eye contact

Leaving my last doctor visit, I had a chance to check myself on their eye chart. It was not official–I just backed up 20 one-foot floor tiles and looked at the chart. For the first time ever I was not able to make out some of the letters in the bottom, smallest row. That means my eyesight is now 20/13 instead of 20/10, or however small the denominator was before I started grad school. (The numerator is distance in feet (in the US) and the denominator has to do, in a way that I don’t quite get, with the size of the letters.) If you can see better than 20/10, you generally never find out: 20/10 is good enough. And so is 20/13–I am not complaining. Not much, at least.

I’m more concerned with my focal length, which has moved out at least an inch during the last four years, to a solid 8.5 inches. This happens with aging, of course, but I am willing to bet it is accelerated by reading 30+ hours a week. It is inconvenient not to be able to see my spoonful of food clearly while I am blowing on it. It is also inconvenient that Reanna and I have no overlap in clear vision. When we are looking into each other’s eyes, we have to choose who gets to see clearly, or else she has to wear her contacts. I know it will someday be inconvenient when my focal length exceeds my reach, and I will need glasses to read a book. Ah, aging. As my friend Robert says, “Getting old is very inconvenient. It is better, however, than the alternative.”

Please remember that I post diagnostic criteria here because it is interesting to know what kinds of behaviors can get you what kinds of diagnoses, not so you can diagnose yourself, anyone in your family, or any of your friends. You just cannot be objective enough and it often leads to people walking around thinking they have Mental Disorders that they do not have. This is especially not good if that person is a child.

This may be especially true for Autism-Spectrum Disorders, which require a team of experts collaborating with the family to make a good diagnosis, including ideally a developmental pediatrician, a psychologist, a social worker, a speech language specialist, an occupational therapist, and a physical therapist. Also maybe a family advocate and an early interventionist.  And that’s just for a medical diagnosis. It varies by state, but often educational eligibility requires, additionally, a school psychologist, a behavior specialist, and an autism specialist.

Notice in the criteria below that diagnosis is made based on social problems, language problems, and repetitive/stereotyped behaviors. Other qualities that we may associate with Autism, such as pickiness about food or other things, sensitivity to noise or textures, visual processing problems, being easily upset, self-harming behaviors, and “splinter skills” are not part of a diagnosis for Autistic Disorder. Even with extreme versions of those qualities, you do not an AD diagnosis without fitting the criteria below.

And here are the criteria, word for word from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (p. 75):

Diagnostic criteria for 299.00 Autistic Disorder

A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):

(1) qualitative impairment in social interaction, as manifested by at least two of the following:

(a) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction.

(b) failure to develop peer relationships appropriate to developmental level

(c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)

(d) lack of social or emotional reciprocity

(2) qualitative impairments in communication as manifested by at least one of the following:

(a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)

(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others

(c) stereotyped and repetitive use of language or idiosyncratic language

(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

(3) restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:

(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

(b) apparently inflexible adherence to specific, nonfunctional routines or rituals

(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

(d) persistent preoccupation with parts of objects

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.

C. The disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder.

I read this sample of how to explain eye contact to couples a few weeks ago, in Brock and Banard’s Procedures in Marriage and Family Therapy (p. 71):

“Good eye contact is designed to communicate that the listener is paying attention to what is being said so that the speaker feels attended to. When good eye contact is present, a speaker usually does not need to get angry or resort to some other attention-getting strategy to make sure that the listener pays attention. Good eye contact consists of looking in the pupil of another’s eye and moving back and forth from eye to eye while the other speaks.”

I agree with all of that except for the last sentence. When making eye contact with your partner, do not shift from eye to eye. That kind of eye contact is better than nothing, but it’s not great. Shifting your eyes back and forth make you look nervous and shifty if you do it fast enough, and even if you slow it down you give the impression of looking at your partner’s face, rather than into their eyes. The same goes double for other popular advice about eye contact, like looking at your partner’s nose or hairline.

Here’s  how to make good, intimate-feeling eye contact:

1) Figure out which of your eyes is dominant. To do this, look at a small object that’s fairly far away, then make a circle around the object with your thumb and first finger. Close each eye and see which one has the object in the circle. That is your dominant eye–the eye that you really look out of. The other eye is more of a backup eye.

2) When making eye contact, look into the pupil of your partner’s eye that is directly across from your dominant eye. If your left eye is dominant, for example, look into their right eye. Check the other eye once or twice to see if that feels better, and stick with the eye that feels the most like you are looking into each others’ eyes. (The reason to check is that your partner may have the same dominant eye as you do, and thus across from your dominant eye. You don’t need to remember or even understand this, but if you’re interested, the ideal situation for eye contact is that you and your partner have opposite dominant eyes, one left, one right. That makes everything easy. If not, you end up figuring out whose dominant eye is more dominant and going that way. Try the procedure with someone you know and love and you’ll see what I mean.)

3) Remember that it can take some practice to do this and stay relaxed, but it is worth it. I recommend setting aside time with romantic partners to simply sit and look into each others’ eyes. And make plenty of good eye contact when talking with each other.

4) Remember also that different people of different cultures may have different reactions to direct eye contact. And I don’t just mean people from other countries. There are  people in eye-contact-making cultures who can’t stand to make eye contact for more than a fraction of a second. Be sensitive to this. Do not force eye contact on anyone. I’ve seen dancers who crane their heads to catch and keep their partner’s eyes and it makes the partner uncomfortable. Remember that there is the I’m-just-looking-at-your-face strategy and the even less intimate I’m-just-looking-at-your-face-every-once-in-a-while strategy.