Intimacy and Desire

Passion in Long-Term Relationships

When Experts Who Want To Be Rich and Famous Stray

An imaginary “secondary Asperger’s syndrome” promoted as if it really exists
Dr. Mark Goulston
This post is a response to Why Rich and Famous Men Stray by Mark Goulston, M.D., F.A.P.A.

 Earlier today, I was made aware of Dr. Goulston’s article "Why Rich and Famous Men Stray" by someone who felt this article was a “knock-off” of my recent posts on Psychology Today. I just published a series of three articles under the heading “Why Rich and Powerful People Cheat” Part 1 (5/19), Part 2 (5/20), and Part 3 (5/22). Part 2 was selected as an “essential read” by Psychology Today web site editors.

 A brief review of my and Dr. Goulston’s posts makes clear why someone might conclude as this politician person did. But my real and overriding concern lies in portions of Dr. Goulston’s article that are unquestionably his own authorship. I’m not referring to him using an addiction model, with which I vehemently disagree. Dr. Goulston creates an imaginary “secondary Asperger’s syndrome” and promotes it to the public as if it really exists. Since he’s interested in hearing from me if I can support his observations, he will probably not be pleased with this response.

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 Dr. Goulston’s article fuels a serious and growing mental health problem: creating pseudo-scientific clinical syndromes that invite misdiagnosis and misuse, and create real problems in conducting effective psychotherapy, especially couples therapy. For instance, ADHD can be a seriously debilitating problem that was often unrecognized in the past. But it has become a garbage-bag diagnosis, too readily presumed, and often misused by partners to excuse deliberate bad behavior and remove accountability. Every generation has its “ADHD,” 150 years ago it was “neurasthenia” and 70 years ago it was “hysteria.” This is the looming problem with Asperger’s syndrome.

In case you’re not aware, the field of psychotherapy is atwitter with the prospect of applying interpersonal neurobiology (brain science) to psychotherapy. Mind-mapping (the brain’s ability to make a mental map of another person’s mind) is one extremely promising application. I, personally, have been developing mind-mapping-based therapy for the last 10 years.

This makes me acutely interested in Asperger’s syndrome, which is one of several medical conditions that can impair mind-mapping ability (autism and schizophrenia being two others). Actually, I’m more interested in Asperger’s syndrome diagnosis, rather than the syndrome per se. That’s because men are increasingly claiming to have Asperger’s syndrome, or being told by their wives they have it, and therapists are increasingly misdiagnosing Asperger’s when confronted with clients’ heart-eating cruelty.

In case you think I overstate the problem, recently a therapist referred a couple to me for intensive treatment. The day before this was to start the man called to let me know he had just been diagnosed as having Asperger’s syndrome by his therapist and an autism expert. He was cleverly laying an “impregnable defense”: he could always claim inability to “get how relationships work,” or anticipate the impact of cruel things he did or said, or know what his partner wanted. Seeing this coming, I made a detailed transcript of the session, which unequivocally documented his mind-mapping ability.

Once an Asperger’s diagnosis is given or claimed, it is not possible to use mind-mapping based therapy. Mind-mapping-based therapy takes the “wiggle-room” and ‘escape hatch” out of traditional psychotherapy and creates an incredibly fast-paced intense treatment. A diagnosis of Asperger’s syndrome puts the “escape hatch” back in again, and Dr. Goulston’s “secondary Asperger’s syndrome” is a perpetrator’s dream.                            

Some good soul is bound to read Dr. Goulston’s article and come away believing “secondary Asperger’s syndrome” exists, and decide they or their partner has it. Or someone at a cocktail party will mention learning about this “condition,” citing Psychology Today as a reliable source. This seems to be exactly what Dr. Goulston hopes for. His tag line is “What is secondary Asperger’s syndrome?” Here, and throughout his article, he attempts to implant “secondary Asperger’s syndrome” as an actual clinical entity in the reader’s mind.

I Googled “secondary Asperger’s syndrome” in case this was a new scientific or clinical development I had missed. Not a single mention was found among numerous government, scientific, and public health sources. I then posted this inquiry to Dr. Goulston:

“Please cite any scientific support for a “secondary Asperger’s syndrome” classification (e.g., research publications, inclusion in existing or forthcoming diagnostic classification—DSM or ICDM, widespread usage by professionals, etc.) Likewise, please provide any publications citing diagnostic criteria or prevalence of “secondary Asperger’s syndrome,” or how someone develops this.”

I received the following response from Dr. Goulston shortly thereafter:

“You reminded me that I should have put a disclaimer on this since the term Secondary Asperger's is based solely on empirical observations. The word Asperger's is used way too frequently and often by spouses of men who don't or won't seem to listen or relate to the frustrated spouse. The distinction I wanted to make is that Secondary Asperger's is not really the actual disorder, but something that people develop after their being so goal oriented pushes aside and/or takes over the motivation to connect emotionally with another person. It's as if any emotional intelligence that a person has gradually or even suddenly (as with immediate success) disappears and that person becomes solely focused on achieving goals (even if one of them is to have sex with an unwilling person). What about this speaks to you? Do you think it is a valid distinction? Thanks for your interest and taking the time to write. Please let me know if you find something that would support these observations.”

Dr. Goulston’s disclaimer contains his ongoing attempt to present his fictitious clinical entity as empirical, rather than based solely on his own observations. Moreover, despite being fully aware of problems posed by abuse of Asperger’s syndrome diagnosis, he has published material that unnecessarily contributes to this problem. He does so by publishing an article for the public, presumably by a competent licensed medical professional and published author, in which he creates a pseudo-scientific disorder he knows does not appear in any diagnostic manual, scientific journal, or professional publication. Were Dr. Goulston to do this on a hospital chart, he could easily lose his medical license. Here on Psychology Today he can do as he pleases.

Make no mistake, this is no different than the recent fiasco of Satoshi Kanesawa’s pseudo-scientific evolutionary psychology article on Psychology Today, (Why are Black Women Less Physically Attractive). It is less immediately revile—and this is part of my concern. Dr. Goulston’s post is more pernicious because it won’t set off most people’s “B.S. alarm,” and is more likely to be adopted into pop-culture and professional wisdom. This risk to public welfare has no upside to anyone other than Dr. Goulston, who is aware of the downsides of over-use of Asperger’s diagnosis.

Many people have found accurate diagnosis of REAL Asperger’s syndrome to be tremendously helpful in coping with this difficult and confusing disorder. In extending “as if” thinking into a fictitious “secondary Asperger’s syndrome,” Dr. Goulston article trivializes their plight, and potentially increases “false positive” diagnoses that compete for limited social service resources needed by their loved ones.

Dr. Goulston’s post epitomizes a serious but often-unnoticed social problem that arises from a widespread difficulty within the psychotherapy industry. Mental health workers shape the “reality” you, the general public, use to label and envision your problems. You don’t catch “fears of abandonment” or “codependency” from your family—you catch these from therapists who think up and then adopt these entities as if they were “real.”

If you are fed up with disgraced public figures adopting mental health lingo and treatment to manipulate public sentiment once they are caught, it’s a matter of time before someone uses this gem. Don’t be surprised if Schwarzenegger turns out to be the “Asperginator.” Don’t you think he wants to cop to being “so goal oriented [it] pushes aside and/or takes over the motivation to connect emotionally with another person.”

You too are now in danger of catching “secondary Asperger’s syndrome.” Watch out!

All you have to do is figure out who you have to watch out for.

 

© 2011 Crucible Institute. All rights reserved.

Dr. David Schnarch is a licensed clinical psychologist and author of numerous books and articles on intimacy, sexuality, and relationships.

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