Expectations govern our perceptions, and even the outcomes, of events we partake in. If your 8-year-old says “ewww, broccoli,” does pointing out that she’s never had it before mean she won’t spit it out? Does the fact that you were technically in the wrong when you thought that jerk in the Explorer cut you off make you any less angry? Was Episode I really all that bad, or had society so collectively hyped itself up for another Star Wars movie that The Clone Wars found itself doomed before it premiered?

Maybe that last one is a bad example.

John Elder Robison wrote several books on the subject of his life, his kid and growing up on the autism spectrum. Each was marked by incisive insight, colorful descriptions and a pretty rich source material to keep things interesting (Robison, before becoming an author, designed sound equipment, built pyrotechnics for KISS and started his own car repair business).

So when his new book has a subtitle of “A Memoir of Brain Change and Emotional Awakening,” you might naturally expect some pretty heady stuff. And for the memoir part, this book delivers. [book]

Robison recounts his experiences as lab rat1 undergoing electrical stimulation of his brain, in what researchers (and he) hope will expand his ability to comprehend, process and respond to emotions. It’s not very spoilery2 to tell you that it worked, and Robison comes out on the other side profoundly changed.

His descriptions of how his mind processes emotions and context, both before and after the treatment, are stunning in that they open the reader up to entirely different ways of processing the same information. It’s a little bit like the old experiment where you have a card with a white side and a black side, and show two people the opposite side to see how confused/angry they get when the other person is clearly lying/wrong. Only in this scenario, the card is the same color on both sides, it’s just that one person actually can see things completely differently.

If for no other reason, you should pick this book up to allow yourself the chance to understand a completely different aspect of the human condition (regardless of which side of the neurotypical scale you fall on).

There’s more to it than that, though. How Robison copes with the changes wrought by the treatment are devastating, but that’s largely due to the experiences he undergoes, which would be tragic under any circumstances. His characteristic wit and erudition carry him through, though, and continue to make him stand out as a memoirist.

But he also delves wayyyy deep into the science, to the point where for the first half of the book I was wondering if he was actually writing a pop science book, a la Mary Roach, only without the citations. It’s understandable to be interested in the mechanisms3, but not particularly inspired reading or helpful to anyone who’s not looking to invest in/start up a treatment center of their own.

While it’s somewhat interesting how the methods they used can relate to Robison’s earlier careers in sound design, the level the reader needs to understand it is about 40 pages in the opposite direction. Likewise, the continual analogies and conclusions he draws about brains in general based on his experience are drawn from a vanishingly small sample set (himself), yet are presented alongside dry, established science fact (the mechanism of how the treatment works, what area of the brain is responsible for what, etc.) in a way that makes it difficult to discern what is learned and what is conjecture.

There’s also an uncomfortable side to all this. I’ll start with this disclaimer: The treatment, TMS (Transcranial Magnetic Stimulation), has sound science behind it and I absolutely believe that through it Robison achieved many amazing things. I also believe that it could help other people in similar situations.

However.

Robison comes off as a full-fledged convert of this particular therapeutic religion. It’s perfectly understandable! He had a life-changing experience because of it. But his son, known as Cubby in the book, also went through the treatment and felt almost zero changes. Robison mentions other people who he interacted with who also had significant4 impacts, but says nothing of the other people in the study and what their outcomes were. The effects that Robison describes were actually not a part or intended to occur in the study, so perhaps it’s understandable, but the fact remains that there undoubtedly were several people who underwent the exact same treatment and had no similar revelations.

Since the publication of his first book, Robison has done a ton of reading and now serves on several research steering committees, so I’m not knocking his scientific credentials. However, I don’t think he should be as unceasing with his praise for the treatment, which comes off sounding like a cure. One young man he mentions toward the end of the book, who undergoes the treatment only sporadically, sees spectacular results that eventually fade away. The reader is left with the impression that if only the treatment were more available 5, his problems would be solved.

To reiterate, I’m not saying the treatment is worthless, that no one should do it or that Robison shouldn’t advocate for it. I absolutely believe that it can be of help to some people. But the effusiveness with which Robison champions it worries me because of how it’s going to affect other people: those who live with autism, those who care for those with autism, and those who direct research. Promising or prolific research into one facet of a problem has a tendency to shut off the funding spigots to alternative approaches; that’s fine when you’re talking about penicillin, but less good when you’re dealing with two things as little understood as autism and the human brain. TMS is extremely unlikely to be a cure, and unlikely to be able to meaningfully help everyone affected with autism.

What we can do, and the memoir parts of the book in no small way assist with this, is try to understand the differences between neurotypical people and those on the autism spectrum — not to make everyone move toward conformity, but merely to help everyone understand and relate to each other. We should be working to help everyone — neurotypical or not — experience the level of connection with with the world (and people) around us that Robison describes by the end of the book. Some people already have that, others are working toward it, and the rest may need a little bit of help. Hopefully, through treatments like TMS and myriad others, everyone can get the assist they need.

 


  1. Hold the Flowers for Algernon references, he gets there

  2. The title being “Switched On,” not “Repeatedly Flicking the Switch to No Effect”

  3. Actually, Robison’s interest and research into his treatment set off major red flags for me in terms of his suitability as a research participant. He also was in regular contact with at least two other participants during the study, asked them how they reacted to treatment, and described his own reactions to the treatment while the study was still being conducted.

  4. Not necessarily positive, although the one person who has a negative reaction to the treatments also has her story come back around to loop into his, so I have to question whether it was included for that reason alone

  5. And the boy still willing to undergo it, which he says he has no interest in