John Elder Robison's Rocky and Exciting Journey in 'Switched On: A Memoir of Brain Change and Emotional Awakening'

Sarah Reader, June 13, 2016

(Photo:  Penguin Random House)

In John Elder Robison’s latest book on the subject of autism, the author describes in captivating detail his participation in experiments on a new brain therapy that could be a game changer for people with autism.  Robison himself has autism, and in his previous books has described growing up different without knowing why he was an outsider in Look Me in the Eye, given tips to autistic people and for living and working with autistic people in Be Different, and provided an intimate glimpse into raising his son Jack who is also on the autism spectrum in Raising Cubby.  His fourth book, Switched On, provides a thorough account of his participation in experiments on transcranial magnetic stimulation (TMS) as a therapy for autism.  This therapy has previously been used with success on patients with depression. 

            Robison grew up in a family scarred by mental illness and was always an outsider in the worlds of school and work, never staying on the beaten path but doing very well for himself all the same.  Without a college education, he worked for the band KISS, designing their flaming guitars.  Later he went on to work for a toy company and engineered the first speaking toys.  Currently he owns JE Robison Service, a repair shop specialized in imported cars in Springfield, Massachusetts, works as a freelance photographer, author, and is an autism speaker, educator, and consultant.   When Robison was 40, a friend carefully suggested to him that he may be on the autism spectrum.  Robison chose to explore this, and was in fact diagnosed with autism as an adult. 

            In Switched On, Robison describes how his understanding of the world and his relationships changed as a result of the TMS treatments.  Further, he provides a glimpse into the science behind TMS, the procedure itself, and the history of brain study and brain therapies.  The detail in which the author describes the history of neuroscience and some early studies using animals and human patients is at times uncomfortable and difficult to listen to.  At the same time, it is truly fascinating to have the current TMS experiments put into a historical perspective and to consider how people might view today’s experiments from an ethical standpoint one hundred years from now.  Robison describes the process he underwent right from the beginning, from being approached to participate in the study, signing the consent forms, and going through the first rounds of the experiment.  Listening to Robison explain how he felt going into the hospital and preparing for the experiments, along with the questions he asked the researchers, gives a rare and riveting account of the TMS process, not just from the technical side, but also from the patient’s perspective.  I find Robison’s detailed narratives to be one of his great strengths as an author, but some listeners may find the precise descriptions and technical terminology uninteresting or even annoying.

The doctors conducting the TMS study with Robison and other autistic adults repeatedly told the patients that they might experience changes in their emotions and perceptions, but that the changes would be temporary:  the effects of TMS weaken and disappear over time.  However, they did not mention what kind of changes the patients might notice or what exactly they were looking for in the study, leading Robison to wonder just what was going to happen to him.  This did not deter him; rather, he forged ahead to participate in the study.  His account of the changes in emotions that he felt himself, reading others’ emotions, and even hallucinogenic experiences following TMS treatments were gripping and, at times, even frightening.  It was truly valuable at this point to have read John’s previous books and have already become familiar with his reflections on his interactions with others and his personal experience of the world as a person with autism before diving into Switched On.  He always does an excellent job describing how he experiences the world, and his report in Switched On about his changed emotions and altered perception of others’ feelings and the world around him is phenomenal.

This book is not in any way advertising for TMS as a “cure” for autism.  There is a lot of pseudoscience circulating about the causes of autism and treatments or cures for it, feeding a lot of false hope in particular to parents of autistic children. This book does not do that.  It is an honest account of Robison’s personal experience with TMS treatments.  He examines the treatment from all sides, providing a gripping account of his experience, but also demonstrating the potential of the human brain to change and make new connections, once again underscoring the concept of brain plasticity which he has written about in his previous books.

            Being familiar with Robison’s outspoken position as an autism advocate in favor of acceptance for people who vary from the norm, people who are not neurotypical but exceptional, I was very curious about his experience with TMS and its effects on his inner life, understanding of the world, and his interpersonal relationships.  Switched On presents a detailed and fascinating account of one autistic man’s experience undergoing TMS, but looks at the treatment from a number of perspectives and considers drawbacks, limitations, ethical questions, and dangers of the treatment as well.  Switched On was another of Robison’s books that left me wishing the book wouldn’t end, wondering, “What’s next?”  The audiobook version is an absolute pleasure to listen to.  The opportunity to hear John himself telling the story of his journey with TMS in his clear and even-keeled voice was enthralling.  Listeners who have heard Robison speak or listened to one of his earlier audiobooks will notice the change in his voice following the TMS treatments.  Previously his voice had an almost robotic quality, now he has added prosody in his still calm and crisp voice.  The only drawback I found to listening to the audiobook is that I did not have the opportunity to reread some of the technical descriptions of the treatment or other passages that I would have liked to read a second time in more detail.  Overall, this book is an outstanding memoir on one man’s perception and changes he experienced as a result of the TMS experiments and is fascinating for anyone with an interest in autism or how the brain works.  

Penguin Random House, 2016, 690 minutes, Audio CD $40, Audiobook download $20