Humor as an Educational and Therapeutic Tool: Living with Asperger’s Syndrome in a Land “Neuro-Typicals”

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Humor as an Educational and Therapeutic Tool: Living with Asperger’s Syndrome in a Land of “Neuro-Typicals”
James E. Kaplar, Ph.D. Summit Academy Institute When individuals with Asperger’s Syndrome interact with so-called “neuro-typicals,” a variety of pitfalls can occur. Each is puzzled by the thinking style, behavioral patterns, and emotional reactions of the other, with the result that miscommunication, as well as misinterpretation of events and expectations, are inevitable. Humor offers an engaging, non-threatening, easily used, readily adaptable framework for teaching about Asperger Syndrome and can serve as a platform to increase understanding and bring practical help. The Commotional Learning Workshop produces a monthly program for AutismOne Radio—“The Kyle Biddy Show”—loosely modeled after old-time radio, using a non-threatening format and delivery method that combines lively humor with practical, down-to-earth advice. The Commotional Learning Workshop Players are a group of creative educational and mental-health professionals from the Summit Academy Schools, educational facilities designed specifically for children with Asperger’s Syndrome, High-Functioning Autism, Non-Verbal Learning Disability, or ADHD. We will begin our presentation by comparing Asperger humor to “neuro-typical” humor, along with the underlying brain functions involved. Then, we will present and analyze excerpts from our monthly AutismOne Radio programs. Asperger Humor, Neuro-Typical Humor, and Underlying Brain Functions Most persons with Asperger’s Syndrome have a sense of humor. They can be quite adept at certain types of humor, but struggle with other types of humor. This reveals a lot about Asperger’s Syndrome and about what takes place in the brain when a person experiences humor. Lyons and Fitzgerald (2004) have written an excellent article on humor in autism and Asperger’s Syndrome, in which they identify types of humor, the essential ingredients of each type, the brain functions involved, and how humor relates to several of the prevalent theories of Asperger’s Syndrome. One of the main components of humor is incongruity. Paulos (1980) views incongruity as encompassing a broad array of potential comparisons and resulting oppositions, such as expectation versus surprise, superiority versus incompetence, balance versus exaggeration, and propriety versus vulgarity. The major theory of humor, according to Lyons and Fitzgerald, is the “incongruity-resolution model,” proposed by Suls (1972)—a two-stage model, based upon an information-processing analysis, for appreciating jokes and cartoons. Appreciating humor is a problem-solving task involving a punch-line, in which the punchline is incongruous with the body of the text. Humor occurs successfully when a person detects the punchline and then reconciles it with the lead. We would hold that whereas in jokes the punch-line is stated verbally, situational humor follows the same model but the punch-line is of an implied, more intuitive nature. In addition to cognitive functions such as incongruity and problem solving, Lyons and Fitzgerald maintain that humor includes an emotional response and needs to be placed in a social context: reciprocity (sharing with others of the humor, such as by laughing), a common interest in the topic at hand, and sharing in an emotional state. Research by Shammi and Stuss (1999) indicates that the right frontal lobe is the major brain region involved in humor. For humor to take place, i.e., to be experienced by someone or to be presented to another person, there must be temporal or spatial integration of verbal or visual information, plus the ability to revise an initial interpretation. Right frontal lobe damage is correlated with inability to appreciate humor. Persons with right frontal lobe damage show significantly muted emotional response, i.e., smiling and laughing. The ability to appreciate humor, whether verbal or non-verbal, involves working memory. In addition, they found that verbal abstract reasoning and mental shifting are necessary in order to appreciate verbal humor, and that the ability to focus attention on details and to visually search the environment are necessary in order to appreciate non-verbal humor. This suggests that right frontal lobe structures are important components of the brain circuits that underlie the cognitive processes required for humor. These include working memory, mental flexibility,
abstract ability, and visual search. Without the right frontal lobe, these cognitive processes cannot be integrated with circuitry from the limbic system to produce an appropriate emotional response. Because it is connected to various brain regions, Shammi and Stuss view the right frontal lobe as a sort of cerebral clearinghouse in which all of the necessary components of humor come together—logic, language, memory, emotion, and sensation. This enables a person to understand humor, due to the ability to make an inference, the ability to have a self-awareness concept, and the ability to make a connection to an emotional reaction. Being able to appreciate humor also requires the use of episodic memory, i.e., memory for personal experiences. Episodic memory allows a person to use previous experience to interpret the current information being presented. PET studies by Tulving and colleagues (1994) demonstrate that the right frontal lobe is involved in the retrieval of episodic and autobiographical memories. The left hemisphere is also implicated in humor, specifically in the cognitive aspects of humor. Other components of the brain are involved as well. Using fMRI, Goel and Dolan (2001) found that the particular type of humor determines which networks are activated. In humor that is based upon semantic juxtaposition, which is a form of incongruity, a bilateral temporal (i.e., left and right hemispheres) network of circuitry is activated. By contrast, in humor that is based upon phonological juxtaposition, such as happens in puns, a left hemisphere network of circuitry involving areas of speech production is involved. They also studied the affective, i.e., emotional, aspects of humor, finding that the medial ventral prefrontal cortex and the bilateral (i.e., left and right) cerebellum are activated. Just and colleagues (1996), also using fMRI, found that when incongruity tasks are performed, the left temporal cortex (Wernecke’s area) and the left inferior frontal gyrus (Broca’s area) are activated. Citing findings by Adolphs and colleagues (1994) and Young and colleagues (1995) showing that persons with bilateral amygdala lesions exhibit a deficit in recognizing the facial and vocal expressions of emotions, Lyons and Fitzgerald state that the limbic system shares responsibility for the emotional aspects of humor, and that failure to effectively process emotional signals will result in impaired humor interactions. The amygdala, in particular, is involved in the processing of emotional responses, emotional information, and mind-reading (i.e., the automatic ability to “read” or know what another person probably is thinking). In our opinion, there is a striking similarity between persons with Asperger’s Syndrome and persons who find it difficult to understand certain kinds of humor. A relative inability to integrate information into and out of the right hemisphere, in particular the right frontal lobe, appears to be a factor common to both. The result is a style of thought and perception that is very weak at processing the emotional and social components of situations and interactions. Just as they may be very explicit verbally in general, Lyons and Fitzgerald conclude that some persons with Asperger’s Syndrome display a talent for the type of humor that almost entirely consists of cognitive and intellectual processing. We, too, have observed this. With sophisticated word games and puns, these individuals manifest a sense of humor that is based upon incongruity and its resolution, and upon the switching of meanings. There is a continuum of humor within the autistic spectrum. In the lower and middle portions of the spectrum, the type of humor centers mainly around obsessive topics; sharing enjoyment and laughter with others is not an active intention. By contrast, in persons with High-Functioning Autism (HFA), and to an even greater degree in persons with Asperger’s Syndrome, their sense of humor is primarily cognitive in nature and seems to be based upon linguistic and logical principles, and seems to be motivated by obsessional characteristics. Individuals with Asperger’s Syndrome, as well as persons throughout the autistic spectrum, seem to like slapstick humor. This is a relatively unsophisticated type of humor, depending strongly upon visual components and surprise. In our experience, the reactions of our students with Asperger’s Syndrome or HFA to slapstick humor are greater in intensity than would be found in neurotypical children of the same age. We speculate that this is because the cognitive style of Asperger and HFA children is relatively concrete and because slapstick humor itself is relatively concrete. Another element of slapstick humor, we believe, is surprise. Surprise, particularly visual surprise, is a relatively unsophisticated type of response to a set of stimuli. In this regard, we are reminded of how a non-autistic-spectrum infant or toddler or very young child will laugh heartily, often out of proportion to the situation at hand and sometimes unable to stop, when playing such games as peek-a-boo, and how the intensity of older children on the autistic spectrum when reacting to slapstick humor resembles this.
A third element of slapstick humor, we believe, is the ability to suspend the natural concern for the emotions and physical welfare of the individuals involved. In reality, falling down, or getting hit in the back of the head with a two-by-four, are painful experiences. A typical child witnessing slapstick humor can mentally and emotionally place himself or herself in the position of the victims. However, this typical child knowledgeably suppresses any concern or empathy about the matters at hand, because he or she knows that the slapstick event is not real. By contrast, a child with Asperger’s Syndrome or other autistic spectrum disorder does not show concern or empathy about the matters at hand, because the child lacks the ability to readily put himself or herself into the position of the slapstick “victim” and, in some cases, may not even realize that what he or she is witnessing is pretend. Slapstick humor, we believe, is consistent with the relatively poor social perception skills and relative lack of “Theory of Mind” of these children. “The Kyle Biddy Show”—Excerpts and Analysis We view humor as offering a powerful tool for helping individuals with Asperger’s Syndrome better understand and handle real-world situations, as well as a way for the people in their lives to better understand them. We chose to emphasize humor as our educational and therapeutic medium because a large body of research suggested to us that humor would enhance the process of learning: humor adds a positive emotional valence to the material presented, it makes the material more interesting, it makes the material non-threatening, and it requires the use of multiple components of the brain to process it. Moreover, because the radio show involves dramatization, the listener is required to use his or her imagination. This has two benefits: it engages the listener, and it helps listeners identify with the characters and situations. We have created an Asperger protagonist—Kyle Biddy, a bright, likeable, but naïve young man, whose exploits provide the basis for each episode. Marty, his neuro-typical friend, helps Kyle to more effectively navigate the neuro-typical world. As a way to “hook” the attention of the listener, we start the show with our “Kyle” theme song, followed by an offbeat fake commercial aimed at “the Asperger market.” A variety of sound effects heightens the listening experience. After Kyle’s adventure, I analyze what transpired, offering observations and advice. After being treated to the theme song, we will listen to a commercial, and then we will play and analyze vignettes—“The Traffic Stop, “The Barry Huckstable Show,” and if time allows, “Valentine’s Day”—using the outlines below. AutismOne Radio - December, 2007 Script: “The Traffic Stop” and “The Barry Huckstable Show” Mark Schweitzer (Italics) Interviews Dr. Jim Kaplar. Dr. Kaplar explains and analyzes what has taken place. “The Traffic Stop” Kyle totally misreads the situation and nearly gets himself in trouble. How did this come about and what can we learn from Kyle’s encounter? Kyle’s interprets literally the wording in the officer’s questions, and Kyle fails to perceive the context in which the officer’s words are spoken. Furthermore, he is unable to perceive what is going on in the officer’s mind (this is referred to as “Theory of Mind”). For example, Kyle doesn’t stop to clarify about “bottles” or “open containers” or “drinking.” Also, literal answer to question about “driving without a license.” Kyle has his driver’s license, registration, and insurance numbers memorized. Not uncommon for someone with Asperger’s. Kyle has poor coordination—like many people with Asperger’s. We can only wonder what impression he gave the officer as he struggled to walk heel-to-toe on the white line. Kyle’s responses and behavior in general could easily have been misinterpreted as being smartalecky. Police officers are trained to be calm and non-provocative, but what if the officer had been having a bad day? Also, how many police officers are knowledgeable about Asperger’s?
Kyle’s situation that he suddenly found himself in, and how he mishandled, are typical of how children and adolescents with Asperger’s get into trouble at school, or with relatives and neighbors, and how adults get written up at work and fired. Kyle may have gotten carried away in fantasy (manhunt), perhaps from stuff he had seen on TV or had read about, and this was the mindset that he brought with him, and from which he interpreted what in some ways was actually a neutral or ambiguous situation (being stopped by the policeman and being asked various questions and being asked to do various tasks). Kyle’s Appearance on Barry Huckstable’s Show Kyle came up with some pretty clever ideas about how to handle social situations such as going to parties or asking someone for a date. What are your thoughts about this? Barry’s point: What do you want to do versus what you think or feel you should do (i.e., what is expected of you). JK: Thus is a dilemma that people with Asperger’s often find themselves in. The answer to this will vary, depending upon the situation, your mood, your anxiety level, etc. Kyle’s advice to first caller (Mark): Have a friend take you to the party or go along with you, and arrange signals beforehand in case you need to exit a situation of talking with someone, etc. Second caller (Denise) doesn’t seem to realize that whether someone likes you is a very fundamental question when thinking about whom to ask for a date. Kyle approaches the question of dating logically and scientifically. This seems to work for him, because it gives him some degree of predictability, and because his logical approach tends to be incompatible with anxiety, because it is a rationally based approach rather than an emotionally based approach. Kyle recommends using a scientific approach, viewing the question of yes or no as a hypothesis test, and weighing the evidence. It’s an experiment. This is a good way to cope with the fear of rejection that most people with Asperger’s typically have. Furthermore, this same approach can be extended to a variety of other anxiety-producing situations, such as applying for a job. And I like the way that he views a “no” response from someone: the hypothesis was disproven and you gained some valuable experience in the process. In contrast to Kyle’s approach, Barry makes a blunt comment about rejection being a part of life. What do you think about that? I agree. And, from a logical perspective, it is helpful for people to realize this. Ultimately we are dealing with probabilities. Nobody gets accepted all the time. The third caller (Daryl) raised the topic of sensory issues, in this case tags in clothes. Is this a common problem? It’s more common than most people realize, and it occurs in degrees. With Daryl it’s clothing. Probably anything wool is very irritating for him, and bumps or seams in his clothes probably bother him. But it’s possible that the first caller—Mark—may unexpectedly run into some sensory issues at the party he will be going to. The noise may become unbearable, or there may be strobe lights flashing, etc. Mark should think back to past experiences, determine whether this might be a problem at the party, explain it to his friend (it’s something that his friend probably wouldn’t have thought of as a potential problem) and work out some kind of a signaling system with his friend beforehand, similar to what they had worked out for social anxiety but with a different set of signals. AutismOne Radio - February, 2008 Script: “Valentine’s Day” Mark Schweitzer (Italics) Interviews Dr. Jim Kaplar. Dr. Kaplar offers some advice and suggestions for individuals with Asperger’s Syndrome. What does a valentine mean for someone with Asperger’s Disorder? A holiday that they can’t quite seem to figure out. Define it more in terms of tangibles and gifts – like Kyle does. May make an elaborate purchase because he feels he should, based upon commercials on television and ads he sees.
The more expensive a card is, the better it must be. How will the valentine recipient react? If Asperger’s, may under-react, over-react, or react inappropriately. May blow it off. Will likely not understand all the sentimentality that the sender put into it. May read too much into it. May take it too literally – may conclude that the person loves him or her rather than that the person simply likes him. May think it is stupid, and wonder why all the fuss. May feel like Charlie Brown – feel left out – everybody else receives valentines. How will the valentine giver react to how the Asperger recipient reacts? What can go wrong? May feel disappointed, or even angry. May interpret a lack of reaction (or reaction to the wrong component of it) as not.caring—such as “My, what a bright red that bow is!” instead of “I can see that you put a lot of care and effort into this.” May feel like in the future it’s not even worth bothering to send a card or give a gift. An individual with Asperger’s may give a practical gift—such as new kitchen utensils; romantic items are a waste of money, are seen as frivolous. For someone with Asperger’s, trying to determine the nature of a relationship with someone of the opposite sex can be fraught with peril, can’t it? For example, if a female smiles and says hello to a male with Asperger’s, such as after church, the young man may wonder if he should ask the girl out, when in reality she is simply being cordial. How to determine how serious the other person is, or how serious you are: Try using a 10-point scale in which you set criteria for each number—maybe from a book on relationships. Have a trusted friend review your ratings as regards how you constructed the scale, see how much they agree or disagree, have them discuss with you why, and then start using the scale. See where what the other person says or does would fall on the scale. When trying to decide how to respond to them, select a response that lies at approximately the same spot on the scale. It sounds like in some ways this can be compared to an apprenticeship training program. The tricky part on all of this is that, if you have Asperger’s, you are trying to build and develop a skill that doesn’t come naturally to you. Go on a double date with a trusted friend. Get feedback from the friend about how your date was acting toward you, and about how you were acting toward your date. It’s similar in some ways to an apprenticeship training program, in which a person learns a skill from a master craftsman, except in this case the skill is how to relate to the opposite sex. If you have Asperger’s and you own a video camera or your friend owns one, when you are with this friend and both of you are with someone of the opposite sex, arrange beforehand that the two of you will shoot some video of all of you, supposedly for fun sake or to remember the day. Have the friend shoot some video of you and the person of the opposite sex interacting with each other, and you shoot some video of your friend and the person of the opposite sex interacting with each other. Have the shots be from different distances—full body shots so you can study body language and gestures, close-up shots so you can study facial expressions, and so that you can study the verbal interchanges that take place. You can study how well what is said matches the non-verbal aspects of communication or does not match it. You can study how appropriate or inappropriate the things you say are, or how appropriate or inappropriate your topic of conversation is. But what if you don’t have a friend? Study about it instead. Go to the library and get books and videos on how to be successful with the opposite sex. Most likely, some of it will work but some of it won’t.
Start with the basics. How to relate to people and make friends is actually an age-old problem. As long as 50 years ago, there was what is now a classic book, called “How to Win Friends and Influence People.” It was written by a man named Dale Carnegie, who was probably the original writer of self-help books. One of the big points he makes—probably the most important one, in fact—is that people generally don’t want to hear you talk about yourself. It can get boring for them. Instead, to be successful in making friends, you want to try to make the other persons feel important about themselves. And, the best way to accomplish this is to get them to talk about themselves. Ask them questions about themselves. Look interested, even if you’re not. But don’t ask questions that they may consider as being too personal. What are some other things you can do? You may want to script out some ideas for what to say in certain situations. You may even want to write them on note cards and carry them in your pocket. And, you may also want to script out some ideas for what not to say. Practice by doing role-playing with a friend. Or, you can even make a game out of it – get some index cards, have a friend write different response on each card, and then guess what the situation is that the friend had in mind for which this would be the most appropriate response. How truthful should you be? In order to help make a relationship successful, you should try to put yourself in the other person’s place. This is hard for people with Asperger’s to do. Being overly factual can derail a relationship. Telling white lies—tiny lies—can make the other person feel better if telling the total truth would make them feel bad or would hurt them. For example, if a person asks you if she look nice, tell her yes, even if you don’t think so. Remember that when someone asks you a question, often there is an unspoken question or a hidden motive. If someone asks you how you like their sweater, she is probably looking for a compliment. References Adolphs, R., Tranel, D., Damasio, H., & Damasio, A. R. (1994). Impaired recognition of emotion in facial expressions following bilateral damage to the human amygdala. Nature, 372 669-672. Goel, F., & Dolan, R. (2001). The functional anatomy of humor: Segregating cognitive and affective components. Nature Neuroscience, 4, 237-238. Just, M. A., Carpenter, P., Keller, T., Eddy, W. & Thulborn K. (1996). Brain activation modulated by sentence comprehension. Science, 274, 115-116. The laughter circuit. (2002, February). Discover. Lyons, V., & Fitzgerald M. (2004). Humor in autism and asperger syndrome. Journal of autism and developmental disorders, 34(5), 521-531. Paulos, J. A. (1980). Mathematics and Humor. Chicago: University of Chicago Press. Suls, J. M. (1972). A two-stage model for the appreciation of jokes and cartoons: and informationprocessing analysis. In J. H. Goldstein & P. E. McGhee (Eds.) The psychology of humor: theoretical perspectives and empirical issues (pp. 81-100). New York: Academic Press. Shammi, P., & Stuss D. T. (1999). Humor appreciation: a role of the right frontal lobe. Brain, 4, 657-666. Tulving, E., Kapur, S., Craik, F. I., Moscovitch, M., & Houle, S. (1994). Hemispheric encoding/retrieval asymmetry in episodic memory: positron emission tomography findings [Review]. Proceedings of the National Academy of Science USA, 91, 2016-2020. Young, A. W., Aggleton, J. P., Hellawell, D. J., Johnson, M., Broks, P., & Haney, J. R. (1995). Face processing impairments after amygdalotomy. Brain, 118, 15-24.