A DISCREDITED CAUSE OF AUTISM
The term refrigerator mother was coined in the
1940s as a label for mothers of autistic children, and provides
an excellent example of the need for rigorous objective research
into all aspects of Autism Spectrum Disorders. These mothers were often blamed for their
children's atypical behaviors, which included rigid rituals, speech
difficulty, and self-isolation.
The "refrigerator mother" label was
based on the assumption — now discredited among a majority of, though
not all, mental health professionals — that autistic behaviors stem
from the emotional frigidity of the children's mothers. As a result,
many mothers of autistic children suffered from blame, guilt, and
self-doubt from the 1950s throughout the 1970s and beyond: when
the prevailing medical belief that Autism
resulted from inadequate parenting was widely assumed to be correct.
Even today, there is still support for the view that Autism is a
result of poor parenting.
Origins of "refrigerator mother" theory
In the absence of any biomedical explanation for
what causes Autism after the telltale symptoms were first described
by scientists, Bruno Bettelheim, a University of Chicago professor
and child development specialist, and other leading psychoanalysts
championed the notion that Autism was the product of mothers who
were cold, distant and rejecting, thus depriving babies of the chance
to "bond properly". The theory was embraced by the medical
establishment and went largely unchallenged into the mid-1960s,
but its effects have lingered into the 21st century. Many articles
and books published in that era blamed Autism on a maternal lack
of affection. By 1964, Bernard Rimland, a psychologist with an autistic
son, published a book that signaled the emergence of a counter-explanation
to the established misconceptions about the causes of Autism. His
book, Infantile Autism: The Syndrome and its Implications for
a Neural Theory of Behavior, attacked the "refrigerator
mother" hypothesis directly.
Soon afterwards, Bettelheim wrote The Empty
Fortress: Infantile Autism and the Birth of the Self, in which
he compared Autism to being a prisoner in a concentration camp:
“The difference between the plight of prisoners
in a concentration camp and the conditions which lead to Autism
and schizophrenia in children is, of course, that the child has
never had a previous chance to develop much of a personality.”
Some authority was granted to this as well because
Bettelheim had himself been interned at the Dachau concentration
camp during World War II. The book was immensely popular and Bettelheim
became a leading public figure on Autism until his death, when it
was revealed that Bettelheim plagiarized others' work and falsified
his credentials. Also, three ex-patients questioned his work, characterizing
him as a cruel tyrant.
As early as 1943, Leo Kanner called attention
to what appeared to him as a lack of parental warmth and attachment
among the mothers of autistic children. In a 1949 paper, he suggested
Autism may be related to a "genuine lack of maternal warmth."
In a 1960 Time magazine interview, Kanner bluntly described
such mothers as "just happening to defrost enough to produce
Although Kanner was instrumental in framing the
“refrigerator mother” theory, it was Bettelheim who facilitated
its widespread acceptance by the public and the medical establishment
cognoscenti in the 1950s and 1960s.
In 1969, Kanner addressed the “refrigerator mother”
issue at the first annual meeting of what is now the Autism Society
of America, stating:
"From the very first publication until the
last, I spoke of this condition in no uncertain terms as “innate.”
But because I described some of the characteristics of the parents
as persons, I was misquoted often as having said that 'it is all
the parents' fault'."
This was somewhat a whitewashing of his own history.
In many of his articles, Kanner does explicitly and clearly blame
Autism on parental behavior. But the renunciation of the idea by
the person who originated it was seen as a decisive blow in any
Other notable psychiatrists
For Silvano Arieti, who wrote his major works
from the 1950s through the 70s, the terms autistic thought and what
he called paleologic thought are apparently the same phenomenon.
Paleologic thought is a characteristic in both present-day schizophrenics
and primitive men: a type of thinking which has its foundations
in non Aristotelian logic. An autistic child speaks of himself as
“you” and not too infrequently of the mother as “I”. The “you” remains
a “you” and is not transformed into “I”.
For Margaret Mahler and her colleagues, Autism
is a defense of children who cannot experience the mother as the
living primary-object. According to them, Autism is an attempt at
dedifferentiation and deanimation (Mahler & Furer 1959). The
symbiotic autistic syndrome used to be called the "Mahler syndrome"
because Mahler first described it: the child is unable to differentiate
from the mother.
Arieti warned that an autistic tendency is a sign
of a kind of disorder in the process of socialization, and that
when autistic expressions appear it should be assumed that there
is a sort of difficulty between the child and his parents, especially
the schizogenic mother. Children who use autistic expressions, Arieti
observes, are children who cannot bond socially.
In Interpretation of Schizophrenia, Arieti
maintained that for a normal process of socialization, it is necessary
for the parent-child relations to be normal. Loving or non-anxiety
parental attitudes favor socialization. Arieti not only maintained
that the parent-child relations are the first social act and the
major drive of socialization, but also a stimulus to either accept
or reject society. The child’s self in this view is a reflection
of the sentiments, thoughts and attitudes of the parents toward
the child. Autistic children show an extreme socializing disorder
and do not want any sort of relationship with people. They “eliminate”
the persons from their consciousness. For Arieti the fear of the
parents is extended to other adults: a tendency to cut off communication
with human beings.
Persistence of the refrigerator mother theory
According to Peter Breggin’s Toxic Psychiatry,
the psychogenic theory of Autism was abandoned for political pressure
from parents organizations; not for scientific reasons. For example,
some case reports have shown that profound institutional privation
can result in quasi-autistic symptoms (Rutter, Andersen-Wood, Beckett
et al 1999).
Clinician Frances Tustin devoted her life to the
theory. She wrote:
“One must note that Autism is one of a number
of children’s neurological disorders of psychogenic nature, i.e.,
caused by abusive and traumatic treatment of infants [...]. There
is persistent denial by American society of the causes of damage
to millions of children who are thus traumatized and brain damaged
as a consequence of cruel treatment by parents who are otherwise
too busy to love and care for their babies” (Tustin 1991).
Alice Miller, one of the best-known authors of
the consequences of child abuse, has maintained that Autism is psychogenic,
and that it is fear of the truth about child abuse the leitmotif
of nearly all forms of autistic therapy known to her. When Miller
visited several therapy centers for Autism in the United States,
it became apparent to her that the stories of children “inspired
fear in both doctors and mothers alike”:
"I spent a day observing what happened to
the group. I also studied close-ups of children on video. What became
clearer and clearer as the day went on was that all these children
had a serious history of suffering behind them. This, however, was
never referred to […]. In my conversations with the therapists and
mothers, I inquired about the life stories of individual children.
The facts confirmed my hunch. No one, however, was willing to take
these facts seriously" (Miller 1991).
Like Arieti and Tustin, Miller believes that only
empathetic parental attitudes lead to the complete blossoming of
the child’s personality.
A book of Jay Joseph released in 2006 challenges
the current genetic theory of Autism:
“Looking specifically at Autism, despite the near-unanimous
opinion that it has an important genetic component, the evidence
cited in support of this position is stunningly weak. It consists
mainly of family studies, which cannot disentangle the potential
influences of genes and environment, and four small methodologically
flawed twin studies whose results can be explained by non-genetic
factors. Not surprisingly, then, years of efforts to find ‘Autism
genes’ have come up empty.” (Joseph 2006)
Despite the current genetic research on Autism
and Autism-related conditions, the “refrigerator mother” theory,
widely discarded in the United States, still has some support in
Europe and is largely believed to be the cause of Autism in South
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