For human beings, eye contact is a particularly critical means of gathering information from people we encounter; for safety, socialization, contributing to our decision-making, etc. It is a behavior that is critical to our interaction and communication with others. Eye contact is perceived differently across cultures. For some, sustained eye contact is socially inappropriate or rude. In our culture, poor eye contact is associated with everything from shyness, lying to neurodevelopmental disorders such as Autistic Spectrum Disorder.

Vision is the most hard-working of our five senses, virtually processing information non-stop, even as we sleep. The volume of information it processes is truly remarkable, other sensory systems having more “down time.” You may remember in grade school or even junior high school having “staring contests”. We would stare into each other’s eyes; the first to look away “lost the competition.” What was the logic behind the response? Why did we look away? The most basic answer is “because it became uncomfortable.” Persistently staring into someone’s eyes over-stimulates the sensory system, creating the discomfort experienced in the form of neurogenic irritability or anxiety.

Poor eye contact is a significant observation in understanding the logic of an individual’s behavior, potentially contributing to diagnosis and treatment. For an individual experiencing high levels of “over-stimulation” (e.g., anxiety, stress, neurogenic irritability), eye contact is particularly overwhelming. Accordingly, patients with high levels of “over-stimulation” have a difficult time initiating and maintaining eye contact, tending to look away most of the time. In more extreme forms, diagnosis of autism or autistic spectrum disorder is suggested for limited or absent eye contact. For those individuals, eye contact can become uncomfortable emotionally or psychologically, some even describing it as “painful.”

With this understanding, it is unsettling to hear of therapists suggesting to parents that they need to prompt eye contact to the point of forcing it. Such intervention should be considered very carefully. Limited eye contact most commonly reflects an “over-stimulated” nervous system (i.e., brain), suggesting a need to reduce that level of stimulation. Environmental control, anti-anxiety medication, sensory integration therapy and neurofeedback are all options of consideration. Reducing the arousal level, along with high levels of positive reinforcement, eye contact will likely improve, approaching what might be perceived as “normal” eye contact.