Why Theories of Mind?

Why Theories of Mind?

In the singular, the term “Theory of Mind” refers to a psychological concept developed by Dr. Uta Frith, pioneering autism researcher, along with Dr. Alan Leslie and Dr. Simon Baron-Cohen. Their research focused on ways people do or do not attribute beliefs to others–in other words, having a theory of mind means being able to imagine what another person thinks based on your knowledge of what information they have. You can read an interesting interview with Uta Frith here.

Theory of Mind ability is often assessed with what is called a “false belief” test. Here is an example: say two friends go shopping. Sally tells Ann, “After we do our errands, let’s meet at the coffee shop on the corner,” but when Sally gets to the coffee shop, it is closed, so she goes next door to the sandwich shop. Where will Ann look for Sally?

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Having a well developed theory of mind means understanding that Ann does not have complete information (she does not know the coffee shop is closed), so she will probably go look at the coffee shop for Sally. Young children tend to assume everyone else knows everything they know, so they will sometimes answer, “The sandwich shop.”

Theory of mind is the ability to speculate about what is going on from other people’s points of view and to understand that other people have different information that you do.

I chose the plural of this theory–“Theories of Mind”–as the name of my practice for three reasons:

First, all of psychology is a practice of understanding the internal workings of the human mind and heart. While psychology is science, it is also a healing profession where beliefs and practices have very human consequences. I believe that as practitioners of a healing modality, we must remember that as much as psychology is a science, like all sciences, it is a process of constantly evolving theories. I believe that it is important to hold our knowledge of human functioning lightly, always remembering how much we don’t know, and being ready to consider new explanations for what we observe. That is to say, we must remember that psychology is only our latest best guess–it may be based on lots of good research and experience, but it is still only a theory about how minds work.

Second, my practice offers psychotherapy to both children and adults. While children are actively in the process of learning that there are viewpoints in the world different than their own, this is a lesson we adults are still learning as well. Most relationship conflicts–in couples, between parents and teens, between siblings–boil down to our attempts to have a solid sense of self–a sense of self and boundaries that may sometimes come into conflict with intimate others. One of the most challenging aspects of learning to be a fully integrated adult is accepting the relational truth that others act as they do for ways that make profound sense from their understanding of the world, and those ways are just as valid and compelling as our own.

I chose “Theories of Mind” for my practice name as an attempt to capture this idea–the idea that there is not just one truth, but many right ways of understanding the world. The therapy I offer operates from this family systems understanding. Within that relational systems perspective, I use a range of techniques from coping skills training, to behavioral and cognitive strategies, to expressive symbolic therapies such as sand tray work. I work with individuals as well as various combinations of family members to expand clients’ sense of self, ability to differentiate, and ability to tolerate intimate connection without falling into old struggles over whose “theory of mind” is more right. Therefore, our best guess at how minds work is not just one theory, it is many theories–yours, mine, and the ones we create together.

The two reasons outlined above get at my philosophical reasons for choosing “Theories of Mind” as my practice name, but there is a third, more political reason as well…

I offer a practice which focuses, in part, on providing services to people on the autism spectrum (and in larger part to people who deal with issues of learning differences, sensory processing differences, anxiety, and other neuro-atypicalities). Anyone who has spent any time in the autism community knows that understandings of autism or neurodifference can be controversial. I view politics around the idea of theory of mind as an issue of disability rights.

For a long time, it was believed that one of the defining traits of autism was a “lack of theory of mind” often equated with a profound lack of empathy or ability to connect with others. However, recent research has brought these ideas into serious question.

First of all, theory of mind appears to be a learnable skill–it is not simply something you have or don’t have, it is something you develop through encounters with the world. Research on theory of mind shows that when specifically taught to think about false beliefs, subjects–including autistic subjects–improve on false belief tests. In other words, lack of theory of mind is not a defining trait of autism. This research does not just apply to logical tests of theory of mind, but to capacity for empathy and connection as well–in other words, people on the autism spectrum have been shown to have ample, sometimes even exceptional capacity for empathy and connection with others. (You can read more about this research in my dissertation.)

It also appears to be true that people develop theory of mind at different rates and use it with differing amounts of automaticity based on their life experiences and other factors like intelligence and verbal abilities. People on the spectrum have been observed to develop differently from typical folks in many ways–faster in some areas, slower in others. Differential development in the area of theory of mind shows up in some autistics, but not others, and even varies day to day and situation to situation in any given person.

The reason theory of mind varies by situation for autistic people seems to have a lot to do with the complexity of emotion involved, and the amount of inferences needed to make sense of any given situation. Seeing another person’s viewpoint, remembering that they don’t know all that you know takes calm and thoughtful engagement. One well-documented way that people on the spectrum differ from typically-developing folks is in the frequency and speed of neurophysiologic arousal process in response to triggering stimuli, as well as greater challenges with down-regulation after being triggered.

In plain language, that means that emotional activation happens more quickly for people on the spectrum, which then interrupts the mind’s ability to calmly consider the viewpoints of others. It seems very possible that the deficits in theory of mind documented in older literature on autism are more indicative of stress and activation than of innate problems in underlying ability structure. Emerging scientific evidence demonstrates that people on the spectrum have theory of mind abilities that are the same as typically developing people, except when they are activated. (This is true for everyone–being upset makes it harder to remember that other people have different points of view from our own).

Because of the nature of feedback and feed-forward circuits in the autistic brain, being activated tends to happen more frequently and more rapidly for autistic people than for neurotypical people. In addition to being vulnerable to becoming quickly flooded, autistic people tend to experience greater variability in their access to and facility with verbal language. The ability to think, and the ability to communicate what we are thinking are two very different skills, and should not be conflated or confused.

But back to the political point…

I consider ideas about theory of mind to be a disability rights issue because autistic people often face a great deal of bias, and the idea that autistics cannot understand the viewpoint of others is one of the most harmful of these stereotypes.

After having done an extensive review of the literature for my dissertation, I believe that the evidence purporting to prove that autistics have impaired theory of mind is too mixed to draw hard and fast conclusions. I believe that when other factors such as level of arousal and related ability to communicate are not accounted for, the research becomes even more unreliable.

For too long, the idea that autistics lack theory of mind has subtly reinforced the stereotype that autistics are oblivious to the needs of others, less able to make meaningful human connections, and even un-desiring of relationship. Autistic authors like Naoki Higashida have written poignantly about these harmful assumptions.

One of the most powerful recent theories about the autistic experience of the world is that being autistic means the world is experienced with an excess of empathy–so much identification with the world around you that it is difficult to filter all the information and keep your emotional balance. This idea is known as “The Intense World Theory” and you can read more about it here.

For this third and most important reason, I chose the name Theories of Mind to refer to this emerging and highly significant evidence that autistic people perceive the world with greater than typical sensitivity rather than less. This choice represents my stance that it is time to expand and reclaim the past conceptualization of theory of mind (the one that characterized autistic people as mindblind and unempathetic) that has contributed to such harmful assumptions.

Instead, I believe that it is time to recognize autistic development as one that represents a different rather than an impaired trajectory–one which includes both strengths and vulnerabilities, both aptitudes and disabilities. I chose “Theories of Mind”–the plural–as my practice name to recognize the plurality and variability of developmental trajectories, not only in autistic people, but in the range of people of various neurotypes and learning differences who make up the spectrum of neurodiversity. I hope you will join me on this journey of discovery and advocacy.