Psychodynamic “acceptance”

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I’ve been sick today, so mostly resting or reading in bed and on the toilet etc. I’m rereading Let Me Hear Your Voice, masochistically enough.

I found an interesting point towards the end, that shows the context in which a lot of people could misinterpret the idea of accepting an autistic person as autistic (and not just those considering themselves opposed to acceptance for that matter). The author — who believes in “recovering” children through Lovaas-style ABA combined with other stuff — points out some similarities in many of the psychodynamic ideas about autistic people.

Basically, a lot of them — regardless of what they think the innate cause of autism is — consider that there is a non-autistic child inside the autistic child, and that child needs to be shown love and acceptance, and anything less than that will prevent that child from “coming out of their shell”. Parents whose kids don’t “recover” are then blamed for not “accepting” their children enough. She describes this in terms of Bettelheim, holding therapy, the Options Method, and other such practices. (She herself was drawn into a holding therapy cult at one point — cult being her word for it, not one I’m imposing.)

So, when a lot of parents hear about acceptance, there’s a good chance they’re hearing echoes of that kind of crap. Which has never sounded all that much like acceptance to me, since it’s acceptance of a person (the “normal child inside autism”) who doesn’t actually exist. And when they hear autistic people saying that parents need to be more accepting, they’re probably actually hearing those echoes of Bettelheim even though they’re not really there. (Such as Kit Weintraub’s bizarre set of accusations against autistic self-advocates.)

Of course the problem is that the counterpoint she sets up against this is just as bad. It’s all about how she’s going to drag her kids kicking and screaming into the world of normalcy, and treating their autistic behavior as horrifying and purposeless and to be extinguished, and so on and so forth.

Both “sides” of this look incredibly medicalized and pathological from where I’m looking.

It’s very difficult to say something like, “No, I’m not saying something from either of two extremes, nor am I in the middle. I’m way off to the side in some other direction entirely.” People want two extremes, or they want (if fashionable enough) a “spectrum” between two extremes. It seems difficult to write something and actually have it read without imposing a black and white category on it, or else a gradation of grey between black and white, when really we may be talking fluorescent purple or dark green or something.

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12 responses »

  1. What I’ve seen in comments on this and other blogs make me think the negative reaction to acceptance is a lot simpler than that. There’s the idea that acceptance=passivity. A lot of parents have the entirely reasonable and admirable goals of wanting their children to be healthy and safe, communicate, learn basic life skill, and grow and develop, but get this mixed up with the idea of a cure. And the first options they see are a number of medicalized options that promise improvement and a cure.

    Acceptance, when it’s mentioned at all, gets portrayed as “do nothing to change your child,” which isn’t reasonable parenting by any standard. I’ve seen more than one parent post about how they’re afraid treated a separate medical issue described as “co-morbid”, or teaching their child to speak or type, or providing non-abusive behavioral incentives for toilet training would somehow mean they weren’t accepting their child. That’s a complete misunderstanding of acceptance, but from what I’ve seen in the comment section of different autism blogs, it’s pretty widespread.

  2. I’ve seen that too.

    But I’m talking about more when people, like Kit Weintraub, make explicit comparison between acceptance and refrigerator-mother theories — a comparison that always baffled me.

  3. I’ve had a big bout of “you are suggesting that we just let our kids rot” on my local group this week. And I’m sick of it.

    Amanda, I love your blog entry on the child “Kate” who needed all those “interventions” in order to become a functioning adult. I don’t understand why parents imagine that accepting autism is the same as letting a child sit in a corner all day. That would be considered abuse if it was done to a typically developing child, and should never be done in any case. Why is it that if you oppose the therapy espoused by a particular group, they assume that it is the only approach available, and if you do not take that particular approach you are “letting your child rot”? And it’s particularly strange that this point is made by both ABA parents and chelation parents equally.

  4. ballastexistenz: “But I’m talking about more when people, like Kit Weintraub, make explicit comparison between acceptance and refrigerator-mother theories — a comparison that always baffled me.”

    Yeh, but you have a brain with a functional mind living as a result of it; Weintraub has let go of the functionally cognitive bits of her brain in order to be able to get away with reacting so reflexively to things and jumping to wrong conclusions…

    Her problem, not yours… don’t be overly concerned about her… I’m not.

  5. It’s very difficult to say something like, “No, I’m not saying something from either of two extremes, nor am I in the middle. I’m way off to the side in some other direction entirely.”

    We read somewhere that the devil sends lies into the world in pairs so that it’s easy to use one lie to scare (or whatever) people into believing the other. There’s usually a tacit agreement between two such lies, an assumption shared by all the people who are trying to figure out which one is true (often the assumption is that it’s an either/or matter, but by no means always; and some things are either/or). So the explaining follows the pattern of, “No, I don’t think it’s a matter of A vs B. A and B both presuppose X, and I don’t agree with that. It’s a matter of X vs Y.” But it can be very hard to get Y into their heads, and sometimes they try to summarize what you said in terms of either A or B, so it’s hard to know if they’ve understood (though it usually means they haven’t).

    People want two extremes, or they want (if fashionable enough) a “spectrum” between two extremes. It seems difficult to write something and actually have it read without imposing a black and white category on it, or else a gradation of grey between black and white, when really we may be talking fluorescent purple or dark green or something.

    For instance the gender binary. You’ve got boys (blue) and girls (pink) and if there is someone who doesn’t seem to completely fit either (in whatever way), they must be either a defective version of one of those, or something in-between (purplish). Well, there is a third primary color out there.

  6. What I’ve seen in comments on this and other blogs make me think the negative reaction to acceptance is a lot simpler than that. There’s the idea that acceptance=passivity.

    You mean the sort of reductio ad absurdum comments that tend to go along the lines of “So you mean to say we should just do nothing and never give anyone any help at all?” We keep running into that… over and over, not just with autism: it seems that the second you criticize the dominant medical approach to anything, or suggest that it doesn’t actually help people as much as it’s claimed to, someone will get in line to castigate you for, supposedly, ‘thinking everyone is perfectly all right and nobody needs any help,’ even if you’ve said nothing remotely of the kind. Or of ‘not taking people’s problems seriously.’ Or of ‘not understanding what a serious issue this is because you’ve never been severely affected/known someone who was severely affected.’ (And then they start in with the horror stories, never mind that some of them might actually just sound like horribly pathologized versions of us at some point in our lives or those of people we know.)

  7. David, it’s not a matter of being overly concerned with one person, it’s a matter of caring how people like that (she’s far from the only person who routinely makes that parallel) think, since it’s a pattern that’s useful to know about. If people are misreading something a certain way, repetitively, it’s good to know why.

  8. Re “leave them to rot”– Yes, I’ve been dealing with a very similar issue in the past few days. It happens with all kinds of ‘mental health issues’– anyone who points out the dangers inherent in many conventional ‘treatments’ and suggests alternative methods is accused of, variously, wanting to leave people to rot, claiming that everyone is okay and nobody needs help, and endangering people’s lives. (Although we know many, many more people who have been put in danger by the system itself.) That was what I was trying to get at in my reply last night, but the thoughts weren’t coming together well.

    I moderate a community where psychiatric issues come up a lot, and there are many people who have a very strong attitude of “The doctors who say that we and people like us are mentally ill are wrong, but they’re right about *other* people needing certain kinds of help and intervention.” I had just given someone the link to the Hearing Voices Network, and people immediately started talking about how concerned they were that I didn’t seem to be taking this seriously. Apparently, for them, ‘taking it seriously’ meant telling her what everyone else was telling her, which mostly amounted to “Listen to your doctor and take your meds.” (And then of course got accused of “saying all doctors are evil” when I talked about the dangers of neuroleptics, but that always happens.) The doctor, of course, was treating this young woman’s experience as ‘paranoid schizophrenia’ and seemed to be doing an out of the package approach.

    …and the irony always seems to be that no matter how many accounts you can give either of your own personal experience or the experience of others you have known, you still get accused of not understanding the seriousness of the issue at hand.

  9. I remember being baffled by a person who claimed she loved her child but would have aborted that child if she could do it over knowing her child was disabled. I wrote a blog entry about this – “Preventing Disabilities or Preventing Disabled People’. Basically, it seems that she thought she could abort her disabled child and have a normal child who would be the same in all aspects except for the disability. When in fact, a) some of that kid’s good points were probably because she was disabled, and b) she would’ve been preventing the whole child. There are differences between me and my brother which aren’t because I’m autistic.

  10. ballastexistenz: “If people are misreading something a certain way, repetitively, it’s good to know why.”

    True.

    Thing is that such people are procrustean thinkers: they wish to fit the world to their view of it, as opposed to the practice of fitting one’s view of the world to the reality that presents itself to us. In Personal Construct Terms, it’s actually a less intelligent way of doing things, since it is excessively rule-driven, the main rule being that the world must fit my expectations or it is a catastrophe (this kinda ties in with Ellis’ theory in RET…) – very akin, also, to Piaget’s concrete operational stage of cognitive development… it’s as if their thinking abilities have halted just there.

    As for what we can do about it…. sadly, nothing.

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