The Ravenous Brain: How the New Science of Consciousness Explains Our Insatiable Search for Meaning (42 page)

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Authors: Daniel Bor

BOOK: The Ravenous Brain: How the New Science of Consciousness Explains Our Insatiable Search for Meaning
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But why should a drug that promotes wakefulness have such a profound effect on one’s feelings of worthlessness? And what other mental illnesses might benefit from being perceived as more closely connected with consciousness than previously thought?
 
The World Health Organization (WHO) estimates that up to a quarter of all people around the globe are affected by mental illness at some point in their lives—with anxiety and depression the most common conditions. Suicide now ranks as one of the leading causes of death in young adults. Unlike other major illnesses, such as cancer and heart disease, which tend to occur later in life, mental illness is most likely to emerge in adolescence or early adulthood. This means both that the pain to the patient can be more long lasting and debilitating and that its economic burden to the state is larger.
Although it’s difficult to estimate the loss to the economy due to mental illness, the World Economic Forum recently made an attempt at this. Taking all the relevant factors into account, such as direct costs to treat the illness, work-hours lost to disability, and so on, it calculated that in 2010 the global cost of mental illness was around $2.5 trillion—a staggering amount, but likely to increase dramatically over the next twenty years. Mental illness will thus soon account for the majority of the world’s economic burden for all noncommunicable diseases (which also include conditions such as cardiovascular disease, chronic respiratory disease, cancer, and diabetes). The entire global health budget is only about double the current mental illness global economic burden, though a tiny proportion of this is spent on mental health. In fact, mental illness must surely be the most underfunded sector of health care by far, when the true costs of mental illness are considered. Therefore, one of the most sensible policy changes that could be undertaken to positively affect economic growth figures would be to focus on improving mental health in the populace.
Perhaps part of the reason for the political neglect of mental illness is the legacy view that these aren’t real illnesses, as well as the assumption that psychiatric conditions are too complicated to treat effectively. While the first assumption is inaccurate and damaging, there is some truth to the second position. As my wife and I know all too well, the decades of research have hardly scratched the surface in our understanding of mental illness. This is probably because many of these conditions are caused by a large set of genes that interact with environmental events in extremely complex ways. But that doesn’t preclude new perspectives from shedding light on these profound sources of suffering. And even minor progress in treating mental illness, a disturbingly common condition, could lead to a dramatic improvement for society, both from its soothing reduction of individual torments and from the potential to make the economy more productive and efficient.
In this chapter I consider the idea that almost all mental illnesses can be rewritten as disorders of consciousness. This is a strategy that may engender useful, novel perspectives on these conditions, as well as exciting new routes for treatment. I’ll also suggest in the epilogue to follow that insights from our emerging knowledge of the nature and purpose of consciousness can help explain and alleviate the emotional struggles we all face on a day-to-day basis.
AUTISM AND OVER-CONSCIOUSNESS
 
From the perspective of consciousness and psychiatry, autism stands out as a special, fascinating syndrome. Although historically seen as a disorder defined by social impairments, it is rapidly being rewritten as a condition caused by an overabundance of awareness.
A developmental disorder that is apparent from early childhood, autism symptoms include a lack of understanding of the thoughts and emotions of others, poor language skills, and obsessive, repetitive behaviors. The majority of autistic children are classed as mentally retarded and have the condition for life.
As with most psychiatric conditions, autism is probably best viewed more as a cluster of symptoms than a single syndrome, and there is much variability in level and type of disability among autistics. For this reason, most people talk of autism spectrum disorders, rather than simply “autism.” And this continuum includes people with Asperger’s syndrome, who have some symptoms of autism, such as poor social skills, but who generally function well in life, and may have a high IQ.
The traditional view is that all autistic symptoms stem from an inborn, specific deficit in grasping anything remotely social—this is why autistics can’t understand other people, and in pronounced cases don’t learn the social activity of communication. Most theories along these lines, though, struggle to explain the full range of symptoms common in autism, such as repetitive behaviors, which seem to have nothing to do with a lack of social skills. And this traditional view seems out of sync with emerging evidence that many severely autistic children can show marked improvements in social and verbal skills if they participate in an intensive behavioral intervention program centering around gentle social encouragement through play, such as the Early Start Denver Model or the Son Rise Program. This raises the strong possibility that these social and communication problems, far from being the central cause of autism, are a reversible side effect of a deeper difference between autistics and others.
One emerging suite of theories on autism suggests that this disorder is centrally defined not at all by a poverty of mental skills, but instead by the excessive richness of information these people experience. In other words, in some sense autistics have an overabundance of awareness, and all their symptoms are merely their way of dealing with this supercharged consciousness.
But how does this fit with the view that autistics are so poor at processing information that they are regularly classed as mentally retarded? The simple answer is that it doesn’t fit, because most autistics aren’t really mentally retarded at all. For a start, the Asperger’s subbranch of the autistic spectrum involves individuals with a normal, or, more usually, a raised IQ, sometimes markedly so, such that many physicists, mathematicians, and engineers probably have some autistic traits. Simon Baron-Cohen, a world expert on autism, and Iain James have speculated that certain prominent figures, including Albert Einstein and Isaac Newton, suffered from Asperger’s syndrome. Einstein, for instance, was very developmentally challenged in learning to talk, was a loner as a child, and would obsessively repeat sentences until about the age of seven.
Some autistics really are severely mentally disabled—for instance, they might be unable to go to the toilet by themselves—but I don’t believe this is
necessarily
because they lack the mental resources to perform such a task. Trying to assess a child who has poor language skills and an aversion to novel activities is remarkably challenging, but increasingly scientists are critical of this mentally retarded label for autistics, and this may well be another case of researchers jumping to the conclusion that poor performance on a test must mean inability to carry out a related everyday function.
There are two popular, but very different, ways of measuring IQ: the Wechsler Intelligence Scales, which use a shotgun approach, giving subjects a large range of different tests, including various language tasks; and the Raven’s Progressive Matrices, a single nonlinguistic test that involves finding the logically correct option to complete the hole in a patterned grid. Unsurprisingly, many autistic children are rated as severely mentally retarded on the more conventional Wechsler IQ scale, with its heavy language component. But if you give autistics the Raven’s matrices test instead, suddenly their IQ jumps. Their scores are, on average, 30–70 points higher than they were on the Wechsler test, and as a group they appear at least as intelligent as normal children.
Thus, autistics generally aren’t mentally retarded, and their social and communication problems can be dramatically improved with the right behavioral therapy. But what evidence is there that they are actually more conscious than normal people? Actually, there is a wealth of data from a wide range of sources.
A small subset of autistic people will exhibit isolated islands of incredible ability. For instance, there’s Stephen Wiltshire, who can draw a landscape with stunning accuracy after just a single viewing. Or there’s Derek Paravicini, who may not know how to hold up three fingers, but despite his blindness is a highly accomplished pianist who has filled concert halls and can play a tune perfectly after hearing it just once. And there’s also Daniel Tammet, already mentioned in this book (Chapter 5), an autistic man who can perform fiendish calculations and memorize gargantuan streams of numbers.
Until recently, it was thought that only 10 percent or so of autistic individuals had some form of superior skill. But increasingly, it’s becoming clear that most have superior abilities in a range of perceptual and analytical areas.
From a biological perspective, in many ways autism is the opposite of schizophrenia. The two conditions share many of the same gene abnormalities, but while schizophrenics will have one variant of a given gene—say, involving a deletion of a section of DNA—autistics will have the opposite variant—for instance, with a duplication of the same section. And while schizophrenics show a slowed brain growth in childhood, autistics have an accelerated brain growth compared to normal children.
Many autistics seem to perceive the world with more detail than the rest of us and can exercise a highly focused and sustained attention. But being flooded by so much detail can be stressful and overwhelming. Autistics tend to hate noisy or busy scenes; while sharp, unexpected sounds cause most people’s consciousness to be taken over by this new event, in autistics the intrusion is particularly pronounced. Some even report a low-grade form of synesthesia, where a particularly loud noise will induce a brief visual flash,
29
as if the intensity of the sound was so powerful in them that it spilled into other senses. This inadvertent sensory mixing also hints at the autistic’s marked propensity to combine information.
If autistics have a wider consciousness than others, from the main thesis of this book it would follow that they would then also have a more patterned, structured mind. This, I would argue, is one of the hallmark features of autism, and one of the most common symptoms, from the most disabled autistic child to the most towering genius classed as having Asperger’s syndrome.
Many autistics, in order to compress their overflow of conscious detail and reduce the related stress, find comfort in crafting structure inside their minds and in their surroundings. This is why they may build blocks in carefully crafted stacks, or develop many rules and rituals. These activities are a desperate attempt to reduce the novelty and chaos in their lives and replace them with reassuringly regular, compressed patterns. It is also why they tend to seek highly ordered hobbies, such as mathematics, being a human calendar, and so on. There is in fact only a small range of superior skills that autistic people adopt, and these are almost exclusively related to logically crisp, hierarchical patterns of meaning. Many of us may nurse a deep hunger for patterns and structure, as exemplified by the sudoku and crossword puzzles we enjoy. But for autistic people, this need is tangible and chronic. For them, attention to such structures, and the habitual application of chunking, is a lifeboat they latch onto so as not to drown in a sea of conscious information. In many cases, it may also be the main source of pleasure and security in their lives. For instance, in his autobiography
Born on a Blue Day
, the autistic Daniel Tammet eloquently wrote, “The pages of my books all had numbers on them and I felt happy encircled by them, as though wrapped in a numerical comfort blanket.”
I suspect that for some autistics, delayed language development or impaired social skills partly arise because these people are initially drawn to other, more patterned aspects of the world, and they have little inclination to learn certain linguistic or social skills of which they are probably very capable. Tammet, for instance, despite his autism, has since his mid teenage years made a concerted effort to learn the social rules. He seemed a particularly amiable, helpful person whenever I met him. He can also speak about ten different languages, and revels in the logical structure hidden behind words. It might also be, though, that many autistics feel easily saturated and upset by the social world, which can be so much more chaotic, random, unpredictable, and uncontrollable than nonsocial, more logical domains. In other words, autistics may initially shy away from social situations because of the stress of an overflow of a form of information that they can’t effectively compress.
Although the wider mental landscape that some autistic individuals possess makes the term “disabled” a questionable label here, if the condition is combined with undue suffering, then there are ways to help. Behavioral therapies are already exploiting the idea that an inability to understand the emotional and social worlds is neither a central nor an immutable feature of autism. And although there has been limited success so far in pharmacologically treating autism, one new drug, arbaclofen, has produced provisional yet promising results. And the way that this drug is thought to work may be in line with the suggestion that autistics have too much consciousness. Normally, our brains are awash with some neurotransmitters that encourage neurons to fire and others that turn down the signal, dampening down neuronal activity. It is thought that autistic people have an imbalance of these chemicals, having too much of the main neurotransmitter that ramps up activity (glutamate) and not enough of its nemesis, gamma-amino butyric acid (GABA), which suppresses neuronal firing. Arbaclofen acts to restore this balance, providing autistics with a more normal, less overwhelming sense of consciousness, and as a result social skills develop more rapidly.

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