The Man Who Wasn't There: Investigations into the Strange New Science of the Self (22 page)

Susan and Roy recalled the first time they realized that something was amiss with the way their son, Alex, was acting around other people. It was his second birthday. Relatives and friends had come to their home to celebrate. Alex was the center of attention, except he didn’t seem to want it to be so. “He was running out into the street, onto the sidewalk,” Roy told me. “I had to drag him back in. I clearly remember most of the guests looking a little confused.”

But even before that incident, it was obvious that the little boy was hypersensitive to sounds and touch. “You couldn’t hug him a lot,” said Susan. He’d only wear soft cotton clothes, with the tags removed, because the tags irritated him. Loud sounds were anathema: he’d often cover his ears and show clear distress. Even his food had to be bland and without too much texture (nothing chewy or crunchy), or he’d gag over it. All this led to an initial diagnosis of sensory processing disorder. There were hints, however, that Alex was dealing with more than just tactile and auditory hypersensitivity.

Even before his second birthday (which was the first big wake-up call for Roy and Susan), a health-care worker had come to do a wellness check on their son. Alex had a collection of dozens and dozens of toy cars. “The minute she came in and saw that he had lined them up in a
straight line, it’s like some red flag went up for her,” said Roy. If anyone disturbed Alex’s particular arrangement of cars, he’d get upset.

However, he wasn’t proprietary about his toys. Most children start developing a sense of ownership of their toys, but Alex didn’t display this tendency. “He just never had that,” said Susan. “Anybody could come play with his toys; anyone could take something away.” Alex was also diagnosed with expressive speech delay. While his language skills and comprehension were age-appropriate, he didn’t talk much about his emotions and feelings (he didn’t say, for example, “I feel happy, or mad, or sad,” said Susan) in the same way that most kids his age would.

Meanwhile, teachers at his preschool were noticing Alex’s anxiety. For instance, when the kids would be sitting in a circle, awaiting their turn to answer a question or talk about something, Alex would start getting nervous as his turn neared. He’d bite his nails and rock back and forth. Eventually, Alex was diagnosed with PDD-NOS, a subtype that has since been subsumed into the larger autism spectrum disorder in DSM-5.

By the time he entered elementary school, his preference for aloneness manifested itself on the playground. “He was a very solitary person. The whole playground would be full of screaming kids playing with each other, and he’d be off by himself, not playing with anybody, not interested in playing with anybody,” said Roy. “And that was a major thing, because all the teachers would notice it, and it’d come up in the yearly discussions we had.”

After years of various kinds of therapies (speech, physical, and occupational), which all parents of autistic children are well aware of, Alex has come a long way. He’s sharp academically, and has developed a keen interest in sports. “He’s a popular kid; he’s very affable, very kind, he’ll never bully anybody,” said Susan. “Because he is bright,
often kids come to him and ask him for help with math and things. He shows no attitude. He’s generally very, very well liked whichever class he’s in.”

Yet, said Roy, “He doesn’t have any close friends, even now.”

Alex seems to regard everyone the same. “If you are talking to kids, they’ll say stuff like, ‘This kid is better than the others,’ or ‘This one is kind,’ or ‘This one is good,’ or ‘I like so-and-so more than I like this one,’” said Susan. She doesn’t see this in Alex. “He’s not very reflective about what he’s done, or what others have done. He’s not discerning in that sense. Pretty much everything is fine with him.”

For Alex, and many kids like him, this has implications for the way they function in society as they grow up. Alex is part of a group that takes part in social language therapy. One of their field trips was to go to a shop and order something. This meant discussing scenarios over and over: asking for something, anticipating what the man behind the counter might say, replying to the man, giving money, receiving change, and so on. “Stuff that you and I would pick up by inference, and know how to handle, these kids have to be taught,” said Roy.

Stuff that you and I would pick up by inference . . .
What are we inferring? We are inferring the mental states of others; we are reading minds. By the mid-1980s, child psychologists began coming up with simple tests to determine when children begin showing an ability to peek into, in a manner of speaking, someone else’s mind. This ability is called theory of mind (ToM). What can autism tell us about theory of mind? And do we need a theory of mind to understand our own minds, our own mental states? Is a theory of mind necessary for a sense of self?

Psychologist Alison Gopnik has a unique way of getting people to appreciate the idea of theory of mind. Imagine a room full of people. Look around. What do you see? Aren’t you seeing things that are “bags of skin that are stuffed into pieces of clothing and have little dots at the top that move back and forth and a hole underneath?” Do we see people as these inanimate objects? Of course not. “That’s mad, that’s crazy,” said Gopnik, when I visited her at her office at the University of California, Berkeley. “You never see other people that way. You see them as psychological beings.”

That means seeing people as entities that have minds. We are constantly inferring what’s going on in someone else’s mind, to understand their behavior, intentions, and desires as well as to predict what they might do next. In a sense, we are constantly theorizing about other people’s mental states. We have a
theory of mind
. It’s this ability that underpins human social interactions. But is this ability something that we are born with? Or does it develop over time? In other words, is there a stage during development when a child clearly acquires this ability?

In 1983, two Austrian psychologists, Heinz Wimmer and Josef Perner, published a paper on how to test whether children have a theory of mind. Their paper began with a quote from a book on artificial intelligence:

A travelling salesman found himself spending the night at home with his wife when one of his trips was unexpectedly cancelled. The two of them were sound asleep, when in the middle of the night there was a loud knock at the front door. The wife woke up with a start and cried out, “Oh, my God! It’s my husband!” Whereupon the husband leapt out from the bed, ran across the room and jumped out the window.

We have to ask, were both husband and wife in the habit of being unfaithful? Wimmer and Perner were discussing the idea of false belief. What was the wife thinking? Why did the husband jump out of the window? Attributing a false belief to another person is being able to infer that what they are thinking does not tally with reality as you know it. For instance, did the wife think it was her husband knocking at the door, and did the husband infer that his wife was thinking such thoughts, even though he was lying next to her? While that doesn’t explain why he jumped out of the window, at least it illustrates the idea of false belief. And being able to figure out someone else’s false belief is a clear indication that you have an insight into their state of mind, that you have a theory of mind.

Wimmer and Perner wanted to test whether children could attribute a false belief to another person and then predict what the person would do. They carried out a series of ingenious, if somewhat involved, tests and showed that children developed this new skill—of reading minds—between the ages of four and six.

Meanwhile, at the University of London, Alan Leslie, a postdoc with developmental psychologist Uta Frith, was looking for evidence of theory of mind in another seemingly innocuous childhood activity: pretend play. Leslie argued that newborns have an innate ability to model the world around them—an accurate internal “primary” mental representation. But this ability cannot explain pretend play, such as pouring pretend tea from a toy kettle into a toy cup. Such pretend play requires a child to be able to do two things: have a primary representation of actual reality and another for the made-up world. Leslie called pretense the “
beginnings of a capacity to understand cognition itself”:

It is an early symptom of the human mind’s ability to characterize and manipulate its own attitudes to information. Pretending oneself is thus a special case of the ability to understand pretense in others (someone else’s attitude to information). In short, pretense is an early manifestation of
theory of mind
.

And evidence was mounting that children with autism, especially those whose autism was severe, did not indulge in pretend play or fantasy (unlike, say, other children with intellectual disabilities, such as Down syndrome, who can pretend play, although they are slow to reach that stage of development relative to normal kids).

I asked Roy and Susan whether this had been true of Alex as he was growing up. “Oh, totally,” said Susan. “He played with his trucks and games and all, but that constant narrative of [pretending that] ‘I’m this and I’m going to be this or that’—absolutely not.”

It was such evidence of lack of pretend play that led Leslie to posit that autistic children should show an impaired theory of mind, but not so children with Down syndrome. In 1985, Simon Baron-Cohen, with his PhD adviser Uta Frith and Leslie as co-supervisor, devised a simpler, more elegant version of the Wimmer and Perner experiment to test theory of mind in autistic children. It was called the Sally-Anne test, after the two dolls that were used to enact a scenario, which went like this:

Sally has a basket. Anne has a box. Sally has a marble, which she puts into her basket, and goes out for a walk, leaving the basket behind. When Sally’s away, Anne takes out the marble and puts it into her box. Sally comes back into the room and
wants to play with her marble. Where will Sally look for her marble?

If you answered “Anne’s box,” then you have failed the false-belief test—because you think that what’s in Sally’s mind is the same as what’s in your mind. If you answered “Sally’s basket,” then you have passed—you are able to peek inside Sally’s mind (she should look in her own basket, because she could not have known of Anne’s duplicity).

As predicted, children with autism (with a mental age above four years) struggled with this task—they were more likely to answer “Anne’s box”; whereas typically developing children and those with Down syndrome were more likely to answer correctly. This suggested that the
autism involved a specific deficit of theory of mind.

By 1988, Alison Gopnik and her colleagues, working with typically developing children, showed that theory of mind and tests of false belief could illuminate something deeper about the very essence of self-awareness: that the ability to know our own mind is related to the ability to know another’s mind.

They showed a group of three-to-five-year-old children a closed box of candy. However, when the children opened the box, they were surprised to find pencils inside instead of candy. The box was then closed and the children were asked a series of questions that were designed to test whether they knew that their current knowledge (or mental representation) of the contents of the box was different from what they had thought the box contained before it was opened. While the five-year-olds remembered that they had earlier harbored a false belief about the contents of the box,
the three-year-olds forgot that they once had a false belief that the box contained candies, not pencils. As far as they were concerned, the box always had pencils. The
experiment had tested the children’s ability to recognize false beliefs, except in this case it was the child’s own false belief at an earlier time.

It’s intriguing that the ability to read another’s mind and the ability to discern what had been in one’s own mind in the past both develop between the ages of three and five. “There is a very strong correlation between what children say about the other person and what they say about their own past self,” Gopnik told me.

Baron-Cohen studied children with autism using similar experiments, the results of which were published in a paper provocatively titled: “Are Autistic Children ‘Behaviorists’?” The experiments essentially tested children to see if they could distinguish between the physical appearance of an object (something that looks like an egg) and the knowledge about its real nature (upon touching, the egg turned out to be made of stone, and only looked like an egg). This so-called Appearance-Reality (A-R) experiment involved seventeen autistic children, sixteen mentally handicapped children, and nineteen clinically normal children (all children had a verbal mental age of at least four years). Baron-Cohen argued that this ability to tell apart appearance from reality was a test of how aware the children were of their own mental states.