Customer Reviews

Autism and Personality: Findings from the Tavistock Autism Workshop

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While the first customer reviewer has a valid and respectable opinion about this book, which should be taken into account, my feeling is that he has misread it. The contributors to this book never deny the neurologic aspects of autism, and often maintain that a child's extreme susceptibility to events that for others would not be traumatic, is due to precisely these neurologic factors. Nor do they maintain that there is another child within, rather that all autistic children have functional areas that need to be developed so that they can take part in life. They also point out that certain personality traits can affect the autistic condition, and vice versa, a statement that refutes the notion that autistic children have little "personality" other than the disorder itself. Let me put it this way: it has been shown that mothers who reflect back to their babies what the babies seem to be feeling enhance the development and interconnection of pre-frontal lobe neurons. We are floundering when we try to separate neurology and psychology, as if the two did not interact in ways we still not not understand. Additionally, the contributors to this book make a point of saying that parents ARE NOT AT FAULT when a child has autism; their viewpoint is parent-friendly, not to say parent-empathic. The other reviewer, does, however, have a point that is worth emphasizing: it is one thing to make the kind of interpretations which I found in this book, and quite another to make the leaps-of-faith interpretations sometimes typical of Kleinian analysts, whose heavy-handed interventions would be enough to turn anyone off. This is a technical book for therapists, and the non-technical reader searching for enlightenment about autism might do better going somewhere else. It requires a knowledge of several schools of psychology, and may seem confusing to those unfamiliar with different schools of psychoanalysis.

Behavioral approaches seem to be the only viable treatment option for autism today. However, the fact that we are dealing with a human being seems to be lost in this whole mechanical process. There is something sad and dehumanizing about "training" a person as one would a dog or any other animal. With a psychoanalytic approach, the idea of a personality is reintroduced to autism. This idea that autism is not the person, offers a more humanistic and optimistic approach to looking at autism. For those that assume that psychoanalytic theory just places blame on the parents, those readers will be surprised to find that much of the book is dedicated to offering support and hope to parents who the authors suggest very often suffer from a form of Post-Traumatic Stress Disorder upon having a child diagnosed as autistic. This book does not say that this is the "right" treatment for all children or that it always works, but it provides another alternative to those who find behavioral approaches too impersonal and mechanical.

This book is marred by its basic though unstated premise that Autism is a pathology or disease rather than a condition of existence. It falls into the trap of treating people with autism as "sufferers" who have to be cured. A more useful approach is to treat it as a condition that impacts the person's ability to communicate and socialise and that help must centre around working on ways to lessen these impacts. As well as this, many of the problems that autistic people face are really due to the inability of others to understand their communication. In other words a lot of work has to go into changing the social environment rather than trying to "fix" a dysfunctional autistic. Still the book does have useful insights into the need of carers and siblings for recognition and support. Overall, though, I find more and more that psychoanalytic approaches are less useful than approaches like those of Atwood and other writers. I am not an authority on psychodynamics, but it seems more and more to me like a model rooted in the past with a dead weight of theoretical and historical baggage to divest itself of before it can address the real worl challenges of people with autism and their carers and siblings.

Although every respectable researcher has acknowledged for the last 20 years that autism is a neurological condition, Anne Alvarez and the Tavistock group are still peddling the line that it is really a deep emotional disturbance to be treated by psychoanalysis.

Ironically, many people with autism themselves (such as Temple Grandin, Therese Joliffe and Gunilla Gerland) have given illuminating first-person accounts of autism and expressed their anger at psychoanalytic "interpretations" which have no connection to their experience.

Alvarez studiously ignores these, and fails to even mention the possibility that autistic people might have opinions of their own on the subject.

After Alvarez's first book advocating psychoanalytic treatment of autism, two people with high-functioning autism actually wrote an article critcizing her work for ignoring and obscuring the real experiences and feelings of people with autism and got it published in the Journal of Child Psychotherapy.

Unsurprisingly, that isn't mentioned here either.

Instead, we have the usual insinuations that parents are deeply involved in their child's condition, that there is a "non-autistic child hidden behind the autism" (presumably waiting to be liberated by psychoanalysis), that at least some cases of autism are caused by "trauma", and that those who point out that autism is a neurological condition are fatalistic and uninterested in helping children with autism.

What I don't understand is how Alvarez can conceivably be unaware of the incoherency and intellectual dishonesty of her views, and claim to be "listening" to people with autism while so consistently ignoring their opinions. One can only assume that this book was written in very bad faith.