Thinking About You, Thinking About Me: Part One
So I'm reading a couple of Michelle Garcia Winner books. Is this a useful thing to do? Possibly not. These frameworks, which have some truth to them sometimes, and are designed to be hard to disagree with without feeling bad, and which can be very very harmful to me and to many other people, get stuck in my head. Nevertheless.
One of the books I'm reading is called Thinking About You, Thinking About Me. The first part is called "Assessing Social Cognitive Deficits".
I take issue with that language. I am not deficient. I am strange, I am perpetually confused, I move my body differently than others because I experience my body and the connections between my body and my brain differently from others. I am sometimes stupid, selfish, or mean. There are things about social interaction I may not understand when most other people would, and things I may understand when most other people wouldn't, though the things I do understand may not be noticed or given language or considered to count. I make a lot of mistakes, including mistakes in interacting with others. The way I socially interact is a product of a million different things about me and a million different experiences I have had, connecting and combining in ways that would be impossible for anyone to fully articulate- this is true of everyone. When I do things, I have reasons, sometimes reasons that are very deeply important to me, and I understand my reasons better than therapists do, even if I can't always explain them.
But anyway, Michelle says the social cognitive learning disability is the most abstract of all learning disabilities, which makes a lot of sense to me. She talks about the difference between using language and using language in a "socially meaningful" way, which I think is a lot more complicated and varied and subjective than she acknowledges. You can't assess whether someone is being socially meaningful, you can only assess whether they are being socially meaningful to you, and if you are not autistic you probably have some especially big "deficits" in understanding some kinds of typically autistic social meaning, and if you are a social skills teacher you are probably putting on the blinders to kinds of social meeting other than the specific and narrow kind you are trying to teach. She notes, truthfully, that people can score fine on social thinking tests and still be really awkward and get picked on. She does not note that people can test really badly and have types of social understanding not captured by the test, or that a student getting picked on does not mean they have poor social skills, it means the people around them are doing something wrong.
She uses the example of a student who scores in the 60th percentile on the TOPL (Test Of Pragmatic Language), but has no friends, has outbursts in class, and "remains intensely focused on his own area of interest at home". She does not mention that, while all of these things could be partially caused by social confusion or trouble putting social understanding into practice, they could also reflect being too exhausted by school to have friends, having the social skills to decide not to be friends with people who are not a good idea for you to be friends with, having social skills involved in resisting people making you do things that are harmful to you or that you do not want to do, being a type of person who expresses love by trying to share the things they love, or being a type of person who uses the things that they love to help themself understand and interact with the people around them. And that's just off the top of my head. Yes, there can be multiple factors, and there could absolutely be a situation where, for example, the kid had (in this situation) social skills involved in resisting doing things they didn't want to do, but had bad judgment about where to apply them. Or where a kid expressed love this way, and could not quite wrap their head around the fact that it was being misunderstood, or think to explain that this is an expression of love because it felt so obvious to them. Or many other things. But none of those things are necessarily and solely social confusion.
She talks about how tests try to measure each segment of social interaction individually but in real life they all work together at once. She talks for a while about eligibility for services.
Reading this book, there is so much I could say about every other sentence that I don't know where to start. Like... You are right, but also wrong, Michelle. What did the philosopher say when he moved into a new house? There is a lot to unpack here.
So now she's talking about moving from a solely behavioral approach to a cognitive-behavioral approach. That's like, moving from just trying to change people's behavior through rewards and punishment to trying to change people's behavior through changing their thoughts and feelings. Not the most complete explanation ever, and there's definitely stuff I don't know here, but it will suffice.
"Dobson (2001) explains that all cognitive-behavioral therapies share three fundamental propositions.
1. Cognitive activity affects behavior.
2. Cognitive activity may be monitored or altered.
3. Desired behavior change may be effected through cognitive change."
Okay, this quote gives me the skeevies. I have spent overly long having my cognitive activity monitored and altered, thank you very much.
Oh, quick disclaimer about the skeevies:
a. Plenty of things that are actually okay or great give plenty of people the skeevies.
b. It is often a really good idea for people who listen to their skeevies. Not always, and people have to figure that out for themselves. But often.
So anyway, they are changing the methodology, but the goal is still basically to make the kids act normal. Though the people enforcing normal probably have a really weird, oversimplified, wishful thinking idea of what normal is. Also, people with clipboards trying to make you more normal will make you more normal in some ways but more alien in other ways. It's complicated. And weird, and confusing, and painful, and sacred, and ugly, and something that burns in my gut and never goes away.
She says: "For students with average or above intelligence, and particularly for older students, there is no other way to help them learn to help themselves."
Now, I don't generally like when people say there is only one way. I especially don't like when therapists seem to think that their particular ideas about what people should do are the only way for disabled people to be okay. I think it's incredibly arrogant. A lot of people object to that kind of thing in a lot of different ideologies.
She says that people with social cognitive deficits have to learn cognitively what other people learn intuitively. This is both true and not true, because social intuition is really weird and complicated.
She says that some students, particularly those with lower IQs, are best served by a behavioral approach that "relies less on understanding their own and other's minds" because they "cannot change their own behavior based on what they are thinking". Okay: some people cannot think in language, and some people are missing some pretty basic understanding about other people, and some people have less conscious control over their actions than other people, however, I am horrified about the assumptions she is casually making about an entire contingent of people. You should never decide that someone is inherently incapable of having any real understanding of themself and other people forever (or that someone is incapable of having any real understanding of themself or other people that you don't give to them). People can have understanding of other people that is real and important and is a different kind of understanding than you have or that you want to acknowledge. People can express their understanding in ways you can't understand.
Then she talks about brain theories. "The Central Coherence Theory states that students on the autism spectrum have difficulty conceptualising to a larger whole. They tend to think in parts and do not fully relate their pieces of information back to a larger pattern of behavior and thought."
This rings true to my experience a bit, personally. I definitely sometimes have trouble getting pieces of information to cohere in a way that makes as much sense as I'd like. However, a lot of stuff that could look like this is me relating pieces of information back to patterns of behavior and thought that are different than the patterns of behavior and thought Michelle was probably thinking of writing this, or me relating pieces of information back to patterns, often multiple patterns, of behavior and thought, and then being unsure what to do now.
Then she talks about executive dysfunction. She talks about difficulties with prioritization, problem solving, and organization. She does not talk about difficulties with the complicated and effortful process of translating thought into action. She says that "personal problem solving is a complex skill that weaves together social and organizational abilities." This is extremely correct and gave me a bit of a lightbulb moment there.
She also says that "the complex skills of managing homework and school projects, solving problems, appreciating the perspective of others" are "all skills needed for achieving independence". This makes me physically ill. It would take me forever to try to deconstruct the truth and untruth and definitions being used in that sentence. The reason it makes me sick is that she is dragging who is allowed to be free, to have human rights, to make decisions about their life, into her therapy theories.
Some people can cook for themselves, and some can't. There are a lot of things like that. But someone can be very, very, very disabled and still have freedom and make their own life decisions, and someone can be way less disabled and still not get to make their own decisions or have rights, because of the people around them, not because of their "capacity for independence". That's the thing about independence. She is one of the keepers of other people's freedom and she has never even questioned that she is entitled to this.
Then she talks about Theory Of Mind/perspective taking. My opinion on this is that everyone has some trouble understanding what the people around them are thinking and feeling. No one just magically knows all the time. It is easier to understand what people are thinking and feeling when those people are more similar to you, giving autistic people a disadvantage. Also, a lot of our trouble understanding what people are thinking and feeling is secondary, not primary- many autistic people have trouble reading faces and understanding spoken language, as well as many other things. If you gave everybody books of poetry for a decade and then declared that dyslexia is a disability characterized by not understanding metaphors, that would not necessarily be the best way to understand dyslexia. Also, autistic people are often characterized as not understanding people's thoughts and feelings when they have at least some understanding, possibly a lot of understanding, but don't know what to do about it, are having trouble putting their knowledge of what to do about it in action, or decide to do different things with their knowledge of people's thoughts and feelings than most people do, often for very good reasons. Goths, people with food allergies, and people with weird gender expressions are not caused by people not understanding that some people think that is weird. Autistic people are also sometimes characterized as not understanding other people's thoughts and feelings even when they are actively demonstrating their understanding of other people's thoughts and feelings because people expect them not to understand other people's thoughts and feelings. Conversely, if a person who is not autistic doesn't understand an autistic person's thoughts and feelings, this is extremely unlikely to be seen as evidence of a theory of mind deficit. This is not to say that no autistic people ever have trouble with theory of mind that is related to their autism, this is to say that it is very much more complicated than that.
She says that perspective-taking, Central coherence, and executive function are interrelated, which makes sense. She then tells a story about a seven year old boy named Michael.
"I met Michael briefly to gain an understanding of his issues. He was an adorable blonde haired, blue eyed boy who smiled easily and enjoyed making jokes. He required cues to "think with his eyes", he jumped from one topic to the next when talking, and he physically wandered away from direct social interactions to look at objects in the room. I asked Michael to put in sequence a series of pictures that described a birthday party. He attended to the task but then place the pictures arbitrarily in a row on the table. When asked to explain his sequence, he exhibited difficulty with the social interpretation of the pictures. One picture was of a boy waving as he and his mom left a birthday party. Michael stated that the picture represented the boy saying hi as he arrived at the party."
So, not arbitrarily then. It sounds like she is thinking in black and white about what the pictures can mean and what story can be made with the pictures.
She then concludes that he has "very significant educational and social issues" and "a limited theory of mind both in his spontaneous interpersonal relatedness as well as in his inability to understand the motives and emotions of those pictured in the photos".
I think she should be awarded a golden Oreo for being amazing at jargon. I also think that she is demonstrating at least as much of a lack of theory of mind, and definitely a more refined and polished lack of theory of mind, as he is, by not thinking of any other reason he would put pictures in an order she didn't agree with etc other than "lack of theory of mind" even when he told her the reason. I also think that I am extremely in favor of walking around rooms looking at objects; it is a very good way to understand one's environment, have a sense of self, formulate ideas and decisions, and keep body awareness and ways of thinking and feeling online. I also think that I, as always, have a ton of stuff to say about therapy, I have been working on this for hours, I am not even through the first section, and this is getting really long.
