Abstract
As argued in previous chapters, the primary disorder in autism is one of consciousness, of the self, and not one of cognition. Autism’s fundamental deficit traces back to that part of the LH responsible for our awareness of personal identity. Self as one and apart from others, self as agent, is missing or undeveloped. The basis for this LH self can be hypothesized as lying within the LH OFC system: the triangle of left amygdala/OFC/MD (Fig. 8.1) as well as the network LH OFC-LH DLPC-LH TPO. Dearth of functioning in this network has profound consequences. It touches not only upon LH I-concept and complex emotions but also LH object-related emotion at every level, including basic emotion.
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Notes
- 1.
The intrinsic network within the amygdala—lateral nucleus (LN)—basal nucleus (BN)—appears to assign objects with emotional significance (see Fig. 7.1). In Chap. 7, I attempted to show amygdala-related deficiencies in autism: no automatic, near instantaneous response to emotionally significant stimuli (preconscious emotional processing en route to consciousness). There are also (1) no attentional preference to emotional versus nonemotional stimuli from presumed lack of amygdala influence on visual processing at its early, preconscious stages (due to its return projections to all levels of the visually related cortex) (Corden, Chivers, & Skuse, 2008; Gaigg and Bowler, 2009); and (2) no superior remembering of emotional versus nonemotional stimuli (amygdala projection to the hippocampus) (Gaigg and Bowler, 2008).
- 2.
See Chap. 2 for a detailed explanation of uniqueness of the RH prevalence in autism compared to other developmental disorders, and also for evidence against compensatory RH dominance in response to the local or diffuse LH damage.
- 3.
Note that continuity of one’s identity does not arise from this level.
- 4.
We can only guess that before Kanner and Asperger described autism as a separate category, psychiatrists, who of course observed autistic children (and adults), diagnosed them with schizophrenia or schizoid personality disorder. Astute clinicians, as Minkowski was, must have seen a difference and struggled to “differentiate” autism within the framework of schizophrenic nosology. Minkowski tried to differentiate autism in patients with schizophrenia into “introverted” and “extroverted” autism. In doing so, he gave a brilliant metaphor for the different, and separate from schizophrenia, entity—later distinguished by Kanner and Asperger and called autism.
- 5.
See Chap. 5.
- 6.
Although, as noted several times already, the cognitive part of the LH DLPC (inner programming for behavior of various complexity) might be intact.
- 7.
- 8.
Recall that the content of consciousness for each level of self is determined by the “space” and “time” framework of experience specific for each level.
- 9.
Or part of the object connected with movement.
- 10.
Calendar savants were discussed in detail in Chap. 6. Here I will just enumerate the involved networks and their functional meaning.
- 11.
The network is RH IT-RH DLPC.
- 12.
The network is RH TPO-RH DLPC.
- 13.
The network is RH DLPC—RH Striatum. The LH DLPC—LH Striatum contribution varies in degree in different calendar savants, but this network does not contribute to the power or scale of the talent.
- 14.
The network is thalamus (LP)-RH TPO-RH DLPC.
- 15.
His answer was: “iron and water.”
- 16.
Interestingly, in this study shapes were treated by the autistic brain as objects, i.e. processed by the RH IT (BA37), within the VSS saturated with affect, while in the control group, activation was bilateral and mostly in the TPO (BA39,40). This may give us a clue to the intense emotional experience of shapes and numbers observed in autism (recall Elly’s example in Chap. 6).
- 17.
DSM-IV defines these as “restricted (or circumscribed) interests.”
- 18.
If we extrapolate experimental data of dopamine system dysregulation by prefrontal cortex due to early limbic lesions.
- 19.
They are also called in this book nonrhythmical repetitive movements (see Chap. 5).
- 20.
This would be the temporal (action) aspect of the VSS (RH DLPC) connected with action programming (LH DLPC).
- 21.
On the other hand, autistic savants can be very important for genetic studies of autism because they represent the autistic brain pattern in its extreme.
- 22.
Lam et al.’s CI factor includes object attachment, so it is closest to my formulation.
- 23.
Individual variability of human brain can be best illustrated by its extreme manifestation in extraordinary individuals. For example, there is a sufficient proof of correlation between Albert Einstein’s mathematical genius and unique morphological features of his brain.
Einstein described his thinking as mostly nonverbal “associative play,” with the ability to voluntarily combine and spatially organize visual and motor-kinesthetic images. He used mathematical terms only to write down results (Hadamard, 1949).
A detailed report of Einstein’s brain was later published (Witelson, Kigar, & Harvey, 1999). It showed the parietal region to be 15% larger than average. In both hemispheres of Einstein’s brain, the posterior ascending branch of the Sylvian fissure is confluent with the postcentral sulcus. Consequently, there is no parietal operculum. These unique features suggest extensive development of the posterior parietal lobes early in brain morphogenesis, thereby constraining the posterior expansion of the Sylvian fissure and resulting in a larger expanse of the inferior parietal lobule (BA40,39). A further consequence of this morphology is that the full supramarginal gyrus lies behind the Sylvian fissure, undivided by a major sulcus (Witelson et al.). Furthermore, it was hypothesized that a gyrus, in general, develops within a region of functionally related cortex to allow for efficient axonal connectivity between opposite walls of the gyrus; by contrast, sulci separate cortical areas having less functional relatedness. Authors concluded that “in this context, the compactness of Einstein’s supramarginal gyrus [mostly BA40]…may reflect an extraordinary large expanse of highly integrated cortex within a functional network” (p. 2152).
The described above region corresponds to the temporal–parietal–occipital region—TPO, the term used in this book. We remember that this area is responsible for visual–spatial ability, mathematical ideation, and spatial schemes for movement.
Ivanov (1978 ) writes of individual variability in the intriguing example of Sergei Eisenstein’s brain. A worldwide cinema producer, Eisenstein described his thinking as a continuous tape of visual images and events which he sometimes mentally “outlined with his hand as drawings.” He confessed that words were not in the focus of his sharp attention. In Eisenstein’s brain, size of the right hemisphere exceeded significantly the size of the left hemisphere (according to V.V. Ivanov, information about Eisenstein’s brain was given to him by the noted neuropsychologist, Alexander Luria, in personal communication).
- 24.
This autistic savant has not yet been discussed in this book.
- 25.
Nikolaenko and Deglin’s work was mentioned in Chap. 3. These authors examine drawings by patients with one cerebral hemisphere functioning in isolation (the other hemisphere was temporarily inhibited) and thereby “reconstruct” how the LH and the RH are different from each other in the way they “see” external space.
- 26.
In the LH’s perspective, there is a loss of object volumeness, coupled with an exaggerated depiction of depth of space due to excessive use of a linear perspective.
- 27.
Superior performance of autistic subjects on recognition of reversed (upside-down) faces has been claimed as evidence of “local” processing in autism. Hobson, Ouston, and Lee (1988) were the first to doubt this conclusion, indicating other strategies might be available. They give the example that when normal adults were presented with upside-down faces, some expressed the view that they were “mentally rotating” the faces. It seems to me very likely that the autistic brain “chose” this strategy during the task as an acting out of autistic fascination with movement and with rotation in particular.
- 28.
From “Infantile Autism—A Clinical and Phenomenological-Anthropological Investigation Taking Language as the Guide” be Gerhard Bosch, Springer-Verlag, New York, 1970. With kind permission from Springer.
- 29.
There is confusion in the literature regarding the functions of STG and V5/human MT areas. They both are characterized as “movement perception” areas. Confusion came from not paying attention to the core function and origin of these areas. The core function of STG is attention, detection of change, which is perceived as movement. The core function of V5/human MT is visual perception of dynamic form (“moving target”), and it belongs to the phylogenetically older Magno system and projects to the where-system, BA39. In contrast, the other circumscribed area within BA19, known as V4, is responsible for static form and color. It belongs to the newer Parvo system and projects to the what-system, BA37, where the visual form is assigned with meaning (object recognition) (Livingstone and Hubel, 1988; Mishkin, Ungerleider., & Macko, 1983).
- 30.
Elly was discussed in Chap. 6 for her outstanding visual–spatial, calculating, and pattern recognition abilities.
- 31.
Franco’s later paintings (see Chap. 7) are also more distant. However, this phenomenon derived from his increasing preoccupation with a “mission” at the cost of the intensity of his feeling. The likely shift in networks would be from LH amygdala-OFC to LH OFC-LH DLPC. The preaching nature of these paintings induces the emotion of irritability in the viewer, especially if one has known the richness of his earlier works.
- 32.
IS insistence on sameness. CI circumscribed interests; preoccupation with objects and their parts is used in this book in a broader sense that includes CI.
- 33.
Reports of Einstein and Eisenstein’s brains as extreme variants within the human brain’s individual variability have already been discussed (see footnote 32), and correlation has been shown between the brain’s unique morphological features and both men’s creative achievements: mathematical genius in the case of Einstein, a unique “visual-motor” talent in the case of Eisenstein.
- 34.
- 35.
A striking similarity with the above example can be found in one split-brain patient’s reaction to a stimulus presented to his RH. This patient who had a posterior commissurotomy was discussed in a previous work (Glezerman and Balkoski, 1999), the example was taken from Sidtis et al. (1981). When presented with the written word “knight” to his left visual field, i.e., to his RH, the patient could not immediately name the stimulus but described a visual scene-situation: “‘I have a picture in mind but can’t say it…. Two fighters in a ring…. Ancient…wearing uniforms and helmets… on horses trying to knock each other off…Knights?’ The patient described his thought processes in the following way: ‘It’s like things are moving around constantly, and I’m trying to narrow it down to something that will just stop. I’m seeing a whole general picture but one thing is almost in the middle’” (p. 156).
- 36.
Vladimir Nabokov had also synesthesia and a history of a prodigious calculating gift. The latter suddenly and mysteriously disappeared after a high fever with delirium at the age of 7 (Nabokov, 1989).
- 37.
Importantly, Nabokov describes his vivid memory of his “awakening of consciousness,” “The inner knowledge that I was I,” which felt like revelation and coincided with the emerging understanding of temporal order (all are the LH frontal lobe functions).
- 38.
Use of term “pathological” indicates not only quantitative differences, but also a new quality, which requires its own pathological network, as hypothesized in a previous work (Glezerman and Balkoski, 1999).
- 39.
Kretschmer did not distinguish schizoid and schizotypal personality disorders as does the DSM-IV. Instead, he demarcated different subtypes within schizoid personality disorder.
- 40.
Thalamic emotion is contradistinct to limbic emotion, the latter being related to Kretschmer’s “diathetic proportion.”
- 41.
Thalamic emotion can emerge to the surface of consciousness in pathology.
- 42.
According to Kretschmer, “Kant…in his private personality displays the schizothymic type…in its highest and purest form, with Spartan freedom from desires, childlike simplicity, and the most genuine idealistic morality” (1999, p. 247).
- 43.
According to Kretschmer, social attitude of the schizoid persons may be expressed in one of three ways (1) simply unsociable; (2) sociable within a small closed circle or else; (3) superficially social, without deeper psychic rapport with their environment.
- 44.
Eysenck believes psychiatric abnormality to be dimensional rather than categorical. His continuum, which includes both schizophrenia and manic-depressive psychosis, parallels Kretschmer’s “categorical” continuum (described earlier) that ranges from schizoid personality (variant of norm) to schizoid personality disorder to schizophrenic psychosis. Kretschmer based his continuum on his sensitivity scale. Thus, if creativity indeed connects in some way with psychopathology, it would be mostly with schizophrenia spectrum disorders, not autistic spectrum disorders. Furthermore, creativity itself manifests not as psychiatric illness but as a latent trait in normal people.
- 45.
Eysenck seems to interchange overinclusive thinking with divergent thinking, which creates confusion. In psychiatry, overinclusive thinking implies pathologically excessive and irrelevant detailization, often referring to circumstantial or even to concrete thinking. In divergent thinking, associations are not irrelevant, they are not known before the creative person “discovers” them.
- 46.
For example, Andreason and Powers (1975) found that highly creative writers were overinclusive on a task designed to measure overinclusion in schizophrenia.
- 47.
Stimuli, with no apparent value for current motivations and goals.
- 48.
- 49.
Maslov’s deepening into the meaning of the whole object can be understood from a neurophenomological point of view as projection of RH self and formation of RH polysemantic symbol.
- 50.
“The sense of purity can manifest itself in a number of ways, including the sense of growing a ‘higher’ awareness, a ‘raising of consciousness’, either on an individual or on a collective level, and also in the sense of being ‘in touch with oneself’… or the sense that a ‘purer’ form of being is being revealed…[to the artist]” (Nelson and Rawlings, 2007, p. 233), the latter is provided by “the sense of self as undivided whole”(p. 233).
- 51.
Although there is consensus that a tendency toward introversion is one of several factors that describe the creative person, the brain basis for this personality trait has not yet been explored in the literature.
- 52.
These rare cases, described in literature, were considered to be due to inborn anomaly of the thalamus.
- 53.
Recall Einstein’s thinking as nonverbal “associative play” with visual and motor kinesthetic image (see footnote 23 in section eight of this chapter).
- 54.
Recent fMRI studies of schizophrenic patients show reversed lateralization in activation of posterior temporal region during spontaneous thought-disordered speech, i.e., LOA (Kircher et al. 2002).
- 55.
Similar interdependence was suggested for the phylogenetic and ontogenetic development of the RH symbolic and LH symbolic (categorical) levels in the brain (Glezerman and Balkoski, 1999).
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Glezerman, T.B. (2013). Pieces of Autism’s Puzzle Fall into Place (Clinical-Brain Pattern of Autism). In: Autism and the Brain. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4112-0_10
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