The History of Autism Part II – Troubled Bits

Full disclosure: The author of this piece is Jewish.

Author: Merrick Egber (June 20, 2017)  With a tip of the hat to Alex Plank, my journey through the history of autism began when I saw John Donvan and Caren Zucker being interviewed for their recent best-selling book called “In a Different Key: The History of Autism”, through Alex’s web series called Autism TV. It was then, that I felt fascinated by studying the history of a condition that I never bothered to do any deep research on before. When was it first diagnosed, who were the first champions of the new diagnosis, for example, I needed to know.

While learning about the origins of the autism diagnosis, I found out about the doctor, Hans Asperger, whose namesake is the condition I have been diagnosed with. During the early 1900s, eugenics was all the rage, and in a specific region of Europe, eugenics became the mandated governing policy by a guy with a silly moustache. Eugenics, for those who don’t know, was a school of political thought ruled by intellectuals who saw the disabled as “useless eaters”, and racial and ethnic minorities as “genetically impure”.  It was one of the trending facets of what we call the “Progressive Era” which lasted from the late 1800s to the early 1900s. Common “solutions” were sterilizations, the banning of marriages, and mass institutionalization. Dr. Eugene Bleuler, who was mentioned in part I of this blog series as the doctor behind coining the terms “autism” and “schizophrenia”, happened to believe in this philosophy and practiced it on his schizophrenic and autistic patients.

Yet one of the most controversial aspects of Dr. Hans Asperger’s life is in how much he endorsed the German Nazi program. While Dr. Asperger stated, and has been defended on the idea that he was never a fan of the Nazis, in Donvan and Zucker’s book, with contributions by Herwig Czech who is prolific at uncovering the level of collaboration between the psychiatric establishment and the Nazi regime, they have argued that Dr. Asperger was an enthusiastic cheerleader for Hitler. Even one of the most recent defenders of Dr. Asperger’s legacy, Steve Silberman, who wrote “Neurotribes” about the neurodiversity movement, found himself a little bit shaken-up by the revelation that Dr. Asperger condemned a girl to death who had encephalitis. It’s also been theorized that Dr. Asperger’s championing of certain autistic patients was due to these kinds of beliefs on the disabled. After all if he wasn’t a cheerleader, why wouldn’t he be as interested in the lower functioning types as in the higher functioning ones?

After reading article after article, I’ve come to a conclusion:

I believe that Dr. Asperger probably felt that he needed to keep his job, but within the limitations of his skepticism towards the Nazi movement, as there is no record of him ever joining the party itself. His zeal in pursuing his goals in assisting his patients is why there are records of him going above and beyond what is typically thought of as a loyal assistant to the Nazis, for example signing every paper with a “Heil Hitler” which was never required for any psychiatrist in his position. It may have even helped in the founding of the school (mentioned in part 1 of this blog), a breakthrough in the psychiatric sciences. I think his guilt in being loyal to Hitler’s ideas is why he denied the darker side of his past to a point of believing himself to be one of the strong dissidents to Hitler’s regime. I also believe that a strong counter-argument is why couldn’t he leave, but it wouldn’t surprise me if his studies were so regionalized and locked-in that he couldn’t just pack up and head to another country such as America to continue them.

Unlike doctors Bleuler and Asperger, Dr. Kanner, being a Jewish immigrant who left Europe and never looked back, had no attachment to eugenics or to Nazism. Still, this was during a time when any unusual neurological or mental disorder, due to their evasive origins and no known cures, led psychiatrists proposing all kinds of hypotheses to the origins, or potential cures for such a malady, and Dr. Leo Kanner had his, related to autism.

In 1943 and 1949, Dr. Kanner published two articles describing a pattern that he had noticed as a probable cause of autistic behaviors in the children he had worked with. The parents themselves, were usually cold and distant towards their children, and thus it was theorized that the children’s behaviors came as a result towards this kind of parenting. An especially important line appeared in his ’49 paper stating that the children were “in refrigerators that did not defrost”. While another line in the same paper “genuine lack of maternal warmth” helped to create the “Refrigerator Mother Theory”, which suggests that the only interactions between mother and autistic child was one of provider and needs-wanting individual.

This theory was popularized, and the term sometimes credited, by one Bruno Bettelheim of the University of Chicago, who wrote books about the subject. In his 1967 seminal book “The Empty Fortress: Infantile Autism and the Birth of Self”, he compared autistic children to Jews in a concentration camp, and the parents compared to camp guards. Since Mr. Bettelheim was a Holocaust survivor, that kind of dramatic analogy was lent greater credentials. It should be noted that during that in 1964 Dr. Kanner eventually rejected the “Refrigerator Mother Theory”, even writing the foreword for the first major publication called “Infantile Autism: The Syndrome and its Implications for a Neural Behavior” by Bernard Rimland, co-founder of the Autism Society of America (ASA) challenging it. Yet, Bruno never gave up on espousing his theory on the true cause of autism, giving magazine interviews, going on talk shows, and being rewarded through a fellowship to the American Academy of Arts & Sciences, in 1971. Later that decade he received two National Book awards for “The Uses of Enchantment”, a Freudian look at fairytales. It was only after his death, in 1990, when it was realized that the good doctor turned out to be a good fraud. Not only did he have no actual expertise in psychology, only taking three introductory courses in college, one of his greatest tales, in meeting Sigmund Freud, was a hoax, and the book I just mentioned was found to be a plagiarized work. Unfortunately, that hasn’t stopped reports of psychiatrists still referring to it as the cause of autism, and in France, a group of filmmakers made a controversial documentary called “The Wall” stating that this theory was extremely prevalent in that country.

As far as my belief, I don’t believe in the “Refrigerator Mother Theory”. I do believe that certain environments may produce symptoms of autism, but I think that autism is such a part of one’s character that one does not become autistic, but rather one has it already ingrained. That is, the genetic theory is the most plausible to me.

So, I’ve gone into some details about the early history of autism. In my next blog, I’ll talk about how the disability’s diagnosis has been re-evaluated as more enlightened research and processes have come into being and I will examine, the more recent history of the diagnosis, and maybe find a few good things about today.