Denise Winn talks with Professor John Ratey about the brain as a social organ, and the need to be alert early to enept social skills.

Winn: Professor Ratey, what exactly do you mean when you use the term, 'social brain'?

Ratey: I define it as the parts of the brain that makes us social! There are certain areas in the brain which we had thought of as having specific functions unrelated to our social lives but which we are coming to realise are very heavily involved in our social development. Neurologists and neuroscientists have shown, for instance, that damage to the cortex can affect our ability to be empathic, that problems in the cerebellum can cause social ineptness and that deficits in the right hemisphere can make it hard to understand life's overall picture. I think of these and other parts as making up the social brain.

A motor problem that is seemingly unrelated to what we think of as making us social — our emotions and empathy skills and all that — can, from birth, influence the ability to bond, the ability to share, and so on. If your motor system isn't allowing you to move your head gracefully and smoothly, navigating with mom when she points to something in the environment and begins the process of sharing what she sees with you, then you miss the critical period for developing social sharing (which begins with the sharing of attention), and it is hard to gain that ability later. The skill of shared attention is a major component of social communication and one of the building blocks of language and conversation. In very many of the people with social problems that I've seen over the years, a lot of them don't — or didn't — have the basic concept of sharing. When a four year old fails to share, we should be alerted to the fact that there's a problem.

Winn: So, now, when you come across a failure to share, do you think that a social brain deficit could be the reason for it?

Ratey: Yes, or rather, I would think it could be a contributing factor. It is never going to be one thing only. But, if you don't have that concept of sharing early on, you're not going to get any practice at social relationships. And practice is something that we depend on.

Winn: It is the cerebellum, isn't it, that is involved in the kind of attention you mentioned just before? I am particularly interested in what you have to say in your book, A User's Guide to the Brain, about its role in the shift of attention.

Ratey: Yes, that is one of the hot areas of research in some of our centres where they are looking at attention deficit disorder. There is a finding that one of the few areas that is consistent across scans is a deficit in the cerebellum. If you have a difficulty in shifting your attention, a difficulty with rhythmically, seamlessly, moving from one thing to another, then your experience of the world and the experience you portray to the world is going to be very choppy, very discontinuous and very difficult in a social situation where smoothness rules.

Winn: And now it is thought that this cerebellar deficit may explain some of the behaviours of autism?

Ratey: Yes, that's where this work really started. Being off balance, not being able to do the social dance is a big element in autism. Neurologist Eric Courchesne has found that while a normal baby can shift attention from a parent's nose to an eye or to the mouth in a fraction of a second, an autistic baby may need as many as five to six seconds to make these shifts.

If we imagine ourselves in the position of the autistic baby, autism starts to make more sense. If it takes five or six seconds to shift your gaze from your mother's nose to her eyes, you are not going to see her face as a coherent image. You are going to see disparate parts of a face that do not combine, in memory, into a meaningful whole. They will be stored simply as face-pieces, and that has been borne out by what many high functioning autistic people have said. They may talk of what we term 'visual dropouts' — not being able to see, for instance, all of a tree at one time, seeing instead just one branch, or one leaf or the bird that is perched on a branch.

So when it comes to social competence, this inability to shift attention can have devastating consequences. The look on a mother's face or a shift in tone of voice is fleeting. If a young autistic boy is looking at a puppy, he will miss her smile. If he pulls the puppy's tail, he will miss her frown. All that vital social information is lost.

Winn: It isn't just in autism, of course, that cerebellar damage may have that kind of impact. Less obvious damage may account for what you call the "social klutz".

Ratey: Right — the kind of person who is awkward, uncoordinated, out of step, lacking social graces, all of it driven by an inability to properly pay attention, share attention, and coordinate all the many simultaneous incoming and outgoing signals.

I would say there is a whole spectrum of not so much damage but differences. So you will have someone with Asperger's syndrome who doesn't have the same differences that someone with autism has. And then you have just your typical engineer who is very socially awkward but does have the feeling responses that perhaps people with Asperger's don't have. Because it is an interactive kind of thing, if you have a difference in the cerebellum, then you are likely to have differences in the parietal lobe, which has to do with knowing where we are, in terms of physical position, and not standing too close to another person and having a sense of social space. That area is very tied into the cerebellum and when there is a difference in one you often see a difference in the other.

Winn: A deficit or a difference?

Ratey: Well, I really prefer to say difference. I don't like the word deficit anymore.

Winn: This isn't just political correctness?

Ratey: No. We do have different shades. We wouldn't have our cyberworld, which is maybe good, maybe bad, if we didn't have these autistic-like people.

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© Human Givens Limited, Denise Winn and John Ratey (2001)

This article first appeared in Volume 8, No, 1 (2001) of the Human Givens journal.

JOHN RATEY is associate clinical professor of psychiatry at Harvard Medical School. He is co-author of Driven to Distraction, Answers to Distraction and Shadow Syndromes and his latest book is, A User's Guide to the Brain.

DENISE WINN is the editor of the Human Givens Journal.

> More information on the human givens approach can be found in the following book by Joe Griffin and Ivan Tyrrell

Human Givens: A new approach to emotional health and clear thinking

> You can find out more about the issues raised in this article on the following Human Givens College events:

From stress to psychosis: How to prevent people having breakdowns (one-day course)

Demystifying autism and Asperger's syndrome
(In-house Workshop)

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