The Brutality of Dr. Bettelheim

Dr. Bruno Bertelheim

Devoted most of his time

Condemning mothers to perdition

By blaming them for their autistic child's condition.

Friend Armand T. Ringer composed the above clerihew after reading a first draft of this column. It is an accurate statement about the enormous harm that can be done by dogmatic, closed-minded Freudians.

Estimates of the number of children afflicted with a broadly defined autism vary from one in a thousand to one in 250. It is more common than Down syndrome. Boys outnumber girls four to one. Symptoms start to appear when a child approaches two, but often are not recognized as autistic until the child begins school. Autistic children look deceptively normal, and many are very beautiful.

Like almost all mental illnesses, autism has a spectrum of symptoms that range from mild to severe. Severe autism has the following traits:

1. Children with autism are self-absorbed ("auto" is Greek for "self"). They live inside a glass shell, hardly recognizing the existence of their parents or others. They are unresponsive to affection and incapable of normal social relationships.

2. They seldom make eye contact, and rarely point to anything. Many refuse to talk or they speak only in brief sentences. Some speak fluently but in repetitive sentences. They are unable to maintain a normal conversation.

3. About 80 percent are mentally retarded.

4. Their behavior is bizarre. They are prone to a wide variety of repetitive rituals such as banging their head, flapping their arms, slapping their face, pulling their hair, or rocking back and forth. They can spend hours repeating such mindless tasks as running sand through their fingers in a sandbox, typing a single key on a typewriter, or spinning objects on the floor or in their hands. The slightest change in their experience, such as a mother wearing a different dress, or a toy moved to a different spot, can trigger a severe tantrum.

5. Some autistic adults resemble idiot savants in developing curious skills such as memorizing a phone book, an ability to multiply large numbers or identify huge prime numbers, or quickly memorize complicated musical scores. Some become obsessed with calendars and can correctly name the day of the week for any given date. Some rapidly solve jigsaw puzzles even when the pieces are picture-side down. Such strange abilities, along with the usual self-absorption, were featured in the movie Rain Man, a film in which Dustin Hoffman takes the role of Raymond, an autistic middle-aged man. [1]

"Joey: A Mechanical Boy," by Dr. Bruno Bettelheim (Scientific American, March 1959), is a famous article about an autistic child who thought he was a robot. He would construct all sorts of weird machines around his bed, and repeatedly connect himself to them to obtain power for running himself. It would be interesting to know Joey's later history.

Autism is a mysterious malady whose causes are not known. There are several competing theories, none confirmed, but all recognize that autism is a brain disorder probably caused by a set of malfunctioning genes. If one of a pair of identical twins is autistic, the other twin will be autistic about 65 percent of the time. The most persistent myth about autism is that there is a normal child inside the shell desperately wanting to emerge if only the shell can be shattered. There is no normal child inside the shell.

For a report on recent research into the causes of autism, see "The Early Origins of Autism," by Patricia Rodier, professor of obstetrics at the University of Rochester, in Scientific American, February 2000, pages 56-63. See also Uta Frith's earlier article "Autism," in the same magazine, June 1993. A London psychologist, Frith is also the author of Autism: Explaining the Engima (1989).

Evidence that autism is in any way related to how parents behave is unconvincing, nor is there evidence that it is related, as so many parents foolishly believe, to early vaccinations. Marian DeMeyer, an Indiana University psychiatrist, made a careful study of three groups: parents with an autistic child, parents with normal children, and parents with a brain-damaged child. Personality tests showed that the three groups were indistinguishable. (See DeMeyer's paper in The Journal of Autism and Childhood Schizophrenia, Vol. 2, 1972, pages 49-66.) More recent work, I am told, has cast doubt on DeMeyer's findings.

Siblings of autistic children are normal. The percentage of children with autism is the same in all cultures, and among all racial, ethnic, and socioeconomic groups. Medication and therapy help mildly autistic children lead normal lives, but for severe autism no cures are known.

Strong evidence that autism is a dysfunction of the brain has been available for half a century, and was taken for granted by neurologists outside the Freudian tradition. For a while it was called childhood schizophrenia. However, psychoanalysts and amateur Freudians persisted for decades in the fantasy that autism was somehow caused by unloving parents, especially by cold "refrigerator mothers." The leading advocate of this absurd view was Dr. Bruno Bettelheim (1903-1990).