The Real Cause of Autism

organic foodMy friend Kit Stolz, who writes a great blog having to do with climate change (www.achangeinthewind.com), sent me the following link, which I really love: http://io9.com/on-correlation-causation-and-the-real-cause-of-auti-1494972271

It clearly demonstrates the real cause of autism, and deals with the issue of causality versus correlation, which as those of you who have been reading my blog posts for a while will know, is one of my favorite topics. The comments on this very short piece are almost as entertaining as the piece itself.

The Dead Man’s Test

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Ever wondered how to pass the Dead Man’s Test? The Dead Man’s Test is a simple procedure developed by Ogden Lindsley back in 1965, when Sam the Sham was singing Wooly Bully and the Beatles’ incomprehensible film Help! was playing in movie theaters. The test is designed to determine if something can be categorized as behavior, which may not seem important to you, but is very important to people who seek to analyze it. Here is the test, paraphrased slightly:

If a dead man can do it, it ain’t behavior, and if a dead man can’t do it, then it is behavior.

What, you might be wondering, exactly is it that dead men CAN do?

For one thing, they are very good at being quiet for long periods of time. Dead men are also very good at keeping secrets, which may have something to do with how they get that way. But mostly, what they are very good at is NOT doing things. My father’s second wife used to say that if you want to get something done, ask a busy person to do it. But the reverse is even more true: If you really DON’T want to get something done, then ask a dead man to do it.

This turns out to be the major point of the dead man’s test. Naïve behavior analysts sometimes make the mistake of trying to study the lack of behavior. They do this by saying such things as “I want to find out how often Johnny doesn’t have tantrums,” or “How often does Jeffrey refrain from using swear words?”

Dead men are exceptionally good at not using swear words. Studying the lack of cursing, therefore, doesn’t pass the dead man’s test.

There are times in our lives when we wish to emulate dead men. For example, dead men rarely eat sweets, red meat, or fried food. In that respect, I admire dead men and would like to be just like them. They don’t hurt other’s feelings, especially after they’ve been dead for a really long time. And they rarely make big mistakes in the stock market. They don’t appear to be highly conflicted, and don’t seem to worry about small things, like whether or not they forgot to zip up their zipper. The list, obviously, goes on eternally.

The Dead Man’s Test can help us become more effective at what we do, because it stresses the difference between substance and absence. Humans have proven over the millennia to do a better job at adding to their behavioral repertoire than decreasing it. In other words, it is easier to learn new tricks than to rid ourselves of the old ones. So, for example, rather than tell yourself to stop watching TV (dead men can do that), tell yourself to read another chapter in the book you are reading. Rather than tell yourself to stop eating sweets (dead men don’t eat sweets), tell yourself to eat more vegetables. Rather than tell your business partner to stop complaining about her ex-husband (dead men don’t complain), tell her to spend more time talking about novel marketing ideas.

Now you know how to pass the test.

Why Fly?

images-5In teaching family therapy, I used to say that “Why” was a four-letter word, not because it starts with a double U, but because when most people are asked why they do the things they do, they feel attacked. Furthermore, when asked why someone does something, the expected response is to give reasons, and reasons are rarely helpful.

That is a popular position among certain strains of therapists, and very unpopular among others.

Psychoanalytic therapists really like reasons. It is the playground in which they spend years and rack up significant contributions to their retirement accounts. Behaviorists tend to abhor reasons, instead focusing on the how of things as opposed to the why. That’s one reason I like behaviorists, because like most guys I like to fix things, and why things are broken isn’t nearly as important as how they are broken. (The fact that you threw the toaster across the room because you were mad as hell won’t get the toaster fixed, but knowing that the spring came loose when it hit the wall will tell you how to fix it. Okay, so it won’t stop you from throwing the toaster again, but that wasn’t the problem you came to me with.) Cognitive therapists like reasons, but principally so that they can change them. I like that, because very often change is good, leading to a reduction in suffering. But of course, change isn’t always good, because sometimes we try to change the wrong things.

Reasons, to me, are a little like medication: they have their place, but hopefully, their main function is to stop using them.

Now, if you are blessed with being in any sort of intimate relationship, you have no doubt been asked the big question (or have asked it yourself): why do you love me? You know that that is an unwinnable question, that any answer you give is going to get you in deep trouble, so you undoubtedly have learned to avoid it. The truth, of course, is that there is never any good reason to love another person, because love, like faith, is beyond reason. Ultimately, honey, I love you just because I do. That’s it. End of story, as my dad would say.

Fortunately, very few people have asked me why I fly. At least most of my friends know better. If you did ask me why I choose to risk my dear life and spend ridiculous sums of money burning fossil fuel just to get above it all I would end up giving you some sort of dumb-ass lecture about mastery and competence and bore both you and me to tears. But if you asked me how I fly, you will see me light up and we both might learn something in the process.

And Who Dies?

images-1More than 150,000 people will die today, according to the CIA (and who better to get our statistics about death from?). I think about dying almost as much as that other thing men think about practically all the time. And frankly, I don’t really understand people who don’t.

In “A Year to Live,” Stephen Levine gives an account of how he lived a year of his life as if it were the last: “One of the first beliefs we come across is that the only reason we imagine we will die is because we are convinced we were born. But we cannot trust hearsay! We must find out for ourselves. Were we born? Or was that just the vessel in which our timelessness momentarily resides. What indeed was born? And who dies?”

What was born? Who dies? Jeez Louise. The conclusion, I suppose, is to question whether that bag of bones we call our selves has anything to do with the essence of who we really are. We are, Levine suggests, timeless.

This is a compelling thought, because I have wrestled with the notion of time almost as much as I have wondered what my life would have been like if I wasn’t born with this terrible nose. Time, I have suspected, is the construct that grants our non-corporeal souls the illusion of mortality. Yup, I really meant to say mortality, because that is the illusion at least as much as immortality is. (I am not a big fan of Newtonian time, which suggests that there really is such a thing. I am closer to Kant, and think that time is primarily that thing that humans create to aid their quest for survival. Sequencing events allows us to predict more accurately, and the more accurate our predictions, the more likely our arrow will end up in the bison.)

As I age, I cling more to life than I did when I was younger and had more of it left. That thing I cling to, of course, is my corporeal life, because as much as I might believe in an afterlife, I don’t know whether it is going to look more like Tahiti or Detroit. And that clinging is certainly a bad thing, because sooner or later I am going to have to let it go, and I am so ill-prepared.

There was a very brief reality TV series back in 2006, an American adaptation of a British series called “The Monastery,” in which a group of 5 men from LA was sent to live in a Benedictine monastery in New Mexico. In one episode, the men were taken to visit the hermit, which was a very honored role within the monastery. One of the LA businessmen asked the hermit what he did all day, and the hermit said incredulously, “preparing to die.” The businessmen looked at each other, puzzled, and one of them finally said to the hermit something to the effect of, “Doesn’t that seem like a waste of time?”

To that, the hermit responded crisply, “I can think of nothing in life more important to do.” The LA businessmen chuckled uncomfortably. Maybe they had more important things to do.

Lacking Perspicacity

In the mid-70’s, a blind, retired neurosurgeon came to my office in Westwood with a profound dilemma. He had been happily married all his adult life, and just before his wife died about 7 years earlier, she made him promise never to kill himself. She knew their love was the thing that sustained him, and knew he would want to end his life when she was gone. He reluctantly agreed to the promise, but now, seven years later, unable to do surgery or even to teach, his depression was intolerable and he no longer wanted to live. He was caught between his promise to his wife and his passionate desire to die in order to escape a life that became meaningless, lonely, bitter, and exquisitely painful.

I did what a novice therapist might do in such a circumstance, which was to offer some words of encouragement, explore other possible ways to find meaning in his life, but was mostly flummoxed. I talked to my supervisor, who wondered along with me why this wealthy, highly successful neurosurgeon would seek therapy in the first place from a young inexperienced man in his twenties, but offered little else that I could grasp. I did in fact discuss this very thing with the patient, but he didn’t reveal how he got my name or why he chose to see me. I offered him the opportunity to see someone else, but he declined.

At the end of the second or third session, which was to be our last, the patient dismissed me, telling me I did not help him at all, and that I lacked perspicacity. I didn’t know what that meant, although after I looked it up that night I never forgot the meaning. Of course, in retrospect, he was absolutely correct.

Over the years I have thought about that man often, wondering if he went home and injected himself with the combination of drugs to which he had easy access and that would end his suffering. But mostly I think of things I would have said and done differently, and wish, as I have about so many other things, that I could do that one over with the knowledge I have now.

I can never know that if I were to face that blind neurosurgeon for the first time now, with the nearly 40 years and many thousands of hours of experience as a therapist behind me, I could say the right words and offer the right guidance that would effectively ease his suffering. I know that I would approach it differently, but that is all I know.

What I lacked the perspicacity to know in my mid twenties as I sat across from that blind neurosurgeon was that I too I am that blind neurosurgeon, and most likely so are you. Those of us who love deeply also suffer deeply. Those of us who pledge ourselves to a path will meet crises along that path that will feel too big to bear, and those of us who insist on having hearts will have them broken. The suffering that allowing ourselves to feel alive inevitably brings with it is not the thing to be feared; it is life itself.

Yesterday, on my sixtieth birthday, my daughter asked me what the positive aspects of turning 60 were. I was ashamed that I couldn’t think of any, and in her characteristic way, she offered, “Well, at least you’re not 70.”

In the moment, I lacked the perspicacity to tell her that it was being there, with her and the rest of my extraordinary family that was most valuable about turning 60. Maybe, if I make it to 70, I will gain the perspicacity to treasure each moment as if it were the last. Maybe not.

The Last Day of Your Life

UnknownOn a dusty street in old Bakersfield at sunset, a round-bellied alcoholic stumbles out of a bar. On the street, he is greeted by a sober alcoholic who just left his 12-step meeting. Eyeing his fellow inebriated alcoholic, the twelve-stepper confronts him: “You need to admit that you’re helpless over your alcoholism. Take it one day at a time. Today is the first day of the rest of your life.”
The fumbling alcoholic pulls a revolver from his waist, points it somewhere in the vicinity of the good Samaritan’s face, and says, “It may be the first day of the rest of my life, but buddy, it’s the last day of the rest of yours.”
If I were an alcoholic, believing that today is the first day of the rest of my life, as AA and the bumper stickers would have you, might not give me the encouragement I needed to stop drinking. I would most likely think, hell, I have my whole life ahead of me, why stop drinking now?
When I wake up I prefer to think that today is the last day of the rest day of my life, because as I get older the probability of that being true increases. If I were an alcoholic, that belief wouldn’t stop me from drinking either, because if it truly was my last day and being drunk was a preferred state, I might choose to spend it that way. I certainly wouldn’t want to spend it checking into rehab. But fortunately, I do not seem to have inherited the alcoholism set of genes (nor had my parents or grandparents), so in reality I would prefer to spend my last day sober and as conscious as possible.
Waking up believing that today might be the last day of my life has some beneficial effects. First of all, if it ends up not being true, I end each day thinking that somehow I cheated Death. If I am going to cheat anyone and get away with it the one I would most want to cheat is Death. There’s a sweet thrill in that. Second, and most obvious, thinking that each day might be my last allows me to make certain choices: I will choose to do those things that I would most regret not having done before my porch swing years (ok, maybe I am already there). And last, it imbues each day with a precious quality.
Ultimately, I cannot argue with the 12-step phrase that today is the first day of the rest of your life. It is actually one of those cute little mathematical tricks. Even if it were the last day of your life, it would still be the first day of the rest of your life. It just may not end up being a very long day. It is, of course, all a matter of attitude. If any day were the last day of my life, and it was lived well, it is going to be a nice day to die.

Snow Falling in Armenia

Sunday morning in Yerevan

Sunday morning in Yerevan

I woke up this morning to the shocking beauty of snow falling outside the window of my hotel in Yerevan, Armenia. I am not talking an occasional snowflake, but a major snowstorm, with six-inch thick piles on the balcony ledges. Now, as I sit in the hotel restaurant, I see just a few people outside on what would normally be a bustling Sunday morning, trudging through foot-deep snow. I had planned to spend the day showing my wife some of the sights around Yerevan that have changed in the 7 years since she has been here. But I think instead we will be spending the day inside.

I have been to Armenia so often that I needed extra pages added to my passport, and in fact am now the proud owner of an Armenia residency passport. It feels like home away from home for me. When I tell my Armenian friends who live here how much I love it, they tell me “that’s because you can leave.” Touché.

Yesterday I spoke on “Inclusion: Best Practices” at Yerevan State University. The chair of the psychology department, in typical Armenian fashion, welcomed me warmly, and I owe a debt of appreciation to Narine Vardanyan, the director of International Child Development Center, for planning and executing the SRO presentation. I believe Shant TV even was there; it’s not difficult to make the evening news in Armenia.

For readers who don’t know it, Armenia is a tiny country, the size of the state of Maryland, with a population of under 3 million. It is a country with a proud, ancient history with archeological evidence of civilizations here dating to before the Bronze Age (4000 BCE), although the kingdom of Armenia officially began after the fall of Urartu about 500 BC, give or take a hundred years. The kingdom of Armenia was once huge, stretching from the Mediterranean to the Caspian and Black Seas, encompassing all of what is now Syria, huge parts of Turkey and Iran. In 301, it became the first nation-state to officially declare itself Christian, making the Armenian Apostolic Church the oldest state church in the world.

More ethnic Armenians live in the diaspora than in the country itself, not unlike Jews. Largely due to their location on critical trading routes, and also because of their religion, they have been associated with the “merchant class,” and have both benefitted and suffered as a result. During the Ottoman Turks’ conflict with Russia in the early twentieth century, amid fear that the Armenians living in the area would side with Russia along with widespread racism, the Turkish military systematically murdered, raped, marched and starved a million Armenians. And, just as there are rabid Holocaust deniers spreading inane ideas on the internet, there are those who deny the extremely well-documented genocide of the Armenians.

Another similarity between the culture from which I came and the Armenian culture is the strong emphasis on education and the arts. 99% of its population is literate, and the list of prominent Armenian singers, scientists, politicians and artists is wildly disproportionate to their numbers.

But this list of facts is hardly relevant as the snow continues to fall on the buildings and streets of Yerevan. In the next week I will continue to observe staff, meet with government officials and other stakeholders in order to promote partnerships in continuing the success of the school for children with special needs that, at the behest of a small group of caring and courageous parents, began here almost a decade ago. In that time we grew from a core group of just a few students to treating over 80 children today. If we can successfully raise the needed funds, we will soon move from a crowded, converted apartment to our own facility. The continued survival of the school and its remarkable growth is a testament to a group of parents trying to do the best for their children, but mostly to the incredible dedication and hard work of our loving and talented staff. Apres!DSC00501
For more information about the school in Armenia, see www.autism.am

Air Hollywood: Flying the Friendly Skies

brace positionThe tagline for this blog begins with the words “aviation” and “autism,” and to say the least it is difficult to find ways of integrating the two topics.   A company called “Air Hollywood” has now made it easy.

Air Hollywood is not an airline per se; it is, as their name might suggest, kind of a fictitious, Hollywood airline.   Their business focuses on providing sets for the entertainment industry, including interiors of any kind of airplane you can imagine, cockpits, terminals, gates, etc., as well as stock footage and almost anything imaginable that is needed for movies and is aviation-related.   You have seen their work in films such as “Flight,” “Wolf of Wall Street,” and “Kill Bill” as well as hundreds of others.

Recently, Air Hollywood took on a new project.   They have decided to offer classes on preparing children and adults for the entire commercial-aviation related gamut of challenges that face them.    Over-stimulation at check-in areas, fluorescent lights, airport waiting areas and queues, boarding airplanes, and sitting in a confined airplane, all can pose challenges to those with autism.  They call their program “Open Sky for Autism,” and it is being offered for free.  It promises to help acclimate those with autism by using supervised repetition during simulations of airport arrival, ticketing, check-in, baggage check, TSA screening, boarding, in-flight simulation, and deboarding.   They even do one better than the “real” airlines, and offer complimentary lunch and refreshments!   Their opening event is scheduled for April 5th.  Here’s the link:  http://airhollywood.com/opensky/

If you have been following either this or my last blog for a while, you know that I am more than intrigued by people who do good things when they don’t have to.    I don’t know the folks at Air Hollywood, but I do know that for whatever their reasons they have decided to do something good for a chunk of humanity that needs it, something that is frankly difficult to do and outside what a typical therapeutic agency or clinic has the means to do.

Every religious tradition with which I am familiar preaches charity.   Growing up, I learned that the yields on the corners of each of your agricultural fields should be left for the hungry and poor.   I applaud any company that uses its resources to do good.