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One of the more
esoteric areas of autism research is its relationship with
schizophrenia. It’s probably not a question that most people know
about, but among clinical psychiatrists and psychologists, there were
decades of historic controversy and confusion over distinctions
between autism and schizophrenia. When the late 19th-early
20th-century psychiatrist Eugene Bleuler first used the
term “autistic” in professional literature, he was not discussing
what we now consider autism, but schizophrenia. When Leo Kanner
performed studies that would form the basis for the first diagnostic
criteria for autism, several of his subjects had previously been
classified as schizophrenic. Through the 1950s, 1960s and even into
the ‘70s, there was ongoing speculation that autism and
schizophrenia were interrelated, most notably a circulating theory
that those diagnosed with autism in childhood would become
schizophrenics as adults. (It is noteworthy that this theory went
into decline at precisely the time when children diagnosed with
autism under Kanner’s criteria would have been reaching adulthood!)
In hindsight, the
fruits of this now-obscure controversy are a mixed bag. The case of
Bleuler alone is highly instructive. Bleuler was best known both in
his own time and in subsequent literature as a pioneering researcher
in schizophrenia, and he favored quite broad criteria for defining
the condition, and as late as the 1970s professionals were still
debating how much to “tighten” the criteria.1
Furthermore, a number of traits of schizophrenia can now be
recognized as at least superficially similar to autism, such as lack
of “affect” or displayed emotion.2
From what is now known about both autism and schizophrenia, it is
quite possible that he did in fact observe some individuals who would
now be diagnosable as called autistic. On a darker note, Bleuler
appears to have assumed an analogy between appearing withdrawn or
detached, as is common in autism, and the landscape of outright
delusion seen in schizophrenia. In hindsight, this was not only an
unwarranted extrapolation, but a failure to recognize the strong
possibility that an individual’s “withdrawal” might in fact be
a response to social abuse.
Moving to the
present, there are developments that could yet revive the issue. The
professional literature has for some time been rather quietly
recognized that a certain number of autistics are also diagnosable
with “comorbid” schizophrenia. A number of researchers have gone
further and proposed that autism and schizophrenia have the same or
similar underlying cause(s) in genes and neurology.3
What may ultimately be of most interest is that a substantial body
of reports has accumulated of autistic people experiencing
schizophrenia-like hallucinations, without clear indications of
full-blown schizophrenia. (For anyone who wants to go looking for
examples, apart from online postings, William Stillman’s writings
on the religious experiences of the autistic, with frequent
paranormal overtones, may be as good a place as any to start.) This
opens up the possibility of a discrete subcategory of autism spectrum
disorders.
That will be as
good a place as any to start my story.
I first found out
that I was diagnosed with Asperger’s Syndrome in 2004. Before
that, I went through a regular alphabet soup of diagnoses: PDD,
PDD-NOS, ADD, ADHD, and not improbably some I don’t remember or
never heard about. As far as I know, the one thing nobody suggested
was the one I thought about the most myself: schizophrenia.
To me, the
centerpiece of my ideas about schizophrenia and autism is the
character of Zaratustra. I first came up with him a few years before
getting the diagnosis, and I always felt that, in some way, he was a
kind of alter ego to myself. After the diagnosis, I realized that
his character pretty well fit the “aspie” distinction. To me,
the most important aspect of Zed is that, no matter how far he gets
from what anyone else would consider reality, he is always rational.
In other words, what he does will always follow logically from what
he perceives as real and what he considers an appropriate and
desirable goal. Perhaps the reason why I feel such an understanding
for his character where readers get confused is that I can really
picture what his inner world is like. Perhaps that should be
frightening.
In this process, I
now know that I hit upon a very important issue in psychiatric theory
and practice. As per the psychiatrists, the defining characteristic
of “real” schizophrenics is that they are not just delusional,
but fundamentally disorganized. Thus, they tend to do things that,
on consideration, do not make a great deal of sense even in the
framework of their perceived world. For example, if someone
otherwise “rational” perceived that a table lamp was telling him
to go out and kill his bank clerk, he would probably assume he was
hallucinating. (Actually, as psychiatrists use the term, this
wouldn’t even qualify as a hallucination, because the perception is
rejected, but I prefer not to make that distinction.) Even if he did
accept the voice as real, he would probably still refuse to obey
because it would be illegal and amoral. Or, if he were like Zed, he
would at least ask the lamp what would be in it for him.
What I find
intriguing about Zed is that he represents a combination of traits
that would be exceptionally dangerous in an actual criminal. By
comparison, actual schizophrenic criminals tend, from a purely
technical standpoint, to be unimpressive. They are as disorganized
in committing their crimes as they are about anything else; even
counting bullets may elude them. Thus, they tend either to get
themselves caught quickly, or to fail entirely in doing the deed.
But, now and then, I run across a real case of a criminal who is
clearly delusional, yet quite successful in planning and carrying out
complex acts of mayhem. Over the years, I have racked up quite a
list. I haven’t cared to commit any of their names to writing, but
I am sure you, the reader, can already think of at least one.
Whether they are well-known is quite independent of their evidenced
capabilities; the single individual I consider most dangerous is
probably the most obscure, and I would just as soon keep it that way.
What first got me
thinking about schizophrenia, however, came years before any of this.
Now, it should go without saying that I have a very active fantasy
life. I have also always been very interested in phenomena that must
be considered either unexplained, actually supernatural, or else
hallucinatory: UFO sightings, Bigfoot encounters, poltergeists, etc,
etc. But, I can’t say I have ever experienced anything that made
me feel either out of touch with reality, or in contact with
something beyond ordinary experience of the physical world. My
closest brush with anything like the uncanny is one childhood memory:
Sometime in later childhood, I woke up and saw an orange light
coming from under a door between my bedroom and a family room, which
wasn’t at all like the family room lights. After a while, the
light flickered and went out. As such things go, on the whole, this
would qualify as downright boring.
Then, starting when
I was 15 or so, I started to have a completely different kind of
experience. It never felt like a hallucination, but it made me fear
very much that I was losing my mind. To describe it, I don’t think
I can do better than repeat a fictionalized account I worked into my
Zombie Vegas! series: “He did not perceive it as sound he
actually heard. Yet, it was a voice, with tone and pitch and
inflection, and it seemed completely beyond his control… The Voice
had started during middle school. He had never believed that it was
anything but a fragment of his own psyche, which had not made things
the slightest bit better.”
My “Voice” was
the persona of a fictional character named O’Cleary, from a jumbled
mess of an aborted science fiction novel I worked on from 8th
grade through high school. His story was that he survives a battle
with monsters by leaving his companions and hiding, and afterward
tells everyone else that the monsters can’t be beaten. He was
never a sympathetic character to me: He was a coward and even a
traitor, and he was supposed to be in some sense a threat to everyone
else. What he really was, to me, was a voice that told me that I was
going to fail (especially in any efforts at romance), and when I did
it would be my fault, especially for not trying hard enough and not
being brave enough. I never believed it was a “Voice” from
outside myself, yet I was absolutely convinced I had to prove it
wrong.
I can see now that
this was, in fact, pretty much the reverse of reality. As I have
recounted, in junior high and high school, I was anything but timid
about approaching girls. By any standard, I was, in fact, too
aggressive and persistent in trying to talk to girls. For a good
part of my life, I don’t doubt that this was directly fed by the
voice. Thinking about it now, I wonder about “chicken vs. egg”.
When it started, I really was very reluctant to talk to a
girl, no matter how attractive and interesting she seemed. But, I
don’t believe now that this was not nearly as much a matter of
being afraid as it was of what I was comfortable with. Back then, I
was still easing my way toward enjoying being around people.
There was no way I was just going to cannonball into a dating
relationship, and I never expected or even really wanted to. I could
feel perfectly happy just watching someone interact with others. I
could even enjoy fancying that I was like a zoologist, observing
without disturbing. (That other people would be aware of being
watched, and might not appreciate it, is another point which eluded
me.) But when I started listening to the “Voice”, I was willing
to approach a girl again and again, even as she got more and more
upset.
This continued
right into college, and I believe it reached a critical level right
about the time I learned of my diagnosis. This brought me to a
situation where I was probably as in love as I’ve ever been, but
still told myself the young woman was “just” a friend. (In
perfect hindsight, I think the real best description was
“acquaintance”, but I think the thinness of the connection only
shows the disproportionate depth of my emotional investment.) Soon
enough, this reached the point where she took me to task emphatically
enough that I believed she never wanted to talk to me again- and I
really never did. In hindsight, I do not believe that was really
what she wanted, but I was ready to assume disaster. In more perfect
hindsight, I think on some level I knew that not talking to her at
all could be the best thing for me. But this didn’t save me from
being around her in all the same places, or keep me out of especially
severe bouts of depression. During one of these dismal, drowsy
spells, I seemed to think spontaneously, who would miss me if I
carried out what had for some time been my strictly hypothetical
“escape plan”.
Even now, I don’t
feel ready to talk about what came after that. Apart from anything
else, I can’t recall with any confidence what happened. Time spent
reflecting on the Bible marked a turning point. Learning about
autism and Asperger’s Syndrome helped, and, in fact, I’m not sure
if I could have benefited the same way if I had been told of the
diagnosis earlier. Probably most importantly, I started sharing more
with friends. It also happened that, at that time, I really started
to wonder whether the “Voice” I had always considered an echo of
my subconscious might be something more, and not at all good.
Through this
process, I benefited particularly from better understanding what a
positive religious experience could be like. To me, the existence of
forces and entities beyond ordinary perception has always seemed like
a straightforward and reasonable proposition. I had no trouble
finding enthusiasm for Judeo-Christian Scripture in particular, on an
intellectual level. But a sense of really relating to God
long eluded me, in no small part because many people’s ideas of
“talking with God” seemed little different than me being
harangued by the Voice. Even now, I don’t relate to the idea of
communing with the supernatural that way. (Quite a bit of my
feelings in this regard have come out through my stories with the
pragmatically pagan Carlos Wrzniewski.) But, I have come to the
point where I can recognize a sense of something more, or at least
different.
I suppose that
leaves just one more thing to tell, which is the one thing that seems
completely unbelievable. Indeed, when I fictionalized this story, I
hesitated to recount this part, because it seemed so much like the
kind of contrived deus ex machina resolution that countless
authors have beaten into the ground simply because they could think
of nothing better to do. But this is what really happened:
The Voice just stopped. Even before I finished high school, O’Cleary
was no longer popping up in my inner world. Even my depressive
episode in college never repeated itself. It has seemed to me the
closest thing possible to an answer to prayer- and I’m willing to
believe that it was.
1
Encyclopedia of Schizophrenia, Noll, 339-340
2
Schizophrenia, Hearher Barnett Veague, p. 4.
3
See eg. Yael Dvir, MD and Jean A. Frazier, MD,
“Autism
and Schizophrenia”, Psychiatric Times.
Vol. 28 No. 3, March 2011.
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