Anthropology of Autism

DailyDose_darkstroke Welcome to Medhum Mondays on the Daily Dose!

Some of you may know that in my other life, I (Brandy Schillace) am the managing editor of an international journal of cross-cultural health research: Culture, Medicine, and Psychiatry. This June 2015, the journal released a special issue on conceptualizing autism. This release featured articles that explore the social and cultural dimensions of autism across the globe, and reviewed the multitude of ways that families with children of autism navigate systems of social support and provide care for their children within their region and their community. As stated on the CMP blog, the entries “illuminate the human experience of caregiving and the often slippery, complex position of developmental disorders in the landscape of medicine, caregiving, and mental health treatment.” In that sense, then, they critically examine the human at the center of medicine, and thus intersect with our common mission in medical humanities. Today, I am reproducing an interview with the guest editor conducted by our blogista, Julia Knopes, at http://culturemedicinepsychiatry.com/–welcome Ariel and Julia!

 Dr. M. Ariel Cascio, guest editor of the special issue, is an anthropologist who studies the cultural and historical position of autism in Northern Italy. Here, the social media editor of Culture, Medicine & Psychiatry, Julia Knopes, interviews Dr. Cascio about the special issue, and her perspective on the future of cross-cultural autism research.

(1) Can you tell us a little about the upcoming June 2015 special issue?

The special issue, “Conceptualizing autism around the globe,” shares anthropological (and allied field) research on autism in Brazil, India, Italy, and the United States. We talk about “conceptualizing” autism as a way to counter the idea that autism “is” or “means” one specific thing. Sometimes autism means the diagnosis measured by a certain instrument (such as ADOS), sometimes it means a more broadly defined set of characteristics (such as those in the DSM), sometimes it means an individual identity, and so many more things. The articles in this issue explore how autism is conceptualized at several different levels: in national policy, in treatment settings, and in the home.

 (2) What’s something new you learned about the anthropology of autism while working on this special issue?

I’ve just enjoyed the opportunity to greater familiarize myself with the group of scholars who are pursuing the anthropology of autism, and to work alongside scholars whose work I have long followed.

(3) So how did you become interested in the study of autism?

I’ve been studying autism since 2008. I actually came to anthropology before I came to autism, and when I first began learning about autism, I saw it as rich for anthropological inquiry (isn’t everything!) because of anthropology’s strengths in focusing on lived experience, challenging deficit narratives of so-called “disorders,” and placing medicine and psychiatry in sociocultural context.

(4) What was it like doing fieldwork in Italy? How do Italians see autism differently than other places in the world?

I’ve studied the autism concept more in Italy than in any other place in the world, and I’m very grateful to everyone there from whom I learned – autism professionals, family members of people with autism, and people on the spectrum themselves. I could hazard comparisons with the literature that address perceptions in other parts of the world – and some of these comparisons come through in the special issue – but for now I would like to focus on the strength of the rich description of the Italian context without external comparison. As my article in the special issue shows, autism professionals tended to take a social model of autism, focusing on creating environments that were tailored to the needs of people on the spectrum and structured to help them learn.

(5) What are some of the challenges you’ve faced in studying autism?

As in many areas of inquiry familiar to readers of CMP, it can be challenging to communicate information about my study to people who study autism in other fields (clinical, psychological, social work, etc.). A lot of research about autism takes a positivist stance, whereas my research takes an interpretivist stance and focuses on autism as a concept whose meaning may vary rather than a diagnosis measured in a particular way. Nonetheless, I love talking about my research interests with a broad audience because in many contexts (especially in the U.S.), so many people have personal or professional interest in autism and we can always have interesting and stimulating conversations.

(7) What’s something you think would surprise non-anthropologists about the anthropology of autism?

I would imagine non-anthropologists would be surprised by the anthropology of autism for the same reasons they might be surprised by anthropology (or medical anthropology) in general. For example, they might be surprised that anthropologists study autism all over the world, particularly if they think of the autism concept as something that represents a universal set of characteristics and experiences that are unaffected by context. The articles in this special issue really show that context matters in all conceptualizations of autism, from Brazil to the United States, from national policy to the family home.

 (8) Where do you see the anthropology of autism heading next?

I see the anthropology of autism becoming more inclusive. In her commentary, Pamela Block expresses optimism that the anthropology of autism will increasingly include researchers who identify as autistic themselves, and I agree. In addition to including more researchers with autism, I anticipate that the anthropology of autism will increasingly work to include participants with higher levels of support needs (those whom some people call “people with low-functioning autism”), and delve deeper into their lived experiences as well.

This interview was originally posted on May 6th 2015 on the Culture, Medicine & Psychiatry blog: http://culturemedicinepsychiatry.com/2015/05/06/june-2015-issue-preview-interview-with-guest-editor-m-ariel-cascio/

You can access the special issue on Conceptualizing Autism here: http://link.springer.com/journal/11013/39/2/page/1

 

MedHum Monday presents: Spectacular Anatomy–The History of Human Dissection

DailyDose_darkstrokeWelcome back to MedHum Monday at the Daily Dose! Today we present a guest post by Julia Balacko, BA, MA, from Case Western Reserve University. An anthropologist and humanities scholar, Julia gives us the fascinating history (and anthropology) of anatomy and public display.

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The History and Anthropology of Human Dissection, Public Display, and Criminality

Male figure, anterior view showing blood vessels, liver heart and bloodletting points.  Woodcut circa 1530 - 1545
Male figure, anterior view showing blood vessels, liver heart and bloodletting points.
Woodcut circa 1530 – 1545

Towards the end of my stint studying English literature, my research posed the following question: what happens whenever human bodies, and the dissection of bodies, becomes a spectacle or form of entertainment? What if the bodies themselves have unique relationships with their audiences in numerous venues? These were less bioethical questions than anthropological ones, in that instead of pondering the moral dimensions of anatomical display, I wanted to know how different audiences responded to anatomy and to displays of human bodies.

I had been trained in my undergraduate and Masters degree programs in early modern English theatre (Shakespeare and his contemporaries, publishing their works in the late 16th and early 17th centuries.) I studied age-old revenge tragedies that were marked with violent scenes of war and capital punishment that mirrored what was happening at the time in English history: when public executions served as popular entertainment and when the preserved, decapitated heads of criminals were displayed on bridges above the river Thames. It was an era in which common people were exposed to bodily violence on a daily basis in numerous capacities, and a time when anatomical science was entering its golden age, spurred by the work of Vesalius and Leonardo da Vinci.

At the jointure of these two cultural movements was a troubled relationship between public entertainment, capital punishment, and human dissection. Bodies of criminals killed on the scaffolds in London were subsequently given to surgeons and physicians for anatomical study after Henry VIII passed a law permitting the legal use of executed felons for this purpose. However unlike today, convicts were scarcely anonymous, with tales of their crimes circulated both in oral retellings and popular print. The people who attended executions knew the criminals’ stories, and they also knew (and often heartily protested) the use of the people whose bodies were employed for dissection, both because they sometimes viewed the criminals as storied antiheroes and because they believed dissection barred a person from entering heaven in the afterlife (an unfair punishment beyond execution.) The public acceptance of human death as spectacle in early modern England is complicated by the fervent response against anatomical study in that period.

There was, then, tremendous tension between who had access to bodies and in what capacity. Why was it acceptable in the public view to watch people be executed, but not permissible for anatomists to dissect the bodies? In my MA thesis, I suggested that part of this public concern came from how limited access to anatomical learning was in that time for the majority of people. While Renaissance dissections have traditionally been called “public,” in that many people assembled to watch one lecturer and one anatomist dissect a cadaver, they were not openly accessible to the general populace. Dissections were uncommon and therefore only frequented by medical students, surgeons, and the educated or wealthy elite. The public did not have the same level of exposure to anatomical inquiry as they did to other forms of bodily violence. Nor was their relationship with the bodies being dissected the same as it must have been for the anatomists, who viewed the bodies as scientific objects. The public tended to see the executed as prisoners who once lived a daring life of crime and who deserved, perhaps, at least some sympathy by not defacing their bodies via dissection.

For anthropologists and cultural historians, understanding issues regarding the disposal and usage of human bodies and the relationship between anatomy and criminality in various fashions continues to be pressing. The popular Body Worlds exhibition poses difficult questions about whether or not non-clinicians should have access to dissected bodies, and whether or not it is acceptable for them to be entertained by such a display. It has also returned scholars to a debate about the ethics of displaying criminal bodies, as enormous fears that the cadavers in the exhibit were those of executed Chinese prisoners permeated many early discussions about the exposition. Likewise, tales of body snatching for anatomical study, and the use without consent of harvested organs such as in the Alder Hey case, still haunt the cultural presence of medical learning. And, of course, such discussions ask us about the democratization of knowledge: who has the right to observe anatomical specimens? Is it wrong to deny the public access to human cadaveric specimens, even if they are observed not out of a need to acquire scientific information? Is anatomy on display more unethical than other forms of publicly viewed violence or destruction?

As scholars, knowing the historical trajectory of anatomical learning from the past up to today sheds light on how and why such issues are present. It is the prime context for investigating where tensions surrounding human dissection derive from, and how they have changed– as well as for reminding us of the cultural impact that our predecessors had on shaping our relationship to anatomical science.

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ABOUT THE BLOGGER

Julia Balacko holds a BA in English Literature summa cum laude from W&J College and a MA in Humanities from the University of Chicago. She is currently a PhD student in medical anthropology at Case Western Reserve University. Her research explores the history and cultural dimensions of anatomical learning and human dissection in American medical education.