The current issue of Harvard Magazine has a cover article on autism. In reading through the piece, I was struck by this one line about Asperger’s syndrome: “they shared key impairments in social interaction, reciprocal communication, and imagination (i.e., repetitive behaviors and interests).” It many ways this description struck me as presenting a similar dichotomy to addiction, where the repetitive behaviors and interests are linked diagnostically with failed social roles, family difficulties and “denial” in communication.
I am not saying that addiction and autism are the same, or that biologically or phenomenology they come from similar causes or problems. But I do wonder if the rush to focus in on singular brain circuits leads us to overlook the human dimensions of imagination, sociality, and behavior. These abilities and practices are linked in profound ways in everyday life, and thus will drive biology in profound ways.
Sandy G, who linked to us (thanks!) through his post on The Rat Park, has several posts on autism. In one on joint attention, he relates Tomasello’s recent work: “The authors concluded that, at least at this developmental period, children with autism seem to understand the social components of situations that call for “helping” behaviors and engage in helping behaviors, but only when such help does not require interpersonal cooperation. However, when cooperation is required to complete the task, these children are less likely to correctly engage with another partner, possibly because the unique “shared” component of cooperation. That is, cooperation requires shared goals, shared attention, and a shared plan of action, processes that seem to be affected in children with autism.”
In another post on “Schizophrenia and Autism: Two Cultures”, Sandy relates: “Overall, one possible mechanism underlying these differences can be a sensori-motor and conceptual gating defect in both the disorders- with schizophrenia signifying a very broad sensori-motor and conceptual gate with consequent broad attentional span, loose associations and too much of context; and Autism representing a very narrow spatial and temporal gate with consequent specialized interests and focus, few associations, literal and convergent thinking.”
While I am not quite as genetically and neurologically oriented as Sandy, and would want a more robust invocation of evolutionary process, I am struck by the effort to engage mental disorders at a more global level. For example, in a post on diametrical disorders of the social brain, Sandy quotes from research by Crespi et al:
By our hypothesis, autism and psychosis represent extremes on continua of human cognitive architecture from mechanistic to mentalistic cognition, with balanced cognition at the center (Figure 4). Each set of conditions is extremely heterogeneous but also highly convergent, in that diverse genetic, epigenetic and environmental effects can generate similar cognitive phenotypes (Happé 1994, p. 2; Keverne 1999; Seeman et al. 2005; Badcock & Crespi 2006; Happé et al.2006). These striking convergences are mediated, in our view, by the dynamics of social brain development, with under-development in autistic conditions and hyperdevelopment in psychotic conditions (Badcock 2004)
The reason I am struck by this sort of work is because it can take its place in a variety of ways that neuroanthropology can engage mental illness: (1) the links between specific aspects of the brain, experience and behavior, and cultural context; (2) more global human biobehavioral patterns, lived contexts, and cultural practices which can shape the expression and impact of disorders; and (3) the mix of environmental, ecological and cultural factors that connect with everyday experience in varied domains, and thus also shape mental illness.
To go to addiction, the #1, it would be the mesolimbic dopamine system and the compulsive desire and seeking of substances; for #2, the cycle of addiction that I have explored in my work, and which could vary in interesting ways by substance or social context (I just had a fascinating discussion on how non-compliance in psychotropic medicines could represent an alternative way to go through the cycle of behaviors, experience and contexts that I have described); and for #3, it would be some of my work on why Colombia has lower rates of illegal drug use by focusing on social knowledge, relationships, and costs as important mediating factors.
In work on mental illness and behavioral disorders, there is often a great deal of focus on either #1 or #3 (which generally carry assumptions about nature or nurture, biology or culture). But I am increasingly persuaded that basic patterns in human experience and behavior are an important way to understand variation in mental health as well as a way we might build more explicit cross-cultural comparisons in anthropology.