From LQ 199 ←Pour consulter l’article en français, veuillez cliquer sur ce lien.
Research into the causes of autism is moving at a breathless pace. Every month, even every week, brings new hypotheses. One week after the publication in Nature of studies pointing the finger at the instability “de novo” mutations of the sperm of older fathers, another publication, on 9 April, in the journal Pediatrics, relaunched the search on the side of the mothers. The article comes from researchers at the University of California, Davis and Vanderbilt University. In this study, maternal obesity was measured as risk factor. The objective was to draw a parallel between the “epidemic” of obesity, (in the US, one mother in three is now considered obese), and the “epidemic” of autism.
One thousand children aged between two and five years old, autistic or not, were studied, as well as their mothers’ medical records. Comparing those who are obese and those who are not, mothers who were obese prior to the pregnancy have a 60% higher risk of having an autistic child, and double their risk of having a child with a non-specified cognitive or behavioural delay. The risk is even higher if mothers had hypertension before or during pregnancy. Irva Hertz-Picciotto, Chief of the Division of Environmental and Occupational Health, Department of Public Health Sciences, at the University of California, Davis, highlights that “The child’s brain is quintessentially susceptible to everything that’s happening in the mother’s body”. She quickly adds that the cause is multifactorial and so mothers should not be blamed. It is not known by which mechanism excessive weight or metabolic disorders might be influencing the development of autism. It is supposed that this could perhaps be due to a malfunction of insulin and therefore of the feeding of the baby’s brain with sugar.
Susan Hayman, chairperson of the Autism Subcommittee of the American Academy of Pediatrics, judges the results of this study in a very positive light. In a commentary she gave to a journalist from the Wall Street Journal on-line, she said: “The statistics on obesity are alarming, but it’s a modifiable risk factor”. It all depends on how this factor is to be modified. It is clear that one sector of the research is seeking to open up a new behavioural line of treatment. Not only can children be treated through behavioural re-education, but also their mothers. It remains to be seen which punishments will be acceptable for this vast project of dietary re-education. Other professors of medicine were alarmed by the multifactorial character of the obesity epidemic. The research on genetic predispositions does not account for the speed of the epidemic. The environmental factors can be listed in abundance: pre-packaged food, with too much sugar and too much salt, omnipresent fizzy drinks, breakdowns in lifestyle and in the family, too frequent meals, eliminating tobacco which helped control weight, work-related stress, etc… To control all these factors seems a daunting task. Only a made-to-measure ethics can propose a solution on a case-by-case basis. Resisting the sirens of discourses of salvation by turning to mass re-educational solutions will not be easy.
The blunt declarations made to Médiapart by the director of the Camus Centre in Villeneuve d’Ascq (see LQ Issue 192) on the link between behavioural re-education and punishment by electroshock give an idea of the will to power of the proponents of these discourses. “In behavioural analysis, there are procedures of punishment by electroshock. Everybody finds this outrageous, but it is accepted by the Dutch government in certain procedures, for severe cases and as a last resort.” She adds, to reassure us, that, “This punishment is efficient if the behaviour decreases rapidly, otherwise it is not a good punishment. So, if it does not decrease, we stop, we will not go up to 80 volts! But in France, when we speak about this, they think of One Flew Over the Cuckoo’s Nest…”. The theme of “French backwardness” is not far off. We have too much memory in France.
Perhaps we weren’t wrong. The US government, like the Dutch government, has given way since the fifties to electric punishments and to the experiments of which Milos Forman’s film gives an unforgettable version, with Jack Nicholson in a role that left its mark on his entire career. An ongoing trial in New York speaks volumes of the consequences of this license. Cheryl Mc Collins, the mother of an autistic child, is suing a “school” in Massachusetts which receives many New Yorkers: the “Judge Rotenberg Center”. New York’s City Magazine has given an echo of this. This school presents itself as the “last resort” for children, adolescents and adults suffering from “behavioural disorders”. The 84 children and 36 adults it receives may suffer from autism, intellectual disabilities, or severe self-harm tendencies. This school is the only Center in the US where electroshock is the standard treatment. A Massachusetts court has learned this week of a video from 2002 in which Andre Mc Collins, then aged 18, after having refused to take off his coat, on arrival at a new classroom, at half nine in the morning, received as punishment throughout the whole day, 30 electroshocks, administered while he was kept bound to an ad-hoc device, and until the end of class hours, at half past four. He spent the following weekend in a state of catatonic withdrawal. His lawyer is prosecuting the Centre for “permanent brain damage related to the stress response caused on that day”. This is the first time a courtroom will be able to view a video showing the direct effect of electroshock aversion treatment, outside the realm of fiction. This trial is not the only one. In another 2006 case, a 17-year-old teenager was electroshocked 79 times in 18 months, with catastrophic results.
The statements by Mme Vinca Rivière, director of the Camus Centre and head of the Masters programme on “Experimental and Applied Behavioural Analysis” at The University of Lille-3, might not therefore be quite as reassuring as she would like to admit. Careful vigilance is necessary for cruel excesses not to occur, beyond the aforementioned “respect for procedure”. The results of the Stanley Milgram experiment at Yale University in the early sixties, which “sought to assess the degree of obedience of an individual before an authority he considered to be legitimate and to analyse the process of submission to authority, especially when it leads to actions which conflict with their personal conscience – as Wikipedia puts it – come to mind. In this experiment it was precisely a matter of seeing up to what intensity of “electroshock” – whose effects were simulated, unknown to the participants, by actors – the students would punish others, this being authorised punishment. As we know, very few of the students who agreed to it were able to resist a fatal process of intensification. It is not just in France that thought has been given to the consequences of absurd commandments by an authority that has become superegoic, “obscene and ferocious”.
Psychoanalysis is a critical discipline that helps to keep alive an ethical distance from wishes that seek to make bothersome symptoms conform at any cost. On 16 April, an account in the British newspaper The Guardian made this tangible for us. The author, Henry Bond, English artist and writer, who had his heyday in the nineties with the YBA movement (Young British Artists), alongside Damien Hirst and others, presents himself as an Autistic Asperger and a Lacanian. Indeed, he has a Masters in Psychoanalysis from Middlesex Polytechnic, under the direction of Bernard Burgoyne, and has published books with forewords by Darian Leader and Slavoj Zizek, such as Lacan on the Scene, published by MIT Press in 2009. He speaks of his psychoanalysis and his sessions of CBT. CBT, administered within the framework of the NHS, taught him to improve his “social skills”. He learned to develop strategies to cope with his “social bluntness”. On the other hand, he learned in his analysis that he is “spoken by the real, possessed by language”. He attributes this quote to Lacan. This is a dimension of existence that seems to be precious to him and to which he has access through his autism. Like other high-functioning autistics, he fears that if a genetic cause for autism is found, they will try to eradicate it, like with Down syndrome. He thinks however that it will take another 50 years before this discovery is made and that, until then, Lacanian psychoanalysis will help to keep open the ethical issues raised by autism. He fully adheres to the remark made by a speaker at a recent autism conference: “No one wants to be loved for being ‘normal’ – everyone wants to be loved for whatever is unique to them”.
Translation: Florencia Fernandez Coria Shanahan
Reviewed by Adrian Price
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