American Normal (2002)
Bill Long 11/21/07
Lawrence Osborne's Work on Asperger's Syndrome
Whenever you pick up a book on autism or Asperger's Syndrome, you discover it is as different from other books on the subject as the autistic individuals that the book considers differ from each other. Many volumes, such as Catherine Maurice's Let me Hear Your Voice (1993), are family narratives about struggles and victories/setbacks in dealing with children with autism. Osborne's well-written, humorous, literate and slightly quirky book is part travelogue, part record of interviews with authors working on historical figures said to have been touched by Asperger's Syndrome (Thomas Jefferson; Glenn Gould) and part philosophical meditation on the human being that is 'behind' or 'possesses' or 'suffers from' (which words do you use) Asperger's Syndrome ("AS"). He also stops in on people of unquestioned creativity who are, as the current lingo goes, Aspies. He leaves the reader with two distinct impressions: (1) that the phenomenon we now call AS is itself very diverse, including in its number people with different "deficits" and gifts; and (2) that the most humane or understanding way for our society to deal with its Asperger population is to try to make accommodation for, rather than seeking to "cure" or "change" or "treat" those with AS. In this review I will do two things: (a) lay out certain "landmark dates" or persons in the study of AS; and (b) present some highlights of Osborne's interviews or philosophical reflections.
Getting a Grip on Asperger's Syndrome
People unfamiliar with the "field" of autism studies might be under the impression that the term and phenomenon have, like Jesus' poor, always been with us. Perhaps the phenomenon has, but the first two studies on children with autism were done fewer than 65 years ago. Hans Asperger, of the University of Vienna's Institute of Heilpaedagogik (therapeutic pedagogy) became the eponymous source of the syndrome through his 1944 study entitled (in English), "Autistic Psychopathy in Children." In this doctoral thesis Asperger presented the case studies of four boys, Fritz, Harro, Ernst and Hellmuth, all of whom had certain common traits, such as social withdrawal, extreme concentration on certain details, and a "faraway look in their eyes." But they also differed dramatically from each other. At least one of them had a "grotesque physique" and, as Osborne carefully notes, some had a sort of menacing, malignant or malicious affect in an otherwise unfocused visage. Osborne sagely observes that when the syndrome was later "discovered" in the English-speaking world, and especially in America, the more malignant characteristics had seemingly dropped out of the equation.
Asperger's clinic was bombed by the Allies near the end of WWII and his work, though continuing elsewhere, seemed to have suffered a similar eclipse. It wasn't until 1981 that Dr. Lorna Wing, a psychiatrist at the London Institute of Psychiatry, made reference to Asperger's work in English and tended to confirm his findings through her study. Her contribution to the study of autism, however, was to take the variety discussed by Asperger and make it into a "system:" i.e., to suggest the existence of an autistic "spectrum" along which classic autism and AS were, as it were, two weights on either end of the barbell.
It wasn't until 1991 that Asperger's study was translated into English by Dr. Uta Frith, a German-born researcher living in London. Then, quickly, in 1994, the 4th edition of the "Bible" of psychological disorders, the Diagnostic and Statistical Manual of Mental Disorders, listed AS as one of the five syndromes on the "autism spectrum." The diagnotic criteria are here. The major developments in the study of AS in the past 13 years (not mentioned by Osborne) have been: (1) to emphasize the benefits, and not simply the "deficits" of the syndrome, which the DSM-IV tended to do, and (2) to focus so much attention on AS that it has almost become a sort of "chic" disorder/syndrome to have. It has a touch of exoticism because several significant historical personages are now purported to have been Aspies; but the very fluidity of its categories for diagnosis has encouraged almost everyone who has had trouble "fitting" into the world over his/her life to consider his plight a result of a hidden or slightly manifest Asperger's tendency.
Because categories are not firm (we don't even have consensus on whether AS is a type of autism or is, perhaps, sui generis), funding is becoming more generous and everyone wants to know where s/he "fits" on some kind of spectrum, there is much room for "creative imagination" in the study of the field. I suppose that this has and will lead to many self-proclaimed experts as well as nostrums for "cure" or "treatment" that will eagerly be sold to willing listeners.
Osborne's Interviews and Philosophical Observations
Osborne entertains with his narratives of going to visit historians who write about past figures who might have had AS, such as Canadian musician Glenn Gould or US President Thomas Jefferson, or creative individuals with prodigous abilities to calculate or write poetry. One might have wished for some critical review of these visits, but Osborne seems to take it as his role primarily to present the uniqueness of his interviewees and their "take" on what they do. Among his most valuable observations are those in his final chapter ("The Poetics of Medicine") where he tries to look at AS in a cross-cultural way. His trip to Lunda, on the border of Indonesia and Malaysian Sarawak, introduces the reader to some local "mental disorders," such as the latah, which seem to be more reflective of the culture which spawns the affliction than a permanent or biological condition of the human personality. This provides him the occasion for asking the question that must be asked--and that is whether and to what extent AS might be more a reflection of some of the eccentricities of Western culture than an organic condition in the human. We are still in the infancy of cross-cultural psychological and psychiatrist diagnosis, evaluation and treatment.
The book doesn't really "advance" the "scientific" understanding of AS but, by presenting interesting case studies both historical and present, reminds us of the bewildering and enticing variety of manifestations of AS or its cousins. The title of the book, taken from poet David Spicer's characterization of "mainstream America," is a haunting reminder that we study AS in the context of great attempts at establishing conformity in American culture. Osborne's book enriches us by teaching us about this strange and alluring world.