Switched On
You say to yourself, This colour thing is bullshit. They see what I see, and they say “colour” to describe the same shades of grey. They’re putting me on!
Now try to imagine what it would feel like to experience a glimpse of the truth. You step into a lab, and for a few hours, scientists turn on your ability to see the world in all its vivid colour. You realize that what people were saying all along was true. It was your senses that were deceiving you.
Then the colours fade. Your world is once again black and white. Yet you are forever changed. Before, “colour” was just a word. Now, it’s a memory, and a vivid, compelling one at that. You strive to make it real, and you interpret everything you see in light of that remembered colour.
One day, perhaps the colours will return for good. Until then, your ability to imagine them remains, and your world is transformed by the memory, even if you never see beyond black and white again.
When I described the experience to my friends later on, some of them asked if it made me feel cheated—gaining insight only to see it slip away. I just smiled. I’m not a churchgoing person, but for me the experience felt miraculous, like a religious vision. For a brief time, I felt a deeper reality, and even as it was happening I knew my memory of the experience would never leave me.
Alvaro and I discussed the colour-blindness analogy a while later in his lab. My experience may have been an unforeseen side effect, but he was ready and willing to explore where it led. “If we use colour blindness as an example, you grew up having to explain away what everyone around you said about colour and emotion. Because we tend to believe our own senses, you decided incorrectly that everyone else was wrong, and even worse, they were putting you on. That’s an example of what we call mal-adaptive behaviour.
“So you would listen to people talking, and they would be expressing emotion in their words, but all you heard was the logical meaning and you eventually started to get angry when you failed to understand what they really meant.
“To me, what the TMS session illustrated was that your ability to see sound was never truly gone. You made paths in your mind when you were young, and then you went on to other things and lost the ability to find them again. But they were in there all the time. Somehow, TMS showed you the way back. Perhaps TMS took them to a greater level, temporarily. The mind is a complex thing.”
“Will the brilliance of music return again?” I asked.
He looked thoughtful for a moment, and I sat there, silent. In the end, “I don’t know” was all he could say.
Over the next few days I thought about our conversation and what I was feeling. At first I’d thought the value of the experience lay in the momentary return of my ability to see really deeply into music. But gradually I came to understand that there was something more—the partial restoration of my “old” music vision was now tied to a new layer of emotional understanding that I’d never had before. And that’s what would remain, long after the crystal clarity of that unforgettable night’s “musical hearing” faded.
Emotion
AS THE DAYS PASSED, I came to see that the colour-blindness analogy was even more appropriate than I’d realized at first. Knowing there was a whole world of emotion hidden within each song made me hear music in a different way, and this remains true even as I write this, seven years after my first experience. Though what I hear and feel today is nothing close to what happened in the car that night, I still have emotions I never felt prior to TMS. I may have listened to a particular song a thousand times over the years with no effect, but after TMS I feel its meaning, sometimes very intensely.
The emotion that made me cry in the car was not sadness. The best way to describe it was intense, or even a little bit scary. I used to listen to music and admire the technical excellence of its production, or criticize the recording’s errors. I might like the flow of the melody or the rhyme or meaning of the words. But the emotional message of a song had never meant much to me. Now I found myself bursting into tears when I heard a beautiful song.
For a person who’d always been as logical as Mr. Spock, this was a very unsettling state of affairs, one I tried at first to understand rationally. I couldn’t talk to my friends about it, because I felt like a fool, getting all teary listening to music. All I could do was keep quiet and ponder.
I thought of composers and performers I’d known over the years and how they often interpreted the songs they wrote or sang in differing ways. Songwriter Jimmy Webb said he’d imagined “Galveston” as an antiwar song, but when Glen Campbell made it a huge hit he called it a “march to war.” That made me wonder if everyone shared the feelings I was having in response to music, or if different people responded in different ways. Might I interpret a song as happy while you understood it as sad? As I tried to define exactly what I was feeling, I realized I couldn’t even describe in words some of what was welling up inside of me as I listened. It was just . . . raw emotion. Not happy, not sad. Just strong. Eastern spiritualists call that Kundalini energy.
If that wasn’t enough, I began getting overcome by things that I read. I’d be at the breakfast table, reading a story in The New York Times, and I’d be blindsided by emotion and have to stop reading. These new feelings were very strange, because they were incredibly strong and they seemed to be triggered by events—in songs or news stories—that had never before elicited the least bit of response from me. In fact, in the past, I had belittled people who burst into tears at the news of a bus crash at the other end of the world. “They don’t know anyone on that bus,” I’d said dismissively. “They don’t even know anyone in that country. It’s just a play for attention.” But now it was happening to me.
My first reaction was surprise. Then I felt ashamed when it started occurring in the presence of other people. There was no real reason for me to be upset by news stories about strangers, but my feelings were unmistakable. It was enough to put me off newspapers.
Martha would look at me quizzically and ask what was wrong, but I shrugged it off as if nothing had happened. This new emotionality was not something I was ready to talk about. She was already very worried that TMS would change me, and even though I didn’t understand why, I sensed talking about it would make things worse. “We have so many shared memories and experiences,” I told her. “TMS isn’t going to change those or take them away.” Yet my words didn’t soothe her, and I wondered if they were mere wishful thinking on my part. “You don’t know what will happen,” she said. But I couldn’t see any danger in the experiments and I was entranced by the experience.
I thought I might seek counsel from Alvaro and the others in the lab, but when I tried to describe the way I felt, I found myself at a loss for words. Usually I had words for everything because I’m a very rational, logical guy. But now the naked emotion stood alone. “I feel things, but don’t know what they are,” was all I could say.
To put my situation in perspective, I recalled a moment a few years earlier when my father was sick and in the hospital dying. As I looked at him, a little voice inside me said, He’s going to die. A feeling of terrible grief washed over me and I started to cry. The few times that had happened before in my life, the voice and the feeling had always been intertwined, so I understood why I felt as I did. Now they weren’t. These strong emotions I was now experiencing were unaccompanied by any insight into why I was feeling them.
Reading or listening to music around other people now made me self-conscious, because I never knew when some innocuous passage would leave me inexplicably teary eyed. As an author at speaking events, I used to read aloud in a clear, calm, steady voice. Now it seemed like anything could set me off and my oratory would fall apart. I barely trusted myself to speak in public.
The research is funded by Robert Wilkins, who gave the medical school sixteen million dollars after the death of his son Alfred. Find a cure, he told us, and that’s what we hope to do.
How hard should it be to recite something like that? Every medical school in the country has pa
ssages like that in its literature. Reading them was now impossible for me. I would be okay until I got to the “death of his son Alfred,” which hit me like a punch in the gut, and I could hear my voice waver when I read, “Find a cure.” Later, when I would recover my composure, I’d reflect on how crazy that seemed. Mr. Wilkins was a stranger to me, and I’d never heard of his son. Hundreds of thousands of people die every day. Why should those words affect me at all?
Melody affected me the same way. At first I thought it was the words of songs that were hitting me so hard, but I listened to classical compositions with no vocals and felt the same powerful emotions well in me with the ebb and flow of the symphony. When I experienced that on the ride home from the hospital it was miraculous: new and wonderful. A week later, it was scary—like a toothpick castle built without glue. With the slightest touch, I’d fall to pieces.
Could one TMS experience have done all this? I wondered.
The researchers had promised that the effects of TMS would be temporary. They had all said it more than once. This can’t be happening, my logical mind reassured me. TMS energy has to dissipate over time. It’s not self-sustaining. You’re imagining the whole thing. But as the days passed, my sensitivity to emotions seemed to get steadily stronger.
“What do you think is happening to turn on these emotions in me?” That was my question to Alvaro on my next visit to the lab. One of many great things about Alvaro was that he never ridiculed my thoughts or feelings, no matter how strange they may have seemed. Whenever I asked him a question, I always got a reasoned answer, to the best of his ability.
What he said was very interesting. “I think there’s a mechanism in our brains that helps us see expressions and body language in other people and act out those things in our own minds, so we can feel them ourselves. It responds to inputs from all our senses, even sound and smell. Your mirroring system has to have a regulatory mechanism, otherwise you would be overwhelmed by emotion all the time. We have hypothesized several regions where that regulatory system might be physically located in the frontal lobe, and we are now going to suppress those possible targets one by one with TMS.
“Our theory is that all people have this wiring, but in autistic people the regulatory system is overactive, preventing the emotional messages from getting through.” We had talked about this when we first met, but now I was matching Alvaro’s words with my experience, and they fit remarkably well.
“I see. . . . So when you suppress that network in my head, and I start to use those paths, I build connections that keep going even when the TMS wears off. Is that why I’m still feeling these things, even after the TMS effect went away?”
“Exactly,” he answered. “At least, that’s what we hope. And the fragility you feel may be because it’s new to you, and you have not yet learned to adapt. If that’s happened, it’s great. But we have to be careful, because when things work out better than you expect, there may be a surprise coming. So we have to watch and see.”
His choice of words—and the possibility of a surprise—was a little worrisome, and I said so.
“Everything you reported so far has been a surprise,” he responded with a smile. “We hoped for good results, but what they would be was not exactly clear.” His caution seemed reasonable, and his notion that I was emotionally vulnerable because the feelings were new made sense too. Maybe this was like getting a filling at the dentist. Any newly repaired tooth is sensitive to hot and cold for a week or so until it acclimates. Lindsay was in an office down the hall, and I wandered down to see if she agreed. She must have better teeth than I do, because she wasn’t sure about the dentist part, but she did agree on the neuroscience. Mirroring networks were actually the subject of her doctoral dissertation back at UCSD, and her work had been published to considerable acclaim in 2005 and 2006. “I’m sure it helped me get the job in Alvaro’s lab,” she told me later with some pride.
Could what I was feeling truly be called mirroring? I pondered the idea. To me, mirroring implied an immediate response. There’s no delay when you look in a real mirror. But the new emotions I was feeling were somewhat delayed. I was hearing things and then having feelings well up as long as a minute or two later. Also, the word “mirroring” didn’t seem to be the best choice to describe a response to things I heard or read. Mirroring implies sight, or mimicking the emotions of another person, but I was now responding to words on a printed page, not a person speaking in front of me.
Autistic people are often excessively literal, as I reminded myself mid-thought: We are trying to explain what’s happening here, not pick the perfect word. Then I thought back to a section I remembered reading in one of Lindsay’s articles: “Are mirror neurons involved in the ability to understand metaphors? Autistic individuals typically have difficulties with metaphors, often interpreting them literally, and the researchers believe this too may be connected to a dysfunctional mirror neuron system.”
That was exactly what was happening to me. What was music if not melody and metaphor? And if that was so, my understanding of music was surely enhanced by TMS. Mirror neurons might or might not lie at the root of the change. Whatever the explanation turned out to be, I knew that Lindsay, Shirley, Alvaro, and company were onto something big.
As quickly as I had that thought, I felt the beginning of tears welling up in my eyes. Tears of joy? I thought. Tears of excitement? Tears of confusion? Once again I didn’t quite know how to describe my feelings. My systems were overloaded, and I could no longer tell up from down, emotionally speaking. TMS had surely started me on a journey, with no predicting where I was headed next. For a person who’d been ruled by logic for fifty years, this new topsy-turvy way of experiencing the world was quite a change.
Singing for Ambulances
A WEEK LATER, I went back to the lab for two more stimulations. As Shirley explained, “We hoped the first stimulation would raise something up in you, and we hope the second will lower it back down.” But she didn’t tell me what exactly would be raised or how it might affect me. So far I’d heard talk of raising and lowering, making new connections in my brain, and opening up suppressed pathways. I assumed those were just analogies to convey complex science to me, but the changing explanations actually left me more puzzled and confused. Now Shirley’s enigmatic plan for the day left me a little bit uneasy, particularly given my last experience. The musical vision that followed the previous stimulation was remarkable, but the emotional instability I was feeling now was difficult to manage.
I wondered what would happen this time.
This day’s stimulation would target a new area of my brain, farther forward, between my right eye and ear. My wife accompanied me on this visit, and she watched me through the process. I had the same feelings of stopping time or being in a meditative trance, but there was also some discomfort because the TMS energy was flexing nearby muscles on my face. Afterward, Martha said my face had twisted with every pop of the coil, but the thing that most disturbed her was my strange expression. “You looked like you were smirking over some joke none of us was in on.” I was surprised, because I hadn’t experienced it that way at all, and there certainly wasn’t anything funny about the TMS.
Her words gave me an odd feeling. She had always been good at watching me and the people around me. Ever since we’d learned I was autistic, she had tried to act as my emotional eyes and ears, and I relied on her for that. Now she was describing emotions on my own face that I did not remember feeling. It was one thing to have her say “that person is not sincere” about a fellow I was talking to. It was something else entirely to have her tell me there were unexpected dramas playing out on my own face that I had no awareness of at all.
The contrast between her observation and my own recollection made me question what was really going on. With such a gap between my remembered experience and her observations, how reliable an observer was I?
My nerves were all jumpy, and I felt rattled as I walked out of the lab. That state of agitation persis
ted as I did the follow-up tests on the computer. I felt like the questions were jumping out at me, even though the computer was silent and the test itself was exactly like ones I’d done before. When I thought about how that made me feel, what came to mind were accounts of people using psychedelic drugs in the 1960s. I’d read about words jumping off a page and grabbing you by the eyeballs, and at the time I’d thought it sounded bizarre and funny. Now, to experience that firsthand, with no drugs in my system, was very peculiar indeed.
Could TMS energy change my mood? That was a good question, and I immediately remembered the work Alvaro was doing with depression. Of course it can, I told myself, and my experience today was the opposite of what they must hope for in treating depression. When I saw Alvaro again I asked him about that. His answer surprised me.
“Responses like that are a funny thing. If we do the depression protocol on someone who isn’t depressed, it can have the opposite effect of what we intend. It can make him unhappy and anxious. But that is a different brain region than what we are stimulating in you, and the TMS pattern is different too.” The incredible complexity of the mind was becoming more and more apparent to me with every step of the process. The limits of knowledge of even these experts was unsettling, just as the way they were pushing the envelope was exciting. At least that was how I saw it. Unfortunately, those thoughts didn’t make me feel any less rattled.
As I wrote to Alvaro in an email later that evening, “If I were to choose a single word to characterize my feelings right now, it would be: jarred. I don’t know if it’s the TMS energy in my brain that leaves me feeling this way, or if it’s a result of the 1,800 contractions of my right lower jaw muscle.
“It’s almost as if I’m irritated at something, but I’m not.”
Back in the lab that afternoon, Shirley seemed to see that, and she suggested some time off to let my brain settle down. “We need to take a break between the first and second stimulations,” Shirley had explained earlier. “Why don’t you walk around, relax, get a bite to eat. Let’s meet back here in two hours, okay?”