In 1967 Bruno Bettelheim published The Empty Fortress: Infantile
Autism and the Birth of Self, forever affecting the world's
view of autism.1 Hailed by the popular press, the book showed how
three children with severe autism were effectively treated at the
University of Chicago's Orthogenic School through Bettelheim's application
of psychoanalytic theory and milieu therapy. Children who once exhibited
bizarre anti-social behavior were, in some cases, completely cured.
No one had ever been so successful with this enigmatic disorder.
Although Bettelheim's book did have its critics, the voices of the
few detractors were effectively drowned out by the overflow of praise
from Bettelheim's advocates.2 As a result, Bettelheim's thesis,
that the source of autism was the infant's relationship with her
"refrigerator mother," soon became the accepted explanation
of the cause of autism in popular and, in some, professional circles.3
For the next twenty-three years the writings of researchers, parents
of children with autism, and adults with autism served to help discredit
Bettelheim's claim of maternal causation. However, shortly after
Bettelheim, a Holocaust survivor, committed suicide in 1990 at the
age of 89, the world suddenly had reason to question more than his
hypothesis. Letters began to pour in to newspapers from former students
of the Orthogenic School. Bettelheim, the staunch advocate of safe
and comforting environments for children with emotional disabilities,
allegedly had physically and emotionally abused the children in
his care.4 Some of the adults that Bettelheim had claimed to have
"cured" of severe developmental disabilities, including
autism, claimed that they had entered the school with nothing more
than behavioral problems. Even more surprising was the discovery
that Bruno Bettelheim had neither a degree in psychology nor therapeutic
training. Instead, he wrote his dissertation on aesthetics and while
in Vienna, he was a lumber merchant.
These and many other posthumous revelations about Bettelheim prompt
serious questions for academics and lay people alike. How did Bettelheim
acquire a directorship at a school for children with psychological
disorders at a major American university, without a degree in psychology?
Moreover, how did he escape the supervision of an administrative
governing board during his entire twenty-nine year tenure as director
of the School? How did he convince so many to give so much to fund
the School and his research? Why did none of the several individuals
in the psychoanalytic field who knew of Bettelheim's false credentials
bring this fact to light? If anything is certain, it is that the
truth, for Bettelheim, was relative.5
Despite the overwhelming evidence against both Bettelheim's character
as well as his account of the etiology of autism, true believers
still exist. Peter Hobson, a prominent English psychologist, affirms
the "refrigerator mother" hypothesis in his 2002 book
The Cradle of Thought.6 Alfred A. Knopf, arguably one of
the most prestigious publishers in the U.S., published in 2002 a
biography of Bettelheim by his longtime literary agent Theron Raines.
The book takes Bettelheim's account of his career at face value.7
Jacques Bénesteau's 2002 book Mensonges freudiens: Histoire
d'une désinformation séculaire (Freudian Lies:
A History of a Century of Disinformation) documents the damage
still caused in France by the popularity of Freud and Lacan. Some
70% of French psychiatrists continue to treat autism and Tourette's
disorder, as well as depression, with psychoanalytic methods.8 Lacanian
psychoanalysis remains a significant force in literary and cultural
studies, despite the consistent failure of its scientific claims.9
Parents of autistic children, including the senior author of this
paper, can attest to the widespread belief by social workers and
other ostensibly educated professionals that autism results from
a failure in maternal bonding.10
The purpose of this paper is to investigate a little-studied phenomenon
in the rhetoric of science: the persistence of false beliefs in
an ostensibly scientific community. We proceed by analyzing generally
how Bettelheim's "ethos" was constructed during his lifetime,
and then focus more narrowly on the specific rhetorical strategies
used by Bettelheim in his response to Bernard Rimland at the end
of The Empty Fortress.
Context, Ethos, Audience
The success of Bettelheim in American academic circles and The
Empty Fortress as a text must be understood within the historical
context within which both were situated. Bettelheim's success was
a result of the state of American university in the 1940's and his
fabricated credentials. The Empty Fortress benefits from Bettelheim's
ethos as well as the American fascination with the Holocaust and
psychoanalysis.
American academe in the 1940's still was greatly prejudiced in favor
of European intellectuals. The influx of immigrants driven from
Europe by World War II helped build the growing university system.
Access to higher education was being granted to a larger portion
of the public and the sudden interest in the education system itself
facilitated the expansion. Bettelheim's first obstacle to attaining
the academic acclaim he craved was getting his first foothold into
the American university, which he achieved initially with his own
credentials, and later through lies, exploitation of social connections,
and his perceived European mystique.
Bettelheim received his first academic position teaching art history
at Rockford College in Illinois and participating in the Eight-Year
Study, which examined art education in American schools. These two
positions would be spring boards for Bettelheim into the Orthogenic
School. It was also at this point that Bettelheim first embellished
his credentials, calling himself a psychologist and claiming to
have treated a child with autism while he was living in Vienna.
Consequently, when the University of Chicago was seeking a qualified
individual to take over the failing Orthogenic School, one of Bettelheim's
colleagues from the Eight-Year Study suggested his name.
The effectiveness of The Empty Fortress in 1967 was, in large
part, due to the social context and intellectual fads of the era
in which it was published. Indeed, many of the preliminary questions
of how Bettelheim became an influential voice in the public sphere
and how he managed to succeed in eluding devastating censure from
the psychoanalytic community is a direct result of the historical
situation. As Pollock has noted, Bettelheim arrived on the academic
scene at a time when " 'the cause' so transfixed the populace
that in 1941 a singing analysand and her dreams starred on Broadway
in Lady in the Dark."12 Freud had become so popular
that his theory had reached into American mainstream culture.13
However, the fact that the American audience was captivated by psychoanalysis
and the Holocaust is not enough to explain Bettelheim's ascendancy
to the fore of child psychology.
Bettelheim was proactive in creating his own myth. It was Bettelheim's
first academic essay, "Individual and Mass Behavior in Extreme
Situations," published in 1943 that really gave him his authority
in psychology and his mystique in the public arena.14 "Extreme
Situations" was the first widely read essay in the United States
on the Nazi concentration camps.15 In this essay, Bettelheim gave
a psychoanalytic account of the mental deterioration of the camp
prisoners at the hands of the SS guards. This essay made Bettelheim
an "expert" on the camps and made his name in psychoanalysis.
It was also in writing "Extreme Situations" that Bettelheim
first used "science" to lend credence to his assertions.16
Although he continued to write for academic journals for the next
decade, these pieces were primarily co-authored with the Orthogenic
School's original psychologist, Emmy Sylvester. His solo academic
career was far less notable.
Upon finding that legitimate scholarly journals would not accept
his "science" merely on his word, Bettelheim turned his
attention almost entirely to writing for a mass audience.17 He wrote
a column for Ladies Home Journal from 1965-75. His mass audience
grew from the early sixties onward, devouring his articles in: Redbook,
Parents, Harper's, the Saturday Evening Post, Scientific American,
and Playboy.18 Bettelheim had something to say about everything
from "Why Working Mothers Feel Guilty" to "Speaking
Out: Stop Pampering Gifted Children."19 Bettelheim recycled
a great deal of his material. For example, an abbreviated version
of the story of "Joey the Mechanical Boy," one of the
case studies in The Empty Fortress was originally published
in Scientific American.20 These and other essays made Bettelheim
a household authority in psychology in the 60's. Although he criticized
others for using their patients to make them famous, it was his
hallmark.21 Bettelheim's celebrity was augmented by the publishing
of several books about parenting and the children at the Orthogenic
School prior to the publication of The Empty Fortress.
One of the main reasons Bettelheim was such a popular public author
was his insistence on the accessibility of scholarly prose.22 He
employed Encyclopedia Britannica editor Ruth Marquis to make
his text more readable. As an encyclopedia editor, writing for a
mainstream audience was her forte. In addition to the vividness
and clarity of writing in his books and articles, Bettelheim used
pictures, films and the students' illustrations in many of his public
presentations. He hired professional photographers and filmmakers
to capture the students in action, which he would then conveniently
interpret for his audience to show the students' progress. These
films, illustrations and pictures were a mainstay of his fundraising
campaigns. Their success is evident in the fact that Bettelheim
was a leader in donation solicitation for the University of Chicago.
By 1963, Bettelheim's colleagues felt that he was so "well
known and respected by the lay public that any challengers risked
being accused of sour grapes."23 It was the same fear that
kept Bettelheim's ex-wife, Gina Weinmann from telling anyone that
it was she who had treated the young "autistic" girl,
Patsy, not Bettelheim. He had probably been given quite a bit of
leeway by the psychoanalytic community initially for his shabby
scholarship on the basis of the subject-matter of "Extreme
Situations," since the majority of the early psychoanalytic
community in America consisted of exiled Viennese and German Jews.
Additionally, Bettelheim's public success helped to disseminate
psychoanalysis to a wide audience. However, by the height of Bettelheim's
popularity, when his lack of theoretical framing and questionable
methodology could do the most harm, it was too late for the community
to begin to criticize him. Instead, the psychoanalytic community
never allowed Bettelheim into the fold, excluding him almost entirely
from all associations, a fact that would trouble him to his dying
day.
Bettelheim's ethos, then, stems from a conjunction of factors: post-WWII
fascination both with Freud and the Holocaust, his careful management
of his public image, his careful attention to writing for a general,
educated audience, and a generalized anxiety about the family in
1950's and 1960's America. A larger question beyond the scope of
this study is: why did so many mothers and medical and educational
professionals in post-WWII America become so obsessed with the image
of the "bad mother"? It may be that some aspects of classical
Freudian theory remain useful, not for individual psychology, but
for collective psychology. Lynn Hunt, for example, makes a persuasive
argument about the dominant role of maternal and paternal imagery
in the discourse of the French Revolution. There may be a similar
"family romance" worth investigating as part of the context
of Bettelheim's work.24
Bettelheim's Critique of Kanner and Rimland
We now turn to an examination of Bettelheim's strategies in dealing
with his primary scientific opponent, Bernard Rimland, in the final
part of The Empty Fortress. Bettelheim states that the purpose
of this section is not to review everything that has been written
about autism since it "would fill a tome many times larger
than this one" (385).25 Rather, Bettelheim states that his
purpose in this book was to set forth the experience of a group
of people who have worked intensively for many years with autistic
children, to tell what we learned from it about the nature of the
disturbance, about treating such children, and about early personality
development" (385). Because he addresses so little of the available
literature on autism, Bettelheim's discussion becomes argumentatively
self-serving, best illustrated in the presentation of his two primary
opponents, Kanner and Rimland.
According to Bettelheim, Kanner's original error was in viewing
autism as a biological disorder. In so doing, Kanner ignored one
of Freud's greatest lessons. By not questioning the underlying motivations
driving an individual's behavior, to believe that an individual
acts without thinking at least on some level, we easily fall into
the trap of attributing cause to an inherent personal defect. Bettelheim
argues that Kanner had access to the necessary information to make
a more thoughtful conclusion than assuming that autism was an innate
disorder.
In his inaugural paper on the subject, Kanner had stated that children
with autism do not relate to others. However, in a later paper Kanner
notes that "emotional refrigeration has been the common lot
of autistic children" (389).26 Kanner speculates further that
it would be difficult to conclude that the child's emotional environment
did not have some affect on his behavior even if the reported "emotional
refrigeration" was not the original cause but the parents'
reaction to having a child with autism. Bettelheim argues that it
is contradictory to state that children with autism do not relate
to others and yet affirm that the child's emotional environment
could be a factor in the child's condition.
In fact, Bettelheim says that he is thankful that his first encounter
with autism came before Kanner had identified the disorder since
his work was not corrupted with the belief that this child could
not form affective contact.27 Upon discovery of Kanner's paper in
the 1940's, Bettelheim was surprised to find that he had indeed
been treating a child with autism but "by that time [he] could
not accept his conviction that for her and others like her it was
'an innate inability to form affective contact'" (392).28
Bettelheim finds Kanner's hypothesis that autism is a disorder existing
from birth equally troublesome. Although some parents have reported
that their children had shown signs of autism as early as a few
months old, Bettelheim says that, upon scrutiny, none of these reports
hold up. In fact, most reports have found that autistic symptoms
become apparent around the age of two, a finding with which Bettelheim
states is consistent with both his theory and experience: "since
I also believe that autism is basically a disturbance of the ability
to reach out to the world, it will tend to become most apparent
during the second year of life when more complicated contact with
the world would normally take place" (393).29
Even though autistic symptoms may not be detectable until the age
of two, Bettelheim argues that this does not mean that the original
damage had not occurred much earlier. For example, studies have
found that in the later months of pregnancy if the mother's stress
level is raised so is the level of fetal activity. Additionally,
children who have been raised in environments lacking in stimulus,
like many institutions, have often been found to have serious mental
and emotional scars. So although Bettelheim does not believe that
autism exists at the moment of birth, the event which caused the
autistic withdrawal in the child could very well have occurred immediately
thereafter.
Like Kanner, Rimland's neurological theory of autism also presupposes
that autism is an innate disorder. Rimland holds that autism is
caused by a dysfunction in the reticular formation of the brain
stem; the portion of the brain responsible for arousal. In response,
Bettelheim argues that even if a neurological source of autism is
definitively discovered, it does not preclude the psychological
explanation. It quite possibly could follow that there exist certain
periods during which certain neurological systems must by stimulated
to maintain normal development. If, as Bettelheim has argued, the
emotional environment of the child is poor, it may explain why the
central nervous system becomes dysfunctional.
Moreover, Rimland's argument that autism is caused by a dysfunction
of the area of the brain responsible for arousal is contradictory
to the behaviors exhibited by these children. If Rimland is correct,
Bettelheim posits, then it makes no sense that many children with
autism will plug their ears, close their eyes, and even scream in
the attempt to shut out stimuli? Instead, Bettelheim believes that
"[t]hrough their shutting out of sensation they [avoid being]
confronted by a frustrating reality" (402).
Bettelheim does agree with Rimland that nothing is to be gained
by blaming parents. Instilling a sense of guilt in the parents of
these children is useless since whatever they may have done to cause
their child's disorder, Bettelheim says we can be certain that "they
did [it] because they could not help themselves to do otherwise"
and "[t]hey suffer more than enough in having such a child"
(404). Keeping this in mind, we still should not cease searching
in the parent/child relationship for anything that may be helpful
to our understanding.
According to Bettelheim, "what counts from a human point of
view is which theory of causation offers the better chance of relieving
the distress of children who suffer from [autism] today" (413).
To this end, Bettelheim compares the results of Eisenberg's long-term
study of patients with autism with his own.30 Eisenberg divided
the patients into three categories; "poor," those who
had not emerged from their autism at all, "fair," those
who had taken some classes at their appropriate age level, had meaningful
contact with others yet still would be identified as deviant, and
"good," those who were successful socially and academically
and who would have been accepted by their peers even though they
may still be considered a little odd. For the sake of comparison,
Bettelheim keeps Eisenberg's categories. Bettelheim says that although
they had worked with forty-six autistic children, six were eliminated
from the study for not having been at the School long enough or
as in one case, having been previously exposed to electroshock therapy.
Bettelheim reports the product of the comparison as:
[T]here were eight in our forty for whom the end results of therapy
were "poor" because, despite improvement, they failed
to make the limited social adjustment needed for maintaining themselves
in society. For fifteen the outcome was "fair" and for
seventeen "good." Thus while Eisenberg reports only 5
per cent good outcome, our experience shows that intensive treatment
can raise this figure to 42 per cent. While he reports only 22 per
cent fair improvement, we can report 37 per cent. Most important,
while he found 73 per cent poor outcome, we had only 20 per cent
poor results. (414)
For Bettelheim, the discrepancies between his results and those
reported by Eisenberg are conclusive evidence that because the psychoanalytic
approach to therapy has been more successful, the ultimate claim
of causation is more likely psychological than physiological.
Kanner noted that children with autism avoid using the pronoun "I"
in favor of the pronoun "you." Kanner concluded that this
reversal of pronouns like the autistic child's tendency to memorize
long lists of information is symptomatic of the fact that language
holds little meaning for them. Kanner and Rimland both agree that
the child with autism is able to repeat words without acquiring
understanding.
Bettelheim states that "Rimland, a psychologist seems uninterested
in the psyche of autistic children, since he did not study them
as persons but inquired only into the neurological structure of
their brains"(433).31 Had both Rimland and Kanner been more
astute, they would have realized that the child with autism does
not use the pronoun "I" for several reasons, none of which
is a lack of understanding of language. The autistic child may avoid
using the pronoun "I" so that he can hide his innermost
thoughts. In some cases, it could also be "either a denial
of selfhood or denotes an absence of awareness of selfhood - while
the substitution of "you" shows some awareness of the
selfhood of others" (427). But primarily the child who avoids
the "I" "is complying with what he considers a parental
wish that he should not exist" (429). Finally, the autistic
child conducts the aforementioned feats of memory, not as exercises
in repetition, but to indicate to the world that he is not feeble
minded. Because these children are too afraid to "speak freely"
they must covertly prove to the world that they are indeed intelligent
(430).
Analyzing Bettelheim's Rhetorical Strategies
Bruno Bettelheim's The Empty Fortress has been called "the
empty book;" Bettelheim himself has been called much worse.
However, if The Empty Fortress were so devoid of value and
Bettelheim such a monster, how is it that his arguments gained credence
and he is still revered in some circles? This apparent contradiction
can be negotiated first through the critical application of three
classical rhetorical tests: Aristotle's ethos, and Cicero's invention
and arrangement. Secondly, the more recent rhetorical theory of
Chaim Perelman offers a discussion of the evidentiary value of example,
the differentiation between the universal and particular audience,
and "presence," the rhetorical function of information
selection.32 Because Bettelheim's claims of scientific validity
were influential in the credibility assigned his conclusions, it
is important to look at The Empty Fortress as not only a
rhetorical narrative, but also as a scientific work. As Alan Gross
has revealed in The Rhetoric of Science, even the sacredly
objective fields of science use these traditional rhetorical strategies
to persuade.33
Gross argues that the use of rhetorical strategies in the scientific
fields necessitates the viewing of rhetoric as epistemic. That is,
rhetorical methods not only help communicate knowledge, they help
us acquire knowledge in the first place. R.L. Scott elucidates the
theory of a rhetorical epistemology.34 As Scott has argued, to view
rhetoric as epistemic requires that one relinquish the possibility
of definitively knowing the "truth." Nonetheless, understanding
can be and is achieved within traditions and communities. These
communities act as check and balance systems for those arguing within
their tradition. As a result, if the understanding achieved within
a specific tradition is consistent with their standards and knowledge,
it is "true" for that community. Scientific communities
must police their own.35 The specialization of knowledge and language
has created a gap in the laity's ability to criticize much of what
comes out of science. It is precisely this chasm of expectation
and knowledge that Bettelheim exploits in The Empty Fortress.
Thus, an analysis of Bettelheim's The Empty Fortress offers
a new chapter to the evolving field of the rhetoric of science.
In The Empty Fortress, Bettelheim had two goals. First, Bettelheim
wanted to prove that autism was a parallel condition to the "moslems"
in the concentration camps caused by an "extreme situation,"
namely the child's parents. Second, Bettelheim attempted to create
a stage theory of infant development that paralleled Erikson's adolescent
developmental theory.
That Bettelheim's theory of development didn't gain acceptance is
no real surprise. First, Bettelheim spends little effort in pursuing
this argumentative avenue. Second, developmental theory has always
been under the authority of child psychology. Although Anna Freud
had for some time been using psychoanalysis to evince child behavior,
it was not generally accepted in the more rigorous divisions of
psychology. Bettelheim was essentially dismissed by those in classical
psychology for his lack of scientific rigor, his ties to psychoanalysis,
and his intentionally sensationalistic prose. When they chose to
speak out against him it was in academic journals and out of sight
from the popular media. Nonetheless, Bettelheim aims for acceptance
with the community by utilizing scientific terminology, form and,
"statistics," while still violating scientific standards.
Because Bettelheim attempts to embrace two approaches to psychology
with two distinct methodologies and traditions, he escapes the censure
of both.
As Gina Weinmann has stated, by the time Bettelheim had published
The Empty Fortress, those in the psychoanalytic community
who knew of his falsified credentials were hesitant to reveal them
in fear that they might be assumed jealous of his stardom. In fact,
Bettelheim had played a major role in increasing the popularity
of psychoanalysis to a mass audience. To argue against Bettelheim
could not only make others appear to be exhibiting "sour grapes,"
it would show a fissure in the community and in turn show that psychoanalysis
was not exactly a "science." But Bettelheim could not
relinquish his ties to psychoanalysis. Without a psychoanalytic
view he never could have made the interpretations of the children's
behavior that led him to his stage theory of development. In addition,
his rationale for viewing the prisoners in the concentration camps
as an explanatory analogy and source for his theory came from "introspection,"
which, while acceptable in psychoanalysis it is denigrated in psychology.
Hence, if one asks who was Bettelheim's community, it was the lay
audience and those on the border of science: social workers, school
counselors, and administrators. Bettelheim geared his message to
them in form and content, but always with an eye towards achieving
the ever elusive scientific legitimacy. So although Bettelheim was
striving to achieve the adherence of two particular audiences, the
psychological and psychoanalytical communities, he too wrote for
what Perelman has called the "universal audience," the
ideal reasonable audience.
Each particular audience is united by common beliefs. It is the
burden of the rhetor to maintain the integrity of his arguments
while still shaping them to the belief system of the particular
audience in order to maximize persuasion. However, as Perelman has
noted, the rhetor can not ignore the larger universal audience,
the ideal reasonable audience. Because particular audiences can
occupy such narrow intellectual space thereby encouraging bias (the
preacher preaching to a room of believers) for his arguments to
truly add to knowledge, the rhetor also must persuade the universal
audience. In this configuration, the particular audience offers
the rhetor the less difficult playing field: perspective is de facto
limited, rules are apparent, and beliefs are shared. The universal
audience presents a much different rhetorical challenge.
The universal audience is a construct of the rhetor's mind. As Perelman
states: "Everyone constitutes the universal audience from what
he knows of his fellow men, in such a way as to transcend the few
oppositions he is aware of. Each individual, each culture, has thus
its own conception of the universal audience."36 The rhetor's
conceptualization of the universal audience affects the nature of
his arguments to the extent that they "must convince the reader
that the reasons adduced are of a compelling character, that they
are self-evident, and possess an absolute and timeless validity,
independent of local or historical contingencies."37 In effect,
the rhetor's construction of the universal audience is telling since
it is through his use of arguments appealing strictly to the reason
of this imaginary audience that he reveals what it is that he believes
to be self-evident.
Oddly, in this case, Bettelheim succeeds in persuading his conceptualization
of universal audience while failing with the particular audiences.
Bettelheim's primary appeal to the reason of his audience is that
autism, in both its source and symptoms, is parallel to the condition
of the "moslems" in the Nazi concentration camps. Yet
it is not enough for Bettelheim to simply argue the parallel case;
his study must also appear to be scientific, lest he be accused
of simply projecting his major frame of reference, his experience
in the concentration camps, onto his theory of autism. To that end,
Bettelheim imitates the structure, form of reasoning, and methods
of proof used in science. But Bettelheim's "science" is
tainted by his psychoanalytic background both in his rationale and
methodology, as well as his utilization of the case study. Nonetheless,
it is this strategic patchwork of theory and methodology that Bettelheim
uses as a foundation for "proof" of the parallel between
those with autism and the "moslems." Bettelheim's conclusion,
that autism is a condition parallel to the "moslems" in
the concentration camps, is dependent on the success of the rhetorical
strategies that he used in an attempt to gain the adherence of his
two particular audiences. So ironically, it is with the arguments
rejected by his particular audiences that Bettelheim is able to
exploit the ignorance of his universal audience.
Each scientific field has its own conceptualization of how theory,
methodology, and proof interact to make a compelling argument. But
science is a rhetorical community and hence shares communal values
relevant to Bettelheim. Hallmarks of good science include: the privileging
of inductive over deductive reasoning, following a standardized
report format, and using case studies as illustration.38
The most damaging of Bettelheim's violations of the scientific method
is his approaching the problem of autism deductively. Science's
purposeful privileging of inductive over deductive reasoning is
a check for objectivity in invention.39 Traditionally, invention
is "where" one looks for arguments. To reason inductively
is to look toward the observed phenomenon to make the arguments;
to reason deductively is to seek in the phenomenon rationalization
for existing arguments. Although never a certain outcome, objectivity
is better served through induction.
As indicated by his grant application and his comments to friends,
Bettelheim sought the cause of autism in the parents. Before he
had admitted one student with autism, Bettelheim had determined
the source of the disorder. In doing so, Bettelheim committed himself
to viewing autism as a psychological disorder rising out of environmental
causes while precluding any other possible explanation. This step
would later allow Bettelheim to make the damaging parallel between
children with autism and those interned in the concentration camps
and further, between the mothers of children with autism and the
SS guards.
This first deductive leap opens a Freudian back door for Bettelheim
into the science of child development. If autism has an environmental
cause, rather than a physiological cause, Bettelheim might be able
to find clues to normal infant development through the recovery
process of children with autism. How severely afflicted the child
was would determine when the child first turned inward. In order
to show the stages of development the most clearly, Bettelheim selects
the most "hopeless" of his students for his case studies;
those who are most like the "infant."40
Bettelheim's deductive reasoning is also demonstrated in the arrangement
of his arguments. The persuasive value of arrangement first taught
by Cicero, has been modified by the sciences to mimic the process
of induction so that the experiment (discovery process) is described
first followed by a results/discussion section (what was proved).
In the scientific article, it is standard to review the topic literature,
indicate a contradiction or a space for further research, show how
the particular study will contribute, and then fill the intellectual
space created (including a description of the theory, rationale,
and methodology to be used).41
On its face, The Empty Fortress appears to maintain the scientific
format. There is an introduction in which Bettelheim describes his
theory, methodology and rationale. Bettelheim then situates himself
and his theory within the literature and utilizes the case study.
He has a conclusion and talks about the implications of his study.
But that is where the similarities end. In both arrangement and
content, Bettelheim's format is inconsistent with the accepted scientific
norm.
First, his rationale for his theory and methodology in his introduction
is his own introspection. This is a particularly suitable approach
since, according to Bettelheim, the restraints of science make it
impossible to examine the human mind in all of its complexity. This
rationale is both an appeal to the psychoanalytic audience and to
the humanity of the universal audience. The conclusion of Bettelheim's
introspection is that autism is a parallel condition to the "moslems"
in the concentration camps caused by exposure to an extreme situation.
Moreover, because Bettelheim had personally experienced the "inescapability"
of the concentration camps, he is uniquely qualified to examine
the parallel problem of autism.
Anticipating that he might be accused of operating out of personal
bias, Bettelheim invokes the "scientific" claim that the
conclusions contained in the book have been verified by his team
of researchers. Because, as Bettelheim states, "the uses of
introspection for understanding others would be a projection of
one's own experience, with little scientific merit."42 However,
as his multiple biographies have exposed, Bettelheim trained each
of his otherwise unqualified therapists thereby calling into question
the objectivity and capability of these women to either vouch for
or to invalidate his hypothesis. It is on the basis of this balancing
act that Bettelheim claims his conclusions are informed, yet scientific;
experiential, yet objective.
Bettelheim's theoretical rationale is no more suspect than his methodology.
Bettelheim describes his "milieu therapy" essentially
as a journey without a map:
[O]ur task as we see it is to create for him a world that is totally
different from the one he abandoned in despair, and moreover a world
he can enter right now, as he is . . . Each of us is implying in
his way that one cannot help another in his ascent from hell unless
one has first joined him there, to whatever degree. There is no
"direct confrontation" available to the sick child, unless
somebody offers himself for the confrontation. This will always,
to some degree, mean a descent to one's own hell . . . At the same
time there is no purpose to such a venture if all that happens is
our offering to accept the child in his desolation. What we also
have to demonstrate is that together we can make a go of it, even
down there - something that he alone at this point cannot do . .
. Hence at the heart of our work is not any particular knowledge
or any procedure as such, but an inner attitude to life and to those
caught up in its struggle, even as we are.43
Although appealing in that it is a sympathetic and moving view
of how to approach a child with a severe mental disorder, Bettelheim's
"milieu therapy" lacks precision and even the most general
of guidelines. Again, the lack of rigor in Bettelheim's "milieu
therapy" would likely be ignored in the psychoanalytic community
in which the analysand/patient guides the treatment and "knowing
the other" is contingent upon "knowing the self"
(3).44
Thus, if the introduction to the scientific article is the point
at which the researcher situates himself within a community of knowledge,
it still remains unclear precisely in which community Bettelheim
chooses to locate himself. It is at this point that his construction
of his universal audience takes form. If knowledge is contingent
on communal agreement, it is in the diversity of appeals, to the
communities of science, psychoanalysis, and those transfixed by
the horrors of Nazi Germany, that Bettelheim creates his universal
audience and hence his grounds for understanding.
Bettelheim continues to develop his theory of causation in the following
two chapters. Although he situates himself within the literature,
it is not within the studies done on autism, of which there were
many. Bettelheim reserves his discussion of the studies on autism
to the end of the book, in which they occupy the argumentative space
of rebuttal. Instead, Bettelheim manipulates animal behavior studies
and research findings on both normal children and children with
a variety of psychological disturbances to suit his needs. Bettelheim's
purpose in using alternative studies to establish his theory serves
several functions. First, Bettelheim is able to retain the "guise"
of science by backing up his claims with scientific research findings.
Second, Bettelheim is able to develop his hypothesis of the cause
of autism without having to deal with any counter-explanations.
Finally, the alternative literature that Bettelheim selects as foundational
to his theory implicitly turns his audience's attention to viewing
autism as a disorder of "nurture," since each of the subjects
concerned in these studies at least began a life as "normal."
For anyone unfamiliar with child development or autism, Bettelheim's
theory sounds groundbreaking. Thus, the reader is fully immersed
in Bettelheim's theory then courted by the presence of the case
studies long before Bettelheim concerns himself with the major works
on autism.
Additionally, since the purpose of the literature is to create a
"research space," in circumventing the studies done on
autism, Bettelheim is able to mold from the alternative studies
the space he needs to reify his deductive claims. In "Where
the Self Begins," Bettelheim argues that there is a point in
a child's development when he is particularly vulnerable to his
outside environment. In "Strangers to Life," Bettelheim
"fills" the research space that he created in "Where
the Self Begins" to show the specific ways a destructive environment,
or "extreme situation," affects the child. It is here
as well that Bettelheim lays the groundwork for his defunct stage
theory of development. In attesting that he is attempting to discover
the stages of early infant development, Bettelheim is able partially
to rationalize the extensiveness of these two sections as well as
his limited selection of literature to review.
So not only does Bettelheim fortify his deductive claims through
his literature selection, but he places his "findings,"
his theory, before his discussion of his "experiments,"
the case studies. In inverting the standard scientific process,
Bettelheim reconstructs his deductive reasoning. Yet this arrangement
is necessary to give "scientific" credibility to his Freudian
interpretations of the children's behavior. For instance, under
this arrangement, Laurie looking upwards toward elusive "good
breast" is made far more reasonable since Bettelheim has already
shown that nursing is "the nuclear experience out of which
develop all later feelings about oneself and other persons
"
(19). Bettelheim is not just another Freudian obsessed with breasts.
Instead, he has already indicated in his theory how it is in feeding
that the infant begins to develop a sense of self and this frustrated
yearning for the breast is the autistic child acting out his frustrated
sense of self.
Circularly, while the theory section helps validate Bettelheim's
interpretations, his interpretations help validate his theory. The
interplay between his theory and interpretations can best be understood
through Perelman's concept of "presence." Perelman describes
this strategy as: "one of the preoccupations of a speaker is
to make present, by verbal magic alone, what is actually absent
but what he considers important to his argument or, by making them
more present, to enhance the value of some of the elements of which
one has actually made conscious."45 Bettelheim has already
"made conscious" to the audience that a child is vulnerable
to the environment and if something in the environment constitutes
and extreme situation he will react similarly to the "moslems"
in the concentration camp, a disorder in children called autism.
The case studies of Laurie, Marcia, and Joey recreate actual instances
of his theory, hence "enhanc[ing] the value" of his theory.
In fact, there is not one behavior exhibited by these children that
had not previously been accounted for in Bettelheim's theory. But,
Bettelheim does not simply describe these children's behavior, he
interprets their behavior through the framework of his theory. As
a result, he makes present "what was actually absent"
in these children's behavior through his interpretations. Because
the behaviors exhibited in the children of the case studies are
so bizarre, his interpretations within the frame of his study begin
to make sense as the only means of explaining these deviancies.
Yet the fact that none of these behaviors goes unexplained is rather
suspect. In essence, this is another instance of Bettelheim's deductive
reasoning. The case studies act as evidentiary examples of Bettelheim's
deductive theory rather than as illustrations of inductive findings.
When Bettelheim finally turns his attention to the arguments of
Kanner and Rimland it is to refute the claims that autism is an
innate disorder. In his "rebuttal" it becomes apparent
why Bettelheim did not originally situate his theory within the
literature of the studies done on autism. Bettelheim takes these
theories to task on two points: 1) they are unable to explain the
autistic child's inability to differentiate the "I" and
the "you" in language use and 2) they cannot explain why
autistic children would shy away from stimuli, if it is a disorder
of the part of the brain dealing with arousal. Only Bettelheim's
theory is able to explain these issues. Nonetheless, Bettelheim
argues that even if a neurological or organic problem is found to
correlate with autism, it could have been a result of the early
environmental damage that caused autism, not the source itself.
Thus, these studies can never refute Bettelheim's claim of causation
until a test is constructed that can detect the biological existence
of autism at birth; thus his claim is proven because it cannot be
disproved. Bettelheim's conclusion is that both Kanner and Rimland
have viewed autism as a problem to be solved while ignoring the
human element. Rimland "did not study them as persons but inquired
only into the neurological structure of their brains" (433).
Kanner, for his part, argued that children with autism cannot relate
to others. Bettelheim says that they do relate, but in their own
fashion.46
Finally, Bettelheim decides to meet the scientists on their own
grounds. In characteristic fashion, when Bettelheim believes his
findings are in doubt, he invokes "science." Bettelheim
argues that the theory that best explains the cause of autism should
be able to be determined by how effective the method of treatment
driven by that theory is. Bettelheim is not satisfied that his theory
should be accepted by default. As a result, he engages in a statistical
comparison with the only long-term study done from Kanner and Rimland's
position. According to Bettelheim, the statistical improvement in
his patients is significantly better than that resulting from the
other approaches. Because Bettelheim's methods of treatment, based
on his theory, create better results, his theory must be right.
However, Bettelheim's statistics are problematic. In his grant application
he states that he is planning to admit twelve children with autism
for his study. The school records show that he admitted ten, only
two of whom had entered with the diagnosis of autism. Yet, Bettelheim
gives a base number of forty-six, forty of which will be used for
comparison. Where are these children? Even if the numbers might
be troublesome, Bettelheim is safe in making his success rate claims
since the children's records are sealed. No one will ever know how
successful Bettelheim's "milieu therapy" really was. Additionally,
Bettelheim never gives Eisenberg's base numbers nor does he discuss
what, if any, sort of therapy Eisenberg's children have undergone.
The comparison and hence Bettelheim's conclusion arising out of
the comparison is faulty.
But, according to Bettelheim, he is the only researcher who has
viewed autistic children as people. Bettelheim's rhetorical ethos,
the credibility assigned a rhetor as a result of his arguments,
is particularly geared to establish this image and the image of
utter competency throughout the book. For those unfamiliar with
his history, Bettelheim reviews in the introduction that he has
written extensively on the subject of child psychology. He also
establishes his credibility as a Holocaust survivor. He is the only
one capable of truly understanding the cause of autism, having first
hand experience of the extreme situation. His insights into the
children's behavior, his "milieu therapy," his expressed
sympathy for the children ravaged by autism, all further his image
of the "good doctor." While we have barely scratched the
surface of Bettelheim's rhetoric in this paper, it is perhaps this
fundamental need to believe in the figure of the "good doctor"
that underlies the mythic rhetorical structure of the persistent
belief in the maternal-cause theory of autism. Viewed in hindsight,
it appears that Bettelheim's work, like that of Freud himself, was
less that of a modernist effort to replace religion with science
than that of an effort to preserve a space for traditional, allegedly
"humanist" values. It was an attempt, finally, to affirm
that we have "minds" and "souls" rather than
simply "brains." That a more humane treatment for autistic
persons would come from focusing on their neurology rather than
on the "meaning" of their lives is but one of the many
ironies of the career of Dr. Bettelheim.
Notes
1. Bruno Bettelheim, The Empty Fortress: Infantile Autism and the
Birth of Self (New York: Free Press, 1967).
2. Although some had begun to doubt Bettelheim's methods before the
publication of his book, most of the comments appeared in academic
journals and were ignored by the popular press. See Jacques May's
letter to Scientific American, 200 (May 1959): 12; Norris Haring
& E. Lakin Phillips, Educating Emotionally Disturbed Children
(New York: McGraw-Hill, 1962): 21; and C. Gary Merritt's, review of
The Empty Fortress, American Journal of Orthopsychiatry
38 (Oct. 1968): 926-930.
3. This hypothesis was originally hinted at by Leo Kanner. Although
Kanner allowed that the child's psychological environment could
be influential he believed, though, could not prove, that autism
was a disorder with which one was born. See Leo Kanner, "Problems
of Nosology and Psychodynamics of Early Infantile Autism" American
Journal of Orthopsychiatry, 19 (July 1949): 425.
4. The first letter appeared in the Chicago newspaper, the Reader
on April 6, 1990. Although it was unsigned, it was later attributed
to Alida Jatitch. Charles Pekow, also a former student, accused
Bettelheim of making incorrect diagnoses and of abuse in the Washington
Post on August 26, 1990. Graduate student Ronald Angres, another
of Bettelheim's students diagnosed with autism, took his turn in
the October 1990 issue of Commentary. Bettelheim biographer
Nina Sutton and others have argued that many of these former students
were upset that Bettelheim had committed suicide and were lashing
out in hurt and anger. Others commented that since these former
students were now such functional adults, Bettelheim's therapeutic
method must have been effective. Some discounted the students' claims
by arguing that when under Bettelheim's care they were considered
"troubled" and thus their recollections are questionable
at best. Yet, in light of the other posthumous revelations about
Bettelheim, the students' story seems feasible.
5. It would seem that Bettelheim believed in relative truth concerning
his credentials since, according to Sutton (1996), he worried about
the possibility of the discovery of many of the half-truths and
outright lies he used to bolster his credibility. However, it should
be noted that Bettelheim never doubted the truth of his scholarly
claims.
6. Peter Hobson, The Cradle of Thought (London: Macmillan,
2002).
7. Theron Raines, Rising to the Light: A Portrait of Bruno
Bettelheim (N.Y.: Alfred A. Knopf, 2002).
8. Brussels: Mardaga 2002. Chapter 15 discusses autism.
9. Here is a typically obscure remark by the Master on autism:
"Autism's weight of words corresponds [...] to a serious slowing
down of language serial games - and not to a state of the infans
being - a slowing down which may go as far as to seal itself in
a deathly silence. The absolute Master, death, submits the serial
to a law which organizes it, whereas seriousness ordains that there
be no possible mistake about the Master; in this sense it does not
deceive." http://www.lacan.com/lacinkI3.htm (downloaded 10/26/05).
10. A social worker in Rice County, Minnesota, in the 1990's was
notorious for pulling autistic children from their homes on the
ground of child abuse.
12. Richard Pollak, The Creation of Dr. B: A Biography of Bruno
Bettelheim (New York: Simon & Schuster, 1997): 127.
13. Freud had become even more popular by the 1960's. For a discussion
on Freud in America see: Nathan Hall, The Rise and Crisis of
Psychoanalysis in the United States: Freud and the Americans, 1917-1985
(New York: Oxford UP, 1995). For a feminist take on the abuse of
Freud, see Molly Ladd-Taylor and Lauri Umansky, "Bad"
Mothers: The Politics of Blame in Twentieth-Century America.
(New York: New York University Press, 1998).
14. Bruno Bettelheim, "Individual and Mass Behavior in Extreme
Situations," Journal of Abnormal and Social Psychology 38
(Oct. 1943): 417-452.
15. Two other essays on the camps had been published in England,
but received little attention in the U.S. (Pollock 116).
16. In "Extreme Situations," Bettelheim states that
he interviewed over 1500 prisoners while in the camps and had resided
in 5 different bunkers. The former assertion is, by all accounts,
highly unlikely. The latter is categorically untrue. In his introduction
of The Empty Fortress, Bettelheim asserts that the scientific
method is likely unsuited for psychological studies (3). Nonetheless,
he utilizes statistics and scientific language in all of his major
works to gain credibility.
17. His last contribution to a major psychoanalytic journal was
in 1950. In 1961 he submitted an article about an autistic girl
to the Journal of the American Psychoanalytic Association.
The editorial board said that it read "almost like a novel"
(Pollock 225) but that they would like it if he "would supply
more details as to how he rea[c]ed his formulations (letter from
John Frosch to BB, Jan. 12, 1961, Max Gittelson papers, Library
of Congress, cited in Pollock 225). Bettelheim made a rather acerbic
reply and subsequently discontinued writing for academic journals.
18. See Sutton's biography for a near exhaustive list of Bettelheim's
life publications.
19. The first was published in the March, 1966 ed. of Redbook,
the second in the April 11, 1964 ed. of the Saturday Evening
Post.
20. This article first appeared in the March 5th, 1959 edition
of Scientific American. In typical Bettelheim style, it was
fully illustrated with "Joey's" drawings showing his progress.
21. Bruno Bettelheim to Daniel Karlin, Nov. 4, 1974, cited in
Pollock 328.
22. In writing for the magazine Politics in 1948, the editor
told him that "for a general magazine, (heavy scholarly prose)
is not necessary, and just loses the reader's attention."
Dwight Macdonald to Bruno Bettelheim, from the Dwight Macdonald
papers, Manuscripts and Archives, Sterling Library, Yale University,
cited in Pollock, 169. He not only learned his lesson, he later
criticized others for the same thing. "In reviewing a book
for the College Art Journal, Bettelheim criticized the author for
making his text 'forbidding for the college student.'" Bruno
Bettelheim review of "The Aesthetic Process" by Bertram
Morris, College Art Journal 3 (May 1994):166, cited in Pollock
126.
23. Pollock 224-225.
24. Lynn Hunt, The Family Romance of the French Revolution
(Berkeley: University of California Press, 1992).
25. In making this admission, Bettelheim directly contradicts
his statement in his grant application. Bettelheim had stated that
there weren't any long-term studies done on the subject of autism,
yet the first researcher Bettelheim contends with is Kanner (with
Eisenberg), who had conducted an extended study on autism before
Bettelheim had begun his project.
26. L. Eisenberg & L. Kanner, "Early Infantile Autism,
1943-1955," American Journal of Orthopsychiatry 26 (1956):
556-566, cited in Bettelheim (1967) 389.
27. The child to whom Bettelheim is here referring is Patsy. Not
only was Patsy never actually diagnosed with autism, but as stated
earlier, by all accounts Bettelheim had little to do with her care.
28. Bettelheim is again contradicting himself here. Earlier he
stated that the reason he and the counselors had originally misunderstood
Laurie's second collapse was because they had just started to work
with children with autism and were still unduly influenced by arguments
that these children could not form emotional relationships.
29. Bettelheim conveniently omits this portion of his theory in
his review of Laurie's history. For Laurie, the autistic withdrawal
was brought about by the desertion of her first nursemaid.
30. L. Eisenberg, "The Autistic Child in Adolescence,"
American Journal of Psychiatry 112 (1956): 607-612, cited
in Bettelheim (1967): 413-416.
31. This is a particularly biting comment since Rimland's own
son suffers from autism.
32. Aristotle, On Rhetoric: A Theory of Civic Discourse,
Trans. George Kennedy (New York: Oxford UP, 1991); Chaim Perelman
& Lucy Olbrechts-Tyteca, The New Rhetoric: A Treatise
on Argumentation, Trans., J. Wilkinson & P. Weaver (London:
University of Notre Dame Press, 1969).
33. Alan Gross, The Rhetoric of Science (Cambridge MA:
Harvard UP, 1990).
34. Robert L. Scott, "On Viewing Rhetoric as Epistemic"
Central States Speech Journal (1967), and R. L. Scott, "On
Viewing Rhetoric as Epistemic: Ten Years Later," Central
States Speech Journal (1976).
35. Gross (129-143) elaborates on this in his analysis of the
peer review process. Gross views peer review as a conjunction of
speech act theory and Habermas' ideal speech situation so that editing
and revising becomes an ideal interaction. Gross does, however,
omit that the peer review process also encompasses the more specific
audience issues referred to here. In scientific communities, Perelman's
conceptualization of the universal and the particular audience are
very nearly one and the same. In turn, this audience's acceptance
of an argument validates that argument whereas the rejection acts
as invalidation - the policing function of the communal audience.
36. Perelman 33
37. Perelman 32
38. Gross (85-96) has argued that the purpose of the scientific
method is to induce cause and effect in order to generalize to a
natural law. As a result, these tenants of "good science"
are a reflection of Bacon's insistence on "true induction"
as the only means of creating objective knowledge in the experimental
sciences. Objectivity and induction are thus necessarily concomitant
ideals in the sciences. To insure that studies are objective and
hence inductive, they must be replicable. As a result, science privileges
clear methodologies which include signs of objectivity checks like
agreement among researchers. If a researcher is able to replicate
the methodology used, they too should be able to discover similarly
objective results, typically shown as statistical data.
39. To say that science privileges inductive over deductive reasoning
does not mean that a researcher engages in a study without a theory
or a methodology. In most cases, a researcher examines the available
methods and theories for the phenomenon to be studied and honestly
reveals her selection and the reasons for making it. Often, as research
proceeds, theory and method are revised per the particulars of the
specific phenomenon. This revision typically does not compromise
the integrity of the study. It is built in to the scientific method
to allow for the best possible understanding to be achieved.
40. Bettelheim says that he could have selected some of his students
who have completely recovered after his treatment of which he gives
several examples, perhaps the most impressive of which is the man
who received his Ph.D. from the U. of Chicago. These testimonials
help improve the credibility of his theory and methods. Nonetheless,
he selected the most difficult of cases because they "showed
[the] deepest arrest in personality." Bettelheim 9-10.
41. For a discussion on the reenactment of the inductive process
see: Peter Medawar, "Is the Scientific Report Fraudulent? Yes;
It Misrepresents Scientific Thought," Saturday Review
47 (August 1, 1964): 42-43. For a commentary on the introduction
of the scientific article see: J.M. Swales, Gene Analysis: English
and American Research Settings (Cambridge: Cambridge UP, 1990).
42. Bettelheim 8
43. Bettelheim 10-11
44. It is also interesting to note that Bettelheim considered
himself the students' "super ego." He was the "somebody
who offer[ed] himself up for the confrontation." As the statements
of former students have attested, Bettelheim's confrontation was
often physically and mentally abusive. This contradiction between
Bettelheim's statements and actions makes his therapeutic methodology
even more suspect. (Pollock, 191-211)
45. Perelman 29
46. Bettelheim is quite right about this. Most researchers at
the time, including Kanner, believed that people with autism did
not relate to others.
|