Mirroring, eye problems, and ADHD

In a couple of earlier posts, I introduced the idea of mirroring and how mirroring affects us and our understanding of others. In most human interactions, mirroring is combined with linguistic behavior and semiotic assumptions. We have called these three taken together LSM (Linguistics, Semiotics, Mirroring). There is more to what happens between people than LSM, but it is useful to highlight just those three factors because they give us a way to gain quick insight into many situations. (For the earlier posts, see Mirror neurons and LSM and How greed is mirrored in social groups.)

What I want to discuss today is how certain American assumptions about what constitutes proper mirroring can lead to very serious mistaken interpretations. Most of us know that American culture requires people to look directly at each other when they speak. We associate a direct gaze with forthrightness, honesty, sincerity, respect, and more. Most parents openly teach their children to look directly at any adult who is speaking to them, to not avert their gaze or let their eyes dart around while they are listening.

This cultural prescription is so widely known and accepted, many Americans don’t even realize that it is not a universal human trait. In many cultures, a direct gaze is a sign of aggression and children are taught not to do it. In those cultures, children are taught to look down or look toward the person but not directly into their eyes. If children in those societies act in the way American children are supposed to, their teachers will think they are defiant and need to be disciplined.

Anyway, one way the requirement for a direct gaze in American culture causes a truly serious problem is a good many children are physically not able to do it.

One fairly common reason some children are not able to do it is they have problems with eye alignment (strabismus). Something like 1/20 children have strabismus and very often their condition is not even noticed, not even by their eye doctors. Strabismus causes eye-strain and difficulty in holding a steady gaze. Children with strabismus often look inattentive–they may tip their heads to the side, seem not to notice things (because they really don’t see them); they may close one eye or appear to be fidgeting, or worst of all “acting disrespectful” to their teacher or other adults. And, sadly, this all too often leads to a diagnosis of ADHD.

Far too many doctors who prescribe medication for children accused of (diagnosed with) ADHD do not know that strabismus could be the actual problem. Now, strabismus is definitely not ADHD, so when a child with strabismus is medicated for a brain problem, they are being harmed twice–once for the wrong diagnosis and failure to treat the actual problem and once for giving them dangerous meds when they don’t need them.

It gets worse. Strabismus is only one type of eye problem that can lead to a misdiagnosis of ADHD. The National Resolution of the NAACP claims: “…current research indicates that approximately 1 in 4 children has [eye] vision disorders that….mimic attention deficit disorder…” (Source)

Spend a few minutes perusing this page ADD/ADHD Attention Disorders, Eyesight, Vision, Diagnosis, Treatment and you will find many links and descriptions of this problem, which to this day is still hardly recognized in the USA.

Now that means that a good many children in American schools are being diagnosed with and treated for ADHD when all they have is a problem with their eyes. Simple eye problems may also be the cause of misdiagnoses for dyslexia, learning disability, developmental disability, ODD, and more.

Back to mirroring. The core problem with misdiagnoses of strabismus is these children have trouble doing the American direct gaze thing. Their eyes don’t work that way. Many of them just can’t do it. They are physically not able to mirror a direct gaze, which supposedly shows how honest and respectful they are.

This causes teachers, parents, and even doctors to form a mistaken impression of these children. Rather than notice their eye problems, these people (and it usually takes all of them) have relied on the erroneous cultural understanding that people can be reliably judged by how steady their gazes are.

What a tragedy of ignorance. Welcome to the human race. Ponder the above for a moment–doctors, teachers, and loving parents in concert can so completely misunderstand their own mistaken views of human nature and/or cultural demands that they actually prescribe medications to treat the brain of a kid with eye problems. This state of affairs shows really well how deeply entrenched cultural assumptions are. Our cultural requirement for a direct gaze is so deep in us most Americans are incapable of seeing an eye problem even in their own children/students/patients. All they see is a failure to mirror in the prescribed way and from that they conclude that medication for the brain is what is needed.

I wonder if Asian cultures (which do not require direct gazes from children) are doing better in school stats simply because they are not causing harm to students who have strabismus or other eye problems. I lived in East Asia for a long time and was often struck by how much more variety of facial and ocular expression is allowed in those societies than in America.

In Asia, the inevitable social hierarchy requires obedience, loyalty, and showing up. Clean clothes and a washed face also help, but the main requirements are obedience, loyalty, and showing up most of the time.

In contrast, in America our hierarchies also require direct gazes. The problem with this begins in school–bright kids with eye problems are treated for behavior problems. But it continues in adult life–those same kids grow up and enter the world of work. For the moment, ignore all of the problems caused by misdiagnosis and resulting poor education and other misunderstandings. Let’s just focus on the eyes of those adults–most of them still have the same problems. It’s a strain for them to mirror the American direct gaze. They couldn’t do it when they were kids and they still can’t do it as adults. So, just as they were misdiagnosed as kids, they will be misjudged as adults. They will appear shifty, uncommitted, inattentive, dishonest, disrespectful, etc. Something is not going to look right to far too many Americans. This means we have a culture that has evolved a social hierarchy where people without eye problems have a stronger hold on our hierarchies than they deserve. And this means we are wasting talent and putting people in high places just because they can do the direct gaze thing. Pretty fucking stupid, if you want my opinion. But it’s a great example of how deeply we can be affected by cultural mirroring.

2 comments on “Mirroring, eye problems, and ADHD

  1. John Crane says:

    Thank you for your ideas. Might I add that generally (and personally), people with strabismus mostly have a natural aversion to making any eye contact for obvious reason (appearance).
    At the same time most of us seem to be aware of the American axiom “look ’em straight in the eye an’ give ’em a strong hand shake”. Gee what more simple instruction could a shyster or a con artist need to acquire a fools trust?

    That aside, I was looking for information on the direct association between strabismus and mirror neurons that must exist. My mirrors don’t really see all that is an others face and all the nuances and reactions and they don’t see mine. I tend to think that is a large part of the lifelong developmental and ostracizing problems of my ilk.

  2. ABN says:

    I agree that strabismus is a lifelong condition, even if surgically corrected. The science on mirroring and mirror neurons is still not settled, but I am all but certain that strabismus will affect how people with this condition mirror others in most cases.

    I have the condition myself and seem also to have trouble recognizing faces. I have not looked into this area much, but from shallow reading have learned that strabismus may cause a condition similar to “face blindness” (prosopagnosia). This makes sense because if you don’t see well and find it difficult to hold a steady gaze, you will be likely to have poor facial recognition skills.

    That said, we are in good company. Lots of healthy people have strabismus and enjoy their lives (Abe Lincoln, for one). I think the condition has been limiting for me and at times a real burden, but when one area of activity is blocked, the brain often finds another outlet. Strabismus may “encourage” (force) us to use our minds more creatively and to develop other senses and cerebral functions more. I have had the condition long enough to know that it can be viewed as having some advantages, despite its obvious disadvantages. What gets me is the condition is quite common (around 4% of the US population) but very poorly understood by those who do not have it. But isn’t it true that we all have something or deviate from the norm in one way or another?

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