To explain why autism services in France lag behind those in other countries, many experts point to the nation’s long-standing ‘autism wars.’ For decades, those favoring psychoanalysis for treating autism (mostly psychiatrists) have been locked in a heated debate with those who support evidence-backed behavioral therapies (mostly parents and scientists).
Psychoanalysis is a “dictatorship of thought” in France that, over the past 40 years, has become part of the national culture, Langloys says. In the 1950s, there were only about 150 psychoanalysts in France, compared with thousands in the U.S. By the early 21st century, though, the number in France had soared to about 10,000 — with a sharp increase during the late 1960s connected to a rise in anti-establishment politics. “Medicine was part of the establishment,” anthropologist Roy Richard Grinker explains in his 2008 book, “Unstrange Minds: Remapping the World of Autism.” By contrast, psychoanalysis was seen as a way to empower individuals against institutions.
Lacanian psychoanalysis really is subversive in a way that other theories of therapy aren’t:
Also in the late 1960s, the Austrian-American psychoanalyst Bruno Bettelheim published “The Empty Fortress,” which instantly became influential in France. In that book, Bettelheim noted that some characteristics of autism — a hesitancy to make eye contact, repetitive behaviors, a shuffling gait — were similar to what he had observed in concentration camp prisoners during World War II. He concluded that these characteristics arose from emotional deprivation. In the case of autism, he lay the blame on emotionally cold ‘refrigerator mothers.’ Around the same time, French psychoanalyst Jacques Lacan blamed overbearing ‘crocodile mothers’ for their children’s autism.
The idea of blaming parents is taboo in the U.S. and elsewhere — with good reason, as it has been “rejected and debunked for 50-plus years now,” says Mayada Elsabbagh, assistant professor in psychiatry at McGill University in Montreal. But it prevailed in France, as Miriam Sarbac, founder of the parents’ group Asperger Amitié, discovered firsthand. In 1995, she noticed that her 2-year-old son, Raphaël, had stopped talking and making eye contact. A teacher at his nursery school recommended a psychiatrist, who credited Raphaël’s “developmental troubles” to the fact that Sarbac was “stressed.” Sarbac had to stay in the waiting room during Raphaël’s twice-weekly sessions, which didn’t seem to help. A psychologist later diagnosed Raphaël with autism when he was 14.
Not so fast. A major feature of life with autism is emotional deprivation, causing an abnormally high level of self-soothing behaviors. There’s a lot of black-and-white thinking, like the word “autism” automatically explains all the problems of autistic people. We have psychodynamics. The child was probably stressed.
Marie Glover-Bondeau had a similar experience. In 2012, doctors told her that her son, Alexis, then 18 months old, showed signs of autism. But the psychiatrist to whom the doctors referred them suggested the boy was “perturbé” because the family moved a lot — from France to Luxembourg and then London and back again. “Then she asked what happened with our grandparents, did something happen in our history,” Glover-Bondeau recalls. “My husband and I, we saw that she couldn’t help in any way.”
I can see how my parents’ childhood affected my childhood affected my adulthood. The circle of life. Epigenetics is a mainstream topic, now, as a physical mechanism for transgenerational trauma. Before I knew I’m autistic, I thought a lot about my third culture kid problems. Moving from country to country as a child can make you a kinda borderline-y outsider.