Autism, Early Narcissistic Injury, and Self Organization: a Role for the Image of the Mother’s Eyes?
Maxson J. McDowell, Ph.D., New York
Peer-reviewed and published in Journal of Analytical Psychology. Copyright: 2004, Society for Analytical Psychology.
Holland has elucidated the new paradigm of self-organization in complex adaptive systems. This paradigm holds for all living systems, including the personality. In conjunction with the theory of archetypes, self-organization suggests two radical hypotheses, one about early development, the other about the origins of autism. Autism is associated with several medical conditions, with genetic markers, and with infant visual deprivation. None of these factors, however, is either necessary or sufficient to cause autism. It is proposed that each of these factors increases the probability of a primary psychological deficit: failure in the first few weeks to acquire (or retain) the image of the mother’s eyes. These hypotheses were derived from analytic work with patients who have early narcissistic injury and with patients who have mild autistic traits. Both diagnoses may arise from the same initial disturbance: Symington and others have argued that autism is an extreme form of infantile narcissism. Indirect evidence for the image-of-the-eyes hypotheses comes from the evolution of primates, from infant-mother observations, from observations of infant vision, and from experiments on vision in other vertebrates. Byrd recently confirmed that the incidence of autism is increasing dramatically. The image-of-the-eyes hypotheses suggest that this increase may be due to the increased use, in early infancy, of non-maternal childcare including television and video. The search for environmental triggers for autism must be interdisciplinary. This paper makes a timely contribution to that search.
archetypal image, autism, narcissistic injury, primary deficit, newborn, eye-contact, self-organization.
My personality1 is a synthesis of instincts, impulses, feelings, images2, memories, ideas and attitudes, some conscious and some unconscious. It is a living psychological system which co-exists with my physical system. Like every other living system, the personality must self-organize. That is to say, it is not ordered from above, like a platoon in an army, but from within, spontaneously, like a group of people who gather together around a common interest (McDowell 1999; Saunders and Skar 2001, p. 318; Hogenson 2001, p. 607).
1. By ‘personality’ I mean all the internal processes and systems which comprise the psychological life of a person.
2. By ‘image’ I usually mean a representation, within the brain, of an external pattern or process which has been perceived via by the senses. When the context requires it, ‘image’ may mean an external visual pattern, or an image in a patient’s material. _______________________
Though self-organization is spontaneous, it is not random: it leads to predictable forms. In a group which gathers around a common interest predictable patterns emerge. One person may accept responsibility, for example, and others may depend on that person to do so. Such a pattern expresses a pre-existing mathematical (spiritual) principle: the principle ‘guides’ the formation of the pattern. Each principle is specific and the total number of principles is limited. I argue that a pre-existing principle is what Jung called an archetype-as-such. For a more detailed explanation with evidence see McDowell (2001a). For another view of archetypes, see Knox (1999, pp. 524-5; 2001, pp. 628-31; 2003 pp. 65-6).
I visualize such a principle not as an abstraction but as an internalized image. I may visualize the mathematical principle of responsibility, for example, as an image of a father. This is what Jung called an archetypal image. In part the principle guides my personality by means of the internalized image. When I need to organize myself for responsibility, I imagine myself as a father.
The forgoing suggests a novel question. The most important stage in the self-organization of the personality is the earliest stage. All subsequent development depends upon it. Can we identify a principle (and its internalized image) which operates very early? You may be skeptical. How could something as complex as the human personality begin with a few images? But the paradigm of self-organization has radical implications. Enormous complexity arises from the interactions of a few simple components. This is consistent with Jung’s view that archetypes generate the personality.
This theoretical paper proposes two related hypotheses. The first hypothesis is that the acquisition of an internalized image of the mother’s eyes is a critical step in the first few weeks of development. Once acquired, the image is associated with and therefore begins to represent (evoke) the feeling of being contained, that is, the principle of containment (McDowell 2001b). This first hypothesis is supported by data on the ontology and ontogeny of social gaze. The second hypothesis comes later.
The evolution of social gaze
We can deduce an evolutionary sequence by comparing modern primates. Humans evolved from ancestral monkeys and apes which were very like modern monkeys and apes. Within that evolutionary sequence social gaze became increasingly important.
In most primates the visible eye consists mainly of dark iris with only a very small proportion of sclera. The sclera is almost always brown or light brown rather than white. But in humans the visible eye has a large expanse of white sclera which provides a sharp contrast to the dark iris (Emery 2000, pp. 583, 585). This helps an observer to determine the precise direction of a human’s gaze.
When viewing faces, a monkey shows an extreme bias for looking at the eyes and the small region surrounding the eyes. The eyes play a central role in a primate’s facial expression and thus in emotional communication (ibid., pp. 585-6). Staring and frequency of eye-contact are key social signals. The direction of one monkey’s attention, coupled with its facial expression, conveys crucial information to a second monkey about the object of attention (joint attention). It may inform the second monkey about the social status of a third, or about food or about danger.
Apes, but not monkeys, appear to use the direction of another’s gaze as a clue to the other’s intended behavior. This is more complex than joint attention because it requires an awareness of the other as a repository of potential behavior. It seems that only humans, however, practice shared attention (ibid., pp. 588, 594), in which two individuals are each aware of the direction of the other’s gaze (I know that she sees it and she knows that I see it). Shared attention is a component of theory of mind. In psychoanalytic terms its equivalent is intersubjectivity.
These observations are direct evidence that, as the primate’s eye has evolved in appearance (towards more visual contrast between iris and sclera and hence towards a better signal of gaze direction), so it has evolved in psychological function (towards enabling intersubjectivity).
This is supported by experiments with human subjects (Baron-Cohen et al. 1997, pp. 323-5). Subjects were asked to identify complex emotional states (scheme, admire, interest, thoughtful, arrogant) from photographs of the whole face, from cropped photographs showing only the mouth, and from cropped photographs showing only the eyes and eyebrows. When the whole face or the eyes alone were seen, accuracy of identification was equally high. When the mouth alone was seen, accuracy was low. Thus the other’s complex subjective state is conveyed by the image-of-the-eyes. This last conclusion is confirmed by the work of Klin et al. (2002, p. 809).
The development of intersubjectivity
Bion (1962/77, p. 36) described the breast-feeding mother’s ‘reverie … [which is] imparted to the channels of communication’. Winnicott (1971/86, p.112) said
when [the baby] looks at the mother’s face … what the baby sees is himself or herself … the mother is looking at the baby and what she looks like is related to what she sees there.
Stern (1985, p. 139) described how the infant develops a sense of self within the infant-mother interaction. At the intersubjective phase, beginning around eight months, the infant senses that infant and mother each have inner mental states which they can share (I want that toy, and she knows that I want it.)
The mother contains the infant not only physically but also psychologically. Just as the infant’s body develops ‘within’ the physical container of the mother’s body and her actions, so the infant’s sense of self develops ‘within’ the psychological container of the mother’s inner life. That is, it develops ‘within’ the mother’s awareness of and inner response to the infant. This is particularly the case for the intersubjective sense of self. If the infant could speak the infant might say:
I see that my mother sees me as lovable, so I see myself that way too.
In the words of Stern et al. (1998, pp. 907-8):
… the intersubjective goal … [is] a mutual recognition of each other’s motives, desires, and implicit aims that direct actions, and the feelings that accompany this process … [This] also implies a signaling or ratifying to one another of this sharing … The work is asymmetrical, with the caregiver … doing the lion’s share.
Stern’s model of development suggests why the eyes are important. The mother senses the presence of the infant’s inner life in part through the infant’s eyes. Likewise, the infant senses the mother’s inner life in part through the mother’s eyes.
Infant and mother also engage each other through smell, taste, touch and sound. An infant has remarkable cross-modal perception. Infants recognize the smell of their own mother’s milk (Stern 1985, pp. 39-40). Beebe, Lachman and co-workers have shown that by four months the infant-and-mother pair have developed vocal-rhythm coordination, the degree of which predicts both attachment and cognition at twelve months (Jaffe et al., 2001; for a review see Beebe, B. et al., 1997; for examples of mother and five-week-old infant interactions, ibid, pp. 153-4; see also Gergely and Watson, 1996.)
If the baby is born blind then it must detect the mother’s inner life through the other senses. Infant-observation studies by Fraiberg (1977, pp. 3-9) and Als et al. (1980) compared groups of blind and sighted infants (all mothers were sighted):
For the blind infant, containment is more difficult. The visual focus is missing. Closer tactile contact, nuzzling, and more continuous enveloping with the mother’s voice make up for it … The sighted infant’s interaction with the mother is similarly structured, yet not as explicit, nor are the cycles repeated as often, as containment and goal attainment are facilitated by visual feedback … the process of implementation is much more conscious for the mother of the blind infant (Ibid, pp. 198, 201).
Considerations of space prevent further discussion of non-visual modalities. The above observations demonstrate that, for a sighted infant, a visual image of containment is central.
You may object that the infant internalizes the image of the mother’s whole face, not just the eyes. Visually, however, the eyes are highlighted in the face by virtue of their duplication, intense color, extreme light-dark contrasts, sharpness of edge, regular shape (which is echoed by moving curved lashes and brows), and rapid movements. That the movements of the mother’s eyes follow (are contingent with) the infant’s movements makes the eyes the more compelling. Gergely (2001, p. 411) noted that ‘young infants are very sensitive to the contingent relationships between their motor responses and consequent stimulus events’. The mother also follows her infant with ears and nose, but these are visually undistinguished and they give no evidence of following. Even to an adult the eyes are visually compelling; as an infant first learns to distinguish forms, the eyes are likely to be the first image the infant masters. The primacy of the image-of-the-eyes is also supported by evolutionary evidence (v.s.). Later in this paper I adduce further evidence: Failure to make eye-contact is characteristic of autism. Distortions in eye-contact are also characteristic of early narcissistic injury. A newborn distinguishes between eyes averted and eyes gazing directly at the infant: the infant looks more often at the latter.
The new paradigm of self-organization in complex adaptive systems has been elucidated by Holland (1998, pp. 229-31). In complex adaptive systems (including all living systems) a limited number of simple elements spontaneously assemble themselves into a hierarchy of increasing levels of complexity. The personality, therefore, must organize itself from simple psychological elements (McDowell 2001a, p. 653). Any sensory image which is reliably acquired very early in development would comprise one of these initial elements.
You may object that the latter is mere assertion unless I can show that the image-of-the-eyes is acquired because it represents a self-organizing principle. But self-organization is not teleological (McDowell 2001a, p. 644). It is the spontaneous coming together of whatever elements happen to be present. What the image-of-the-eyes represents would be determined by the infant’s association of simultaneous events.
At birth the infant emerges from a container, the womb, which had previously met many needs. The infant’s personality must then organize itself to ensure continued physical and psychological containment. Stern (1977, pp. 37-8, 18) has shown that at about six weeks, for example, the infant learns to make continuous eye-contact with the mother. Stern observed that continuous eye-contact stimulates the mother to play more with the infant: she plays with facial expression, with voice, with face presentations, with head movements, and with proximity games. In this manner she contains her infant’s impulse to play. For more than 70% of play time a mother gazes at her infant’s face; her average gaze duration is extremely long (20 seconds).
To establish continuous eye-contact the infant must learn to recognize the mother’s eyes. This means that the infant must, in some sense, acquire an internal image-of-the-eyes. (In order to recognize something I must have a stored internal image to compare it with.) Several lines of biological evidence show that a cerebral cortical image which is peculiar to humans cannot be genetically pre-wired: the total number of genes is too small, human evolution is too fast relative to genetic change, and most wiring in the cortex is determined by sensory input (McDowell 2001a, pp. 640-2). If the internal image of the mother’s eyes is not pre-wired in the cortex, then it must be acquired from the environment.
Failure to internalize the image.
Bion, Winnicott and Stern (v.s.) have all shown that infant’s personality cannot develop without containing. If the infant fails to acquire the image-of-the-eyes in the first weeks of life, the likely result, I propose, would be a pervasive cascade of developmental failure. This leads to my second hypothesis: failure to acquire (or to retain) the image of the mother’s eyes is the primary deficit in autism. A corollary is that mild autistic traits may originate in a disturbance in the internalized image-of-the-eyes.
Gomberoff et al. (1990, p. 252) surveyed psychoanalytic studies which support their view that ‘the emergence of an autistic object … [represents] consolidation of more extended phenomena described as narcissistic’. Symington (1993, pp. 81, 105) argued that ‘infantile autism is closely allied to infantile narcissism … autism is another way of describing an extreme form of narcissism.’ A person with autism tends to ignore the other’s gaze. A person with early narcissistic injury tends to seek the other’s gaze insatiably. For both there is a diminished capacity to take in, and be satisfied by, the other’s gaze. If these two syndromes represent different positions on the same spectrum then, I propose, they both originate in a disturbance of the internalized image-of-the-eyes. This suggests that the unconscious productions of an adult with narcissistic symptoms may include disturbed images of the eyes.
In the next sections I discuss the incidence of autism and the biological factors which are statistically associated with it. Then I present the case of ‘ …..’ who had symptoms of early narcissistic injury and produced a series of images of the eyes. Next I illustrate, in the case of ‘ …….’, the combination of mild autistic traits and symptoms of early narcissistic injury. Then I discuss experiments on vision in human infants and in other vertebrates. Finally I discuss more severe autism.
The incidence of autism is increasing
In America and Europe the number of children diagnosed with profound autism has increased drastically. For California in 1987, 1998, and 2002 the numbers are 2,778, 10,360, and 20,377. Byrd et al. (2002) showed that the increase from 1987 to 1998 cannot be accounted for by changes in diagnostic criteria, by mis-classification, or by the immigration of autistic children. Huff et. al. (2003) estimate that among children born in California in 1976 the incidence of autism was one in 2,500, while among children born in 1997 the incidence was one in 323.
Genetic changes cannot account for this sudden increase. (This contradicts recent suggestions that autism is caused by a genetic defect in a specialized brain module – see Gergely 2001, p.418; Trevarthan & Aitken 2001, pp. 3-4, 30; see also Elman et. al. 1998, p. 368). The increase must, therefore, be caused by an as-yet-unknown change in environmental factor(s). There must be a vigorous new effort to identify these factor(s). The problem should be debated across disciplinary lines. This paper makes a timely contribution to that debate.
A biological primary deficit?
Autism is without question a pervasive developmental disorder: a primary deficit in the fetus or infant begins (to a greater or lesser degree) a cascade of secondary developmental failures. After several decades of research, however, the primary deficit has not been identified (Ungerer 1989, pp. 85-8). A variety of biological factors are statistically linked to autism. In current literature the overwhelming weight of opinion is that the primary cause (deficit) of autism is biological. Rodier (2000, p. 59), however, who argued for a biological cause, said that:
In utero exposure to rubella (German measles) or to birth-defect-causing substances such as alcohol … increases the chances that autism will develop. People with certain genetic diseases, such as phenylketonuria and tuberous sclerosis, also have a greater chance of developing autism. None of these factors, however, is present frequently enough to be responsible for many cases.
Rodier’s group have identified an allele (a mutation) which plays a role in autism:
The allele’s … presence does not guarantee that autism will arise. The variant allele occurs in about 20 percent of the people who do not have autism, and in about 40 percent of those who do. The allele doubles the risk of developing the condition. But in about 60 percent of people with autism, the allele is not present (ibid., p. 63).
In genetically identical twins, one twin may be autistic and the other not.
Thus many biological factors are associated with autism. A true primary cause, however, would be both necessary (without it, no autism) and sufficient (when present, so is autism). None of the biological factors is either necessary or sufficient.
The logic of causation in cascades is relevant here. The event which sets a cascade in motion, the primary cause, is the same in kind as the events which comprise the cascade.
The following example shows why this distinction is important. Death results from a cascade of bodily failure. Households with handguns show an increased frequency of death. But households with a high-cholesterol diet also show an increased frequency of death. A gunshot wound is neither necessary nor sufficient to cause death. A high-cholesterol diet is likewise neither necessary nor sufficient. The cessation of the heart beat, however, is both necessary and sufficient. It is also the same in kind as the other bodily failures which lead to death. It is the primary deficit which begins the cascade. When we identify the primary deficit we can see how other factors (gunshot and cholesterol) increase the frequency of the primary deficit.
None of the suspected biological factors is the same in kind as the cascade of developmental failures which is autism. It follows that none of the biological factors can be the primary deficit; the primary deficit should be a very early failure in psychological development.
Tracking the care-giver’s face
The following is further evidence that a biological factor is not the primary deficit. The correlation between autism and congenital infant blindness is stronger than the correlation between autism and any other biological factor (Brown et al. 1997, p. 701; Hobson et al. 1999, p. 54). If the mother of a blind baby relates to it actively by means of touch and sound then her baby’s development may be close to normal; if the mother does not do so then her baby is very likely to develop autism (Als et al. 1980, pp. 198-201). These autistic children do not have higher-than-normal rates of any other biological factor. What they have in common is blindness and a consequent failure to relate to the mother in infancy. Tustin (1966, p. 54) provides the clinical example of ‘John’, a young boy with autism, whose newborn behavior had resembled that of a blind newborn: he was ‘a poor sucker and … for one week after birth he did not open his eyes.’
There is also a high incidence of autism in children who were institutionalized at birth (Fraiberg 1977, pp. 185-187). There was a high incidence, for example, in children who were adopted in the U.K. from orphanages in Romania (Rutter et al. 2001, p. 101). The Romanian children are normally sighted but were neglected in cribs during infancy. They do not have higher-than-normal rates of any biological factor. Infants who have cranial nerve palsy with consequent paralysis of eye muscles are also liable to develop autism (Stromland 2002, p. 35).
These three different groups, congenitally blind children, children institutionalized at birth, and children with cranial nerve palsy, share one common deficit: they are all unable to track a care-giver’s face. In the absence of any biological cause, therefore, it seems that early deprivation in visual stimulus by a care-giver’s face often leads to autism. The lack of early visual stimulus by a care-giver’s face is neither necessary nor sufficient to cause autism. While not itself the primary deficit, it must increase the incidence of a primary deficit.
A very early step in development
Mahler and co-workers (1975, pp. 42-6 ) observed that face-to-face interaction between infant and mother, especially ‘the eye-to-eye encounter’, helps an infant to develop beyond the initial normal autistic phase. Fordham (1976, pp. 88, 90-2) argued that autism represents the
failure of the self to deintegrate … [because] there has been a basic catastrophe in the relation between the baby and the breast-mother … Sometimes the mother can recognize that … apart from the physical acts involved in feeding … there is no effort to relate to her, no play, no looks, no smiles (my italics).
Mahler’s and Fordham’s observations are consistent with the image-of-the-eyes hypotheses. Bergman’s compelling demonstration (1985, pp. 91-120) that autism can sometimes be cured by analytic treatment is also evidence that its cause is developmental.
An autistic child seems not to know that his or her mother has a subjective self. Hobson et al. (1999, p. 55) suggested that the ‘final common pathway’ (primary deficit) is a failure to develop a theory of mind. A theory of mind (or the lack thereof) may be inferred from a child’s visual behavior. An autistic child makes little eye-contact, pays little attention to the mother’s face, and ignores the mother’s facial expressions. Consequently the child lacks social referencing: it cannot evaluate an ambiguous situation by checking the mother’s expression. The child also lacks shared attention: it cannot follow the mother’s eyes see what she is seeing, nor point to share feelings about something with the mother. Such deficits have recently been demonstrated at less than six months. These studies used home movies of infants who were later diagnosed as autistic (Maestro et al. 2001). Since some form of eye-contact begins at birth (Farroni et. al., 2002), a deficit in eye-contact may also begin at birth.
Klin et al. (2002, p. 809) have shown that an autistic person looks preferentially at the mouth rather than the eyes in another’s face. A normal person does the opposite. Klin et al. suggest that this preference may represent a core social deficit in autism. From evidence of this kind, Trepagnier (1998, p. 158) proposed that brain differences in autism are secondary. She suggested that a failure in face-processing is the key.
The image-of-the-eyes hypothesis
Both Hobson and Trepagnier have proposed that developmental deficits cause autism. I propose that the primary deficit is the failure to acquire or retain the internalized image of the mother’s eyes. Provided a blind infant is actively mothered, then he or she may acquire an equivalent image through the other senses. A sighted infant who is neglected may fail to acquire or retain the image. Each of the biological factors associated with autism increases the risk that the infant will not acquire or retain the image. As I suggested earlier, the acquisition or functioning of the image may be disturbed to varying degree.
The case of ……..
[clinical material is omitted here]
Kohut (1971, pp. 25-8; 1978, pp. 489-94) argued that mirroring supports healthy grandiosity, a sense of being powerful, admirable, and desirable. Under favorable circumstances such feelings are gradually internalized to create a vigorous sense of self. A narcissistically wounded mother, deficient in her own sense of self, may react to her infant with envy and rage and may withhold mirroring. Unable to develop a healthy sense of self the infant compensates with archaic defenses. These may translate, in adult life, to feeling grandiose, boundlessly important, or negatively grandiose, boundlessly worthless. If my parent withholds mirroring then I experience my parent (or my parent’s eyes?) as a vortex into which I put more and more of myself, seeking in vain for affirmation. If, as an analyst, I am unconscious of my own narcissism, then I may withhold mirroring and thus deepen my patient’s narcissistic injury.
A related image occurred in the case of Rachel (McDowell 2001a, pp 637-8). Like …..’s mother, Rachel’s mother was severely narcissistic. Rachel dreamt that her mother was a witch who flew over the town and burnt up the lawns. Green lawns suggest new life. There are similar images in mythology. In Egyptian myth Sekhmet, the avenging eye of the sun-god, flew over the desert and burnt up the people, turning them into pools of blood which she meant to drink. Thus the eye both burned and devoured. In Indian myth Kali burns up the world with her third eye. There is also the myth of the evil eye (of envy) which must be averted. These myths constitute objective evidence that the image-of-the-eye is universally important in human psychology, and that it sometimes symbolizes devouring narcissistic envy and rage (Elder, 1996 pp ….)
Bathing in the mother’s eyes
The image also appears in myth. Aphrodite would return to her temple to be bathed by the three female graces. This restored her youthful beauty and virginity, that is, her feminine self. In Celtic myth, warriors who had been wounded in battle would be healed, no matter how serious the wound, if they immersed themselves in the ‘Cauldron of Rebirth’ (Green, 1993 p.76). The healing of warriors is a metaphor for the healing of an injured capacity for self-assertion. Such healing requires mirroring. Like the rocky lagoon, the hard-edged, liquid-filled cauldron resembles the mother’s eye.
The devouring eye
The (sometimes disturbed) image of the mother’s eyes seemed to reappear in several different analyses. That the image sometimes represents an archaic transference is consistent with it being acquired early. The image seemed to be evoked by the analyst’s mirroring, as the narcissistic injury was beginning to heal.
Narcissistic injury coupled with mild autistic traits
The autism-spectrum quotient
Baron-Cohen et al. (2001, pp. 8, 10-1) argued that autism represents an extreme on a continuum of normal psychological styles. They designed a screening instrument which measures the autism-spectrum quotient. Individuals tested themselves. Scores were grouped. Averages for each group were: females 15.4; males 17.8; humanities students 16.7; science students 18.5; gifted mathematics students 24.5; subjects diagnosed with Asperger’s syndrome 35.8. When the subjects diagnosed with Asperger’s syndrome were retested by one of their parents, scores averaged 2.8 points higher.
[clinical material omitted here]
How the infant ‘chooses’ the image-of-the-eyes
If, for normal sighted infants, one image is always associated with containment, then there must be a reliable mechanism which guides the infant towards that image. Here I discuss that mechanism.
The inheritance of reflexes.
As noted earlier, neither a cortical image nor a pattern of behavior which is peculiar to humans can be genetically inherited. A reflex, however, is genetically inherited. A reflex is not peculiar to humans but is intrinsic to the function of an organ. Blinking and coughing are examples. When the eyelid evolved in reptiles it necessarily had a movement reflex (Gans and Parsons 1973, p. 104). A reflex is a simple element of behavior involving only a few muscles which is hard-wired into the nervous system. I will show that reflexes help to predetermine the image which a newborn chooses to represent containment.
Visual edges in the image-of-the-eyes
In a newborn infant some behaviors seem to precede learning. For example, Spitz and Wolf (1946) found that an infant gazed preferentially at a human face or at a schematic drawing of a face. A line drawing of two eyes, a nose, and a mouth was sufficient. They suggested that the infant inherits a schematic image of the human face and seeks a match for that image in its immediate environment.
Friedman (1964) and Haaf and Bell (1967) proved, however, that the infant gazed preferentially only at some elements of the face. It made no difference if the elements were scrambled in the drawing. The infant gazed preferentially at moving edges. The most attractive moving edges within the mother’s face were the sharp angles at the corner of the eyes (two edges intersecting), the light/dark contrasts between the pupil and the white sclera of the eye (an edge), and the contrast between eyebrow and skin (an edge) (Stern 1977, p. 37). There are also edges around the lips and around the outer rim of the head.
Haith (1966, p. 242), Karmel et al. (1974, pp. 45-7), and Salapatek (1975, p. 226) proved that, from birth to about one month, an infant seeks out any visual stimuli which includes both movement and ‘edge density’, that is, the concentration of edges in a given space. By two months the infant’s vision is beginning to mature: the infant begins to recognize when facial features are scrambled and shows a preference for naturally-ordered features.
Farroni et al. (2002) found that when a human newborn is presented two photographs of the same face, one gazing directly at the infant, the other with eyes averted, the newborn looks preferentially at the direct gaze. These authors argue that their results support theories of an innate ‘eye-direction detector’ or of a face-detection mechanism in newborns (see McDowell 2001a, p. 639). But, when one compares their direct-gaze and averted-gaze photographs (available online), it is vividly apparent that the former provides more visual edges. Their conclusion notwithstanding, Farroni et al.’s results support the hypothesis that a newborn detects eye-contact via his or her preference for visual edges.
Visual edges and the cortex
Research on the vision of adult vertebrates (fish, frogs, cats, and monkeys) helps to explain the human infant’s preference for visual edges (Michael 1969, pp. 109, 114). All vertebrates analyze visual input primarily into a series of moving edges. The analysis is done by neurons in the retina of the eye and by neurons in areas of the visual cortex which are adjacent (closely connected) to the retina. This means that the brain does not initially ‘see’ a whole image. Rather it initially ‘sees’ a series of moving edges.
A computer analyzes an image into a stream of digits, zeros and ones, which it records. The stream of digits contains the information needed to recreate the image but is not itself a spatial analog of the image. In a similar fashion the retina and the adjacent visual cortex analyze the image into multiple streams of moving edges. Elsewhere within the brain, this data must be ‘synthesized’ in some way to form an ‘internal image’. I imply nothing about the mechanism by which this is accomplished, nor about the nature of the internal image. These are not known. It is logically necessary, however, that an internal image is not achieved whole, like a photograph, but by synthesis.
The experiments of Friedman and Haaf and Bell (v.s.) distinguished a stage through which the infant must pass before it learns to see like an adult. Since the newborn recognizes moving edges, we know that the neurons in the newborn’s retina and adjacent cortex are pre-wired (or very quickly wired) to analyze visual input into edges. The newborn also has functioning muscle reflexes which enable it to focus its eyes, to fix upon an object, and to track an object (Stern 1977, p. 34; 1985, p. 40). All this pre-wiring provides for the visual reflexes by which the newborn tracks the visual edges in its mother’s face.
Cortical neurons have been identified which only fire when the infant recognizes a face (Elman et al. 1998, p. 116). Only after the infant has learned to ‘synthesize’ an internal image of the face could the infant discriminate between naturally-ordered and scrambled images of the face. This explains what Salapatek ( v.s.) observed experimentally, that at two months infants begin to distinguish between scrambled and ordered features.
Although the newborn can focus its eyes, it can only do so within a limited focal range. When it feeds, therefore, it cannot see the breast. But when the infant feeds the mother’s eyes are within the infant’s focal range, provided that the mother is looking at the infant. Stern (1997, pp. 35-6) observed that, during breast feeding, a mother spends about 70% of her time gazing at her infant’s face. Thus the human infant-mother pair is designed to ensure that the newborn will stare at the sharp, high-contrast, moving edges of its mother’s eyes. Hence, through learning, the infant must synthesize a cortical image of the mother’s eyes (and face) and associate that image with breast feeding.
It is perhaps my conscious sense of self which most distinguishes me, as a human, from other mammals. It is remarkable, therefore, that my sense of self may be initiated by the geometry of human breast feeding. A cat’s eyes are equally sensitive to moving edges but, because of the way the kitten feeds, it does not begin life gazing at its mother’s eyes.
Temple Grandin: an autistic person’s view
Sean had mild autistic traits. Grandin has more severe autism. She is an international expert on sensory stimulation in livestock. Grandin (1996, pp. 52-4, 65-81) argued that an autistic person suffers primarily from over-sensitivity which leads to sensory over-stimulation. In particular, visual and auditory sensations are often overwhelming (ibid pp. 67, 73). Touch may also be overwhelming but ‘touch is often their most reliable sense’ (ibid pp. 54, 65, 150). Smell is usually not overwhelming (ibid p. 75). ‘Rapid shifting of attention between two different stimuli is very difficult.’ Grandin (1996, p. 76) quoted another autistic writer:
Reality to an autistic person is a confusing interacting mass of events, people, places, sounds and sights. There seem to be no clear boundaries, order, or meaning to anything. A large part of my life is spent just trying to work out the pattern behind everything. Set routines, times, particular routes and rituals all help to get order into an unbearably chaotic life.
For a related description of autistic symptoms see Stockdale-Wolfe (1993, pp. 9, 18). Grandin and Stockdale-Wolfe both argue that an autistic person withdraws in part to reduce sensory over-stimulation.
Grandin believes that the primary deficits in autism are biological. Her descriptions, however, suggest the contrary. Stern (v.s.) has shown that at six weeks the mother engages her infant in a dialogue, signaling with her eyes, face and voice. The mother both initiates stimulation and regulates its intensity. The infant must learn to modulate stimulation. The eye-and-voice dialogue would aid this learning. Failure of eye-contact is characteristic of autism and may begin at birth. If the infant fails to enter the eye-and-voice dialogue then the modulation of visual and auditory stimulation may be compromised. Because the eye-and-voice dialogue does not rely upon touch or smell, failure of the eye-and-voice dialogue might compromise the modulation of touch and smell to a lesser degree. Thus early failure of eye-contact might cause the symptoms Grandin describes. (As discussed earlier, there may be predisposing organic factors.)
The symptoms which Grandin describes resemble those of non-autistic adults who had been blinded from birth by cataracts and, in adult life, had their cataracts surgically removed. These adults ‘found the visual world confusing, nonsensical, and a painful sensory experience. Many wished to be blind again’ (Stern 1977, p. 34). They had to learn as adults to modulate their visual input. They could do so more readily than an autistic person, I argue, because their developmental deficit was not pervasive.
This paper suggests that we may identify some of the initial elements from which the personality organizes itself. Autism may be investigated via the analyses of adults with mild autistic traits. Several questions may be answered objectively: Does the material of other narcissistic or autistic patients include disturbed images of the mother’s eyes? Amongst people diagnosed with early narcissistic injury, is there a higher incidence of mild autism?
As noted earlier the incidence of autism in California has increased dramatically, apparently because of an environmental factor. It seems improbable that the physical or chemical environment has deteriorated rapidly enough to account for this increase. The image-of-the-eye hypothesis suggests an explanation. We know that the use of childcare, including childcare soon after birth, has increased rapidly over this time period. Early childcare has been shown to predict problem behavior at 54 months (National Insititute of Child Health and Human Development, 2003). On average childcare must afford less eye-contact than maternal care. (Childcare includes the use of television, video and computer games â€“ Rideout et. al., 2003). Thus childcare may increase the risk of a very early failure to acquire the image of the mother’s eye. A prediction which can readily be tested is that the diagnosis of autism is statistically linked to the use of early childcare.
Many thanks to my wife, Joenine E. Roberts, C.S.W., N.C.PsyA., for invaluable insights and criticisms.
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