Selected Replies to "Asperger's by Proxy"

Note: Because my psychology correspondence has gradually evolved toward offering people advice, I want to say I am not a psychologist and any advice I offer is based only on common sense and life experience. I think most educated readers will accept this.

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Autism or Asperger's I

[ Case history deleted ... ] He is now [ ... ], but when he was about 18 months old, somethign very dramatic happened to him that changed a very happy and outgoing little fella to a clingy, and (most frighteningly) afraid infant in a matter of literally hours.Based on that description, it was some sort of organic brain trauma, well removed from the subject matter of psychology.The MDs and PhDs don't know exactly what happened, and it took a lot of years and effort to bring him back to almost at a level with his age-peers. Whatever the cause, he was left with probably some physical brain damage and some (what I would call) faulty wiring.I sympathize with your situation, but based on the published diagnostic criteria (and I am not a psychologist), in my opinion this is another misuse of the Asperger's label. How could the same label be applied to your son, with what appears to be some organic (as opposed to psychological) issues, and such people as Bill Gates, Isaac Newton and Albert Einstein, all of whom have been identified as Asperger's sufferers?

This list only shows that Asperger's is a catch-all label, one that can be applied to anyone in order to justify psychological treatment.The brain is a marvelous, complex piece of work that is not at all well understood. How can this little clump of soft tissue process and store so much, be so important, and be so fragile all at the same time? The MDs and the PhDs couldn't, and still can't, explain all that, but it's somehow comforting to know that there are people who care enough to want to know and who at least try.Yes, but in most areas of medicine, science is the tool, and research is the method. Because psychology is not a science, clinical psychologists famously apply any diagnosis they want to, typically one they prefer to treat, as shown in my article "Is Psychology a Science?"

My point is psychologists often race ahead of the scientific evidence, make diagnoses based on vague criteria and offer treatments of no established efficacy. Sometimes they do great harm through this practice of putting the cart before the horse.We all understand that "autism" is not a label, it's a very broad category, useful only for some loose common ground of communicating a range of "stuff".In point of fact, that way of describing it makes it a "label," rather than something that can be strictly tied to the outcome of a clinical evaluation.The little boy in the wheel chair with very little body/expressive control had such deep eyes. He was profoundly autistic, and perhaps still is.In such a case, the label "Asperger's" is very clearly misapplied, because your description doesn't correspond even to the broad diagnostic criteria presently used for this assessment.Our son was in the borderline/mild range then and is now within the range of Asperger.And there it is. Your account confirms that Asperger's is being applied to nearly everyone — from those who would ordinarily be diagnosed as autistic with organic elements, to those who are merely smart and poorly adjusted to a world of average people.To me it's a range, a category, of "stuff" that goes along with the total package that is my son.Please imagine a legal system willing and able to put people in jail because of, as you put it, "a category of 'stuff'". In fact, over the past several decades people have been accused, tried, and jailed for crimes such as child molestation and even murder, based on psychological fads such as "recovered memory" and "facilitated communication." Most of these victims have been declared innocent and released, after the falsity of the claims, and of the psychological beliefs that led to the claims, was revealed.The term means different things to different peopleThis is why psychology is not a science. Imagine saying that gravity "means different things to different people." This also puts us on the slippery slope toward post-modernism, a scheme in which everything is a matter of opinion and there are no objective facts.I don't disagree with what I assume is your point about Asperger. It can be nisused, as a label, or it can provide some basis of understanding, as a category within a list of categories that can be useful in knowing a person.But that's the very point I make in my articles. The Asperger's label is neither a basis for understanding, nor is it useful — except as a way to get people into the psychological system, where the treatments are as vague as the diagnoses. This is why most HMOs (health maintenance organizations) won't pay for psychological counseling — once it gets started, it never stops. Some think this is by design.We all do it. My son's teachers were frustrated that an intelligent young man had such problems with learning, but they were proud, as we were and are, of those things he does. Maybe it takes more tries, and requires more effort on his part and on our part as parents, but it's worth it."It's worth it." Only science can make that determination, and science is not being applied to this issue.

Please avoid confusing correlation with causation. Imagine a parallel universe, one in which your son never visited any of those well-educated specialists, and only experienced your very obvious love and devotion to his welfare. Maybe his condition would have improved without intervention, and maybe he would be in the same position he is in now.

We will obviously never know, and this is why science uses control groups. Unfortunately science holds little sway over the behavior of clinical psychologists.I don't blame the MDs and the PhDs and the counselors for not knowing the cause/effect/cure for his difficulties. But I do appreciate their efforts to understand and to help where and when they can. If the term "Asperger's" is useful in those efforts, then so be it.As presently applied, the Asperger's label is not a useful description, any more than gravity can be usefully described as a rock's love for the earth. As long as the ancients thought rocks fell to the ground because of their love for the earth (and they did), we couldn't do the science required to find out what gravity really is.

It's the same with clinical psychology — it's time to say very clearly that it is long on belief and short on evidence, and the public's trust is misplaced.

Autism or Asperger's II

Thank you for your thoughtful reply. I found it to be a little short on optimism, though.Really? If I were a pessimist, I would accept the basic position of clinical psychology, that it's all too confusing, so there's no point in trying to apply reason and science to it (I've heard psychologists use almost these exact words). I am too optimistic for that. I think there's a crucial need for science in clinical psychology, one that is not being met. And in a system that sometimes jails people for nonexistent crimes, the application of reason is essential.

If I were a pessimist, I would never have written the article.

Activist Mom I

I just read your essay and personal account on Aspergers. I thoroughly enjoyed it and am going to share it with my husband tonight. We have a wonderfully brilliant son - 10 years old. He loves computers, video games and math. Some kids make fun that he is obsessed and he is. so what. We have had teachers bug us for 3 years for a diagnosis.This is so funny. A kid is obviously exceptional, likely to succeed, possesses the kinds of skills the future will be built on (like math), and the teachers want you to find out what's wrong with him.In the past few months we submitted, but went and got a private assessment that the schools would not get their hands on. And you guessed it, the Phd. Clinical Psycologist has diagnosed our son as having Aspergers! We don't want this label and we don't think he needs it.Good for you. I am not a psychologist, and I have always felt that if there is no clear cause or treatment and very loose diagnostic criteria (all true in this case), then what is the point of stigmatizing someone that way? The diagnosis can only make a child believe he has an extra burden to bear (or an excuse not to try if he is so inclined).We will never let the school system in on this and let them take control and ruin his life. [ ... ] Your article has totally inspired me to again rely on what I already know - he's perfectly fine. He is a math nerd and so am I. And that is o.k. with me... and thus far it's been o.k. with every one, but the teachers.They probably notice his unwillingness/inability to fit in. I personally think this is a good thing, but then I never fit in either. I was a seventh grade dropout, I was someone everyone thought would fail, now I get invited to schools to explain how I succeeded. I try to avoid saying "drop out now". :)

In all seriousness, I think kids should try to socialize, but I think they should not be made to feel as though it is a life or death issue, because it isn't. Getting along with people is nice, getting along with yourself is essential. Anyway, I just want to THANK YOU!!!! And by the way, do you want to mentor a really bright math nerd who LOVES computers and [ ... ] and enjoys silly jokes?!!! I've been talking about finding a mentor in the computer field for him!!! [ ... ]It's very difficult — too many kids needing guidance, too few willing guides, too many ruts in the road. As for myself, I appreciate your offer but I am not going to try mentoring again for a while. My experience with "Jim" was too heartbreaking.

Good luck!

Activist Mom II

Thank you for your response and your openness to share with people. The big distinction with our son is that he has a lot of what the clinical psychologists call "social intent". He has a lot of friends and wants to hang out with them. He is smart and very aware of social pecking order and knows where he fits in and would like to be the more popular. His awkwardness, nervousness etc are barriers to succeeding to the degree he'd like to. But it is getting better, we are working with him.

We are in the process of changing our focus now. So far, we have supplemented his education as much as possible, got him into [ ... ]. Now we are adding more outdoors activities - hiking, boating, fishing etc... more earthy activities. And we need to be more social - allowing more friends over, including his friends in our outings etc... this is not easy for us - we are pretty reclusive ourselves... so we are doing our best. I hope it's good enough!!! (that's why the mentoring is so important - to get a third party perspective... we are thinking of hiring a young man as a kind of "coach" to work with him on stuff and help build his skills and confidence).

Again, thanks for that article, your perspective helped me a lot.Okay, again, I am not a psychologist, but damn. Your son wants to hang out with his same-age peer group, he is willing to take on new activities with which he is unfamiliar, he is outgoing, social — he is obviously developing in a normal way for his age. This is not Asperger's, not remotely. "Real" Asperger's is more like Dustin Hoffman's performance as "Rain Man" than anything closer to normal, and (in my view) the only reason for the epidemic of Asperger's diagnoses is because it got included in the current DSM, the "Bible" of psychology, and the therapists have been taking liberties with the published diagnostic criteria, for reasons that should be obvious.

I wouldn't be surprised if many of the individual cases that make up this current epidemic are like your account — overzealous clinical psychologists, and sometimes, overzealous parents, obviously not including you. My two cents is that the Asperger's label could only hurt your son as he finds his place in the world.

Good for you for having the common sense to see though this fad.

Perplexed Parent

I've never felt compelled to write until reading your Asperger's article. I have three sons with similar personality traits (i.e., nerdish, just like Mom!), all bright, and two of whom have been diagnosed this year with pervasive development disorder, Asperger's fraternal twin brother.

The diagnoses actually ensured that they were put in classes that were appropriate to their learning styles, which is great; but I still fear their getting labeled "autistic." I've come to the conclusion that with high-functioning autistic people, it's just a different way of thinking, and equally valuable to the type of thinking typically labeled "normal."

We're a [ ... ] family and will be [ ... ] soon; at that point, I'll probably homeschool both of them. Until then, I'll just keep fighting to make sure they get appropriate schooling without being labeled or drugged.

Thanks for writing such an inspirational article — I don't feel alone now!

Older, Wiser Student

I would suggest that people who practice these obviously quack therapies should be prosecuted or severely discouraged before they have the opportunity to inflict harm on others. Sure, as you've said, responsibility is in the hands of the individual, but how much responsibility was Candice [ 10-year-old Candace Newmaker, killed during a quack therapy session ] able to take for herself? I'm "glad" that the parent was prosecuted even though the child was undergoing "therapy." An admission from your goverment that people ought to know better.

I was diagnosed with Asperger's Syndrome too, and for a while I was letting myself live under that label. I had a horrible time in public school [ ... ], and it seemed like everyone just wanted to push pills at me. Eventually I found it so incredibly condescending that I quietly stopped taking the pills. And it worked, and I grew up.

I just got back from a youth exchange that took place in [ ... ]. In high school, I would never have felt myself capable of being selected for anything like that. But I was, and I had an excellent time in the exchange country, and I want to write a short e-book about it. In high school I was convinced that my life would end, one way or the other, after it was over. I listened too well to my detractors, and I didn't know how to think independently, and my life was just one long reaction to everything.

To put it crudely, I wish "stop and think" advice could be given to more children. They're capable of much more independent thought than we give them credit for.

Outraged Older Sister

A month or so ago, I stayed and read your article on AS. To my suprise - I couldn't have found a more accurate and well written article that expresses exactly how I feel.

My younger brother has been labeled by my Mother and Grandmother as having AS and it handicaps the way they deal with him. In my opinion, its a bunch of crap! I emailed the article to my Sister and she is also in agreement.

It's nice to know that there are intelligent people out there who don't just swallow the popular scientific (or lack of scientific) opinion and continue to think for themselves. My Brother is almost [ ... ] and graduating from [ ... ] school in 2 weeks. AS my ass.

Thanks again. You rock!

The Mercury Connection

I have just finished reading your article on Asperger's syndrome, and I was wondering if you have every read any of the reports that link the rise in Asperger's and Autism diagnoses with the amount of Mercury that pharmaceutical companies are using in immunization shots?I have, but that idea is pure conjecture at the moment. There is no study that connects the two in a scientifically valid way. This may change in the future.As a parent with a child that has been diagnosed with Asperger's, after a list of other diagnosis that physician use to try and explain his manic behavior,Manic behavior is not a symptom specific to Asperger's, and Asperger's diagnoses are often provided when nothing else seems to fit. To a nonspecialist like me, this appears to be one of those cases.I would like to have a legitimate cause for an average infant developing behaviors that are not present in his siblings.Genetics? There is ordinarily a great deal of genetic variation between siblings. This is a reasonable explanation. And if one of your children differs markedly from the others, he is not average, is he? That sounds more like an expectation than a statement of fact.Just for the record I have no claim to any court case that involves Mercury in immunizations and my child is not on any medication.You might have a tough time showing a connection with mercury. I am not saying there is no such connection, I am only saying an evidentiary link hasn't been made.Through [ ... ] we have been able to control my sons mania through diet, something physicians will tell you is a myth.If you successfully controlled your child's mania through changes in diet, and if mania was the primary symptom, then the root cause is neither Asperger's nor is it mercury poisoning.I just wanted you to consider the thought that maybe the rise in diagnosis has more to do with Mercury and petroleum based colorings then narcissism.My article's reference to narcissism was obviously with reference to a single case history, and a fictional one at that. There are as may case histories as there are diagnoses.

Also, if clinical psychologists are now issuing Asperger's diagnoses when "petroleum based colorings" is thought to be a cause and manic behavior is the primary symptom, things are worse than I thought.

God is my Narcissistic Enabler

While reading this feedback page, readers may wonder whether this isn't a picture of a make-believe world — unrealistically wise parents and relatives, too astute to buy into silly psychological explanations for ordinary human behavior. Some readers may wonder whether I am being too selective in the messages I include — don't I ever hear from the truly certifiable? Don't they also have a right to be heard? Well, my answer is yes, and yes. Here's an example, unedited in its perfect wackiness.

I hate crooked people that steal from God's children and so does He, Jesus!!!!!

I hope you haven't been using my ideas or anything else that belongs to me. My name is [ ... ]. If you have you owe me money!!!! I am a believer!!!!!

And I have way more talent/creativity than you!

Jesus is the one who give talents read the Bible. He gives them to individuals not groups and will take them away so easily. And if you try to use someone else's work it might help you for a while but will not succeed for you because the talents do not belong to you!!!!!!!!!!!!!

In Christ,
[ name and address deleted ]

PS if you hsve been crank calling me or calling my house asking for someone who doesn't live here take me off your list. Do not call unless you are asking for me. I live here alone!!!!!!!!!!!!!I would have bet money that you lived alone, dear.

Deeply Offended

What follows is a conflation of the content of several posts from people who need to look up the word "fiction."

Today I read your article about Asperger's and I want to express my outrage. The character in the supposedly fictional story is a mom with an Asperger's kid and I am a mom with an Asperger's kid. Most of the other points of comparison don't match up, but two hits is too much similarity to be a coincidence, therefore I think I am the person in the story.I believe this may be a misuse of the word "therefore," a word that normally connects one or more postulates to a logical conclusion. And even though I don't ordinarily object to how individuals choose to steer their metaphorical boats across the sea of consciousness, in this case I want to say clearly that "Joan Smith" is a fictional character, the story is very clearly marked "fiction," and you are not her at all.As I read your story, I became deeply offended by how I was being described.You were not being described, because no living person was being described. Again, "Joan Smith" is a fictional character, and you are not her at all.Your story didn't describe me fairly or accurately — how dare you! In point of fact, there is scarcely any overlap between who I really am and your "Joan Smith" character. I mean, I'm not her at all!*sigh* ... yes, dear. You are not her at all.I am considering legal action against you. I hope you have a lot of money, because my position is unassailable.Indeed it is. Because within a short time span you have argued that you are, and are not, the person in the story, and since there are no other possibilities, your position really is unassailable. It is equally clear that you are mentally unbalanced. But legal action is your constitutional right. When you go to court, be sure to emphasize how little similarity you found between yourself and the fictional, narcissistic "Joan Smith" character, and how unfair you thought that was. This will help the judge grasp your mental state.

I hasten to add there is a term for people who think every story is about them, even when the comparison is uncomplimentary or implausible. They're called "narcissists."

Returning to my "ocean of consciousness" metaphor, you are free to choose any course across the deep reaches. I should tell you there is another boat out there, a much larger boat named "Reality," and it is steering a different course than yours. But don't worry, there is little chance you'll collide with Reality, and if you do, it will surely be an accident. I am a rather tolerant person, in most circumstances and with most people. But I have my limits. As the above exchange shows, I reserve my intolerance for examples of outright stupidity.

Baffled

Dear Paul, I am a community support worker and have just started working with a young man who was diagnosed with Aspergers. He is in his late thirties and is very bright. During my visits I have come to know him as an intelligent caring person. Yet I have been baffled by some of his 'meltdown' behaviour, when he frequently changes character and personality, using a different voice and language. I have been looking at the senario from various angles and your essay could have been written about my young man. It has helped me to see more clearly the situation, as a layperson I had viewed and treated the young man as an individual, without fully appreciating the role 'parents' play. Thanks again for your easy to read, clear definitions and common sense approach which is often lost in the world of medicine and psychology.You are most welcome. With each new reader response to "Asperger's by Proxy" I am happier that I researched and wrote it.

As many of the other responses show, and as many leading mental health professionals suggest, Asperger's is at present a diagnostic trash bin, a simple way to categorize people using a vague diagnosis into which nearly anyone can be fit. I should add this is consistent with much of the history of clinical psychology.

Put in its simplest terms and in my opinion, if Asperger's is the only available diagnosis for a particular person, the mental health practitioners should instead acknowledge that they have nothing to offer.

As to the role of parents, opinions in clinical psychology have swung wildly back and forth on this issue, once blaming parents for everything, at the moment blaming them for nothing, and with no realistic hope of discovering what is true. The present fashion motivates some parents to get a diagnosis as quickly as possible to avoid any hint of personal responsibility. I know one case in which a mother got diagnoses — and regular therapy — for both her children around age six. I imagine the children lying on a couch, describing a childhood they haven't had yet.

With regard to your client, and reminding you that I am not a psychologist, my educated layperson's opinion is that there is something other than Asperger's going on.

Not Fair I

Hi I am a 25-year old recently diagnosed with Asperger's. You seem like an extremely smart person and I agree with a lot of things you have said. I liked the part where you have criticized the psychology field [ ... ] But my point to you is, why are you so focused on narcissim as an absolute category of people with such negative undertones and not Asperger's?Because narcissists, unlike Aspies, are in perpetual denial, extremely resistant to change and are sometimes dangerous. None of these is true for Aspies, with rare exception.Asperger's diagnosis accepts that there are weaknesses with certain personality types, but what's so wrong with Aspies trying to find famous people to relate to that have had similar personality traits?Nothing at all, but my point in the article is that Asperger's is an appealing diagnosis, consequently it gets assigned far too often, sometimes to people who are simply bright, not Aspies at all. This is not just my view, but that of many practitioners in the field of psychology, as the reading list shows.So what if it's a coping mechanism of being ostracized by the psychiatric and psychological fields with such a bad category? If it's helping people to cope with their conditions (and yes, genetics plays a large part in a lot of these behaviors), then what's so terrible about that? I actually found asperger's hard to deal with until I found out other famous people had it and then I thought maybe my personality isn't such a socially unacceptable thing.But that is not remotely the point I make in my article. My article discusses the problem of overdiagnosis, not the facts surrounding Asperger's itself.Anyway, I know you have some personal issues against asperger's ...No, that is false. My issue is not with Asperger's, it is with the exploitation of Asperger's as a dodge by parents and a way to assure job security for psychologists.... but I don't think you're seeing the big picture.To get to this viewpoint, you cannot have read the article very carefully. Overdiagnosis and exploitation is the big picture, Asperger's is a minor theme.

Not Fair II

But I can't imagine that anyone would actually want their kid to be diagnosed with Asperger's.Well, hard to believe, but plenty do. Some parents, once they see how their children are turning out, want a mental diagnosis because it relieves them of responsibility. A misbehaving youngster might result from bad parenting, but an illness isn't anyone's fault, and that becomes a motivation for an insecure parent to get the diagnosis.For instance, like my mom went into denial when I got the Asperger's diagnosis and she got really upset. She said I was just fine even though I had been suffering for years and teachers had requested that I go to a doctor since I was a kid.Maybe your mom objected because she didn't think the diagnosis would change anything except to put a label on it. There is some truth to that.But I will say that getting the diagnosis hasn't helped me much.That's because there isn't any substantive treatment. And some will argue that it isn't even a mental illness in a conventional sense.I still have most of the same problems even though they're trying to help. Like twirling out my hair at night and rocking.It's funny that they would try to deal with that, as though changing some outward sign would make a difference to the basic reality. It's as though they believe modifying the symptoms modifies the underlying reality. But at this stage, not enough is known about Asperger's to do anything besides treat symptoms.I actually think that probably more people have Asperger's that need to be treated for it and diagnosed and haven't than that have chosen to get it for the fun of it.Possibly, hard to say. But I hope you realize there isn't actually any treatment. What clinical psychologists call "treatments" are simply common-sense suggestions to deal with it, not to cure or ameliorate it.

In any case, as you may be aware having read my article, there are plenty of very successful Aspies. It isn't as though it stands in the way of personal success.I just can't see that as happening but you could very well be right because I only know my own family's situation, I haven't seen others.....But I can't even imagine that someone would want it if they didn't have it. It actually makes you feel more insecure in some ways.....nobody really wants to be different...No, not at your age. But as you become older, being different is less of a stigma. Such issues as what you can accomplish becomes more important than how you fit in with your peer group. Aspies accomplish plenty. ... and some of these things aren't easy to control...most of the time when I'm twirling out my hair or rocking I'm spaced out and not even paying attention to the fact that I'm doing it....My neurologist said it's a short-term memory problem but I don't know all the specifications.Believe me, neither does he. Whatever you do, don't assume the "specialists" have a recipe to fix you, or even that you are broken, or that an Asperger's diagnosis means your subjective experience is not valid.

Nature made you the way you are, and nature is smarter than us. Before you go to sleep at night, just say, "Bill Gates is an Aspie."

Not Fair III

I re-read your article and think it makes sense. I don't think I have a disability either. I just have different strengths and weaknesses than the "average" or "normal" person.Good for you. At the present level of psychological understanding, your personal evaluation is wise, and it shows you are willing to accept personal responsibility for your life's direction, rather than leave it in the hands of "experts."

I believe an honest, candid clinical psychologist would tell you to do exactly what you've decided to do on your own — evaluate the evidence and choose you own path. As to the rest, well, that's why I wrote the article.I think overall the Asperger's label is not helpful to anybody and I can't comprehend that a woman would actually want her child to be known as "developmentally-delayed."The story is presented as fiction to conceal the identities of the persons involved, but the essential facts are there, and that is one of the facts, amazing as it sounds.It just brings shock and horror to me because I thought moms wanted to do anything so that their children were happy and felt like they fit in.Over and over again, I couldn't believe "Joan" would do what she did, until she did it. I still find some of her actions hard to believe. I quickly wished I hadn't been so gullible as to get involved in the situation, and ended up doing all I could to minimize the harm this woman could do to her children.At least that's how my mom is. I feel sick thinking somebody had to live with a mom that was really that way. And I won't lie, I wanted to doubt your story because it's almost too sick to fathom.I wrote the article as a cautionary tale — there really are people like that. I wouldn't have believed the story if I hadn't experienced it firsthand, and until then I had been rather naïve about the motivations of parents who ask me to mentor their kids. Therefore I felt the public interest was served by telling the story, but without any real names or identifying details.So you said that just because you gave him confidence and made him feel good about himself she wouldn't let him see you anymore because it was taking away her sort of "control" of the situation right?There were several issues, that was one of them. Another is that I argued against her use of clinical psychology as a way to control her kids. We ended up disagreeing about virtually everything, then her histrionic and narcissistic personality disorders kicked in and she repeated a vile accusation of wrongdoing she had used against another person in her life. This tactic had worked for her before, but with me it didn't work so well — I was willing to defend myself, and I guess she hadn't expected that.

Without revealing some details that must remain private, the person she had accused before had more to lose by vigorously defending himself, but I realized if someone didn't expose her, she would repeat the same behavior again and again. It's my hope that her public humiliation will prevent her from falsely accusing anyone else. But I have to remember she really doesn't live in the same reality as the rest of us, so it's not easy to predict her behavior. It's certainly not behavior that does her any good.I'm upset because humans are overpopulating the planet and destroying everything in their paths to the point there's no respect for other animals and now people are having kids that are just going to turn out dangerous because they shouldn't have kids in the first place!That's an easy problem to state, but not so easy to solve. I think there should never be a policy that decides particular people are unfit to be parents. The risk is too great that, with such a policy in place, someone like my young friend, a very smart person with admirable values, might never be born.

Also if such a policy existed, it would necessarily be in the hands of a government, and history proves no government can be trusted to carry it out. So I guess we'll have to put our trust in nature.I really have never met anyone with a personality disorder.Actually, you have probably met many people with one or another personality disorder, but I doubt you've met anyone as extreme as "Joan." I was in my sixties, a seasoned world traveler, but I had never seen a case as extreme as that.

"Joan" simply couldn't understand why people who heard her description of reality quickly saw through her — witnesses, various mental health professionals, and a judge — and it was at that point that I realized she lived in a world almost completely divorced from reality.I heard psychologists talk about such things like it's black-and-white but I still haven't met one. But that definitely sounded like one.That's an interesting way of putting it — black and white. Real life is rarely black and white, but that story is an exception. Problem is, it's so true that it doesn't make very good fiction.

The Contrarian

Thank you so much for your postings on the overdiagnosis of Asperger Syndrome. It's really alarming how widespread this diagnosis has become, and how willing many parents are to accept unnecessary and harmful labels for their children. In my own case, what struck me the most (maybe because of the irony?) was how little attention was paid by the professionals I dealt with to nuance and context and intent.

I was misdiagnosed with Asperger's way back at the beginning of the fad (1994-ish, before it was enshrined in the DSM-IV). I was twelve, and I distinctly remember the frustration of being talked to and about as if I had no inner life — as if all the particulars of my very innocuously nerdy existence had no root and no resonance either in my own history or in the larger world. Luckily, I was enough of a contrarian that I didn't take it to heart.

The psychiatrist who diagnosed me (having known me all of twenty minutes) wanted to set me up with a caseworker and a support group, and made dire predictions about my future sans "treatment". I refused. I was lucky enough to have parents who let me refuse. Instead, I changed schools, made friends, and grew up.

Now I'm happily married, about to start a master's program (in English, not math — I never was any good at the nonintuitive stuff) and frankly pretty boring — I barely graze "quirky" these days. It was a long time before I found any validation at all for my claim that Asperger's is overdiagnosed, so it's nice to see that a few people are coming around! It's heartening to see all the replies from parents who don't believe that "smart and slightly dorky" warrants a DSM-IV diagnosis.

Keep up the good work!

Linda [ ... ]Since I wrote the article, I've learned a lot more about Asperger's and the field of clinical psychology, and feedback like yours has been heartening. There are simply too many nebulous conditions like Asperger's that lack a clear cause, unambiguous diagnostic criteria, or meaningful treatment. With specific reference to Asperger's, it's not clear that it can be distinguished from intelligence, in a society that appears to regard intelligence as a deplorable but treatable condition.

Thanks for writing and sharing your experiences.

In this exchange I include a correspondent's given name only to identify her gender (an earlier female correspondent's gender was more obvious). Asperger's diagnoses were once rarely made for women, but this trend is increasing as the financial drawback to excluding fully half the population occurs to the less ethical practitioners of clinical psychology.

Concerned Parent

My son was recently "diagnosed" with AD. The neuro-psych Dr. seemed to overlook all of the concern that I had. She took the fact that his behavior had changed after a sexual assault for granted and said that that was from the disorder. I am at a loss for how to proceed. So many people who know my child are shocked and do not agree with this diagnosis either. Any suggestions?I can only offer the suggestion to ignore such a diagnosis. It is well-established that psychologists, when presented with the same subject under the same circumstances, cannot produce the same diagnosis. The head of research for the DSM (the "bible" of clinical psychology) recently said, "There are lots of studies which show that clinicians diagnose most of their patients with one particular disorder and really don't systematically assess for other disorders. They have a bias in reference to the disorder that they are especially interested in treating and believe that most of their patients have."

Translated into plain English, this means psychologists invent diagnoses, and, because of an absence of rigorous science, no one can call them to account.

If rigorous scientific studies were to be conducted that conclusively excluded some individuals from this diagnosis, I might feel differently, but that is extremely unlikely, given the state of the field.

You need to realize that, for each parent like you who doubts these cookie-cutter diagnoses, there are ten who want the diagnosis to be made, because it replaces doubt and angst with a bogus certitude, unfortunately at the expense of the child's emotional well-being.

I recommend that you read the book "Misdiagnosis And Dual Diagnoses Of Gifted Children And Adults: ADHD, Bipolar, OCD, Asperger's, Depression, And Other Disorders," located online at (among many other places):

http://www.amazon.com/Misdiagnosis-Diagnoses-Gifted-Children-Adults/dp/0910707642

The bottom line is that a psychologist has zero incentive to hold back from offering this or another similar diagnosis. It puts bread on his table.

As to your son, how exactly does such a diagnosis help him cope? He needs to be given every incentive to respect and develop his abilities and move forward. A formal psychological diagnosis like this can only rob him of self-esteem and give him an excuse not to try.

I want to congratulate you for doubting this diagnosis in the midst of a common perception that everyone has Asperger's, if only they would visit their local psychologist to find out.

At the moment psychologists seem to have a diagnosis for everything — if you can't spell, or can't do math, or you smoke cigarettes, or you like coffee, or you don't like your older brother, psychologists have a diagnosis and a course of treatment that is vague, expensive and perpetual. But there is one mental illness that doesn't appear in the DSM — it is the compulsion among psychologists to invent a diagnosis for any imaginable behavior. This harmful and debilitating condition doesn't even have a name.

Autism is Real I

This entry continues an earlier exchange.

An email and it's content does not prove a person's aptitude for intellectual activity. An e-mail proves nothing, but it supplies evidence. In your prior post, you argued as though I had claimed psychiatry has no value and that autism results from bad parenting. As to the first, I have never said this, and as to the second, I've strongly argued the opposite position. All one need do is read.

Your prose is filled with unsupported assertions, positions for which there is no evidence — "Your response did not make me angry as you probably have wished it would" — which makes me think you have no intellectual training and cannot reliably gather evidence for your own positions. I actually happen to agree with you. Psychology is not evidenced based. And I was angry when I wrote the email. Maybe it would be better and more productive to wait until you aren't angry, assuming that ever happens, before writing.

Do you know why I write as I do? It's a way to quickly and efficiently discover whether a correspondent can rise above emotion toward meaningful discourse. It's a miniature intellectual boot camp. Now either drop and give me twenty, or start thinking — it's your choice. I understood you to say that autism is not real. No, you didn't understand me. You made that conclusion on the basis of no evidence whatsoever. I have never argued anywhere that autism is not real. I have argued that psychologists make unsupported, unjust claims about it, like psychologist Bruno Bettelheim's famous claim that it results from incompetent mothering (with no evidence at all).

Based on your posts so far, if I were to take a position against racism, I should expect to get a reply saying black people really exist. My son did not become autistic at two years old like many parents are claiming their children to have become. Who cares what parents claim? Parents can say and do anything they please. There is no social rule more sacred than parents' right to do anything short of feeding their children into microwave ovens — and even then, someone tries to offer an explanation:

Modern society can create anything it wants out of silicon and oil — except children. For that it must go to independent contractors (parents) who work in cottage industries across the landscape (and who love their work). The contractors set the rules, and in exchange society gets a new generation of volunteer soldiers, obedient taxpayers, and whiners. And, no, I am not as intelligent as you are. But that doesn't mean I do not possess the capacity for understanding evidence based scientific research. Since you cannot properly decode clearly written prose, a position for which there is plenty of evidence, it is fair to conclude that you also cannot decode scientific research.

If you were qualified to read and understand scientific writing, you would at the very least know what key property separates a scientific theory from an ordinary one. But I say you don't know this trivial distinction, and I invite you to prove me wrong. The property can be expressed using a single word. My frustration lies in the fact that I wish to pursue a science that will allow me to do research in the field of autism without getting myself involved in the "googlely gak" of psychology. That option doesn't seem to be there as of yet. I would wish to be able to somehow make an impact in the field of psychology to make it more evidence based. And, no, I do not possess that experience. You aren't qualified to understand or produce science, but you can function as an informed consumer. You can point out the many strongly held positions psychologists have taken over decades, and then had to abandon for cause (as in the Bettelheim example above). You can refuse to add to the perceived acceptance of psychology. I think you are already disposed to do that.

In any case, even the president of the APA hasn't succeeded in pushing clinical psychology toward an evidence-based model, so you don't need to feel too bad about having little effect on the behavior of psychologists. Your response did not make me angry as you probably have wished it would. I hoped for the opposite, and you are providing evidence that you can't interpret everyday prose. It helped me to step back and realize that your writings have caused me to understand the reason I wrote you the email. Too many children are being misdiagnosed. Too many gifted children are being called autistic. Hold on. Do you realize your original message took me to task for the position you are now taking? How many emails do you get every day from angry parents? Plenty. Why do you suppose that is? Many of them can't understand the article they've just read. People like you. People who think I am claiming autism isn't real, in spite of my arguments to the contrary. Is it because they're all mired with emotion? Among other things, yes. Is it because they do not possess intellectual capacity for anything other than writing angry emails? Think before you respond. I have, and yes, that's normally the reason. If this were not the reason, more parents would act intelligently toward psychology, require it to prove its claims, rather than becoming compliant drones and idea consumers.

Clinical psychology has its present form because clients enthusiastically pay for it to be that way. Ironically, the relationship between modern clinical psychology and its clients fulfills the classic definition of destructive codependence.

Autism is Real II

I don't have a scientific education or training. By now, you are probably well aware of that. It wouldn't have taken a genius such as yourself to figure that out. (irony). I am aware that I do not write in a scientific manner. I'm not going to give you reasons or excuses for such. Hold on. It isn't as though having a scientific outlook is the only legitimate mental state. It happens to be the most efficient way to sort out reality, but that is a special occupation and one can spend a lifetime without doing it. I say this because science is not a religion or a special social class, it is just a tool meant for a specific purpose. No excuse is required.

Science is simply a way for us to get around how we feel about things. Eventually, thousands of years from now, we won't need science any more, because we will understand how to think efficiently. This doesn't mean we won't have feelings. It means we won't trust them as a guide to everyday life. However, it's always been my wish to begin a pursuit of scientific learning. I am at a point in my life which might allow me do to so. I'd like to learn how I may teach my very curious children. My eldest is very interested in all things scientific. He's only nine years old. The youngest child is 3 and she's holds a very strong imagination. It would be a very good thing if they understood what science is about. A scientific outlook is useful, even in a life spent focused on other things. My fear is that neither one of them will be educated to their full potential in any type of school. That's a virtual certainty, because (1) schools only teach us how to teach ourselves, and (2) education never ends. For a "full potential" education, one must be willing to learn new things perpetually. I understand that I do not possess the intellectual capacity that my son does, but I feel that it is my responsibility to provide adequate material for him to use. You've raised the issue of my lack of scientific knowledge or ability to understand such. This fact has been at the forefront of my thoughts for a while. There is plenty of literature to assist you in this endeavor, in libraries, bookstores and online. But try to avoid confusing science with the results of science. Science is not a vaccine, it is the thought process that led to the vaccine. I did not pursue a B.S. Instead, I have a B.A. When I was young, I wanted to study science, but was disassuaded. Now, I feel that I may be too old to begin where I left off 20 years ago. Recent studies have disproven an old belief that the human brain stops developing after a certain age. This turns out to be false — our brains can take on new challenges at any age. So don't give up based on your age. Other than me getting a brain transplant, do you have any suggestions as to where I may begin? (I know, first I argue and insult you and then I come crawling back for advice). Well, science is very easy to summarize, but somewhat more difficult to adopt as a mental discipline.

Here's the summary. First, science is a tool to help us see beyond our feelings, beyond what we wish to be true. Science does this by focusing entirely on evidence — nothing else matters.

Second, in our earlier exchange, I said there was a key property of scientific theories that sets them apart. That property is falsifiability. If a theory makes propositions that can be tested in practical experiments and if the theory would be falsified by an experimental failure, it is scientific. If a theory cannot be tested in practical experiments, or if it doesn't make testable predictions, it is not scientific. This requirement explains why clinical psychology isn't scientific.

Third, scientific theories can only be disproven, not proven true once and for all. Scientific Philosopher Karl Popper summarized this by saying, "No amount of observations of white swans can allow the inference that all swans are white, but the observation of a single black swan is sufficient to refute that conclusion." This is why there are only scientific theories, no scientific truths (even though one sees that phrase in popular writing).

Fourth is an important scientific principle called the "null hypothesis," which can be summarized by saying that without evidence, a proposition is assumed to be false. Most people assume things are true until proven false, but science takes the opposite view. It is because of the null hypothesis that scientists are regarded as having a skeptical outlook.

That's a short summary. Here is an article of mine that expands a bit on the science idea:

Levels of Experience: Ideas I apologize, Paul, for not understanding you and for not making the proper attempts to do so. It's probably not the first time it's happened to you and I feel badly that I've added to the rubble. I don't care about that. Where you've been doesn't matter, only where you are going.

Another Victim Speaks Out

I have immensely enjoyed and been stimulated by reading your articles, particularly those on narcisissm. I was, until a couple of years ago, a victim/enabler of a narcissist and am still repairing my, sense of self, career and bank account after her seismic assault. So it was a "she", yes? I ask because psychologists believe the vast majority of narcissists are men, not women, but this isn't my experience. My correspondence isn't remotely a scientific sampling, I'm just curious. Your refreshingly intelligent articles on the subject have helped me put a much more robust framework on what happened to me and, I am sorry to say, it has been something of a comfort to read that even someone as intelligent and articulate as you was almost drawn into peril. Oh, I must tell you, very bright people are in some ways more susceptible to social parasites, because we tend as a class to be socially inept. I wouldn't dream of taking this position were I not a member of the group I'm describing.

I certainly didn't take what I now regard as normal precautions, and I rationalized continuing my friendship with "Joan's" son by saying, "this woman would have to be crazy to try to spin the situation in any way other than as someone sincerely offering help", but without ever taking the next mental step and seriously considering whether she was, in point of fact, crazy.

As to "almost drawn into peril," I think the episode was closer to the precipice than that. Consider the Duke University case, where a single angry woman destroyed a number of lives before it became clear she was both mental and lying:

http://en.wikipedia.org/wiki/2006_Duke_University_lacrosse_case

Or this case from Britain, in which a man is falsely accused, jailed for three years, then his accuser is exposed as a pathological liar — but the victim is obliged to pay the government £12,500 for his room and board:

http://www.dailymail.co.uk/news/article-505428

"Not only did Mr Blackwell not commit the crime, but the crime had never taken place."

"It also emerged she was a serial accuser, having fabricated at least seven other allegations of sexual and physical assault against blameless men."

"She kept changing her name and moving around, so police forces never realised they were dealing with the same woman."

This certainly sounds familiar (my accuser had a history of false accusations), and as it turns out, experienced judges hear fantasies like this regularly. In my case, the judge quickly realized "Joan's" story was nonsense, and all I was obliged to do was offer a two-word defense: "absolutely false". But I certainly needed to say something — silence would have constituted an acknowledgment of culpability, something my accuser didn't grasp when it was her turn to defend herself (something she failed to do). Your way of life is admirable and your way of thinking even better. Thank you. Oh, thank you! Now I can mull over whether I deserve such praise. And if you ever pass through London I will gladly buy you a beer - this is not a request for a date. I see you read carefully and understand what you read. Very impressive from an American perspective.

Thanks for writing!