies have found that strabismus, amblyopia and refractive errors, such as short-sightedness, long-sightedness and/or astigmatism, may be more common in those with ASD. " from https://www.eyecarekids.com.au/understanding-the-link-between-vision-and-autism/
Not sure how trustworthy the source is, though. And short-sightedness is caused by behaviour (not getting sunlight), so it would be really hard to prove that vision problems lead to autism, and not the other way round.
Mirrors-- and, especially, common availability of mirrors-- are a relatively modern invention. They can't be a fundamental part of how people evolve a sense of self, though I wouldn't be surprised if they have an influence on modern people.
True, but I’m sure but puddles and bodies of water we’re pretty common.
Narcissus…
I find it interesting to consider
I was definitely someone who grew up identifying in a mirror but my favorite one was using a door knob because I like the wacky perspective
For some reason your comment made me think of the Medusa and Perseus’mirror shield.
That mirror idea is interesting. I had never thought about it. Thank you.
"Psychotics (schizophrenics) arises when this entrance into the linguistic field fails, and the psychotic ends up identifying too closely with language"
Psychotic is a particular condition of being, not a type of person, and even people with schizophrenia whose illness is relatively poorly managed do not inhabit an undifferentiated state for their entire existence. Nor is their internal state always blatantly visible to others, as it is in a crisis.
What I think you are referring to as "psychotic speech" is an extreme overflow of associations, where the mental activity is overloading the capacity to filter and communicate. Psychoanalyzing it is like psychoanalyzing a seizure.
Have people tried asking schizophrenics to wear blindfolds 12 hours a day?
By the same token, have people tried shining bright light into the eyes of people who are Way Too Autistic?
When I was a kid, I used to shine a flashlight in to my eyes out of self-destructive boredom, and I'm still pretty autistic.
You’re in good company. I remember waking my mom up at midnight one night after shining my dad’s brightest light in my eye me for long enough that I thought I’d gone blind, although I think I turned out slightly less autistic than my brother so maybe light therapy is the next big thing in autism therapy.
They have to test *variation* of the stimuli. A constant never-changing light might be useless, disco flashes or highly varied movie frames might work.
Mumblemumble'predictive'processing…
Being outside in full sun is uncomfortable for me (autistic), I have to wear a hat or I get headaches.
This agrees with common wisdom that autistic people try to minimize sensory perception. I think this is not restricted to sudden flashes, it also includes bright light and loud sounds in general.
Note that the effect is only in congenitally blind people.
How strong is the qualifier? If you're born with vision and go blind at six months.... how many people meet that criterion, anyway? Enough to do a study?
Of course they have! There are way too many researchers, and they’ve done a lot. https://scholar.google.com/scholar?hl=en&q=sensory+deprivation+schizophrenia
The first study, when scihubbed, says that sensory deprivation rooms improved schizophrenics. But given it’s a clinical report at a mental institution, idk how much to trust either the relevance (maybe they got better because even a sensory deprivation room is better than a mental institution) or the interpretation.
I think there is really something to the fundamental axis of autism vs schizophrenia being understimulation vs overstimulation. Autistics are understimulated and so never get used to high levels of stimulation and are easily overwhelmed by them, but on the other hand have a quiet working environment inside their heads that's useful for intellectual work. Schizophrenics are overstimulated and so learn to pull complex patterns out of noisy data, but then end up also finding a lot of patterns that aren't really there.
But people also start hallucinating when in solitary confinement, which is understimulation -> “”””schizophrenia””””
I'm not sure if this is what you were getting at, but both schizophrenics in a normal environment and other people in solitary confinement would have a lower level of stimulation than their body expected, so by the stimulation theory both would experience classic schizophrenia symptoms, e.g. hallucinations.
And autism - at least the sort of smart people with autism - “detect a lot of patterns” in the course of being very smart - despite not being schizophrenics, so I don’t think this is quite right
But they are blind to social patterns.
Yeah, but being blind to social patterns but “”finding lots and lots of patterns” in those and other areas suggests that it’s not a question of too many or too few patterns
Mirror neurons?
I don’t think so, but even more I have no clue. Not a neuroscientist so I don’t really know what a mirror neuron is beyond the likely entirely wrong pop science thing, but (smart) autistic children still talk and can imitate the way other people move and stuff so it’s not like they don’t
Is there such a thing as debilitating congenital schizophrenia?
Not blind. Noticing different things, in different ways, but I really wish this “autistics are socially blind” thing would die off.
The number of times people have ridiculed me for noticing social patterns that they did not, saying “whatever, you're autistic, how would you even know”, is not a small number.
Yeah. I don’t think robin Hanson’s social uniqueness is able to be understood as “not noticing”
I wonder if having Aphantasia, having no mind's eye, pushes one to autism. Aphantasia would clearly seem to reduce levels of stimulation within ones brain. I have autism and Aphantasia.
I don’t think so tbh, as I discussed in an open thread I think the idea of aphantasia is given way too much weight by a lot of popular Reddit style ideas
I find this plausible enough to investigate further
>but then end up also finding a lot of patterns that aren't really there.
I do wonder if instead of overstimulation vs understimulation in the traditional sense, it has something more to do with how much sensory stimuli are processed.
Like, schizophrenics may experience sensory stimuli more deeply and in more detail, and as such find patterns much more often and over-assign meaning to sensory inputs. Whereas autistics don't tend to 'notice' or deeply consider sensory inputs (including physical social cues etc) unless something draws attention to them and they focus really hard.
How do we know there's not some boring allele that increases rates of both congenital blindness and autism?
Although we don't, it's highly unlikely a priori.
Mypriors on biolog is that everything is at least a bit correlated with (or against) everything else.
To explain the effects described, you'd need (very) large correlations, not just mild ones.
Also, I suspect that someone would've found that allele by now if a pleiotropic gene explained everything.
I fundamentally disagree
I suspect you're reading a motive into the question, and feel like you're defending ASD people by responding thus, but if you're not going to actually respond to the question, I personally (as a diagnosed autistic who has suffered greatly due to misconceptions, to the point of being locked up drugged against my will for months a year ago) feel that you're doing more harm than good.
Different communities have different norms, and one of the norms here is to bend over backwards to assume good faith.
That would not be a boring allele, that would be a very interesting allele that we'd want to look into further!
Congenital blindness has a wide variety of indentified causes. The 50%+ of blind kids with higher rates of autism is greater than share of heritable congenital blindness
I have no intelligent insights into any of these phenomenon. I just want to say they are very interesting and I intend them a topic of conversation among smart people at dinner parties soon.
ok
My conjecture is that:
1) A lot of ASD symptoms are secondary or tertiary from "real ASD genes/phenotypes" - specifically, they are the end of a chain of dominoes emanating from some other thing 'directly caused' by the ASD-causing genes.
2) Congential blindness, via a different pathway, tends to knock over such an early domino, and thus ends up propagating outward into the symptoms knocked over
Like, to throw out a random sounds-good-story to illustrate perhaps what I might mean - suppose that not making eye contact in some critical range makes some brain-development thing go wonky in a small set of ways.
Someone with ASD might find not make that eye contact because (like myself) looking at someone's eyes feels overwhelming (it's... sensorily overwhelming in a similar way to looking at the sun, except without that particular searing eye-pain).
Someone born unable to see doesn't get the same eye contact because they can't see the eyes in the first place.
Both would then end up with the same brain-effects of not having that eye contact.
Well 1 is almost tautologically true - what isn’t downstream from a complex multifaceted causality involving hundreds or more genes we don’t understand lol
Schizophrenia is a disease that causes one to find social patterns where none exist.
Autism is a disease that inhibits one from finding social patterns that are obvious to others.
Yes, to some degree, although I feel like it's less clear than that because schizophrenics sometimes seem equally good at finding non-social patterns.
Autism isn't purely social either, is it? My understanding is that they're bad at intuition in general, and dealing with other people involves a lot of intuition.
That doesn't really line up with my experience. More along the lines of having more explicit access to the machinery, able to plug in different interpretations to run different scenarios, and _much_ more likely to end up emotionally overloaded as a result, vs blithely (I'm being a bit cheeky here, but I'm not convinced I'm wrong :p) blundering ahead with an confident understanding of a situation that is "intuitive", but also (sometimes/often/occasionally depending on the situation) wrong.
Random thoughtless and unqualified guess but: could the "axis" just be some parameter of how(finitely?) the world model gets divided into separate representations? In schizophrenia I'd guess all concept representations begin to overlap too much, so the model of the world starts to take the shape of a single pattern to react to(hence extra brain tissue loss due to not needing the extra processing capacity to distinct separate models and having extra affect over them?), while in autism distinct parts of the world model get fragmented into their own, poorly overlapping but individually "rich" sub-models(maybe the local weights are too much so the sub-models barely communicate globally?) which causes fixation on specific detail and a difficulty in grasping the overall tone?
Utterly anecdotally, someone I knew with schizophrenia once told me that smoking helped him separate his ideas better from one another, so maybe whatever nicotine does as a stimulant is somehow connected to strengthening the cues that distinguish the cellular level representations of those sub-models from one another or maybe just increase the local representations' "weights" in the network...
E: To simplify: too much global connectivity on discrete pieces of the model vs not enough global connectivity?
And two last thoughts, I'm sorry for the triplepost but the lack of an edit feature here is grating: the tissue loss is actually probably the causal root for conceptual merging and not the reverse for schizophrenia. And I'd then assume that blind people don't get the sensory "unification" vision tends to grant and focus on individual sounds and sensations more so then the sub-models might naturally end up having fewer points of overlap...
[Repeated post for great offense-taking :D HaHaJustSerious :p]
Not blind. Noticing different things, in different ways, but I really wish this “autistics are socially blind” thing would die off.
The number of times people have ridiculed me for noticing social patterns that they did not, saying “whatever, you're autistic, how would you even know”, is not a small number.
Interesting, can you give some examples of the sorts of things you notice that others don't?
See my username 😄
But seriously, I'll try to think of some concrete examples that aren't betraying confidences (ie, the reason I know that I wasn't wrong in the memorable cases).
I can try to help fill this in. I don't look at peoples faces very much at all. Often that's because I'm just staring off into space thinking about abstract ideas, but equally often I am looking at *people*, just not at their *faces*. This means I notice a lot of details about how they hold and move their bodies. I spot subtle shifts in their weight as they lean a tiny bit forward or backward, unconscious or aborted small hand movements, and tension or relaxation in the arms and shoulders. Sometimes people point their bodies in the direction of somewhere they want to go, or repeatedly start lean in while psyching themselves to say something, or tense their arms in time with the pulses of chronic pain. I also fix these things in my memory and can return to them later.
Fairly often I'll say "you look like you ____" (wanted to say something about a certain topic/weren't feeling well/didn't like something that happened/were thinking about going to the kitchen/etc." This can visibly startle people and lead them to question how I could know or accuse me of being a "mind reader." I suspect that people expect to be able to modify their perceived affect by manipulating their facial cues and are unnerved by people who aren't thrown off by this.
Whereas I find I tend to be more hyper-aware of tells from phrasing and terminology, how carefully avoidant people are of saying particular things and how that translates to an outsize importance of the thing they always happen to avoid ever going anywhere near.
Does Melvin still see all? ‹points at child reply›
Though I've never been formally diagnosed with Asperger's, I suspect I'm on the spectrum — so take this for what it's worth. For me I seem to be OVER-reading and OVER-thinking social queues. I've come to believe that most people just don't really spend much time observing other people's facial expressions and body language — or rather they get a gestalt of what they're observing, and either respond accordingly or shrug their mental shoulders and move on to the next phase in the social interaction.
Also, I'm hyper aware of the emotions of cats (and dogs) — I guess because I've been around them all my life. The standard Ethological theory is that cats and dogs can't really display facial expressions except in extreme stress (hissing, pulling back the jowls to expose teeth, etc.). But up close (at least with my cats) I can read some emotional states from their "neutral" expressions. Cat jowls hide some very delicate lips, and if you look close enough those lips can display very human expressions.
Yeah, I'm similar with animals, there's a lot of body language and "behaviour language" that people don't seem to be able to extract any meaning from.
I am a fan of the model of autism as a disorder of prediction, especially since recently Pawan Sinha measured some features which haven't been looked at before of motor impairment and sensory habituation impairment, are very much like his model predicted 6 years ago.
https://www.pnas.org/content/111/42/15220
I feel it can be combined with Scott's and others' writing into a picture that autism and schizophrenia may be both disorders of "how much weight to put on top down priors", with autism defaulting to "too little" and schizophrenia to "too much".
Going on this model, it makes sense that vision during early childhood development is super important for calibrating your prediction machinery. If you literally can't see sensory input coming, you'll accept that the world is entirely unpredictable. That will lead to both 'passive' symptoms of autism (e.g. motor or sensory overload problems), and adaptive symptoms (like stimming or echolalia, which according to the prediction model are simply ways in which the child can create predictable sensory input in an otherwise scarily unpredictable world).
That said, this is a post-hoc justification and I don't know what I would have said if you asked me in advance whether blind kids are likelier to have ASD, so I will try hard to not update on this evidence.
> I am a fan of the model of autism as a disorder of prediction
I think it's neat too, but can't escape the feeling that it all smells a bit too much like Ancient Greek medicine for my liking.
The ancients noticed "Hey, there's a lot of weird fluids in the body, and they seem to be pretty important", so they speculated that maybe all the diseases were caused by imbalances between different bodily fluids, and eventually built an entire bullshit theory of physiology out of it. Nowadays we of course understand a little more about physiology and know that bodily fluids are one part of something more complicated.
The idea that everything wrong with the mind is some kind of predictive processing gone wrong smells to me a bit like the idea that everything wrong with the body is an imbalance of the four humors.
Somebody recently did a pretty in-depth analysis about how history did the relevant philosopher pretty dirty.
https://acoup.blog/2021/05/20/meet-a-historian-robin-s-reich-on-making-sense-of-medieval-medicine-humors-weird-animal-parts-and-experiential-knowledge/
And see also https://slatestarcodex.com/2016/02/07/list-of-passages-i-highlighted-in-my-copy-of-superforecasting/
No, that's a strawman of what the ancients thought. See https://astralcodexten.substack.com/p/your-book-review-on-the-natural-faculties
Quote from the review I think about often:
"The more I read about history, the more I realize that it was made up of people just like us. They didn’t always have the same tools we do, and they made some weird mistakes, but they weren’t any less intelligent than we are. Some of them were pretty smart.
I’m also concerned that this criticism doesn’t pass the sniff test. If Galen was really a moron, why did he have such a lasting impact? Most philosophers, including great ones, aren’t even known in their own time. There must have been something about Galen’s works that kept them around for thousands of years.
All this makes me very suspicious. Was Galen actually a dope? Or did someone pull an intellectual hit job on the guy? If so, why? What was he actually like, and why did he have such a huge influence?"
Ah, that's the link I was trying to remember (I read acoup.blog often enough that I conflated the two)
I knew this was exactly the post you were referring to in your first comment, heh. Maybe I should've linked it under your comment
Nah, reply notifications on substack don't recurse, so if you did that melvin wouldn't see it unless he happened to look at the comment.
I accept it's a strawman, for the purposes of fitting the entire field of ancient medicine into about twelve words in the service of an analogy picking on something else.
But I think it's fair to say the following about ancient medicine:
1. They had a few of the basics right
2. They had vast gaps in their knowledge (e.g. cells, germs, chemistry) which prevented them from understanding a lot of what's going on
3. They leaned heavily on the few things that they did vaguely understand in order to explain all the things that they didn't, which resulted in a model of human physiology which wasn't all that true and wasn't all that useful for treating disease either.
And sometimes it feels to me, as a non-expert, like the study of the human mind in 2021 is roughly at the same point as the study of the human body in 400 BC.
3 not necessarily being true is precisely the point being raised by the book review:
"""
In fact, I was surprised by how modern Galen’s reasoning seems. At one point he discusses magnets, and argues against an atomic explanation of their action. Before you laugh, remember that the modern explanation is electromagnetic fields, which look a lot more like one of Galen’s natural faculties (a tendency for mutual attraction over distance) than they do Epicurus’ view that “the atoms which flow from the stone are related in shape to those flowing from the iron, and so they become easily interlocked with one another”.
In making this argument, Galen first points out that the idea that nature has “powers which attract” is sufficient to explain the observations. Next he says that since the proposed entanglement can’t be observed, it’s not clear why anyone would prefer this explanation to another. Even if we do allow it, he says, it doesn’t explain why a piece of iron that has previously touched a lodestone will then go on to attract other pieces of iron. The atomic explanation predicts that this shouldn’t happen!"
""
Certainly, there were a lot of gaps, but there was also recognition of those gaps, rejection of explanations due to contradiction, empirical testing, and cross pollination with other schools of thought.
Further, the nature of the textual record in an age with limited literacy practically requires that that record be distorted: from the acoup.blog link:
"""
One example I like to turn to is about medieval leprosy. Throughout the medieval world, people with leprosy were often removed from society, placed in leper colonies or leprosaria, and approached with a combination of fear and awe. But for a long time, and arguably even still, medical historians have questioned whether medieval peoples could actually distinguish Hansen’s Disease (the modern name for the disease that causes leprosy) from other skin conditions. Because medical texts don’t make it clear that they could. Just describing the symptoms of leprosy in these limited texts, it sounds a lot like late-stage syphilis. But studies of grave sites in leper colonies show that almost everyone buried there indeed had advanced Hansen’s Disease, which is apparent in the bones, particularly the bones of the face, which develop distinctive pitting on the upper jaw and degradation of the nasal cavity. This suggests that medieval understanding of these diseases in practice was a lot more sophisticated than theoretical writings suggest.
"""
I'm not arguing that they know everything (and by analogy, so do we), but that we do seem to have a foothold that makes actual useful predictions that can be falsified. It's incremental progress, but so is climbing a sheer mountain face, once you know how to find the footholds.
Isn't a more plausible explanation that those who didn't have leprosy would've caught it in the colony?
That was my take, but it turns out leprosy is much less contagious than you'd think (so not contagious that I don't understand how anybody gets it), and also a lot of people are genetically immune and can't catch it under any circumstance.
I get what you're saying, and I'm wary of it 'explaining everything' too (hence my hedging on "what would have I predicted if I would've had to guess"), but the model is more constrained than "everything wrong with the mind is some kind of predictive processing gone wrong".
It does not explain everything wrong with the mind (e.g. depression or mania or various psychoses), just the seemingly unconnected symptoms of autism - social deficits, sensory (and sometimes emotional) overload, motor impairments (e.g. walking on uneven ground or catching a ball), stimming and echolalia, adherence to strict patterns and routines etc.
Musings on schizophrenia are mine and mine alone, going off of Scott's writing.
Here's why I do like it:
1) Most importantly to me as a scientist, it already made new predictions about the details of some symptoms that weren't known before and were borne out by experiment. A model that makes new predictions gets a lot of points in my book.
Specifically, that severely autistic patients (unlike NT's) don't look ahead of the trajectory of something moving, only trail after it, and their motor response when catching a ball looks exactly like someone who can't predict where it will land until the last moment. Also, that they have much weaker sensory habituation to constant stimuli (the way we can 'tune out' a smell or noise) at the most basic neurological levels (of immediate sensory processing/prefrontal cortex).
Some of these experiments I don't know if they've been published yet, I heard them at a seminar that Prof. Sinha gave a few months back.
2) It really does tie together very elegantly symptoms that are really weird and unconnected, in a way no other model did before. And it focuses on the more basic neurological symptoms and less on the social aspect, which I appreciate. It's hard to imagine what does inability to register sarcasm have to do with stimming, and then it all clicks together as the result of living in a scarily 'magical' unpredictable world.
3) It ties into the PP framework nicely, and fits with some personal observations (e.g. that much of my experience on LSD was similar to the day-to-day experience of my partner, who has a bunch of autistic symptoms).
I really recommend the review I linked. Can send a file if paywall's an issue.
It is indeed very interesting, thanks!
These comment threads on this post are making me wonder if I'm actually schizophrenic instead of ASD. Which is weird because I would not have thought that before.
Maybe my brain is just twitched in some completely different third way...
Huh. Do you mind elaborating why (i.e. what does your brain do that you) were diagnosed (or self-diagnosed) with ASD but think it might be schizophrenia instead?
I wouldn't be surprised if the space of "brain can't assign prediction weights properly" is mostly bimodal with tendency to settle either on ASD-like brains or SCZ-like, but with some people outside of the bimodal, as always.
A bit off topic but related in the sense of “Hmm, that’s interesting”
James Fadiman’s micro dosing site says that people who are red green color blind should not micro dose.
“People with colorblindness report lasting visual distortions from microdosing”
https://sites.google.com/view/microdosingpsychedelics/faq-on-microdosing
wonder if that’s not above the rate of lasting visual distortions due to hallucinogens (lol Sartre crabs, tho they were from mescaline)
Also: >we specifically do not recommend... with psychotic disorder or along the autism spectrum try microdosing
And Gwern on microdosing, finding “no meaningful effects and worrying trends” https://www.gwern.net/LSD-microdosing
Yeah, it was mescaline. Sartre said he had a nervous breakdown from the experience.
Thanks, that is super interesting!
Okay, now I'm wondering about links between colour-blindness and such. Gotta be a coincidence of the dna encoding multiple things, otherwise what on earth should a pigmentation failure have to do with anything neurological 😵 (I'm very colour-blind FWIW)
So this may be a dumb question, but I take from all this that Schizophrenia and Autism is never diagnosed in the same person either?
> some people even get diagnosed with both
It's in the post
Oh missed that somehow, thanks.
> more likely to get autism
Why does this seem like weird phrasing to me? It feels like it should say "more likely to have autism", but I'm not really sure why.
I had the same reaction.
It's not an infection!
Scott,
This website says that schizophrenia rates may be three times higher than normal in autistic people.
https://www.spectrumnews.org/news/schizophrenia-prevalence-may-threefold-higher-people-autism/
Is the spectrum model, where Autism lies on one end and Schizophrenia on the other, fundamentally misleading?
Contrary to what I expected from spectrum news . Org, they cite a “systematic review and meta analysis” https://pubmed.ncbi.nlm.nih.gov/30284394/ with “ The meta-analysis of the prevalence of schizophrenia in individuals with ASD encompassed 1,950,113 participants and 14,945 individuals with ASD.”. Interesting!
Yeah, this is part of what I'm trying to explain away with the paragraph "In theory you could use this kind of thing to help figure out what causes both conditions. In practice, it’s a lot more complicated. Autism and schizophrenia also resemble each other in a lot of ways, a lot of the genes for one also increase risk for the other, and some people even get diagnosed with both. I try to make sense of this conflicting information by speculating that autism has at least two components, which are correlated and anticorrelated with schizophrenia respectively (see here for guesses about what these might be), but still - all speculation and trivia."
I explain it a little further at https://astralcodexten.substack.com/p/ontology-of-psychiatric-conditions-653 , and if I'm right, the people in that study are people at the top of the graph at https://cdn.substack.com/image/fetch/f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F40d3097d-8f2e-4bc1-b217-a81f987e43d9_673x551.png
So to test this, you’d want to see at higher IQs if schizophrenia and autism separate, or at least correlate less? Sounds like the sort of thing it’d be tough to find a good and large enough sample for
bored-anon: Ugh, copy/paste broke while fixing a typo; if you have the comment I typed out in a notification email, would you mind recovering my comment for me?
If you’re trying to dox me via hidden email metadata the copy will carry, nice try ;) (I doubt that’s doable exactly as it’s probably text only, and obviously you aren’t but it does gesture towards possibilities. Also it probably wouldn’t work as i segregate identities online)
FWIW, I'm very high IQ, diagnosed ASD, not at all schizophrenic (uot-patient psychiatrist agrees), but with a way of describing the world that for some reason convinces in-patient psychiatrists that I am in fact schizophrenic, which… is not a fun place to be. My out-patient psychiatrist has been giving me advice on this dilemma that amounts to “you probably should talk less and be really careful about how you phrase what you do say to mental health professionals if they don't know you really well”
Bless your heart, thank you so much 😆
As it happens, my comment contains an exploit for a fault in many mail servers that results in encoding ip addresses in the form of varying the unicode spaces used between words.
…is what I would say if it were at all possible 😅
That is vaguely plausible-ish techno-babble tho I think bored-anon's concern might have been exposing their email address.
I can't think of any way that any email body data would encode metadata that could identify the recipient. I don't _think_ any (at all commonly used) email clients run JavaScript and, aside from convincing a reader to download and execute a file, you'd have to exploit something like a JPEG decoder/viewer library/program vulnerability (which _have_ existed).
The more prosaic 'attack', and one that's probably still common, is to link to an image on a server you control. When the recipient's email client downloads the image, your server can log/record the IP address for the host that initiated the download. That _could_ be the recipient's IP address, tho I think almost all of the popular web email services download images on their own services. But this wouldn't alter the email on the recipients end regardless. And IP addresses aren't particularly sensitive, or at least I don't think they are.
FWIW, I'm very high IQ, diagnosed ASD, not at all schizophrenic (my long-time out-patient psychiatrist agrees), but with a way of describing the world that for some reason convinces in-patient psychiatrists that I am in fact schizophrenic, which… is not a fun place to be. My out-patient psychiatrist has been giving me advice on this dilemma that amounts to “you probably should talk less and be really careful about how you phrase what you do say to mental health professionals if they don't know you really well”.
[Thank you bored-anon for helping me recover this comment from a copy-paste screwup!]
Very curious what sort of statements. Maybe you’ve pierced the veil of conformity and mystification?
Honestly, I can really only make guesses (I have a significant degree of memory loss from last year, including much of my time in the hospital). Knowing a bit about myself, probably trying to explain existential angst to a doctor (or a nurse, and therefore to the doctor via an extra stage of telephone-game) while in the middle of a sensory meltdown episode.
Given some of your other comments about making inferences from details of people's verbal behavior that neurotypical people don't anticipate or follow, maybe you make assertions about what other people are feeling or thinking that the inpatient doctors interpret as paranoid or delusional?
I'm kind of curious how this interacts with aphantasia. It may be too hard to study, or I don't know how to look for studies about it, but anecdotally, I have total aphantasia, and I've worried on numerous occasions that my mind indulges in bouts of paranoia and "magical thinking" of the kind that is described by diagnostic criteria for schizophrenia. But ultimately, it seems like my ability to "roll to disbelieve" these things like intrusive thoughts, delusions, paranoid suspicions about conspiracies against me, etc, is pretty strong. They show up, I sometimes get tripped up by them briefly, but I notice it and dismiss the thoughts as "crazy" or "nonsense" rather than believe them strongly.
And then also, I notice that there's a really weird split between whether people immediately peg me as autistic. I've never been formally diagnosed, but seem to have a number of incidental traits (difficulty "tuning out" stimuli, preference for direct and explicit communication more than is considered "normal" or even "socially appropriate" in some contexts) that would seem to indicate being at least mildly fitting the description. I especially seem to have trouble intuitively grasping social norms about framing information in a way that will upset people, and I notice that the way people describe this to me (especially the people who get the most upset) sounds a lot like what I feel like when I notice intrusive thoughts. People have told me that I've said something that gave them really terrible imagery they can't get out of their heads, which I have a hard time understanding, not just because I don't literally get visual imagery, but also because it's easy for me to dismiss upsetting thoughts when they're not tethered to an unpleasant reality I actually have to deal with, much like I can disbelieve thoughts I come to think are delusional. I don't think people are just being overly sensitive, this really does seem to be a significant difference in how we process information, which is most stark with people who describe their mental processes as involving a lot of vivid visualization
This leads me to wonder whether a visual processing mode is just kind of inherently harder to dismiss. If your brain went to all the trouble of producing some imagery for you, it seems to me from the outside that this might make those thoughts associated with the imagery "stickier" in a way, harder to treat as meaningless or not change other beliefs to accomodate
DnD “roll to disbelieve” suddenly makes much more sense as a roleplay mechanic. Still not convinced people can create and throw fireballs with their mind though :D
That's probably for the best :)
I don't think this is true. From the account of someone suffering from schizophrenia - which I think I read in a previous post here - is that you don't just get rid of delusions by disbelieving in them. The writer of the account in question knew he was having a psychotic break and that he needed help, and at the same time being convinced that his friends and family were conspiring against him. I'm not sure how aphantasia plays into that - maybe it does intensify the delusions - but it's definitely not a case of "Just say no to psychosis."
Well that's exactly what I'm saying. I've read that and other first-hand accounts of schizophrenia, and understand that a lot of people who suffer psychotic breaks are fully aware that they're experiencing delusions. I also know that I've had delusional thoughts that sound extremely similar, including very complicated social conspiracies, and including auditory and even once or twice visual hallucinations that persisted for at least a couple of hours in some cases. But this nonetheless fails the diagnostic criteria outlined by the DSM, because like most pathologies, that requires rising to the level where it interferes with your life in some significant way, and as I described before, I seem to be able to ignore this sort of thought until it goes away, tell what's real and what isn't, etc. I've always wondered if this was just normal variation on some general spectrum of schizophrenic delusion on which I'm simply "very mildly delusional" or if there's some way in which this pattern of noticing delusions happen, and then being able to dissolve them more readily than people with the diagnosed malady seem to be able to is different from the delusions simply being "less delusion-y" in the first place. That's why when I read stuff like "blind schizophrenics don't exist", I start to wonder if there's something about persisting visual information that just makes it harder to dismiss information your brain is insisting to be true. I do find that for example, if I know that I am visually hallucinating, I can often clear it by closing my eyes for a few seconds
Suzette Haden Elgin wrote about assuming she would be able to tell that hallucinations were too implausible to believe, but then she had delusions (from steroid withdrawal, I think) of the CIA having an office in her hospital room, and she didn't doubt it when it was going on.
The ability to doubt hallucinations might be a very different thing than the ability to not have hallucinations.
Historically, it's been noticed that sensory deprivation helps bipolar mania as well. Here is a short story from 110 years ago mentioning this in passing
https://en.wikisource.org/wiki/A_Red_Flower (a beautiful if sad read, well worth it).
> He awoke at night. Everything was still; from the large neighboring room could be heard the breathing of the sleeping inmates. Somewhere from afar sounded a strange, monotonous voice. It was that of a patient conversing with himself in a dark room; and from the top floor—the women's department—a hoarse contralto was singing a wild song. The patient listened to these sounds. He felt a terrible weakness in all his organs; his neck pained him frightfully.
> "Where am I? What is the matter with me?" were the thoughts that came into his head, and suddenly, with an unusual vividness, there appeared before him the events of the past month, and he understood that he was ill and the nature of his illness. A whole row of disconnected thoughts, words and actions came into his memory, causing him to shudder in his entire body. "But this is ended, thank God, this is done," he muttered, and fell asleep again.
Another quote:
> Sometimes, as on the first night, he would awaken amidst the stillness, after a whole day of turbulent motion, feeling rheumatic pains in all his organs and a terrible heaviness in the head, but nevertheless in full consciousness. Perhaps this effect was produced by the absence of sensations in nocturnal stillness and dusk; or perhaps it was due to the weak efforts of a suddenly awakened brain, enabling him to catch, during these few moments, a glimpse of reason, and to understand his condition as if he were in a normal state. With the approach of day, however; with the reappearance of light and the reawakening of life in the hospital, the other mood would seize him again; the sick brain could not cope with it, and he would become mad once more.
Perhaps sensory deprivation can help both over-sensitive and under-sensitive people by serving as a "turn it off, then turn it back on again" fix for the brain? There's always a certain amount of filtering to perception - noticing smaller and smaller sensations when they're the only things happening, or becoming numb to things in an active, crowded environment - like turning a volume dial to the comfortable level. When moving from no stimulation to a normal amount of stimulation, the brain might naturally "turn the dial" to a neurotypical level, and then whatever makes you autistic or schizophrenic gradually changes the dial to a different number.
Think of somebody with a messed-up sleep schedule. They're stressed out and exhausted, but in spite of being exhausted still can't sleep at a regular time! Then they go on a nice, relaxing vacation in an isolated valley off the grid, with sunset and sunrise their only clock. Their sleep schedule heals and they start to feel normal again. Emerging back to regular life, they're still well-rested and happy for a while, but it doesn't last - daily stress, a cup of coffee in the afternoon, late-night Netflix - gradually they become the same exhausted insomniac as before the vacation. If the things that make you autistic or schizophrenic work like caffeine and stress in this metaphor - gradual damage that builds up until you're in a maladaptive state - then "autism" and "schizophrenia" could be attractor states in the machinery of sensory processing. Sensory deprivation tanks are like the off-the-grid vacation, completely cutting you off from the damaging influence. There's no sensory processing failure with no senses to process. It doesn't matter whether you were going to process it too much or not enough, as long as the "reset" puts you substantially closer to normal - in the same way that the off-the-grid vacation fixes the insomniac's sleep schedule whether they were sleeping too soon in the day or too late before leaving for the valley.
"Still, as far as we can tell that’s not it."
I can't tell you how valuable it is for someone like you to discuss these issues with so much humility. I don't have to tell you how often people online promote themselves as experts while the real experts are the first to say that the answers aren't always clear. I have two kids with psychiatric issues and we love their doc because she is so transparent about how difficult it can be to find successful approaches to their issues.
I'm not a doc myself but I have picked up a lot from the parental sidelines, and I can't name a more informative site than yours.
Same here, it's so refreshing. The comments on this post are amazing too.
I'm hoping the genes from my schizophrenic father are sorta balanced out by the high functioning autism-ish genes from my mother. So far so good. I'm in the richest 1% and never hallucinated anything.
Wishing you well on continued avoidance of any ill effects.
So, a common-to-the-point-of-there-being-tiktok-videos-about-it talking point is that we autists notice _different_ things in social settings, and that this often violates expectations about what knowledge/information about mental states is public knowledge.
This makes people deeply uncomfortable, consistently. Which makes us uncomfortable, and prone to doing odd things to try to… not cause that.
Obviously there are a multitude of different ways it can play out, but this resonates with me.
And it makes a lot of sense to me that someone with a dramatically different weighting of available sensory information would tickle this discomfort in others.
This doesn't really feel like my experience at all. YMMV
The diametrical model of autism and schizophrenia is complete nonsense. I can't say I'm surprised, because autism research has suffered from a truly appalling lack of rigor for the last eighty years, but I'm disappointed to see Scott fall for it. A few counterarguments:
Autism becomes apparent in early childhood. Schizophrenia rarely becomes apparent before adolescence. And yes, I know there are certain personality traits that appear much earlier and can increase the risk of schizophrenia. A Slate Star Codex article I'm too lazy to look for linked to the experience of recovered psychotic Peter Chadwick, who described his "problematic hardware tendencies": narrow attentional beam, poor context processing resulting in social awkwardness, little ability to integrate thought and feeling, chronic anxiety and threat sensitivity. I would hardly describe those traits as the opposite of autism.
Some of the genes that increase autism risk also increase schizophrenia risk. I recently read "Hidden Valley Road," about a family with twelve children, six of whom were schizophrenic. Every member of the family who was tested had a gene associated with schizophrenia, autism, and bipolar disorder. One of the neurotypical family members went on to have a child with sensory processing disorder.
Schizophrenia can in some cases be medicated. There is no medication that can treat autism. Taking antipsychotics won't make a neurotypical autistic, and taking hallucinogens won't make an autistic neurotypical. (Source: I once hallucinated vividly as an uncommon Ativan side effect, and remained autistic the entire time.)
Not all autistics are oversensitive. Some are undersensitive. Some - probably the majority - are oversensitive and undersensitive in different areas. I'm sure you've heard of autistics who scream when touched, but barely react to actual injuries.
Also, this is a bit of a digression, but I'm sick of seeing autism described as a social disorder. People only think that because of a combination of the double empathy problem - empathizing with people who are different from you is hard, and if everyone is different from you, your inherent human shittiness will be more obvious - and terrible research that involves putting kids through highly artificial lab situations and assuming they'll react to real-world situations the same way. There's the Sally-Anne test, which trips up autistic kids and non-native speakers alike with its confusing sentence structures (and which a significant minority of autistic kids pass, but neurotypicals never mention that because it would get in the way of their sweeping generalizations). The "Reading the Mind in the Eyes" test, which ignores the minor detail that real people aren't static black-and-white photographs of actors' eyeballs with multiple choice options floating around them. Various tests that involve making kids watch a cartoon of a square shoving a triangle, or whatever, and treat the child as socially defective when he correctly states that squares don't have motives. Meanwhile, I'm part of the minority of autistics who actually do lack empathy, but I'm good enough with language and familiar enough with acting and storytelling conventions to pass most of these tests with flying colors. When will people realize that genuine empathy isn't something that can be tested in a lab?
I more or less agree with the frustration expressed in this comment, and the expressed reasons for it, although I waot to personally emphasize that my frustration is more with society et al than with “Scott trying to figure it out while starting from a non-ideal starting point”
[the lack of editing has caused me to lose a comment when trying to do the copy-delete-paste dance once today already, so please excuse my inability to spell: I'm on a phone with a non-traditional keyboard that makes a different set of typos common, not an idiot 😜]
And here I was thinking you were an idiot. Just kidding. I cringe at my phone app typos too. Those auto correct errors look rely bizarre. Someone should really add a ducking edit feature.
Autocarrot is really the ducking wurst.
(Hilarious anecdote from just now, I had *intentionally* and correctly typed out "ducking" for the joke... and autodefect corrected it to "fucking". Which presumably days something about how frequently I engage in profanity. ;-) )
I miss for a lot of reasons the fact that the 'like' button was apparently removed from this blog for some reason, including that I now need to type out a whole "Yes, all of this" comment rather than expressing "Yes, all of this" in a way that also doesn't detract from more complex conversations in the comment chain.
Yes, all of this.🙂
It annoyed enough of the commentariat here that Substack let Scott remove it.
If there was a way to turn off email notifications for likes but not replies it would probably have been fine - I like knowing that someone has something to say in response, but it's really annoying to be emailed every time someone clicks the like button.
I find getting an email of "Someone thinks you're wrong" much worse than getting an email of "Someone thinks you're right", and people are generally a lot more driven to leave comments when they think someone's wrong than when they think someone's right.
That's a matter for community norms and rules though. Such as the recent "content free disagreement is grounds for a banning" rule Scott mentioned.
I personally am far too prone to seek out the quick fix of writing comments to acquire internet points if the place I'm writing them is at all points oriented, and that's really toxic for an environment like this.
I think "people do stuff because they want recognition from their peers" is wired far deeper than anyone can solve by removing a like button, and also not a problem to be solved in the first place. There are environments (imageboards, mostly) that strive to avoid doing that, and they're interesting places in their own right, but they're even further from ACX-comments-intended-norms than "ACX comments, but with a like button". It's really something you have to go all-in on -- just the shape of human psychology is that any environment where there isn't a way to quickly say "I see you and I see what you're saying here" is one that's suddenly shifted to working on a completely different ruleset. The pre-like-button solution was "+1"/"this"/etc in actual replies, but post-like-button internet norms shift to considering this a net negative, so it's something you'd need to explicitly encourage in turn if you wanted it.
If the complaint is "when people have access to like buttons I feel more incentivized to make mindkilling quick political takes and less incentivized to make effortposts", the coordination problem there is that people should stop clicking it for mindkilling quick political takes and start clicking it for effortposts. My general experience is that rat-adj types are reasonably good at this compared to most communities where discussing politics is a thing.
Sure but we also, it would seem, want reasoned discussion and informed contrarianism here, and prefer that to likes. And the reason they were disabled is probably seeing the like numbers on all posts rather than just yours
Entirely disagree. I love knowing how and why someone disagrees, but could not care less for individual reminders for every person in the expected x% that agrees with something
I thought I lacked empathy for a bit, but it turned out to be a choice. Food for thought.
> Not all autistics are oversensitive. Some are undersensitive. Some - probably the majority - are oversensitive and undersensitive in different areas. I'm sure you've heard of autistics who scream when touched, but barely react to actual injuries.
I can't stand the feeling of my skin after I've showered, I'm basically unable to function for a while after if anything at all is also wrong (extraneous sounds, smells, etc).
On the other hand, when I shattered my wrist, the hospital didn't give me any pain medication for the first several hours because I didn't appear to be in any pain. Although I was asked "Have you had anything to eat today? You look quite pale" at least 3 times during that period.
Obviously, it's impossible to compare subjective experiences, but when I was growing up, many people remarked about my apparently undereaction to injuries.
On the other hand, I've never experienced the shower thing you describe.
"Also, this is a bit of a digression, but I'm sick of seeing autism described as a social disorder."
Yeah. On the one hand, my lack of social ability has probably handicapped me in life. On the other hand, I don't like people - or rather, I don't like interacting with people. I don't have a 'social life' and I don't want one.
Imagine that somebody holds your head down beside a road drill for three hours, all the time going "Isn't this great? Aren't you enjoying yourself? I could do this all day!" and then afterwards, when you said that in fact you did not have fun, the attitude was "Well, the problem is with *you*, not with our fun-having drill!" That's my attitude towards parties and other fun! social! activities!
(And for roadworkers and others who do have to operate drills for more than three hours in a day, you have my sympathies).
I like it here under my rock. Stop trying to drag me out and shine bright lights in my eyes.
Well, for a self proclaimed misanthrope you seem to be pretty well loved around these parts. I guess you’ll just have to learn to live with that affection. :)
You are all very kind to me. I can handle things at a distance, and since most of you are about four thousand miles away from me, that's manageable 😀 If you lived down the road, it'd be a completely different manner.
Thank you for the kind thoughts, though!
I would like to second the kind thoughts. I've always liked your contributions.
You present your views eloquently, interestingly and in such a way that it's not grating to people with other, different views (such as myself, some of the time).
I know that feelings as well; still I don't like to socialise when sober. About the power tools, it was different. I was pretty happy when I was once allowed to handle a jackhammer all day.
Part of it is just wanting different things in friends and sociability. I for one supremely enjoy your comments, and would be delighted to have more friends who did nothing but digress at length about similarly interesting things
If you talk about schizofrenia, know that these are people with halucation problems (chronic psychosis) AND are treated with poison, see for example zyprexa here: https://pubchem.ncbi.nlm.nih.gov/compound/Olanzapine The symptoms you see are not of schizofrenic people but of schizofrenic people treated with poison.
I love all my schizo fren ics! (It’s phren)
How can I put this in line with the large number of schizophrenics or bipolars that I know who claim their “disease unmedicated made them unable to work or do anything meaningful and destroy all their relationships with friends and family” and that “only on the drugs, even though they are awful and poison, can they have something resembling a fulfilling and normal existence”? I do wish less people would take such drugs, but it is harder than it seems. And a lot of people have schizophrenia or bipolar for many years before the hard drugs? They obviously should meditate and self overcome it our, and the few that do are better for it, but they are maybe .1%?
Thoughts, roughly itemized:
1a. The blindness-SZ thing is much less clear than it's popularly reported. The actual papers on it will freely shrug and say "Yeah, our evidence for this is pretty weak and heavily supplemented by anecdata". That's not to say it's not true -- it's probably at least adjacent to truth, because the "this should be a common enough comorbidity that the anecdata would be much less certain" argument is pretty strong (but see 1b). The big thing that gives pause here, though, is that much of both the data and anecdata is from parts of the world where two things are true: congenital blindness is very rare, and SZ is generally a disabling chronic illness causing lifelong medical dependency. In the parts of the world where congenital blindness is much more common, the association between SZ and long-term contact with medical frameworks is much weaker, and a lot of people can easily be "lost to follow-up".
1b: No one at all has bothered to look at (though one group, as far as I can tell, has bothered to complain that no one is looking at) by far the single most important thing you would want to look at for this hypothesis: whether blind people are less *schizotypal* than the general population. There's little good excuse at this point to look at SZ as a random thing that Just Happens Sometimes in neurotypical young adults rather than as a semi-common [progression/adaptation] in a common neurodivergence that may or may not be clinically relevant before, but, well, here we are. Whether blind people are less schizotypal or not is the absolute core of the blindness-SZ speculation, and it has completely different consequences for whether this is likely to be a real effect, what it theoretically means, what it might clinically mean, etc.
2a. "Some people are diagnosed with both schizophrenia and autism" is one way of saying it. Another way of saying it is that about 8-15% of autistic adults fit SZ criteria in meta-analyses and as many as 40% in some individual studies. That is, that the risk is about the same as having an SZ parent (and in some samples to having *two* SZ parents). When I corner imprinted-brain/diametrical types and ask them to explain this, I tend to get some stammering about how high-functioning autism is akshully super misdiagnosed and none of those people were ever autistic at all. I am very sympathetic to explanations of weird shit that just look like "yeah, autism diagnosis is atrocious" (see below), but I think this requires much more bullet-biting than any of those parties actually think through; if you assume as in genpop that there are 2-3 people fitting schizotypal PD criteria for each person fitting schizophrenia criteria, you quickly ring up numbers where you'd just have to shrug and go "Yeah, high-functioning autism basically doesn't exist and it's all misdiagnosed schizotypes". I don't think this accurately represents the schizo-autistic spectra range -- even if I bite the bullet on myself and go "those can't overlap, I was always just schizotypal and there's some purely schizospec explanation for my autism-specific characteristics", I've certainly met people who are clearly and entirely on the other one. If you *don't* force yourself to bite really bad bullets for thought experiments just because they're common in pop-psych, I am definitely confident in the existence of distinct spectrum edges *and* their overlap.
2b. Has anyone sat down and read the schizotypal PD criteria? Or talked to a schizotypal person? I can't imagine doing that and coming away with the takeaway that these are unimaginably different, mutually exclusive conditions. Imprinted-brain/diametrical claims about the schizospec consistently strike me as written by people who have no clue at all what the schizospec is and how people on it act, especially when those people are not floridly schizophrenic. (There is still not much better excuse for a "schizospec but only full-blown SZ and everything else is vaguely backfilled" model than an "autism but only the most severe forms of autism and everything else is vaguely backfilled" model.)
2c. The autism-SZ associations are even stronger in childhood-onset SZ, which is generally conceptualised as a more "core" form of the neurotype that digs more directly at the neurological things going on underneath. Most children with COS fit PDD criteria premorbidly, and a substantial proportion fit full autistic criteria.
3. Routing around to the opposite end of Screwy Diagnosis: I've read a lot on autism diagnosis with pre-existing substantial disability in other fields, whether sensory, cognitive, motor, or otherwise. I've come to the conclusion I don't trust any such study as far as I can throw it. The children fitting ASD criteria here were more disabled on just about every axis, which is the case in ~every such sample; as long as ASD continues to essentially supplant intellectual disability alone as the diagnosis of choice for people fitting the latter criteria, I can't look at the sample characteristics here and go "Yes, this is clearly, obviously getting at a neurotype more complex than 'people with low birth rates, cerebral palsy, more signs of underlying brain damage, and lower socioeconomic status are more disabled than people without those characteristics'".
4. Until earlier this year, the Wikipedia article for the imprinted brain hypothesis -- that is, the first thing any random reader was likely to encounter researching this topic -- was a glowing hagiography with a fuckoff-huge table correlating random primary studies that didn't say the things they were represented as saying at all to the hallowed hypothesis cast down by angels, and featuring huge positive block quotes about this revolutionary new theory that was extremely true and about to rewrite psychiatry from the ground up. It looked like that for ten years. It no longer looks like that. I'm looking forward to seeing the long-term consequences.
*paraphasia: low birth WEIGHTS, not rates
Good ideas. I have been thinking, schizotypics and high functioning autists could not be mixed up because of the childhood sensory things, jactations and the like. Have to look things up.
Anyway, the guy in my secondary school class who later got schizophrenic was as weird as me but I found him boring, liked a few others more and made friends with at least one.
This convinced me. I now think schizophrenia and autism are at least as related as (and probably more related than) they are different, and that either or both are also really complicated and multi causal and presentational so as to make such a statement about two related descriptions for a wide variety of disabilities quite difficult to interpret and support.
Unrelated, and I don't have access to the article, but couldn't the low prevalence of smoking in autistic people also be caused by the effects of lower ability to socialize, not just (or even necessarily) biology?
Or just one of a million other confounding effects of the way smoking was distributed among populations and people at whatever time the study was done
Is it possible that Tourette syndrome deserves a place in this constellation?
https://en.wikipedia.org/wiki/Tourette_syndrome
> I don’t know what’s up with the echolalia
Phonological loop things maybe? Caching stuff while you process audio input for more than just the speech?
I was born with one eye. I also believe I am slightly autistic. I am a schizoid personality but the relationship between schizoid and schizophrenia is not conclusive. I can relate a lot to this post and the comments. For me it is a chicken and egg thing as in are some of the things mentioned in the post and comments biology i.e. a result of my partial blindness and other genetic issues or did my lack of socialization due to my self consciousness of having a prosthetic eye as a child contribute to my schizoidness, autism, sensitivities, etc. As a child it was obvious that I had a prosthetic eye so I was teased and bullied a lot. Also my parents both worked in the evenings so I was not socialized much as a child. Fully adult it is much less obvious as my prosthetic eye, eye lid, etc look no different than my good eye. Even without my birth defect I have always felt different. So did my partial blindness contribute to my autism and schizoid personality? Yes but having studied a considerable amount of neuroscience I believe it is also in my innate biology not necessarily hereditary. I also think it is partially due to birth trauma and prenatal environment as my mother had a difficult pregnancy. So again genes and environment. Like the rest of us it is a combination of factors that made me who I am. Thanks again for this post it help me understand myself a bit more even at 62 years old.
Just spit-balling, but I wonder how schizophrenics, autistics and the blind experience inner speech the same or differently. Might the inner voice as a focal point be probative?
About schizophrenics' heavy smoking: Knew some researchers 20 yrs ago who believed the smoking was actually driven by one of the med side effects of the drugs most commonly given then for schizophrenia -- akasthisia. Nicotine apparently gives some relief from akasthisia. Don't know whether this theory has held up, though.
wonder if its possible that autism is at its core a kind of sensory overactivation. That the brain dedicates too much effort to processes most automate away. This for me would explain the pathological rationality, as well as the correlation with blindness (as blindness would require a heightened sensitivity of the remaining senses).
Being a pseudoscientist, I was actually thinking that autism and narcissism were at the respective extremes of introversion and extroversion.
Epistemic status: speculative (as in: I'm a mechanical engineer and read papers on predictive processing as a hobby, let's wait for some sane people to weigh in on this)
We don't know what autism actually is, but predictive processing (PP) offers some theories. Yon and Frith 2021 explain that "characteristics of autism (e.g., a preference for stable and repetitive environments) can be cast as an consequence of overly-strong beliefs about the precision of incoming evidence - where every fluctuation in our sensory system seems to signal the need to change our models of the environment (i.e., the world seems unstable)." (1). The causal direction is not really clear to me, maybe high expected sensory precision leads to bad generalization capabilities and strong reliance on bottom-up sensory input, maybe it's the other way around? Beren Millidge's master thesis (2017) has a theory on a potential neural basis for Autistic Spectrum Disorders: "It argues that the observed pattern of long-range underconnectivity and local overconnectivity observed in ASD, when instantiated in a predictive processing framework, will lead to impoverished high level regions and lower-level regions which down-weight prior information coming from above and prioritise incoming immediate sensory information. This pattern is hypothesised to result in many behaviours recognised in autism such as sensory hy- persensitivity, a local, detailed-oriented processing style, and a preference towards predictable behaviours and routines." (2)
I'm even more confused on the schizophrenia side of the story. The best discussion I've seen so far is (3), which ties PP and the diametric model together and compares schizotypy to an underfitting strategy in machine learning: "One of the downsides of the generalization function of positive schizotypy is apophenia. It is considered the predisposition to false positives: if you have noisy data and you want to see a pattern in the data, you need to be giving a low weight to sensory input - that's the only way you're going to find the line of best fit. The downside: well, you're also going to sometimes see patterns that aren't actually there. You're essentially imposing your assumptions onto the data and you're imposing your model onto the world." (I'm not so happy with this source here, I just don't have anything better right now)
Now I don't see any way of looking at the theory above and coming up with a prediction of low schizophrenia and high autism rates for blind people. So let's push our luck and see if we at least in retrospect fit this together and come up with a few follow-up predictions.
I'd be really surprised if autism leads to blindness. Let's try to reverse the causal arrow: could blindness lead to autism? I'm not sure either, but to get the ideas started: there's an ongoing discussion of how exactly the brain learns in young children. Think of it as a nature vs nurture question: either you provide a genetically encoded brain for an infant (e.g. for animals who can walk right from day one) or you only provide some brain infrastructure and have the system learn on it's own (e.g. cats that fail to see horizontal stripes if they don't encounter them in the first weeks of life). There's some plausibility the human brain might be similar, especially when brain regions are missing at birth with the brain routing around this issue. Soooo maybe, by being blind, the brain reuses the area intended for visual processing and this kinda shifts the whole brain balance to a higher-autism structure?
You can find both links to the source papers and some discussion on r/predictiveprocessing:
(1) https://www.reddit.com/r/PredictiveProcessing/comments/myasvt/precision_and_imprecision_in_the_predictive_brain/
(2) https://www.reddit.com/r/PredictiveProcessing/comments/njv87k/a_predictive_processing_theory_of_autism_a_neural/
(3) https://www.reddit.com/r/PredictiveProcessing/comments/no563j/relevance_realization_predictive_processing/h0omw1k/
My very humble opinion: the over/underfitting aspect is difficult and may depend on implementation details in a more intricate manner than in ML. Plausible stories can be told linking both disorders to either side of over/underfitting. I believe Autism represents over-sensitivity to present-moment input, not an experience vs priors weighting, and this largely changes the conclusions drawn in 3. There are good reasons for these being orthogonal algorithmic choices, which are obscured when you simply do ‘training’ then ‘testing’. The concept of precision is pretty robust though. Very intuitively, lacking the most informationally dense perceptual modality massively reduces prediction confidence.
Scott sez: “Maybe blindness makes children seem more autistic in some boring, mechanical sense? Like maybe if you can’t read other people’s body language or even consistently know where they are, it’s hard to be social and so you don’t interact with other people and that seems autistic to people trying to diagnose you?”
Here’s a proposal for how blindness could make children actually be more autistic in a real and interesting sense: Their inability to see what other people are doing, and especially their inability to see faces, results in their having a very substantially impoverished feed of information about people and the rest of the world. They suffer from a sort of cognitive malnutrition that causes autistic-like stunted and abnormal development in many areas; or produces full-on autism.
Babies are wired to pay attention to faces: Even as newborns they are especially attentive to faces, and they become able to recognize their caregivers very early, at about 2 months I believe. The responses they see on faces are crucial data to them, and if their caregiver suddenly goes deadpan they become desperate and disorganized (Still Face Experiment, https://www.youtube.com/watch?v=apzXGEbZht0). As they learn to navigate the world, the facial expressions of observers are important data for them (Visual Cliff Experiment, https://www.youtube.com/watch?v=p6cqNhHrMJA). The approval, disapproval, fear or even just friendly interest they see on the faces around them gives them information and probably also makes the explorations more satisfying. And of course babies and toddlers don’t just see faces looking at them with various expressions, they also see people with faces they recognize doing all kinds of stuff. Maybe the interpersonal data about visually recognizable people — what the people did, how they looked at me when I did this and that — even forms the framework on which hangs all the rest of the what people learn about how things work. Even if it does not, it must be very important.
Consider the situation of a blind baby: She lives perpetually in the Still Face Experiment. She navigates life’s visual cliffs without being able to see whether her caregiver is enthusiastic or terrified. She toddles around without the benefit of seeing smiling and interested faces observing her. She never gets to see anybody else do anything at all. It doesn’t seem terribly surprising to me that growing up with this very impoverished feed of info about one’s own actions and about life in general leads to social deficits and also deficits in using the body, using objects, activity level, flexibility, adaptability etc. Of course, caregivers can mitigate the damage by staying in touch with the young child via other channels — touch, speech, etc. Still, if we are born wired to tune into faces and to use them as a portal to learning everything else, it may not be possible to make up the visual-interpersonal shortfall via other channels. That shortfall could account for the high-frequency of autistic-like traits even in blind kids who are not actually autistic.
What does this theory have to say about sighted babies who develop into autistic children? Well, maybe they are born with something wrong with the face-processing parts of their brain. Maybe they are born without the wiring that makes them interested in faces, good at recognizing different people, naturally predisposed to be highly responsive to affective displays on the faces of others, naturally interested in the activities of facially recognizable others.
And about that Hobson and Bishop paper: Yeah, it’s really blurry-minded. My theory, above, may or may not have been what they were trying to get at. I did wonder, after reading it, why they had not examined the literature on the development of infants blind from birth. There must be a substantial body of research, and also a bunch of stuff out there, not all of it wrong-headed, about how to foster the development of blind babies. For them not to have incorporated any of this info into their study seems sort of — well, impoverished and rigid, if not frankly autistic. We should not make that mistake ourselves.
Autism is primarily sensory, motor, and cognitive. The social difficulties are a side effect. Wondering if blindness causes autism by stunting social development is like wondering if pollen causes the flu by making people's noses run - the underlying causes are completely different.
I don't think my theory is like saying maybe pollen causes flu by making people's noses run. It think it's like saying maybe being unable to chew due to a jaw malformation as a child causes thinness and short stature by making the chlld chronically malnourished.
And I'm not saying blindness causes autism by stunting social development. I'm saying it could cause autism by greatly impoverishing the feed of information about the world that babies and small children get. Sensory and motor and cognitive skills develop on a poorer information base. Much of the information small children get originates in a social context, because it is coming from interaction with and observation of the people that are around them. But what they are getting is not just social information, it is information about EVERYTHING. It's the impoverishment of the info about everything that leads to impaired sensory, motor and cognitive skills.
Maybe I partly misunderstood your comment. I can definitely buy that growing up in the different sensory world of blindness could cause an infant to develop autism. But I really disagree with the part about sighted babies developing autism because they can't read faces properly. I mean, babies take a lot of cues from other people, but not enough to rewire their entire nervous system!
===But I really disagree with the part about sighted babies developing autism because they can't read faces properly===
I do not think sighted babies "develop" autism because they can't read faces properly but I think the social difficulties is more than a "side effect". There is a test called The Reading the Mind in the Eyes Test which is very popular for assessing the ability to read faces especially eyes. Overall women score higher, Men score poorly, and people on the Autism Spectrum score the worst. As I mentioned in my comment above I am half blind from birth and my high functioning autism/social difficulties were not "caused" by my half blindness. BUT I truly believe that without being half blind at birth and all the consequences of that including how I was parented, teased and bullied in school, and many of the things that Eremolalos and Scott mention above, I would have not have some of my autistic traits. I was a very awkward child (because of my inability to perceive, sense, and see the same way a fully sighted person can) which was partially a result of my half blindness and how my brain dealt with the limited information it was getting. By nature I am an introvert, cerebral, intellectual, high IQ, so if I had complete sight in both eyes I still would lean into what is now called the Twice Exceptional 2e gifted realm of which high functioning autism is a part. But did my half blindness increase my autism or social difficulties with traits and behaviors that Eremolalos/Scott mentioned? Hands down, no question. So as I said my comment above it is always a chicken and egg thing. Everything in context. Genes/Biology and Environment in constant complex interaction. I hope that helps.
I'll take your word for it that being half-blind may have increased your autistic traits, but I have to say, the Reading the Mind in the Eyes test is, like so many autism-related tests, fatally flawed. Here's a lengthy blog post that explains some of the test's many problems:
https://ballastexistenz.wordpress.com/2016/05/01/dont-ever-assume-autism-researchers-know-what-theyre-doing/
The tl;dr is that real people aren't static black-and-white photographs of an actor's eyeballs with multiple choice options floating around them. There are some autistics who can read real people's body language with a startling degree of accuracy, but fail the test because it excludes so much of the information a real person gives out. On the other hand, there are people like me who are hopeless at reading real people but still pass the test because we've seen enough movies to be familiar with acting conventions.
"...the consequences of that including how I was parented, teased and bullied in school..."
I'm really glad you mention that - it's something I really wish autism researchers would take into account. Autistics tend to have such abnormal upbringings that it's hard to tell which symptoms are autism and which are trauma. For example, I was an affectionate kid until bullies kicked it out of me. Now I can't stand to be touched. Some other autistics are pathologically passive, which is always assumed to be an inborn deficit even if it comes after years of compliance training.
> Consider the situation of a blind baby: She lives perpetually in the Still Face Experiment.
Consider the situation of a baby born during Covid...
Wow. Too much new information for me. One silly question. Is someone working on a drug/thing that replaces smoking for schizophrenics so they don't incur the downside cancer risk of smoking? (As a x-smoker, cigs are both a drug and a thing to do. I sometimes miss the 'thing to do' part of smoking.)
The brain has "nicotinic" receptors, but obviously they didn't evolve for cigarettes, any more than our noses evolved to support glasses. Therefore something must stimulate them in the absence of smoking, but it seems as if people with schizophrenia somehow have too little of that stimulus and therefore often self-medicate.
It's also a well known pattern that drugs that mess with your brain build tolerance. Blocking a receptor makes it more sensitive, and overloading it makes it less.
So, as an alternative to smoking for schizophrenia, or obtaining nicotine some other way, why not take a drug that is intended to help *quit* smoking? By *blocking* the nicotinic receptors, they should become more sensitive to the environment that exists.
This theorizing was motivated by how well bupropion worked for me. It has a dual approval, as an aid to quit smoking and an antidepressant.
But now, my mind jumps, what if a drug that blocks *opiate* receptors also might make them grow and help with symptoms?
As it happens, such a drug, called naltrexone, exists in combination with bupropion, but it is only recognized as a weight loss drug.
I want to call this "reverse neurology".
Thank you for reminding me about that. I want to quit smoking and also switch antidepressants, so I'll suggest bupropion the next time I talk to my psych.
I found wellbutrin highly effective for smoking cessation. It really does greatly reduce the craving. Even with the help of wellbutrin you still have to work hard at becoming a non-smoker, though. You have to break the smoking habit and deconstruct the belief that you NEED cigarettes to concentrate, to relax, to enjoy life -- to do whatever the addiction made you believe you need them for. I was very very hooked on cigarettes, and got off them, and do not miss them one bit. You can do it too. Good luck!
"You have to break the smoking habit and deconstruct the belief that you NEED cigarettes to concentrate, to relax, to enjoy life -- to do whatever the addiction made you believe you need them for."
Allen Carr's Easy Way to Stop Smoking was a great help for me in doing that.
We already have one for those nicotinic receptors. It's bupropion. Highly recommend.
It blocks them, rather than stimulating them, though, no?
More trivia from what I'm currently reading: 'Visually impaired people usually have more sensitive photoreceptors, which react very sensitively to every slight change in light. This is also one reason why depression (seasonal affective disorder, or SAD), a condition that is linked to, among other things, disturbed melatonin production, affects them three times as often.'
Source, The Magic of Melatonin by Dr. Fautek and https://doi.org/10.1192/bjp.bp.114.162354.
Scott, are you aware of Dehaene's theory that schizophrenia is caused by an impaired consciousness? More precisely, because the threshold for perception to become conscious is higher than in neurotypicals? The difference is ridiculously strong, e.g. here:
https://www.pnas.org/content/pnas/100/23/13722/F2.large.jpg
Perhaps cutting away a large part of perception makes it easier for other perceptions to propagate to consciousness, because there are less competitors.
I am not sure how this relates to an axis schizophrenia-autism, but Clark's theory from "Surfing Uncertainty" is that autism is caused by too much error signal propagating upwards. Or rather, by too low thresholds for error signals to propagate upwards, so that it happens all the time.
Oversimplifying, perhaps schizophrenics are people with too little consciousness, while autistics are people with too much consciousness.
"the threshold for perception to become conscious is higher" - could you explain how someone who is paranoid is less sensitive or conscious of perceptions? By definition, wouldn't it be the opposite?
It's not a theory that this threshold is higher. One can measure this. For example, in masking experiments a picture is shown for x milliseconds before another picture (the mask) is presented. If x is below a threshold, then this picture does not enter consciousness, if x is larger, then it does. For neurotypicals, the threshold x is about 50-60 ms. For schizophrenics, it is about 90 on average. That is a really big difference, much higher than the variation among neurotypicals.
It is much less understood *why* this is different in schizophrenia. But one theory is the following: when some perception or thought is propagated to consciousness, then this involves the whole brain. So when the brain makes a Bayesian update, it can take into account all sort of knowledge; also knowledge from brain areas that say "this is dumb, don't believe it".
When something does not enter consciousness, then learning still takes place, but it is a different mode of learning. It is bilateral associative learning between small subregions of the brain.
According to the theory, you get paranoid when this second mode of learning is dominant over the first one, because you just learn some random associations without the "wait a minute, this does not make sense"-inhibition from other brain areas.
If you want to know more, I have written a review of Dehaene's book on consciousness:
https://docs.google.com/document/d/1WPjiLQYyxA7LnGGrAC-w_PpBhY-XEGAAf7BGJz5qMXs/edit?usp=sharing
"you just learn some random associations without the "wait a minute, this does not make sense"-inhibition from other brain areas"
Ok, but you said the difference is 30 milliseconds. That is obviously not the timescale on which paranoia and evaluating any situation rationally occurs on. Schizophrenia is not about failing to make the correct judgement of every situation in under 1/10th of a second. That's not a thing anyone does in the first place.
There are two different times involved: One is the threshold that is needed to spark a conscious perception. This threshold is 50-60 ms. But the conscious perception itself takes much long, about 500 ms. It's just that if the stimulus is presented longer than the threshold, then the conscious perception takes place, and otherwise it does not take place.
There are also other thresholds for conscious perceptions. For example, if you don't vary the time, but you vary the contrast from the background, then there is a minimal threshold for seeing something consciously.
The theory now assumes that in schizophrenic people, those threshold are not crossed so often in everyday life. So they have fewer conscious moments throughout the days. So less moments in which the whole brain cross-talks which each other. And more moments in which only some specific brain areas bilaterally talk with each other.
And the implication is not: "paranoia lower your thresholds". The (assumed) implication is "if your threshold is permanently lowered, then you start learning wrong/weird associations, because the association-learning is now based on bilateral learning between parts of your brain."
If you have a conscious perception, you first integrate the knowledge from all parts of the brain, and then learn the result. That's not cognition or something fancy, it's something automatic that happens in half a second. In unconscious moments, you only integrate the knowledge of two or three brain areas, and learn the result of that.
Adding a neuroscience viewpoint on sensory deprivation:
One effect of the day/sleep cycle is that synapses become on average stronger during daytime, and become weaker (go back to baseline?) during sleep. The homeostatic theory of sleep says that this is one of the reasons for sleep.
Sensory deprivation has the same effect. Your synapse strengths become weaker during sensory deprivation. At least some studies claim that.
There are lots of theories of autism and schizophrenia where signal strengths play a role, so this invites endless speculations on the interplay between sleep/sensory deprivation/signal strength/autism/schizophrenia.
"The homeostatic theory of sleep says that this is one of the reasons for sleep"
Wondering if you've seen this, apparently an astonishingly clear cut demonstration of the function of sleep and that it's not fundamentally about the brain:
"Sleep Loss Can Cause Death through Accumulation of Reactive Oxygen Species in the Gut" https://www.sciencedirect.com/science/article/pii/S0092867420305559
Thanks, that is really interesting!
I think that there are a lot of functions of sleep. I buy the story about Reactive Oxygen Species (ROS). But your brain also starts to show strange behaviour when you are tired (large and intense waves travelling through your brain and killing your thoughts), and I doubt that this is due to ROS damage.
If you don't sleep, you start malfunctioning in many places, probably for different reasons. But it might well be that ROS is what kills you first.
I see a lot of comments here about blindfolding, sleep, sensory deprivation. Has anyone ever tried anesthesia? There is no clearer analog of just turning if off and back on again for the human brain. Is it considered too dangerous to be used outside of surgery where it is absolutely necessary? Surely, it isn't more dangerous than electroshock therapy. Is it just no history of collaboration between psychiatrists and anesthesiologists?
I don't nearly have the means in terms of domain knowledge or journal access to do a real lit review, but a web search seems to indicate there are potentially dangerous interactions between anesthesia and antipsychotic drugs. I can't quickly find any indication of whether anyone has ever tried to use anesthesia as an actual treatment *before* the patient has a lifelong history of taking antipsychotics. I suppose one problem is this would be extremely expensive compared to things like electrocuting or blindfolding a person.
I could imagine that anesthesia *is* more dangerous than electroshock therapy. It's the most dangerous aspect of many operations.
I have taken antipsychotic medication for a long time, and had no problem with anesthesia for a sigmoidoscopy or for wisdom teeth removal. I believe it was the kind where it removes your ability to form memories. So it's hard to tell just what the experience really *is*. But I don't think it is an analog of "turning your brain off". Sometimes I have dreams that I think may be flashbacks to experiences under anesthesia, so I am not totally sure that all memory formation is blocked either.
What does seem to be correlated with an altered mental state for me is electrolyte imbalances, going back to low potassium when I was originally hospitalized on suspicion of schizophrenia.
Insulin coma therapy was used as a treatment for schizophrenia in the 30's, 40's and 50's. Was thought to be efficacious, and was discarded not because it was proven not to be, but because antipsychotic drugs came into vogue.
I have a relative who experiences Intense Imagery Movements (IIM; https://pubmed.ncbi.nlm.nih.gov/26561043/). Because of frequent stimming, he was checked out for autism by a neurologist as a toddler. He's definitely not on the spectrum and actually is quite empathetic and insightful about others' emotional states. Nevertheless, as he's grown older, we've noted many autism-adjacencies and similar sensitivities. For instance, he has deep sensitivities to various sounds and tactile experiences.
The idea that there are constellations of related neurological conditions that manifest differently makes a lot of sense IMHO.
Need study with people blinded in infancy. Couldn't make it double blind though.
If you have twins, and they're both blind, that's double blind.
=D
Also I wonder if the congenitally deaf have higher rates of schizophrenia. I had 3 deaf patients on decanoates at our clinic, and none just there for depression/anxiety. Though maybe deaf people with depression/schizophrenia go to places staffed with people who use sign language.
Sorry- last sentence should say depression/anxiety.
Actually, quick check reveals Usher syndrome is syndrome of congenital deafness and 'schizophrenia-like psychosis,' and is a common cause of congenital deafness.
As an autistic person, this is possibly relevant: Until I was fifteen or so, I would walk around the house blindfolded (or with my eyes shut tight) quite often, as a way to relax. I never knew any other autistic people to ask if they did something similar, but I'd be interested to find out!
On a related note - I've thought about the possibility of treating auditory hallucinations in schizophrenia patients using some sort of sensory substitution (see https://eagleman.com/science/sensory-substitution/ - he even has a TED talk!). Maybe having something vibrate when speech is recognized would help patients recognize hallucinated speech as such, and eventually something something predictive coding would lead to having weaker beliefs regarding inner speech. It might also be interesting to think of utilizing some form of sensory substitution in autistic people
My best shot at this would be: melatonin
The levels of melatonin depend strongly on the visual cues, that blind people lack. I wasn't able to get a full picture of how melatonin levels fluctuate in blind vs non-blind people, but there surely is a difference, that's probably most pronounced when it comes to rare, non-standard situation: let's say staying in a brightly lit room long past sunset would create a strong deviation in melatonin cycle in non-blind person but not in a blind person.
The dopaminergic theory of schizophrenia is far from a complete explanation. In fact it can be posed that D2 antagonists simply mask the disease as they largely don't revert schizophrenics to normal functioning.
The alternative theory of schizophrenia involves glutamate receptors. Now, there is a multitude of interactions between melatonin and glutaminergic system in the brain and it's hard to tell which interaction, if any, would explain the lack of schizophrenia in patients that aren't strongly affected by light, ie. for example blind people.
One potential link is that melatonin is a potent neuroprotector in cases of glutaminergic excitotoxicity. So one hypothesis here can be that non-blind people are at risk of being exposed to bright light and consequently having low levels of melatonin. And then in the case of increased glutamate secretion they wouldn't be protected from excitoxicity and subsequent death of certain neurons.
I'm far for claiming that this particular hypothesis has much chance of turning true. But I have a fairly strong belief in that melatonin and glutamate are strongly implicated in the biological basis of schizophrenia.
Isn't this perfectly explained by sparsity of data resulting in more hesitant tuning of a precision parameter?
Intuitively, it looks to me (someone with zero expertise in the matter) like schizophrenia is a deficit of recursive processing in the brain relative to the amount of sensory input, and autism is an excess of the same. Consider what we might expect for different amounts of recursive processing versus sensory input:
(1) Too little recursion: inability to stay on topic (which looks like disorganized thought and lack of concentration), inadequate processing of thoughts (which looks like failure to distinguish between thoughts, impressions, and reality) and too direct translation of sense data into action (which looks like lack of internal motivation in unstimulating environments but flighty, compulsive behavior in stimulating ones)
(2) Low-ish but healthy amounts of recursion being handled well: somewhat reduced processing of thoughts (which looks like an intuitive or artistic style), reduced constraints the brain is trying to satisfy (which looks like uninhibitedness, confidence, and creativity), relative quickness changing topics in a conversation, relatively more effort put into finding or creating a stimulating environment
(3) Normal amounts of recursion - most folk (the baseline for comparison)
(4) High-ish but healthy amounts of recursion being handled well: somewhat increased processing of thoughts (which looks like an analytical or rational style), increased constraints the brain is trying to satisfy (which looks like inhibitions, awkwardness, and uncreativity), relative slowness moving on to new topics in a conversation, relatively less effort put into finding or creating a stimulating environment
(5) Too much recursion: leading to cyclic bodily motions, getting stuck on a topic obsessively, sometimes failing to respond to external stimuli, and sometimes experiencing painful sensory feedback analogous to a microphone screech.
I'd expect sensory deprivation to help people at (5) mainly by preventing the painful sensory feedback, maybe also thereby letting them relax and spare thought to control their other symptoms, and to help people at (1) mainly by making internal motivation the "loudest" remaining input, giving them a chance to focus.
A big chunk of the brain is dedicated to processing vision, so maybe congenitally blind people can re-purpose enough of that they all have enough processing capacity to spare, keeping them out of group (1).
TBH, the reason this account comes to mind is because of the effects of cannabis. Google tells me cannabis probably helps autists and definitely makes schizophrenia worse. From a (4)-ish starting point, cannabis makes me feel like much of my working memory has been turned off, and as a result I get reduced ability to concentrate, a more intuitive/less rational style, fewer inhibitions and more creativity, and even twinges of paranoid ideation that feel like my insecurities getting a free pass to invade my brain instead of being quashed as obviously unjustified.