Sunday, August 17, 2014

Delusional aversion in special needs: maladaptive learning?

As #1 moves to adulthood he shows many cognitive improvements — including better planning abilities. Improvements in some areas inevitably expose disabilities in other areas; we must then choose which to work on and which to wait on.

One of those newly defined disabilities is something we have started to call “delusional aversion”. For example - a sudden, inexplicable and emotionally intense aversion to a mountain biking site. If you didn’t know him better you’d think some terrible and unspeakable secret trauma had occurred there. That does not seem to be the case — though we can’t rule out some minor issue like someone speaking sharply to him, or some brushing grass creating an unpleasant sensation.

Once these aversions develop they are strong and persistent. You could not, for example, pay him enough to put a big bag under his bike seat. He will often produce “explanations” for the aversion, but they are illogical. If pressed he will respond with angry speech. They are classic “fixed beliefs without rational explanation” — delusions in other words. I suspect they are structurally not all that different from the well studied delusions of schizophrenia and they, of course, are very much like phobias.

We think of these delusional aversions as a form of dysfunctional associative learning. He associates something unpleasant with a location (human memories are strongly bound to place), and his disability rapidly amplifies a “single-exposure” learning circuit. I suspect this is a fairly common issue with dogs and other learning animals, but most humans are better able to control these associations. He cannot.

The accumulation of aversions is disabling across a wide range of activities of daily life. So this is a problem we’d like to address.

Naming and framing a cognitive disability is a first step to mitigating it — but we don’t yet know the next step. Presumably we can borrow from techniques used to treat phobias, particularly desensitization and association-subsitution. That’s hard and slow work though, and he’s very difficult to motivate. He does not see these accumulating aversions as a problem, and it’s hard to treat a problem a person doesn’t have.

We may try a bit more of a cognitive tack. This is definitely a reach — introspective cognition is very hard for him. It is not, however, impossible. If he can begin to label his aversions as non-rational learning…

(Incidentally, as one approaches guardianship age these are things to note down for the benefit of court hearings.)

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