Autism and the Lucid Temperament

A brief encapsulation

I just read an excellent paper published in the journal Frontiers in Psychology, by Finnish professor Joona Taipale, entitled “Caught on the Surface: Tustin on Autistic Experience.”

It seeks to resurrect the psychoanalytic work of Francis Tustin, who worked with autistic children on the severe end of the autistic spectrum, for modern use and integration.

Tustin’s work has been controversial, I gather because it has been seen, along with psychoanalysis in general, as contrary to modern-medical physiological commitments, but as Taipale shows, her work does not essentially preclude physiological explanations, and indeed Tustin herself was rather open to these, increasingly so as her career evolved.

What her work perhaps most helpfully does is to describe the dynamics she encountered in her clinic, offering ways to understand autism phenomenologically.

When taken along with descriptions from adults who see themselves as “on the spectrum” (e.g., Temple Grandin), and the insight that the dynamics pertaining to autism exist to a degree as a factor in all of us, it gradually becomes possible to relate in a personal way to autistic experience, of great interest to a therapist like myself who wishes to understand, empathize, and be helpful with respect to a broad range of human concerns.

In this short article I’d like to summarize what I learned in Taipale’s paper and add some thoughts of my own.

First, a short and likely simplistic but hopefully serviceable summary (and please do take this as my own potentially misleading formulations; there is much more nuance and context in Taipale’s paper):

1. Autism pertains to a profound, primal level of selfhood in which sensory structures and boundaries are the key elements

2. The repetitive behaviors and self-absorption characteristic of autism can be understood as defenses against a horrible feeling of self-dissolution that can occur at this most basic sensory level before the sensory self is securely formed

3. In the effort to maintain sensory structure, there is some preclusion of depth, perhaps to some degree spacially (especially in more severe cases), and more pertinently (across the spectrum), symbolically and interpersonally

Taipale refers to this last phenomenon as a “collapse of intentional depth.”

I will now offer a few reflections on the basis of my own thinking and clinical experience.

As a general disclaimer, I am personally wary of using the concept “neurodiversity” because 1. I am not a neurologist, 2. autism is still technically and officially diagnosed behaviorally on the basis of DSM-5 criteria, and 3. there has been a tendency in my field in recent years to use neurological terms in a manner I find pretentious.

However, my own experience, and I believe a variety of research as well, does point to the existence of temperamental diversity among human beings, and it would not surprise me if one day neurological correlates to various temperamental dispositions are discovered.

I see temperamental dispositions as, in effect, emphases on different character functions. Similar to the way some people have long legs and some people have broad shoulders, etc., in the realm of temperament, some people have a big LOVE function, some have a big PURPOSE function, some have a big THINKING function, some have a big CREATIVE function, etc.

Indeed it seems to me people tend to organize, psychologically, at least to some degree, around their strongest function, and I would offer the following list of functions in this connection:

• LUCIDITY

• EXPRESSIVITY

• PRACTICAL INTELLIGENCE

• COMPETENCE

• PLAY

• STRENGTH

• LOVE

• THINKING

• PURPOSE

• CREATIVITY

• ADAPTABILITY

All humans have all of these functions, but in different proportions, and character differences can be understood in this way.

The various psychological syndromes that have been identified over the centuries¹ can be understood as disorders of the various functions listed above, and indeed the above list is to some degree a creative adaptation of the list of “classic syndromes,” if you will, but with a focus on the positive aspects of character rather than pathology.

So, for example, obsessive doubt (“obsession” or “obsessionality”) can be seen as a disorder of the THINKING function. Alienation (studied under the rubric of “schizoid” dynamics) can be seen as a disorder of the CREATIVE function. Negativity (resentment, envy, etc., studied under the rubric of “masochism”) can be seen as a disorder of the STRENGTH function. Etc.

It is my impression that these 11 temperamental emphases (I hesitate to speak in terms of typology, though that is in effect what this is) are roughly equally proportioned throughout the population.

With that in mind, I wager about nine or ten percent of the population has what we could call a LUCID temperament, which is to say they have a high sensory acuity, and in lieu of severe troubles, operate very effectively in the physical world.

That said, having a high sensory acuity, they naturally have significant sensory needs, and are thus more prone than average to experiences of sensory deprivation, and thus the kind of “unthinkable anxiety” (related to that feeling of basic self-dissolution) — or, as one French autism researcher not mentioned in Taipale’s paper has termed it, “precipitation anxiety,” though a better term I believe might be “precipice anxiety” — that is said to underlie autistic sensory and related psychological and interpersonal dynamics.

One must be careful in this department not to offend through offhand interpretations of another’s experience, so let me emphasize here a few relevant points:

• temperamental differences are differences of emphasis; those with what we might call a “lucid temperament” may have an especially strong sensory capacity, but all of us have sensory capacity and I suspect most of us can relate to at least mild and at least occasional moments of precipice anxiety or painful social awkwardness and behaviors that involve some level of sensory self-absorption (e.g., fidgeting)

• the point here is not to prance around diagnosing people with autism, but there is a dearth of clinical information regarding this issue (perhaps especially as regards non-severe cases); indeed much of my experience with the matter has come from clients bringing up with me their own sense of being “on the spectrum,” due to relating strongly on a personal level to descriptions they come across of this condition in popular culture

• the point of clinical diagnostic concepts in general is decidedly not to “other” clients, although unfortunately diagnostic concepts are sometimes used this way, but rather quite the opposite: they are clinical tools (which in their technical formulations are not meant for popular culture) that at their best help clinicians understand and empathize, often by tuning clinicians into those aspects of themselves in which they have experienced the syndromes described

Indeed, technical-sounding diagnostic concepts in my experience often become limiting factors when taken on by clients via popular culture as rigid identities, which is one of the reasons I like to reformulate these concepts so they are more down-to-earth and straightforward.

Diagnostic concepts in clinical work (even in their technical formulations) are not explanatory but syndromal in nature, a point too few understand. Thus, instead of the misleading “masochism” I prefer negativity (resentment, envy, etc.); instead of the misleading “narcissism” I prefer self-inadequacy; instead of “hysteria,” panic; instead of “obsessive compulsive disorder,” obsessive doubt and compulsive guilt.

Similarly, and with respect, instead of “autism” — which I believe can be a misleading term (it essentially means, etymologically, “self”-ism) — I might prefer to focus on the common complaint involved, which might be “painful social awkwardness,” or perhaps, going a little deeper, “precipice anxiety.”

In this way we simply name the suffering or pain involved, rather than focusing on defenses that may or may not be present at least in any overt way.²

That’s not to say there isn’t value in being aware of defenses; it’s just to strive for objectivity and relatability.

Once again, my own objective is to be of more and more service with respect to this aspect of human experience (including in myself) and to clients for whom these sorts of issues are predominant in terms of what troubles them.

I hope my humanistic concerns come across clearly in this article and that readers can appreciate why I’ve not wished, in this territory in particular, to beat around the bush.

1. See Nancy McWilliams for an excellent exposition, although her work does not deal with the issue of autism, another reason for my interest in this topic.

2. Another issue is that the technical diagnostic terms often represent others’ view of the situation rather than the client’s. No one comes to therapy, for example, complaining “I’m narcissistic.” But they do come complaining of “lack of confidence” or the like.