I'd rather see a student psychologist. Really

I'm in therapy right now. I have been (in this iteration) since late January, both dealing with deaths in the family (three this semester, one of which hit me harder than most - that was my grandfather near the start of January) and trying to get something resembling a handle on my anxiety. On the to-do list is gender-related stuff, eventually, since I do have some physical dysphoria in addition to the social stuff. But that's not the point. The point is that I actually prefer to have a student as my therapist, and there are a few reasons.

1. Students are usually less confident. That might seem like a disadvantage, and I suppose it could be for some people, but in my case it's important. I am very good at being an outlier. Someone who is confident in their expectation that things that work for most people will work for me ... is not going to be a good match, because they are often going to be confidently wrong.
   
2. Students knowledge is as up to date as it is ever likely to be. It's a reality of graduate school that we have to be reading a lot of recent research. It's a reality of regular practice in most fields, including psychology, that people don't have time to be reading that much recent research. There are, of course, exceptions, but in general your best bet for the most up to date information is a current graduate student.
   
3. Those two things combine to increase the likelihood that students have heard of neurodiversity and are at least open to the idea. I'm not actually the one who brought up neurodiversity in my sessions, because my initial focus was on grief. My autism was only relevant in the way it's always relevant: the way my brain is wired up affects how I process literally everything, including grief. At some point it was relevant and the therapist I'd been seeing asked me if I'd "heard of" neurodiversity. (I think this must have been the day I my ability to speak went out part way through the session and I switched over to typing, because I didn't burst out laughing immediately.) Yes. Yes, I have heard of neurodiversity.
   
4. The psychological consultation center on my campus doesn't take insurance, but it runs on a sliding scale based on income, and sessions are $5 for students. That's cheaper than co-pays even on most good insurance.

Between these factors, I'd really rather go to a clinic where students are being supervised. Folks there are more likely to be a reasonably good match for me.

Party Giraffe, Hot Spicy Autism, and Small Acts of NO.

By inclination, I'm a bit of an imp. I will say a true thing (I'm nonbinary) in a slightly silly way, messing with people using truth. ("Good man. Wait. Woman." gets responded to with "still no" followed by "nonbinary, good luck".) This is a character trait, not an isolated incident. On National Coming Out Day, I wrote "I draw cool stuff using straight lines, which is funny because I'm not straight." One day when I was pointing out "typos" on the white board while non-speaking, I was told to "be quiet." So I wrote on the side board, "I didn't say anything!" It was technically true. 

I like puns. (Nonbunnary!) I like satire. (Turn it Down Taupe!) And while I wear many metaphorical hats (mathematician, engineer, graduate student, teacher, Autistic person, "person in the lab who can sew", writer, AAC user, Queer person, culturally Jewish person, "that weird person who doesn't get cold", and on and on), I don't necessarily choose to emphasize the set of hats I have in common with the other people in the room. I tend to emphasize the ones that are most effective for messing with my colleagues, even. See again: bit of an imp.

So of course it makes sense that I would have shirts that say things like "Autistic Party Giraffe" (explanation), "Hot Spicy Autism", "We Are Like Your Child", and "I Love Someone Lacking Autism." Recently, I've started wearing those shirts more frequently. And yes, I can trace this back to the election. 

No, I don't think that wearing my identities on my shirt (or my bag, as I've been known to do) will magically make everything OK. That's not the point. Reading Trump Presidency to be Large-Scale Replication Experiments in Destructive Obedience: Here is How to Resist will help the actual points make sense, though. Even though Milgram's experiments were based on a pretty unrepresentative sample in terms of people generally, it's 1) a decent sample in terms of who tends to have power in the USA, and 2) not the only study that's been conducted, though Dr. Alfano's link on the subject loops back to his own post, presumably accidentally. In any case, I'm not after the "most people obey" information. I'm after the "what did the disobedient do?" information.

Point the first: If you want to be able to refuse immoral expectations later, starting earlier helps. There's not been any orders about wearing snarky autism T-shirts, and I don't expect there to be. Why would there be? But I said expectations, not orders, and there's a reason for that. Preemptive obedience (doing what you expect the authority figure would want before there is an order, or on things too small to ever deserve an order" is a thing, and not doing that would logically fall under refusing/resisting early. So instead of hiding or closeting the identities that an incoming administration wouldn't like, I get more open about them. I get (visually) louder. T-shirts. Flapping and rocking in public. Using AAC as a teacher. Throwing myself conspicuously into a wall at the American Academy of Arts and Sciences. There can be no compliance ahead of time, because there should be none later. (As opposed to because I think the ahead of time bits are going to fix things on their own. I don't. They just keep me in a "no, you move" sort of mindset for when I'll need it.)

Point the second: Resist noticeably, and you increase the likelihood that those around you who notice will also resist. I don't want to be alone here. 

Point the third: I'm a Queer Disabled Jew. I may not be near the head of the line of people who'll be victimized, because I am also educated, also have class privilege, and am not Muslim. But I've heard the rhetoric about queer people (including trans people, remember that I'm nonbinary?) and about disabled people. I've seen the antisemitism getting more obvious. Let's not pretend I'm not in that line, even if people sometimes forget. (Read: prefer not to think about it?) So when paying attention to the individuality, to the personhood, of (potential) victims is part of how you make it easier to resist, reminding people I'm on that list seems like a good idea. 

I know myself. I know that, impish nature and all, it took me until I was eleven to figure out, even in theory, that intentional defiance was an option. A special education teacher had to tell me, so I'm not sure how much I can claim to have figured it out. There's a heck of a lot planned that I'm going to need to resist. So I'm going to need all the help I can get. (All the help I can give myself.)

"Blind imagination" neuroscience press release

For anyone new to the aphantasia discussions: It's a fancy word for not visualizing, or as I've tended to describe it, not having a mind's eye. I don't picture characters or scenes when I read books, for example.

As a rhetoric person and disability studies person, I looked at how we talk about aphantasia, in three parts. (Part one, part two, part three). As a neuroscience student, I wrote about one of the articles (Zeman et al, 2010, the case study) in terms of significance. And yes, some of the results are things I could totally have told you myself. Like the fact that "mental imagery" tests such as rotation (check if two block structures with angles are the same or not) can be done in ways other than rotating an image of the object. I know that because I don't view such images in my head and I'm good at the task. Testing everything is how science works, and trying to figure out what someone is doing rather than just what they aren't doing is still handy. So here it is!

A research team in the UK has shown the potential for dissociation between the experience of visual imagery and performance in tasks typically associated with visual imagery and visual memory in a case study. The patient, a 65 year old retired surveyor referred to as MX, reported the sudden loss of his ability to visualize. However, he retained the ability to complete tasks typically associated with visual imagery and visual memory, including mental rotation tasks.

The authors did a series of tests both on MX and on a group of controls of similar age, IQ, and professional backgrounds. These tests included assessments of general intelligence, memory, executive function, visual perception, subjective vividness of visual imagery, and imagery abilities. MX scored significantly lower than controls on subjective assessments of visual imagery. However, his scores in the other tests were not significantly different from that of controls. In the fMRI experiments, MX showed similar areas of activation to the control participants while viewing images. However, MX showed significantly different activation patterns when asked to generate faces. Rather than activating the posterior visual network, MX showed prefrontal activation in areas associated with many executive tasks.

Further behavioral testing was conducted to test if MX was using alternative cognitive strategies. The researchers gave MX variants of Brook's matrix and verbal tasks, along with mental rotation tasks. Here, MX's performance differed from typical patterns. While typical controls consistently perform better on the spatial Brooks task than on the verbal one, MX performed better on the verbal task. When asked to perform the typically visuo-spatial version of the task with verbal or visuo-spatial interference, MX showed no significant difference in performance between no distractor and visuo-spatial interference. However, his performance was significantly lower with the verbal distractor, again in reverse of the typical performance pattern. On mental rotation tasks, MX showed no impairment in correct performance. However, he consistently required more time than controls and showed a different relationship between angle of rotation and time required from the controls.

Both the behavioral and fMRI testing indicate the use of alternative cognitive strategies in order to perform tasks typically associated with visual imagery. On most tasks, these alternative strategies yield similar levels of accuracy to controls with typical visual imagery abilities. The case of MX provides insight into alternative ways of completing typically visual tasks. His performance indicates that mental imagery is not essential to tasks typically associated with it, making it less clear that mental imagery is the subject of mental imagery tests. It also indicates that reliance on the mind's eye in decision-making as suggested by Kosslyn is not universal. In addition, this case study may provide insight into the cognitive functioning of a small but significant subset of the population who report no mental imagery. Surveys dating back to 1880¹ show a group that report never having experienced mental imagery, alongside documentation of prior cases where imagery is lost. Further study could determine if similar strategies are used by this population, and what cognitive differences, if any, this is associated with.²

1  Galton, Francis. "I.—Statistics of mental imagery." Mind 19 (1880): 301-318.

Also relevant is: Faw, Bill. "Conflicting intuitions may be based on differing abilities: Evidence from mental imaging research." Journal of Consciousness Studies 16.4 (2009): 45-68.

2 Spoiler alert! This happened to some extent in Zeman, Adam, Michaela Dewar, and Sergio Della Sala. "Lives without imagery–Congenital aphantasia." Cortex 3 (2015). This case study got written up in Discover, then some people who have never had subjective mental imagery [like me!]  contacted the authors. Then people saw the follow up, some of whom also contacted the authors. The 2015 letter was actually the first one I found, followed by the two commentaries on it. [They wonder if there may be a connection with faceblindness, or prosopagnosia, which I also have. My brain. It is multiply interesting.]

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#Rhetoric and #Aphantasia (2/?, Faw and Galton)

I continue to look at the rhetoric around aphantasia, or not having a mind's eye. Part 1 is here. Now I'm looking at two papers written before the word "aphantasia" was coined. Both recognize that some people do have mental pictures (minds eye type stuff) and that some people don't, which involves recognizing some level of cognitive diversity. What people then do with the knowledge is another story. Galton is known for eugenics, after all.

So I'm starting with Bill Faw's paper, "Conflicting Intuitions May Be Based on Differing Abilities," which looks at the history of psychological/philosophical thought about mental imagery or the lack thereof. He points out a tendency for people to assume that everyone does this imagery (or doesn't do this imagery) the way the researcher them-self does(n't) do it. By and large, researchers assume it's a thing: most people can visualize things, after all. Faw claims, “Much of the current imaging literature either denies the existence of wakeful non-mental imagers, views non-imagers motivationally as 'repressors' or 'neurotic', or acknowledges them but does not fully incorporate them into their models.” 

Faw argues that the everyone uses mental images camp (thanks Aristotle) comes from two things: most people have mental images, and people tend to assume that what they do is what everyone does. Which leads me to ask regarding mental imagery what I've asked before regarding autism: theory of whose mind? (Sam mentions the incident in his thesis and on his blog.) Also, Faw is himself aphantasiac, or a non-mental-imager, as he calls it in his paper. (He's writing before the word aphantasia was coined. I kind of want to check if he's written on the topic since.) He describes reactions of disbelief from others, that non-imaging is even a thing, as well as challenges to the notion that he could know this about himself. Hello, parallels to autism with the “you can't know what it's like you be yourself” thing.

It does make skeptical sense to question whether people filling out a 5- or 7-scale survey all mean the same by ‘vague and dim’! But it seems untoward to dispute such strong statements of mental imaging abilities — and the lack thereof — as seen in the self-reports that Galton and I and many others have elicited. (16 in the ResearchGate PDF, probably 60 in the actual journal)

And that's the thing: I don't think people all mean the same thing by vague, dim, vivid, or any other inherently subjective descriptor. I (and Faw) do think there's a clear difference between "vivid" and "non-existent," though. Enough of a difference that assuming that everyone does (or doesn't do) mental imagery the same way seems ... less than logical? But it's something quite a few philosophers and psychologists seem to have been doing along the way.

Aristotle assumes “normal” thought involves imagery. (What the heck is normal? Hi, neurodiversity paradigm, it'd be nice to see you here.) Hobbes isn't talking about pictures so specifically, but does seem to hold that thinking/imagination depends on internal sensory creations. Locke writes of memory as re-experiencing or re-creating prior perceptions with the knowledge of having had them before. That's probably what my intro to neurobiology teacher meant by vivid recall, and it's not a thing I do except with sounds. Titchener describes his own mental imagery as a gallery and can not conceive of even small gaps in the streams of others imagery, assuming that his own experience is universal. (Theory of whose mind?) He was actually one of the respondents to Galton's survey, and he challenges the reports of other respondents who don't experience mental imagery.

Then he turns to the opposite intuition, where someone who describes what sounds like their own experience without conscious mental imagery (Watson, in this case) and assumes that this experience is the one that generalizes. (Theory of whose mind?) He denies mental imagery as being important to anyone and questions its very existence for most. And I do think generalizing ones own experience is a reasonable way to make guesses unless and until you get better information, but he's doing this in the face of a whole lot of descriptions of mental imagery by/from/for others. Interestingly, this guy was one of the big definers of behaviorist thought, and he claims thought as internal speech. (My thought is usually internal speech, but sometimes it's externalized typing or handwriting. Sometimes it's recognition of patterns that I then need to somehow translate into language in one of those forms.) That's the only person Faw describes as having rejected the importance and possibly existence of mental imagery, and even his descriptions of non-imaging are called ideological rejection by folks who assume we all have mental pictures.

On a similar note, Faw suggests (following Thomas Leahey) that Watson might have been a strong auditory imager but weak or non- visual imager. Which is a funny way of writing about it, since I always thought imagery meant visual stuff, but there doesn't seem to be a word for any similar activity with the other senses. Now that's a fun question – why don't we have words for internally created sensory perceptions for hearing or smell? We do have the idea of songs getting stuck in our heads, so I don't think it's most people not having those sorts of perceptions. Since I describe my own non-imagery as “no minds eye” I would make a parallel description using the idea of a minds ear, nose, or tongue, but that doesn't quite work with tactile sensations.

Then he gets into Galton. I actually read Galton's 1880 paper, and my thoughts on it come next:

This paper is cited as being the first place where aphantasia is described. Galton had no problem calling it a mental deficiency (unlike the folks who coined the term in 2015; Faw refers to it a dis-ability in describing his own experience in 2009 and gets cited in 2015):

"They had a mental deficiency of which they were unaware, and naturally enough supposed that those who were normally endowed, were romancing." (302)

Remember that this guy is one of the big eugenics guys. Of course, he found this was most common in "men of science" and therefore had some motivation to find a reason that this was OK. Or not genetic, instead caused by disuse. Or both.

"Scientific men as a class have feeble powers of visual representation. There is no doubt whatever on the latter point, however it may be accounted for. My own conclusion is, that an over-readiness to perceive clear mental pictures is antagonistic to the acquirement of habits of highly generalised and abstract thought, and that if the faculty, of producing them was ever possessed by men who think hard, it is very apt to be lost by disuse ... I am however bound to say, that the missing faculty seems to be replaced so serviceably by other modes' of conception, chiefly I believe connected with the motor sense, that men who declare themselves entirely deficient in the power of seeing mental pictures can nevertheless give life-like descriptions of what they have seen, and can otherwise express themselves as if they were gifted with a vivid visual imagination." (304)

That doesn't stop him from calling it a feeble ability or a mental deficiency, but he talks about compensation as not just a possibility, but as something that definitely happens.

But what does Faw have to say about Galton? He points out that Galton's the one of the few who seems not to have assumed that his own experience of mental imagery or lack thereof is everyone's experience of mental imagery, and that this is good research. Which is true enough. I still don't trust Galton as far as I can throw his long-decayed corpse, because eugenics, but his thoughts on mental imagery seem to be better balanced than the other folks Faw's been reading.

George Betts made a scale to measure visual imagery and looks around to see how common aphantasia is. He finds 2% among his college students and 19% among other psychologists. Which means he, too, has to have worked under the assumption that variation is a thing.

Then we get more recent work which tries to check mental imagery objectively rather than based on subjective self-reports, alongside continued surveys of subjective reports that find people tending towards “vivid” imagery. (Ok, but I'm still only understanding vividness as a thing that I don't experience.) I assume that some of the assumptions that internal imagery is required for object recognition (I can do this), freehand drawing (I am terrible at this), and spatial reasoning tasks (I'm good at these) come into play with the supposedly objective measures, since Faw described this sort of conflation as an issue in much of the literature. Even Faw's eventual hypothesis of subliminal/unconscious imagery that doesn't reach the conscious level still seems to be working with the assumption that some sort of image-like process is needed. It does recognize that it doesn't require an actual image, which is nice (and which may relate to Faw being aphantasiac himself and therefore knowing it's possible!)

Works Cited

Faw, Bill. "Conflicting intuitions may be based on differing abilities: Evidence from mental imaging research." Journal of Consciousness Studies 16.4 (2009): 45-68.

Galton, Francis. "I.—Statistics of mental imagery." Mind 19 (1880): 301-318.

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#Rhetoric and #Aphantasia (1/2, not academia)

So I'm Autistic. I've seen all sorts of contradictory ways of thinking about autism. Somehow we both lack imagination and are lost in our own worlds? You kind of need to pick one, considering that making our own world involves imagination.

Well, about a year ago they gave a name to one of my other cognitive quirks. "Aphantasia" is now either an "intriguing variation in experience" (specifically stated not to be a disease!) which about 1 in 50 live with, or it's a "newly described condition" we'd like to investigate for insights into the imagination and ways to boost visual imagery (presumably in the folks who have such visual imagery) in order to "improve our memory, increase our empathy and even gain new treatments for conditions like addiction and anxiety."

The basic idea of aphantasia is that I don't have a mind's eye. (I do have a mind's ear, and absolutely get songs stuck in my head.) If you ask me to picture an object, I'll either sit quietly and then relay factual information about the type of object, or I'll bluntly tell you that I can't do that. Most creative exercises, there's a way around actually visualizing the thing. I can tell you this because I don't see images that are not literally in front of me, not when I'm awake. My mind just doesn't work that way. (So no, I don't think in pictures. I suspect that "no minds eye" and "thinking in pictures" is a combination you can't actually have in one person.)

And yes, I am interested in better understanding how my own mind works. I don't think that's unusual. Pop psychology exists, after all. And Tris, from Divergent, made her cooperation with Erudite's tests contingent on her getting to understand the results of the tests they were performing on her. She wanted to understand how her mind worked, and especially the ways her mind didn't follow the operating procedures she'd been implicitly taught were standard. But that's not why I'm following the discussion on aphantasia, really.

I'm watching the rhetoric.

Shortly after the publication of "Lives without Imagery -- Congenital Aphasia," a letter to the editor in Cortex authored by Adam Zeman, Michaela Dewar, and Segio Della Sala, we see a human interest story on aphantasia in the "future" section of BBC.com. We talk about one adult man who does not visualize, and we talk about the difficulty inherent in understanding the internal mental processes of another person. We see discussion of potential advantages of reduced or missing mental imagery -- not needing to re-watch disgusting or traumatic events, for one thing. It's mentioned that verbal and logical skills tend to get practiced more (hi, did you know that I'm a mathematician?)

This is also the article with the mention of treatments for other conditions -- anxiety and PTSD among them. Which ... well, I've got anxiety and already don't have any mental imagery. If reducing mental imagery helps some folks with anxiety, that's great but let's not pretend that will be a silver bullet, ethics around activating and suppressing cognitive abilities aside. (I think that it's fine to do so by the request/desire of the person whose head you're messing with, but there's a lot of space for coercion towards "typical" cognitive processes.) There's some talk about manipulating people's levels of mental imagery for various reasons, but it's in both directions. Despite calling aphantasia a newly described condition (as opposed to cognitive style/variant), this article is probably the furthest away from disability tropes of the BBC articles. (Which isn't that far.)

B percent live with, affects as many as X in Y. These are condition words, pathology words, but they show up in the article that calls aphantasia a variation and specifically states that it is not a disease. And the article's headline? "Aphantasia: I can't visualize my own children." It's in the "health" section. A professional describes the effect on memory more generally, and then three people give short descriptions. One talks about how he does things. Another talks about what he can't do. We close with another professional, speaking to medical history and to educational impacts. (As an aside, I hate mindmaps.) This article reads more like a personal interest story describing the experience of a disability than anything else. It wants to be a disability story, but this Adam Zeman guy who was first author on the congenital aphantasia study won't call it a disease.

Another piece in the health section discusses both aphantasia (not visualizing) and hyperphantasia (visualizing extra.) Zeman continues to insist that aphantasia is not a disorder, thank you very much. I'm sure he's seen enough of the discussion to realize that the way we talk about it is going that way. The discussion for aphantasia here is largely focused on what we can't do, though. His insistence reads as a bit incongruous with the way the rest of the article talks about aphantasia.

(If you want to call it a disability, or conditionally a disability, I'd give you that. The social model of disability, which recognizes interactions between people and their environments, is a thing. The insistence on visual methods of learning and things like mind maps is also a thing, and presumably just as inaccessible to other aphantasiacs as it is to me. Now we're bringing in ideas of neurodiversity, where a neurological type can be a disability without it being disordered. There's not just one right way for a mind to work)

Then there's the aphantasia forums. These started shortly after the first BBC articles, if I remember my timing correctly. I've got an account, and will probably be sharing my thoughts there too, but I honestly don't post much. There's places where people share articles about aphantasia, including ones they wrote themselves. There's crowd research. (I notice that one of the questions is about people having other cognitive disorders as well, which positions aphantasia implicitly as being a disorder.) I've seen general discussion where quite a few people talk about having trouble with mathematics, which is opposite what some of the published articles hypothesize (compensatory skills in logic, verbal stuff, and/or math.) That could be going in the direction of mutually contradictory stereotypes.

Blake focuses on the experience of realizing that the way his mind works is most definitively not how most people's minds work. It's almost an attempt to analyze the psychology of the visualizing majority from the outsider perspective of an aphantasiac. Which, I mean, if they're going to do that to how we think, yeah, let's do this. Let's add a wing to the Institute for the Study of the Neurologically Typical. We've got an Autistic wing and a Dyslexic wing, why not an Aphantasiac wing?



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Multicultural Psychology Post on Health (care) Disparities

This was a discussion board post for my Multicultural Psychology class. The topic was culture and health, and the chapter focused pretty heavily on health disparities and health care disparities. We're supposed to write at least 600 words and cite at least 5 research sources outside the textbook per discussion, though I usually (as here) will be making at least one of those citations in my responses to other students. (So, uh, professor? If you do a plagiarism check, yes I am the math TA in your class. Congratulations on finding my blog.)

Chapter 8 discussed culture and health. Part of the chapter is on health (care) disparities. Health disparities are the different rates of being healthy or sick (or having specific conditions) between groups, while health care disparities are the differences in treatment and in access to treatment (Mio, Barker, & Tumambing 2012). These two disparities can not be reasonably separated, as receiving poor care (or no care) can lead people to try to deal with health problems on their own and mistrust doctors, which in turn rather definitively leads to not accessing health care. I know that past healthcare experiences have influenced my decisions to (not) seek care for illness or injury. After I had a doctor explain that my injury (which I had already said was a month prior) could not be a broken foot because for a broken foot to appear as it did on the MRI, the injury would need to be about a month old, my trust definitely decreased. It was, in fact, a broken foot. I suspect he couldn't believe a person would be able to walk on a broken foot for a month. Another doctor taking my inability to assign a number to my pain to mean I wasn't in pain decreased my trust further. The only pain scale I've ever found that I could comprehend is based on behavioral cues, and since I'm fairly sure walking on a broken foot isn't supposed to be 2/10 on any pain scale, I can't exactly use that scale at the doctor's office. There are many who believe that autistic people have a reduced sensitivity to pain or don't feel pain as well, which really doesn't help when I'm trying to seek treatment for issues where pain is a symptom. Fitting that particular stereotype only makes getting medical treatment harder (Allely 2013), and I expect the experience is similar for other groups who are often assumed to feel less pain.

Mio et. al. give multiple examples of people of color receiving care later or receiving less treatment than white people in the chapter, both in personal stories and in statistics (2012). Racism has historically played a role in treatment, and knowledge of this racism plays a role in the decision to seek care or not (Bhopal 1998). Similar forces are in play for people living in poverty, who may choose to delay care due to an inability to pay for it or wait until they are in need of the emergency room because the ER (theoretically) can not turn them away entirely. Interestingly, decreased utilization of healthcare by those of lower socioeconomic status holds even when they have health insurance (Fiscella, Franks, Gold, & Clancy 2000).

In terms of the choice to attempt access to health care or not to make the attempt, historical and current racism play a significant role for many people of color. Medical and scientific racism, such as that which was partially involved in eugenics and in experiments like the Tuskegee syphilis study, led to continuing mistrust of the medical system. In addition, research on health care disparities has often framed the problem as lying within cultural choices of the marginalized group, which does little to create trust (Bhopal 1998).

In connection to these issues, I look back at the concept of imposed etics: “imposition of an outsider's worldview on a different culture” (Mio, Barker, & Tumambing 2012, p. 64). There really are differences in (attempted and successful) health care utilization between marginalized groups and privileged groups. However, in assuming this is because marginalized people culturally don't care about their health or don't believe that modern medicine can be effective at what it claims it can do, researchers are imposing their worldview and ideas of what reasons for action make sense on members of other cultures who have other worldviews! I know that as an Autistic person, I absolutely care about my health, including my mental health. I also totally believe the analysis suggesting that autistic people who are referred to interventions earlier and who received applied behavioral analysis are more likely to achieve the “optimal outcome” of losing their diagnosis (Orinstein et. al. 2014). I just don't care. No amount of evidence that an intervention can “help” me achieve a goal I don't have and rather explicitly reject is going to convince me to pursue that intervention, because it isn't evidence that the intervention can help me reach goals I do have. In fact, the imposed etic where outsiders presume my ideal outcome for mental health care is to stop being autistic, or at least act less autistic, contributes to my reluctance to pursue any mental health care. Even therapy meant for issues comparatively unrelated to autism gets sidetracked by this assumption, and also by assumptions about what it means to be mentally healthy that may not apply given that my natural cognitive styles are, by definition, not standard.

References

Allely, C. S. (2013). Pain sensitivity and observer perception of pain in individuals with autistic spectrum disorder. The Scientific World Journal, 2013(2013), 1-20.

Bhopal, R. (1998). Spectre of racism in health and health care: lessons from history and the United States. British Medical Journal, 316(7149), 1970-1973.

Fiscella, K., Franks, P., Gold, M. R., & Clancy, C. M. (2000). Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care. Jama, 283(19), 2579-2584.

Mio, J. S., Barker, L. A., & Tumambing, J. S. (2012). Multicultural psychology: Understanding Our Diverse Communities (3rd ed.) New York, NY: McGraw-Hill.

Orinstein, A. J., Helt, M., Troyb, E., Tyson, K. E., Barton, M. L., Eigsti, I. M., ... & Fein, D. A. (2014). Intervention for optimal outcome in children and adolescents with a history of autism. Journal of developmental and behavioral pediatrics: JDBP, 35(4), 247-256.

Theory of Mind Inside Out Note

I am (very slowly, partially because I've got a ton to do and partially because I have trouble with the way most philosophy-type academics write) piecing my way through Daniel Hutto's Folk Psychological Narratives. It's led to my writing thinky thoughts here before.

Well, I just found a paper that I think connects. It did, of course, study just the DMAB folks and is presumably going to be full of pathology language, but it talks about autistic people using more deliberative reasoning where we go through all the steps instead of stuff being instinctive. That paper is here: Reasoning on the Autism Spectrum: A Dual Process Theory Account.

Since Hutto's argument for why he thinks people don't typically reason out why other people acted as they did/attempt to explicitly figure out the mental states of others is that it'd involve more mental effort, and since autistic people tend to describe spending a lot of energy trying to understand the actions of others, I think we get a lot more practice at deliberative reasoning out of social interaction, which is then more tiring, but also since we have more practice at it we might use it more in other domains. 

Computers and Writing Session D5, Friday May 29 3:00-4:15pm, Disability and Universal Access.

I attended the Computers and Writing conference at University of Wisconsin-Stout. One of the panels where I took pretty good notes was session D5, Friday May 29 3:00-4:15pm, Disability and Universal Access. I'm now posting my write-up of the panel and my notes. 

Here's the nicer write-up, which I also added to the Digital Rhetoric Collaborative's Wiki. Maybe someone else will edit it with additional information, so that may not remain the same as what's below.

This panel began with Steven Hammer of Saint Joseph's University presenting on “The Sounds of Access: Disability, Art, and Open Source DIT (do-it-together) Interventions.” Hammer's presentation is concerned with Western art history and multimedia writing's tendency to ignore the perspectives and contributions of disabled people, and with the tendency towards a deficit model. He notes that after a diagnosis, there is a prognosis, which rather than simply describing what life will or could be like, it uses a presumed (and now unavailable) norm as a basis and describes how life will be different from that norm due to the diagnosis.

He suggests, rather than asking about how only certain people with certain diagnoses have bodies which are failing or considering how all bodies will eventually fail, asking “how are you failing right now?” He proposes that we consider the medicines we are taking to keep our bodies running every day.

With this question, however, Hammer mentions the risk that people will presume their experiences of bodily failure is equivalent to that of people with disabilities, who face oppression and marginalization based on their abilities in addition to the primarily practical concerns of keeping their bodyminds running.

Hammer then spoke about projects done together which use open source and glitch-theory methods to increase the accessibility of artistic production. One such project was his work on instruments for Arduino.

Hammer also drew a connection between Alexei Kruchenykh's idea of developing a language with no fixed meanings and his communication with his son, where the sounds are not words and the meanings might change from day to day.

After Hammer's talk, Samuel Harvey from Saint Cloud State University spoke on “Autism, Neurodiversity, and Identity Formation Through the Internet.” Harvey's talk covered the history of work on identity formation and on theory of mind, including the relations of these issues to autistic people. Noting that work on identity formation presumes that identity formation rests upon social interaction and the ability to understand what others are thinking (Theory of Mind,) and that autism comes with difficulties in social interaction, he asks what this would mean for identity formation in autistic people.

From there, he continues on to enthymemic dehumanization of people, particularly autistic people, where statements about identity formation, humanity, and theory of mind are made which logically lead to (never explicitly stated) denial of identity or humanity to marginalized people. The two primary examples Harvey notes are: 1) If identity formation depends on an understanding of what others think, or a theory of mind, and autistic people lack a theory of mind, then autistic people would be unable to develop an identity, and 2) If theory of mind is innate to humans, and certain groups are found not to have a theory of mind, that members of those groups are not human.

Harvey also notes issues with the current methods of testing theory of mind, primarily the Sally-Anne test, in that passing these tests depends on linguistic ability and upon cultural factors. He finds that rather than being innate to humans, theory of mind is innate to dominant groups, who use it as a tool of oppression to rob people of identity, agency, and personhood.

The third planned speaker for the panel, Annika Konrad of University of Wisconsin-- Madison, did not appear to speak on “Visually Communicating Visual Impairments.”

Liberty Kohn of Winona State University spoke third, on “Sound Pedagogy: Sound Art as Rhetoric, Poetic, and a Voice in the Composition Classroom.” He explored audio assignments, noting that while it is common to assign students to read multiple kinds of media, if students are not also writing multiple kinds of media they are not participating in a fully multimedia experience. He spoke about meta-language, and having students make versions of audio both including and excluding the meta-language in their assignments, and of the rhetoric of these choices.

In addition, he covered the idea of teaching non-musicians to produce audio in the classroom, as audio assignments are currently primarily the domain of people whose areas of study relate directly to audio. 

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Now for the less polished notes I took during the session:

Session D5: Friday May 29, 2015, 3:00-4:15, Disability and Universal Access themed panel.

Steven Hammer, “The Sounds of Access: Disability, Art, and Open Source DIT (do-it-together) Interventions”

Diagnosis, puts a thing on us.

Prognosis. Based on knowing that a person has a given thing. “What's life like based on what it could have been before.”

What does “no significant development” mean?

Asks, “How can we get beyond a deficit model?”

Amundon, 2000 “normal/abnormal is the basis of the deficit model.”

“human variation rather than pathology” Reid & Valle, 2004.

“[the] non-neutrality of techno-social artifacts and contexts... they are embedded... theya re not sterile, they're imperfect...” Cates 2014.

“from temporarily able bodies to always-already malfunctioning bodies” is on the presentation and he said it and I think that's original wording to Hammer. Also I like this wording.

Asking “how are you failing right now?” rather than the thought of this as “someday” your body will fail, think about the medicines you're taking.

Of course, we need to make sure people aren't concluding that they belong in disabled people's spaces because they have a headache or some such because that'd be fucked up.

Draws a parallel between Alexei Kruchenykh's idea of developing a language with no fixed meanings and his communication with his son, where the sounds are not words and the meanings might change from day to day.

The world is built for people who have an identity that is fucking fictional!

Samuel Harvey, “Autism, Neurodiversity, and Identity Formation Through the Internet”

Henderson, Davidson, Hemsworth, and Edwards 504?? Something Sam's citing.

“If identity is formed through communicating with others, and autistic people struggle with communicating with others...” [Ask Sam if I can see his slides after?]

Samuel brings up the possibility of written language as a discourse where autistic people could develop their identities.

Davidson 796. “NT conversations have a very fast-paces rhythym...”

Erikson+Cohen=> identity is formed by having a theory of mind.

First two publications of theory of mind, the titles are Does the X have a “Theory of Mind”?, with Chimpanzee and then Autistic Child. Erm erm erm.

Enthymemic dehumanization, leads to Autistic people not being able to have identities because we lack a theory of mind... yup.

Theory of mind innate in humans, bunch of folks don't, therefore those groups aren't human.

Yeargeau+Heilker state that autistic people have our own rhetoric and language, oh hey, that fucks up our test results in the area of language.

Halle and Tager Flusberg (2003), Lohman and Tomasello (2003) as cited in Miller.

Folks like to claim that language has no impact on the results of the test, which 1) Wrong, and 2) claims the test is arhetorical.

Tons of other factors wind up actually messing with theory of mind results. Whoops. Cultural stuff, socioeconomic stuff, linguistic stuff, and also quite a few kinds of neurodivergence.

Theory of mind is (maybe) innate in dominant groups, used to fuck over the disadvantaged groups.

“Theory of mind is innate in dominant groups, it is a tool of oppression meant to rob people (mostly autistics) of identity, agency, and even personhood.”

Harvey thinks theory of mind is a theory of the minds of dominant group members. That is, the folks who have a theory of mind don't actually have it about members of the groups said to “lack” a theory of mind.

What if autistic people guess other's mental states MORE?

I've been (slowly) reading Daniel D. Hutto's book, Folk Psychological Narratives: The Sociocultural Basis of Understanding Reasons. I say slowly because, well, it's slow. It's meant for people who are much more able to handle (and thrive on) philosophy jargon, as opposed to my sometimes ability to essentially liveblog it and hope that what I wrote out in what amounts to a liveblog in my own language sticks.

I'm only bothering at all because the ideas in the preface looked interesting, and I'm only able to at all because this one is better than most about using words I can understand and providing examples I can understand.

Right now, I want to talk about an idea that reading his stuff has let me work through a bit better. Here's some of the stuff from him that I'm looking at:

1. It makes sense to ask if we even seek to understand people using predictions and explanations anyways. “For one thing, it is not plausible that we could take a detached interest in the movements of all those we encounter, for to do so would surely sap our intellectual resources” (250.)
2. Hutto repeatedly points out that speculating on others reasons for their actions, even when we have evidence to support us, is unlikely to get us the right reasons, and that while the person's own explanation for why they acted isn't 100% foolproof, it's way more likely to be accurate than the guess is. I think I have this in my notes 3-4 times and I'm still on chapter 1 (and its endnotes.)
3. In some cases, a person's beliefs and desires could be sufficiently different from those expected that knowing what they were doesn't actually help make their actions understandable. It just moves the confusion from “Why did you do that?” to “Why would you think/want that?” In that case, further explanation, using cultural differences or individual differences, is needed to understand. (Paraphrase from a paragraph on pages 7-8.)
4. Stories can help us understand unusual actions: they can either show us why the reasoning behind an action is actually familiar or they can make it familiar. (Summary of a paragraph on page 8.)
5. “Sometimes the behavior of others is so erratic that we have no option but to regard those individuals in the same light as we do objects” (8.)

I think that covers the ideas and quotes I'm using for this bit.

Anyways.

Now for immediate responses I had to each of those things.

1. I've seen a lot of autistic people write that trying to understand what others are doing, trying to understand social situations, is exhausting. It's cognitively taxing! As an autistic person, I'm going to agree. Handling social situations does “sap [my] intellectual resources.”
2. And people insisting on taking that kind of spectator guessing without listening to the person's explanation when trying to explain the actions of neurodivergent people (my experience would be as an autistic person) is basically using this kind of logic. No wonder it doesn't go well! Folks, we already know it doesn't work that great when it's within the same culture and neurotype! (Grumble grumble theory of mind grumble grumble doesn't know what it's like to be themselves grumble grumble nonsense.)
3. Oh, you mean like people thinking big parties are fun? Or that strobe lights are fun? Or that fluorescent lights were a reasonable idea? Or one of any number of ways that sensory processing and general cognitive differences mean that people's wants could be different to the point of not being able to understand them.
4. Huh. So that's going to tie into representation stuff for all the groups ever. If there aren't stories about neurodivergent people acting for reasons that make sense to neurodivergent people, then it'll be harder for folks to understand the reasons neurodivergent people might have for doing things. Which goes back into thinking we're not understandable. I guess I'll keep writing fiction with autistic characters, especially protagonists, who don't die, get cured, or get sent away.
5. THIS IS NOT AN AUTISTIC PERSON SAYING THIS. THIS IS A PRESUMABLY NEUROTYPICAL ACADEMIC SAYING THAT WE SOMETIMES REGARD PEOPLE IN THE SAME LIGHT AS OBJECTS. Now that that's been established:
   1. The reason given that we would do so is when their actions are super-duper not understandable to us. Super-duper not understandable, not even a little bit sense-making.
      
      
   2. Isn't it people in privileged and majority groups who tend to have trouble seeing members of oppressed and minority groups as human? And the stories are about the people in the privileged and majority groups, so... yeah, actually this totally fits.

Now, I have some connections between the things!

Hear me out.

What if it's not that autistic people have some sort of inability to use folk psychology or theory of mind or any of those other things? What if it's that the reasons for doing things that make automatic or near automatic sense to autistic people are sufficiently different from the ones that make automatic or near automatic sense to neurotypical people that we have to resort to those kinds of guesses more? Then we run into the fact that no one is actually very good at those guesses.

And what if we resort to those guesses because the reasons that make sense to the dominant neurotypical culture are supposed to be “obvious” and we get laughed at (and probably still not answered) when we ask?

What if the idea that autistic people see others as objects... is because that's what most people do, at least a little bit, when their actions are super-duper impossible to understand, and the differences aren't being explained in ways that make sense to us? (I mean, also autistic people generally don't actually think of other people as objects.)

What if the exhaustion that autistic people often have trying to do social things is because, unlike people who are close enough to the mythical exactly average neurology that these expectations can be picked up by osmosis, we do have to use the kind of prediction and explanation that Hutto was arguing against on page 250, and he's right that the problem with doing that is exhaustion?

What if a willingness to explain the reasons and cultural underpinnings on the neurotypical side, and a willingness to listen to the neurominority-side explanations, could go further to solve the supposed lack of theory of mind or inability to use folk psychology (different things according to Hutto, and both things that I think aren't what's going on) than any amount of “therapy” to teach those skills ever could, because those skills weren't what was missing?

And by what if, I totally mean that I think those are what's going on. And I know other neurodivergent people have thought of a lot of these things before, but I think the specific way of looking at it through Hutto's ideas of folk psychology stuff and challenging how the neurotypical folk do things might be new. Also the turning theory of mind upside down and saying that  maybe we resort to that more, and that since it's not that reliable for anyone, that's part of where social differences are coming from. (Which would make the social differences a lot less "core" to autism than they're usually treated as.)

Work Cited

Hutto, Daniel D. Folk Psychological Narratives: The Sociocultural Basis of Understanding Reasons. Cambridge, MA: MIT, 2008. Print.