What botox tells us about embodied cognition and ASD

Some of you may be familiar with the theory that mirror neurons may underlie our understanding of others' emotions. The evidence for this theory also supports the theory of embodied cognition, which states that many features of what we think of as higher-level cognition actually stem from aspects our ability to act and to sense the movement of our bodies. Mirror neurons fire both when a person performs an action (e.g., reaching for an object) and when he or she sees someone else perform the same action. They are also highly active in situations where people have to imagine others' mental states . This evidence suggests that a large part of understanding others comes from the ability to simulate oneself doing what another person would do. Our brains literally put us "in someone else's shoes." Not surprisingly, research on autism has often investigated the mirror neuron system.

It is not intuitively obvious that mind-reading should be grounded in the same system that represents states that are not fundamentally mental, such as reaching for an object. In fact, some philosophers have supported the idea that instead, mind reading is instead based on a commonsense theory, akin to a scientific theory.1 That imagined action is such a fundamental part of mind-reading, when it need not be, suggests that mind-reading is another function based on embodied cognition.

An intriguing study on users of Botox presents further evidence that embodied cognition underpins mind-reading. Botox smooths out frown lines, making it harder to convey anger and other negative emotions. In keeping with a long-standing finding that smiling actually makes one feel happier and scowling actually makes one feel angrier, researchers wanted to figure out whether Botox users actually were happier.

However, the study was designed in such a way that it actually measured not one's personal mood, but one's ability to imagine how someone would feel in a particular situation. Forty volunteers participated in the study twice: before and after they got a Botox injection. Each time, they read statements describing situations that typically make someone feel angry ("the pushy telemarketer won't let you return to your dinner"), sad ("you open your e-mail inbox on your birthday to find no new e-mails") or happy ("the water park is refreshing on the hot summer day"). After reading each sentence, they pushed a button to indicate that they understood it.

If mind-reading is a theoretical process, there would be no reason to expect a before-after difference in how quickly people respond. If, however, mind-reading is a process of embodied simulation, then reducing participants' ability to express anger and sadness should reduce their ability to simulate these emotions, which in turn should reduce their ability to understand situations involving them. There should be no change in response to happiness, because Botox does not interfere with expressing it.

In fact, the post-Botox volunteers pressed the "I've read and understood this" button just as quickly, but took longer to read and understand the sentences involving anger and sadness. As the Newsweek article puts it, "the emotions just did not compute as easily as before their sadness and anger muscles were paralyzed." This study adds to a large amount of data supporting the theory of embodied cognition in all sorts of seemingly abstract cognitive processes.

The researcher's adviser, UW Madison professor emeritus of psychology Arthur Glenberg, discussed further implications of the study. The Botoxed patients took less than a second longer to understand statements of angry and sad situations than before, but this is more than enough to affect social interaction: "In conversation, people respond to fast, subtle cues about each other's understanding, intention, and empathy. If you are slightly slower reacting as I tell you about something that made me really angry, that could signal to me that you did not pick up my message."

What are the implications for autistic spectrum disorders?
I have sometimes entertained the idea that somatosensory perception might be different in some people with autistic spectrum disorders than for other people. Lack of accurate information about their own bodies may make it harder to see how they look from the outside, which may affect both their understanding of others' reactions and their understanding of themselves (since we rely in large part on information from others in order to develop beliefs about our strengths, weaknesses, and other qualities). If this theory turns out to be true, then Aspergers could be viewed as the condition of approaching life top-down because one cannot approach it from a fully embodied perspective.

Gwen McKay has a more interesting, and less intuitive, theory about the implications of the Botox study for how we should help children on the spectrum. In SHIFT, he writes:

Like the Botox patients, many autistic children placed in behavioral therapy programs have been prevented from engaging in physical movements that their brains associate with specific emotions. Autistic individuals may, for example, rock back and forth when they are anxious or flap their hands when they are happy and excited. Behavioral programs often focus on suppressing these autistic traits because they are socially stigmatized, without considering whether they serve any useful neurological functions such as processing the associated emotions and their expression in language.

Although the results of the Botox study do not conclusively establish that suppressing body movements associated with emotion can impair the cognitive functioning of autistic people, we should, at the very least, be aware of the potential risk. Because many autistic mannerisms such as hand-flapping are completely harmless, they would be better dealt with by ending the stigma and improving society’s acceptance of neurological differences. It makes no sense to put the mental and emotional health of our autistic children at risk just to teach conformity to narrow, prejudiced expectations.

Seems like a good idea to me.2

1 If this were actually true, one would expect people with Aspergers to be the social geniuses of the species, as they are highly intelligent, theory-driven, and known for coming up with theories of human behavior to replace a lack of intuitive understanding.
2 However, the stigma may be difficult to overcome because a lot of stimming gestures--intermittent sounds, head-banging, flapping, rocking, stomping, etc.--can be intrinsically distracting, even for people who understand and are tolerant of autism. (I plead guilty here).