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Who or what is TOM and what does he or it have to do with autism?

10/5/2016

10 Comments

 
A core quality of autism is an atypical way of connecting with other human beings.  It is often (mistakenly) believed that autistic people lack empathy.  We are also said to lack TOM, which is not a person but an acronym for Theory of Mind.  However, I think often the use of the term Theory of Mind in the context of autism is misleading as what is usually being referred to is intuition and not theory.

The attribute called TOM is the ability to understand what thoughts another person is likely to be thinking.  For this to affect your actual interactions with other people you have to be able to discern and respond to their thoughts in real time. Having an excellent ability to work out what someone might be thinking in theory or in retrospect wouldn’t help your relationships with people if you are unable to do it while you are engaging with them.  

Saying that difficulty with relating to others is due to lack of theory of mind is therefore not particularly helpful, as someone can have a brilliant theoretical understanding of how minds work, but this is useless to them in practise if they don’t  have access to that understanding when it matters most, that is when actually interacting with other people.

My guess is that most obstetricians are male, and have a better understanding of the processes involved in childbirth than most mothers, all of whom are female. Despite the fact that male obstetricians have the best theory of childbirth, they will be trumped every time at actually producing babies by women who may have absolutely no theory of childbirth, but possess the equipment to produce babies.

Similarly autistic people might have what would be called in everyday English theory of mind, however without the equipment to intuit what other people are thinking this theory does not enable actual real time typical social interaction.

It seems to me that a disproportionate number of autistic people study psychology, however this study being theoretical doesn’t really help them with actually getting on with people. Many non- autistic people who have never formally studied psychology have an intuitive grasp of what another person might be thinking and use that to socialise.

However, the idea that autistic people lack “Theory of Mind” is often a barrier to people believing that they or another might be autistic, because the relevant person is extraordinarily adept at explaining motivation, despite not getting along easily with other humans.

So while I do think that autistic people tend to lack the ability to intuit the thoughts of others, I know for sure that we don’t lack empathy and many of us are superb at explaining psychological theory!
10 Comments
Peter Munday
10/5/2016 02:03:34 pm

This is very helpful.

I have mild autism. I work as a counsellor and do try my best to understand and empathise with my clients. I believe I do have a reasonably good theory of mind. But I often find it hard to read emotions in people's faces. It is something of a disadvantage in counselling and in social interactions, and so I have to work round it.

Reply
Caroline Hearst
10/5/2016 09:53:43 pm

I'm glad you found it helpful. I also intend to write about empathy and emotional connectivity at some point.

Reply
Planet Autism
10/5/2016 02:08:35 pm

Yes there is much dispute about TOM in autism. For starters, there are several different types of empathy and most of us have intact affective empathy (so called sympathy).

Cognitive empathy may be more tricky for some of us. I find this is the area I am impacted in. But it's affected by rigidity too.

I do think some psychiatrists don't fully understand ToM and how it displays in autistics.

Many autistics are highly concerned about what others might think of them (as Attwood says, it can lead to a paranoia based on social experiences) but this still doesn't mean they are aware of what others are thinking.

Many autistics as you infer, can cognitively understand that others do have thoughts and feelings that differ to their own but the real life application of that knowledge is hugely difficult, because of the disconnect of the two in the autistic mind.

Real-time application requires instant understanding, there is no time to analyse which option might be applicable and coupled with the difficulties we have with non-verbal body language and tone of voice makes social communication highly challenging.

NTs use nuance, subtle tones of voice, deadpan humour and sarcasm and hidden motives. Is it any wonder we get confused.

Reply
Caroline Hearst
10/5/2016 09:57:44 pm

Thanks for your comment, I agree that TOM affects cognitive empathy, and also that there are all sorts of other factors that go into the mix of real life social interaction.

Reply
Planet Autism
10/5/2016 10:41:26 pm

You might find this interesting too:

http://www.eurekalert.org/pub_releases/2006-02/uow-eqp021606.php (regarding a talk with Morton Gernsbacher, Research Professor of psychology at the University of Wisconsin-Madison)

"It behoves us as scientists to distinguish uninformed stereotypes from scientific reality and to move beyond myths and misconceptions."

"During her talk, Gernsbacher will cast doubt on the prevalent notion among autism researchers that autistic individuals lack a "theory of mind." The belief that autistic children lack a sense of both their own minds and those of others emerged about 20 years ago, becoming a seemingly undisputed tenet in the literature since then, says Gernsbacher"

"When the psychologist began delving into the question, however, she found that scientists usually ascertain how well individuals perceive the mind with tasks that require a relatively sophisticated level of linguistic ability. Since a common diagnostic criteria for autism is the impairment of communication skills, Gernsbacher says it's not surprising that most autistic children don't fare well on such theory-of-mind tests."

"I think we as a society fall prey to a slippery slope when we begin talking about members of our society as not appreciating that they or others have a mind," says Gernsbacher. "An uncritical acceptance of the hypothesis that autistic individuals lack a theory of mind can seriously compromise how autistic individuals are treated in the workplace, the community and society in general."

"Laurent Mottron, an autism researcher and physician at Montreal's Hopital Riviere des prairies, will discuss the common idea that most autistic people are cognitively impaired. Mottron will assert that the numbers of cognitively impaired autistic individuals have been over-estimated - a fact that has important implications for the kind of therapies that autistic individuals receive."

Reply
Caroline Hearst
11/5/2016 01:56:43 pm

I know a few autistic people who don't think we lack TOM - while I think the term is misleading I know that I for one absolutely lack intuition of mind, I don't however lack empathy, or the ability to work out what someone else might be thinking.

Reply
mary mullen
11/5/2016 10:07:46 am

Thanks Caroline for the ToM post, very thought provoking as are the related comments - need to read more about this, I find it difficult to understand, how it might manifest personally and in others, good to read about thanks

Reply
Caroline Hearst
11/5/2016 01:59:18 pm

Glad you found it helpful Mary, as Planet Autism says there is not universal agreement on this (or much else really!) and I'll be writing some more about my take on it and the difference between TOM and empathy.

Reply
Claire
12/5/2016 12:13:00 pm

This was very good Caroline and explains why I'm so good at analysing the way people behaved after the event but frustrating bad at dealing with them at the time!

Reply
Caroline Hearst
23/6/2016 06:08:48 am

So glad you found it useful Clare

Reply



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