In a Different Key: The Story of Autism (14 page)

So there it was. By picturing the infant Steven as a chicken, Rita had instilled a sense of rejection in her defenseless baby boy. Her devotion to him since then—the long nights awake, the travails over feeding him, the exhausting days chasing after him—none of it counted. He just went on being autistic, because there was something wrong with her.

Some mothers might have dismissed such an explanation out of hand. But Rita, ironically, was too well educated to be able to do that. She had graduated from Hunter College with a degree in sociology, and over the next few years, served as a caseworker in New York’s Bureau of Child Welfare. She had also worked at an adult psychiatric hospital and taught fifth grade in a special-education program in the South Bronx. Along the way, she had read enough about autism to know what the experts said: where autism occurred, it was always the mother’s fault.

Who thinks of her son as a chicken? she kept asking herself. She knew the answer, and sadly, she knew the outcome. She was a textbook case. She only hoped that her full admission of responsibility, and her willingness to submit to continued treatment to get at the root of her failures as a mother, would be enough, in time, to save her son.

—

R
EFRIGERATOR MOTHER
. That was the term. And it was a slur—the first seed of which was planted in
Time
magazine’s earliest-ever report on the topic of autism, which ran on April 26, 1948, under the headline “Medicine: Frosted Children.” The main point of the piece was to introduce
Time
’s readers to the existence of these rare “
diaper-aged schizoids,” who were “happiest when left alone.” But the whole thing was written with a heavy slant of blame, summed up in the magazine’s rhetorical question: “Were the cold parents freezing their children” into autism? In all documented cases, according to
Time
, the mothers and fathers were of one particular type. These were parents who “hardly knew their children,” who were “cold” and “undemonstrative.” To put it bluntly, “there was something wrong with all of them.”

An expert quoted near the end of the story offered up the image that would define most public discussion of autism for the next two
decades. It was his metaphor for the fate met by these young, “pathetic patients,” as
Time
called them, at the hands of their flawed, icy mothers and fathers. These children, said the expert, were
“kept neatly in a refrigerator which didn’t defrost.”

Over time, the discussion about blame would start to look past the role of fathers and focus almost entirely on mothers. The “refrigerator” metaphor stuck to them, transforming sympathy for their difficulties into contempt. Almost the entire apparatus of American psychiatry participated in this ostracizing and debilitating portrayal of the refrigerator mother. One expert in particular, however, took the concept to such an extreme that his name became synonymous with mother blaming: Bruno Bettelheim.

8

PRISONER 15209

H
e was called
Dr
. Bruno Bettelheim, sometimes just Dr. B, although he wasn’t actually a doctor, not in the sense of someone who went to medical school or earned a degree in psychology. A former Austrian lumber merchant, he had earned his doctorate in art history. Still, in the 1950s and ’60s, he somehow became the nation’s most beloved, respected, and trusted dispenser of insight on the human psyche.

Bettelheim, by his own forlorn admission, was ugly to look at, to an extent that bothered him all his life. He acquired English late, in his thirties, when he first set foot in the United States. But he had wit, charm, intelligence, and drive, and on the strength of those qualities and a Viennese accent, he talked his way to the top of American popular culture. His books, though not easy reads, became bestsellers. He wrote cover stories for magazines, and magazines wrote cover stories about him.
Chicago Magazine
’s front-page profile called him “The Man Who Cares So Much.” A BBC documentary placed him among the world’s “greatest living child psychologists.” He was a
Today
show guest, a “get” on late-night television, and, when Woody Allen was casting his mock documentary film
Zelig
, which came out in 1983, he contacted Bettelheim to tell him he had written in a cameo appearance for him, playing an authority on the human mind. Bettelheim took the part. After all, he had been playing it for thirty years.

—

P
RISONER NUMBER
15209 stood before the desk of a young Gestapo captain, who gestured to the prisoner to help himself to a chair. The
prisoner, who was Jewish and knew how the captain felt about people like him, declined the invitation. Despite the snub, the Gestapo officer produced a rubber stamp and, after asking a few preliminary questions, brought it down, with a proper and precise thump, onto the official document that released the prisoner from incarceration in the Buchenwald concentration camp. The stamped paper gave the freedman a limited number of days to depart Austria for the United States, with the strict condition that he never return. It was April 1939.

That was how Bettelheim told the story. As his version would have it, he was the prisoner, and the young captain was an up-and-coming Nazi named Adolf Eichmann. Such a chance encounter, between the future star of American pop psychology and the Nazi destined to hang for engineering the machinery of the Holocaust, seems almost too improbable to be believed. Perhaps it was.

As shown by Richard Pollak, his most critical biographer, Bettelheim was a prolific embellisher of the truth. Pollak’s extensive research found instance after instance over several decades in which Bettelheim exaggerated or left out important facts about his work and life. For example, Pollak discovered that Bettelheim had told parts of the prisoner story on numerous occasions, but only once did he talk about facing down the engineer of the Holocaust. On all other occasions, according to Pollak, “Eichmann made no appearance.” Pollak concluded that Bettelheim almost certainly never met Eichmann.

It is true that Bettelheim spent eleven months as a concentration-camp prisoner. He was picked up in a general roundup of Jews in Vienna in May 1938 and shipped off to Germany’s first concentration camp, Dachau, in a cattle car. His first few months, he survived basically blind, for he was severely nearsighted, and one of the guards had smashed his thick-lensed eyeglasses.

At this stage, after Germany had annexed Austria, but before World War II began, the camps did not yet serve primarily as death factories. For Jews, the camps were a tool used to terrorize them into fleeing the Reich. Treatment was brutal, beatings were frequent and random, and prisoners died daily of disease, malnutrition, and summary executions. Buchenwald, where Bettelheim was transferred after four months, was even harsher. Yet there was, for Jews in particular, the real possibility
of release in those early days, on the condition that a prisoner leave the Fatherland for good, abandoning his property to the state.

Bettelheim, upon his release, was given a week to leave the land of his birth. In May 1939, he landed in New York—traumatized, severely underweight, missing several teeth, and stripped of the better part of his life’s savings. He had no job, little English, and, as far as credentials, only that doctorate in art history from the University of Vienna, which he had earned over seven years while running the family lumber business. It was not, on the face of it, the key to finding paying work in a foreign country.

He had nothing but his freedom and temporary permission to reside in the ultimate land of second chances. He made everything of the opportunity. Ten years later, he was on his way to fame, having created a new life and constructed, for public deployment, a new self. The “Dr.” in front of his name was now a permanent part of his identity.

In 1950, the University of Chicago placed Bettelheim in charge of the Sonia Shankman Orthogenic School, which functioned as a working laboratory for developing new methods in the treatment of disturbed children who lived full-time within its walls.

In short order, Bettelheim was reporting extraordinary success in healing mental illness in the students under his charge. This in turn created a huge demand for his pronouncements on the best approach to raising “normal” children.

For years, in addition to writing advice articles for parenting magazines, and taking calls from reporters needing a quick quote on deadline for anything related to psychiatry or mental health, Bettelheim also held monthly sit-downs with young Chicago mothers, focused on telling them how to raise their children correctly. Forty or so women at a time would cram into a seminar room at the university in the evening, after their children were asleep, and the conversation would unfold for hours.

“He was God, we idolized him,” one mother told Richard Pollak, who later interviewed as many of them as he could track down.

At least three full-length biographies of Bettelheim, ranging from hostile to sympathetic, have taken on the question of how an Austrian lumber merchant with a doctorate in art history became recognized as an eminent child psychologist and the world’s leading expert on what
causes autism. The answer remains elusive. Part of the explanation may be that Bettelheim actually did acquire, on his own, a meaningful knowledge of psychoanalysis, which fascinated him. He was a denizen of Jewish Vienna, where psychoanalysis was born, and where it wove itself into the fabric of intellectual discourse, affecting drama, literature, politics, and art—something Bettelheim did know a good deal about. At the University of Vienna, it appears, he took at least two psychology courses, and he read widely in the field throughout his life.

With a few clever adjustments here and there, Bettelheim nudged and stretched his life’s narrative into a seductive curriculum vitae. No one, it appears, bothered to fact-check these adjustments, even as they opened doors for Bettelheim into ever-higher reaches of academia. Ultimately, Robert Hutchins, the president of the University of Chicago, would be one of his most enthusiastic patrons.

Bettelheim’s ace card was his history inside the Nazi camps. On this subject, he had credentials and authenticity no American academic could match. When he wrote that Europe’s Jews were partially to blame for the Holocaust—for being too unwilling to assimilate before it began, and too unwilling to put up resistance after—he felt he had the right to do so, due to the fact that he had been there and had made it out alive. American Jewish audiences who heard him say these things exploded with shock and outrage, but he never backed down.

As a survivor living in the United States, he was appalled that few Americans knew about the camps or seemed to believe the few incredible scraps of information that leaked out from time to time. He was driven to prove that what sounded unbelievable was true, and in 1942, after working on it for more than a year, he completed an essay on what he had witnessed during his imprisonment. He wrote not only about the conditions inside the barbed wire, but also about the psychology he had seen in play: why some prisoners were able to mentally withstand the nightmare, while others wilted and gave up. It was another year before he could persuade anyone to publish it.

When at last his piece, entitled “Individual and Mass Behavior in Extreme Situations,” was printed in
The Journal of Abnormal and Social Psychology
, it startled readers. Soon, other, more widely read publications were reprinting large chunks of the article or reproducing it
in full. Bettelheim’s standing soared. For several years, it stood as the definitive account in English of the atrocities the Nazis were attempting to carry out in secret, as well as an analysis of the psyches of the prisoners. True, the author wasn’t a psychiatrist; in fact, when one publisher called him that, Bettelheim wrote a short note to correct him.

By coincidence, Bettelheim’s piece was published only a few months after Leo Kanner wrote for the first time about Donald and the other ten boys and girls he was seeing at Hopkins. While few Americans knew much of the camps, virtually none knew anything about autism. A decade was to pass, during which the condition remained obscure, familiar only to a small circle of psychiatrists who read Kanner and thought perhaps they were seeing cases in their own practices.

Then Bettelheim decided autism deserved his attention.

In 1955, Bettelheim applied for a grant from the Ford Foundation to bring a handful of children with autism into the Orthogenic School for a period of seven years. He proposed to track their development while figuring out the best ways to reach them, and he pointed out that the lessons learned could have wider applications.
“From these children who have never made a normal emotional adjustment,” he wrote, “much could be learned about both normal emotional adjustment and adjustment through mental illness.” He received the funding.

—

T
O BE SURE
, Bettelheim did not intend to study the brains of these children. It was the wrong era for that sort of approach. The brain was an organ, and mainstream psychiatry put little stock in the notion of organic causes of mental misbehavior.

For Bettelheim, an autistic child, especially one who could not speak, was the perfect canvas upon which to scrawl a Freudian interpretation of behaviors. Consider, for example, his explanation of why children with autism have a hard time going to the dentist. Ask any parent of a child with severe autism: this is a classic struggle. The dentist’s chair has everything wrong with it. It’s unfamiliar, it’s confining, it moves, it may even vibrate. Blinding lights hover. Equipment screeches and squeals. A stranger in strange clothing comes to poke strange instruments
into the child’s mouth
. Sometimes there’s pain.

Inspired by Freud, Bettelheim had an explanation:
“From what we know of autistic children, their main anxiety is that the dentist will destroy their teeth in retaliation for their wish to bite and devour.”

His theories on dentistry and autism appeared in
The Empty Fortress
, the 1967 book that catapulted him to the top of the list of autism’s explainers. The book is constructed as a guided tour through a weird, wondrous corner of the “fascinating” human condition known as autism. In a detailed sketch of a handful of children under his care at the Orthogenic School, he offers their strange behaviors and obsessions as clues—clues that explain why these children might choose to run from reality.