Asperger's By Proxy : Feedback

Note: Because my psychology correspondence has gradually evolved toward offering people advice, I want to say I am not a psychologist and any advice I offer is based only on common sense and life experience. I think most educated readers will accept this.

Some of the longer entries originally on this page have been moved to the "Feedback" department.

Autism or Asperger's I

[ Case history deleted ... ] He is now [ ... ], but when he was about 18 months old, somethign very dramatic happened to him that changed a very happy and outgoing little fella to a clingy, and (most frighteningly) afraid infant in a matter of literally hours.Based on that description, it was some sort of organic brain trauma, well removed from the subject matter of psychology.The MDs and PhDs don't know exactly what happened, and it took a lot of years and effort to bring him back to almost at a level with his age-peers. Whatever the cause, he was left with probably some physical brain damage and some (what I would call) faulty wiring.I sympathize with your situation, but based on the published diagnostic criteria (and I am not a psychologist), in my opinion this is another misuse of the Asperger's label. How could the same label be applied to your son, with what appears to be some organic (as opposed to psychological) issues, and such people as Bill Gates, Isaac Newton and Albert Einstein, all of whom have been identified as Asperger's sufferers?

This list only shows that Asperger's is a catch-all label, one that can be applied to anyone in order to justify psychological treatment.The brain is a marvelous, complex piece of work that is not at all well understood. How can this little clump of soft tissue process and store so much, be so important, and be so fragile all at the same time? The MDs and the PhDs couldn't, and still can't, explain all that, but it's somehow comforting to know that there are people who care enough to want to know and who at least try.Yes, but in most areas of medicine, science is the tool, and research is the method. Because psychology is not a science, clinical psychologists famously apply any diagnosis they want to, typically one they prefer to treat, as shown in my article "Is Psychology a Science?"

My point is psychologists often race ahead of the scientific evidence, make diagnoses based on vague criteria and offer treatments of no established efficacy. Sometimes they do great harm through this practice of putting the cart before the horse.We all understand that "autism" is not a label, it's a very broad category, useful only for some loose common ground of communicating a range of "stuff".In point of fact, that way of describing it makes it a "label," rather than something that can be strictly tied to the outcome of a clinical evaluation.The little boy in the wheel chair with very little body/expressive control had such deep eyes. He was profoundly autistic, and perhaps still is.In such a case, the label "Asperger's" is very clearly misapplied, because your description doesn't correspond even to the broad diagnostic criteria presently used for this assessment.Our son was in the borderline/mild range then and is now within the range of Asperger.And there it is. Your account confirms that Asperger's is being applied to nearly everyone — from those who would ordinarily be diagnosed as autistic with organic elements, to those who are merely smart and poorly adjusted to a world of average people.To me it's a range, a category, of "stuff" that goes along with the total package that is my son.Please imagine a legal system willing and able to put people in jail because of, as you put it, "a category of 'stuff'". In fact, over the past several decades people have been accused, tried, and jailed for crimes such as child molestation and even murder, based on psychological fads such as "recovered memory" and "facilitated communication." Most of these victims have been declared innocent and released, after the falsity of the claims, and of the psychological beliefs that led to the claims, was revealed.The term means different things to different peopleThis is why psychology is not a science. Imagine saying that gravity "means different things to different people." This also puts us on the slippery slope toward post-modernism, a scheme in which everything is a matter of opinion and there are no objective facts.I don't disagree with what I assume is your point about Asperger. It can be nisused, as a label, or it can provide some basis of understanding, as a category within a list of categories that can be useful in knowing a person.But that's the very point I make in my articles. The Asperger's label is neither a basis for understanding, nor is it useful — except as a way to get people into the psychological system, where the treatments are as vague as the diagnoses. This is why most HMOs (health maintenance organizations) won't pay for psychological counseling — once it gets started, it never stops. Some think this is by design.We all do it. My son's teachers were frustrated that an intelligent young man had such problems with learning, but they were proud, as we were and are, of those things he does. Maybe it takes more tries, and requires more effort on his part and on our part as parents, but it's worth it."It's worth it." Only science can make that determination, and science is not being applied to this issue.

Please avoid confusing correlation with causation. Imagine a parallel universe, one in which your son never visited any of those well-educated specialists, and only experienced your very obvious love and devotion to his welfare. Maybe his condition would have improved without intervention, and maybe he would be in the same position he is in now.

We will obviously never know, and this is why science uses control groups. Unfortunately science holds little sway over the behavior of clinical psychologists.I don't blame the MDs and the PhDs and the counselors for not knowing the cause/effect/cure for his difficulties. But I do appreciate their efforts to understand and to help where and when they can. If the term "Asperger's" is useful in those efforts, then so be it.As presently applied, the Asperger's label is not a useful description, any more than gravity can be usefully described as a rock's love for the earth. As long as the ancients thought rocks fell to the ground because of their love for the earth (and they did), we couldn't do the science required to find out what gravity really is.

It's the same with clinical psychology — it's time to say very clearly that it is long on belief and short on evidence, and the public's trust is misplaced.

Autism or Asperger's II

Thank you for your thoughtful reply. I found it to be a little short on optimism, though.Really? If I were a pessimist, I would accept the basic position of clinical psychology, that it's all too confusing, so there's no point in trying to apply reason and science to it (I've heard psychologists use almost these exact words). I am too optimistic for that. I think there's a crucial need for science in clinical psychology, one that is not being met. And in a system that sometimes jails people for nonexistent crimes, the application of reason is essential.

If I were a pessimist, I would never have written the article.

Activist Mom I

I just read your essay and personal account on Aspergers. I thoroughly enjoyed it and am going to share it with my husband tonight. We have a wonderfully brilliant son - 10 years old. He loves computers, video games and math. Some kids make fun that he is obsessed and he is. so what. We have had teachers bug us for 3 years for a diagnosis.This is so funny. A kid is obviously exceptional, likely to succeed, possesses the kinds of skills the future will be built on (like math), and the teachers want you to find out what's wrong with him.In the past few months we submitted, but went and got a private assessment that the schools would not get their hands on. And you guessed it, the Phd. Clinical Psycologist has diagnosed our son as having Aspergers! We don't want this label and we don't think he needs it.Good for you. I am not a psychologist, and I have always felt that if there is no clear cause or treatment and very loose diagnostic criteria (all true in this case), then what is the point of stigmatizing someone that way? The diagnosis can only make a child believe he has an extra burden to bear (or an excuse not to try if he is so inclined).We will never let the school system in on this and let them take control and ruin his life. [ ... ] Your article has totally inspired me to again rely on what I already know - he's perfectly fine. He is a math nerd and so am I. And that is o.k. with me... and thus far it's been o.k. with every one, but the teachers.They probably notice his unwillingness/inability to fit in. I personally think this is a good thing, but then I never fit in either. I was a seventh grade dropout, I was someone everyone thought would fail, now I get invited to schools to explain how I succeeded. I try to avoid saying "drop out now". :)

In all seriousness, I think kids should try to socialize, but I think they should not be made to feel as though it is a life or death issue, because it isn't. Getting along with people is nice, getting along with yourself is essential. Anyway, I just want to THANK YOU!!!! And by the way, do you want to mentor a really bright math nerd who LOVES computers and [ ... ] and enjoys silly jokes?!!! I've been talking about finding a mentor in the computer field for him!!! [ ... ]It's very difficult — too many kids needing guidance, too few willing guides, too many ruts in the road. As for myself, I appreciate your offer but I am not going to try mentoring again for a while. My experience with "Jim" was too heartbreaking.

Good luck!

Activist Mom II

Thank you for your response and your openness to share with people. The big distinction with our son is that he has a lot of what the clinical psychologists call "social intent". He has a lot of friends and wants to hang out with them. He is smart and very aware of social pecking order and knows where he fits in and would like to be the more popular. His awkwardness, nervousness etc are barriers to succeeding to the degree he'd like to. But it is getting better, we are working with him.

We are in the process of changing our focus now. So far, we have supplemented his education as much as possible, got him into [ ... ]. Now we are adding more outdoors activities - hiking, boating, fishing etc... more earthy activities. And we need to be more social - allowing more friends over, including his friends in our outings etc... this is not easy for us - we are pretty reclusive ourselves... so we are doing our best. I hope it's good enough!!! (that's why the mentoring is so important - to get a third party perspective... we are thinking of hiring a young man as a kind of "coach" to work with him on stuff and help build his skills and confidence).

Again, thanks for that article, your perspective helped me a lot.Okay, again, I am not a psychologist, but damn. Your son wants to hang out with his same-age peer group, he is willing to take on new activities with which he is unfamiliar, he is outgoing, social — he is obviously developing in a normal way for his age. This is not Asperger's, not remotely. "Real" Asperger's is more like Dustin Hoffman's performance as "Rain Man" than anything closer to normal, and (in my view) the only reason for the epidemic of Asperger's diagnoses is because it got included in the current DSM, the "Bible" of psychology, and the therapists have been taking liberties with the published diagnostic criteria, for reasons that should be obvious.

I wouldn't be surprised if many of the individual cases that make up this current epidemic are like your account — overzealous clinical psychologists, and sometimes, overzealous parents, obviously not including you. My two cents is that the Asperger's label could only hurt your son as he finds his place in the world.

Good for you for having the common sense to see though this fad.

Perplexed Parent

I've never felt compelled to write until reading your Asperger's article. I have three sons with similar personality traits (i.e., nerdish, just like Mom!), all bright, and two of whom have been diagnosed this year with pervasive development disorder, Asperger's fraternal twin brother.

The diagnoses actually ensured that they were put in classes that were appropriate to their learning styles, which is great; but I still fear their getting labeled "autistic." I've come to the conclusion that with high-functioning autistic people, it's just a different way of thinking, and equally valuable to the type of thinking typically labeled "normal."

We're a [ ... ] family and will be [ ... ] soon; at that point, I'll probably homeschool both of them. Until then, I'll just keep fighting to make sure they get appropriate schooling without being labeled or drugged.

Thanks for writing such an inspirational article — I don't feel alone now!

Older, Wiser Student

I would suggest that people who practice these obviously quack therapies should be prosecuted or severely discouraged before they have the opportunity to inflict harm on others. Sure, as you've said, responsibility is in the hands of the individual, but how much responsibility was Candice [ 10-year-old Candace Newmaker, killed during a quack therapy session ] able to take for herself? I'm "glad" that the parent was prosecuted even though the child was undergoing "therapy." An admission from your goverment that people ought to know better.

I was diagnosed with Asperger's Syndrome too, and for a while I was letting myself live under that label. I had a horrible time in public school [ ... ], and it seemed like everyone just wanted to push pills at me. Eventually I found it so incredibly condescending that I quietly stopped taking the pills. And it worked, and I grew up.

I just got back from a youth exchange that took place in [ ... ]. In high school, I would never have felt myself capable of being selected for anything like that. But I was, and I had an excellent time in the exchange country, and I want to write a short e-book about it. In high school I was convinced that my life would end, one way or the other, after it was over. I listened too well to my detractors, and I didn't know how to think independently, and my life was just one long reaction to everything.

To put it crudely, I wish "stop and think" advice could be given to more children. They're capable of much more independent thought than we give them credit for.

Outraged Older Sister

A month or so ago, I stayed and read your article on AS. To my suprise - I couldn't have found a more accurate and well written article that expresses exactly how I feel.

My younger brother has been labeled by my Mother and Grandmother as having AS and it handicaps the way they deal with him. In my opinion, its a bunch of crap! I emailed the article to my Sister and she is also in agreement.

It's nice to know that there are intelligent people out there who don't just swallow the popular scientific (or lack of scientific) opinion and continue to think for themselves. My Brother is almost [ ... ] and graduating from [ ... ] school in 2 weeks. AS my ass.

Thanks again. You rock!

The Mercury Connection

I have just finished reading your article on Asperger's syndrome, and I was wondering if you have every read any of the reports that link the rise in Asperger's and Autism diagnoses with the amount of Mercury that pharmaceutical companies are using in immunization shots?I have, but that idea is pure conjecture at the moment. There is no study that connects the two in a scientifically valid way. This may change in the future.As a parent with a child that has been diagnosed with Asperger's, after a list of other diagnosis that physician use to try and explain his manic behavior,Manic behavior is not a symptom specific to Asperger's, and Asperger's diagnoses are often provided when nothing else seems to fit. To a nonspecialist like me, this appears to be one of those cases.I would like to have a legitimate cause for an average infant developing behaviors that are not present in his siblings.Genetics? There is ordinarily a great deal of genetic variation between siblings. This is a reasonable explanation. And if one of your children differs markedly from the others, he is not average, is he? That sounds more like an expectation than a statement of fact.Just for the record I have no claim to any court case that involves Mercury in immunizations and my child is not on any medication.You might have a tough time showing a connection with mercury. I am not saying there is no such connection, I am only saying an evidentiary link hasn't been made.Through [ ... ] we have been able to control my sons mania through diet, something physicians will tell you is a myth.If you successfully controlled your child's mania through changes in diet, and if mania was the primary symptom, then the root cause is neither Asperger's nor is it mercury poisoning.I just wanted you to consider the thought that maybe the rise in diagnosis has more to do with Mercury and petroleum based colorings then narcissism.My article's reference to narcissism was obviously with reference to a single case history, and a fictional one at that. There are as may case histories as there are diagnoses.

Also, if clinical psychologists are now issuing Asperger's diagnoses when "petroleum based colorings" is thought to be a cause and manic behavior is the primary symptom, things are worse than I thought.

Deeply Offended

What follows is a conflation of the content of several posts from people who need to look up the word "fiction."

Today I read your article about Asperger's and I want to express my outrage. The character in the supposedly fictional story is a mom with an Asperger's kid and I am a mom with an Asperger's kid. Most of the other points of comparison don't match up, but two hits is too much similarity to be a coincidence, therefore I think I am the person in the story.I believe this may be a misuse of the word "therefore," a word that normally connects one or more postulates to a logical conclusion. And even though I don't ordinarily object to how individuals choose to steer their metaphorical boats across the sea of consciousness, in this case I want to say clearly that "Joan Smith" is a fictional character, the story is very clearly marked "fiction," and you are not her at all.As I read your story, I became deeply offended by how I was being described.You were not being described, because no living person was being described. Again, "Joan Smith" is a fictional character, and you are not her at all.Your story didn't describe me fairly or accurately — how dare you! In point of fact, there is scarcely any overlap between who I really am and your "Joan Smith" character. I mean, I'm not her at all!sigh ... yes, dear. You are not her at all.I am considering legal action against you. I hope you have a lot of money, because my position is unassailable.Indeed it is. Because within a short time span you have argued that you are, and are not, the person in the story, and since there are no other possibilities, your position really is unassailable. It is equally clear that you are mentally unbalanced. But legal action is your constitutional right. When you go to court, be sure to emphasize how little similarity you found between yourself and the fictional, narcissistic "Joan Smith" character, and how unfair you thought that was. This will help the judge grasp your mental state.

I hasten to add there is a term for people who think every story is about them, even when the comparison is uncomplimentary or implausible. They're called "narcissists."

Returning to my "ocean of consciousness" metaphor, you are free to choose any course across the deep reaches. I should tell you there is another boat out there, a much larger boat named "Reality," and it is steering a different course than yours. But don't worry, there is little chance you'll collide with Reality, and if you do, it will surely be an accident. I am a rather tolerant person, in most circumstances and with most people. But I have my limits. As the above exchange shows, I reserve my intolerance for examples of outright stupidity.

Baffled

Dear Paul, I am a community support worker and have just started working with a young man who was diagnosed with Aspergers. He is in his late thirties and is very bright. During my visits I have come to know him as an intelligent caring person. Yet I have been baffled by some of his 'meltdown' behaviour, when he frequently changes character and personality, using a different voice and language. I have been looking at the senario from various angles and your essay could have been written about my young man. It has helped me to see more clearly the situation, as a layperson I had viewed and treated the young man as an individual, without fully appreciating the role 'parents' play. Thanks again for your easy to read, clear definitions and common sense approach which is often lost in the world of medicine and psychology.You are most welcome. With each new reader response to "Asperger's by Proxy" I am happier that I researched and wrote it.

As many of the other responses show, and as many leading mental health professionals suggest, Asperger's is at present a diagnostic trash bin, a simple way to categorize people using a vague diagnosis into which nearly anyone can be fit. I should add this is consistent with much of the history of clinical psychology.

Put in its simplest terms and in my opinion, if Asperger's is the only available diagnosis for a particular person, the mental health practitioners should instead acknowledge that they have nothing to offer.

As to the role of parents, opinions in clinical psychology have swung wildly back and forth on this issue, once blaming parents for everything, at the moment blaming them for nothing, and with no realistic hope of discovering what is true. The present fashion motivates some parents to get a diagnosis as quickly as possible to avoid any hint of personal responsibility. I know one case in which a mother got diagnoses — and regular therapy — for both her children around age six. I imagine the children lying on a couch, describing a childhood they haven't had yet.

With regard to your client, and reminding you that I am not a psychologist, my educated layperson's opinion is that there is something other than Asperger's going on.

The Contrarian

Thank you so much for your postings on the overdiagnosis of Asperger Syndrome. It's really alarming how widespread this diagnosis has become, and how willing many parents are to accept unnecessary and harmful labels for their children. In my own case, what struck me the most (maybe because of the irony?) was how little attention was paid by the professionals I dealt with to nuance and context and intent.

I was misdiagnosed with Asperger's way back at the beginning of the fad (1994-ish, before it was enshrined in the DSM-IV). I was twelve, and I distinctly remember the frustration of being talked to and about as if I had no inner life — as if all the particulars of my very innocuously nerdy existence had no root and no resonance either in my own history or in the larger world. Luckily, I was enough of a contrarian that I didn't take it to heart.

The psychiatrist who diagnosed me (having known me all of twenty minutes) wanted to set me up with a caseworker and a support group, and made dire predictions about my future sans "treatment". I refused. I was lucky enough to have parents who let me refuse. Instead, I changed schools, made friends, and grew up.

Now I'm happily married, about to start a master's program (in English, not math — I never was any good at the nonintuitive stuff) and frankly pretty boring — I barely graze "quirky" these days. It was a long time before I found any validation at all for my claim that Asperger's is overdiagnosed, so it's nice to see that a few people are coming around! It's heartening to see all the replies from parents who don't believe that "smart and slightly dorky" warrants a DSM-IV diagnosis.

Keep up the good work!

Linda [ ... ]Since I wrote the article, I've learned a lot more about Asperger's and the field of clinical psychology, and feedback like yours has been heartening. There are simply too many nebulous conditions like Asperger's that lack a clear cause, unambiguous diagnostic criteria, or meaningful treatment. With specific reference to Asperger's, it's not clear that it can be distinguished from intelligence, in a society that appears to regard intelligence as a deplorable but treatable condition.

Thanks for writing and sharing your experiences.

In this exchange I include a correspondent's given name only to identify her gender (an earlier female correspondent's gender was more obvious). Asperger's diagnoses were once rarely made for women, but this trend is increasing as the financial drawback to excluding fully half the population occurs to the less ethical practitioners of clinical psychology.

Concerned Parent

My son was recently "diagnosed" with AD. The neuro-psych Dr. seemed to overlook all of the concern that I had. She took the fact that his behavior had changed after a sexual assault for granted and said that that was from the disorder. I am at a loss for how to proceed. So many people who know my child are shocked and do not agree with this diagnosis either. Any suggestions?I can only offer the suggestion to ignore such a diagnosis. It is well-established that psychologists, when presented with the same subject under the same circumstances, cannot produce the same diagnosis. The head of research for the DSM (the "bible" of clinical psychology) recently said, "There are lots of studies which show that clinicians diagnose most of their patients with one particular disorder and really don't systematically assess for other disorders. They have a bias in reference to the disorder that they are especially interested in treating and believe that most of their patients have."

Translated into plain English, this means psychologists invent diagnoses, and, because of an absence of rigorous science, no one can call them to account.

If rigorous scientific studies were to be conducted that conclusively excluded some individuals from this diagnosis, I might feel differently, but that is extremely unlikely, given the state of the field.

You need to realize that, for each parent like you who doubts these cookie-cutter diagnoses, there are ten who want the diagnosis to be made, because it replaces doubt and angst with a bogus certitude, unfortunately at the expense of the child's emotional well-being.

I recommend that you read the book "Misdiagnosis And Dual Diagnoses Of Gifted Children And Adults: ADHD, Bipolar, OCD, Asperger's, Depression, And Other Disorders," located online at (among many other places):

http://www.amazon.com/Misdiagnosis-Diagnoses-Gifted-Children-Adults/dp/0910707642

The bottom line is that a psychologist has zero incentive to hold back from offering this or another similar diagnosis. It puts bread on his table.

As to your son, how exactly does such a diagnosis help him cope? He needs to be given every incentive to respect and develop his abilities and move forward. A formal psychological diagnosis like this can only rob him of self-esteem and give him an excuse not to try.

I want to congratulate you for doubting this diagnosis in the midst of a common perception that everyone has Asperger's, if only they would visit their local psychologist to find out.

At the moment psychologists seem to have a diagnosis for everything — if you can't spell, or can't do math, or you smoke cigarettes, or you like coffee, or you don't like your older brother, psychologists have a diagnosis and a course of treatment that is vague, expensive and perpetual. But there is one mental illness that doesn't appear in the DSM — it is the compulsion among psychologists to invent a diagnosis for any imaginable behavior. This harmful and debilitating condition doesn't even have a name.

Another Victim Speaks Out

I have immensely enjoyed and been stimulated by reading your articles, particularly those on narcisissm. I was, until a couple of years ago, a victim/enabler of a narcissist and am still repairing my, sense of self, career and bank account after her seismic assault. So it was a "she", yes? I ask because psychologists believe the vast majority of narcissists are men, not women, but this isn't my experience. My correspondence isn't remotely a scientific sampling, I'm just curious. Your refreshingly intelligent articles on the subject have helped me put a much more robust framework on what happened to me and, I am sorry to say, it has been something of a comfort to read that even someone as intelligent and articulate as you was almost drawn into peril. Oh, I must tell you, very bright people are in some ways more susceptible to social parasites, because we tend as a class to be socially inept. I wouldn't dream of taking this position were I not a member of the group I'm describing.

I certainly didn't take what I now regard as normal precautions, and I rationalized continuing my friendship with "Joan's" son by saying, "this woman would have to be crazy to try to spin the situation in any way other than as someone sincerely offering help", but without ever taking the next mental step and seriously considering whether she was, in point of fact, crazy.

As to "almost drawn into peril," I think the episode was closer to the precipice than that. Consider the Duke University case, where a single angry woman destroyed a number of lives before it became clear she was both mental and lying:

http://en.wikipedia.org/wiki/2006_Duke_University_lacrosse_case

Or this case from Britain, in which a man is falsely accused, jailed for three years, then his accuser is exposed as a pathological liar — but the victim is obliged to pay the government £12,500 for his room and board:

http://www.dailymail.co.uk/news/article-505428

"Not only did Mr Blackwell not commit the crime, but the crime had never taken place."

"It also emerged she was a serial accuser, having fabricated at least seven other allegations of sexual and physical assault against blameless men."

"She kept changing her name and moving around, so police forces never realised they were dealing with the same woman."

This certainly sounds familiar (my accuser had a history of false accusations), and as it turns out, experienced judges hear fantasies like this regularly. In my case, the judge quickly realized "Joan's" story was nonsense, and all I was obliged to do was offer a two-word defense: "absolutely false". But I certainly needed to say something — silence would have constituted an acknowledgment of culpability, something my accuser didn't grasp when it was her turn to defend herself (something she failed to do). Your way of life is admirable and your way of thinking even better. Thank you. Oh, thank you! Now I can mull over whether I deserve such praise. And if you ever pass through London I will gladly buy you a beer - this is not a request for a date. I see you read carefully and understand what you read. Very impressive from an American perspective.

Thanks for writing!

Aggressive Diagnosis

I'm writing in response to your discussion of AS. Until now I've trawled the web looking for anything that chimed with my belief that professionals were wrongly diagnosing and was beginning to feel desperate in my isolation. You might want to read "Misdiagnosis And Dual Diagnoses Of Gifted Children And Adults". I suggest this because the authors are professionals [and I am not], their analysis is more complete than mine, and they come to exactly the same conclusion. I was led down the diagnostic road for my son (age 8) after he experienced a difficult transition to a new school. I was reassured that they were not concerned with labels only with finding ways of helping my son. Suddenly I was given a diagnosis of AS and told the case had been closed. Schools have a stake in creating a diagnosis, just as psychologists do. A diagnosis allows an individual to be placed in a category other than "individual," which, when you think about it, isn't really a category.

Your son's Asperger's diagnosis might qualify his school for additional state funds. An individual doesn't have this advantage. I am just hypothesizing here, there are any number of reasons to aggressively assign the label. When I questioned the diagnosis which does not fit my son I was told that I was being resistant and that to help my son I would need to accept he had a lifelong disability and that I needed to start making allowances for his behaviour. A classic Asperger's clinical encounter. It might interest you to hear what the Yale Child Development Center has to say about Asperger's:

"Clearly, the work on Asperger syndrome, in regard to scientific research as well as in regard to service provision, is only beginning. Parents are urged to use a great deal of caution and to adopt a critical approach toward information given to them."

This means the professionals are on your side. I haven't told anyone about the diagnosis because I don't believe it's valid. And even if it were valid, there's no treatment, and your son has to make his way through the world just like the rest of us. All that's happened is he's been assigned a stigmatizing label. He is a popular (now but not initially), bright, kid. Yes he is a little eccentric, I call that character, and yes he doesn't look adults in positions of authority in the eye, Oh, so now they have a name for that? I spent my first fifteen years not making eye contact with the adults who towered over me. That was once regarded as normal behavior. I call that, rebellion. Actually, looking an adult authority figure in the eye would be a sign of rebellion. Not making eye contact is likely to mean your son would rather be somewhere else. He is considered 'cool' by his peers for his quirky ways, I'm just glad his friends are more accepting of not conforming than the 'professionals'. As it happens, if everyone was supposed to turn out the same, there would be no evolution, no reproduction, and no genetics. The assumption that there is one "normal" and a thousand "abnormals" is a gross misreading of nature. But to psychologists, it's bread and butter on their table. I no longer feel like a deluded nut, many thanks. You're welcome, and thanks for writing.

Sad Ordeal

It was with no small amount of sorrow that I read about your ordeal with the troubled mother of the teenage boy you attempted to reach and mentor. Please consider that you have been a welcome mentor to many who have had the good fortune to read your webpage. Thank you, sincerely. I have to say, though, that I won't be mentoring again. Once I realized I would have to perform a background check on anyone who asked me to meet their children, I decided it wasn't worth it.

It's a sad commentary on modern society that the village doesn't raise the child any more — they wouldn't dare.

Thanks for writing — and caring.

My "Joan"

Years ago I had an interaction somewhat like that between you and Joan. The details are unimportant, but reading your description has finally given me a hint as to what might have been going on. At the time I could make no sense of what was happening. [I be a engineer.] Fortunately there was no innocent third party to be injured (like Jim) and the hearing officer quickly understood the situation and dismissed the case.

But had the officer not understood how irrational my accuser was, my career might have ended (I needed security clearances which were at risk) and I might have been sent to prison (after a trial, of course).

Fortunately the evidence was in my favor and showed that although I had not shown the best judgment I certainly had done nothing illegal or unethical.

It was my good luck that my Joan moved on and went on to other targets. One hearing was enough for me.

One enduring negative result was that my interactions with people at work were changed forever. As an example, other than formal handshakes, I have not touched another human at work since - 30 years. [The complaint was not about touching.] I think as time passes, the public will begin to see the harm these lies do. There is the backdrop of real crimes committed by real criminals, and an atmosphere in which any accusation is incredibly harmful without regard to issues of truth or falsehood.

I say this on a day when a Toronto schoolteacher killed himself rather than try to repair his reputation after a newspaper published a false report about him. In response, the newspaper tried to blame the victim for reacting as he did.

For a particularly sick, cowardly kind of person, such a lie must seem terribly tempting — it cannot but do enormous harm, and the liar is virtually certain to go unpunished. The other victims of these lies are all the people who won't be believed when they come forth with similar but true accounts.

Thanks for sharing your story.

The Self-Effacing Therapist

My son has tentatively been diagnosed by his therapist as having aspergers. That and a dollar will get me a cup of coffee. He is a bright quirky kid (I think his quirks make him unique and interesting). He has alot of issues with flourescent lights, noises, smells and has a fear of going to public places (unless they are outside and have few people present) but will talk to a complete stranger about science or video games in a fluent albeit monotone way. As a non-psychologist, I would say that identifies him as smart and focused. But again, I am not a psychologist and I tend to avoid psychological categories if they appear to do more harm than good. It's my view that the Asperger's diagnosis is too often applied, even when it's a legitimate possibility, because there are no treatments and the victim is stigmatized as mentally ill but with no compensating advantage. when he was little he would draw pie charts around pictures in coloring books and then color in each pie piece rather than the people or objects. I could go on and on but I don't see these behaviors as problems unless they keep him from being able to get out and be in the world. he is seeing a behavioral therapist to help him with his inability to stand public places and she explained to him that there was nothing "wrong" with him that he just thinks differently. That was a daring stand for her to take, but with that as a foundation, your son's relationship with the therapist isn't therapeutic, instead it's that of an adult friend, and any sufficiently committed and well-adjusted adult friend would do just as well. Maybe someone less expensive could accomplish the same ends. The advantage to having an adult friend instead of a therapist is that it eliminates the stigma of mental illness.

There was a time when the village really did raise the child — it was more than a cute saying. But those days are gone. Ask yourself what you would do if you lived in a small, rural village of at most 2500 people, everyone knew everyone else, no one moved in or out, and there were many old, wise people with time on their hands. Why would you bother with an expensive psychologist?

Psychologists don't normally make the tactical error your son's therapist made. I think she is probably a very good counselor and human being (and I admire her candor), but I don't think she's a particularly wise psychologist. One must remember that clinical psychology is primarily a business and only secondarily a source of wisdom and self-sacrifice. my ex-husband has not seen his son in several years and after reading your article is suggesting I have munchausen by proxy (he emailed me the article). my son has never been hospitalized, no ambulances, no weird illnesses and only goes to the doctor occasionally for normal childhood things like strep and flu. he is sweet and loves to learn and seems to me like a wonderful [ ... ] year old child. Two responses:

Based on this one post, I doubt you are an MSP sufferer, and I emphasize that I am not any kind of mental health professional. I happen to have have studied MSP for some years out of an instinct for self-preservation.

The reason I take this position is that you just don't seem crafty enough to have MSP. There is an artless pose of faux cleverness common to real MSP sufferers that everyone can see through but them, and it appears you lack this trait.
Most people who read my article don't understand its purpose. I was confronted by someone who was (a) dangerous, and (b) utterly dependent on clinical psychology for her source of authority in support of a real and pathological level of narcissism. But because "Joan" was rather dull and lacking in personal insight, it never occurred to her that someone could turn the tables on her and use a psychological diagnosis against her in the same way she used them against others — her children, her husband, and her friends.

My actions, and the article describing them, were meant to defend myself against a real danger, but also to show "Joan" that she would never tolerate her own behavior if she experienced it from another. By the time I got done with her, she had been placed in the position of tacitly, publicly acknowledging serious mental handicaps in open court — her irrationality, her history of false accusations, her inability to test reality or produce credible testimony, and her parental incompetence. The small credibility she possessed on entering the courtroom had evaporated by the time she was ushered out.

The irony is that "Joan" may never have figured out that I was holding a metaphorical mirror before her, but she certainly hated what she saw reflected in the glass.

because my ex believes the munchausen crap, he refuses to pay the behavioral therapist and is taking me to court. he has the financial means to do so and I have no funds to hire a lawyer to fight him. I am not in any way blaming you for my ex's behavior. I am just asking you to think about the other end of the spectrum. there are some men who falsely accuse to control situations...Joan could have easily been a John in a slightly different scenario. My article wasn't meant to suggest that women are the only bad actors in the psychology game. There is certainly enough blame and misbehavior to share between the sexes. My article is a broadside against the more common and harmful abuses of psychology, and only secondarily a story about a specific example.

Unlike Asperger's, MSP is not a diagnosis that anyone makes lightly, and it would take more than an expensive lawyer to produce a diagnosis. You would have to possess certain very distinctive behaviors to be at risk of this diagnosis, and based on my limited exposure, I doubt you have what it takes.

As to a custodial risk, I think you may be alarmed for no good reason. This is why I think so: my ex-husband has not seen his son in several years ... Just point this out to the judge. If it's true, you have been the primary or only caregiver for years and your ex hasn't been a responsible parent. You might lose the right to buy therapy for your son, but I doubt you will lose custody (if that is what's on your mind).

Oh, one more thing. I am not a lawyer either, and you would be much better off getting the counsel of a real lawyer with experience in marriage issues.

I wish you the best.

Update I

I notice it was written in 2005; how did everything turn out for the kid in the end? The drama still unfolds. Do you see the self-defeating irony of categorically attacking the diagnoses of clinical psychology while in the very same breath invoking diagnoses like narcissism and MSP to bolster your argument? Not at all — my primary purpose was to make "Joan" aware that her own strategy could be turned around and used against her. It seem that possibility had never occurred to her. You've heard the expression "fight fire with fire", yes?

My psychological claims about "Joan" were based on as much objective evidence as her psychological claims about her children — no more, no less. This placed her in the uncomfortable position of questioning the reality of psychological diagnoses, e.g. she was maneuvered into arguing my point for me. And this was no academic tea party — a great deal was at stake, just as it had been for her prior victim.

The fact that psychology isn't scientific doesn't mean these conditions don't exist or cannot be identified. They just can't be identified scientifically, which opens them up to all sorts of abuse.

So rather than being a "self-defeating irony", it was a survival tactic that turned the tables on a clinical narcissist who had never seen her own methods used against her. My insincerity in adopting "Joan"'s methods was only exceeded by her inability to imagine a copycat. That aspect of your essay was so glaring that I fully expected you to turn the tables at the end and make a point about how easy it is for a writer to draw sympathetic readers more deeply into his own world of beliefs as accomplices. I assumed readers would see that for themselves — maybe that was naive of me.

Update II

It was written in such an earnest and didactic and often self-righteous authorial voice that it did not seem obviously intended. To produce its intended effect, the prose needed to have an earnest, non-satirical tone. It was my hope that those above a certain intelligence level would see that I was holding a perfectly reflecting mirror in front of a self-destructive narcissist.

Update III

How is it supposed to be a perfectly reflecting mirror? Narcissists are famous for relying on absolute authority (religion, the supernatural, law, magic) to support their views. This makes them a problem for reasonable, evidence-based people. The strategy recommended by mental health professionals is simply to get away from them. In this case, even though I had departed and would never return, "Joan" kept throwing court hearings that I was obliged to attend out of a desire for self-preservation. In the first hearing I simply declared her claims false, which ruined her argument but not her motivation.

By the time of the second hearing I had realized my mistake in not adopting her tactics, and it was obvious that she would continue to throw hearings until someone made her pay an unacceptable price. So I used her own tactics against her — I put her in the position of having to respond to the same kinds of unanswerable claims she had been making against others for years. She discovered she couldn't respond to such arguments any more effectively than her victims could.

In summary, she saw herself reflected in a mirror and hated what she saw.

The Risk of Silence

Thank you for sharing your experiences with the mentor-abusing mother ("Aspergers by Proxy"). You certainly got me thinking. On the whole, I think you responded as well as any ethical person could, to an extreme example of scary parenting. That's exactly how I saw it as well — I had no choice but to act as I did. I had one qualm in reading your description of courtroom proceedings. I know at least a couple of people (male and female) who are otherwise good-hearted adults, but who have a panic-response of holding their tongues to avoid conflict. This ingrained tendancy is even more marked in the presence of 'authorities'. (I speculate that in the case of both my examples, this 'defensive silence' was learned early in childhood to cope with abusive parents.)

A courtroom's intimidating grandeur would almost certainly render them extra 'polite' (and dumb in their own defense); they might need to be asked an explicit question to prompt them to defend themselves, if the other party made a false accusation. That is an excellent reason to hire an attorney to represent one's interests. It's a fact that in some courtroom contexts, silence in the face of an accusation constitutes tacit acknowledgment of guilt. This is a different situation from your fictional 'Joan;' as you described, she had no difficulty finding her tongue to make demands, though she might ignore the need to defend her own actions. "Joan" forced both hearings, made certain accusations, then when it was time for her to substantiate her own claims and defend herself, she fell silent — twice. On the second occasion she was described as a serial false accuser as well as severely dysfunctional. Her silence on that occasion effectively demolished her credibility before the court. In response, the judge congratulated me on my presentation and closed the proceedings. It's sad to think that my friends might suffer the same fate in a case where they were legitimate petitioners, simply from not knowing this courtroom technicality. Silence in the face of an accuser is not uncommon, especially among those who grew up in dysfunctional families or institutions. It's a real risk with real consequences, so I recommend that people hire attorneys to avoid the possibility. So thanks for bringing that to everyone's attention.

After reading the feedback and your responses, I'm left unclear whether the story describes your real experience and views (with fictionalization to protect identity), or is a wholely fictional example created to illustrate your frustration with harm perpetuated in the name of therapy. The story is true in all particulars except those that might lead a reader to identify a specific person. This is normal practice in the so-called social sciences, where there is a huge literature of case histories with the same safeguards in place. At some points in responding to feedback you seem to say that the article describes a real experience; at others, that 'Joan' is fictional and any resemblence to a real person (such as your reader) is illusory. Both are true — the described events are true, but "Joan" is fictional, to avoid an accusation of libel (which requires that a person be either named or identifiable). Because much of the (non-geek) world are literalists, I wouldn't recommend taking someone else's poor choices as license to use the same tactics. 'Fighting fire with fire' can be effective, but it does cement your reputation as a pyromaniac if you're not careful. It is said that the best defense is a good offense, and in this case I had no choice — "Joan" was the mother of minor children, therefore she could get any number of hearings, unless and until she had to pay an unacceptable price. I made her pay that price, and truth was my weapon.

A Psychology Ph.D. Speaks out

1. I'm a licensed psychologist and after 25 years, I think I'm experienced enough to say that @ 90% of psychology is garbage. (OK, that's an estimate; let's just say "a whole bunch" of psychology is garbage.) Hah! My readers are going to think I made you up. 2. With reference to your experience with the Asperger's proxy mom, do you know if there was children's disability (SSI) involved? Follow the money is the best map to what is going in the minds of parents like this. I agree that following the money is a useful guideline, but no, SSI wasn't involved, at least as far as I know. But a very seriously disturbed housewife certainly was — someone for whom a quiet life on a pretty, well-tended suburban street, was entirely beyond her coping ability.

Thanks for writing!

Zombie Diagnosis

(May 2014, one year after Asperger Syndrome was officially abandoned) Paul, I found your article on Aspergers by Proxy so insightful and just sensible! There is very little on the net of the processes that lead to misdiagnosis, everyone just appears to be pushing for the diagnosis. My son has just been diagnosed by Aspergers by an over-zealous psychologist and we are now trying to undo the mess that she and his school has created. He had been labelled as highly gifted at the age of 4 - far too young in my opinion - based on the fact that he had an enormous amount of knowledge of topics not typical of his age including conceptual understanding of them. He did not drone on and on about them but had reciprocal conversations with people who understood what he was talking about.

[ ... personal details omitted for privacy ... ]

My husband and I have learnt an important lesson: we will never consult a psychologist again! I can hardly believe my eyes! Asperger's has been abandoned by the psychiatric and psychological professional societies, it has been described by the mental health field's guiding lights as "not an evidence-based term", it has been removed from the current edition of the mental health diagnostic manual (DSM-5) to stop people from misusing it, but Asperger's keeps coming back to life like an undead zombie in a horror movie.

If psychology were a science, and if it were a medical field, these attempts to assign a nonexistent diagnosis would result in legal prosecution and expulsion from the field. But neither is true — psychology doesn't honor scientific evidence and isn't a proper medical field, meaning psychologists can do whatever they please, at your expense.

When I hear a story like this, I wonder what's going through the minds of psychologists. How does assigning a nonexistent diagnosis, one that cannot be reliably diagnosed and has no meaningful treatment, help a child accept adult responsibilities?

I applaud your persistence and intelligence, and thanks for writing.

Imaginary Illnesses

I'd be willing to say, from my own experience, that the vast majority of people diagnosed with "Asperger's" don't have anything wrong with them, similar to your description. I would say that, if there's something wrong, it's volitional — something at the person's whim and under his control, unlike the classic model brought to mind by the word "illness", meaning something inflicted by nature against a hapless victim. I've talked to a few people where my usual assessment could be summed up as "they're assholes, not aspies". I actually like most people who self-describe as Aspies, except that their attachment to Asperger's is as annoying as a person's blind attachment to religion, Country & Western music or Apple products. I have the diagnosis myself — I usually refer to myself as "autistic" instead, because of Asperger's having become a fad diagnosis. A noble gesture, but one that undercuts the logic of Asperger's and similar diagnoses, which is to take what people assume is a bad thing, an involuntary affliction, and turn it into an asset. When psychologists invented Asperger's, their now-famous intellectual shallowness prevented them from seeing what would happen to an "illness" that everyone thought was cool, and that you could get paid for having (through benefits offered by the U.S. Social Security system and programs in other countries).

It's not common that psychologists un-invent their imaginary diseases, but it does happen — Asperger's was cast out recently, homosexuality was reluctantly abandoned in the 1970s, and there were earlier examples, like Drapetomania, an imaginary affliction invented before the U.S. Civil War that explained why slaves ran away from their masters — somehow Drapetomania was a disease, not a desire for freedom. I have talked to people, you can tell there's something "not right", their voice is pitched oddly, they slur, they act like they're mentally impaired - the point where you can tell there's something clearly wrong... that's not what I see from a lot of these other people who are called "aspies". But I've seen it in myself. Yes, but the point is that some are open to objective diagnosis — you can see the causative agent in a microscope or a brain scan, and you can objectively say whether the ailment is present or absent, no "professional" opinions are involved. And you can either treat such conditions or explain why you can't treat them. Because of objective scientific evidence, real doctors are forced onto the same page, forced to offer the same diagnosis based on unambiguous laboratory results. None of this is true for mental illnesses. For the record, my own status as "disabled" was based on a different condition, I suspect it was "Intermittent Explosive Disorder". (Don't you just love these ridiculous names?) Yes, pretty absurd. The tragedy of modern psychology is that psychologists can't seem to look at their own behavior with the same critical eye. They're unwilling to describe their behavior as an ailment, a treatable social handicap. For this genuine ailment, the treatment of choice would be to force psychologists to learn science.

Asperger's Redux

First Pardon my english. I´m a native german speaker from austria, who ins´t used to writing letters in english.

[ Editorial note: because of the importance of this account, from this point forward I have heavily edited this correspondent's prose to make it more readable, while trying to avoid inserting too many of my own views. ]

My congratulations on your articles about "Asperger Syndrome". Years ago my son was diagnosed with this condition by a psychologist (who more recently has been accused in court). The consequences of this diagnosis were nearly fatal for the child (he was physically and mentally abused — beaten like a dog, while his mother throws dinner at him, shouting, "Eat, you miscarriage [Fehlgeburt]!" On other days she called him "Cretin [Kretin]" and other things). He was scratched, wrestled by the hair and locked up in the cellar. This child, with an IQ of 140, spent two years in an institution for disabled children where he was sequestered with four other children eight hours per day, among which none could speak or walk normally. In local family court practice, this treatment is regarded as normal because the child has been given the Asperger's diagnosis, which served as an excuse for all such treatment.

As the child grew older, he become a good pupil, the mother lost custody, and three doctors claimed that the child doesn't suffer from autism at all. The mother (herself a psychiatrist) tried to enlist the aid of the police to commit the boy to a psychiatric ward with a diagnosis of neuroleptica [ Ed.: I think this refers to Neuroleptic malignant syndrome, an adverse reaction to antipsychotic drugs ], most likely to end his progress toward normal behavior.

Maybe it's not an everyday occurrence, but "Asperger's by Proxy" may be a real danger for kids in first world nations. In Austria there is much money to be earned with such diagnoses because the welfare state pays for the so-called professionals and helpers who dispense diagnoses of Autism and Asperger Syndrome. I think this works against the health and welfare of our children. Thanks for writing! Stories like yours explain why Asperger Syndrome was abandoned as a diagnosis several years ago and voted out of the diagnostic guide (the DSM). This means it is not available to ethical mental health practitioners. It can no longer be offered as a diagnosis — it is gone.

But unethical practitioners still make the diagnosis, even though opinion leaders in the mental health field have strongly recommended its abandonment. This is outrageous and in my opinion should be illegal. In medicine, a science, such a thing would in fact be illegal. But psychology is not a science, and psychiatrists and psychologists are neither scientists nor doctors. The problem is that the legal system hasn't figured this out yet.

Again, thanks for writing and recounting this sad tale.

The "Joan" scale (June 2021)

I'm in my late 20s and my MBP mother (8/10 on the "Joan" scale) ... Hmm — the "Joan scale" — a new scale of social dysfunction. Maybe it will catch on. ... has 3 very young children. I don't want her to get them prescribed any medication. Advice? As much as I would like to offer encouragement, from a legal standpoint you have few options (and I am not a lawyer). Unless you can show credible evidence of harm to children, the authorities won't take action. In the original Joan story (all names changed), her children were in such obvious danger that it was a slam dunk. Child Protective Services had an open file on Joan before I met her, so I had more options. All I needed to do was call Child Protective Services and report my findings including my having witnessed the childrens' frequent voicing of intended self-harm.

Interestingly, my first clue about the real situation was Joan's frequent use of the term "CPS" for Child Protective Services — in Joan's world it was too much trouble to fully articulate a name she was obliged to utter so often. After a conversation with Joan in which she first tossed out this acronym, I had to look it up to figure out what she was talking about. I then realized how bad the situation was. I don't want her to get them prescribed any medication. Good plan, but medication isn't the only danger in these situations. A toxic environment can easily stand in for toxic drugs.

I obviously can't reveal details, but a combination of action by public authorities against Joan, and private intervention by in-laws, succeeded in removing Joan's children from a toxic environment.

I wish you the best in this difficult situation.