“They saw their injured country's woe;
The flaming town, the wasted field;
Then rushed to meet the insulting foe;
They took the spear, - but left the shield.”
―Philip Freneau
.
And by a prudent flight and cunning save A life which valour could not, from the grave. A better buckler I can soon regain, But who can get another life again?
Archilochus
When you will have made him a body without organs,
then you will have delivered him from all his automatic reactions
and restored him to his true freedom
-Antonin Artaud, "To Have Done with the Judgement of G_d" (1947)
Joey's story illuminates how autism was understood in the 1950s, a time when the term was still new to many Americans. The Johns Hopkins child psychiatrist Leo Kanner had first described the syndrome in a 1943 case report recounting 11 children cut off from the world by what he called “extreme autistic aloneness.”2 Many had a prodigious talent for rote memory. Others, similar to Joey, were obsessed by rituals, spinning toys, and mechanical objects. Kanner had the field largely to himself until the 1950s, when Freudian psychoanalysts discovered and reinterpreted his work.3 They argued that autism represented nothing less than the emotional withdrawal of an infant at the hands of a cold and emotionally distant parent—the so-called refrigerator mother.4
No one did more to promote this theory than did Dr Bruno Bettelheim. A survivor of the concentration camp of Dachau, Bettelheim had emigrated to the United States to become a prominent public intellectual through a series of books that capitalized on postwar America's infatuation with Freudian theory.5 As director of the Orthogenic School in Chicago, Illinois, a residential treatment center for young people with severe emotional disturbances, Bettelheim became fascinated by autistic children, whose avoidance of social contact reminded him of the withdrawal he had seen among concentration camp prisoners.6 In 1956, he obtained a grant from the Ford Foundation to observe a series of autistic children admitted to the Orthogenic School over the course of several years. Joey would become one of his most famous patients.
Bettelheim twice related Joey's history, once for Scientific American in 1959 and in more detail several years later in his best-known book on autism, The Empty Fortress.7 According to both accounts, Joey was a colicky infant who spent much of his early life screaming for hours at a time. He had yet to speak by 18 months of age and was described as “remote and inaccessible” by his grandparents. Machines engaged him far more than did people, and at a surprisingly early age he learned to take apart and reassemble an electric fan. At the age of 4, when a special school finally raised the possibility of autism, he was spending much of his time rocking back and forth and his first mechanical obsessions had appeared. He refused drinks, for example, unless connected to an elaborate “piping system” constructed with straws.
Bettelheim had little doubt that Joey's behavior represented his response to parental rejection. He related how his mother had first denied her pregnancy and after his birth wanted neither to see nor nurse him. She kept him on a rigid 4-hour feeding schedule (typical at the time for formula-fed infants), oblivious to her infant's crying. Joey's father was less patient and sometimes “discharged his frustrations by punishing Joey when the child cried at night.” From Bettelheim's perspective, Joey had no choice but to withdraw into his own world.1
Countless parents of autistic children in the 1950s and 1960s sought professional help only to be sent into psychoanalysis intended to help them understand how they had, perhaps unknowingly, rejected their child. Does Joey's case history help us to explain how such a “bad idea” became so pervasive among the child psychiatry community? First, it is worth emphasizing that we have only Bettelheim's side of the story, distilled from repeated psychoanalytic sessions. We have no independent corroboration. Second, Bettelheim and his contemporaries thought of autism as the earliest manifestation of schizophrenia, a diagnosis applied in the 1950s to a wide range of severe behavior disturbances in young people.8,9 Some of these children (especially those who presented after the first 3 years of life) may have developed delusional or withdrawn behavior after physical or sexual trauma. Child abuse, it should be remembered, remained largely unrecognized by the medical profession before the 1960s.10 Either way, extensive literature on what psychiatrists called the “schizophrenogenic mother” likely predisposed them to view parents' motives with suspicion.11
For many in the autism community, the popularity of the refrigerator-mother hypothesis before the 1970s continues to be remembered as an example of what might be called “the tyranny of expertise”—the danger of giving professionals too much power. It is a theme that runs deeply in popular renditions of the history of psychiatry, portrayed in movies ranging from The Snake Pit to One Flew Over the Cuckoo's Nest. Although significant questions have been raised regarding Bettelheim's own credentials as a psychoanalyst, he did function as a public intellectual representing his profession in popular media.12 His story provides a bitter reminder that experts do not always listen and cannot always be trusted.
The most obvious legacy of the refrigerator-mother saga has, thus, been a willingness to question medical authority. This questioning reflects, of course, a broad social trend not limited to autism: patients since the 1970s have increasingly sought greater participation in decision-making in almost every domain of medical practice, both conventional and otherwise.13,14 Every physician who works with autistic children has encountered the formidable array of restriction diets, vitamins, and other alternative “biomedical treatments” embraced by many parents for autism despite a lack of evidence from controlled trials. The coalescence of the antivaccine movement around autism has become especially polarizing, pitting parents against one of the most valued tools in the pediatric armamentarium to promote child health.15,16
Yet, focusing on the theme of antagonism obscures the positive contributions made by many parents to research and treatment approaches in autism. It was, in large measure, thanks to parents that the refrigerator-mother paradigm finally collapsed. In 1967, for example, Clara Park challenged the psychogenic theory in The Siege, a firsthand account of her own autistic child.17 Bernard Rimland, a psychologist and parent of an autistic child, joined other parents to found the National Society for Autistic Children (now the Autism Society of America) to promote intensive behavioral interventions that have evolved to become the gold-standard treatment for autism.18,19 Eric Schopler, founder of the influential TEACCH (Treatment and Education of Autistic and Related Communication-Handicapped Children) approach that uses parents as co-therapists for their own children, made clear that he learned much of his approach from parents.20 Parents of autistic children have lobbied Congress for research funding and formed major foundations of their own (such as Autism Speaks, founded by an executive and grandparent of an autistic child) to promote research.21
At a moment in time when the polarization over vaccines has created a deep rift between many parents and professionals, it is worth viewing today's conflict from the vantage point of history. Forgotten for the most part by physicians, the memory of the refrigerator-mother explanation of autism has fundamentally shaped the autism community. It is a story that continues to stand as a warning to the danger of shutting out the voices of parents in the name of a persuasive theory.
Proximity towards the jouissance of the Other, or the neighbor, in Lacan’s seminar The Ethics of Psychoanalysis becomes a matter of ethical concern because the Other as das Ding (the thing) poses problems outside of the moral relationship. The proximity towards the excessive jouissance of the neighbor as das Ding presents a number of interesting ethical problems. Žižek’s confrontation with das Ding is a complex procedure that remains ambiguous, particularly in light of his sympathies towards the Christian Pauline agape version of radical love. Žižek’s treatment of proximity towards the Other seeks a total escape from the fantasmatic symbolic coordinates of the oppressive symbolic order, whereas with Santner, in his text The Psychotheology of Everyday Life, the “mental excess” of jouissance caused by confrontation with the Other as das Ding is sought to be converted into an owning of the excessive proximity into a “blessings of more life.”
Is the post-68’ drive to jouissance - to reaching the extreme of forms of sexual pleasures that would dissolve all social links and allow me to find a climax in the solipsism of absolute jouissance - not the very opposite of the consummation of the commodified products promising jouissance? The first (best exemplified by the work of Foucault) stands for a radical, "authentic," subjective position, while the second signals a defeat, a surrender to market forces... Is, however, this opposition effectively so clear? Is it not all too easy to denounce jouissance offered on the market as "false," as providing only the empty package-promise with no substance? Is the hole, the void, in the very heart of our pleasures not the structure of every jouissance? Furthermore, is it, rather, not that the commodified provocations to enjoy which bombard us all the time push us towards, precisely, an autistic-masturbatory, "asocial," jouissance whose supreme case is the addiction to drugs? Are drugs not at the same time the means for the most radical autistic experience of jouissance and a commodity par excellence?
The drive to pure autistic jouissance (through drugs or other trance-inducing means) arose at a precise political moment: when the emancipatory "sequence" of 1968 exhausted its potentials. At this critical point (mid-1970s), the only option left was a kind of direct, brutal, passage à l’acte, push-towards-the-Real, which assumed three main forms: the search for extreme forms of sexual jouissance; Leftist political terrorism (RAF in Germany, Red Brigades in Italy, etc.) whose wager was that, in an epoch in which the masses are totally immersed into the capitalist ideological sleep, the standard critique of ideology is no longer operative, so that only a resort to the raw Real of direct violence - l’action directe - can awaken the masses); and, finally, the turn towards the Real of an inner experience (Oriental mysticism). What all three share is the withdrawal from concrete socio-political engagement into a direct contact with the Real.
The problem with today’s superego injunction to enjoy is that, in contrast to previous modes of ideological interpellation, it opens up no "world" proper - it just refers to an obscure Unnameable. Even the Nazi anti-Semitism opened up a world: by way of describing the present critical situation, naming the enemy ("Jewish conspiracy"), the goal and the means to achieve it, Nazism disclosed reality in a way which allowed its subjects to acquire a global "cognitive mapping," inclusive of the space for their meaningful engagement. This is why Badiou recently started to elaborate this topic of world, the "logic of worlds": what if the impetus came from his deeper insight into capitalism? What if the concept of world was necessitated by the need to think the unique status of the capitalist universe as world-less? Badiou recently claimed that our time is devoid of world - [1] how are we to grasp this strange thesis?
Perhaps, it is here that one should locate the "danger" of capitalism: although it is global, encompassing the whole worlds, it sustains a stricto sensu "worldless" ideological constellation, depriving the large majority of people of any meaningful "cognitive mapping." The universality of capitalism resides in the fact that capitalism is not a name for a "civilization," for a specific cultural-symbolic world, but the name for a truly neutral economico-symbolic machine which operates with Asian values as well as with others, so that Europe's worldwide triumph is its defeat, self-obliteration, the cutting of the umbilical link to Europe. The critics of "Eurocentrism" who endeavor to unearth the secret European bias of capitalism fall short here: the problem with capitalism is not its secret Eurocentric bias, but the fact that it REALLY IS UNIVERSAL, a neutral matrix of social relations.
In what, more precisely, does this "worldlessness" consist? As Lacan points out in his Seminar XX, Encore, jouissance involves a logic strictly homologous to that of the ontological proof of the existence of God. In the classic version of this proof, my awareness of myself as a finite, limited, being immediately gives birth to the notion of an infinite, perfect, being, and since this being is perfect, its very notion contains its existence; in the same way, our experience of jouissance accessible to us as finite, located, partial, "castrated," immediately gives birth to the notion of a full, achieved, unlimited jouissance whose existence is necessarily presupposed by the subject who imputes it to another subject, his/her "subject supposed to enjoy."
Our first reaction here is, of course, that this absolute jouissance is a myth, that it never effectively existed, that its status is purely differential, i.e., that it exists only as a negative point of reference with regard to which every effectively experienced jouissance falls short ("pleasurable as this is, it is not THAT!"). However, the recent advances of brain studies open up another approach: one can (no longer only) imagine the situation in which pain (or pleasure) is not generated through sensory perceptions, but through a directly excitation of the appropriate neuronal centers (by means of drugs or electrical impulses) – what the subject will experience in this case will be "pure" pain, pain "as such," the REAL of pain, or, to put it in precise Kantian terms, the non-schematized pain, pain which is not yet rooted in the experience of reality constituted by transcendental categories.
"Neurotheologians" applied this insight to religion, by way of identifying the brain processes which accompany intense religious experiences: when a subject experiences himself as timeless and infinite, part of the cosmic All, delivered of the constraints of his Self, the region of his brain which processes information about space, time, and the orientation of the body in space "goes dark"; in the blocking of the sensory inputs which occurs during intense meditative concentration, the brain has no choice but to perceive the self as endless and intimately interwoven with everyone and everything. The same goes for visions: they clearly correspond to abnormal bursts of electrical activity in the temporal lobes (the "temporal-lobe epilepsy"). The counterargument here is: while, of course, everything we experience also exists as a neurological activity, this in no way resolves the question of causality. When we eat an apple, we also experience the satisfaction of its good taste as a neuronal activity, but this in no way affects the fact that the apple was really out there and caused our activity. In the same fashion, it is totally undecided whether our brain wiring creates (our experience of) God, or whether God created our brain wiring… Is, however, the question of causality not simple to resolve? If we (the experimenting doctor) directly intervene in the appropriate parts of the brain, causing the brain activity in question, and, if, during this activity of ours, the subject "experiences the divine dimension," does this not provide a conclusive answer? The further question here is: how will the subject who is aware of all this subjectivize his religious experience? Will he continue to experience it as "religious" in the appropriate ecstatic sense of the term? The extreme solution is here that of a US religious sect which claims that God, who observes us all the time and took note of the lack of authentic religious experiences among his believers, organized the discovery of drugs which can generate such experiences… Further experiments show that when individuals are able to directly stimulate their neuronal pleasure-centres, they do not get caught into a blind compulsive drive towards excessive pleasure, but provide themselves pleasure only when they judge that they "deserved" it (on account of their everyday acts) – however, do many of us not do the same with pleasures provided in a "normal" way? What all this indicates is that people who experienced directly generated pleasures do not suffer a breakdown of their symbolic universe, but integrate smoothly these pleasure experiences into it, or even rely on them to enhance their experience of sacred meaning. However, again, the question is what disavowals do such integrations involve: can I really accept that the industrially fabricated pill that I hold in my hand provides a contact with god?
