Theory of Mind and Autism

“Theory of Mind” is one of the many theories that are often considered “key” concepts when it comes to understanding the autistic brain. It took me a little while to get my head around it, and I’m still not entirely sure I have it worked out entirely!

The short description is: it’s the ability to understand what other people may be thinking, and having deficiencies in this ability is sometimes referred to as “mind-blindness”.

As with most theories surrounding autism, ToM has its supporters, research papers, critics, and counter-papers. Damian Milton’s idea of the Double Empathy Problem is a different perspective on some of the behaviors that might have been lumped under ToM problems. I haven’t read enough about it to analyse how it would relate to my own experiences yet, so for now this post is just about ToM as I understand it.

As a theme, it also links in with several other “aspects” of autism such as emotion-recognition, central coherence, and empathy.

The Sally-Anne Test

The classic experiment to demonstrate ToM is the “Sally-Anne” test (Wikipedia: Sally-Anne Test).
In it, a child is shown two dolls, Sally and Anne, who possess a box/basket each. Sally puts a marble into her own basket and then leaves the room for a walk. Anne goes over and moves the marble from Sally’s basket into her own box, re-covers the basket and closes the box. Sally then comes back.
The child is then asked: where will Sally look for her marble?
When this experiment was run, it was found that a much higher number of children on the spectrum would point to Anne’s box in response: the box where the marble ended up. They were unable to understand that Sally did not have the same knowledge as them regarding the marble’s whereabouts, as she had been out of the room when the switch occurred and so would not have been aware that the marble had been moved. Sally’s mistaken belief that the marble is still in her basket is known as “false belief”.

When I first came across the Sally-Anne test, it was one of the (many) things that made me think I couldn’t possibly be autistic. Sure, it’s aimed at children and really I have no idea how my younger self would have answered the question. I’ve always enjoyed logic puzzles like these, so I’d like to think I would have gotten it correct, but I just don’t know for sure. As an adult I have no problem identifying that subterfuge has occured, and someone who hasn’t witnessed an event obviously doesn’t have magically instant knowledge of the details.

Part of the problem may have been that almost all the information I came across in my initial searches was aimed at children and their parents. Most studies that I’ve come across since do specify that autism is linked to a delayed development of theory of mind: eg, it is not expected that autistic adults will still struggle with the Sally-Anne test specifically (though they may)!

How Do Theory of Mind Issues Manifest for Autistic People?

More broadly, ToM deficit and mind blindness may manifest as autistic individuals “not realiz[ing] that others may have different thoughts, plans, and perspectives than their own” (- Stephen M. Edleson).

Agony Autie identified four subheadings in her video Autism & Theory of Mind (along with giving some great examples, check it out!):

  • Difficulty explaining one’s own behaviours
  • Difficulty understanding people’s emotions
  • Problems understanding the perspective/viewpoint of others
  • Problems inferring the intentions of other people

She also said that it’s a problem where sometimes autistic people struggle to put themselves in others’ shoes (and can’t tell what they’re thinking/feeling), but other times we put ourselves in others’ shoes too much (and assume the other person must think/feel just like we do).

I should also note that, like many many things that autistic people have difficulty with, they often collect strategies and coping methods as they get older. I haven’t gathered any together yet though, so that might be a post for another day.

My Experiences

As far as I can identify it in my own experiences, I think there are a few places where Theory of Mind issues may be reflected.

Firstly, in the way I judge knowledge, skills and achievements
If I see someone who has extraordinary skill, or unusual levels of knowledge in a subject, I’ll be rightly impressed, and have no idea how they manage it. However, if I acquire the same skill, it suddenly becomes worthless. I can’t get past the idea that because I can do it, everyone can do it, and therefore it’s not special. People who tell me I’m talented are just “being kind”, or making a joke at my expense, because anyone could do it if they wanted.
Same with knowledge. If I acquire considerable knowledge in a field, or understand a particular way of looking at something, I’ll then assume everyone else also has the ability to understand it in the same way. I’ll get very frustrated if someone seems unable to do so, and may even assume they’re trying to annoy me on purpose. I’ll also often not tell people things because I assume they already know or can easily work it out themselves.

That said, I do enjoy trying to help people understand things. If someone asks me for help with a task, then I do enjoy the mental process of breaking it down into easily digestible chunks of information. And likewise, I enjoy sharing facts and information about topics of interest to me. But again, it’s at least partly the mental processing and verbal presentation of the information that I like, not necessarily the idea that I’m imparting it to another human being.

I have a definite naivety when it comes to other people’s motivations and intentions. I’ve been alive over 30 years, and have encountered my share of horrible and manipulative people, but every time, it comes as a shock when I discover that people have very different values, priorities, and modus operandi to me.

In my head, all people need is the information. In an argument, if I can just provide them with the right information, we will surely agree. I can only imagine that if we disagree over something that I know to be true or correct, it must be because they don’t know or understand something. So, I’ll try and explain it over and over, with them just getting more annoyed and thinking that I’m being deliberately condescending.

I rarely get angry or annoyed at other people these days, so if someone else gets angry or annoyed, I find that very hard to understand. Especially if it’s something that wouldn’t annoy me, or, even worse, if the annoying thing is me! In those situations I tend to just shut down. I don’t know what to do, I don’t understand the problem, and I don’t want to make it worse. So I try to make myself as unobtrusive, compliant, and unprovocative as possible. It’s happened so much that I’m hardly even aware that I’m doing it until later. And I don’t think it’s a healthy reaction at all…

TW: gaslighting and relationships in the following paragraph:

ToM problems also mean that I’m more susceptible to deception, manipulation, bad relationships. My brain assumes that everyone else is like me: fundamentally good, honest, and always seeking to do their best not to hurt, cheat, or disadvantage others. Turns out there are an awful lot of people who are not essentially like me. If someone explains why they did something, I believe them. If someone apologises, I believe them. If someone I love is an abusive gaslighter… well, it’s a good thing I had friends and family around to get me out of it. Add in my tendency to shrink away inside my own head if someone is angry at me and… well. It’s not good. Unfortunately there is evidence that autistic women can be particularly vulnerable to bad relationships like this.

Photo by Toa Heftiba on Unsplash

I’m trying to work some skepticism into my assessments of people and situations, but gosh it makes me tired and sad that I have to, and even then I still often only realise much later or when someone else points it out to me. I already analysed conversations over and over, but to add a whole extra layer of “but did they even mean any of it? What ulterior motives did they have? Better go right through the list logically to see if any of the potential deceptions match” is exhausting.

I also often fail to convey how I’m feeling to others. I somehow expect them to just know, despite the fact that I’m rarely able to read others’ emotions myself (many things about my brain make me feel like a hypocrite, and this is one of them!) They always seem to expect me to be able to tell how they’re feeling without them giving any clues, so I suppose I’ve learned that it’s not the done thing to blurt it all out, and assumed that the societal norm is that everyone is playing a gigantic guessing game.
I’ve often seemed to go from perfectly calm, to bursting into tears. Looking back, I think some of my sudden meltdowns were because people kept pushing me when I’d thought it was obvious that I was struggling. How could they keep doing the thing that was upsetting me? They must just be being mean for no reason! And meanness-for-no-reason is not something that I understand so my brain would switch from “gotta keep it together: everyone else is managing” to “the heck is going on? Does not compute”… Boom.
My teenage counselling sessions did not go well, primarily because I did not volunteer any information. I expected the counsellor to just magically be able to tell what the issues were.

My understanding of ToM and how it might apply to my own experiences is still evolving as I research, so I’d love to know what other people think of the theory.

Other Theory of Mind Tests

I’ve collected a few of the other simple tests and examples of ToM deficit in children below to give you a wider range of information.

A simple example of Theory of Mind not having yet developed in very young children is the belief that they can hide from you by covering their eyes. If they can’t see you, you can’t see them!

Another test is the band-aid (‘plasters’ in the UK) test:
A child is shown a closed band-aid box and asked what they think is inside. They will generally answer “band-aids”.
The box is then opened to reveal that it is filled with crayons, not band-aids!
The box is closed again, and the child is asked what another child who comes into the room now will think is in the box.
Children under 4, or those without a developed ToM, will answer “crayons” because they do not understand that the other child will not have the knowledge regarding the contents that they now have.

The Scottish Autism website gives the following two examples of how mind-blindness might manifest:

Susan is 7 and has autism. She is doing well in school but will, periodically become very upset and rips up her school work. Her teacher has worked out that this usually happens when she is stuck and needs help. Susan does not know that she needs to indicate to the teacher that she needs help. Her distress is born of frustration as she does not know that the teacher will not appreciate she needs help unless she asks for it and she becomes anxious upset when it is not forthcoming.

James is 11 and has Asperger’s syndrome. He has a strong interest in Dr Who and consequently has a vast knowledge related to it. Often he will ask others detailed questions about Dr Who. James sometimes gets frustrated and exasperated if others do not know the answers. He often responds by telling them that the answers are “obvious” and that they are “idiots”.

Rosenthal et al (2019) developed a more complex test for adults, involving participants having to infer the beliefs of a subject based on their behaviour during a charitable donation exercise. The details and results can be found here: Deconstructing Theory-of-Mind Impairment in High-Functioning Adults with Autism

Header photo by Laurenz Kleinheider on Unsplash

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