Background to my interest in teaching children with autism

PSYCHOTHERAPY BEYOND THE FRINGE, continued

            The usual EEG report is barely two short paragraphs long.  This report was almost two full single‑spaced pages of typing.  In it, the neurologist indicated that the patient was subject to psychogenic narcolepsy which could be provoked by asking him to consider almost any subject concerned with dirt.  Moreover, a high level of arousal could be evoked in the patient by asking him to consider either his own death or performing a faux pas in public.  The neurologist recommended a trial of treatment with Ritalin and offered a prescription for Alton with the report.

            In the utterly trite jargon of medicine, narcolepsy is just a big word for sudden onsets of narcosis or sleep, or of a lowered level of consciousness.  Sleep is brought about by the activation of the sleep centre in the brain, sometimes, quite suddenly, by a temporary short‑circuit (electrical activity spreading across nerve fibres), such as occurs in epilepsy.  That suggests the use of the composite word: ‘narco-lepsy’.  The term describes a symptom — of sudden onsets of sleep.  Similarly, ‘psycho-genic’ just means that the condition is generated, and the response evoked, by a (‘non-physical’) psychological or mental state.  Ritalin is a chemical which arouses the person — keeping the brain awake so it is harder for the person to go to sleep.  Let’s demystify some of medicine: Ritalin is used to keep people awake when their brains want them to go to sleep.  So the neurologist’s report agreed that Alton tended to lower his level of consciousness, or to go to sleep, when he thought about dirt.  And thinking about dying or about shocking others tended to upset or excite him, and perhaps wake him up.

            Did the neurologist’s report confirm Felicity’s strange hypothesis?  It did not.  It only provided what psychologists call consensual or concurrent validation for the first part of the sequence of events hypothesized or guessed to be involved in Alton’s homosexuality.  That is, the neurologist had made the same observations Felicity had made.  The neurologist had made his observations with the help of a machine – in this case, the EEG; and Felicity had made his observations with the help of a psychological test – in this case, the Rorschach.  Both had simply noted that Alton tended to fog out or go to sleep (perhaps due to acute discomfort) when thinking about dirt.  His indelicate opening remark, when he and Felicity met, had indicated the same kind of thing.  As Felicity later discovered, Alton considered homosexual acts, such as anal intercourse, to be dirty and disgusting.  And,  presumably, he had expected Felicity to ask him to describe his homosexual activities as part of the clinical inquiry.  So it seems likely that he was thinking about ‘dirt’ as he entered Felicity’s office.  If so, and if Felicity’s hypothesis was correct, his thoughts may have triggered off a lowered level of alertness, so that he lost normal socialized control over what he said.    

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