Wednesday, January 18, 2006

Disease Du Jour

If you were tuned into television yesterday, you may have noticed that Asperger's Syndrome was the disease du jour. Not one, but two—count 'em two—major network shows featured AS.

The Dr. Phil Show, 1/17/06 "Extreme Disorders"

Boston Legal, 1/17/06 "Helping Hands"

In a program called "Extreme Disorders" Dr. Phil reported on a family whose son has Asperger's—thanks to Kristina Chew for the heads-up on that—while Boston Legal included a plot line in which a nerdy attorney who didn't make senior partner goes ballistic, holds his boss hostage at knife point, and is later revealed to have Asperger's.

With all of this attention for AS, one hardly knows where to start. But let's start with violence. Violence is the ingredient that gave Dr. Phil's Asperger's segment its pizzazz. Violence is the ingredient that moved the Boston Legal plot line.

The lead-in to Dr. Phil's Extreme Disorders episode featured the jagged, jumping letters "extreme disorders" against a stormy, lightning-punctuated sky. Alex, a teenager with Asperger's, is introduced as "a ticking time bomb."

Oh, the horror, the horror
, you can almost hear the producers murmuring—that is if they weren't afraid that Alex might come after them with a baseball bat.

When Alex's parents were interviewed they spoke about living in fear of their son—of how he had, even as a 10-year-old, had the strength to throw his father across the room when he was in a midst of an episode. Not a Dr. Phil episode, of course. An AS episode. But then you knew that.

Asperger's is a strange, baffling, mysterious, and dangerous affliction, which holds dark secrets . . .

What secret has Alex's dad Rich, been keeping from Karen, his mom? asks Dr. Phil.

Those of us who live at the edges of autism or in its midst could guess the answer: Rich has hidden the kitchen knifes, the screwdrivers and hammers, and the more potent prescription medications. Alex's parents fear for themselves and for their son.

What Alex talks about, when he's interviewed, is the constant teasing he encounters and his bouts of anger and rage.

What Alex says is: "Sometimes people call me 'retard' and it makes me feel bad on the inside, and I wish there was a way they could stop calling me that." Alex goes on to describe his own angry outbursts, "My friends would describe me as probably a person who at one point would be the nicest guy in the world," Alex explains, "but if you egg him on, his stress level is high, he will get mad at you, he may hurt you. You just don't know what's going to happen."

Storyboard summaries for "Extreme Disorders" are available at

Dr. Phil brings out his neurological expert and shows some FMRI slides. "On the left hand side of the screen," the expert begins, "we're looking at a normal brain, if you will . . . the red coloration in this particular palette or scale denotes normal brain activity, normal blood flow. And on the right what we're seeing is on this scale significant areas of his temporal lobes and part of his frontal lobes, the two circles, the white circles are the temporal lobes; and the yellow color denotes areas that are two standard deviations below normal; green, three standard deviations below normal."

I don't need functional magnetic resonance imaging to know that what I'm seeing is a kid who is being teased and bullied into a state of unremitting rage. Dr. Phil offers to have his neurological expert take some pics of Alex's brain—then jokes that Alex can show 'em to his friends—and suggests that somehow this imaging technology is going help him personally, that somehow these pictures constitute a "revolutionary new treatment" when, in point of fact, Dr. Phil's show did not discuss any treatment options at all.

But who can resist the razzle dazzle of images that claim to show our inner selves—our brains at work in the FMRI, our babies sucking their thumbs in utero in the prenatal sonogram—our selves and our offspring rendered from the inside out? It's dazzling technology, and so very televisual. But I'm guessing that it will do little or nothing to stop the bullies from calling Alex a retard, even if he can pull a couple of snapshots of his brain out of his pocket to impress his schoolyard oppressors.

I wish I could have picked up the phone and called Alex and told him about ASPIE, the school that Valerie Paradiz has started for Asperger's adolescents. In a December 20, 2004 New York Times story one of Valerie's students observes, "People don't suffer from Asperger's, they suffer because they're depressed from being left out and beat up all the time."

If Dr. Phil's show was the appetizer, Boston Legal was the primetime main course. In an episode punningly called "Helping Hands," oddball attorney Alan Shore (played brilliantly by James Spader) defends his former colleague, an associate nicknamed "Hands," so-named because he holds his hands against his thighs in a rigid body posture.

In a previous episode Hands (aka Gerald Espinsen) had gone after his boss with a butcher knife. Guess they hadn't gotten the word from Dr. Phil to hide all the knives. But seriously now—just from the point of view of verisimilitude, at the level of believability—what were they doing with a butcher knife in a law firm conference room? Simple: they were cutting a cake, celebrating the partnership of the smooth-talking, disingenuous but ever-so-socially-savvy associate who'd made partner.

It was in the midst of this social context that Hands lost it and held his boss Shirley Schmidt (played amazingly by the amazing Candice Bergen) hostage.

Despite 15 years of extraordinary service to the firm, Hands hadn't made partner because he wasn't, according to his personnel file, "partnership material." Although Hands had an encyclopedic knowledge of case law that had served the firm well, he was wasn't going to be going out to charity events, meeting and greeting, pressing the flesh. In short, Hands wasn't going to be shaking hands.

In the end—and this is your early warning that I am going to spoil the ending—Alan tries to persuade Hands to accept a plea bargain. Hands refuses, saying that he can't plead guilty because then he'll be disbarred, and separated from the law, the only thing in his life, the only thing he loves (other than his pet gecko Linda).

Then Hands starts muttering about his mathematics professor father who, he explains, asks over and over, "May I have some eggs?" "Eventually," Hands says, "Someone brings him some eggs. Never give up."

Alan has an epiphany that this isn't just odd and aberrant behavior, it's genetic. The next thing you know, Alan is interviewing a psychiatrist who explains Asperger's. Before long Alan is trying to get Hands to agree to an Asperger's defense. But once again, Hands refuses: "Who," he asks, "will hire an autistic lawyer? I don't want to be the autistic lawyer."

At this point it's Alan's hands that are tied. But in his role as the ever-inventive oddball attorney, Alan persuades Shirley and the DA to drop the charges against Hands, arguing that under the Americans with Disabilities Act (ADA) courts will find that Hands is no longer just a nerdy guy who lost it and went postal (maybe we should say he went legal), but a member of a protected class, a disabled person. This, Alan says, changes everything. Which, of course, it does. Sort of. Well, almost.

Alan argues that Hands has suffered all of his life with this affliction, and wouldn't justice be better served if Hands gets treatment for his outbursts, his social deficits, his tics and other oddities? Assured that Alan will find treatment for Hands, Shirley and the DA agree to drop the charges. Happy ending? Kind of . . .

Of course the larger question of the justice, or actually the lack thereof, of Hands having no opportunity for advancement because he lacks the NT characteristics of glad-handling clients, is dropped. Hands will be rehabilitated; the employment practices of law firms will remain undisturbed. And the years of ridicule, scorn, and humiliation that "Hands" suffered at the hands of his colleagues and bosses, will not be redressed. It is Hands who will have to change.

So, we have to ask ourselves, is justice really served? Were these really just desserts?

The taken-for-granted, everyday violence—of the schoolyard bully, in the case of Alex, and in the law firm's pecking order that the non-typical individual endures, in the case of Hands—these omnipresent acts of sadism are not labeled as violence. The Asperger's individual, who becomes the nexus of this violence, the site of this sadism and its victim, is misperceived as its source.

Yale law professor Kenji Yoshino argues in a recent New York Times Magazine article that the courts, with their emphasis on equal protection, rather than diversity, are not necessarily the best arena for advancing the cause of human freedom, of human flourishing. Yoshino argues that conversations about our differences and cultural distinctions should "happen outside courtrooms - in public squares and prayer circles, in workplaces and on playgrounds. They should occur informally and intimately, in the everyday places where tolerance is made and unmade."

That's what we're doing here on the internet, here at autism's edges, we're looking for human flourishing, and for a place where justice can really be served. In fact, that's just the sort of dessert we're looking for: not just a fair share of the pie (or cake, in this case) but a sweeter pie for everyone.



GClef1970 said...


I felt exactly the same way and posted as such last night after watching it. I am truly disappointed. Dr. Phil had such an opportunity to educate the masses and he just absolutely blew it by going for the shock value of a poor boy whose parents scream at him incessantly. No wonder he is filled with rage. I would be, too.

MothersVox said...

Melissa, Thanks for mentioning the parents screaming at him. Between the school yard bullying and his parents ranting at him, it's amazing Alex is doing as well as he is. Three cheers for him.

Anonymous said...

You are so right! The TV producers are spouting stereotypes and inciting bigotry against a minority group for no reason other than to improve their ratings. It's deplorable. I have already written a letter of complaint to the Dr. Phil show; those media weasels probably don't care in the least about diversity, but if enough of us bitch them out and post about it on the Internet, we might get their attention.

Estee Klar-Wolfond said...

Thank you so much for writing this. Thanks to Kristina, too, for letting many of us know about the show (I didn't get to see it). I was very concerned when I heard that sensationalistic title "Extreme Disorders," and I'm glad you were able to make this commentary. I will direct readers to this post from my site. On a more positive note, Vicki Gabereau (a CTV program) may have mitigated Dr. Phil's Hollywoodism with a great and positive show about autism today featuring Temple Grandin and the mother/author of the new book, Artism.


kristina said...

Looks like the Internet is succeeding is letting discussion, justice and maybe even the truth come through---unlike TV with its "reality shows" and courtoom (melo)drama. Thanks for your cutting-edge critique.

Alana said...

I missed this but am quite glad, as I am quite sure if I saw it, it would anger me enough to want to go sock Dr. Phil! Thank you for this critique, as it is write-ups like this that cause me to search for logical answers via the internet rather than television.

hollywoodjaded said...

Just a small aside: The imaging pictures were not fMRIs - they were NeuroSPECT scans. SPECT scans are used to pinpoint what area of the brain is causing an "issue" and, thereby, assist in what meds might work ... hopefully alleviating a lot of medication and trial and error - not to mention misdiagnoses.

That THIS is what was at the core/should of been at the core of the PHIL show, should not be missed. Although it was explicit to me, because I am very familiar with SPECT scans, I can see now it was not so obvious.

I have only seen PHIL (can't use his title) on Letterman and I agree a lot with the content of your blog post on this, btw.

To me, the show, appeared to be a rather large promo for UCLA's Brain Matters program. However, if someone is not familar with SPECT scans, Brain Matters, the Amen Clinic, etc. I can now see how that important element would have been missed.

As for PHIL: no comment. As for the parents: no comment. As for the young man with the AS, I found him to be a dear.

Let's hope he gets what he needs, if not from UCLA and Brain Matters, then from someone truly experienced in AS.

Also, there's lots of places to look at SPECT scans, they can show if you are having anxiety vs. ocd or both, for example. This, of course, could be very helpful to counter those who may want to, for inexcusable dramatic purposes, frame everything in an extreme manner.

MothersVox said...

Thanks to hollywoodjaded for the info about SPECT scans. They don't look all that different from the fMRI's I've seen elsewhere on the internet.

I'm guessing from the comments that you've posted that you might be involved as a clinician . . . your reluctance to give Phil his Dr. title and your note elsewhere that you'll start using "islets of ability" instead of splinter skills. Plus, you're jaded in Hollywood . . . maybe not so far from UCLA brain scan programs, no?

If you are a doctor and you've dropped in here, *welcome* . . . welcome to the world of autie mom's . . . from the inside out. Bring your colleagues along. We need folks like yourself on our side.

And if you're not a medical or therapeutic professional welcome welcome anyway because we're looking to raise autism awareness far and wide.

Now about that Phil show. What you're suggesting is that the entire program was more or less intended to be an advertisement SPECT scans. A sort of super high-end stealth infomercial. Interesting.

But that the problem in the ad happened when some of us in the audience couldn't see any real advantage (other that the wow factor) in getting our kids heads examined (again, with new technologies).

Perhaps there could be an advantage if such imaging could actually sort out the different Dx categories and treatment options, but the point of my Dr. Phil/Boston Legal post is that the difficulties for our kids are not all in their heads. ;)

You see what I mean, don't you?

hollywoodjaded said...

Very briefly, MotherVox, I was merely addressing the issue of SPECT scans - which measure brain-blow flow. This is not a brand-new technology, many have been using it for years. Dr Mena is renowned for it in his ASD/ADHD research.

That the overt (as I saw it) advert failed is something with which I do agree. It's not the venue I would have chosen. Also, perhaps I mis-heard, but I was under the impression that the guests would do a return show, post-SPECT, that would shed more light on the subject matter.

I would be especially interested if the SPECT aided in dx'ing co-morbid issues that the young AS man may be having.

I believe I stated in my prior post that I agreed with your blog post, so I think I got your meaning - but if you think I could do with some educating into the "world of autie moms" then who am I to argue? Just point me in the direction you think I should go.

hollywoodjaded said...

Blogger did not like it when I attemped to hyperlink the following URL into my previous post, so I shall try it this way:


Anonymous said...

alex goes to my school we're in the same grade, NO ONE makes fun of him , to his credit hes made tonnnnsss of progress, in middle school he used to throw fits all the time... very scary as an 11 year old little girl. but in all seriousness no one wants to hurt his feelings, and even greater than that, noone wants to be on his hit list. Its really frustrating when he starts singing in the middle of class and you get to the point that youd rather rip your ears off instead of listen to his god awful voice, i know he has mental problems but id really like to feel safe in my school. and i do not when alex it there.

Anonymous said...

Recently, one of the contestants on ANTM had AS. I thought it was a slightly sugar-coated version of the girl "managing her disease". However, it was at least not a biased hick version of what living with AS is...

Anonymous said...

Apparently there is no follow-up!
/There a lot of angry people who have been dupped by Brain Matters

Anonymous said...

Alex's parents look like weird claymation figures. His dad is all squashed potato-looking and what, in the name of all that is holy, is going on with his mother's hair? Did she style it that way deliberately or did the Dr. Phil makeup people try to make her look as hapless and pathetic as possible?
Dr. Phil is a dumbass. He panders to all that is sensationalistic. he has the empathy of a cancerous tumor and the intellect of a slug. Just an angry egotistical creep.

God Bless! Georgiana said...

I am sorry but I totally agree with Dr Phil's show. My son has aspergers and acts like the boy Alex only much worse. People think that my son cannot be bad because he acts perfectly fine at times. In fact, we even have had psychologist and psychiatrist simply not believe us when we tell them how violent our son can be. They say put him back in public school and give him Karate lessons. (Yeah, I should teach him how to kill me and I should allow him to carry out his threat of killing all the kids at school and then himself...Dr that went to foreign medical school say WHAT???) But Dr Phil's show gives an example of a kid that can keep himself together for a period of time but then falls completely apart. That is my son X 100. Thanks Dr Phil.