3.04 Lines in the Sand

I would say it's possible, even probable that House is a high functioning Aspy. It's possible, yes, but I don't think it's probable. I don't think we know enough about the character and his internal life to make a qualified decision on the subject – and as extra_cat pointed out, the diagnostic criteria don't cover House. With all diagnoses, if we can't come to a conclusion, we can't diagnose and must rely on pure speculation so speaking of probabilities seems like a slippery slope to me. FYI about 1 in every 150 children are being diagnosed with some form of Autism Spectrum Disorder now, anything from the very general Pervasive Developmental Disorder (in other words, we don't know what the hell it is) to Autism. I actually knew this is the case in the US, but it doesn't stop me from wondering if there's room left for personality quirks or if psychiatry has finally fallen into the trap of 'because it's average it's normal and because it's normal it's right'.

With older kids, you can ask them if they know that behavior is inappropriate and they'll say they understand that it is. They make the decision to do it anyway. The compensation part comes in with deciding to control some of the things that before may have been spontaneous. *asking inappropriate questions There's another trait that I didn't notice the first time I skimmed the Language scale. "Do you have hair on your special place" is about as inappropriate as you can get! LOL It's not a matter of fitting every characteristic. You can't say "Well, he doesn't do this" and thereby exclude the syndrome. It takes looking at the full picture which we simply can't get because of his age. I'm looking at characteristics phrased for 2-18 year olds. He's had 40 years to learn to compensate and is certainly intelligent enough to compensate. We can not say that he unequivocally has AS, but looking at the scale it really makes me think that if we had Young House in front of us, he might fall somewhere on the spectrum if his behavior as a child was anything like his behavior as an adult. Can we say he does not have it? Yes, because he falls outside the parameters for a diagnosis. Can we speculate that he would have fit the criteria as a child because there are enough behaviors as an adult? Sure. I bet you that someday when the top dogs of Autism research are doing seminars and include famous people/characters on the Autism Spectrum, House will be included just because the possibility exists. :lol:

I'm 99% sure I'm an Aspie (in my mid thirties), so what drew me to House as a character, amongst many other things, were the traits that echoed some of my own. But the thing which started to move me away from that thought was the particular way he reacted to the arrival of Chase's father in Cursed. He's too manipulative, he takes too much glee in screwing with people - as an Aspie, in my day to day life, I'm just not that bothered by the relationships between other people. I'm stressed out enough dealing with my own interactions to want to stir up trouble in someone elses! Also, when Chase tells House it's easier not to care, House holds back and doesn't divulge what he knows, because he empathises. In general, House also lies and cheats with a proficiency that is baffling to me. So, while House ticks a lot of boxes on the Autistic Spectrum, there are the areas above that, for me, don't fit, they don't quite ring true in my overly sensitive Asperger's ear. Here is some further waffle-age, spoliered so you can avoid if you want: Re. the lying thing, my brain defaults to the truth and I struggle to make up even the whitest of white lies. House delights in breaking rules, I don't break rules, I like them, it makes the world more predictable, I hate to have to improvise and spontaneity is an alien concept. I have a job and own my own home, I'm integrated for want of a better term and have, with great and continuing effort, some degree of social skill - but it's always like doing long division in my head, it's never gong to be second nature and it's never going to be my choice - it's done out of necessity and I'll avoid those interactions given any opportunity!

Can you have it and learn to compensate? Absolutely. There are very high functioning people with the syndrome and extremely high intelligence can go hand and hand with it. High-functioning Aspies can learn to mimic and cope with interpersonal communication and social interaction. Just as say, a blind person can cope with the sighted world and even mimic some sighted behaviors. To bring up Robison's book again, for example, he was taught to basically deal and is helped along in social situations by his wife. He's obviously extremely high functioning: intelligent, good career, wife and family. But he'll never be a manipulative bastard: people with Asperger's just don't have those tools. A person with Asperger's (or autism) will never excel and fully understand those behaviors. Because obviously, they have a neurological disease that impairs their brain's processing in that way. Practice can help them cope, but it will never change that. What clinches it for me is that House is someone who excels at understanding emotions and behaviors - he's not mimicking others. It's not something he learned because at the scope he does it, it's not learnable. I do wish the show (or even fanfic!) had explored more the aftermath of the shooting. Was the carpet issue some lingering indication of PTSD? He was assaulted in probably the most secure place he has - his office is basically his home. Presumably this man who tried to kill him is still out there.

What clinches it for me is that House is someone who excels at understanding emotions and behaviors - he's not mimicking others. It's not something he learned because at the scope he does it, it's not learnable. DrSpaceman, you put into words exactly what has been bothering me about the whole House-has-Asperger's. IMO you are right. From what I've experienced with my sister, she has no idea why people do things/react in certain ways/are upset by things, but she did learn to sort of predict reactions in certain circumstances, so she tends to react in the right way (most of the time), but it doesn't come instinctively, so to speak.

extra cat, most of the people I know have at least one of the "symptoms" on your list! FYI about 1 in every 150 children are being diagnosed with some form of Autism Spectrum Disorder now, anything from the very general Pervasive Developmental Disorder (in other words, we don't know what the hell it is) to Autism. House probably would have been diagnosed with the syndrome as a child. I would have been too. Doesn't mean I have Asperger's. To me the whole point of the episode is that he doesn't have it. Wilson clearly stated it, and House himself rambled on about how lucky the kid is to have an excuse to behave however he likes because House himself doesn't have it. As others have pointed out, he has many characteristics that flat out contradict such a diagnosis. Someone upthread mentioned that he could behave appropriately and charm people if he wanted to: we've seen him do this on a few occasions (remember SDL when he made the girlfriend think it was her idea to donate her liver?) I've read a lot of these arguments and it always seems to come down to House fans with Asperger's wanting to believe that a TV character they like has it too. it doesn't stop me from wondering if there's room left for personality quirks or if psychiatry has finally fallen into the trap of 'because it's average it's normal and because it's normal it's right'. Actually I think it's more a case of "I have a disorder as listed in the DSM and therefore I'm not responsible for my behaviour and everyone has to cater to me." DrSpaceman, I too wish they'd explored the aftermath of the shooting more. Only 15% of the population is prone to PTSD so we don't necessarily need to see that, but how could it not bother House that the person who tried to kill him could come back? At least they could have told us if they figured out who the guy is and why he did it!

extra cat, most of the people I know have at least one of the "symptoms" on your list! One symptom doesn't make a syndrome. If it did, we'd all be classified as something. Any of us could find something on the scales that would fit us. I'm not sure many of us could find 10-15 things that would fit us personally. As I've said, the picture isn't complete because I'm looking at a scale that excludes adults. The disorder itself excludes adult diagnosis. For clarification, it's not MY list, it's from the Asperger Syndrome Diagnostic Scale, a norm referenced instrument used by clinicians every day as part of a comprehensive assessment. As I said before, the cut-off age is 18. Psychological evaluation is a huge part of my job. It seems I haven't been clear enough about my standpoint. I simply believe that if we saw House as a child there is a great possibility that we would see further evidence that would land him an AS diagnosis. Obviously, it wouldn't be appropriate now. I just believe it would have been possible and in today's climate of recognizing the syndrome, it would have been probable. But House isn't a child in today's climate. I've read a lot of these arguments and it always seems to come down to House fans with Asperger's wanting to believe that a TV character they like has it too. I don't have AS. I'm not trying to make House fit something I see in myself. I think that's kind of a harsh generalization to make. Being open to possibilities isn't necessarily dicated by personal experience. My belief that House could possibly have been given the diagnosis as a child comes from a professional standpoint that has nothing to do with my personal idiosyncrasies.

extra_cat, why does AS exclude adult diagnosis?

Simply because you have to be diagnosed by the age of 18. I think that's national, but it could be state. Mental Retardation has the same requirement. Say, for instance, a person gets a massive head injury that causes brain damage and they are, for all intents and purposes left MR. That would be considered "Traumatic Brain Injury" instead of true retardation. I know "retardation" is a hot button word, so I apologize if someone is offended. I get very offended if the word is used in improper context. Our state guidelines use that instead of "mentally deficient" or any of the other more pleasant phrasing, so that's what I use.

Somebody told me that in Britain the correct term is "retarded" and it's "developmentally disabled" that they find offensive. Different cultures.

Somebody told me that in Britain the correct term is "retarded" and it's "developmentally disabled" that they find offensive. Different cultures. Interesting! Here, "developmentally disabled" is a ruling you can get only up to age 5 (or is it 6?). You have to have a significant delay in 2 of 5 areas (motor skills, adaptive behavior, social skills, cognitive ability, or language). Back to the episode, I thought one of the most interesting scenes was Cameron's uberbitchiness to Chase in the kid's yard. That was totally uncalled for. He was talking about how devoted the parents were and how they took responsibility for their kid and she had to waylay him about his now dead father had never spent time with him. LOW.

Here's my thing: House says he doesn't have it (or at least doesn't deny his lack of having it and even speaks longingly that he wished he had something like it. House is a medical genius. If House says he doesn't have Aspergers or something like it, who are we mere mortals to second guess him? Well, he also says he's been alienating people since he was three and Stacy implies his lack of self esteem in a way that's pretty clear (IMO) we're supposed to take it as fact. If you've been told all your life that you're just a jerk and that your difficulties are the result of your own moral and personal failings, it can be hard to wrap your brain, decades later, around the notion that oh, maybe it's not just because you suck. The paradigm shift itself is a pretty huge change to adjust to. And if you know you'll never be officially diagnosed because of the age thing, then even trying to wrap your brain around the idea must seem like pointless self-torture. Which is not to say that he is on the spectrum anywhere -- I lean toward the idea that he is, but his manipulative ability (and his behavior in "Cursed") is a strong argument against it. I just don't think his failure to self-identify as AS works as an argument against it too. On the contrary, the wistfulness you mention strikes me as a strong argument in favor of it. Who would want to have such a diagnosis if social interactions weren't a huge and exhausting burden for them (no matter how successfully they manage them in the end)? I noticed in the posts above that "understanding social interactions" is presented as if there were a clear fork and no middle ground between "understanding and following the rules" and "understanding and choosing to disobey the rules". There's a lot of things that, if you asked me "What's appropriate NT behavior in such-and-such a circumstance?", I could give you the right answer, because I've made an effort to try to learn the answers. But that doesn't mean I actually follow the rules most of the time, and it's not because I'm choosing to ignore or disobey them. Sometimes it's because the situation doesn't exactly match the "case study" I learned from and I can't improvise quickly enough. But more often it's because it just simply doesn't occur to me to behave in a way that's unnatural to me. I can put the effort into behaving unnaturally -- meeting people's eyes, smiling at them, greeting them -- if I know in advance that I'll have to for a specific event or period of time, but I can't concentrate on doing that 24 hours a day or even 9 to 5. And if I'm not concentrating on it, I'm going to fall back into the patterns that are natural for me. And, yes, maybe I'm just trying to see myself in a favorite character, but I can't help seeing House through that lens. He just doesn't seem to me like the sort of person who'd spend all his time thinking about how to offend the sheeple today -- really, does he consider them worth that much of his thought process? It makes more sense to me to imagine him just going through his life doing what feels right at the time, just saying what's true at the time, and realizing after it's done that "Oh, I've offended the sheeple again; God, they're annoying and easily offended!" And the best way to avoid offending them is to stay the bleep away from them!

I just happen to have an Asperger Syndrome Diagnostic Scale in my hands right now. Okay, not exactly. I'm typing. But I have one that I had picked up to take to a school. House is too old to be diagnosed. The scale is normed for ages 2-18. In fact, Aspergers has to be diagnosed prior to the age of 18 anyway. FYI about 1 in every 150 children are being diagnosed with some form of Autism Spectrum Disorder now, anything from the very general Pervasive Developmental Disorder (in other words, we don't know what the hell it is) to Autism. House probably would have been diagnosed with the syndrome as a child. There are some things on the scale that fit him even as an adult, especially in the social and maladaptive subscales. I'm not sure where you're from extra_cat, but I believe in most places anyone can be evaluated for Asperger's Syndrome at any age. In the United States, Asperger's Syndrome was not officially recognized as a disorder until 1994, so adults who grew up before that, like House, would have had no chance of being diagnosed. That doesn't mean they don't have it! Many people receive correct diagnoses for Asperger's as adults, who were often misdiagnosed or simply written off as eccentric and quirky when they were children. As for House, I believe he does not have Asperger's. His social manipulations seem to come very naturally to him, and reading body language is his specialty. Not that someone with Asperger's can't learn this skill, it just seems to come very naturally to House. And extra_cat, I don't mean to criticize or offend, I know diagnostic criteria for any disorder can change based on location, I just want to point out that the 18 and under rule does not apply everywhere.

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