On Mon, 19 Mar 2001, Jeff Ricker wrote:
> In the current issue of the NY Review of Books, there is an article by
> Oliver Sacks in which he reviews a book written [about] an autistic person. I
> have excerpted the first paragraph, but I just noticed that you can get
> the entire article at
> http://www.nybooks.com/nyrev/WWWfeatdisplay.cgi?20010329004F
Thank you, Jeff. Great article, and don't forget to click on the
two urls easily missed at the top of the article, which show
examples of Jessy Parks' remarkable artistic talent.
But I want to comment on this remark of Oliver Sacks (sorry, my
comment turned out longer than I expected):
"For many years autism was seen as a defensive withdrawal from
the world on the part of a child neglected and alienated by cold,
remote parents. Leo Kanner, who identified the condition and
named it, spoke here of refrigerator mothers."
For many years I agreed with the accusation that Leo Kanner
supported a psychogenic view. I used to tell my class that while
Kanner sometimes suggested that autism was inborn, at other times
he implied it was caused by the parents. I now think this is
unfair to Kanner. In fact, Kanner himself protested against this
interpretation of his position (Kanner, 1971). He said:
"As for the all-important matter of etiology, the early
development of the 11 children left no other choice than the
assumption that they had "come into the world with an _innate_
disability"...the concluding sentence of the 1943 article said
"here we seem to have pure-culture examples of _inborn_ autistic
disturbances"...Some people seem to have completely overlooked
this statement...and have referred to the author erroneously as
an advocate of postnatal "psychogenicity" [all emphasis here and
below appears in the original].
I think the misinterpretation may have resulted from a discussion
by Bernard Rimland (1964) in his classic book. Rimland had
referred to Kanner's comment in a 1949 paper that the mothers
treated the children like "an overconscientious gasoline station
attendant", certainly a vivid and disturbing description. Rimland
also noted that Kanner had written elsewhere "of the
"refrigerator" type of parent". Rimland rightly criticizes the
interpretation that this indicates psychogenesis as confusing
correlation with causation. But Rimland doesn't directly
attribute this mistaken conclusion to Kanner himself, although
I'm sure people jumped to that conclusion, as I did. Most people,
I expect, only know about Kanner through Rimland, rather than
through reading his original reports. Rimland did say that he
believed that the psychogenic view "may be traced in part to
observations made by Kanner" but he does not say that Kanner
himself believed this, a crucial but easily-overlooked
distinction.
When I finally got around recently to retrieving his 1943 paper,
I discovered that it does support Kanner's (1971) protest that he
had never argued psychogenesis. In 1943, in addition to the quote
above, he had also said, "There is from the start an _extreme_
autistic aloneness".
And at the end of the paper he also states "In the whole group,
there are very few really warmhearted fathers and mothers...the
question arises whether or to what extent this fact has
contributed to the condition of the children. The children's
aloneness from the beginning of life makes it difficult to
attribute the whole picture exclusively to the type of the early
parental relations"...We must, then, assume that these children
have come into the world with innate inability to form the usual,
biologically provided affective contact with people".
Admittedly, Kanner left himself open to misinterpretation by
first citing these parental characteristics and then rather
timidly rejecting this possibility [note his unfortunate use of
the qualifier "exclusively"].
So why would Kanner cite these parental observations if he didn't
believe they were the cause of autism? I think it was because he
intended them to indicate that the parents were themselves
peculiar and autistic-like, which would support a genetic
interpretation. I think recent twin evidence showing the very
strong genetic contribution to autism fully supports this view.
Had he been more forthright and clearer in what he believed back
in 1943, he might have saved parents of autistic children much
unnecessary hardship.
After writing this, I remembered that we had had a discussion of
this topic on another list, Cheiron. One enterprising participant
wrote to Leon Eisenberg, Kanner's student. Eisenberg replied:
"Leo Kanner reported in 1943 in Nervous Child "Autistic
disturbances of affective contact."(2:217-50). (The journal went
out of existence not very long afterwards.) In that paper, he
referred to an "innate inability to form the usual, biologically
provided affective contact with people, just as other children
come into the world with innate physical or intellectual
handicaps.." He also called attention to the schizoid
characteristics of the parents and suggested that they perhaps
were successful autistic adults. The Zeitgeist was such,
however,that autism was characterized, like schizophrenia, as a
psychogenic disorder to the dismay and distress of parents who
now not only had an ill child but were held responsible for
causing the devastating disease. Some 30 years had to pass before
the conventional wisdom was reversed."
When this was posted I was sceptical, and thought that both
Kanner (1971) and Eisenberg (in December, 2000) were engaging in
wishful historical revisionism. But now that I've read Kanner's
1943 paper for myself, I have to agree. Kanner did not believe in
psychogenesis.
-Stephen
References
Rimland, B. (1964). Infantile autism. Appleton-Century.
Kanner, L. (1943). Autistic disturbances of affective contact.
Nervous Child, 2, 217-250.
Kanner, L. (1971). Follow-up study of eleven autistic children
originally reported in 1943. Journal of Autism and Childhood
Schizophrenia, 1, 2 (?), 119-145.
------------------------------------------------------------------------
Stephen Black, Ph.D. tel: (819) 822-9600 ext 2470
Department of Psychology fax: (819) 822-9661
Bishop's University e-mail: [EMAIL PROTECTED]
Lennoxville, QC
J1M 1Z7
Canada Department web page at http://www.ubishops.ca/ccc/div/soc/psy
Check out TIPS listserv for teachers of psychology at:
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