Bettelheim and the Nature of Autism

1. Bettelheim and the Nature of Autism Hannah Piper and Jesse Allen

2. Our Presentation • Through the observations of the treatment process of children with autism, we attempted to define the similarities in the Son-Rise Program (SRP) and the work of Bruno Bettelheim • Through Anna’s home-based program, we examined location, environment, staff, attitude, and overall approach of the Son-Rise Program in relation to the work at Bettelheim’s Orthogenic School

3. What is autism? • Autos means “self” • In Autism Spectrum Disorder (ASD) neurological problems develop that make it difficult for a person to communicate and form relationships with others • Interestingly, William Crain in Theories of Development defines autism as “a mysterious condition in which children are totally unresponsive to people” (pg. 317) • It is classified as a Pervasive Developmental Disorder, where impairments exist in social interaction, communication, and the range of interest and activities • Onset before the age of three • Cause is unknown

4. Areas of Learning Affected by Autism Autism can cause… • Language difficulties • Repetitive and obsessive behaviors • Sensory overload • Problems with memory and recall *ASD ranges widely on a spectrum of severity*

5. Anna • 8 years old in July • Worked with Anna since February of 2008 • Diagnosed Autism Spectrum Disorder • Son-Rise Program for about 2 ½ years • We logged 6+ hrs of observation of Anna’s home-based program

6. The Original Son-Rise Program • Barry and Samahria Kaufman’s son, Raun, was diagnosed severely autistic in 1973 with an IQ under 30 • Determined not to institutionalize or “condition” their son, they began their own home-based program • Raun was fully recovered in 3 years, lived a typical childhood, and attended Yale University • They now run the Option Institute and the Autism Treatment Center of America, with Raun as the CEO

7. The Son-Rise Program of Today • Places parents as key teachers, therapists and directors of their own programs and utilizes the home as the most nurturing environment in which to help their children. • Suggests that respect and deep caring is the most important factor impacting a child's motivation to learn • It has made love and acceptance the central part of its teaching process. • With this attitude, SRP seeks to create bonding and a safe environment in order to inspire growth

8. Bruno Bettelheim • 1903 – 1990 • Hometown: Vienna • 1932 adopted a girl, Patsy, who later was diagnosed with autism • 1938 – 1939 Bettelheim was a prisoner in the German concentration camps of Dachau and Buchenwald • Kept detailed records • His experience greatly influences his perception of autism • 1944-1973 director of the Orthogenic school

9. Bettelheim’s Theories on Autism • Outcome of early interactions with social environment, i.e. parents and caretakers • Lack of a developed autonomy • Develops the sense that his actions are more likely to result in indifference, anxiety, or retaliation • As a result, the child gives up autonomous actions and withdraws from the world • “…human beings are not shaped once and for all.” - The Empty Fortress, pg 41

10. Sonia ShankmanOrthogenic School • Chicago • Treatment for all children is on a residential basis; students live in the school full time • When Bettelheim was the director, the school generally housed 45 – 50 children but never attempted to treat more than around four at a time • Treatment usually lasted at least 5 years • School’s philosophy under Bettelheim was the provision of a tremendous amount of love, care, and protection - nurture the child away from the misconception that others wish their destruction • a “way toward convincing a person that he is in charge of himself; that he can and does have some say in the functioning of his body.” – The Empty Fortress pg. 34

11. Welcome to the Orthogenic School! • Children admitted into the school • Ages 6-14 • “free of physical disorder, but suffer from severe emotional disturbances that have proved (or are expected to prove) beyond the reach of the common therapeutic techniques” (Pollack 136) • It was Bettelheim’s sole decision when parents would see their children again—he often saw home visits as disruptive to development • School Day • 9am-3pm • while many children were in a classroom together, each child worked at his or her own pace with a primary emphasis on emotional well-being • “a child who felt the work too threatening could, without fear of censure, spend his time in class playing on the linoleum floor with blocks or, in some cases, skip school altogether until he felt confident enough to return” (Pollack 157)

12. The Environment of the School • From his experience in the concentration camps, he believed that if an environment could destroy a personality so quickly and drastically, then he aimed to create an environment that could repair the “broken personalities” in his care (Pollack 142) • “Thus, he sought to re-create the Orthogenic School in the reverse image of the camps, to make it a place where the doors were locked against the outside but the children could walk away at any time” (Pollack 142)

13. Location Son Rise Playroom A relatively bare room Home-based No electronics Because autistic kids are so sensitive, colors and sounds are kept to a minimum Everything a child might need is in the room Often a mirror is in the room to promote eye contact One-on-one situation (in another effort to reduce incoming stimuli) Bettelheim’s Orthogenic School • “…autistic children have so alienated themselves from the experience of time that only space and its emptiness remains. And this they try to master through sameness.” • The Empty Fortress 45 • Avoided things that “seemed to mechanistic and distant” (Empty Fortress 102) • Left the rooms bare, orderly, and same • Encouraged artwork and fantasy in order to allow creation for a personal environment--control

14. Anna’s Playroom

15. Anna’s Playroom

16. Staff Son-Rise Facilitators Most SRP ask for and accept any volunteers willing to commit to between 2-8 hours a week, or 2-3 sessions a week Bettelheim’s Counselors Hired young women in their early 20s One scientists who observed the school noted that while the staff seemed highly motivated, energetic, and devoted, they seemed to lack a “carry over of scientific rigor” (Pollack 252) Encouraged his staff not to depend on the ‘experts’ and textbooks more than themselves and the children Encouraged staff to put themselves in the position of the children to attempt to understand why they do what they do

17. A Closer Look at Bettleheim’s Counselors Paid special attention to the attitude of the staff • Staff meetings were not only to dissect the behavior of the children, but also the counselor’s—often challenged them to confront themselves • Held many individual psychoanalytic sessions with counselors • “the attitudes the counselors brought to their interactions with the children often determined how those interactions would play out” (Pollack 153)

18. A Closer Look at Son-Rise Facilitators • Like Bettelheim’s sessions with his counselors, SR encourages weekly or even daily ‘feedback sessions’ with the facilitators • These sessions consists mainly of “why” questions—“why did you do this when the child did this?” “how did you feel in this situation”—leading the facilitator to understand his or her own cognition and belief system in relation to interactions with others • Also believe that the attitude that one goes in the room with greatly affects the interaction in the room • 3 Es • energy, excitement, and enthusiasm • with the 3 Es, children are much more enticed to whatever interaction the facilitator is presenting

19. Son-Rise Attitude • Attitudinal Points • Loving, Accepting, Non-Judgmental, Happy • This is a rare attitude received by autistic children • While people claim to “love” Anna, Barb explained that SR finds that one can hardly love Anna and also be disapproving and unhappy with who she is. The Option Institute believes that “to love means to be happy with” • As of today, there is no Anna that does not ‘ism,’ or one that completely interactive and ‘normal,’ therefore in order for one to love Anna, they must love the present Anna

20. Approach • Bettelheim’s Approach • “job was to give the children a childhood” (Pollack 136) • Gave control to the students in order to develop the sense of autonomy • Instructed his counselor’s to come with a “How may I serve you?” attitude • “too often psychotherapists in the United States assumed they knew it all and their patients knew nothing” (Pollack 153) • Idea that a child has his/her own answers • “We do not care when or what they eat, whether they eat mainly at meals, or in between; our chief concern is that eating itself become a pleasure to them” (Pollack 154) • Toilet Training Son-Rise Approach • Child-led • There are 2 periods Anna’s life: interactive and exclusive • “Bonding through acceptance, inspiring growth”

21. Class Exercise!! • A modern way of responding to stimming is to physically stop, interrupt, or playfully distract • Pick a partner and decide which will be the autistic child and which will be the facilitator • ‘Autistic Child’ gets a card (rocking, flapping, tapping, flipping pages) • Facilitator try to interrupt or stop • How did that feel?

22. Son-Rise 2 Periods • Exclusive period -During exclusive periods, Anna is ‘isming,’ that is, exclusive, repetitive behaviors, the facilitator practices the attitude by joining her, i.e. “eye thing” • SRP believes ‘isming’ to be self-protective and self-soothing behavior • Showing Anna that we are interested in what she is interested in, further, we are completely okay with what she wants to do • Through bonding in the exclusive period we reach Anna

23. Son Rise 2 Periods • Interactive Period • When the Anna is interactive, her facilitators work on 4 points (note these are not academics) • Eye contact • Language • Interactive attention span • Flexibility • Using the 3 Es and the methods Anna demonstrates, the facilitator interacts with her, finding a motivator, and then asking her for what they want (eye contact, language, flexibility). • Celebration always follows whether or not the request was granted

24. Joining the Exclusive Period

25. Interactive and Exclusive Period

26. Conclusion • We found similarities between Son-Rise and Bettelheim in matters of • Environment – ordered, same, in control of child • Staff – enthusiastic and loving • Attitude – loving, accepting, and non-judgmental • Approach – trusting the child to know how to best take care of themselves

27. Criticisms Son-Rise Bettelheim • Son-Rise is often criticized for not being easily quantitatively understood like ABA • Many claims that Dr. B falsified his credentials • Further, reports of Dr. B as an abusive and degrading employer • However, we’re not here to discern Dr. Bettelheim’s character, but rather his theories in relationship to Autism Spectrum Disorder • “Refrigerator Mom”

28. Nature vs. Nurture Bettelheim Rousseau Kant Locke Nature Nurture