By Darold Treffert, MD
Savant Syndrome raises many questions. But two especially intriguing questions are of particular importance: (1) How do they do it? and (2) What does savant syndrome say about hidden potential, perhaps, within each of us. The answer to the first question, addressed in sections elsewhere on this site, provide some clues to answering the second question. My answer to that second question: “Does some Rain Man ability — savant-like skill and capacity — exist in each of us?” is Probably so. Let explain me why.
There is evidence that some savants, because of prenatal, perinatal or postnatal central nervous system damage, from a variety of genetic, injury or disease processes have substituted right brain capacity in a compensatory manner for left brain dysfunction and limitation. Simultaneously, because of those same injurious factors, these savants have come to rely on more primitive cortico-striatal (procedural or habit) memory rather than higher level cortico-limbic (semantic or declarative) memory. This combination of right brain skills coupled with procedural memory produces the constellation of abilities and traits that is savant syndrome.
But that more primitive memory circuitry, and right brain capacity, both still exist in each of us. However because of their inherent, utilitarian usefulness we have generally come to rely more heavily on left ( dominant) hemisphere functions such as language, logical and sequential thinking, for example, than on right (non-dominant) hemisphere skills. Likewise in our day to day functioning we have come to generally use and depend upon semantic or declarative memory much more than usingour more primitive, and less facile, procedural or habit memory capabilities. The question becomes then, is it possible to tap and use those still existent, but less frequently used, capacities and circuits, with some of their savant-like characteristics, in those of us more wedded to left brain capacity and higher level memory? In that sense is there some Rain Man within each of us? I am convinced there is.
What evidence is there for that possibility? The most compelling evidence comes from what I call “acquired savants”–previously non-disabled persons who after some injury or disease begin to demonstrate some, until then, dormant savant characteristics and capacities. One such case was reported as early as 1923 by Minogue (“A case of secondary mental deficiency with musical talent,” Journal of Applied Psychology 7:349-357). In this case musical genius appeared at age 3 following meningitis. Brink described the case of Mr. Z who demonstrated savant skills, behavioral traits and abilities that emerged at age 9 following a bullet wound to the left hemisphere, leaving him paralyzed on the right side, mute and deaf but with some special mechanical abilities and other savant skills. Alonzo’s sculpting talent emerged following a head injury as young child. A now 20 \-year-old shipyard worker developed calendar calculating skills and a spectacular memory for days, dates, music and a wide variety of other materials following an injury to the left side of the head at age 10. These cases and others are described in greater detail in Extraordinary People.
As a matter of fact many instances of savant syndrome represent the ‘acquired’ form of that condition (as opposed to genetic or some other inborn defects) even though not generally referred to as such. They are ‘acquired’ savant syndrome in that before, during or after birth some central nervous system (CNS) injury occurred leaving the left hemisphere and limbic memory circuitry damaged as described above, with right brain and habit memory compensatory takeover of the type seen in many savants. Both the mental handicap and savant abilities then emerge as the infant grows older. To this point the term ‘acquired’ savant has been generally reserved for those who suffered some CNS injury or disease in later childhood or adult life but these prenatal, perinatal and postnatal damages (including testosterone as a neurotoxic agent discussed elsewhere on this site) should rightly be included as etiologic causes in the “acquired” savant.
In the case of the prodigious savant particularly, the question arises as to whether without this CNS damage the person would have been emerged a genius in their particular skill area anyway but without mental handicap? Or does the genius in the prodigious savant represent skills and abilities that were created specifically and only because of some compensatory changes elsewhere in the brain, or perhaps from even paradoxical facilitation, due to the CNS injury itself? For a variety of reasons, I favor the latter possibility.
The most interesting new findings regarding such “hidden’ potential” come from the work of Dr. Bruce Miller and his coworkers as described in the October, 1998 issue of Neurology and summarized elsewhere on this site. In that article the researchers describe five cases of older adults who acquired new artistic skills with the onset and progression of fronto-temporal dementia (FTD). While the emergence of such savant skills following CNS injury or disease in early life is not new, the uncovering and unfolding of such new skills in previously non-disabled, older adults is most intriguing. Consistent with the findings in other savants, in these older persons whose artistic skills and abilities emerged after the onset of FTD, the creativity was visual, not verbal; the images were meticulous copies that lacked abstract or symbolic qualities; episodic memory was preserved but semantic memory was devastated; and they exhibited intense obsessive preoccupation with their art skills. Imaging studies showed a predominance of left brain injury. These researchers hypothesize that selective degeneration of the anterior temporal and orbitofrontal cortex decreased inhibition of visual systems involved with perception, thereby enhancing artistic interest and abilities–artistic interest and abilities relatively dormant until the FTD disease, with its compensatory processes, released those abilities and hidden potential within.
In more recent work (in press) Miller has expanded the number of cases to 12 individuals who acquired or sustained new savant skills in art or, now including musical abilities in some instances, despite the progression of their dementia of the FTD type. Miller’s paper on Artistic Savants (see New Findings and New Resources on this site) reaffirms the emergence of new artistic skills in some persons with fronto-temporal dementia and the left-sided foci of those changes, but he goes on to compare the functional brain imaging findings in those six older persons, previously non-disabled, with the imaging findings in a nine year old savant artist (DB) noting “remarkable parallels” between these two different age groups — with shared artistic abilities — that involved loss of function in the left temporal lobe and enhanced function in the posterior neocortex. The similarities of neuropatholgy as demonstrated with SPECT imaging in these two very different age and disability groups, who share savant artistic skills in common, is striking and intriguing.
Drs. Alan Snyder and D. John Mitchell of the Centre for the Mind in Australia share the impression that “the mechanisms for certain savant skills reside equally in all of us but cannot normally be accessed,” however they propose a different reasons than those I hypothesize. They discuss their hypotheses in a paper entitled “Is integer arithmetic fundamental to mental processing?: the mind’s secret arithmetic” in Proceedings of the Royal Society of London (1999) 266:567-592. Essentially they propose that savant skills represent brain processes that occur in each of us regularly (or could) but they are swamped and buried by more sophisticated conceptual cognition and the savant-like capacities remain largely at an unconscious level. Autistic savants, they conclude, “have privileged access to lower levels of information not normally available through introspection… we all have the same raw information but just cannot directly access it, at least on call.” They believe “all savant skills have a common origin and the skill for interger arithmetic (like that for drawing, perfect pitch and recall for meaningless detail) arises from an ability to access some mental process which is common to us all, but which is not readily accessible to normal individuals.” An article in New Scientist (Volume 164, October, 1999) entitled “Turn Off, Tune In” by Rita Carter describes the conclusions of a number of researchers, including the theories above, regarding the savant skills that may reside within each of us.
The concept of “cerebral refreshment,” also elaborated upon elsewhere this site, adds strength to the concept of buried potential within each of us by suggesting that there is a constant renewal of neurons, and, even more pertinently, that there are “”of stem cells in the CNS that perhaps can be triggered into producing even more new neurons with CNS injury or disease Perhaps in fact that same triggering occurs prenatally, for example, with CNS injury. Several persons have described to me recently such a triggering and renewal process that occurred in them, in some manner, either by renewal or rerouting, following a head injury or stroke which had left at first significant incapacity, but was followed by impressive later improvement.
So what might all of this mean? First, in my view it means that in each of us some of the same circuitry and pathways intrinsic to savant functioning still exist, but are less used for all the reasons outlined above. Second, each of us can, with some effort, tap more right brain capacity and habit memory than we typically use. We tend to be a left-brain, declarative memory society. Sometimes though with retirement, for example, a number of older persons “discover” hidden or latent talent as they have the time and inclination to do something different — without a dementia freeing up that hidden capacity in their instances. TIME magazine described that as “Catching Their Second Wind” in a 1/31/2000 issue. Grandma Moses of course is a stellar example of that. While without doubt, in my view, some such “discovery” comes from psychologically having the time and freedom to pursue sidetracked interests and talents after the pressures the workplace and child-rearing are lessened, some of that discovery comes also, I am convinced, from being able neurologically shift, by deliberate design and effort, from the well worn left brain/sematic memory circuits to still intact, but relatively less frequently used, right brain/procedural memory circuits.
I liken the phenomenon of experiencing a new capacity or capability by deliberately changing mind-set and mind-circuitry to the popular stereograms in which one first sees only a series of dots. But then, by “changing set” in terms of focus and eye dominance apparently, in the case of stereograms, all of a sudden — aha! — there it is, the three dimensional dinosaur or grizzly bear the caption said was present, but remained unrevealed until “something happened” internally to allow the hidden image to emerge. The dots on the paper did not change, but one’s perception and interpretation of that series of dots was altered dramatically with an affirmative and deliberate effort to experience that transition. In like manner, but by an entirely different mechanism, it appears in some instances in each of us it is possible to tap different areas of CNS functioning than typically or customarily used with a freeing up of, and possibility of tapping into, dormant abilities and habit memory capabilities.
Several young adults have recently described to me how after a severe concussion, or stroke, they ‘changed’ and while not left severely disabled, they now have began to tap abilities and traits seemingly hidden or covered until that injury or incident occurred. In the opposite manner, a woman who wrote to me after Extraordinary People was published described how at mid-life she decided to give up her professional career as a doctor and become a concert pianist. She had always been able to play quite impressively ‘by ear’ but went to a conservatory, in those later years, to become more polished, and more learned. When she did that, and when she deliberately substituted reading music for playing by ear, the ability to play by ear suddenly vanished. In her case her musical capacity migrated from the right brain (playing by ear) to the left brain (playing by reading music) and in that process she apparently lost substantial right brain access. This woman’s experience mirrors what PET scans on musicians have shown, that is, that rather than there being a single musical center of the brain, it depends on which strategy is being used (analytical and visual— play by sight=left brain and non-analytical and subjective— play by ear=right brain) as to which hemisphere is more involved. I describe this work by Dr. John Mazziotta and his colleagues in greater detail in the book. There I also describe the enlightening experience of a graduate student who set out to deliberately ‘learn’ how to calendar calculate. He did so rather slowly until at some point he discovered his speed increased dramatically as his brain, to his surprise, had somehow automated the complex equations and he no longer had to consciously carry them out. Dr. Bernard Rimland who reported this case in Psychology Today in August 1978 speculated that in this instance there was some migration of function from left hemisphere to right hemisphere.
To some degree each of us has experienced the “I’ve got it” experience whether in finally learning to ride a bike, doing our algebra or learning a new language. After that, the process, whatever it might be, becomes more automatic and less conscious. So migration from one brain area to another, and from semantic memory to “memory without reckoning” occurs regularly throughout life. The question is whether one can by other deliberate effort tap hidden skills and abilities, if present, by accessing and harnessing circuits and brain areas ordinarily used less regularly. I think so. I add ‘if present’ to that possibility because of another piece of this complex equation, something one might call innate talent.
We tend to think of ourselves as being born with a fantastic piece of hardware — the brain — and a huge blank drum — a hard disk for memory. We become then, it is often thought, a product of what experiences and learning we put on that blank drum as our life proceeds. In the case of prodigious savants particularly, however, the only way their spectacular ability can be explained — since so many of those have such prodigious skills early in life and in some instances are so mentally impaired as seemingly incapable of learning — is by what I refer to as “ancestral memory,” or the genetic transmission of knowledge. These individuals come heavily endowed from birth with what might be termed “software,” if you like, to carry the computer analogy further. Such a differential endowment of “software” — innate ability or talent — is distributed to all of us, non-disabled or disabled persons alike, in the usual bell-shaped curve. Thus within each of us, it seems to me, is not necessarily the talent of a Picasso or Mozart, for such prodigious ability is rare on that bell-shaped curve for all persons, disabled or not. But we do each have differential endowments of various inborn talents and abilities. Some of us are more musically inclined than others. Some of us are more mechanically inclined, mathematically inclined, athletically inclined than others and so forth. What direction and strength our buried talent might take, should that be tapped by disease or injury, as in the case of the FTD patients described above for example, or by design and determination as might be possible as suggested here, would be determined, as in the case of savants, by some of these genetic factors beyond exposure and learning opportunities.
In the case of the prodigious savant, it appears to me, there is a marvelous coalescence of idiosyncratic brain circuitry from all the factors mentioned above perhaps involving right hemisphere and habit memory compensatory processes, coupled with magnificent innate ‘software’, obsessive traits of concentration & repetition and tremendous encouragement & reinforcement from family, caretakers and teachers. Does some of that same possibility, a little Rain Man as it were, perhaps reside within each of us? I think that it does, for all the reasons above. We now have the technology to view the brain at work, not just it’s structure, and from these incredible new windows into brain will come, over time, the “final answer.”
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For more information, please contact:
Darold A. Treffert, MD
St. Agnes Hospital, Fond du Lac
Wisconsin Clinical Professor, Department of Psychiatry University of Wisconsin Medical School, Madison
Personal Website: http://www.daroldtreffert.com