What Does It Mean To Be Autistic?

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Much can be said about the peculiarities of the era by the pictures of mental illness that it invents. In the days of Freud, such a "fashionable" diagnosis was conversion hysteria, today it is autism. Having appeared quite recently, this diagnosis has become firmly established both in the medical community and in popular culture. It arouses interest not only among doctors, teachers and psychologists, but also attracts the attention of the general public, cultural figures, journalists, and politicians.

According to the latest revision of the gold standard of psychiatry, DSM-5, autism has entered the autism spectrum disorders, the diagnostic criteria for which are persistent impairments in social communication and social interaction, as well as limitations, repetitiveness in the structure of behavior, interests or activities.

To date, the etiology of autism is not fully understood and generates a lot of controversy in the scientific community. Some insist on organic causes, congenital or acquired, while others speak of a predominantly mental origin. The resolution of this issue may be of interest to doctors (determining drugs) or parents raising an autistic child (for example, identifying organic causes will reduce the share of guilt generated by categorical accusations of coldness and neglect of a child in the early years of his life).

But for psychologists (we will talk about psychologists working in the paradigm of behaviorism) and psychoanalysts, the answer to the question about the origin of autism is not so important, although for different reasons.

ABA therapy is recognized as an effective method of working with children with autism. This is a teaching program, the technique of which is entirely focused on the formation of skills, on the correction of undesirable behavior, on the achievement of the level of adaptation and socialization available to the child. The program is based on the discoveries of behavioral psychology, primarily on the idea of operant conditioning by Frederick Skinner, who believed that behavior can be studied, predicted and controlled by controlling the external environment in which the organism is involved (human or animal - it does not matter much). The reasons for our behavior, according to Skinner, lie entirely in the external world, and even the study of the brain as an internal organ (to say nothing of the mythical soul) is an erroneous way in determining how a person functions. So, using the reward-punishment system, it is possible to achieve the desired results in working with autists: under the supervision of educational psychologists, children learn basic skills from holding a spoon in the right way to reading. The main thing is to keep the child's attention on the task at hand, not to allow him to leave contact and close in his own shell. The subject, as well as his symptoms-inventions, are bracketed as something insignificant. At the same time, an abstract society is placed on a pedestal as something where you need not just fit in, but fit in in such a way as to be convenient for other members. Of course, skill building is very important and necessary, but by focusing only on this, we miss the human dimension and reduce a person to the level of a mechanism in which something broken must be repaired.

Psychoanalysis offers a radically different view. His break with the behavioral sciences lies in the place where the dominance of the mental world of drives, the world of desires, the world of fantasies, the world of experiences is recognized. Psychoanalysis returns the soul to psychology and thereby opens the human dimension, where the subject is not reducible to his behavior. Attention to human subjectivity and the uniqueness of each makes it possible to see new facets of symptoms that are created by a person, created by an autistic child in order to maintain the ability to live. The question of what is primary in autism - organic damage or the phenomena of mental functioning - turns out to be insignificant for the reason that in the clinic we can everywhere observe how even organic diseases acquire a psychological appearance. The main question an analyst can ask is what does it mean to be autistic?

The prevailing definition of an autist as a person imprisoned in his own world, as one who turns away from external reality, collapses upon careful observation of a child's play. An autistic, on the contrary, is captured by a thing from that very reality, he is absorbed by it, he is excited by it, attached to it, shocked by it and excited by interaction with it. This can be a special absorption in an object, light, sound. Autistic people are experts in a partial world of details, tact, facts, and parts. They grasp fragments with amazing clarity, but they are not able to grasp reality as a kind of integrity. For this reason, they can quickly put together the pieces of the puzzle, but be unable to see the whole picture. The psychoanalytic solution may consist in considering the subject chosen by the autistic as a way of communicating with the world and therefore trying to establish contact with the child through this object. This is a bridge capable of connecting two people.

Another feature of autistic behavior is endless repetition, stereotypes, rituals. It may seem that their special dream is to turn life into a set of predictable, repetitive actions. Any innovation for them turns out to be unbearable, traumatic and experienced as terrible. The outside world appears to be an attacker, and contact with it is painful. And only compulsive repetition makes it possible to stabilize reality, cope with its intrusion and try to structure it. The material world is more important for an autistic person than the interpersonal world, the world of communication. Our familiar way of communicating through words can become a big barrier between us and the autistic. It protects itself from direct contact. If we do not address him directly, we look away - this can calm the child and make him feel better. In order for speech to become bearable, it is necessary to make it only background noise, so that then a section can be carried out in this noise. Otherwise, a loud, harsh sound may be perceived by an autistic person as an attack on the body. Then he closes his ears, eyes, turns away, wraps himself in a blanket, or devises another way of protecting against excessive stimulation coming from the other and facing him. Already the differences in these inventions indicate that the autistic child creates a symptom, he is not driven exclusively by reflexes, as behavioral psychologists assume. Instead of removing this behavior, we should accompany the child in his decision, respecting his symptom, respecting his way of being in the world.

If an autistic person has access to speech, then you can see how he uses language like a kind of code, as if one word means only one thing. Then we find ourselves in the world of unambiguous statements, where the dimension of metaphor and metonymy is absent. In autism, words are depleted in their meaning, double meanings and richness of speech slip away. Therefore, when addressing a child, you can try to clearly formulate thoughts, avoiding double messages. Do not force the child to speak if he refuses to do so. Losing a sound by speaking a word can be tantamount to losing a body part for them, and therefore it hurts so much. Better to try to create a supportive, calming environment. Perhaps, when the world begins to be perceived as more bearable and safe, the child himself will gradually open up to contact. And, perhaps, it is worth respecting his decision more if he refuses contact.