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Book ChapterDOI

Disruption to embodiment in autism, and its repair

01 May 2021-pp 69-96

Abstract: This paper offers a neuroscientific explanation of life with autism which recognizes that human behavior and experience is by nature both personal and interpersonal. With a focus on insights of Penelope Dunbar (Pum) who has lived with autism for decades, we explore an affective neuroscience understanding of autistic experience and how to work creatively with its impulses for health and personal development. Pum describes her autistic disruptions to the intrapersonal coherence of her basic states of being, moving-with-feeling in self-awareness, and how this disturbance to her internal subjective coherence of mind challenges her capacity to self-regulate arousal, and communicate with others. By examination of the source of her problems in childhood and ways of working with them, Pum has clarified fundamental elements in the development of her capacity to regulate self-care in creative efforts that facilitate both affective embodiment and sensory-motor coherence in growth of understanding in her mind and body. With her advice we explore how current neurobiological insights in autism as a disruption to the regulation of affective embodiment and sensory-motor integration leads to new recommendations for therapeutic care to relieve autistic distress and restricted modes of being. Although particular to her circumstances and cultivated habits of autistic expression, this analysis offers insight into the fundamental nature of autism, and ways of positive working with one’s autistic nature for creative gains.
Topics: Autism (57%), Affective neuroscience (50%)

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Papaneophytou & Das (Eds.) Delafield-Butt, Dunbar, & Trevarthen
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Disruption to Embodiment in Autism, and Its Repair
ACCEPTED AUTHOR MANUSCRIPT
To be published in N. Papaneophytou & U. Das (Eds.), Emerging Programs for Autism
Spectrum Disorder. Academic Press.
The full copy-edited manuscript will be available at:
https://www.elsevier.com/books/emerging-programs-for-autism-spectrum-
disorder/papaneophytou/978-0-323-85031-5
Please cite as:
Delafield-Butt, J., Dunbar, P., & Trevarthen, C. (2021). Disruption to Embodiment in
Autism, and Its Repair. In N. Papaneophytou & U. Das (Eds.), Emerging Programs for
Autism Spectrum Disorder. Academic Press.
Jonathan Delafield-Butt
Professor of Child Neurodevelopment and Autism
Director, Laboratory for Innovation in Autism,
University of Strathclyde, Glasgow, Scotland.
E-mail: jonathan.delafield-butt@strath.ac.uk
Penelope Dunbar
Independent Artist and Creative Researcher, Glasgow.
Colwyn Trevarthen
Professor (Emeritus) of Child Psychology and Psychobiology,
School of Philosophy, Psychology and Language Sciences,
The University of Edinburgh, Edinburgh, Scotland.
E-mail: c.trevarthen@ed.ac.uk

Papaneophytou & Das (Eds.) Delafield-Butt, Dunbar, & Trevarthen
- 2 -
Disruption to Embodiment in Autism, and Its Repair
Abstract
This paper offers a neuroscientific explanation of life with autism which recognises that
human behaviour and experience is by nature both personal and interpersonal. With a focus
on insights of Penelope Dunbar (Pum) who has lived with autism for decades, we explore an
affective neuroscience understanding of autistic experience and how to work creatively with
its impulses for health and personal development. Pum describes her autistic disruptions to
the intra-personal coherence of her basic states of being, moving-with-feeling in self-
awareness, and how this disturbance to her internal subjective coherence of mind challenges
her capacity to self-regulate arousal, and communicate with others. By examination of the
source of her problems in childhood and ways of working with them, Pum has clarified
fundamental elements in the development of her capacity to regulate self-care in creative
efforts that facilitate both affective embodiment and sensory-motor coherence in growth of
understanding in her mind and body. With her advice we explore how current
neurobiological insights in autism as a disruption to the regulation of affective embodiment
and sensory-motor integration leads to new recommendations for therapeutic care to relieve
autistic distress and restricted modes of being. Although particular to her circumstances and
cultivated habits of autistic expression, this analysis offers insight into the fundamental
nature of autism, and ways of positive working with one’s autistic nature for creative gains.
Keywords: autism, affective neuroscience, embodiment, self-regulation, art, movement

Papaneophytou & Das (Eds.) Delafield-Butt, Dunbar, & Trevarthen
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Introduction
In the human mind, consciousness of ‘the self as agent’ (Macmurray, 1957) is not a singular,
homogenous phenomenon, but is a layered set of systems integrated by a hierarchy of
phylogenetic principles of brain growth and animated activity that give rise to sympathetic
actions and reactions that connect ‘persons in relation’ (Macmurray, 1961). Comparative
neuroscientist of emotions, Jaak Panksepp (Panksepp, 1998a; Panksepp & Biven, 2012).
identified three levels of neural processing in mammals, each generating an awareness of the
Self made in relation to internal and external environments, and mediating between the two.
His view advanced by detailed comparative neuroanatomy with penetrating observation of
affective expressions and responses common to rodents and primates gave psychology
improved description and richer evolutionary understanding of the basic notion of a ‘triune’
brain of Paul MacLean (1990) – the idea that evolution of vertebrate ecology in social groups
toward the human cultural intelligence incorporated three distinct, but inter-connected levels
of processing. First of the reptilian brain stem, then the palaeo-mammalian midbrain limbic
system, and finally the complex neo-mammalian powers for acquiring adaptive experience
recorded in what is known as the neocortex of the forebrain.
What a human person experiences in healthy activity of the body and brain with awareness
as a singular coherent conscious Self (Sherrington, 1906) is the result of efficient composition
of action in the layers of neurobiological processing working in synchrony (Buzsáki, 2006).
Regulations of energy in internal embodied well-being of an integrated person is maintained
by an affective system linked to the autonomic visceral organs (Panksepp, 1991; Panksepp,
1992), and this is coupled with all voluntary and imaginative neuromotor control of the
skeleto-muscular system of the body in purposeful movement (Bernstein, 1967). This inner
life’ from which all arts, mathematics and philosophies grow (Langer, 1942; Lashley, 1951) is
both graceful or aesthetic in its efficiency (Turner, 1991), and gracious or moral in inter-
subjective social cooperation (Trevarthen, 2015).
Efficient communication between all the elements of the intentional and self-conscious
nervous system in one rhythm of time (Buzsaki, 2006) is critical. The animal brain evolved as
an integrative organ to bring the experiences and activities of all parts of the body into one
composite awareness. In human beings the fingers, hands, elbows and feet move the body in
ambient and focal awareness to exploit what the outside world affords for use (Gibson, 1977).
Inner vitality coordinates functions of the stomach, liver and heart, and the information-
seeking assertions of neck, head, mouth and eyes that become powerful media of
communication of individual impulses and their effects in social partnerships (Reed, 1006).
Every movement acts as a coherent and coordinated whole with its own, singular purpose in
transformations of the body made in movement with prospective imagination of the effects
(Bernstein, 1967). The innate coherent rhythmic ‘musical’ composition of all wilful agency of
the individual is elaborated within each body as the common code for shared cultural
awareness and understanding (Malloch & Trevarthen, 2009b; Trevarthen, Gratier, & Osborne,
2014).
At the anatomical centre of this integrative system of neurons in all vertebrates is the
brainstem. At the anterior end of the spinal column it brings together information from the
visceral organs on maintenance of inner life, and information from the moving muscles of the
skeleton together which sense information about the surrounding world from the distance

Papaneophytou & Das (Eds.) Delafield-Butt, Dunbar, & Trevarthen
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receptors, the eyes, ears, and nose for sight, sound, and smell. This brainstem ‘head ganglion’
(Coghill, 1929), has access to all of the information from outside and inside the body required
for prospective conscious awareness along the intended course of locomotion. It’s basic
anatomy and neural function is shared across ‘vertebrates’ – all animals with a spine; reptiles,
amphibians, birds and mammals. As the most ancient phylogenetic layer of this neural system
it is the site of rapid integration and evaluation of information across the body and brain, in
what Panksepp calls the ‘Core Self’, the first ‘centre of conscious awareness’ (Northoff &
Panksepp, 2008; Panksepp, 1998b).
Interestingly, and importantly, this Core Self can operate on its own in humans, cats, and rats,
without the addition of information from the phylogenetically more recent neocortex the
large, voluminous convoluted brain mass that fills the skull and that most educated people
(including cognitive neuroscientists) think of as ‘the brain’ (Bjorn Merker, 2007; Penfield &
Jasper, 1954). In fact, we can be conscious without a cortex, as surgical decortication
experiments have shown, and as is proven by children born with rare congenital total loss of
neocortex (Shewmon, Holmse, & Byrne, 1999). This simple fact is lost in most contemporary
neuropsychology sources, but it is critical to our understanding of autism. The brainstem is
the site of coherent integration of information about the world outside in consciousness, and
also of the state of the world inside, rich with vital needs of the body, which are afforded
opportunity for satisfaction in active appreciation of benefits, and apprehension of dangers,
in contacts with the world outside.
Second, above the brainstem sits a complex of pathways and larger nuclei that hold special
abilities to store memories and appraise these as benefits or risks of harm. These store and
organise past experience so it can be recalled and deployed to help organise action in the
present moment, and in service of future goals. The accumulated memories of the past serve
understanding of the consequences of actions in the present, and set goals for a desired and
imagined future of purposeful life.
In the third level of organisation experiences grow with our expanded cognitive or ‘knowing’
capacities, and with tools of symbolic abstraction that enable defined experiences to be held
‘off-line’ in memories and manipulated in our imagination. This third level of processing
occurs across the vast array of brain space we recognise as the cortex. It’s unique format
presents layers of neurons stacked as vast, broad sheets of integration that can process the
rich variety of experiences near-simultaneously. This new element of the brain provides
capacities of enhanced perceptual discrimination, memory, abstract reflection, conceptual
organisation, planning, and evaluation. These ‘cognitive tools’ become the structures that
build our human intelligence, knowledge, and technical mastery (Gigliotta, Pezzulo, & Nolfi,
2011; Pezzulo & Castelfranchi, 2009). It is the seat of our post-industrial rational human mind
and reflective pragmatic intelligence recorded symbolically in manufactured media.
Our conscious experience in each moment varies and shifts, contingent on changing needs
and circumstances. It is a single point in what William James called ‘the specious present’
(James, 1890), a unique moment in time that slips ever forward, its experience structured by
the remembered past and anticipated future. We now understand its structure is the product
of deep evolutionary layering, adapted for an adventurous animal life that expands our ability
to anticipate and prepare for the organic needs of growth, sustenance and learning especially
highly developed in humans. It enables an exceptional capacity to project the imagination
into the future, to make plans in the present moment based on a remembered past, for a
desired future (J.T. Delafield-Butt & Gangopadhyay, 2013) (Figure 1).

Papaneophytou & Das (Eds.) Delafield-Butt, Dunbar, & Trevarthen
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Jaak Panksepp’s three levels of conscious processing demonstrate that what we have
traditionally considered ‘unconscious’ is in fact the core of our conscious experience it is a
primary, pre-reflective consciousness that is evident in, and that structures, everyday actions
of the animal. As Solms and Panksepp (2012) put it in their title, “The “Id” knows more than
the “Ego” admits.” We accept this as the hierarchy of human motor intelligence , and how it
grows between the intuitive invention of activity in awareness of the body, and the articulate
record and interpretation of thinking with semantic codification of foci of interest in gestural
and linguistic syntax with affective prosody (Delafield-Butt & Gangopadhyay, 2013; Delafield-
Butt & Trevarthen, 2015; Malloch & Trevarthen, 2009a; Trevarthen & Delafield-Butt, 2017).
Figure 1. Schematics of the nested layers of the Self showing (A) their nested organisation
(reproduced from Solms and Panksepp, 2012) and (B) their integration and contribution to
experience over time. The primary, core self is the most phylogenetically ancient and
therefore ontogenetically primary self a site of integration of integrative, evaluative
experience and agency. This is brainstem mediated. The secondary self stores with greater
precision the memories with greater powers of discrimination for evaluation, but finally the
tertiary self is empowered with the cognitive tools built on abstraction from primary
experience through its secondary process and considered ‘offline’. Cortically mediated.
These layers of processing are reflected in the artwork, “Profile of a collaged mind, finding
sense through fragment and movement autism as sensory motor disruption to core self”,
shown in Figure 2b.
Autistic Experience as a Disruption of the Primary Affective Self, and its Coherent
Integration with Secondary and Tertiary Processing
In this paper we examine lived autistic experience to reveal its nature in light of the vertical
organisation of mental processing. We build on self-reflection, scholarship, and dialogue
between Penelope Dunbar (Pum) and Jonathan Delafield-Butt, made in recorded interviews
about Pum’s life with autism over a period of five years, and placed into context of a

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TL;DR: A review of over 50 empirical studies of coherence suggests robust findings of local bias in ASD, with mixed findings regarding weak global processing.
Abstract: "Weak central coherence" refers to the detail-focused processing style proposed to characterise autism spectrum disorders (ASD). The original suggestion of a core deficit in central processing resulting in failure to extract global form/meaning, has been challenged in three ways. First, it may represent an outcome of superiority in local processing. Second, it may be a processing bias, rather than deficit. Third, weak coherence may occur alongside, rather than explain, deficits in social cognition. A review of over 50 empirical studies of coherence suggests robust findings of local bias in ASD, with mixed findings regarding weak global processing. Local bias appears not to be a mere side-effect of executive dysfunction, and may be independent of theory of mind deficits. Possible computational and neural models are discussed.

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TL;DR: Susceptibility to ASD has moderate genetic heritability and a substantial shared twin environmental component.
Abstract: Context: Autism is considered the most heritable of neurodevelopmental disorders, mainly because of the large difference in concordance rates between monozygotic and dizygotic twins. Objective: To provide rigorous quantitative estimates of genetic heritability of autism and the effects of shared environment. Design, Setting, and Participants: Twin pairs with at least 1 twin with an autism spectrum disorder (ASD) born between 1987 and 2004 were identified through the California Department of Developmental Services. Main Outcome Measures: Structured diagnostic assessments (Autism Diagnostic Interview–Revised and Autism Diagnostic Observation Schedule) were completed on 192 twin pairs. Concordance rates were calculated and parametric models were fitted for 2 definitions, 1 narrow (strict autism) and 1 broad (ASD). Results: For strict autism, probandwise concordance for male twins was 0.58 for 40 monozygotic pairs (95% confidence interval [CI], 0.42-0.74) and 0.21 for 31 dizygotic pairs (95% CI, 0.09-0.43); for female twins, the concordance was 0.60 for 7 monozygotic pairs (95% CI, 0.28-0.90) and 0.27 for 10 dizygotic pairs (95% CI, 0.090.69). For ASD, the probandwise concordance for male twins was 0.77 for 45 monozygotic pairs (95% CI, 0.650.86) and 0.31 for 45 dizygotic pairs (95% CI, 0.160.46); for female twins, the concordance was 0.50 for 9 monozygotic pairs (95% CI, 0.16-0.84) and 0.36 for 13 dizygotic pairs (95% CI, 0.11-0.60). A large proportion of the variance in liability can be explained by shared environmental factors (55%; 95% CI, 9%-81% for autism and 58%; 95% CI, 30%-80% for ASD) in addition to moderate genetic heritability (37%; 95% CI, 8%-84% for autism and 38%; 95% CI, 14%-67% for ASD). Conclusion: Susceptibility to ASD has moderate genetic heritability and a substantial shared twin environmental component.

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Abstract: The evolution of the autonomic nervous system provides an organizing principle to interpret the adaptive significance of physiological responses in promoting social behavior. According to the polyvagal theory, the well-documented phylogenetic shift in neural regulation of the autonomic nervous system passes through three global stages, each with an associated behavioral strategy. The first stage is characterized by a primitive unmyelinated visceral vagus that fosters digestion and responds to threat by depressing metabolic activity. Behaviorally, the first stage is associated with immobilization behaviors. The second stage is characterized by the sympathetic nervous system that is capable of increasing metabolic output and inhibiting the visceral vagus to foster mobilization behaviors necessary for 'fight or flight'. The third stage, unique to mammals, is characterized by a myelinated vagus that can rapidly regulate cardiac output to foster engagement and disengagement with the environment. The mammalian vagus is neuroanatomically linked to the cranial nerves that regulate social engagement via facial expression and vocalization. As the autonomic nervous system changed through the process of evolution, so did the interplay between the autonomic nervous system and the other physiological systems that respond to stress, including the cortex, the hypothalamic-pituitary-adrenal axis, the neuropeptides of oxytocin and vasopressin, and the immune system. From this phylogenetic orientation, the polyvagal theory proposes a biological basis for social behavior and an intervention strategy to enhance positive social behavior.

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