Autism's anatomy: A dissection of the structure and development of a psychiatric concept

Only a few decades ago, autism was a rare and largely unknown psychiatric disorder. Today, autism is one of the most diagnosed, researched and discussed psychiatric disorders. What is more, in less than thirty years, autism has become an almost inescapable cultural phenomenon. Despite its current omnipresence, the nature of autism remains disturbingly unknown. Autism neuroscience is thriving but, as of yet, there have been no clinically relevant findings or discoveries from basic autism research. Autism’s Anatomy describes these developments and the unremitting search for the neurobiological basis of autism, without taking the idea of autism for granted. It explores the historical determinants of our current understandings of autism by analyzing the history of the concept of autism, the underlying concepts of disease, and the uncertainties and assumptions in contemporary autism research. The author tries to understand how autism became such a recognizable, prevalent and indisputably neurobiological syndrome, while it is at the same time contested as a disorder, notoriously elusive and heterogeneous, socially-inflected and historically rather variable.
Autism’s Anatomy does not directly criticize the reductionist models and tenacious reifications of mental disorders. Nor is it a quest for a superior model of psychiatric disease. Instead, it describes and discloses a pervasive disease-centered style of psychiatric thought – a directed and restricted way of perceiving, thinking about, and dealing with mental ailments as diseases that exist independently of their manifestations in individual patients. In addition, this study describes some of the consequences of this particular style of thought, such as the growing gap between basic autism research and clinical practice, and particular difficulties with demarcating mental abnormality. Against the background of yet another crisis in psychiatric science, Autism’s Anatomy argues that a recognition of this style of thought enables feasible alternatives for thinking about autism and mental ailments in general. With a commitment to understanding mental health problems as problems of entire human beings in complex worlds and not merely as problems of human bodies and brains, an alternative ‘person-centered’ style of psychiatric thought is explored.