Thinking in Pictures: My Life with Autism Page 4
Visual Thinking and Mental Imagery
Recent studies of patients with brain damage and of brain imaging indicate that visual and verbal thought may work via different brain systems. Recordings of blood flow in the brain indicate that when a person visualizes something such as walking through his neighborhood, blood flow increases dramatically in the visual cortex, in parts of the brain that are working hard. Studies of brain-damaged patients show that injury to the left posterior hemisphere can stop the generation of visual images from stored long-term memories, while language and verbal memory are not impaired. This indicates that visual imagery and verbal thought may depend on distinct neurological systems.
The visual system may also contain separate subsystems for mental imagery and image rotation. Image rotation skills appear to be located on the right side of the brain, whereas visual imagery is in the left rear of the brain. In autism, it is possible that the visual system has expanded to make up for verbal and sequencing deficits. The nervous system has a remarkable ability to compensate when it is damaged. Another part can take over for a damaged part.
Recent research by Dr. Pascual-Leone at the National Institutes of Health indicates that exercising a visual skill can make the brain's motor map expand. Research with musicians indicates that real practice on the piano and imagining playing the piano have the same effect on motor maps, as measured by brain scans. The motor maps expand during both real piano playing and mental imagery; random pushing of the keys has no effect. Athletes have also found that both mental practice and real practice can improve a motor skill. Research with patients with damage to the hippocampus has indicated that conscious memory of events and motor learning are separate neurological systems. A patient with hippocampal damage can learn a motor task and get better with practice, but each time he practices he will have no conscious memory of doing the task. The motor circuits become trained, but damage to the hippocampus prevents the formation of new conscious memories. Therefore, the motor circuits learn a new task, such as solving a simple mechanical puzzle, but the person does not remember seeing or doing the puzzle. With repeated practice, the person gets better and better at it, but each time the puzzle is presented, he says he has never seen it before.
I am fortunate in that I am able to build on my library of images and visualize solutions based on those pictures. However, most people with autism lead extremely limited lives, in part because they cannot handle any deviation from their routine. For me, every experience builds on the visual memories I carry from prior experience, and in this way my world continues to grow.
About two years ago I made a personal breakthrough when I was hired to remodel a meat plant that used very cruel restraint methods during kosher slaughter. Prior to slaughter, live cattle were hung upside down by a chain attached to one back leg. It was so horrible I could not stand to watch it. The frantic bellows of terrified cattle could be heard in both the office and the parking lot. Sometimes an animal's back leg was broken during hoisting. This dreadful practice totally violated the humane intent of kosher slaughter. My job was to rip out this cruel system and replace it with a chute that would hold the animal in a standing position while the rabbi performed kosher slaughter. Done properly, the animal should remain calm and would not be frightened.
The new restraining chute was a narrow metal stall which held one steer. It was equipped with a yoke to hold the animal's head, a rear pusher gate to nudge the steer forward into the yoke, and a belly restraint which was raised under the belly like an elevator. To operate the restrainer, the operator had to push six hydraulic control levers in the proper sequence to move the entrance and discharge gates as well as the head- and body-positioning devices. The basic design of this chute had been around for about thirty years, but I added pressure-regulating devices and changed some critical dimensions to make it more comfortable for the animal and to prevent excessive pressure from being applied.
Prior to actually operating the chute at the plant, I ran it in the machine shop before it was shipped. Even though no cattle were present, I was able to program my visual and tactile memory with images of operating the chute. After running the empty chute for five minutes, I had accurate mental pictures of how the gates and other parts of the apparatus moved. I also had tactile memories of how the levers on this particular chute felt when pushed. Hydraulic valves are like musical instruments; different brands of valves have a different feel, just as different types of wind instruments do. Operating the controls in the machine shop enabled me to practice later via mental imagery. I had to visualize the actual controls on the chute and, in my imagination, watch my hands pushing the levers. I could feel in my mind how much force was needed to move the gates at different speeds. I rehearsed the procedure many times in my mind with different types of cattle entering the chute.
On the first day of operation at the plant, I was able to walk up to the chute and run it almost perfectly. It worked best when I operated the hydraulic levers unconsciously, like using my legs for walking. If I thought about the levers, I got all mixed up and pushed them the wrong way. I had to force myself to relax and just allow the restrainer to become part of my body, while completely forgetting about the levers. As each animal entered, I concentrated on moving the apparatus slowly and gently so as not to scare him. I watched his reactions so that I applied only enough pressure to hold him snugly. Excessive pressure would cause discomfort. If his ears were laid back against his head or he struggled, I knew I had squeezed him too hard. Animals are very sensitive to hydraulic equipment. They feel the smallest movement of the control levers.
Through the machine I reached out and held the animal. When I held his head in the yoke, I imagined placing my hands on his forehead and under his chin and gently easing him into position. Body boundaries seemed to disappear, and I had no awareness of pushing the levers. The rear pusher gate and head yoke became an extension of my hands.
People with autism sometimes have body boundary problems. They are unable to judge by feel where their body ends and the chair they are sitting on or the object they are holding begins, much like what happens when a person loses a limb but still experiences the feeling of the limb being there. In this case, the parts of the apparatus that held the animal felt as if they were a continuation of my own body, similar to the phantom limb effect. If I just concentrated on holding the animal gently and keeping him calm, I was able to run the restraining chute very skillfully.
During this intense period of concentration I no longer heard noise from the plant machinery. I didn't feel the sweltering Alabama summer heat, and everything seemed quiet and serene. It was almost a religious experience. It was my job to hold the animal gently, and it was the rabbi's job to perform the final deed. I was able to look at each animal, to hold him gently and make him as comfortable as possible during the last moments of his life. I had participated in the ancient slaughter ritual the way it was supposed to be. A new door had been opened. It felt like walking on water.
Update: Brain Research and Different Ways of Thinking
Since I wrote Thinking in Pictures, brain imaging studies have provided more insights into how the brain of a person on the autism/Asperger spectrum processes information. Nancy Min-shew at Carnegie Mellon University in Pittsburgh has found that normal brains tend to ignore the details while people on the autism spectrum tend to focus on the details instead of larger concepts. To view this phenomenon, she had normal, Asperger, and autistic people read sentences while they were in a scanner. The autistic brain was most active in the part of the brain that processes the individual words while the normal brain was most active in the part that analyzes the whole sentence. The Asperger brain was active in both areas.
Eric Courchesne at the University of California in San Diego states that autism may be a disorder of brain circuit disconnections. This would affect the ability to integrate detailed information from lower parts of the brain where sensory based memories are stored with higher level information processing in th
e frontal cortex. Lower level processing systems may be spared or possibly enhanced. He discovered in an autistic person that the only parts of the brain that are normal are the visual cortex and the areas in the rear of the brain that store memories. This finding helps explain my visual thinking. Scans of autistic brains have indicated that the white matter in the frontal cortex is overgrown and abnormal. Dr. Courchesne explains that white matter is the brain's “computer cables” connecting up different parts of the brain while the gray matter forms the information processing circuits. Instead of growing normally and connecting various parts of the brain together, the autistic frontal cortex has excessive overgrowth much like a thicket of tangled computer cables. In the normal brain, reading a word and speaking a word are processed in different parts of the brain. Connecting circuits between these two areas makes it possible to simultaneously process information from both of them. Both Courchesne and Minshew agree that a basic problem in both autistic and Asperger brains is a failure of the “computer cables” to fully connect together the many different localized brain systems. Local systems may have normal or enhanced internal connections but the long distance connections between the different local systems may be poor.
I am now going to use what I call visual symbol imagery to help you understand how the different parts of the normal brain communicate with each other. Think of the normal brain as a big corporate office building. All the different departments such as legal, accounting, advertising, sales, and the CEO's office are connected together by many communication systems such as e-mail, telephones, fax machines, and electronic messaging. The autistic/Asperger brain is like an office building where some of the interdepartmental communication systems are not hooked up. Minshew calls this underconnectivity in the brain. More systems would be hooked up in an Asperger brain than in the brain of a low-functioning individual. The great variability in austistic/ Asperger symptoms probably depends on which “cables” get connected and which “cables” do not get connected. Poor communication between brain departments is likely the cause of uneven skills. People on the spectrum are often good at one thing and bad at something else. To use the computer cable analogy, the limited number of good cables may connect up one area and leave the other areas with poor connections.
Develop Talents in Specialized Brains
When I wrote Thinking in Pictures I thought most people on the autism spectrum were visual thinkers like me. After talking to hundreds of families and individuals with autism or Asperger's, I have observed that there are actually different types of specialized brains. All people on the spectrum think in details, but there are three basic categories of specialized brains. Some individuals may be combinations of these categories.
1. Visual thinkers, like me, think in photographically specific images. There are degrees of specificity of visual thinking. I can test run a machine in my head with full motion. Interviews with nonautistic visual thinkers indicated that they can only visualize still images. These images may range in specificity from images of specific places to more vague conceptual images. Learning algebra was impossible and a foreign language was difficult. Highly specific visual thinkers should skip algebra and study more visual forms of math such as trigonometry or geometry. Children who are visual thinkers will often be good at drawing, other arts, and building things with building toys such as Legos. Many children who are visual thinkers like maps, flags, and photographs. Visual thinkers are well suited to jobs in drafting, graphic design, training animals, auto mechanics, jewelry making, construction, and factory automation.
2. Music and math thinkers think in patterns. These people often excel at math, chess, and computer programming. Some of these individuals have explained to me that they see patterns and relationships between patterns and numbers instead of photographic images. As children they may play music by ear and be interested in music. Music and math minds often have careers in computer programming, chemistry, statistics, engineering, music, and physics. Written language is not required for pattern thinking. The pre-literate Incas used complex bundles of knotted cords to keep track of taxes, labor, and trading among a thousand people.
3. Verbal logic thinkers think in word details. They often love history, foreign languages, weather statistics, and stock market reports. As children they often have a vast knowledge of sports scores. They are not visual thinkers and they are often poor at drawing. Children with speech delays are more likely to become visual or music and math thinkers. Many of these individuals had no speech delays, and they became word specialists. These individuals have found successful careers in language translation, journalism, accounting, speech therapy, special education, library work, or financial analysis.
Since brains on the autistic spectrum are specialized, there needs to be more educational emphasis on building up their strengths instead of just working on their deficits. Tutoring me in algebra was useless because there was nothing for me to visualize. If I have no picture, I have no thought. Unfortunately I never had an opportunity to try trigonometry or geometry. Teachers and parents need to develop the child's talents into skills that can eventually turn into satisfying jobs or hobbies.
Concept Formation
All individuals on the autism/Asperger spectrum have difficulties with forming concepts. Problems with conceptual thought occur in all of the specialized brain types. Conceptual thinking occurs in the frontal cortex. The frontal cortex is analogous to the CEO's office in a corporation. Researchers refer to frontal cortex deficits as problems with execution function. In normal brains, “computer cables” from all parts of the brain converge on the frontal cortex. The frontal cortex integrates information from thinking, emotional, and sensory parts of the brain. The degree of difficulty in forming concepts is probably related to the number and type of “computer cables” that are not hooked up. Since my CEO's office has poor “computer” connections, I had to use the “graphic designers” in my “advertising department” to form concepts by associating visual details into categories. Scientific research supports my idea. Detailed visual and musical memories reside in the lower primary visual and auditory cortex and more conceptual thinking is in association areas where inputs from different parts of the brain are merged.
Categories are the beginning of concept formation. Nancy Minshew found that people with autism can easily sort objects into categories such as red or blue, but they have difficulty thinking up new categories for groups of common objects. If I put a variety of common things on a table such as staplers, pencils, books, an envelope, a clock, hats, golf balls, and a tennis racquet, and asked an individual with autism to pick out objects containing paper, they could do it. However, they often have difficulty when asked to make up new categories. Teachers should work on teaching flexibility of thinking by playing a game where the autistic individual is asked to make up new categories for the objects like objects containing metal, or objects used in sports. Then the teacher should get the person to explain the reason for putting an object in a specific category.
When I was a child I originally categorized dogs from cats by size. That no longer worked when our neighbors got a small dachshund. I had to learn to categorize small dogs from cats by finding a visual feature that all the dogs had and none of the cats had. All dogs, no matter how small, have the same nose. This is sensory-based thinking, not language-based. The animals could also be categorized by sound, barking versus meowing. A lower-functioning person may categorize them by smell or touch because those senses provide more accurate information. Dividing information into distinct categories is a fundamental property of the nervous system. Studies with bees, rats, and monkeys all indicate that information is placed into categories with sharp boundaries. French scientists recorded signals from the frontal cortex of a monkey's brain while it was looking at computer-generated images of dogs that gradually turned into cats. There was a distinct change in the brain signal when the category switched to cat. In the frontal cortex, the animal image was either a dog or a cat. When catego
rizing cats from dogs by size no longer worked for me, I had to form a new category of nose type. Research by Itzahak Fried at UCLA has shown that individual neurons learn to respond to specific categories. Recordings taken from patients undergoing brain surgery showed that one neuron may respond only to pictures of food and another neuron will respond only to pictures of animals. This neuron will not respond to pictures of people or objects. In another patient, a neuron in the hippocampus responded to pictures of a movie actress both in and out of costume but it did not respond to pictures of other women. The hippocampus is like the brain's file finder for locating information in stored memory.
Becoming More Normal
More knowledge makes me act more normal. Many people have commented to me that I act much less autistic now than I did ten years ago. A person who attended one of my talks in 2005 wrote on my evaluation, “I saw Temple in 1996, it was fun to see the poise and presentation manner she has gained over the years.” My mind works just like an Internet search engine that has been set to access only images. The more pictures I have stored in the Internet inside my brain the more templates I have of how to act in a new situation. More and more information can be placed in more and more categories. The categories can be placed in trees of master categories with many subcategories. For example, there are jokes that make people laugh and jokes that do not work.There is then a subcategory of jokes that can only be told to close friends. When I was a teenager I was called “tape recorder” because I used scripted lines. As I gained experience, my conversation became less scripted because I could combine new information in new ways. To help understand the autistic brain I recommend that teachers and parents should play with an Internet search engine such as Google for images. It will give people who are more verbal thinkers an understanding into how visual associative thinking works. People with music and math minds have a search engine that finds associations between patterns and numbers.