Saturday, February 11, 2012

Dr. Sabra Explains Autistic Thinking

(I'm going to reprint a post that turned out to have legs. People keep finding it, and they either love or hate Dr. Sabra, and they obsessively TELL me about it. As far as I'm concerned, that's fine.)


My friend Dr. Sabra (not her real name) is a psychiatrist of fame and powerful flair. I thank God every day that I'm her friend and not her patient, since paying her consulting fees would definitely make me more depressed than before. She's famous for cracking her patients like whips, for being plain-spoken to the point of eye-popping rudeness. Who needs it? If I want someone to tell me off, there are many friends and relatives who are eager for the task, and they won't charge hundreds of dollars an hour.

According to rumor, when in full psychotherapeutic rant, Dr. Sabra might accuse one patient of "wallowing in the mire of your Mickey Mouse obsessions," or another of "returning to your evil Ex like a dog to its vomit." Not everybody enjoys being accused of having inferior obsessions. Not everyone wants an impossible but beloved former partner to be compared to barf. Dr. Sabra will also sometimes casually mention, during a session, that she hates the patient's haircut.

But, whether you love her or hate her, she knows her psychiatric onions. So she was the person I asked to explain a term which has been cropping up lately: "Autistic Thinking." Politicians, poets, conspiracy theorists, celebrity couples, suddenly everybody is accusing everybody else of this. What does it mean?

As Dr. Sabra considered the phrase, her eyes gleamed like a mighty tigress spotting a juicy gazelle. "That's one of my favorite subjects. It's simple. And the phrase has almost nothing to do with true autistics. It has to do with whether a person insists on lying to himself.

"There are two types of people in this world. There are people like me, who know that reality is their friend. They don't want to wander in fantasyland. Their home is planet earth. They want their feet on the ground and their eye on the prize, whatever that might be for them. They want to listen, learn, think, and then move in response to reality. I love people like that. They really have a chance in this world.

"Then there are the autistic thinkers. They think that reality is whatever they prefer to believe.
'No, it's not, you idiot,' I tell them. A lot of my patients are like that, but also many everyday people who would never think of themselves as disturbed. I've conducted thousands of hours of sessions, and believe me, they don't always sound so different from conversations with friends. A patient tells me that the earth is 6,742 years old, or that the drunken husband who shoved her head in the toilet last Saturday night is really a good guy at heart. 'No, he's not good,' I tell her. Or a friend tells me at a bar mitzvah that his adult children, who haven't visited for eleven years and only call when they want money, really love him. 'No, they don't," I tell him. Is that cruel? How cruel would it be to let him keep waiting for those children?

"We all know people like this. There's something wrong in their heads that makes them think they can mash reality around like it was a piece of Wonder Bread. One of my acquaintances is a nasty gossip. She makes up stories about people she sees as a threat. She's fearful that she's going to lose her partner, be kicked out of the house that the partner owns. She was spotted rushing around outside throwing gravel on a neighbor's roof whom she dislikes, God knows why. She said it was because of 'something she heard.' Would you like to be holding your breath until this woman admits to herself that she heard WRONG? What would you call someone like that?"

"Hysterical cow?" I suggested.

"You got it. An autistic thinker denies the plain evidence of his senses, and is an enemy to his own brain. Some of them are rich and successful, but I always think of them as orphans of the storm. I picture them driven across the sky by violent winds, with their heads upside down and their hair spiralling out in electric shocks, like in a Marc Chagall painting. When they're my patients, I try to convince them to climb down, or jump, or cannonball, or do whatever they need to do so they're no longer stuck in the sky of delusion.

"Why are they so afraid? Truth, facts, reality, all of these can cause pain. But it's always better to know. Because nothing, nothing, could ever be more painful than to move like a stranger in their own minds."