Autism and French Psychoanalysis

In America Freudian psychoanalysis is on life support. At best, it is a charming relic of a bygone age.

In France psychoanalysis is alive and well. Thanks to Jacques Lacan nearly all French psychiatrists have suffered the influence of Freudian psychoanalysis.

While France has never stinted on psychiatric medication the dominant modes of psychological treatment for mental illness all involve some version of Freudian psychoanalysis.

French psychoanalysis is a hermeneutically sealed world where presumably intelligent people spin out narratives that pretend to tell you all you ever wanted to know about human behavior.

Most of the time the analysts do not pretend that their theoretical fabulations produce good clinical results. The more sophisticated among them do not even believe in clinical results.

Some of you may know that I have more than a passing familiarity with the French psychoanalytic scene. I was a part of it for many years. Two decades ago I departed from it. I have been warning people away from it ever since. I make no claim to objectivity here. 

I mention this to preface an amazing story, one that shows the dark side of French psychoanalysis. It has caused considerable chagrin in the French psychoanalytic community.

Two days ago the New York Times reported on the controversy that has erupted around a documentary film produced by one Sophie Robert. See also Robert’s website here.

Robert decided to examine the way autistic children are treated by the psychiatric establishment in France. She compared the clinical results achieved by one child whose parents chose an American behavioral technique called PECS and another child who had been treated with psychoanalytically-inspired methods as a day patient in a psychiatric clinic.

For the record: PECS stands for Picture Exchange Communication System. It works to help autistic children learn to use language.

The film notes at the beginning that autism is generally considered a neurological condition. In the distant American past Bruno Bettleheim attempted to treat autistic children with a variant of psychoanalysis, to little avail. His work has long since been discredited on this side of the Atlantic.

He still has a following in France, and his work, coupled with Freudian theory, has caused French psychoanalysts to believe that, even if autism is a neurological condition, its root cause is psychogenic.

In everyday language, this means that mothers are to blame. If you watch Robert’s film and listen to the various French psychoanalysts proudly offer up their theoretical narratives about autism we discover that they believe it is either caused in utero by a mother’s depression, or  by bad mothering.

The psychoanalysts indict mothers for being too close or too distant, too warm or too cold. In any case a mother's bad parenting skills or psychological defects are the root cause of her child’s autism.

For the record some of the psychoanalysts belong to the Lacanian School where I trained. Others belong to French psychoanalytic groups that are part of the International Psychoanalytic Association, the IPA. Most of the important psychoanalytic societies in America belong to the IPA.

When it comes to treating autism the psychoanalysts do not seem to have very much to offer. It is difficult to conduct a talking cure with a child who cannot talk.

But they do not seem to be especially bothered by the inconvenience. A couple of them seem to think that a silent patient constitutes a special challenge to their fortitude as psychoanalysts. They see themselves being challenged to listen attentively to a patient who is incapable of talking.

When the interviewer asks these psychoanalysts what they would consider to be a good treatment result, they themselves are rendered speechless. They act as though the question has never crossed their minds.

French psychoanalysts have been cured of any obligation to provide treatment for their patients.

The film has caused more than a scandal in France. It has provoked a lawsuit.

The French psychoanalysts come across in the film as blithering fools and they are none too happy about. Most of them speak at length about their theories of autism. They offer what I consider to be a fair rendering of their bizarre belief system.

And yet, three of them, the more Lacanian analysts, are suing the filmmaker for making them look like fools. They want their interviews removed from the film. They also want monetary damages.

I am not surprised. Free and open debate and discussion has never been permitted in the world of Lacanian psychoanalysis. Take my word for it.

I will tell you that Robert did not select a bunch of psychoanalytic cranks. Many of those she interviewed are pillars of the French psychoanalytic community, both from the Lacanian School and the IPA.

One might surmise that they were unaware of how foolish they looked until they saw themselves on film. Once they saw what they looked like they ran screaming into the night and decided to blame to the filmmaker.

In reality, they had agreed to be interviewed; they all signed releases. Most of them seemed to thrill to the opportunity to present their grand ideas to a larger public.

It’s one thing to sound like a fool. It’s quite another to be actively militating against effective treatment for autistic children. That is the charge that Sophie Robert levels against the psychoanalytic establishment.

In her film Robert shows that the French approach to psychotherapy is actively preventing autistic French children from receiving the most advanced and most effective current forms of treatment.

That, dare I say, is the rub. And it is not a theoretical rub.

Here is the way the New York Times presents the case:

“Le Mur,” or “The Wall,” a small documentary film about  autism released online last year, might normally not have attracted much attention.

But an effort by French psychoanalysts to keep it from public eyes has helped to make it into a minor cause and shone a spotlight on the way children in France are treated for mental health  problems.

The documentary, the first film by Sophie Robert, follows two autistic boys: Guillaume, who has been treated with the behavioral, or “American,” approach; and Julien, who has been kept in an asylum for six years and treated with psychoanalysis. Guillaume, though challenged, is functioning at a high level in school. Julien is essentially silent, locked out of society.

Since Sept. 8, when the film first became available on the Web, it and Ms. Robert, 44, have been the targets of criticism from both the analysts who appear in the film and from within the country’s psychoanalytic establishment. Three of the psychoanalysts whom Ms. Robert interviewed for the film have sued her, claiming she misrepresented them in the 52-minute documentary, which has not yet been screened in cinemas or on television.

Since the documentary is on Youtube I am offering it for your interest. It is in French with subtitles.

I will mention that the boy named Julien was not kept in an asylum. As I understood it, he was treated in a psychiatric clinic in a program where he spent his days in the clinic and his evenings at home.

If you watch the film you will see that Guillaume, while still autistic, is functioning reasonably well. He goes to school, gets fairly good grades, and requires only a minimum of extra consideration.

Thanks to the American “behavioral” approach, which his mother discovered on the internet, he will have a good chance to lead a productive life.

If you watch the film you should also pay close attention to Guillaume’s mother. If you keep in mind the psychoanalytic mania about blaming mothers you will be surprised to see how good a mother Guillaume has.

But, if it is so well established that the American approach provides better treatment why don’t all French children undergo it?

That is the real story here. And that is why Robert’s film has been so viciously attacked.

The film claims that the behavioral approach is simply not available to most autistic French children.

It is not available because it bears what French intellectuals consider to be a stigma: it comes from America. Therefore, it offends the cultural sensibilities of French psychoanalysts.

Since upwards of 80% of French psychiatrists learn psychoanalytic therapy, their influence is considerable.

Given the stigma attached to behavioral approaches to therapy, very, very few therapists are willing to risk their careers by learning it.

For French psychoanalysts it is not about effective treatment. It is about cultural purity. Lacanian psychoanalysis is a purely French production. Thus it must be preferred over the American behavioral approach that does not blame mothers and that actually works.

One French analyst even mentions with considerable pride that he and his cohorts have saved France from an “invasion” of alien American cultural influences.

It is a truly amazing statement, one made all the more amazing by the fact that the man who speaks it is oblivious to what he seems to be saying.

A psychoanalyst trained in a school that places special value on speech and language ought to weigh the implications of his words. He ought to know that when you say that you are actively fighting off an American invasion you are evoking an historical antecedent.

As everyone knows in 1944 allied armies did invade France. On D Day they invaded occupied France in order to liberate the nation from its Nazi occupiers.

Why Frenchmen would fear an American “invasion” is almost beyond comprehension. One day I will explain it, but not today.

Now, faced with the threat of an alien American invasion French psychoanalysts are fighting to prevent autistic children from receiving the best treatment available.

That they are doing it in the name of French honor and integrity renders us speechless.

Worse yet, Sophie Robert’s film has exposed them as fabulators, as perpetrating an intellectual con. In good French one might say that they come across in the moving looking like cons. (The word has an altogether different meaning and implication in French.)