People with severe depression often find it hard to sense the emotions of others. Drugs that affect serotonin can help the illness - and their immediate effect, sometimes within hours of the first pill, is to improve a patient’s ability to interpret their fellow citizens’ feelings from their faces. That simple talent turns the key that restores them to society.
Nowhere is the importance of signals better seen than in children. When very young their insights are limited and self-centred, but soon they begin to understand and to respond to the moods of those around them. Darwin wrote a
Biographical Sketch of an Infant
, an account of child development based on his son William: ‘When 110 days old he was exceedingly amused by a pinafore being thrown over his face and then suddenly withdrawn; and so he was when I suddenly uncovered my own face and approached his. He then uttered a little noise which was an incipient laugh.’ William ‘did not spontaneously exhibit affection by overt acts until a little above a year old, namely, by kissing several times his nurse who had been absent for a short time’. By then he could tell faces apart (some of which pleased him more than others) and could copy movements. By the age of eighteen months most children can separate false movements of anger or upset made in play from real gestures and by five - school age - they send and receive information well enough to allow them to live in groups, to learn and, in time, to join society. A sense of self and a sense of other are closely related, for the younger a child is able to recognise a picture of itself the better it interacts with its fellows when it grows up.
William and his brothers and sisters were lucky for they were raised in an affectionate household. Many youngsters are less fortunate. An infant brought up in isolation or by cruel parents may never adjust to the world around it and can feel isolated for the rest of its life. The fit between childhood abuse and adult depression is well established and those taken into care because of poor parenting are at far higher than average risk of emotional problems later in life. A failure to be provided with the signals of affection that bind children to their mothers and fathers and to society as a whole is to blame.
A few unfortunates suffer from loneliness or despair for the opposite reason. What condemns them is not neglect by those who should provide the crucial emotional messages, but their own inability to receive and interpret them. Such children are often diagnosed as autistic. They may live in isolation and unhappiness, with an existence that can seem scarcely human at all, for children with severe autism cannot make or understand the cues needed to find a place among their peers. Their plight shows how central is the ability to express, and to understand, emotions in allowing every citizen to take part in society.
Autistic children are now treated with sympathy and concern, but once they were regarded almost as animals. To those curious about where the essence of humanity might come from, they were useful raw material for speculation. Rousseau wondered whether a youth brought up ‘wild, untamable and free’ would be safe from the corruption faced by those who undergo a normal education. He pondered an ‘impossible experiment’: to raise a newborn infant in isolation, but as he wrote, ‘by our very study of man, the knowledge of him is put out of our power’ - nobody would be so cruel as to do such a thing. Such a child might, he thought, show how the true signals of inner sentiment emerge in a creature that had never received them.
The eighteenth century was a vintage era for ‘wild children’, those raised - metaphorically or otherwise - by wolves, in the fashion of Romulus and Remus. The naturalist Linnaeus classified them as
Homo ferus -
wild men - whose nature would reveal what made thinking humans,
Homo sapiens
, different. Most of the supposed examples were fakes, but a few were not.
In 1797, a young boy was found alone and almost naked in the forests of the Aveyron, in south-central France. He was captured, escaped, recaptured and escaped again, but in time he emerged from the woods under his own volition. He was about twelve years old, unable to speak and savage in his behaviour. A vicious scar on his throat hinted that his parents had tried, but failed, to kill their aggravating child. The lad appeared to have been without contact with others for almost his whole life and showed no obvious signs of joy, fear or gratitude when at last he met members of his own species. Here, perhaps, was an opportunity to investigate the springs of emotion.
A young student, Jean-Marc-Gaspard Itard, heard the story and saw the chance to test Rousseau’s ideas. He took the forlorn boy to Paris and set out to try to raise him to the spiritual level of his fellow citizens.
Itard had trained as a tradesman, but took up medicine at the time of the French Revolution and later became a pioneer in the study of diseases of the ear, nose and throat. In stark contrast to Rousseau he was convinced that the essence of the human condition lay in the ability to sense the feelings of others and, armed with that talent, to build a society in which passions could be kept in check for the good of all. In his ‘Historical Account of the Discovery and Education of a Savage Man’ he set out his theory that ‘MAN can find only in the bosom of society the eminent station that was destined for him in nature . . . that moral superiority which has been said to be natural to man, is merely the result of civilization’.
The doctor took young Victor - whom he named after one of the few sounds, ‘o’ (as in the French word for water), he was able to recognise - into his household and attempted to train him to express, and respond to, emotions. He was soon disappointed. The boy was ‘insensible to every species of moral affection, his discernment was never excited but by the stimulus of gluttony; his pleasure, an agreeable sensation of the organs of taste; his intelligence, a susceptibility of producing incoherent ideas, connected with his physical wants; in a word, his whole existence was a life purely animal’.
Itard laboured for five years with both kindness and cruelty (the latter based on his charge’s fear of heights) to transform the boy from monster into Frenchman, but with little success. Victor’s behaviour stayed strange: he was obsessed with the sound of cracking walnuts but ignored gunshots close to his ears, and loved to rock water back and forth in a cup. He never learned to speak and showed no gratitude for food or shelter. The sole sign he made of any response to the sentiments of others was that, when Itard’s housekeeper was in tears after the death of her husband, Victor appeared to comfort her. Apart from that he stayed apart from his fellow men.
His protector insisted that the young man’s failure to adapt to the inner worlds of those around him and to express his own feelings arose because he had been rescued too late to pick up the skills needed, but that view was too optimistic. The lad would nowadays be diagnosed as deeply autistic; as unable to respond to, or give, the signs - the smiles or frowns or conversations - that bind people to their parents, to their friends and to the community in which they live. The dire effects of the illness show how the expression of our own emotions and our response to those of others makes us what we are.
The term ‘autism’ was invented in the 1940s to describe a condition in which children fail to interact or to smile or express sentiments apart from anger and unhappiness. They speak with difficulty or not at all and are filled with obsessions about particular foods, places or clothes. About a third suffer from epilepsy. Three out of four of those with a grave form of the illness struggle to cope with society throughout their lives. Autism shades from the severe disturbance shown by Itard’s Wild Boy himself, through Asperger’s syndrome, in which the language problems are less marked, to general problems in the development of normal conduct. Often, the problem is noticed when parents become concerned by their child’s depression or rage. Some autists, once unkindly referred to as
idiots savants
, have remarkable talents in drawing or in particular mathematical tasks, but their gifts do no more than disguise their deeper problems. Once, the illness was said to be rare, with one child in two thousand affected, but now the diagnosis is made far more often, with an incidence of one in a hundred in Britain.
Autists cannot understand the signals of their fellows or make the full complement of their own. All children have that difficulty in their earliest years. As Darwin wrote in the
Sketch of an Infant
, ‘No one can have attended to very young children without being struck at the unabashed manner in which they fixedly stare without blinking their eyes at a new face; an old person can look in this manner only at an animal or inanimate object. This, I believe, is the result of young children not thinking in the least about themselves, and therefore not being in the least shy, though they are sometimes afraid of strangers.’ For most infants such self-absorption soon passes but an autistic child is locked into that phase for life. Many, when they look at other people, ignore the eyes, the flags of sentiment. They are just as unconcerned when someone else gazes long and hard at them.
The Expression of the Emotions
used the blush as a prime example of a social cue but embarrassment plays a lesser part in life today. Yawns - unacceptable in a nineteenth-century parlour - are more frequent. We do not know why we open our mouths when tired or bored (although the book discusses the gesture as a threat in baboons). Yawn and the world yawns with you and even to read about it can spark the gesture off, as about half the readers of this book can now attest. The habit begins at about the age of six. Not, however, for children with autism, for a yawn sparks off far fewer responses among them than among the general population. Such failures of empathy lie behind many of their problems.
Psychologists talk of ‘theory of mind’, the ability to infer the mental state of others from smiles, frowns, gestures and speech. People with autism have little or no insight into the inner world of their fellows and cannot express their own internal universe in a way that makes much sense to those around them. They are blind to the messages written on another’s countenance and find it hard to separate gestures of anger, fear, sadness or joy. Like chimpanzees (but unlike dogs) some autistic children cannot understand what is meant when their parent or doctor points at an object. They are denied even that simple social talent.
Autists also find it harder to tell people apart or to recognise a photograph of themselves. A certain group of brain cells is activated when monkeys or men see or copy the movements of others or observe an expression of pain, fear or disgust. They are also involved in the shared response to a yawn or a smile. These mirror neurons, as they are called, are almost silent in children with the severe form of the disease. Perhaps they are part of the system that helps us see into the souls of those around us. In their failure they condemn people with autism to a world whose other denizens act in a mysterious and unpredictable way.
Nobody knows what causes autism and the condition has no cure, even if some of its symptoms such as insomnia or depression can be treated. The illness is four times more frequent in boys than girls, but shows no fit with race, social class or parental education. Infection, immune problems, vaccines, heavy metals, drug use while pregnant, Caesarean births and defective family structure in Freudian mode (the child psychologist Bruno Bettelheim spoke of ‘refrigerator mothers’) have all been blamed but those claims do not stand up. Some say that the brain of a typical autistic child grows too fast too soon, but then slows down. The amygdalae - those detectors of fear - are overactive in some patients, but many other parts of the brain have also been implicated. Problems with serotonin, that universal alibi for disorders of emotion, may be to blame, for some autistic children synthesise the stuff less well than normal. Certain drugs used against depression can help, as a further hint of a tie between social isolation and the emotional universe.
Genes are without doubt involved in some patients, even if not more than a tenth or so of cases can be ascribed to a definite genetic cause. If an identical twin has autism its sib is at a seven-in-ten risk while the figure risk for non-identicals is far lower. The incidence increases by twenty times above average in the brothers and sisters of those with autism and some among them are tactless, aloof or silent but are not diagnosed as ill.
Such behaviour sometimes presents itself as part of a larger medical problem. Fragile-X syndrome is the commonest cause of mental disability among boys. It comes from a huge multiplication of a short segment of DNA upon the X chromosome. Some patients have symptoms quite like those of autism and some individuals diagnosed with that condition may in fact have the chromosomal abnormality. Other deletions, duplications or reversals of a segment of chromosome are behind other cases of the illness. Often, these arise anew in the children compared with their parents. Some badly affected patients have problems with a gene involved in the transmission of impulses between nerves. A few may have errors elsewhere in the DNA - and dozens of genes, with a variety of tasks, have been blamed. One candidate belongs to a group of genes that is multiplied in number in humans compared with all other mammals, is active in the brain and is damaged in at least a few autistic children. In spite of such hints the biology of autism remains obscure and there are likely to be several explanations for a condition that is not a single disease but many.
Autistic children are an experiment in emotion. Their isolation is mental rather than physical, for they are cut off by an inability to respond to the flow of information that passes between others. A world full of autists could not function, for all societies depend on a silent dialogue in which every member’s intentions are overtly or otherwise expressed. Civilisation turns on the ability to bear another’s company.
Those who break civilisation’s rules must be punished; and part of that invariably involves the manipulation of a criminal’s mental state. Prisons are, of their nature, places in which social interactions are forcibly reduced. Solitary confinement is a penalty far more severe than mere imprisonment, for it is autism imposed: a permanent denial of what it means to be human, inflicted upon someone who once experienced the full range of human emotion. The penalty is bitter indeed and is much appealed to by punitive societies, from medieval England to the modern United States. Charles Dickens visited such a penitentiary in Philadelphia and wrote that ‘I hold this slow and daily tampering with the mysteries of the brain to be immeasurably worse than any torture of the body.’ The infamous ‘Supermax’ at Marion, Illinois, a jail built to hold the most violent offenders, together with political prisoners such as Black Panthers and members of the American Indian Movement, allowed almost nobody out of their cells for twenty years, even to exercise. It closed in 2007, but some of its forty and more replacements are just as brutal. Some even feed their inmates on tasteless ‘Nutraloaf ’ further to reduce their contact with the world of the senses. Many inmates - like autists - become anxious, agitated and angry, and may end in insanity, killing themselves should the chance arise.