Joe is now 11, almost 12. His lack of social understanding means he can occasionally be insensitive; he embarrassed me the other day by loudly pointing out the “fat lady” at the supermarket. He’s also the sweetest kid in the world, who greets me each day with a cuddle. My son is socially naive, a babe in the wood; much more likely to experience hurt than to hurt others.
In the lead up to Christmas, when the dreadful news of the Sandy Hook massacre in Newtown, Connecticut, came through, I crossed my fingers and hoped the words ‘autistic’ or ‘Asperger’s’ would not enter the equation, as they had after the 2007 Virginia Tech shootings.
It didn’t take long. Salon reported that Adam Lanza’s older brother, Ryan, ‘told authorities that his brother was believed to suffer from a personality disorder and be “somewhat autistic”’. Other media outlets reported that Lanza, a socially aloof loner, suffered from Asperger’s syndrome. Personality disorders are a difficult concept for the lay public to get its collective head around; Asperger’s on the other hand is a more familiar concept and was immediately latched on to. Many news reports dropped any reference to personality disorders to focus completely on Asperger’s, some going as far as to suggest the empathy deficits associated with autism/Asperger’s could offer an ‘explanation’ of Lanza’s behaviour. Thanks guys.
The irony of this is that the personality disorders (PDs) — there are several listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders — have as one of their defining characteristics ‘significant impairments’ in empathy and /or intimacy. In fact, it’s at the extreme end of one of the PDs, antisocial personality disorder, that the psychopaths sit. British studies have found that half the male prison population fit the diagnostic criteria for antisocial personality disorder, although only about one-tenth of these would be considered bone fide psychopaths. My husband, in his capacity as a doctor, has met the occasional psychopath and can testify that they are very scary human beings.
Asperger’s syndrome, on the other hand, is an autism spectrum disorder (ASD), associated with social and communication deficits. People with autism can misread body language and the other emotional cues that most of us pick up naturally. This means they can struggle to get inside someone else’s head, what autism experts such as Simon Baron-Cohen have termed a theory of mind deficit or mindblindedness. So yes, technically they may lack empathy, but this usually leads tactless remarks, not premeditated violence.
In a 2011 article in Research in Developmental Disabilities, Lorna Wing, one of the world’s leading autism researchers, characterised the empathy deficits of ASD:
‘…the anti-social psychopath usually has full understanding of what goes on in his/her own and other people’s minds. However he/she uses this knowledge to manipulate other people to achieve his/her own ends. He/she has empathy but no sympathy. A person with an autism spectrum disorder lacks empathy but may have sympathy in other situations where they can perceive another’s distress. When they do understand, they respond.’
The difference is subtle but important. Someone with ASD may not always completely understand (empathy), but that doesn’t mean they’re incapable of caring (sympathy).
In the aftermath of Sandy Hook much has been written on the topic of autism and violence. Science writer and autism mum, Emily Willingham, also addressed the empathy issue, differentiating between cognitive (reading people) and emotional (feeling the emotion) empathy, noting that people with Asperger’s ‘aren’t great’ at the former but are unimpaired in the latter, the reverse pattern to the one we observe in psychopaths. I suspect Willingham and Lorna Wing are probably talking about the same thing, just using different terminology.
All this fits with my experience, not only with my son but with my friends’ children. In fact, one of the words parents frequently use to describe their child on the autism spectrum is ‘kind.’
It’s true that people with autism are occasionally violent They can lash out physically when overwhelmed, frustrated and anxious; without good communication skills they often have trouble expressing their frustration in more appropriate ways. But the evidence is clear that people on the autism spectrum are no more likely to commit violent crime than those without autism; instead they are much more likely to be victims of violence.
Interestingly, in the above-mentioned article, Wing refers to British research which found that psychopathy and ASD can very occasionally occur in the same individual; however researchers found that ‘callous/psychopathic acts…probably reflect a “double hit” involving an additional impairment of empathic response…which is not part and parcel of ASD itself [emphasis my own].’
Does this explain Adam Lanza? Only the psychiatrist who diagnosed him has any proper understanding of the young man’s mind and until he or she speaks I suppose we’re all just engaging in speculation. Adam Lanza may well have had Asperger’s but I’ll go out a limb and say it’s pretty clear he also had something else, whether a personality disorder, an as-yet undiagnosed psychosis or some other form of mental illness that tipped his behaviour over into the unimaginable.
In the meantime, the media needs to report the facts responsibly so that vulnerable groups aren’t stigmatised by association. The real problem here is that a seriously disturbed young man had an arsenal of legally-acquired assault weapons, ready and waiting for when that tipping point came.