Manipulating your brain with magnetic fields sounds like science fiction. But the technique is real, and it’s here. Called transcranial magnetic stimulation (TMS), it is approved as a therapy for depression in the US and UK.
More controversially, it is being studied as a way to treat classic symptoms of autism, such as emotional disconnection. With interest and hopes rising, it’s under the spotlight at the in Baltimore, Maryland, next week.
I can bear witness to the power of TMS, which induces small electrical currents in neurons. As someone with Asperger’s, I tried it for medical research, and described its impact in my book Switched On. After TMS, I could see emotional cues in other people – signals I had always been blind to, but that many non-autistic people pick up with ease. That sounds great, so why the need for debate?
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Relieving depression isn’t controversial, because there is no question people suffer as a result of it. I too felt that I suffered – from emotional disconnection. But changing “emotional intelligence” to relieve that comes closer to changing the essence of how we think.
Changing who you are
Yes, emerging brain therapies like TMS have great potential. Several of the volunteers who went into the TMS lab at Harvard Medical School emerged with new self-awareness, and lasting changes. While I can’t speak with certainty for the others, I believe some of us have a degree of emotional insight that we didn’t have before. I certainly feel better able to fit in. As fellow participant Michael Wilcox put it, we have more emotional reactions to things we see or read.
Would I do it again? For several years after the study I said yes without hesitation. But now doubts have crept in.
Why? At first, I thought only of remediating disability. Now I wonder, if there might be a cost in achieving that.
The parts of the brain that weren’t seeing emotional cues were doing other things too. Actually, at my age (I’m now 58), they were probably optimised for other abilities, like my instinctive understanding of how machines work, or Michael’s insight into mathematical formulae.
Might TMS, while apparently improving social cognition, reduce these other abilities? It is speculation on my part, but I can’t help wondering if it might. This question, which science cannot yet answer, is enough to deter me from having more treatment.
Balance of traits
Socially disadvantaged as I may have been, my extraordinary understanding of machines is what made me a success. I wouldn’t trade it for anything.
There will be autistic adults who embrace TMS because they want better social connectivity. Others will decline, choosing to live with the balance of traits they have. That’s fine, because adults can get good information and choose freely. My concerns are focused on children.
When parents look at autistic kids unable to make friends, TMS may seem like a very attractive fix. But what will those children be giving up?
I can look back on my life and see how autism shaped me for good and bad. A teenager – or parent – may only see the disability. I’m concerned that parents may choose TMS without ever knowing the price paid.
Normalisation is a very dangerous idea, even when done with the best of intentions. Some autistics fear “forced normalisation”, particularly for children whose parents seek “the cure” in a quest for an idealised child.
Yes, TMS is a tremendously powerful neurological tool. It and other technologies are opening the door to a future where doctors do more than cure disease and relieve disability. Brain tuning and optimisation may become possible and even ordinary. But the ethical issues are huge, and the time to start the conversation is now.
