The Autistic Brain: Thinking Across the Spectrum Read Free Page A

this!
What I hadn’t thought was
I can do this kind of drawing because I have walked around the yard, committed every detail of it to memory, stored the images in my brain like a computer, then retrieved the appropriate images at will. I can do this kind of drawing because I’m a person with autism
. Just as I didn’t think,
I scored in the sixth percentile in reasoning and in the ninety-fifth percentile in verbal ability because I’m a person with autism.
And the reason I didn’t think these thoughts was that “person with autism” was a category that was only then beginning to come into existence.
    Of course, the word
autism
had been part of the psychiatric lexicon since 1943, so the idea of people having autism had been around at least as long. But the definition was loose, to say the least. Unless someone pointed out an oddity in my behavior, I simply didn’t go around thinking of what I was doing in terms of my being a person with autism. And I doubt that I was the exception in this regard.
    The second edition of the
Diagnostic and Statistical Manual of Mental Disorders
was published in 1968, and, unlike its 1952 predecessor, it contained not one mention of autism. As best as I can tell, the word
autistic
did appear twice, but again, as in the
DSM-I,
it was there only to describe symptoms of schizophrenia and not in connection with a diagnosis of its own. “Autistic, atypical, and withdrawn behavior,” read one reference; “autistic thinking,” read another.
    In the 1970s, however, the profession of psychiatry went through a complete reversal in its way of thinking. Instead of looking for causes in the old psychoanalytic way, psychiatrists began focusing on effects. Instead of regarding the precise diagnosis as a matter of secondary concern, the profession began trying to classify symptoms in a rigid and orderly and uniform fashion. The time had come, psychiatrists decided, for psychiatry to become a science.
     
    Being able to “download” images from my visits to cattle-handling facilities in order to create this blueprint for a double-deck loading ramp didn’t seem unusual to me.
    © Temple Grandin
     
    This reversal happened for a few reasons.In 1973 David Rosenhan, a Stanford psychiatrist, published a paperrecounting how he and several colleagues had posed as schizophrenics and fooled psychiatrists so thoroughly that the psychiatrists actually institutionalized them, keeping them in mental hospitals against their will. How scientifically credible can a medical specialization be if its practitioners can so easily make incorrect diagnoses—misdiagnoses, moreover, with potentially tragic consequences?
    Another reason for the reversal was sociological. In 1972, the gay rights movement protested the
DSM
’s classification of homosexuality as a mental illness—as something that needed to be cured. They won that battle, raising the question of just how trustworthy
any
diagnosis in the
DSM
was.
    But probably the greatest factor in changing the focus of psychiatry from causes to effects, from a search for a psychic injury to the cataloging of symptoms, was the rise of medication. Psychiatrists found that they didn’t need to seek out causes for symptoms to treat patients. They could ease a patient’s suffering just by treating the effects.
    In order to treat the effects, however, they had to know what medications matched what ailments, which meant that they had to know what the ailments were, which meant that they were going to have to identify the ailments in a specific and consistent manner.
    One result of this more rigorous approach was that the APA task force finally asked the obvious question: What is this autistic behavior that is a symptom of schizophrenia? In order to answer the question, the task force had to isolate autistic behavior from the other symptoms suggesting schizophrenia (delusions, hallucinations, and so on). But in order to describe autistic behavior, they had to describe