‘SWITCHING ON’
INSIDE A ‘ LIFE- CHANGING’ BRAIN TREATMENT THAT CAN BRING EMOTION TO AUTISM. PLUS: THE SURPRISING LINK BETWEEN THE CONDITION AND PRODIGY,
He had heard the bootleg R& B set by the Tavares brothers dozens of times. He knew the words, the melodies, but as a longtime music engineer for major bands such as KISS ( he once made their flame-throwing guitars), he could also hear every technical detail of how the sound was recorded.
This time, though, driving down a Massachusetts highway, John Elder Robison sensed something more, an almost religious transcendence. He could feel the music in a new way, charged with the emotion of the singer. He began to weep at the wheel, “not because I was happy or sad, but because it was all so intense.”
“( The) emotions of the songs washed over me,” he writes in his new memoir Switched On. “Every little nuance of the recording held meaning for me. My range of sonic comprehension had just widened a thousandfold.”
The trigger for this epiphany, Robison is convinced, was a brief session of transcranial magnetic stimulation, an experimental new therapy for people with autism spectrum disorder.
As he tells it, growing up with autism — one of medicine’s great mysteries — had obscured the pathways of t hought t hat allow most people to grasp the emotional content of words, to sense the emotions of other people, and to respond empathetically. After TMS, though, a vast new geography opened in his mind.
“The filter of autistic disability — if that is what hid the emotion from me before — seemed to have vanished.”
His memoir reads like a triumph, except for one strange tension. Robison is known for more than just his work on concerts for musicians as diverse as Dan Hill and Pink Floyd. He is a major figure in the neurodiversity movement, which seeks to recast autism as a distinct identity, a different way of thinking rather than a disorder or a disease. Robison’s previous memoirs, Look Me in the Eye and Be Different, recount his struggles with undiagnosed Asperger’s syndrome, now subsumed under the wider autism spectrum disorder, but also how he turned his unique abilities into highly successful careers, first in music, then in luxury auto repair.
Taking part in frontier science to test a new autism therapy makes for an inspiring story. But if TMS really can “switch on” the emotional faculties of people with autism, and literally change how they think, could that undermine those fighting to be accepted on their own terms? called because of historical medical descriptions of people who seemed wrapped up in themselves. It is a diverse disorder, now described as a spectrum, from mild social impairment through to non-verbal people with unstable behaviour in need of constant care. But a common trait across this spectrum is a deficit in emotional insight.
A key moment in neurological development comes when children realize other people have thoughts and emotions, just like their own. Known as “theory of mind,” this allows children to understand their social environment. And its absence in autistic children is so common that it has been proposed as a defining feature of the condition.
One theory is that, in people with autism, the mechanism that regulates emotion is overactive, which flattens their emotional sense and inhibits their empathy for other people.
The intriguing flip- side of that deficit, though, is that people with autism might at the same time have a heightened ability to imagine what it is like to be other things.
In Look Me In The Eye, for example, Robison describes at length what it feels like to be a concert lighting system, wired up for the grand spectacle, a talent that made him, as he puts it, “one of the most successful engineers of that in the working rock and roll world.”
“We autistic people, people with different neurological wiring, we have perhaps an ability to put ourselves in mind of other creatures or other things more readily than a typical person could,” he says in an interview from his auto shop in Massachusetts.
Likewise, the famous autism advocate and animal behaviour expert Temple Grandin, whose endorsement is on the cover of Switched On, has written about what it is like to be a cow, taking a unique perspective that helped to make her, “the most successful designer of animal handling systems in farming in the world,” Robison says.
But for many people with autism, the challenge of relating to other people, of recognizing and responding to their emotions, can lead to chronic disability. This is where TMS offers its greatest promise.
A few years ago, a post-doctoral researcher for Beth Israel Deaconess Medical Center in Boston, a teaching hospital of Harvard University, approached Robison at a talk he gave, asking to recruit him into an experiment at the frontier of autism therapy research. She said they were trying to help people with autism read emotion. He was excited and agreed.
The treatment seems simple. By using a hand- held wand to briefly expose his brain to a magnetic field, and thereby induce an electric current through his neurons in a specific and tightly controlled way, the researchers hoped to open new pathways in his mind.
Some cognitive faculties seem to be suppressed by TMS, and it is already approved for therapeutic and diagnostic use, with applications in everything from depression and addiction to stroke and nerve damage.
In one of Robison’s sessions, for example, the experimenters targeted a brain area crucial to speech, leaving him feeling completely non-verbal. “I believe that I thought like a dog,” he says. As they are suppressed, other faculties seemed to be enhanced, or perhaps coaxed out of dormancy, just by using magnetism to boost the flow of electrons through the brain.
Robison thinks his TMS treatments may have suppressed the autistic mechanism that inhibits his emotional faculties, giving him a chance to build those emotional connections. Over time, the same mental trails blazed by those early treatments have metaphorically widened and smoothed with repeated use, so today he no longer needs regular TMS to summon the abilities it gave him.
These are just theories. Much like electroconvulsive therapy, the exact way TMS works remains mysterious to science. The scientist who directed Robison’s TMS — Alvaro Pascual- Leone, a leading cognitive neuroscientist — was not treating him medically for autism. He was experimenting, and Robison’s life- changing results were “his singularly subjective account … not necessarily the objective outcomes of the study,” Pascual- Leone writes in a foreword to Switched On.
But if this simple non- invasive procedure truly did help Robison to, as he puts it, see into other people’s souls for the first time in his life, then a purely scientific explanation might be beside the point.
He describes, for example, suddenly get- ting all weepy at the breakfast table while reading about some foreign calamity like a bus crash or mudslide, something that used to baffle him in of course they did not know any victims personally
Now, he could recoginize and share in the human tragedy.
His new emotional insight showed him what it was like to be a typical human “Not a normal human, because i would say there’s not really such a thing as TMS showed me what it's like to be a person who's emotionally
aware and insightful. And of course there are those people like me, who are insightful into machinery".
His new awareness was not entirely positive. It left him “essentially naked in a hostile world.” In time, for example, he came to feel crushed and drowning under the depression of his now former wife. He made it worse, he observes, by "jabbing at her constantly
trying to make her more like me. “I had been oblivious to it for so long and, and I felt horrible because i'd turned on her with-
‘IT SHOWED ME WHAT IT’S LIKE TO BE A PERSON WHO’S EMOTIONALLY AWARE AND INSIGHTFUL’
out warning,” he wrote. “I was different and she was the same, and things had ceased to work between us.”
He compared it to discovering colour after a life of seeing only shades of grey. For the neurodiversity movement, Robison’s story presents a moral quandary, because it sounds very much like a cure — a word so loaded with stigma that many people with autism regard it as a terrible slur.
Robison specifically rejects the word “cure,” saying TMS offered relief of a specific disability. It did not remove his autism, as for example penicillin removes infection.
“An autistic person who’s miserable because he can’t complete a job interview or he can’t form a romantic relationship, no reasonable person would oppose developing a therapy that could help him achieve that dream. I think that’s very different from saying, ‘ We want to eliminate his autism,’ ” he says. “If you grow up as an autistic person, and you’re like me, you’re 50 years old, you have this lifetime of developing and wiring your brain with understanding of these autistic differences, there’s no taking that away.”
If not a cure, Robison’s musical epiphany on the turnpike at least marked a sort of awakening. He is tempted to compare it to the rapture of the religious mystic, but instead he draws on the more modern kind of transcendental experience he knew from his rock and roll youth, the psychedelic trip on mushrooms or acid.
“I’m not a particularly religious person, and I therefore don’t really have experiences like visions to talk about. But the thing you could say about people who have these religious visions, whatever the reasons are — whether they were psychotic or because God visited them, whatever you believe — is that people can have these visions and their lives will be changed from that moment forward. People can go out in the desert and have experiences with peyote and mushrooms with a shaman, and their life will be changed for evermore.
“I wanted to make a point that TMS has a similar transformational power through brief experience, that it can show you things after which your life will never be the same.”