[Posted on 2 April, 2019 by Nouchine Hadjikhani]
One often reads that autism is a disorder of theory of mind, and that autistic individuals have difficulties putting themselves in other people’s shoes.
But wait a second… aren’t neurotypical people remarkably bad at putting themselves in the shoes of autistic people as well?
Recently, a friend of mine, who is autistic, told me a very aggravating story. She needed to go to the hospital for an intervention, and she asked the person who was making the referral for the appointment whether it would be possible to go to a smaller hospital, as that would be less stressful for her in terms of hostile environment sensory bombardment. The answer she got left her speechless: “Oh yes, of course, I understand, even for us normal people these places can be overwhelming!”. After a few moments of stunned silence, my friend was then able to articulate: “you mean for non-autistic people?” and the answer she received was “Oh yeah, of course”.
This was a health professional talking to a patient. How much more tone-deaf could one be? Did this person realise what she was saying, and how it would affect the person she was talking to? Was she inferring that my friend was abnormal? As such, can we really say she was walking in her shoes?
Then, a couple of days later, I saw another autistic woman in her fifties. She happens to also have physical ailments that are seriously affecting her daily life, and has been trying to seek help for this. But because she comes to the clinic with a psychiatric diagnosis, she is immediately considered a person with a psychosomatic problem, which sadly means her physical care needs are dismissed – even if this involves a broken bone.
Here again, we are talking of doctors and nurses who are unable to empathise with a patient, because this patient supposedly has a problem with empathy.
Almost 20 years ago an article was published that reported that autistic individuals process faces like objects, with this remarkable statement: “(…) these results suggest that the perceptual processing of faces in autism spectrum conditions is more like the perceptual processing of objects in persons free from social disability”. Later, research proved that this was of course not the case, and that when gaze was controlled, autistic individuals were in fact showing the same level of activation – or even slightly greater – than typical people, and that these results were probably reflecting gaze avoidance. Yet, they showed a context of thoughts that is worrisome.
No, autistic individuals are not people without emotions who should be treated as if regardless of what we tell them, their feelings couldn’t be hurt. Quite the contrary, a lot of them are extremely sensitive, and a lot of suffering can be inflicted by not understanding them. This is especially true when professionals are the ones who fail to empathise, as they really should know better. We need to ask ourselves more often what it is like to be in their shoes.