The Reason I Jump by Naoki Higashida: Autism from the inside

Naoki Higashida has written a sparkling collection of Q&As, reflections and stories which describes like with autism from a first-hand perspective.

The Reason I Jump
Naoki Higashida
Translated by K A Yoshida and David Mitchell
Sceptre, 192pp, £12.99
When we think of autism, we think of solitude – of the child who prefers to play alone, away from the hurly-burly of the rest of the class, or the adult who would rather not join in with everyone else this weekend, thanks all the same. Collectively, we have been trained by our understanding – or lack thereof – to think that leaving autistic people alone is for the best, that it is what they want.
In The Reason I Jump, Naoki Higashida shows us how wrong we are. Shows rather than tells, that is, for although Higashida is autistic and was only 13 years old when he produced this book, his words flow smoothly, with no hectoring quality to his tone. His frequent pleas for understanding and patience as he tries to answer such questions as “Why do people with autism talk so loudly and weirdly?” and “Why are your facial expressions so limited?” never cease to humble you as you read.
Part question-and-answer text and part short story, The Reason I Jump has been translated into English by the twice Booker-shortlisted author David Mitchell and his wife, K A Yoshida. The couple first came across it in the original Japanese and it offered them a crucial breakthrough in understanding what their autistic son was experiencing. As Mitchell writes in his introduction: “It felt, as if for the first time, our own son was talking to us about what was happening inside his head, through Naoki’s words.” Now, by translating it, they hope to share the insights it provides more widely.
Fictional representations of autism-like traits, such as in Mark Haddon’s The Curious Incident of the Dog in the Night-Time and Dustin Hoffman’s Oscar-winning turn in the 1988 film Rain Man, make us think we know what to expect when we encounter the real thing. But as Mitchell explained in a recent piece for the Guardian, the avalanche of articles and books on dealing with autism that he and his wife received from well-meaning friends and family when their son received his diagnosis only emphasised our collective ignorance. Most advice bears little relation to reality. How do you explain that your son has bruises on his head because he likes to bang it on the floor, hard, up to a dozen times a day? A wise therapist advised Mitchell to put a foot between his son’s head and the floor “so the impact is softened” but it took Higashida’s writing to help the frantic parents understand why their son felt compelled to hurt himself in this way.
Every page dismantles another preconception about autism. For a start, Higashida writes mainly in the plural – we need your help, we need your understanding – as if he is not alone but part of a great community of silent children around the world. He explains that it’s physically painful for him to hold back his “weird voice” (that loud, thick, overworked diction that autistic people sometimes use) because it feels “as if I’m strangling my own throat”. And the concept of time makes him anxious, because although he can see the hands on the clock move, he can’t feel the passing seconds rushing past him like the landscape does when he runs.
At first glance, the book can be read as a manual for autism and it is certainly helpful in that regard. We assume that autism is a disease of the interior – a mysterious malfunction that happens inside the sufferer’s head. Higashida, with what I imagine to be a wry smile on his lips, uses both his answers and his stories to show us yet again how wrong we are. He explains that trying to control his body is “like remote-controlling a faulty robot” and that every aspect of autism that affects his mind has a corollary in his physical existence. If you try, as you read, to link your mind to his as he describes his thoughts, you start to get little hints of what it must be like to have no sensation of where your legs and arms are attached or to have limbs that feel as if they are “a mermaid’s rubbery tail”. It isn’t pleasant.
Higashida’s language is precise and has a poetic quality that elevates it far beyond a self-help book for the parents of autistic children. His fictional stories, also included in this book, vary in length from a few lines to dozens of pages and are united by their beautiful simplicity. They all share a strong single theme, namely, that even if living is different and difficult, you can still find companionship and happiness. As he proves in his answer to the question implied by the book’s title – “Why do you jump?” – Higashida is grasping at something universal about the human mind: “When I’m jumping, it’s as if my feelings are going upwards to the sky. Really, my urge to be swallowed up by the sky is enough to make my heart quiver.”
Once you understand how Higashida managed to write this book, you lose your heart to him. It’s a slim little volume, but in order to write a single word he had to select and point to each character on an alphabet grid drawn on paper, while someone sat beside him transcribing the words he formed. His autism is such that dictation was out of the question and computers were too distracting. Every letter was painstakingly chosen and deliberately selected. With all the effort that has gone into putting these words before our eyes, it’s impossible still to think that autistic people prefer their loneliness. Higashida has shown us that they are just waiting for us to have the patience to listen to what they want to say.
Autism has been represented in fiction, but seldom has a first-hand account emerged. Photograph: Getty Images.

Caroline Crampton is web editor of the New Statesman.

This article first appeared in the 22 July 2013 issue of the New Statesman, How to make a saint

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Tetris and sleep deprivation: how we can help emergency workers cope with trauma

First responders are at serious risk of developing PTSD during events like the Paris attacks. 

Some people seem able to deal with anything. They save a stranger from bleeding out in a bombed restaurant, protect passers-by from heavily armed gunmen, pull dead and dying people out of collapsed buildings, and they keep going because it is their job. These people are first responders.

When trauma goes on for days, as it has recently in Paris, however, the odds of them bouncing back from the violence, death and injury they are witnessing rapidly diminishes. They are at greater risk of developing a severe stress reaction known as post-traumatic stress disorder (PTSD). One study found that the worldwide rate of PTSD among first responders is 10 per cent, much higher than the 3.5 per cent rate among those not involved in rescue work.

Tetris to the rescue

So how best to address the problem? Research is in its infancy, but there are some promising studies. Emily Holmes’ group at the University of Cambridge has been looking at the benefits of playing Tetris, a video game, after a traumatic experience. The idea is that this could block the consolidation of traumatic memories so they don’t “flash back” later on.

For the study, her team first traumatised people by showing them distressing footage from public safety videos. The next day they invited them back into the lab to reactivate the memories with still images taken from the videos. One group then played Tetris for 12 minutes while the other sat quietly. Over the following week, the group who played Tetris had about 50 per cent fewer unwanted memories from the films compared to the group who didn’t.

The team concluded that playing Tetris helped individuals because it soaks up their visual processing capacity, making it harder for the brain to consolidate the visual parts of a traumatic memory.

Since it takes about six hours for the brain to cement a memory, the key is to play the game soon after trauma or within six hours of re-activating the traumatic memory. How long the helpful effects of playing Tetris will last and whether it will translate into helping people after real-life trauma is still unknown.

Talking it through

Other techniques, such as “updating”, taken from a highly-effective talking treatment for PTSD, may be more practical and easier to implement.

Like a detective, updating is a technique that focuses on finding new information and linking it to the case, the past memory. This is necessary because when the brain and body are in survival mode during trauma, the mind finds it difficult to encode all the relevant facts. Often key pieces of information that could make the memory less traumatic are lost. Updating links new information to someone’s memory of their trauma to make it less upsetting.

But can updating help to reduce unwanted memories after trauma?

We carried out a study, published in PLOS ONE, in which we traumatised people by showing them terrifying films of humans and animals in distress. We then divided our participants into three groups. One group watched the films again but were given new information about how long people suffered and whether or not they lived or died – essentially, they were updated. The second group watched the same films again but without the new information. And the third group watched films of humans and animals who were not in distress. The updated group had fewer traumatic memories and PTSD symptoms than the other two groups.

Updating is now being used by some UK emergency services. First responders will gather after critical incidents and update their memories of what happened before they go home.

Sleep deprivation

There are other techniques that may be helpful. One study found that depriving people of sleep may be useful in the aftermath of trauma.

But the same study found that a week after the trauma, people who had been deprived of sleep had the same number of unwanted memories as people who had slept well afterwards. Consequently, it remains unclear whether there would be any long-lasting benefits using this method. There are, however, certainly health risks linked to lack of sleep.

Still looking for a solution

To develop preventative interventions, we need to study newly-recruited emergency workers who haven’t yet suffered on-the-job trauma and follow them over time, spotting which “coping styles”, present before trauma, may predict their reactions afterwards.

For example, some people naturally react to stressful life events by dwelling on them, thinking about why they happened for hours on end. This strategy, called rumination, has been linked to PTSD in people who survived car crashes.

If rumination predicts PTSD in first responders, then preventative interventions could train people to spot when they are dwelling on an event and refocus their attention to the task at hand.

When we have identified which factors heighten emergency workers’ risk of developing PTSD, programmes can be developed to target those vulnerabilities. Only then can an intervention, directed at first responders most at risk of developing PTSD, properly protect them in their line of work.

The Conversation

Jennifer Wild is a Senior Research Fellow in Clinical Psychology at the University of Oxford

This article was originally published on The Conversation. Read the original article.