Straight “A”s

Autism spectrum disorder, aphantasia—and anxiety

In the middle of last year, I asked my GP to refer me to a specialist to see if I had ASD (autism spectrum disorder). It first crossed my mind that I might have Asperger’s (as I would have thought of it at the time) when I read The Curious Incident of the Dog in the Night-Time, around about 2004 or 2005. I didn’t do anything about it immediately. In 2006, I found a questionnaire online that measures Autism Spectrum Quotient (AQ). I completed the questionnaire, and learned that my AQ at that time was 28. The Autism Spectrum Quotient isn’t intended as a diagnostic tool, but I understand that an AQ below 26 effectively rules out the possibility, whereas one of 32 or more suggests that it’s something to be looked into. An AQ in the range 26–31 is said to give “a borderline indication of an autism spectrum disorder.” It may indicate that the person has some of the characteristics of autism, but not so many as to lead to a diagnosis of the condition. (I haven’t included any references in this paragraph: your Google results will be as reliable as mine.)

So, I left it at that until last year. At my request, my GP referred me to a psychologist, with whom I had 13 weekly hour-long sessions. The psychologist didn’t say in terms that I don’t have ASD but it was clear to me that she thinks it unlikely that I do. What she did say is that it’s very difficult to test for ASD in people of my age. So, the upshot is that I more than likely don’t have ASD, though I may have some autism-like characteristics. I know that I have a pronounced tendency not to meet the eyes of somebody I’m speaking to and an inability to “read” people’s demeanour. I’ll often put a lot of effort into arriving at a literal interpretation of what a person is saying, without paying any attention to the context or manner in which it’s said. So, I think of myself as being not “on the spectrum” but perhaps somewhere on the approach road to it.

Something that became very clear in the course of my sessions with the psychologist is that ever since childhood I’ve suffered from persistent anxiety which has, at several times during my life (and sometimes for long periods), affected my work, my relationships and my way of interacting with the world in general. My mother also suffered badly from anxiety and it seems likely that I “acquired” (learned, and also possibly in part inherited) this trait from her. But how is it possible that I lived to the age I am, without consciously realizing that anxiety has played such a large part in my day-to-day existence? I think it’s because anxiety is closely related to fear, and most of us aren’t ready to admit that fear has so much power over us.

So, at varying times, I’ve blamed my inactivity or my avoidance of stressful situations—my general lack of energy—on depression, or laziness or simple bloody-mindedness or boredom or, during the last 14 years, on putative ASD. None of these explanations seemed quite right. I knew I wasn’t depressed, didn’t really believe I was lazy (though I showed every external sign of being so). But now that, with the therapist’s help, I’ve identified the problem as anxiety, I feel a great sense of recognition and relief. I don’t really want to say any more about anxiety at the moment, except that from now on I’ll be concentrating my attention on getting to grips with it.

The third “A” that I want to talk about is aphantasia. I read Blake Ross’s story in Vox two years ago and, like him, had this extraordinary, “mind-blowing” sense of revelation. Not only do some other people have “pictures in their minds”: if this is to be believed, it seems that most people do. I found this really quite exciting but I more or less ignored it because I didn’t really believe it to be true. When people spoke about a mental image, or “picturing” a face or a place, they were surely using figurative language. It wasn’t that their brains worked differently from Blake Ross’s or mine, it was just that we were interpreting the language they used too literally. So I bookmarked Ross’s essay, meaning to get back to it eventually and this week, nearly two years later, I did.

And, on second reading, it seems that it’s all true. People — most people — can “see” a loved one’s face or a favourite place in their “mind’s eye”. It’s hard to describe how amazing I find that. I’m used to the idea that concepts, thoughts and memories just don’t work that way, and it’s not easy for me to overcome that ingrained assumption. Now a lot of things that used to puzzle me in films and tv shows—like Sherlock’s mind palace or the police sketch artist who manages, by some magic, to draw a picture of the suspect from the victim’s memory—no longer seem (entirely) like ludicrously implausible genre conventions. I’m still coming to terms with this but I’m tickled pink to learn that thought and memory are more graphic and exciting than I’d ever believed they were.

Unlike my imagined ASD or my very real anxiety, aphantasia isn’t directly causing me any discomfort or making my life more difficult. I suspect it means that I’ve a slightly worse memory — for some things at least — than the majority of people. I have very few memories of childhood and I was astonished recently to learn how much one of my sisters can remember. I expect it’s a little easier when you have the illustrated version.

I didn’t mention my aphantasia to the psychologist: it just wasn’t at the forefront of my mind when I was speaking to her. A few days ago, it occurred to me that it might conceivably have something to do with ASD — I suppose I’m not quite ready to give up the idea completely — so I Googled “correlation ASD aphantasia”.

As you’d expect, there are some people who have both conditions and, understandably, some of those are inclined to believe that there’s a connection between the two. But it seems that the question hasn’t been studied in detail and, from what I was able to find on Google, it doesn’t look as if any correlation has been found.

So, apart from the pleasing coincidence of their initial letters, why do I mention aphantasia at all in the context of ASD and anxiety? When I started to write this, I didn’t have a good answer to that question, but one occurred to me while I was editing it. Is it possible that the inhibiting effect of anxiety on my actions has been reinforced by the fact that I don’t “visualize” (or, to put it more neutrally, “imagine”) a satisfactory outcome to those actions? After all, it’s hard to remain focused (perhaps even metaphorically) on a goal or aim that isn’t visible.

“Where do you see yourself in 5 years?” has long seemed to me a pointlessly cruel question, a typically sadistic mind-game (which is to say a power game) devised by management consultants. I don’t see myself in 5 years’ time: I don’t see myself at all except when I look in a mirror or catch a glimpse in a shop window.

So, have my apparent aimlessness and my recurring lack of focus anything to do with my aphantasia, or am I asking a purely metaphorical sense of “visualize” to bear much more weight than it can support? I really don’t know. I think it’s a possibility worth considering, so I’m going to consider it. And in the meantime, I’ll work on my anxiety.

Update: My posts on the topic of aphantasia have been developing into an accidental series. Here’s a full list, which I’ll update if and when I add further posts.

I’ll delete Medium profile end June 2021, then these posts will move to my own site: https://www.artkavanagh.ie |Newsletter: https://talkaboutbooks.substack.com

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