essentially falsified. Dr Spock is a psychiatrist, and he has tried to tell us that babies are tough, but we have been rendered too nervous to listen. We hear on every hand that what we do in the first months of life — it may be six, or twelve, or twenty-four — may mark our child for ever. Who are we to qualify this account of our responsibility? Even the parents of normal children move with a certain knowledgeable edginess. What goes through the minds of parents who know they have a child whose development has gone wrong? Bettelheim writes that parental rejection is an element in the genesis of every case of childhood schizophrenia he has seen. [7] Beata Rank sets out as her ‘main hypothesis’ that ‘the atypical child has suffered gross emotional deprivation’, and adds that ‘the younger the child, the more necessary is it for us to modify the mother’s personality’. [8] Even the wise and humane Erikson, though he remarks that the rejecting mother is the ‘occupational prejudice’ of child psychiatrists, reiterates in the same study that a ‘history of maternal estrangement may be found in
In this respect it made little difference whether what ailed Elly was called schizophrenia or autism. Kanner’s original hypothesis was consistent with the psychiatric consensus. He considered that the parents must play a lage part in the genesis of infantile autism. Certainly (like Erikson) he took account of a possible constitutional predisposition in the child; he reported that many autistic children (unlike Elly) were manifestly unresponsive from earliest infancy. But in his discusion of aetiology he devoted far more attention to the role of the parents. In the process he discovered some curious facts, facts that, since they in some sense affected how we thought of ourselves as we lived with our situation, it is necessary to summarize here.
I have already said that my husband and I are typical of the parents of autistic children. I must now make clear what this entails. Early in his work Kanner was struck, not only with how similar one autistic child was to another, but at the unexpected similarity of their parents. The fathers of the first eleven cases Kanner saw included four psychiatrists, one lawyer, one chemist, one plant pathologist, one professor of forestry, one advertising man, one engineer, and one successful businessman. Of the eleven mothers, nine were college graduates. Hardly an average group, one would think; yet as Kanner collected more cases he found that the pattern varied very little. Almost without exception, the parents of his autistic patients seemed unusual both in their intellectuality and in their professional achievement. Naturally it occurred to him that he might simply be registering characteristics shared by all the parents who brought patients to an outstanding child psychiatrist at a famous research centre. Accordingly, he checked his impressions. He took out the file of each of his autistic patients, and the file directly next to it in his cabinet. These control files represented a random cross-section of his practice — children suffering from the full variety of conditions a modern child psychiatrist sees. Kanner compared the two sets of parents. He found that statistics bore out his impressions. The ‘autistic’ parents, as a group and individually, had more years of education and significantly higher professional competence. Moreover, they differed in another particular, especially from the parents of schizophrenic children. The incidence of recorded mental illness among them and even among their families, was unusually low. Whereas schizophrenic patients had in their families more mental illness than is found in the populaton as a whole, the autistic patients had less.
Kanner began to study more closely the parents who had produced, out of such apparently strong material, such pathetically deviant children. He began to dissolve the idea of ‘professional achievement’ into the less measurable characteristics which make achievement possible. He found in these parents, in addition to intelligence, an unusual degree of energy and persistence, as well as a capacity to control both events and their reactions to them. As he observed them in his interviews, where they might be expected to be under considerable stress, he found them a very reserved group. The capacity of these parents for detachment and objectivity seemed to him extraordinary. It is not surprising that he was led to try to relate these unique group characteristics to the unique condition he was trying to understand.
If a group of parents differed from the average as extremely as these seemed to, was it not likely that they had treated their children differently? The combination of drive and detachment may augur well for success in a profession; it is not so well regarded as a qualification for bringing up a child. To Kanner, these parents seemed
When my husband and I read these characteristics in Dr Blank’s reprints we did not find it hard to recognize ourselves. Objectively we belonged in the group; we had a Ph.D. and an M.A. , and the nearest we had come, before Elly, to mental illness was a single great-uncle who had spent a few years in a sanitarium. Subjectively we felt, both of us, the acute shyness that defended itself as reserve. We both knew what it was like to cross the street to avoid an acquaintance seen fifty feet away — not because of any anticipated unpleasantness, merely because one is not always able to sustain the effort of finding something to say. We were both capable of detachment; sustained thought is rather difficult without it. We had both been bred to self- control, and perhaps born to it. Four times I had discovered that one of the difficulties of having a baby is that nurses won’t give you so much as a sedative if you can’t scream. We were well suited, my husband and I. These characteristics had brought us together and kept us close. They had served us well. Most of them had seemed to be strengths. We saw them now transmuted into pathology.
Time had taught us, we thought, to live with our shyness, to fight it, increasingly to transcend it. But it is easy to deceive oneself; psychologists know that. Consider — as I considered — this sketch of the mothers of ‘atypical’ children as I read it in one of the books my solicitous friends lent me:
On the surface these mothers may give the impression of being well-adjusted; not too rarely they are highly intellectual, prominent people. Close investigation reveals that the majority of them are immature and narcissistic with precarious social contact… who have struggled heroically to build and maintain the image they have created of a fine woman, wife, and mother. The nearer to perfection die success of their efforts, the stronger their belief in magic and their own magic (impenetrable defences)… In spite of the outward appearance of self-assurance or worldliness, there is inner isolation. This type of mother tends to function on two levels: the surface level in contact with the outside world is a thin crust only, overlaying a strong tendency to detachment. When this dual level of functioning is a constant way of living, it bespeaks a serious disturbance.
The article then got down to cases.
The picture which Mrs I. had of herself and which she successfully communicated to the world was that of a well-educated, vigorous, charming woman with many abilities and a host of satisfying interests. She had in fact obtained a graduate degree and had achieved success in her professional career… The personality behind this facade was gradually revealed to us during the course of Mrs I.’s therapy. We came to see her as a very isolated person who tries to combat her perception of her own emptiness and her tendency toward withdrawal by precipitating herself into constant activity and excitement. [11]
I would have been obtuse indeed not to reflect that the therapists who on close investigation had revealed the reality below Mrs I.’s facade might uncover something very similar below mine.
These were threatening ideas to confront. Yet somehow they did not take hold.
It is hard to see why we were not crushed with guilt. Not long ago, in a television programme on autism, I heard a distinguished psychiatrist say that ‘of course, all the parents feel guilt’. Even a close friend, a psychologist herself, once suggested I should have an analysis ‘to work my guilt-feelings through’, and I don’t think she believed me when I told her I never had any. I should have. Even if I had not been a typical autistic parent, I had been far from welcoming my pregnancy with Elly. I knew that and so did my friend. It would have made good Freudian sense for me to fear, as I slowly awoke to the severity of Elly’s condition, that she rejected human beings because her mother had rejected her.
The dogma that all parents of the psychotic must suffer guilt- feelings is well based. Popularized psychology has encouraged a high level of free-floating anxiety even in the parents of normal children. The situation is made worse by the fact that a disproportionate number of abnormal children in general, and of autistic children in particular, are first children. Their apparent rejection of love is more terrifying because their parents have no
