Autism Treatment In France: Retro, Controversial And Featured In Film, 'Le Mur'

http://www.youtube.com/watch?v=TBUFMYythJQ

By Karen Weintraub
CommonHealth ContributorWatching a documentary last night about autism care in France, I thought I was back in my college Psych 101 class – the part where we learned about the soiled history of the profession.

Autism, a handful of French psychoanalysts say on camera, is caused by a mother who becomes too sexually attached to her child, and a father who fails to assert his masculinity enough to separate them. Or else by cold mothers – the vastly discredited “refrigerator mother” theory suggested by Bruno Bettelheim 60-plus years ago.

Several of the doctors now say that they were misled as to the intent of the film, called The Wall, and several of them are trying to get it banned; there’s a French court hearing on the 26th. (Here’s yesterday’s New York Times article on the subject.) Watching the 50-minute documentary on YouTube (French with English subtitles that are sometimes hard to read because they’re in yellow), it’s hard to see how so many comments could have been taken out of context and how filmmaker Sophie Robert wouldn’t have been outraged by what she heard.

In addition to seeming perverted and ragingly sexist to contemporary ears, the psychoanalysts “explanation” of autism denies decades of biomedical research. Science has established that people with autism have some genetic vulnerability, coupled with environmental factors that are still unclear, but range from toxins to immune challenges to low birthweight.

And yet, these psychoanalytic viewpoints still drive much of autism care in France.

The film features two boys, one who received an “American-style” autism education, has learned to talk and relate to people and is earning strong marks in a traditional 7th grade classroom; and the other who received psychoanalysis but very little formal education, who is still nonverbal and detached from society. The film suggests that the second boy would have done as well as the first with the same education – a dubious assumption based on how differently autism can manifest and respond to treatment in different people.

But it certainly defies credulity to believe that a child with autism would be helped by playing with a plastic crocodile, as one doctor suggests in the film. (The crocodile represents the child’s mother, says the sweet-looking little-old-lady analyst, and sticking things in the crocodiles’ mouth represents the sexual fantasy of penetrating its mother.)

Another doctor is speechless when asked what his treatment does to help autistic children. A third says the child learns “the pleasure of taking interest in a soap bubble,” though it’s unclear whether he means he or the child is learning this lesson.

An autism researcher I respect, Michelle Dawson at the University of Montreal, says France’s backward ways are well-known in the autism world (though, of course, there are more forward-thinking French scientists, as well).

Unfortunately, there are egregious examples of autism “care” in many countries, including the US and Canada, she says, citing shock therapy (such as at the Judge Rotenberg Center in Canton whose controversial director was pushed out last year), and dangerous stem cell treatments totally unsupported by science.

“Basic scientific and ethical standards, which automatically protect and benefit nonautistics, should apply to autistics in France and everywhere else,” Dawson wrote in an e-mail. “In my view, recognized standards of science and ethics must be applied in evaluating all approaches to autism, not just psychoanalysis.”

A friend with a child on the autism spectrum and training in psychoanalysis, also finds these psychoanalysts’ comments deeply disturbing. The statements felt like a “rusty dagger through your soul,” she said when I described them to her. “I think it’s abusive both to the children and the parents – abusive to kids who are denied proper medical care and abusive to the parents that we should be forced to listen to this kind of theory.”

The Thinking Person’s Guide to Autism, a collection of bloggers, also posted a commentary this morning excoriating the French psychoanalytic establishment. And in this Huffington Post blog posting from last summer, autism mom Chantal Sicile-Kira talks about moving to the US to escape the terrible care children with autism receive in France.

Most of the psychotherapists pictured in the film look to be in their 60s and 70s. Unless the filmmaker totally distorted their positions, it seems like now would be a good time to consider retirement.

Karen Weintraub is a Cambridge-based health/science journalist. Her first book, The Autism Revolution, with Dr. Martha Herbert, is due out this spring.