Showing posts with label 9/11. Show all posts
Showing posts with label 9/11. Show all posts

Thursday, April 14, 2022

Clinical Detachment = Lack of Empathy?

One tired myth that I have encountered repeatedly is that autistic people lack empathy. This seems to be fueled by the perception that when many of us hear about a tragedy or witness a disturbing scene, we don't broadcast the expected visceral reaction. 

Consider the following hypothetical scenario: in the days following 9/11, 15-year-old Emma's parents watched in horror as news networks repeatedly aired footage of the second plane hitting the South Tower. Emma's mother broke down crying. Emma's father cringed and said, "I can't watch this anymore," and left the room. Emma, however, said nothing. Her concerned mother turned to her and said, "Emma, isn't what happened just awful?" Emma responded with a slight shrug. Her mother was horrified at this reaction. In 2001, autism wasn't as well-understood as it is now, and Emma's shrug might have been perceived as a cold, unempathetic, "All those people died? Who cares?"

There are a few possibilities as to what actually was going through Emma's mind: Sure, she could have genuinely not cared about the deaths of 3000 people, but if that were the case, then that is not autism-related and stems from a separate issue. Another possibility is one that I hear from a lot of people in the autism community: that when something this intense happens, they are so overwhelmed with emotion that they don't have the presence of mind to respond in ways that people expect. They just shut down, and others perceive this reaction is one devoid of empathy. 

There is one other possibility that I'd like to explore in depth, and that is that the person is experiencing clinical detachment. Before I continue, I want to emphasize that responding with clinical detachment is not the same as not caring. Rather, it is taking an analytical approach to the situation. While Emma might not have had a visceral reaction to the idea of thousands of people dying in a terrorist attack, she still thought it was horrible and wanted to understand why it happened. What would possess someone not only to kill thousands of people but kill oneself in the process? What would make someone literally throw their life away in the name of an ideology and take others down with them? In fact, Emma might have even gone online to every news site to learn about the hijackers and Al-Qaida. She would have done so not amid tears, but amid a thirst for knowledge and understanding. Unfortunately, in the age that this story takes place in, Emma's mother might have thought that she had some kind of morbid fascination with death and took perverse joy in tragedy.

Fortunately, in the years since 9/11, there has been an impressive growth in societal understanding of autism. However, I want to point out that this sort of clinical detachment that Emma experienced in my example is not unique to people on the spectrum. In that particular context, possibly, but neurotypical people demonstrate clinical detachment in all sorts of contexts. The difference is nobody freaks out about it because neurotypical people aren't already perceived as "different". And like it or not, a certain amount of clinical detachment is absolutely necessary for all sorts of tasks. 

It's an inconvenient truth that people who research 9/11-- or Columbine, or the Holocaust, or the Crusades, or some other violent episode of world history-- have to do so with clinical detachment. And I'm glad that some people are able to do it, otherwise none of this important research would get done because researchers would be too busy dealing with their emotions. Clinical detachment is also necessary when performing surgery or conducting an autopsy. It doesn't mean that the surgeon doesn't care about the patient or that the pathologist is glad that the person they're examining is dead. It just means that they don't experience the emotions of empathy in an overwhelming or visceral way. And I'm glad they don't. Could you imagine a heart surgeon doing a bypass operation while thinking, "Oh my God, this poor man! If he dies, he's going to leave behind a wife and kids. I'm crying just thinking about it!" The surgeon wouldn't be able to concentrate on the task. 

I actually wonder if the ability to deal with looking at "gross" images, whether or not they are in the context of a tragedy, is correlated with the ability to experience disturbing images with clinical detachment, or at least without having a significant visceral reaction. I see an interesting range of differences of reactions in my own family. My dad and I can watch medical documentaries that involve graphic surgeries without even flinching. Not only that, we find them interesting. And I will even admit that I have a collection of "creepy medical photos"-- organs during surgery, microscopic photos of scabs, etc.-- that I pulled off the Internet. I showed some of them to Dad and he thought they were interesting. He also thought it was interesting when I showed him a picture of YouTube celebrity Matt Dillahunty's heart that his surgeons took photos of (at his request) when he had a triple bypass. 

My mom and brother, on the other hand? As soon as I showed them the picture of Matt Dillahunty's heart, both cringed. Neither of them can watch medical documentaries like Dad and I can; they just can't stand the sight of exposed organs and knives cutting into flesh. Here's what's interesting that supports my hypothesis about the correlation between the ability to watch surgeries and look at disturbing images-- but only partially: Dad and I can both watch the footage of the second plane hitting the South Tower on 9/11 without cringing. My mother, predictably, cannot. It's just too emotionally painful for her. My brother? He can watch it. Go figure.

And it isn't that Dad and I don't have our cutoff points. We do. I get an uncomfortable chill when I see footage of people jumping to their deaths from the Twin Towers on 9/11. I'm not sure what, if any, visceral reaction Dad has. But I do know that he has a seemingly-arbitrary hangup about amputations. I have a very dark sense of humor, and I once made a joke about a limb amputation (I don't remember what the joke was and what the context was in which I told it). Dad cringed, saying he couldn't even listen to me joke about it. I'm not sure if he can watch limb amputation surgery in a medical documentary, or if it's specifically violent or accidental amputation that he has a hangup with. I found recently, too, that I have a hangup with violent amputation. I was watching the psychological thriller Netflix series You, and in one scene, the main character, Joe, is assaulted and one of his fingers is cut off. In another scene, he cuts off his own toes as part of a plan to fake his own death. In both scenes, I surprised myself by cringing in a very visceral way. I actually curled my fingers and toes, as if recoiling from knives. Watching both scenes was a very unpleasant experience, and I just wanted them to end!

I think what it comes down to is that human emotion exists on a spectrum, and reactions to extreme imagery will range from clinical detachment (with a few exceptions, as with Dad and me) to pronounced visceral reactions (as with Mom and, to a lesser extent, my brother). I really feel that it's important to keep in mind that this range is present through all of humanity, autistic or not. It's just that when an autistic person-- particularly a girl or woman, in my experience-- doesn't display a pronounced reaction to certain images, people read deeply into it. It is here that I encourage you to check your own biases. Additionally, I strongly suspect that many neurotypical people fake certain visceral reactions because they know that this is what is expected of them. And I'm sure you know that we on the spectrum are often terrible at such fakery.

Bottom line, a certain level of clinical detachment is necessary in some contexts-- and humanity is all the richer and better for it.




Thursday, October 4, 2018

A Final Act of Catharsis


Disclaimer: The following is inspired by information that I recently learned about my ex-best friend Melanie and wrote about here. It involves me showing up unsolicited at her house. It is a story. It is a fantasy. It is fiction. Please don't read into it as anything more than a work of catharsis, my own way of getting closure. I know that showing up unannounced at the house of someone you haven't spoken to in eleven years-- even if they owe you an explanation for hurting you and even if they had once been your best friend-- is creepy. This is not something I would do in real life. 

The names of the people in this post have been changed to protect their privacy.

I turn the corner and walk up to the tan brick house, my hands jammed into my pockets, my fists clenched to ebb the shaking.
The building is one of those small northeast Philadelphia houses where the first floor sits above the garage and the basement opens up to the backyard. The large maple tree from my past recollections still dominates the street corner, partially covering the front door and steps. I am brought back to memories extending through my adolescence to my early twenties.
I think about my first time there, in sixth grade.  Melanie and I had gone to a nearby carnival, and then came back to spend the night. The summers just before I would leave for seven weeks at camp, we ventured off to see the latest Disney movie together, followed by a swim in the above-ground backyard pool. There was an end-of-summer party where I met one of Melanie’s friends, Jenna. We hit it off immediately, and remained close for a few years before losing contact. I smile, thinking about coming here for Melanie’s high school graduation party and how excited she felt to be accepted to a local university, where she would commute every day to pursue a degree in animation. And even after I moved to Brooklyn to pursue my own animation degree, we still got together a few times a year for Disney movies and sleepovers.
I sigh.
I’ve parked the car a block away, despite there being ample room on Melanie’s street. At least I didn’t have to track her down to find out where she lived— I had heard that she didn’t even move out when she married Mark, let alone when they had kids. Had I needed to, well, I would have felt what I was doing was akin to stalking, and I am not certain that this doesn’t qualify.
It is a beautiful July day, not too hot, but just right for swimming. Is the pool still in the backyard? Some giggling and splashing comes from nearby. Yes, the pool must be there still. Melanie, Mark, their two children—and possibly Melanie’s parents, Mildred and Ben—are likely swimming in the pool. Maybe they’re even having a backyard barbeque with some of the neighborhood families. And perhaps tomorrow, Melanie, Mark, and the kids will spend a day at the Jersey Shore. Melanie and Mark will be holding hands as they stroll along the beach while their children collect seashells. And the following night, maybe a Pixar movie in Pennypack Park. Melanie will rest her head against Mark while the kids alternate between watching the movie and chasing fireflies.
And for a second, I bitterly wonder, do they have a white picket fence and a dog named Spot?
I pause at the foot of the stairs leading up to the front door. After ten years, I just might finally get a straight answer. I'm out of my mind for doing this, but I need to know. I remember when Melanie and Mark first met in late 2001 or early 2002, when Melanie was twenty-two years old. Mark was her first boyfriend. The idea of her dating was about as fathomable, well, me dating. But she found the right guy. I met him a few times and he was pretty cool. I was happy for her. A couple years later, the two of them were engaged. In 2006 or 2007, Melanie informed me that she’d set a date for the wedding: August 16, 2008.
But in mid-2008, I called my parents, upset that the date of the wedding was fast-approaching and I still hadn’t received an invitation. In fact, Melanie had stopped answering my calls, emails and hadn’t even accepted my friend request on MySpace. My parents, especially my mother, seemed perplexed that I believed I’d be at Melanie's wedding, let alone still friends with her. 
“I can’t believe she did this to me!” I exclaimed. “I hate her! She’s a bitch!”
"No, she’s not. This is what happens when people get married," Mom said with an air of authority. "Melanie is in a stage of her life where you're not invited."
"But we've talked about the wedding a number of times. She made it clear that she wanted me there." I said.
"Well, she obviously changed her mind."  Mom's tone indicated she couldn't believe she had to explain something so obvious. "And you need to learn to take hints. She's trying to tell you something."
"What?" I muttered, though I knew what Mom meant.
"She's not interested," Mom muttered back. I could practically hear her facepalming on the other end of the line.
Then, Mom said that relationships change, and you don't always have the same friends you had growing up.
But I knew the difference between a building collapsing due to lack of maintenance and a building collapsing because somebody had flown a plane into it. This was an example of the latter, and it was deeply personal. And I knew that what Mom had said was wrong, at least for a lot of people in the liberal, northeastern United States. A few of my peers had married friends, some with kids.
But I was different— always different. I was that weird girl with Asperger’s Syndrome who people constantly labeled as “immature”. I had come to think of many people I’d come in contact with over the years as being “Forbidden” to me: It was if I was literally not allowed to have friends who fit certain categories: older, married, or someone who otherwise had had “adult” experiences. It seemed that I had to all but formally request the privilege of even being in their presence. There was Carlos, a guy a year younger than me, who I’d met through Ann, a friend and co-worker at a summer camp. The three of us had spent a week together: a few days at my parents’ house in Pennsylvania; a few days in Washington, D.C.; and a few days in New York City. We got along great. And yet he had kept in touch with my parents instead of me.
“Carlos is an intellectual. He has traveled the world and speaks five languages,” Dad had said. “He has more in common with us.”
I supposed, then, that despite the fact that Melanie had never moved out of her parents’ house— not even when she went to college— she was an adult, just because she was getting married. I was still— and probably always would be—a child. She was living in a grown-up world that I was not an appropriate fit for, one that I might disrupt in the literal and figurative sense, starting with the wedding and continuing with the yet-to-be-conceived children.
            Like Carlos, Melanie had become Forbidden.
I stand on the front step of Melanie’s house thinking about how I learned through the grapevine that Melanie’s son is autistic. I hope he never has to go through the same traumatic social rejection that I did. I hope he never has to think of certain people as Forbidden.
What am I even going to say to Melanie? I've rehearsed this scenario in my mind countless times, but all that’s surfaced are raw accusations instead of adult-sounding questions: "Melanie, why the hell did you cut me off? Was I not good enough for you? How did you think I was going to react? Just shrug and say, ‘Oh fiddlesticks!’?” I know I can’t handle it like that. But in reality, I don’t know what I will say until the situation presents itself.
At the top of the stairs, the exterior door is open and only a screen door separates me from getting the answers I’ve needed. It is finally going to happen. Maybe the torturous, recurring dreams I’ve had over the past decade about running into Melanie only to have her freak out and bolt in the other direction will stop.
I listen to laughing out back. I hear a splash and calls of "Marco!" and "Polo!".
I raise my hand and slowly press my finger to the doorbell. Will they even hear it ring from the backyard?
“Come in,” calls a man— Ben, Melanie’s father. “I’m in the kitchen.”
I freeze. I didn’t expect this. Before I can say anything, Ben calls, “You’re here to fix the leak, right? Come in.”
I open the door and step over the threshold. I climb the small flight of stairs to the living room.
The room still looks more or less as I remember it, with a couch, a coffee table, a La-Z-Boy chair, television, and DVD player. But, now there is something else— children's toys. And from the looks of it, Melanie’s kids had been in the middle of an intense game before getting distracted by something else— a family afternoon in the pool, maybe? A toy canoe from Moana sits on the floor next to the coffee table. A Maui figure stands authoritatively on one end of the boat while a Moana figure stands on the other. She holds a paddle in both hands and her pet rooster stands beside her. Tamatoa, the giant crab, is near the boat, his claws raised menacingly.
I have some of the same toys.
“The leak is in the kitchen,” Ben calls, bringing me back from my thoughts. “Come in here.”
I turn and step into the kitchen.
“The sink is over—” Ben starts to say.
“Oh,” says Ben when I enter the room. “I thought you were the plumber.”
Ben sits in a kitchen chair, a cane in one hand. Right, because he’s fourteen years older than Melanie’s mother. He must be in his eighties now.
“Um, no,” I say, my hands once again having found their way into my pockets.
I see a hint of recognition in Ben’s eyes, and yet he’s not quite able to place me.
“I’m… I’m an old friend of Melanie’s. I’ve come to say hello.” I pause. “My name is Julie.”
Ben’s eyes widen. “Oh, yes,” he says, “I remember. It’s been a while. Well, I think Melanie’s downstairs taking a nap.”
Ben stands up. He looks a bit uncomfortable. Somehow, I know it's more than just the fact that his daughter's ex-best friend is in his house, but I don't know exactly why. "Um, let’s see if she's awake."
I look at my watch. It's going on 3:30. Why would Melanie be asleep?
Oh, right. She's a mother of two young children. Of course she's going to need a nap sometimes.
I nod and follow Ben down to the basement. It isn't nearly as I remember it. When Melanie and I had sleepovers, this was where we came to spend late nights watching movies and playing video games. There had also been a bar for when her parents entertained other adults. I used to play with this toy slot machine that sat atop it. The bar is gone, and in its place are a couple chests of drawers. Now there is a king-sized bed where the couch used to be. 
And Melanie is in it, wrapped tightly under the covers, her head facing the door to the backyard. I realize she must be sick, but I sense it isn’t some bug she caught from one of her kids.
My eyes are drawn to the nightstand, where a few half-empty prescription bottles sit.
"Melanie," Ben says softly. "Someone's here to say hello."
Melanie doesn't stir. I look at Ben.
"Um... this isn't one of her good days," he whispers, wringing his hands. "She… she has fibromyalgia..."
I freeze and stare in disbelief. I think about Jenna, the friend I'd met through Melanie at one of Melanie’s parties. We'd lost touch over the years until early 2015 when I reconnected with her— now them, as they've since come out as genderqueer—over Facebook. Jenna also has fibromyalgia. I cannot believe this bizarre coincidence.
I turn to the sound of the door to the backyard sliding open.
"Be-en," whispers a familiar soft, singsong voice. "Was that the plumber?"
I turn to face Mildred, Melanie's mother, her eyes wide open. "Julie, what are you doing here?" she asks.
"I— I just wanted to talk to Melanie," I stammer.
"Well, you can see that Melanie is asleep right now.”
“Huh?” Melanie mutters, her eyes still closed, her head now turned slightly toward me. “Who’s there?”
“Don’t worry about it,” Mildred says. “Go back to sleep. You need your rest.”
Melanie puts her head back to the position it was in just a minute ago, her eyes shut. But this time, they aren’t closed in the gentle, natural way of sleep.
They’re screwed shut.
Mildred stares at Ben.
"I just thought..." Ben whispers. "I mean, not many of her friends have come by in the past year."
Mildred shakes her head in disbelief and then nods toward me. “And she hasn’t been over here in God knows how long.”
And you think that was my idea? I want to retort.
But I say nothing. If Melanie is in a lot of pain, it would probably be cruel to bother her with the question, no matter how much I’ve been dying to ask it. Then again, she had no trouble being cruel to me ten years ago. But I doubt she is awake enough to even register my question, so asking would be pointless. Wait, maybe I could…
I turn to Mildred. “I just wanted to know why…” I begin slowly, but my words dissipate before I can get them out. It’s eerily like one of the recurring dreams I have in which I finally encounter Melanie, get ready to ask the question, to simply ask why, but when I move my lips, nothing comes out. Mildred turns to look at me. I try again. “I mean, all this time… I just need to know…”
But I am distracted by Melanie’s sleeping form, still amazed and disturbed by the coincidence that two of my closest friends from my teenage years now have fibromyalgia. I look at Melanie and think about the experiences with fibromyalgia that Jenna has told me about. They have told me that they have some days in which they can't even get out of bed, and other days in which they do get out of bed but are in constant pain. Then occasionally there are days when the pain isn’t so bad, and Jenna can go out with their friends. And for Jenna, sometimes medical marijuana is the difference between an intolerable and a tolerable day, as they’ve never found any prescription medication to be particularly helpful. Is Melanie having one of those can’t-get-out-of-bed days? How often does she have them?
            And I try again, the words leaving my mouth more quickly than I’d anticipated. “Why…why wasn’tIinvitedtothewedding?WhydidMelaniecutmeoff?”
            Mildred’s eyes widen. Did she even understand my question?
“Julie, you need to leave,” Mildred says. “Right now.”
At first, I don’t move, but then I head to the stairs. I stop and turn around when I hear the sound of the door to the backyard opening and closing again. A little brown-haired boy and a little blonde-haired girl, each in a bathing suit, run inside in fits of giggles. I look outside and see Melanie's husband, also in a bathing suit, his back turned to the house, looking off into the distance.
The boy, who looks about seven, rushes past me, runs upstairs, laughing and flapping his hands.
"Mommy, come play!" the little girl, who looks about five, shouts as she tugs Melanie's arm.
"Not now," Melanie mutters, her eyes still closed.
"Mommy, please!" the little girl says. "It'll be fun."
Melanie's mother kneels and grabs the girl by the shoulders. "Mommy isn't feeling well now. Okay? Go outside and play with Daddy." She pauses. "Goodness, you have mud on your face again. What did I say about keeping yourself clean?" 
I am still standing at the bottom of the stairs. This is a little girl! I want to shout. She's, what, five? It's summer and she's playing outside. Of course she's going to get muddy once in a while!          
But then I think back to when Melanie told me about the time when she was a teenager and was at a family gathering, playing basketball with some boys. Her mother, who had been sitting on a bench with some other middle-aged ladies, had called out, "Melanie, come sit with the women."
Mildred turns to face me. “Julie, you need to go.”
I nod, barely even looking at her. 
I begin to climb the stairs, and the little boy comes back downstairs, whooshing right past me, still flapping his hands as I press against the wall of the staircase. "I'm a bird! I'm a bird!" he shouts. "I can fly!”
I turn around to see Mildred take the boy’s hands in hers. "Mommy is asleep right now," she says. "And what have we said about 'quiet hands'?"
The boy stares at the floor.
I wish I could tell Mildred that there’s a growing consensus among professionals that in most situations you should not force an autistic child to stop stimming. Then again, if I—or anybody—told her, would it make a difference? I think about the time when Melanie and Mildred wanted to try a weight-loss plan which restricts carbohydrate intake for the first two weeks. This was not a diet created by a random person looking to get rich and famous, but a doctor, specifically a cardiologist. Mildred apparently knew better than this doctor: she told Melanie that restricting carbohydrates wasn’t enough, that they needed to also restrict fat during those two weeks. What was she supposed to eat, then? Grass? I remember asking Melanie if she and her mother had even read the book that explained how to do the diet. Melanie said that yes, she had. But her mother said that they were going to do it her way.
I can guess Mildred probably doesn’t allow medical marijuana in her house.
I continue up the stairs. I remember the very last time I saw Melanie, in the summer of 2005, when we met at Six Flags Hurricane Harbor in New Jersey. Melanie  intended to come back to New York City with me to spend the night, but her mother said no, that she already planned a girls' day out for the next day. And she also wanted her back home at eight that night.
Melanie was twenty-five years old.
As I head to the top of the stairs, I think about the grown-up, pristine, white-washed, even idyllic, adult life that I’d imagined Melanie having—despite living with her parents—all because she was married and had children. I realize I was not the only one who had imagined Melanie living this life. Her mother had imagined it, too—or more specifically, had planned for it. I remember how long before Melanie had gotten married, when she was working at Macy’s for $8.00/hour, Mildred was nagging her relentlessly about how she wanted to be a grandmother. Melanie had said that she wanted to have children. But now I wonder if she really did. Was she even aware that not having kids was also an option? Would she have explored both options had her mother not pressured her?
I realize something.
Melanie isn’t just a perpetrator in this story. She’s also a victim, specifically a victim of her mother, in this and in a lot of other things in her life. And on top of it, she has fibromyalgia.
I turn around one last time. I can't leave without saying something. I go back down the stairs with the intention of letting Mildred have it with both barrels, age-appropriateness be damned. I’m going to tell her, You've destroyed your daughter. You kept her under your skirt, forced her to repress her true self, and prevented her from achieving independence. For what? So she could be an extension of you? She had so much potential and you just squashed it. And now you’re doing it to your grandchildren.
I reach the bottom of the stairs, where Mildred glares at me. "Julie, you need to leave now."
I point a right index finger at Mildred and open my mouth, but all that comes out is a brusque, "I hope you're satisfied."      
"Julie, get out before I call the police," Mildred says, this time her voice raised.
I see Melanie’s eyes open very slightly. But then they close again.
"Hon, isn't that a little harsh?" Ben asks as I climb the stairs.
I can hear Mildred lecturing Ben, but she’s dropped her voice to a very low whisper and I can't make out what she's saying. I almost laugh as I open the front door. Funny Mildred should talk about calling the police. Ben is a retired cop. But that's the last thing the casual observer would suspect...
I shake my head as I open the door and step outside. I pull out my iPhone to send Jenna a text on Facebook messenger.
"You're not going to believe this. I just found out that Melanie has fibromyalgia."
Jenna asks me how I know. So I tell them about what I did.
Then Jenna says, "Honestly, I'm not interested in hearing about someone who cut me off without explanation."
I stop at the bottom of the outside steps. "What??" I text back.
"I thought I told you a while ago," Jenna says.
"No. What happened?" I reply.
As it turns out, around 2002 or 2003, Melanie simply stopped taking Jenna's calls, stopped answering their emails . . . and Melanie and Jenna had once been close, too. But I also remember asking Melanie around that time, "Do you still talk to Jenna?" and she'd said something, I forget exactly what, that made it sound like they’d merely lost contact.
I shake my head and I walk to the car. What I saw inside that house today tells me everything I need to know. I never got to ask Melanie why she ended our friendship, but I don't need to. Whether she thinks she just "lost contact" with me—and Jenna— or whether it had ultimately been her decision to end everything, I'll never know. But it's clear that she didn't do it in a vacuum. 
I get in the car and start the engine.  I pass Melanie’s street on the way out of the housing development. I briefly glance at her house, but then return my eyes to the road.


Footnote: Yes, I'm aware of the irony of using a fantasy to discredit another fantasy. But parts of this story are based on memories as well as a few things I've heard about Melanie through the grapevine, so it's not a fantasy in a vacuum.