Sherlock Holmes: autistic or sociopath?

I am a brain, Watson. The rest of me is mere appendix.

Sherlock Holmes

Sherlock Holmes

Holmes. Sherlock Holmes. The New York Times has diagnosed him as being on the autism spectrum.^[1]Hidden Clues | The New York Times But there are others who say that he is a sociopath, in particular Sherlock portrayed by Benedict Cumberbatch.

Sherlock Holmes

So what diagnosis might good ol’ Holmes have? Let’s discuss the evidence.

Diagnosing fiction

It is obviously impossible to diagnose a fictional character. We can do no psychometric testing, nor a psychological interview to confirm or rule out our hypotheses.

That said, the fact that fans debate whether or not Holmes is autistic or not—or whether he is psychopathic or not—speaks to how the public perceives autism and sociopathy/psychopathy. It is interesting that there is so much confusion about what kind of personality he is at all.

The challenge of deciding what diagnosis he might have is further confused by the numerous portrayals in shows and movies that have depicted him.

For the sake of this answer, let us look at the original Holmes that the author Arthur Conan Doyle created for the detective novel A Study in Scarlet, published in 1887.

Arthur Conan Doyle

Watson’s account

Sherlock Holmes’ sidekick, Dr. Watson refers to Holmes as distant, callous, unknowable, and inexplicable.

Dr. Watson

Interestingly, these are attributes often used to describe autistic people. It’s incorrect that we are callous, but we can certainly come off that way sometimes, for instance when we respond with an apparent lack of empathy because a situation and/or the state of mind of another person is not understood. Hans Asperger made the same mistake in 1944, and described his subjects as having:

A lack of empathy, little ability to form friendships, one-sided conversations, intense absorption in a special interest, and clumsy movements.^[2]Asperger’s Syndrome: A Guide for Parents and Professionals

For more information on autism and empathy, have a look at:

Autism & empathy

Cold-blooded

When I hear the word cold-blooded in reference to a person, the first thing I think of is psychopathy/sociopathy and callousness, and I think most people would share these connotations. But in context, is that actually what cold-blooded means in reference to Sherlock Holmes?

Lisa Sanders M.D. writes in The New York Times:

He [Holmes] appears oblivious to the rhythms and courtesies of normal social intercourse—he doesn’t converse so much as lecture. His interests and knowledge are deep but narrow.

He is strangely “cold-blooded,” and perhaps as a consequence, he is also alone in the world. He has no friends other than the extremely tolerant Watson; a brother, even stranger and more isolated than he, is his only family.^[3]Hidden Clues | The New York Times

On all accounts it seems Doyle’s Sherlock shows distinct autistic traits. The cold-bloodedness I think is a sort of sinister way of saying Holmes seems to have reduced affect display, which is also seen in autism. What this means is that a person outwardly does not express much in terms of emotions, even though internally they may feel emotions very deeply. The issue then is that autistic people are often perceived as cold or robotic, while quite the opposite is true. Sherlock seems to be driven by passion, in any case. Passionate objectivity, as one paper on Sherlock Holmes puts it.^[4]Passionate objectivity in Sherlock Holmes This is something that resonates strongly with us (Natalie and Martin, as well as a lot of other autistic people we know), as we try to be as objective as we can, and have a deep interest in facts and truths.

So was Doyle presenting autism/Asperger syndrome as he had observed? Or perhaps a personality disorder or mental illness that had not yet been described in the medical literature? Or was Holmes merely an interesting character created from scratch? Whatever the case may be, it’s interesting that the first Sherlock Holmes novel was published 39 years before Asperger syndrome was first described (by Grunya Sukhareva),^[5]The first account of the syndrome Asperger described? Translation of a paper entitled “Die schizoiden Psychopathien im Kindesalter” and 57 years before Hans Asperger would describe the condition.^[6]On the origins and diagnosis of asperger syndrome: a clinical, neuroimaging and genetic study

Incidentally, though, the first Sherlock Holmes novel was published in the very same year John Langdon Down gave a lecture on what would later be regarded as autism with high-support needs.^[7]Review of: On some of the mental affections of childhood and youth / J. & A. Churchill, 1887

For more information on the history of autism, have a look at:

A timeline of autism classifications

Let’s take a step away from Doyle for a moment, and consider his inspirations.

Inspiration

Sherlock Holmes was in part based on—and certainly inspired by—Doyle’s former university teacher, Joseph Bell.

Joseph Bell

Joseph Bell learned from his grandfather, Benjamin Bell—who is considered to be the first Scottish scientific surgeon—the importance of close observation in making a diagnosis. Joseph Bell would, for example, by observation of strangers deduce their occupation and recent activities. Bell once remarked to an outpatient:

I know you are a beadle and ring the bells on Sundays at a church in Northumberland somewhere near the Tweed.

Astonished, the outpatient responded:

I’m all that, but how do you know? I never told you.

Bell addressed the others when the outpatient had left bewildered:

Ah, of course, gentlemen, you all know about that as well as I did. What! You didn’t make that out!

Did you not notice the Northhumbrian burr in his speech, too soft for the south of Northumland? One only finds it near the Tweed. And then his hands. Did you not notice the callosities on them caused by the ropes?

Also, this Saturday, and when I asked him if he could not come back on Monday, he said he must be getting home tonight. Then I knew he had to ring the bells to-morrow.

Quite easy, gentlemen, if you will only observe and put two and two together.^[8]Dr. Joe Bell: Model for Sherlock Holmes

This sounds amazingly like Sherlock Holmes, does it not?

Bell’s focus on observation and deduction based on character and objective features strikes me as an early stage of forensic profiling. Not that profiling was new in that time per se (profiling techniques existed as early as the Middle Ages), but nevertheless Joseph’s skills stood out, and in fact he was considered a pioneer in forensic science, and in particular forensic pathology.

This is at a time when science was not yet widely used in criminal investigations. For reference, Bell was 51 when Jack the Ripper struck in 1888, and in fact Bell gave his analysis of the Ripper murders to Scotland Yard. Bell was also involved in several other police investigations, including the Ardlamont Mystery of 1893.

Note that Holmes is known for many of the things that Bell was known for; Holmes is proficient in observation, forensic science, and logical reasoning that borders on the fantastic (as does Bell’s!), and similar to Bell, Holmes investigates cases for a wide variety of clients, including Scotland Yard!

From Bell to Doyle to Holmes

In 1892—five years after A Study in Scarlet was published—Doyle wrote a letter to Bell, stating:

It is most certainly to you that I owe Sherlock Holmes […] round the centre of deduction and inference and observation which I have heard you inculcate I have tried to build up a man.^[9]Letter to Mr Bell about Sherlock Holmes (4 may 1892) | The Arthur Conan Doyle Encyclopedia

Years later in 1924, Doyle further remarked in his autobiography, Memories And Adventures:

It is no wonder that after the study of such a character [Bell] I used and amplified his methods when in later life I tried to build up a scientific detective who solved cases on his own merits and not through the folly of the criminal.^[10]Memories And Adventures

So Doyle was inspired by his teacher’s methods of deduction, inference, and observation. But of course it says a lot about Doyle himself, that it’s precisely these methods—tools with which the truth can (often) be revealed—that he admires and utilizes in his detective novel, which is something arguably not seen before in novels.

It’s interesting that it’s these tools that made such an impression on Doyle, because in our experience autistic people—ourselves and the people we interact with, anyway—have a deep desire for learning, getting to the truth, and understanding the world we live in—as well as reality at large—and how we relate to it. It seems we have a sort of academic spirit, though admittedly this may be a personal bias.

At the very least, there is a subgroup of autistic people for which Sherlock Holmes embodies quite a few of the traits, skills, and principles which they also possess or live by.

Physician

So we just talked a lot about Doyle’s inspiration for Holmes—his university teacher and professor at the University of Edinburgh Medical School. Arthur Conan Doyle was in fact trained as a physician, and he imbued his Sherlock Holmes novels with his medical knowledge.

Like his character Sherlock Holmes—as well as his teacher Joseph Bell—Doyle was adept at recognizing symptoms, and is suspected to have recognized a number of diseases well before they were identified.

His Sherlock Holmes stories are filled with detailed and accurate descriptions of medical disorders. Some theorize that he may have recognized autism or perhaps autistic savants.^[11]Hidden Clues | The New York Times

Symptoms

Let’s have a look at some of the autistic symptoms we can observe in Sherlock Holmes.

Autistic intelligence

• Holmes has fluid intelligence—an ability to see the world from a very different perspective than most people, often by focusing on details overlooked by others.

Drug use

• Autistics have a higher than average addiction rate.

Read more about autism and addiction here:

Autism & addiction

Family members

• Sherlock Holmes’ brother, Mycroft Holmes, may be on the autism spectrum; he is more distant and unique than Sherlock.

Sleeping problems

• While working, Holmes seems inexhaustible—not sleeping for days. Between cases, he sometimes falls into a state of deep lethargy.

Social differences

• Holmes is oblivious to the rhythms and courtesies of normal social intercourse—he doesn’t converse so much as lecture.
• Holmes lacks (apparent) emotionality (lack of affect).
• Holmes lacks friends, other than Watson.

Special interests

• Holmes frequently talks of his detailed knowledge of all kinds of strange phenomena.
• Holmes’ interests and knowledge are deep but narrow.
• Holmes has extensive knowledge of odd subjects, and is said to have written a monograph on the distinctions between 140 different types of cigars, pipes, and cigarette ashes.

Weak theory of mind

• Holmes often seems oblivious to what others are thinking or feeling, even his dear Watson.

Diagnoses (suspected)

Other diagnoses that have been suggested for Holmes:

• Bipolar disorder — It turns out we share a gene, and many of us are misdiagnosed with bipolar disorder).
• Sociopathy — We are commonly misdiagnosed with sociopathy by laypeople. In fact, in many ways, autism could be regarded as the opposite of psychopathy, although our lack of affect/reduced affect display can be confused with a lack of emotions.

Read more about the confusion between autism and psychopathy in Natalie’s Quora answer to the following question:

Why have many people with high-functioning autism thought
they might be psychopathic before they got diagnosed with ASD?