Ever wonder why you look at a situation that’s occurring and
wonder why you’re mind starts racing and over-interpreting every single facial
expression? Every single voice inflection? What did that blink mean? Is he
glaring at me? Or was that just dust in his eye? Is she about to cry because of
something I said? Or is she simply sniffing because of allergies? Why are we so
prone to emotional dysregulation and over interpretation of the emotional
situations around us? In my research I found one nicely compared clue. Many of
us are well aware of how Autistic Spectrum Disorders are viewed and how it’s
pretty well accepted they don’t react normally or over-interpret emotional
situations. In fact, they typically under-interpret emotional situations
if they interpret them at all. When these studies were applied to people with
BPD, they results were quite interesting. Where people on the autistic spectrum
tend to be hypo-mentalistic, - deficient in mentalism… people on the BPD
spectrum tend to be hyper-mentalistic… but here; check it out for yourself. It
explains a lot:
Borderline
Hyper-mentalism UnMASCed
A new test proves
BPD adolescents hyper-mentalize
Published on June
10, 2011 by Christopher Badcock, Ph.D. in The Imprinted Brain
We have known for some time that sufferers from
autistic spectrum disorders (ASDs) have mentalistic deficits--so-called mind-blindness.
They tend to think in concrete, non-mental terms, and to be poor at detecting
and interpreting social and emotional cues such as direction of gaze, facial
expression, and body-language. And they are also poor at seeing things from
another person's point of view. For example, if shown a tube of sweets which
proves to contain a hidden pencil and then asked what the next child to be
shown it would think it contains, many children under 3 or 4 tend to expect the
next child to know what they already know, completely failing to appreciate the
next child's inevitable ignorance. But much older children with ASD make the
same mistake and fail this test of appreciating so-called false belief.
Thanks to specially-designed tests like this and
others, researchers have been able to measure these deficits quantitatively.
However, exactly the same tests have caused confusion as far as the imprinted brain theory
and its distinctive, diametric model of mental illness is concerned
because, when applied to those diagnosed with psychotic spectrum disorders
(PSDs) such as schizophrenia, mentalistic deficits are also often found.
The problem here is that the diametric model proposes that if ASD is
symptomatically hypo-mentalistic--deficient in mentalism--then PSD is the
opposite: hyper-mentalistic. Here are some examples (explained and
illustrated at length with clinical examples in my book):
·
Gaze
Awareness: deficits in ASD v. delusions of being watched or
spied on in PSD
· Awareness
of and interpretation of intention: deficient in ASD v.
delusions of persecution (negative intention) or erotomania (positive
intention) in PSD
· Shared
Attention/group participation: deficits in ASD v.
delusions of conspiracies in PSD
·
Theory
of Mind: deficits in ASD v. magical ideation/delusions of
reference in PSD
· Sense
of self/personal agency: deficits in ASD v. megalomania/
delusions of grandeur in PSD
·
Ability
to deceive: lacking in ASD v. delusional
self-deception in PSD
Other findings which fit the pattern here are the
pathological single-mindedness of autistics v. the pathological ambivalence of
psychotics, and the age of onset. This is early in ASD because mentalistic
development is truncated but late in PSD because normal development has to be
completed before mentalism can become pathologically over-developed.
Of course, you would expect to find mentalistic
deficits in both under-mentalizing and over-mentalizing minds just as you would
expect to find visual or hearing deficits in people with both over- and
under-sensitive eyes or ears. What you have to do is to develop tests which can
tell the difference, and now for the first time techniques are beginning to
appear which do indeed do this where mentalism is concerned.
New research by Carla Sharp and others published in The
Journal of the American Academy of Child & Adolescent Psychiatry (50,
(6), 563-73, 6 June 2011) kindly brought to my attention by my colleague,
Bernard Crespi, does exactly this, with results perfectly in line with our
predictions.
The study used a naturalistic, video-based instrument
for the assessment of mentalism called the Movie for the Assessment of
Social Cognition (MASC). Subjects watch a depiction of an interactive social
scenario and are periodically asked questions about it. This approach can
distinguish between under-mentalizing, involving insufficient mentalistic
reasoning resulting in incorrect, reduced mental-state attribution, andnon-mentalizing involving
a complete lack of mentalism in which a participant may fail to use any
mentalistic term whatsoever in explaining behaviour. But crucially for the
diametric model, the test can also assess hyper-mentalism, reflecting
over-interpretation of mental states.
As the authors comment, this study is the first to use
a mentalistic task that resembles the demands of social cognition in
everyday-life to examine mentalizing difficulties in relation to borderline
personality disorder (BPD) traits in adolescents. Although other studies
have investigated aspects of emotional processing in young people diagnosed
with BPD, this is the first to use a task specifically developed to assess
mentalizing impairment in a psychiatric disorder by considering both
insufficient mentalistic reasoning and a complete lack of mentalizing. The
study found that neither under-mentalizing nor complete absence of mentalizing
was linked to borderline traits. By contrast, hyper-mentalizing
("over-interpretive mental-state reasoning") was strongly associated
with borderline features in adolescents.
According to the diametric model, BPD is a PSD and as the
authors note, these adolescent BPD subjects showed the opposite tendency to ASD
adolescents: where they hyper-mentalized and over-interpreted social cues,
autistics symptomatically under-interpret social signs and fail to mentalize
sufficiently.
In the words of the authors, "the current study
adds to the growing body of evidence linking varying types of social-cognitive
dysfunctions to particular psychiatric disorders and specifically linking
hypermentalizing to borderline traits in adolescents. Taken together, these
results confirm clinical, and theoretical evidence that, in patients with
borderline personality disorder, the dysfunction of mentalization is more
apparent in the emergence of unusual alternative strategies (hypermentalizing)
than in the loss of the capacity per se (no mentalizing or
undermentalizing)."
They add that "Hypermentalizing, which involves
overinterpreting social cues in others, in turn, derails the emotion
regulation system spinning the adolescent into a vicious cycle of
overinterpreting what others are thinking and being unable to regulate the
anxious rumination caused by this overinterpretation"--just as the
diametric model predicts.
Let's hope that many other researchers begin to use
tools like MASC to test the predictions of the diametric model and resolve once
and for all the confusions surrounding the true meaning of mentalistic deficits
in illnesses on both sides of the autism-psychosis spectrum.
(With thanks and acknowledgement to
Bernard Crespi)
**********************************************
So what do you think of that? Interesting, right? I’m going to dig a little further for you and
see what else I can unearth along these lines.










