Fluxury by Sergio Benvenuto

Autism: A Battle Lost by PsychoanalysisJan/10/2022


 

Published in DIVISION/REVIEW, 19, Summer 2019, pp. 26-32.

 

 

 

            For some time now, in many countries (including Italy and France), those who detest psychoanalysis –  organicist psychiatrists, cognitivists, evolutionary psychologists – take up autism as their main argument to launch a massive attack on psychoanalysis. They say: autistic individuals, children and adults, should not be entrusted to the care of psychoanalysts because the psychoanalytic theory of autism has proved wrong. Better to resort to other techniques, perhaps of a cognitive-behavioural type, to rehabilitation systems such as ABA (Applied Behaviour Analysis).

I must warn that my practice is that of a psychoanalyst. I believe that psychoanalytic theory is very powerful and unjustly underestimated by many psychologists and psychiatrists today. I believe this type of therapy, if carried out correctly, is a powerful system of treatment. In short, I cannot be suspected of being a Freud-eater. I do however believe that until now psychoanalytic theories on autism have been a failure. Amicus Freudus, sed magis amica veritas.

Those who are against psychoanalysis have chosen to focus precisely on the psychoanalysis of autism and not on other psychoanalytic approaches – for instance to neuroses, psychoses, perversions, psychopathy – because they sense that autism is the Achilles’ heel of psychoanalysis. And that psychoanalysis does not adequately deal with this heel. Just as in any war, the enemy is attacked in its weakest spot.  

 

1.

The fragility of psychoanalytic theories on autism so far developed does not so much depend on the weakness of its etiopathogenesis, as its detractors think. It is not so much a matter of what mainstream psychoanalysis invokes as the essential cause of autism, an “inhuman” mother-child relationship (the “refrigerator mother” theory, which for decades informed the explanation of autism especially in the United States). The weakness of psychoanalytic theories consists rather in their vision of autism as such, or in their way of considering its specificity. On this point, I believe that cognitive science is ahead of psychoanalysis.

            Strangely, those who intend to support the current psychoanalytic approach to autism at all costs limit themselves to attachment theory (which does indeed derive from psychoanalysis): in short to the idea that the mother-child relationship explains everything, from schizophrenia to autism, from perversions to sociopathies. However, the great thinkers of psychoanalysis, from Freud to Lacan and M. Klein, never advocated a similar theory: that all the “fault” of psychopathologies lies with the mother or with the first caregiver. Indeed, every subject brings his/her own contribution to the relationship, so to speak, also to that with important adults. We are not entirely the products of our mother or of early childhood caregivers.  

            The psychoanalytic approach to autism rather lacks an understanding of what autism really is. Firstly it is necessary to ask the question “what is it essentially?” Now, it seems to me that a large part of psychoanalysis – starting from Bruno Bettelheim, the main exponent of the analytical theory of autism, openly challenged from various sides in these last decades – confuses the “autism” of which Eugen Bleuler spoke with the autism described later by Kanner and Asperger, or with autism as we know it today. Autism for Bleuler[1] was the basic symptom of schizophrenia, or the psychotic mode of withdrawal from the world and from relations with others, but has nothing to do with what is now called the “autistic spectrum” [2]. In short, psychoanalysis has continued to believe that autism is a specific form of psychosis, therefore explainable the same way other psychoses can be explained[3].

            In my opinion, the clinical analysis by non-analysts suggests something that is more important. That is, to put it very simply, they have understood that autistic individuals are cognitive-behavioural subjects. Not in the sense that an autistic person believes in today’s cognitive and behavioural theories, but in the sense that the functioning of the autistic mind more or less coincides with the way behaviourists and cognitivists conceive of the mind in general. In other words: if the cognitive-behavioural theory of the human mind were universally valid, we would all be autistic. We may say that the pathology of autism is cognitive-behavioural in essence.

To say it concisely, autism, in its more or less severe forms, is a particular form of agnosia. That is, it is a kind of psychic blindness to something very particular. There are various types of agnosia[4]. According to cognitivists, in the case of autism it is a blindness to recognize the minds of others. That is, autistic individuals lack a “theory of mind”, both of their own and of others. The well-known awkwardness of autistic people in relating to others shows that they do not understand what is going on in the minds of others, whereas for most of us we may say it is something immediate, which needs no special psychological insight.

One of the greatest physicists of the last century, Paul Adrien Maurice Dirac, suffered from Asperger’s. Carlo Rovelli writes that[5]

 

During a conference [by Dirac], a colleague interrupted him: “I don’t understand that formula”. Dirac, after a brief pause, continued as if nothing had happened. The moderator interrupted him, asking him whether he would like to answer the question, and Dirac, sincerely amazed replied, “Question? What question? The colleague made a statement” (“I did not understand that formula” is an affirmation, not a question...) It was not arrogance: the man able to see the secrets of nature which escaped everyone did not understand implicit language, he did not understand his peers and interpreted all sentences literally[6].

 

In this case, Dirac did not grasp what philosophers of language call the performative nature of words: the fact that language is not simply a series of statements, and that indeed we act with language. In the above case, Dirac’s colleague had posed a question, and when asked a question one is forced, in a certain sense, to give an answer; maybe even just saying one is not going to answer.   

To use a distinction made by philosophy of language, that between ‘statement’ (énoncé) and ‘enunciation’ (énonciation), we will say that an autistic person understands statements but does not grasp enunciations.

A statement is the literal sentence, an enunciation is the subjective act of enunciating something, the meaning of which depends on the context and on unexplained intentions. A good example of the difference between statement and enunciation is illustrated by a famous Jewish joke, told by Freud.

 

Two Jewish rivals in commerce meet on a train in Poland. One asks the other where he is going, and the other answers: “To Krakow”. To which the man replies, indignant: “Why are you telling me you are going to Krakow so I will believe you are going to Warsaw, when in fact you are going to Krakow?”

 

This is a language game that an autistic person would certainly fail to understand. After all, the one thing the autistic person does not have access to is sense of humour.

It must be noted that, in the case of autism, mainstream psychiatry is moving from a categorical paradigm to a dimensional one. A categorical approach considers each disorder as a discontinuous category, a break with normality, and implies a binary opposition between “healthy” and “ill”. A dimensional approach instead sees everything as being more or less. Consequently, autism tends to become dimensionalized. A person can be more or less autistic, the same way one is more or less tall or short, or the same way one has a more or less high or low IQ. Thus, autism is not a pathology, the result of an injury, but a way of being that is more or less. For this reason today we tend to talk about the autism spectrum, a continuous series of traits.

But if the opposite of being tall is to be short, and if the opposite of being intelligent is to be stupid, what is the opposite of autistic? As we will see, nowadays we tend to believe that the opposite of autism is the capacity for empathy.

 

2.

The classical cognitive theory of autism – supposedly the autist would lack a theory of mind[7] – has been refuted by neuroscientists inspired by philosophical phenomenology, in particular by Vittorio Gallese[8], one of the discoverers of mirror neurons (together with a team led by Giacomo Rizzolatti).  

According to these neuroscientists, we directly perceive intentions, allusions, hints?, implicit messages, and metaphors of others not because we have constructed a theory of mind over time, as the cognitive model claims, but because we directly perceive the subjectivity of others. In the statement of the physicist, “I don’t understand that formula”, we all perceive – rather than ‘interpret’ – that a question is being expressed. In short, autism is agnosia of a very particular ‘object’ that cognitivism cannot trace and conceptualize: of subjectivity, both our own and that of others. An autistics person does not perceive subjectivity, and so perceives only cognitive minds, in which the function of metaphorization is very scarce.

This situation is well described in an Hungarian film, On Body and Soul, by Ildikó Enyedi: the female protagonist is a well integrated autistic woman, she works in a slaughterhouse, but has difficulty grasping the sense of desire for a man and the desire of this man, because desire is the fundamental expression of subjectivity. This is also the specificity of Temple Grandin.

Temple Grandin is perhaps the most famous autistic person in the world[9]. She has written many essays on autism, and is also a renown specialist in breeding (she invented a cattle slaughtering system that makes the process much less traumatic for animals), a subject she teaches at the Animal Science Department of the Colorado State University. Her autobiography, published in 1986 and titled Emergence: Labelled Autistic, is a bestseller and has been translated into many languages[10]. A brilliant polemicist, she attacked Bettelheim’s vision and supports – as do all learned autistic people – a purely neurological explanation of autism.

It should be noted that, as many autistic people, Temple lacks erotic desire, and sexual feelings are completely incomprehensible for her. Temple is also known for having built a mobile machine that massages her, which she says gives her a sense of well-being. Her friends have always told her it is a hugging machine. Temple sees no sense in the sensual embrace of a man or a woman, but she does in that of a machine. However, the autistic scientist has difficulty seeing how a human and mechanical embrace might be related. Indeed, this is an eloquent example of the very nature of autistic subjectivity.

In our non-autistic experience of an embrace, also in the absence of sexual attraction for the person embracing us, at least three different dimensions converge. One is the physical dimension of the “massage”, which in itself is pleasant – one need only think of the various professional massage practices available today. Another dimension is signification, we may say a “symbolic” one: by embracing me, the other metaphorically includes me in him or her, becoming the place that welcomes me, “internalizing” me bodily, as if he or she were eating me with his or her arms. There is also a precise emotional dimension linked to the other: an embrace is a bodily way of feeling loved by another person. Now it seems clear that for Grandin only the first dimension of the embrace is present, the physical one, while the other two do not appear; and this allows her to replace another human being with a machine she has built. The delicate question is as follows: is such an intense and soothing enjoyment, the enjoyment the autistic person draws from a mechanical massage, only physical, or does the physical experience translate an experience with another subject and an experience of signification which are both “reified”? It is as if a mother took enjoyment in continually feeding her little son despite not feeling any affection or love for him: yet the pleasure of feeding him mechanically might be seen as the surrogate of an unperceived love. In this case she would most certainly be an autistic mother.

 

3.

Everything we have said so far should lead us to understand why autism should not be confused with psychosis. On the contrary, I would say autism is its opposite. In fact, we say subjects are psychotic – schizophrenic, paranoiac, manic-depressive – when in our opinion they attribute an excess of signification to the world, especially to the human world. That is, they see, they perceive, they mean far more signifiers than there actually are, and in this sense we say they are delirious; they produce far more signifiers than what (for us) is necessary, as in a flow of ideas (disorganized speech, Ideenflucht).

It is commonly understood that the main pathognomonic trait of every psychosis is hearing voices. This means that for a psychotic person the world is much more talkative than it is for us. In psychosis there is always an excess of signifier (which does not at all mean an excess of sense! Voices can be pressing, continuous, pervasive, but nonsensical). In the delusion of interpretation of paranoid subjects we are convinced they read too much signifier in real events, which for us are irrelevant or casual. In short, we speak of psychosis when a subject lives in a world that is too signifying compared to “our” world, and this regardless of whether the psychotic person finds sense in this signifying excess (as in systematized paranoid delusions) or does not find it at all, abandoning him or herself to the pure nonsense of the unbridled flow of words that do not circumscribe sense.

On the contrary, the world in which autistic subjects live appears to us to be lacking of signifier. An autistic person sees the other and also him or herself as a series of behaviours, but has difficulty seeing a meaning subjectivity behind them. We could indeed say that the autistic world is anti-hermeneutic, it is a purely ontic world. It is therefore not correct to say that autistic people live in a world of their own: on the contrary, they are completely absorbed by the real world, which is, however, completely devoid of any metaphorical ambiguity, of any subjective openness, and for this reason often unbearable. It is a bare being-in-the-world, hence the horror caused by strong sensations, by certain noises, gestures... The “bare skin” we are alluding to is our own subjectivity, which covers and somehow softens our relationship with reality, which makes external reality less brutal. In fact, it is thanks to autism that, perhaps, we can infer the sense of what we call subjectivity, a concept that is very difficult to grasp. In fact, subjectivity is not consciousness or self-consciousness (an autistic person is very conscious), nor is it mind in the cognitive sense. We may say that autism allows us to grasp something of our own subjectivity because of its lack or absence: that is, subjectivity is a void around which the world rotates orderly.

We are never completely exposed to reality in its full insignificance, we always modulate it subjectively, both with our thoughts, and by “reading” the thoughts and feelings of others. Subjectivity seems to be the equivalent of a film soundtrack, which conveys sense to images and therefore helps us take them in. An autistic person is not, in short, an empty fortress (The Empty Fortress is the title Bettelheim gave to his main book on autism[11]): autistic subjects are indeed empty as to subjectivity, but not because they have withdrawn from the world by building a defensive barrier around themselves. If they have built such a barrier, it is anyhow secondary to the feeling of being “lost” in the world of those who are not autistic. Rather, for them the social world, the world of human relations, is incomprehensible – and therefore threatening – because they do not have the ability to “read” the subjective and signifying part of the world. This is precisely what an autistic person once said: “From an early age I felt isolated because I saw that other children were talking with their eyes. And I couldn’t understand them”.  

 For this reason, I would say that an autistic person is a “house with no walls”, that is, a house that is not actually there.

In the most severe cases, as is known, autistic people do not even access articulated language. However, this lacking access to language is not caused by a cognitive deficit, the inability to use symbols to the extent that they are abstract signs: the cause for this closing to language is rather the great difficulty in accessing the subjective dimension of language, the fact that speaking is not merely putting words together, but manifesting something subjective through words. For autistic people language is something abstract, disconnected from subjective expression.

A common trait of autistic people is that they look not into the eyes of the other talking, but at their mouth. Also very small normal children, before the age of two, already look at the eyes of adults before anything else. This difference is crucial. In our view eyes are the “mirror of the soul” even though nothing comes out of them, and it is only subtle ocular variations that tell us what the other person is feeling; eyes refer to something immaterial, that is, to the supposed location of subjectivity, which seems to be hidden behind the eyes. The “inner opening” (for intérieur in French) some say. From our mouth, on the other hand, material sounds, words, come out, and an autistic person is essentially a materialist, so to speak, sensitive to what comes out from another’s subjectivity, not to subjectivity itself. The eyes of another person refer us to a function that mirrors our own: the other looks at me just as I look at him. A mouth, however, does not mirror anything: the other speaks, and so my mouth must stay shut. The difference lies in the assumption of the subjectivity of others.

In my opinion it is for this reason that it is not correct to speak of autism as a “developmental disorder”: this implies that each child goes through an autistic phase, and that an autistic person is blocked in this phase and is not able to progress. There is, however, no autistic phase in children, unless they are already autistic. Autism is a developmental disorder in the banal sense that we can say a person born blind will never develop sight. Blindness, however, is not a developmental disorder, it is caused by the absence of development of an organ or a function.      

 

4.

It is not true – Gallese claims – that an autistic person has not been able to construct a theory of mind, as is supported by cognitivists: according to them the truth is that a person can enter into contact with others only thanks to the construction of a theory of mind, not thanks to the immediate intuition of the other’s subjectivity which renders our relations with others fluid and meaningful (at least to a certain extent). An autistic person does construct theories, also correct ones, on the mind, the same way we construct theories on chemical elements of galaxies; we do not, however, speak to chemical elements, or to galaxies, and for this reason we need scientific theories. It is as if the other, in the eyes of an autistic person, were an object of an objective investigation, not a being-with-me or a being-against-me. The other’s subjectivity does not manifest itself in what the other person says or does. 

This allows us to understand why autistic people are good at maths operations, sometimes better than average, or operation requiring calculation, memory, or purely logical ones. Signifiers in mathematics require no subjective premise. Autistic people are good with computers – and can be excellent with computers – because they have something in common with computers: both do not perceive subjectivity. No one thinks that one’s computer has a mind, we all know it is only a machine, even though it can talk, and it might be Siri talking. In purely formal operations, in fact, it is best not to show anything relating to our subjectivity, or that of others.  

It is striking that autistic people seem to like centripetal movements; such as, for example, spinning a rope. Many like riding in the rotor, a spinning machine that can be found in amusement parks, in which people are pressed against the walls of a rotating cylinder. We might call this the autistic passion for the spinning top. How might we explain this passion? In my opinion our subjectivity is like a centre which, in a certain sense, structures the surrounding world like a whirl around it. It is what we mean by saying that every “I” is the centre of the world. The world is ordered by subjectivity, which is first of all centralization, and allows to rotate everything around our “I”, like the Ptolemaic world. It seems that autistic people are deprived of this central subjectivity, hence a certain terror of being transported by things, of drifting away. Generally young male (normal) children love linear transportation, like trains, cars, planes…, the centrifugal movement is erotized. Instead an autistic child loves centripetal movements.  In fact, autistic people are afraid of being sucked into reality because they cannot give it meaning through subjective angularity. It is for this reason that when they encounter, in the world, something their mind lacks – the centripetal nature of the world – they are seduced by it. In circular and concentric shapes they see a solution to an intrinsic difficulty of theirs, relating to their being-in-the-world.

Likewise, their tendency to rock seems to be aimed at reproducing a pivot, that is, the ideal “fulcrum” that each one of us thinks we have or that perhaps we are, around which our body performs but also our thoughts. It is as if the autistic person continuously tries to re-shape, in the real world, a sense of centrality or axiality as subject, a centrality and axiality which for us are not spatial but mental.  

We must also say, however, that the neuro-phenomenological theory that views autism as lacking an empathic ability (perhaps due to dysfunctional mirror neurons, as Gallese claims) is not enough. It is true that autism lacks empathy, but only to the extent that empathy is the function, we can say the affective function, that accompanies the perception of one’s own subjectivity or that of others. Those who reduce autism to a lack of empathy have difficulty in commenting the famous Sally-Anne test[12].

 

 

 

In this test there are two girls in the same room, Sally has a basket next to her, Anne has a box next to her. Sally puts a cube into the basket, then goes away. Meanwhile Anne takes the cube from the basket and introduces it into her box. At a certain point Sally comes back and one asks the person being tested: “Where does Sally think the cube is?” It is remarkable that most normal children and even those with Down syndrome give the right answer, while the majority of autistic people (and many young children under the age of four) say that Sally will look for the cube in Anne’s box. This is supposedly proof of the fact that autistic people lack a “theory of mind”.

The difficulty encountered by the theory according to which autism is a lack of empathy stems from the fact that the wrong response by an autistic person does not seem to be related to an empathic relationship with the other, but to something even deeper, which I would call the primacy of the ontological dimension of autism, with respect to the epistemological dimension. What matters is the state of things, not who considers the state of things. Knowing or not knowing tends to be irrelevant to autistic individuals, because knowledge implies a gap between subjective function and extra-subjective reality. If an autistic individual were a philosopher, I bet he or she could never be Kantian: for him or her noumena and phenomena, the thing-in-itself and the things that appear to us, must necessarily coincide. Autism is embodied realism. Thus, the lack of empathy of the autistic subject is a consequence of the fact that he or she not only does not perceive the subjectivity of others, but also lacks perception of his or her own subjectivity.

In other words, autism, thanks to the conspicuous absence characterizing it – absence of a perception of subjectivity – can reversely provide us with a precious image of what we have termed subjectivity, something which both the philosophies prevailing today – cognitivism and phenomenology – struggle to conceptualise. Cognitivism deals only with the mind, which is essentially a cognitive mind, and therefore cannot see subjectivity, which is an occurrence located beyond the mind. Phenomenology instead reduces subjectivity to something integrated with our being-in-the-world, always situated in the relationship with other subjects, but never described as such. Perhaps it is here, then, that psychoanalysts should get to work, because psychoanalysis is a research program that deals with subjectivity – even though psychoanalysis itself has many problems in describing it. Hence autism, precisely because it lacks this quid, allows us to better grasp the essence of this quid. Around which psychoanalysis does not cease to revolve.

 

5.

Unfortunately, however, it does not seem to me that analysts have, for the most part, grasped the specificity of autism, its being agnosia of subjectivity. Some even hypothesize an autistic phase in child development[13], which, however, appears to me to be entirely fanciful.

For this reason, I cannot agree with the campaign that various analysts in various countries are launching against the non-psychoanalytic approach to autism. It is a whining attitude, and ultimately one bound to fail – indeed when one assumes a defensive attitude one is also confessing one’s weaknesses. At its peak, in the ‘60s and ‘70s, psychoanalysis did not defend itself, it attacked; this is how it was able to call into question traditional psychiatry, psychiatry in asylums and purely nosological psychiatry. Psychoanalysis should indeed concentrate on what other research has clarified, completely reformulating its hypotheses on autism. According to a possible line of research I will speak of.

The defence strategies of psychoanalysts aim at a clear opposition between two etiopathogenetic theories, on the one hand the “relationship with adults (especially the mother)” theory, on the other the “organic cerebral constitution” theory. This rigid opposition – we may call it “relationship versus state of the brain” – is however a trap, and psychoanalysis should be careful not to fall into it. Let’s imagine the discovery is made that certain organic (cerebral) predispositions are needed to develop hysteria: would this ipso facto falsify all that psychoanalysis has said and elaborated on hysteria? Not at all. Everything we speak of in terms of psychic language can, at least in theory, be given a cerebral equivalent, the fact is that these two languages are incommensurable, but not incompatible. Proper psychoanalysis has never rejected a priori constitutional factors or cerebral predispositions: the point is what the subject – and those around him or her – will make of these predispositions. Indeed, some organic predispositions and subjective stories are so intertwined and blended that one cannot trace a clear distinction between “relationship” and “state of the brain”. I do not at all rule out that a certain relationship established by a mother with her autistic son may be an essential factor in the evolution of autism; but precisely because of this, the problem I pose here is not etiopathogenetic, but of essence.  

Behind this “relational” conversion of psychoanalysis – which is a modernized form of the old opposition “soul versus body”, with the difference that today the soul is an inter-soul – there is an assumption, in many cases explicit: that psychoanalytic therapy is a sort of second appeal to maternity, that the analyst is a second mother, this time a good enough one, who will allow the subject to undergo the evolution that the first mother, not good enough, has hindered. Since the therapy is, in this view, a second maternage, it is therefore necessary that the cause (but in fact the fault) of autism is the first (real) mother. All of this is, however, a huge simplification. I do not believe that analytical reconstructions, and even less analytical therapies, are simple corollaries of an etiological theory. A psychoanalytic therapy is above all an ethical option, a certain way of addressing inhibitions, symptoms and anxieties.

 

6.

In fact, if everything I have just said is correct, autistic patients represent a difficult problem for psychoanalysts, especially for those who intend to operate therapeutically with them. For the simple reason that, if autism is a form of agnosia of one’s own subjectivity and that of others, the unavoidable conclusion is that the autistic person practically has no unconscious, at least not the kind the psychoanalyst grasps in neuroses, perversions and psychoses. We can say that whereas with psychosis the unconscious makes itself manifest, that is, the subject is submerged by his or her own unconscious, in autism, on the contrary, the subject seems to be lacking all unconscious. The autistic person would need a much greater degree of unconscious to enter into a meaningful relationship of exchange with others, to the extent that our ability to understand others is rooted in our unconscious. Freud described the psychoanalytic work in analogy with the Zuiderzee in the Netherlands, as the act of filling the sea of ??the unconscious with land[14]; in the case of autism, however, we have too much dry land, and what would be needed is a drastic irrigation of the Es. The Freudian unconscious is a surplus of signifier (and impulses) that our Ego (the part of subjectivity that controls and organizes) cannot control, use, take in. According to Freud the unconscious is not made up only of repressed drives: these impulses are continuously signified, and the Ego – a human being’s rational and cognitive functions – is often threatened with being submerged by this plus of signification, which makes us signifying bodies. The ego is also enriched by these impulses, which make it creative if it manages to direct them. In autistic people the opposite happens: their subjectivity is impoverished by a minus of signification. This certainly does not mean that they lack affections and emotions, which in fact may be so strong as to become overwhelming. The point is that autistic emotionality is poor in subjective signification, it is made up of emotions without an “I”. Of course, autistic people express joy, fear, anger, etc., but they are not in tune with social expectations. In fact, it is with social emotions that autistic people appear to be incompetent, because social emotions imply the recognition of the subjectivity of others, and the fact that one’s subjectivity is recognized by others. Hence the way they often feel like they are “animals”, not in the sense that they are driven by bestial inclinations, but in the sense that they do not feel fully human – they are somewhere in between animals and computers, they skip humanity.

Autistic subjects do not experience feelings such as modesty, shame or guilt. They do not understand the reason behind social taboos and therefore cannot understand the social hypocrisy that regulates our relationships. Hence all their blunders. Many have certainly learned in a very formal way how to behave in public; some learn to live in society so well that their diversity is hardly noticeable. For instance, they know that if one is presented to a child one must to say “what a nice child!”. It is also true, however, that if this child is horrible and malformed, one must not be “hypocritical”, it would be a mistake to say to the child or the parents “what a nice child!”. And this is exactly what autistic people tend to do. They do not understand that social hypocrisy needs limitations, otherwise it exposes itself as such.

Autistic individuals are not able to deceive, nor do they try to impress others. They never manipulate, they never get involved in gossip. They have no sense of ownership, they feel no envy and they like to give. In short, they lack all the range of affections, perhaps even contemptible, that make our being-with-the-others meaningful.

This does not entail that they do not feel compassion for the suffering of people or animals. Grandin, for example, felt sorry for pigs: she cried while taking them to the slaughterhouse. Autistic compassion is, however, lacking empathy, as we have said. Which is not the same as feeling sympathy for others, or pity for them: empathy is to feel that the suffering of others is also mine. We feel compassion for another when this other suffers harm, while, I would say, we empathize with the very existence of the other. It is the existence of another person that moves us, also when nothing terrible has happened to this other. We can therefore say that the autistic subject is certainly capable of compassion – it might even be possible to sympathize with an object – not of empathy. This is the thesis of Gallese: because of a (probable) deficiency of mirror neurons, autistic people are incapable of empathy. I have, however, already said that in my opinion this lack of empathy is the corollary of a deeper agnosia.

 

7.

According to psychoanalysis the unconscious is not constituted by emotions, which are always conscious. The unconscious is a network of significations that make certain emotions possible in certain situations. The unconscious is the other side of our relationship with others in that they are recognized as subjects – Lacan would say that for the subject it is the Other – a condition underlying the fact that in turn other subjects may recognize me as subject. The mutual recognition between subjects as “subjects”, the possibility of weaving subjective meaning, is the basis of all psychoanalytic work.

But how then to cure an autistic person with psychoanalysis? The analyst, also when not interpreting, makes everything the patient says resound metaphorically, so it means something different from what he or she is saying or doing literally: the analyst brings out the significant plethora of the subject. This is commonly described as “listening with a third ear”. This third ear is the ability to consider things which do not appear meaningful as significant things that seem to have a flat, literal meaning. Indeed, this is not possible with autistic people because they cannot listen with this third ear: they see the human world, including themselves, as significantly poor. Dirac did not grasp the enunciation of a question in the statement of his colleague, he only grasped the description of a fact, because for him it was difficult to see the interrogative signification. In his view his colleague was describing his mind, he was not showing his question, that is, his desire to better understand. 

Does this mean that only cognitive-behavioural interventions with autistic people are possible? Probably not. I believe that certain mothers and fathers, in spite the fact they have been spoken badly about by psychoanalysts, instinctively know how to find surrogates, prostheses of subjectivity, we might say, that allow their autistic children to understand a little of the subjectivity of others, and their own. It is probable that Grandin’s mother was very good not at “healing” her daughter – it is very unlikely that one can recover from autism, the way one cannot “heal” from being a dwarf or a giant – but at compensating for her deficiencies to the point her daughter became a famous personality and writer. Whatever analysts think they might do, they should start from recognizing the true specificity of autism: its lacking an unconscious. Is it possible to graft a certain amount of unconscious into someone else?

I am not able to give advice to analysts who would like to attempt to treat autism. I do, however, believe that they will be able to achieve something only by overturning the traditional analytical listening strategy. The analyst cannot listen to the unconscious of an autistic person because it is missing, (not completely, we may say the unconscious is frozen): the analyst should rather talk him or her, in order to strengthen the abilities of the autistic person to perceive the subjectivity of others. What an analyst should do with autistic people, is not so much listen, but speak.

Here too, the opposition with psychosis is decisive. With psychotics we tend not to interpret at all, because – as we have said – psychotics already interpret too much: they super-signify the world. If one interprets delusions, the risk is to fuel them, it is like throwing oil on a fire. Many analytical interpretations are in fact viewed as persecutory by psychotics, because for them words are always acts. With autistic subjects analysts – who by behaving in such a way would be doing the opposite of what they always do – should be active, and expose the autistic subjects to experiences which may spark the beginning of a recognition of something that purely cognitive beings such as themselves do not perceive: our human subjectivity as meaningful. The fact is that what counts is not only what we say, but also what, by means of what we say or do not say, shows itself. And what shows itself is one’s own subjectivity, which can never be reduced to what is said.

 

 

 



[1] E. Bleuler, Dementia praecox oder Gruppe der Schizophrenien, Deuticke, Leipzig-Wien, 1911. Dementia Praecox; Or, The Group of Schizophrenias, International Universities Press, Ann Arbor, 1950.

 

[2]L. Wing (ed. by), Aspects of Autism: Biological Research, Gaskell, London 1988. L. Wing, Autistic Spectrum Disorders: an Aid to Diagnosis, National Autistic Society, London 1995. L. Wing, The Autistic Spectrum: a Guide for Parents and Professionals, Constable, London 1996. As is known, the DSM-5 also adopts the term Autism Spectrum Disorder (299.00) and places it among Neuroevolutionary Disorders, so separately from the “psychotic spectrum”.

 

[3] In line with this view: F. Tustin, Autism and Childhood psychosis, The Hogarth Press, London, 1972. See. A. Ballerini, Patologia di un eremitaggio. Uno studio sull’autismo schizofrenico, Bollati Boringhieri, Turin 2002.

 

[4]I have dealt with Unilateral Spatial Neglect in particular, which is a very specific form of blindness: the subject does not see what is on the left of his field of vision, or the left side of an object in front of him. S. Benvenuto, “Neglect. Riflessioni tra filosofia e neuroscienze”,       http://www.sergiobenvenuto.it/meditare/articolo.php?ID=140. “Neglect”, Lettre Internationale, 112, Frühjahr 2016, pp. 122-125.

 

[5]C. Rovelli, La realtà non è come appare, Raffaello Cortina, Milan 2014, p. 106.

 

[6] A biography of Dirac which speaks of his autism is: G. Farmelo, The Strangest Man: The Hidden Life of Paul Dirac, Quantum Genius, Faber & Faber, 2009.

 

[7]One of the major interpreters of this approach is S. Baron-Cohen: Social and pragmatic deficits in autism: Cognitive or affective?, in “Journal of Autism and Developmental Disorders”, 18, 1988, pp. 379-402. Joint-attention deficits in autism: towards a cognitive analysis, in “Development and Psychopathology”, 1, 1989, pp. 185-89. The development of a theory of mind in autism: deviance and delay?, in “Psychiatry Clin North Am”, 14/1, 1991a, pp. 33-51. The theory of mind deficit in autism: how specific is it?, in “British Journal of Developmental Psychology”, 9, 1991b, pp. 301-14. Mind blindness. An essay on autism and theory of mind. MIT Press, Cambridge (Mass.) 1995.The autism spectrum quotient (AQ): Evidence for Asperger syndrome/high functioning autism, males and females, scientists and mathematicians, in “The Journal of Autism and Developmental Disorders”, 31, 2001, pp. 5-17.S. Baron-Cohen, A. M. Leslie e U. Frith, Does the autistic child have a ‘theory of mind’?, in “ Cognition”, 21, 1985, pp. 37-46.S. Baron-Cohen, H. Tager-Flusberg e D. J. Cohen (ed. by), Understanding Other Minds. Perspectives from Autism, Oxford University Press, Oxford 1994.S. Baron-Cohen, H. Tager-Flusberg e D. J. Cohen (ed. by), Understanding Other Minds. Perspectives from Developmental Cognitive Neuroscience, 2° ed., Oxford University Press, Oxford 2000. See also U. Frith, Autism: Explaining the Enigma, Basil Blackwell, Oxford, 1989.

 

[8]V. Gallese, La molteplicità condivisa. Dai neuroni mirror all’intersoggettività, in S. Mistura (ed by.), Autismo. L’umanità nascosta, Einaudi, Turin, 2006. V. Gallese, “Intentional attunement: Mirror Neurones, Inter-subjectivity, and Autism” in G.B. La Sala, P. Fagandini, V. Iori, F. Monti, I. Blickstein, eds., Coming into the World. A Dialogue between Medical and Human Sciences, Walter de Gruyter, Berlin-New York, 2006, pp. 45-64.

 

[9] For accounts of autistic people on their way of being in the world, see D. Williams, Nobody Nowhere, Doubleday, London 1992.

 

[10]T. Grandin, Emergence: Labeled Autistic, Arena Press, Novato (CA) 1986. Also: T. Grandin, Thinking in Pictures; the biographical film Temple Grandin by Mick Jackson (2010). O. Sacks has also talked about her in: O. Sacks, “An Anthropologist on Marx” in An Anthropologist on Mars, Vintage Books, 1996.

 

[11]B. Bettelheim, The Empty Fortress: Infantile Autism and the Birth of the Self, Free Press, New York 1967.

 

[12] Baron-Cohen, Simon; Leslie, Alan M.; Frith, Uta (October 1985), “Does the autistic child have a ‘theory of mind’?”. CognitionElsevier21 (1): 37–46.

[13] For instance, Henri Rey-Flaud, L’enfant qui s’est arrêté au seuil du langage, Aubier, Paris 2008.

 

[14] Freud, SE, 22, p. 175.

 

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