Autism and Asperger's Syndrome
With additional post graduate qualifications in autism and Aspergers, and with many years personal experience of living with family members who are dealing with this condition, I have for a long time been very been interested to understand this better.

Many of my clients, both children and adults, experience difficulties because of this condition. Anxiety is probably the most common mental health condition that arises with people who struggle to understand the complexity of social situations, the often overwhelming stream of sensory information, and the high expectations placed on them in this fast changing world we now experience.

Although there are still many questions to be answered about the condition, I believe the new idea of 'caetextia', developed by the authors and founders of the Human Givens approach, to be the most comprehensive, understandable and effective working model I have come across.

All people, wherever they are on this spectrum, have the same emotional needs and therefore Human Givens therapy will work towards helping all people to get these needs met. Adjustments can be made to some of the strategies we use, but not to the basic idea that getting needs met in due balance is the key to reducing the anxiety, depression, and other stress responses that people on the spectrum often face.

The Human Givens approach and understanding is quoted below:
Context blindness and Asperger's traits
Caetextia — context blindness caused by an inability to keep track of multiple interconnecting variables and to reprioritise any change in those variables by referring to a wider field that contains the history of them. This causes people with caetextia to resort to one of two mental modus operandi: logical, straight-line thinking or thinking by random associations.

Joe Griffin and Ivan Tyrrell first coined the term "caetextia" in 2007 to describe the most dominant manifestation of autistic behaviour at the highest levels of the autistic spectrum. Their first publication of this idea is in an article first published in the Human Givens Journal Vol 14, No 4 (2008) and a paper presented and illustrated with numerous filmed examples of Caetextic behaviour at a MindFields College Advanced Studies Course and also at the Human Givens Institute Conference in 2009.
Introduction: Parallel Processing
Autistic traits are generally recognised as occurring along a spectrum — with severe autism at one end and a higher-functioning, ‘milder’ form (known as Asperger’s syndrome) at the other. The core areas affected, to varying degrees, are ability to understand and use non-verbal and verbal communication; ability to understand social behaviour and behave in socially appropriate ways; ability to think and behave flexibly; and over- or under-sensitivity to sensory information. Even people labelled as having Asperger’s syndrome can vary in the severity and number of traits they display, ranging from severe learning difficulties and low IQ to high IQ and a talent for learning that brings acclaim.

It seems remarkably odd to us that a person who needs specialist help and assisted housing can be included in the same category as a professor of physics, say, or a gifted poet or musician, or a computer programmer who is married with a family — individuals who, despite having Asperger’s syndrome, have managed to make an accommodation with the world and learn enough of the ‘rules’ to function highly efficiently and relate to people to some degree.

We suggest that, by looking at the evolutionary history of mammals and humankind, we can arrive at a more comprehensive way of viewing the autistic spectrum than has been offered to date — and that this new understanding can help us help those who seek therapy for psychological difficulties. We are going to put forward the idea that occurring throughout the entire autistic spectrum is a phenomenon that has not previously been identified; that a remarkable mental capacity, one that came to the fore once mammals started to evolve, is missing from all people on the autistic spectrum; and that this major deficit, while it may be just one aspect of what is missing in autism, is uniquely what is missing at the higher performing end of the Asperger’s spectrum. It is the ability to read context.

Professor Simon Baron-Cohen of Cambridge University, one of the world’s leading authorities on autism, has suggested that there is a systemising brain (usually associated with the male thinking style) and an empathising brain (traditionally associated with female behaviour) and that we all have varying amounts of each.1 He has provided much evidence for this claim, showing how these sex differences arise more from biological than cultural causes, and goes so far as to support Dr Asperger’s suggestion that the syndrome is an extreme form of the male brain.1 However, after many years of working therapeutically with male and female adults with Asperger’s syndrome, as well as interacting with them socially and in business, we believe that the extreme male brain theory of autism, which does at first seem persuasive, is an insufficient explanation for the various deficiencies seen in this syndrome. It does not explain, for example, why many otherwise extremely feminine women show Asperger’s traits but many men who are good systematisers don’t. It was this sense that the puzzle of autism remained that led us to look back to our evolutionary past to search for new clues.

The evolution of mammals and birds began when they developed the ability to generate and maintain a constant internal body temperature, irrespective of the external environmental temperature — popularly known as ‘warm-bloodedness’. Reptiles regulate their body temperatures by moving to different places in their environment to get warm or cool down; they can move around quickly only when their blood has heated up and are sluggish when their blood is cold. In contrast, mammals can respond quickly and move around whatever the external temperature.2 But this greater mobility, flexibility and freedom of behaviour came at a high price: a staggering 0–90 per cent of a mammal’s energy is spent on maintaining its constant internal temperature. Compared with a similar-sized reptile, which controls its temperature by external means, this means a fivefold increase in energy requirement. Early mammals couldn’t afford to give way to impulses that would waste energy unnecessarily. So they had to evolve a mechanism which would make them more intelligent in their reactions. Mammals had to develop a brain that could store memories of previous encounters and use these to appraise future encounters more efficiently. In effect, this enabled them to subject every arousing event to a risk analysis: “Does that noise signify potential food – or danger? Should I hide? Am I likely to succeed in catching that rabbit?” They had to make decisions based on the specific circumstances or context that they found themselves in — and do so swiftly, as their survival might depend on it. Even if a rabbit was near enough to chase, it would be wasted effort if a rival could get there first — or fatal, if a bigger predator appeared on the scene.
The brain and context
To see context, we need to be able to attach events and see them from different viewpoints. The early behaviourists believed that mammals and birds simply responded mechanically to stimuli, but more sophisticated experiments revealed that there is a cognitive component involved in their response, which relates to prior experience. One significant experiment demonstrated that there is a mammalian intelligence that searches for and assesses relationships between different events — some part of the brain has reviewed the history of past experiences of a similar kind.3 Many subsequent experiments have substantiated this finding. So, millions of years ago, mammals evolved, in effect, a biological form of what computer buffs today call ‘parallel processing’: a mechanism capable of gauging risk by processing multiple streams of current information, at the same time as unconsciously comparing similar, previous experiences with each new one. It is something we take completely for granted today but, millions of years ago, it was the key to surviving and thriving.

When we say that the profoundly disabling impairment that runs across the whole autistic spectrum is the inability to perceive context, we mean this mammalian ability to maintain separate streams of attention and switch effortlessly between them to assess the relevance of each to what is currently happening. This can be done only if the brain can dissociate: review what it knows about something it has come across before, while still paying attention to that something in the here and now. Modern brain scientists have ascribed this function to the anterior cingulate gyrus. As one neuroscientist puts it, “This region is active when we need controlled, distributed attention, such as listening to our friend at the party while also watching our colleague dance. It also tells us to forget both of those people and pay close attention to the other side of the room when we sense that potential combatants may start a fight.”4

‘Context blindness’ — the inability to switch easily between several foci of attention and track them — is clearly seen in autism (the child transfixed by spinning the wheels on a toy car has no sense of a car’s real purpose, for instance) but is the most dominant manifestation of autistic behaviour in high-achieving people with Asperger’s syndrome. We have therefore named it ‘caetextia’, from the Latin caecus, meaning ‘blind’ and contextus, meaning ‘context’. We are suggesting that caetextia is a more accurate and descriptive term for this inability to see how one variable influences another, particularly at the higher end of the spectrum, than the label of ‘Asperger’s syndrome’.

If you can read context, it seems like the most natural thing in the world. You might be talking to Maggie about something, for example, but another part of your attention is aware that Jill is listening as well and could read implications into what you are saying that you didn’t intend. So, straight away, because you have this awareness, you are able to alter the way you speak and detach attention from different objects to take into account Jill’s possible reactions too. When you can do this easily, it is difficult to imagine not being able to do it. But caetextic people can’t. As a consequence, they also have difficulties understanding complex metaphors because they mainly rely on logical thinking and random associations.
Other theories
Leading researchers in the field of autism have also linked the word ‘context’ to Asperger’s syndrome. Cognitive psychologist Uta Frith, along with others, has put forward a theory of ‘central coherence’, which suggests that, when carrying out tasks, people with autism show a relative failure to process information for context dependent meaning.5 For instance, it has been found that, if a high-performing person with Asperger’s syndrome is asked to retell a story which they have been told, they are likely to focus intensely on the small details in it — whole sections of whatever they can recall, almost verbatim – but will completely miss the overarching idea, meaning or metaphor. They fail to extract the main idea because they are not sensing context. Frith points out that, if you tell a story to someone who is not on the autistic spectrum and ask him or her to retell it, they can invariably give you the gist: its central meaning.

Another theory to explain Asperger’s syndrome and autism was developed by Simon Baron-Cohen, Uta Frith and their colleague Alan Leslie, while all were working at the Medical Research Council’s Cognitive Development Unit in London in the 1980s. It proposes that people with autism lack ‘theory of mind’: what is missing in autism is the ability to read other people’s minds and, from that, to predict other people’s behaviour.6 As Frith describes it, “Thinking about what others think, rather than what is going on in the physical world outside, is essential for engaging in complex social activity because it underpins our ability to cooperate and to learn from each other. Our research has shown that theory of mind is either absent or severely delayed in autistic individuals and that this can explain their difficulties in social communication.”5

Frith is now looking for a way to relate the theory of central coherence to the theory of theory of mind. We propose that the theory we are putting forward does just that and also provides a much richer view of context than the theory of central coherence. To us, central coherence and theory of mind are limited examples of the deeper principle we are describing, which is the crippling inability to see the world from multiple perspectives and to recognise how sudden change can alter a current situation.
Examples of context blindness
A friend of Joe’s, who had Asperger’s syndrome, used to stand in front of a mirror and brush the front of his hair, but never the back. The image he saw in the mirror didn’t show the back of his and, clearly, he was not relating the image he saw to a bigger ‘picture’ of his head as a whole. He was genuinely unaware that a human being can be seen from all angles and that, therefore, he should comb his hair back and front, if he wanted to make a neat impression. Clearly, there was a major category of information missing in his mind: being able to view a situation from different perspectives (context).

Sarah, a woman with Asperger’s syndrome, was asked by a friend what she thought of an expensive fancy handbag the friend had just bought. Sarah didn’t like the bag and was completely nonplussed as to how to respond. She could see only two possibilities: to tell the truth, which was that she disliked it, or to say nothing. She was unable effortlessly to juggle in her mind conflicting perspectives (not liking the bag, liking the friend) and choose an appropriate one to communicate, on the basis of a wider knowledge of the possible consequences (upsetting or pleasing her friend). She was unable to see, for example, that an honest opinion is not always required in such circumstances; she could have pretended to like the bag, complimented her friend for buying it, or told her that it was a bargain. In fact, she said nothing at all, which totally perplexed and unsettled her friend. (This inability of people with Asperger’s syndrome to be tactful or diplomatic is often interpreted as frank honesty.)

A very intelligent man who had Asperger’s syndrome used to come out in a rash whenever he was anxious, which bothered him. One day, he read in a health magazine that mustard was good for skin rashes and promptly bought an industrial-sized pot of it, so that he could plaster mustard over his face every day. It never occurred to him that customers in the shop he managed would think it odd to see him walking around with a bright yellow face.

Another man with Asperger’s syndrome, also highly intelligent, described to us how his wife gave him a little box of chocolates just before they went out to celebrate his birthday and said, “You can eat the whole box while I go upstairs to get ready”. When she came down a little later, dressed for their night out, she found him eating the cardboard box. She immediately got angry and shouted at him — but he had absolutely no idea why. After telling this anecdote, he said, “It seems as though other people have a concept to follow that I am missing. I just follow the instruction.” If he had had instant access to the knowledge that humans are not expected to eat cardboard boxes, just the contents of the box, he would not have engaged in this bizarre behaviour. (Interestingly, such literalism can also be observed in people in deep trance.)

Another example: a professional woman who came to see one of us had decided to give up her job in a bank and go and live in a Buddhist meditation centre. Although she was keen to do this, she was also very sad and upset because she would never see her mother again. When asked why, she said, “My mother’s a Catholic”. She assumed that, if she went to visit her mother, she would have to tell her about her own change in religious belief, and that her mother wouldn't be able to cope with it. It didn’t occur to her that people of different faiths can still know and love one another, especially if they are family; or that she could choose to protect her mother from what she thought would be devastating information for her, and just continue to go to Mass with her mother whenever she was home.

Clearly, in such cases, people lack the information necessary to inform their judgements about the choices and actions available to them in different situations.
Struggling to cope
It is, therefore, easy to see why people with caetextia experience high levels of frustration, anxiety and anger when other streams of information keep intruding into whatever they are trying to do — especially when their needs for structure, rules and rituals are transgressed. Because they don’t know instinctively that multiple factors affect any given situation, they may be nonplussed even when just two simple interacting factors require attention. We saw this clearly in the jerky way a colleague with Asperger’s syndrome would drive. Whenever he became aware that a gap between his car and the one in front was closing or widening, he responded by jamming on his brakes or speeding up inappropriately, instead of gently moderating his speed to accommodate what is, after all, a continually fluctuating situation when driving. He found it difficult to negotiate varying circumstances smoothly — other drivers changing speed, closeness to other vehicles, the curve of the road, weather conditions, etc — all of which need constant simultaneous attention.

On one occasion, he was in the wrong lane when approaching a set of traffic lights. When it was pointed out to him that he needed to move over to the right lane, he refocused his attention on this new task and was unable at the same time to continue processing and prioritising other relevant information — such as the fact that the light had changed to red and that driving through it could get him and his passengers killed. Indeed, he proceeded to drive on through the red light, causing us much alarm and consternation! Although he was aware of this deficit, and described it as ‘straight-line thinking’, he was unable to do anything about it.
Dancing with horses
A dream, by chance related to Joe by his teenage daughter Liley-Beth, served to crystallise our thinking about the role of context. In the dream, she went to a club with a horse; all the other girls there were dancing with horses and she, too, started dancing with a horse; it seemed the most natural thing in the world. Then the horse asked her out and she was just wondering whether to accept when she woke up. When Liley-Beth described the dream over breakfast, she said that what astonished her most about it was her unquestioning acceptance, in the dream, that humans can go out with horses. Everyone who remembers dreams will recognise this feeling of accepting as perfectly natural a phenomenon that is actually distinctly odd: it is the same as that described by the man who had felt it was natural to eat the cardboard box — except that he was awake.

So why did Liley-Beth unquestioningly accept, as we all do in dreams, such bizarre happenings? The reason has to be that in dreams we have access to emotions and metaphor but not context because, while dreaming, the prefrontal cortex, which the right hemisphere draws on for background information, is switched off. The context missing in this dream was the information that humans do not go on dates and dance with horses; horses can’t walk around on two legs and speak like humans. Because, in the dream, Liley-Beth was cut off from the background information usually available to her, she was totally accepting of the validity of the dream imagery. Exactly the same thing appears to be happening in the experience of people with Asperger’s syndrome (caetextia). They accept absurdities as true and make judgements about them, without the background information to apply to the context they find themselves in.

For those of us not permanently suffering from caetextia (it can be a temporary phenomenon, too, induced by stress and anxiety and depression) our minds can unconsciously draw on a vast hinterland of information that informs different aspects of any situation we find ourselves in. People with caetextia cannot do that because, although they may have collected millions of individual ‘facts’ in their memories, they are missing the ability to scan instantly for patterns in that rich background of information. Consequently, when something changes, they can’t evaluate the importance of the change and how it affects what is going on in the wider environment. They can no more do a reality check while awake than anyone else can while dreaming.
Chaotic emotions
For caetextia sufferers, one of the main consequences of not being able to manage separate streams of attention simultaneously is that they have no easy way to control their emotions. They cannot detach from a conditioned response pattern and see the possible consequences of that response or consider other more beneficial ways of reacting. Thus they feel confused and out of control, suffer extreme anxiety and anger, and can swing between wild mania and the blackest depression. They may also have trouble with sexual emotions and their sexual identity. Enduring this emotional turmoil must sometimes feel like living with an unpredictable wild creature. Indeed, some people with caetextia have told us that this is exactly how it feels.

Maybe the sensory overload that many people on the autistic spectrum experience is because of their inability to process within themselves the changes going on around and within them. As they struggle to moderate their feelings, the only hope they have of reducing the pain that this sensory overload causes them is to try and control the environment and other people as much as possible. Because exercising control keeps their arousal down, and thus makes them feel better, they tend to do it obsessively. Unfortunately, as reducing their stress levels in this way involves exerting control over others, this raises the stress levels of everyone around them.
Left and right brain
As the intelligence system evolved in humans, our higher cortex became more complex and its left and right hemispheres developed specialisations for different processes. Whilst maintaining the ability to interact with and complement each other, the hemispheres developed exponentially to support rational and contextual thinking. Human language and thought, for example, are primarily ordered through the left hemisphere, which sequences and structures information moment by moment in a way that fosters reason. But our logical thinking is informed, and also coloured, by associative thinking and imagination, both faculties that emanate from the right hemisphere. Whereas previously we had relied on instinctive responses to keep us safe, once the cortex developed in modern humans we became able consciously to review feelings and not just act on them. In other words, we could investigate what was going on around us with a more refined reasoning ability.

But when people are missing the mammalian ‘parallel processing’ template for handling multiple streams of information, they are forced to try and resolve problems by other means. If a person is left-brain dominant, we see Asperger’s behaviour as traditionally recognised: literal, logical, analytical reactions with difficulties in communication and empathy because of a severely diminished ability to think contextually. This happens because the left neocortex is itself ‘autistic’ — it doesn’t have access to the feelings that create context. But if a person is right-brain dominant and is missing the template for reading context, we suggest that caetextia may express itself through an undisciplined, very strong imagination. The right brain looks always for associations, so, without a strong left brain to moderate the myriad associations that the right brain makes, a person with caetextia cannot discipline them and check them out. The associations made are unlikely to be the right ones because, without access to a personal emotional history, they are not anchored in reality. The constant, undisciplined association-making can lead not only to inappropriate but often quite bizarre thoughts and behaviour.

Right-brained caetextia is caused by a lack of instinctive feelings to moderate the person’s thoughts and behaviour, leaving the mind to run free, making directionless, random associations. Because a right-brained caetextic person is more emotional, it may seem odd to suggest that their condition is due to a lack of instinctive feelings, but it is the lack of emotional instincts to discipline associations that give rise to problems. Scientists researching decision making have determined that it is emotion, fired by imagination, that prioritises decision making, not logic. “Emotions arise when events or outcomes are relevant for one’s concerns or preferences and they prioritise behaviour that acts in service of these concerns”7 (our italics). Both right- and left-brained caetextia result in black-and-white thinking. Indeed, when heavily stressed, we can all become temporarily caetextic: prone to black-and-white, crazy, irrational behaviour and faulty reasoning.
More women than men
The contention that Asperger’s syndrome is overwhelmingly a male condition, with the male-to female ratio ranging up to 15:1, is not consistent with our clinical experience. As psychotherapists we see more females than men with his condition and, even taking into account that more women than men come for therapy, we believe that the prevalence of Asperger’s syndrome in women is underestimated.

We would suggest that females are much more likely than males to suffer from right-brain caetextia, and that clinicians are not yet recognising this expression of Asperger’s syndrome. This could be because, although in right-brain caetextia we see the same inability to track multiple foci of attention and think contextually, such people have ready access to emotions in a way that left-brain dominant caetextics, who, in our experience, are predominantly male, do not. Right brain caetextics can become emotional quickly and very, very easily, crying at the slightest upset, for instance. This accessibility of emotion, much more common in women generally, disguises the caetextia. However, they are sometimes just as poor at interpersonal intelligence as those diagnosed with Asperger’s syndrome. They also lack empathy and cannot see how inappropriate their behaviour or beliefs appear to others.

Two conditions that we have noted, not infrequently, to be co-morbid with right-brain caetextia are fibromyalgia (a chronic disorder, primarily occurring in women, characterised by widespread musculoskeletal pain and fatigue) and chronic fatigue syndrome (CFS, also known as myalgic encephalomyelitis, or ME), which is three to four times more common in girls and women than in boys and men.
Sense of self
When, in our evolutionary past, humans gained conscious access to the right hemisphere of the brain (the source of imagination), complex language with a past, present and future tense could develop.8 Only with the arrival of complex language could we escape from the present and describe things that were not there in front of us. It was this that opened up the possibility of universal reasoning: discovering the underlying patterns and rules by which matter and life operate. Only then could we begin to develop and test hypotheses and start to unravel the cause-and-effect sequences in the world around us — water enables plants to grow; sunshine facilitates growth; there is a rhythm to the seasons, and so on.

Although missing the template for parallel processing, the more intelligent a person with caetextia is, the more likely they are to have access to universal reason. They may then be able to use thought to reflect back consciously on whatever has happened and construct another perspective. But this is a slow process and, without instant access to their own reinforcement history, their sense of self will be impaired – that sense of ‘I-ness’, of being separate from whatever context we happen to be in. People on the autistic spectrum, lacking this ability, may struggle to develop a sense of self and typically feel insecure in a world where everything is constantly changing. It may be this impoverished sense of self that keeps driving the more creative people with this condition to find out who they are, trying out roles to play in life and reinventing themselves, etc. Since scientists began studying Asperger’s syndrome in the 1940s, it has been continuously remarked upon that sufferers lack a sense of who they are. “I feel like an outsider, and I always will feel like one,” the autistic writer Anne Rice once said, in an internet interview. “I’ve always felt that I wasn’t a member of any particular group.”9

Perhaps because they feel like outsiders, people with caetextia are often attracted to professions that give them an off-the-peg identity, very often one that comes with a uniform that announces that identity, such as army fatigues, police uniforms, church regalia or even the more eccentric costumes of ‘artists’ and ‘intellectuals’. Uniforms confer status. Professions that require uniforms also tend to have more tightly defined structures – rules, rituals and coded modes of speech – all of which render life more predictable and make people with caetextia feel more secure. In a well-ordered life, the sensory overload feared by autistic people can better be kept at bay.
The Observing self
For some years, whilst teaching psychotherapy, we have been using the term observing self — awareness of awareness itself. The observing self is different from our thinking self, emotional self or functioning (physical) self. It is outside these, yet experiences all of them. Arthur Deikman expressed this beautifully as follows: “The most important fact about the observing self is that it is incapable of being objectified. The reader is invited to try and locate that self to establish its boundaries. The task is impossible; whatever we can notice or conceptualise is already an object of awareness, not awareness itself, which seems to jump a step back when we experience an object. Unlike every other aspect of experience — thoughts, emotions, desires, and functions — the observing self can be known but not located, not ‘seen’.”10

The observing self is a waking state in which we dissociate from the external world and become aware of being aware, entering the daydreaming (REM) state just enough to allow us to review different aspects of reality — to see multiple contexts. But if we were to become absorbed to the same extent as when we are dreaming, our sense of reality would disappear. While daydreaming, our brains are still contextually aware, so that, when we stop introspecting, we know very quickly where we are and can reorient ourselves. Whereas, in the dream state, we are totally ‘associated’: completely lost in the dream.

Accessing the observing self is something that caetextic people have great difficulty doing because it involves focusing on something specific and then defocusing, to see a bigger context; then, whilst holding the bigger focus in mind, focusing back down again. When we give our lectures, for example, we are totally focused on the point we are making at any one time but, every so often, we have to defocus: we must open up our minds to see where we are in terms of the work that has to be covered that day, assess whether we are being fully understood, whether it will soon be time to stop for lunch, etc. This continual process of focusing, defocusing and refocusing keeps us aware of the bigger context.

Those who struggle to see context cannot detach or dissociate. This is why certain psychotherapy techniques are ineffective with at least some caetextic clients. The powerful technique we know as the rewind technique, which can effectively neutralise even the most severe symptoms of post-traumatic stress disorder (PTSD and phobias), involves guided imagery and dissociation. First, we deliberately emotionally arouse the client, by momentarily focusing them on the traumatic memory that is bothering them, and then help them to achieve a state of physiological calm in which they are guided to defocus, so that they can view the traumatic memories in a dissociated way. The technique requires the client to set up two different streams of attention: seeing themselves on a screen and ‘fast forwarding’ through the traumatising event(s), and going backwards very fast through the same event(s), until there is no longer emotional arousal associated with the memories. This technique, when correctly carried out, is highly successful for most people, leading to a cessation of their post-traumatic stress symptoms, such as panic attacks and nightmares; however, it doesn’t seem to work for many people with caetextia. That must be because the process is dependent on the patient’s ability to maintain different perspectives simultaneously.
Caetextia as an organising idea
The term Asperger’s syndrome was derived from the name of the doctor who first described its traits, and means nothing in itself, whereas the term caetextia represents the underlying condition. Because the name is innately descriptive, it points to more effective ways that we can work with and relate to people who have caetextia. Because they can’t read context and can’t, therefore, take certain necessary cognitive leaps for themselves, caetextic people can bene fit from ‘borrowing’ someone else’s brain to help them learn how to do what others can do instinctively. Someone has to explain the rules of behaviour to them, using clear, concrete, terms and train them in how to keep to those rules. As people with caetextia are very literal minded, metaphors, when used, must be extremely simple. (For instance, Ivan used the metaphor of a train switching between tracks to convey to the woman who wanted to become a Buddhist that she could choose to ‘switch’ to behaviour that would please her Catholic mother (ie go to Mass just during her brief visits). People with caetextia may have little or no facility with guided imagery and it works less effectively with them.

However, we have often found that teaching them breathing techniques to lower anxiety can help them a lot. Those vulnerable to outbursts of extreme anger have also found helpful the idea of identifying the anger as a wild animal that they need to let calm down (by taking time out and doing some aerobic exercise, such as brisk walking, jogging or other energetic activity).

Undoubtedly, many highly imaginative right brained people, who may be vulnerable to psychotic thinking, display caetextic tendencies that compromise their ability to connect to the ‘ordinary’ world. Anyone involved in psychotherapy soon comes across such people: emotionally intense, self-absorbed patients whose strong imaginations are not moderated by their left brain. They spend much of the time disconnected from reality, pay only lip-service to reason and are often eccentrically involved in ‘arts and crafts’. Despite showing undoubted signs of creativity, they might not be able to discriminate good work from bad and can take their work intensely seriously, even if it isn’t particularly good. It is important to recognise, however, that people suffering from psychotic illnesses, perhaps the majority, do not necessarily suffer from caetextia; their vulnerability arises from traumatic experiences and an imaginative mind. It is also important to recognise the developmental potential in creative people with caetextia. Some of them mature as they grow older, improve their ability to read emotional contexts, resolve their emotional problems and become more secure in themselves, whilst still retaining their creative faculty.

Caetextia is a significant disability yet, much of the time, manages to go unnoticed. This is because, when a person at the higher end of the autistic spectrum becomes familiar with an environment, and what is expected of them in it, they may become sufficiently competent and confident in that role, so the caetextia remains concealed. This is analogous to somebody with a poor sense of direction. When that person is in an environment that is familiar to them, their poor sense of direction does not reveal itself. It is only when they find themselves in unfamiliar territory that it becomes obvious that they cannot naturally find their way around it, whereas the brain of someone with a good sense of direction automatically maps it. For instance, in a large, unfamiliar hotel, when someone with a good sense of direction first makes their way to their room, their brain automatically not only records the route but, when they come out of their room, automatically relocates them in its mental map, so that they walk the right way back. But, if someone has a poor sense of direction, the brain will remember only the direction taken to the room. It hasn’t recorded an internal ‘map’ and can’t reorient position accordingly, so when the person leaves the room, they find themselves going in the wrong direction.

Of course, lacking a sense of direction is not a serious disability and can be compensated for easily, unlike inability to recognise context. Thus it is that many people with unrecognised caetextia end up seeking therapy because of difficulties with emotions such as anger, anxiety or depression, aroused by problems in new relationships, confusion about sexual identity, unmet sexual needs, obsessions, inability to hold down a job, managing money, etc. We suggest, therefore, that caetextia (context blindness) not only plays a role in autism and is the key deficit in high-functioning Asperger’s syndrome but degrees of it affect very many more individuals than might be thought of as suffering from an autistic spectrum disorder at all.
The REM state and autism
Dream sleep occurs primarily in the state of sleep known as REM sleep. We and others have argued that acquiring conscious access to the REM state – daydreaming – was a major precursor of the development of complex language and culture.8 Daydreaming enabled humans to see beyond the present moment and to develop complex language to describe a past and plan a future. To focus intensely on solving problems also required the use of the imagination. So there must have been, and still remains, great pressure on genetic selection to favour the ability to achieve this state of focused attention. However, in increasing access to daydreaming, are we also potentially increasing access to an autistic state? We have already seen that people are caetextic whilst dreaming. Perhaps children who are able to go too deeply into the REM state whilst awake (as a result of a genetic vulnerability) are consequently less able to switch out of this caetextic state fully (whereas most of us automatically reorient to reality after dreaming or daydreaming). Could it be these children who are most vulnerable to autistic spectrum disorders (caetextia)? In autism proper, a great many mammalian templates are not accessed,11 in addition to the one for context thinking. This vulnerability could also arise for the same reason.
Caetextia and Chronic Fatigue Syndrome (CFS)
We reviewed the cases of people with Chronic Fatigue Syndrome (CFS) that we had seen and found certain characteristics stood out that clearly overlap with caetextia/Asperger’s syndrome. These include:

  • inability to think contextually, leading to unrealistic expectations of capabilities. People may talk about life goals that are not really reachable from where they are. For example, one right-brained caetextic woman with a diagnosis of CFS had, as her somewhat unrealistic aim in life, “healing wild animals, like lions and tigers”. A depressed, left-brained caetextic man had an equally unrealistic goal of starting a sailing school in Malta, when he couldn’t sail or even swim
  • a history of relationship difficulties
  • difficulties in developing rapport with a therapist, due to obsessive self-focus and lack of emotional reciprocity
  • resistance to change, inflexibility of thought and rigid behaviour patterns
  • problems with short-term memory, concentration and maintaining attention, typical of predominantly right-brained people. (By contrast, left-brained caetextics have enormous powers of concentration.)
  • sleep disturbance
  • clinical depression
  • extreme mood swings – sufferers may get angry or depressed for no apparent reason
  • inability to ‘read’ what others might be thinking
  • tendency to do too much at one go, then collapse with exhaustion. This can take the form of workaholism: taking on tremendous responsibility, working excessively hard and then collapsing
  • perfectionism. Combined with an excessive workload, this stresses the immune system to such an extent that even a simple viral infection can trigger CFS. Indeed, CFS is sometimes called post-viral fatigue syndrome.
Joe Griffin explores Caetextia and the default network
This is a developing idea, and since the publication of the original article available on this site, caetextia theory has evolved. We have made available a recent lecture by Joe Griffin in which the explains the latest developments to the theory. The REM state, caetextia and the development of self-concept on Vimeo.
In this lecture given at the Human Givens Institute Conference in May 2009, Joe Griffin explains the connection between madness and creativity, why we dream, why we are caetextic in dreams, and how caetextia is supported by the current brain research into the default network.
1 Baron-Cohen, S (2002). The extreme male brain theory of autism. Trends in Cognitive Sciences, 6, 6, 248–54.

2 Rose, K D (2006). The Beginning of the Age of Mammals. Johns Hopkins University Press.

3 Rescorla, R (1973). Effect of US [unconditioned stimulus] habituation following conditioning. Journal of Comparative and Physiological Psychology, 82, 17–143.

4 Ratey, J (2001). A User’s Guide to the Brain. Pantheon Books. New York.

5 Frith, U (2003). Autism: explaining the enigma. Blackwell, second edition.

6 Baron-Cohen, S, Leslie, A M and Frith, U (1985). Does the autistic child have a “theory of mind”? Cognition, 21, 37–46.

7 Zeelenberg, M, Nelissen, R M A, Seger, M, Breugelmans, S M and Pieters, R (2008). On emotion specificity in decision making: why feeling is for doing. Judgment and Decision Making, 3, 1, 18–27.

8 See, for example: Griffin, J and Tyrrell, I (2003). Human Givens: a new approach to emotional health and clear thinking. HG Publishing, East Sussex; Bromhall, C (2003). The Eternal Child. Ebury Press.

9 See

10 Deikman, A J (1982). The Observing Self: mysticism and psychotherapy. Beacon Press, Boston.

11 For more information on this, see Griffin, J (1999). Autism: a sea change. The New Therapist, 6, 4, 10–16
All text on this page, courtesy of Caetextia.
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