A recent conference on autism held in Philadephia earlier this year was more controversial than usual. Along with the presentation of papers relating to the causes and treatment of autism, a new film by French documentary filmmaker Sophie Robert showed the powerful hold that psychoanalytic theories about the cause of autism has in France. Titled Le Mur (The Wall), Robert's film is the result of four years of research and interviews with more than 30 French professionals, many of them heads of pediatric departments in major hospitals. In showing the continuing stigma that parents of autistic children still face in France, Robert has stirred up considerable controversy of her own. Three of the professionals that she interviewed have filed lawsuits against her and demanded that the film be banned. Despite controversy, The Wall has generated an international following through YouTube and served as a graphic reminder of the continuing popularity of an early theory about the causes of autism long thought debunked: the "Refrigerator Parent" hypothesis.
When child psychiatrist Leo Kanner first identified the syndrome that would become known as autism in a 1943 paper, he went beyond describing the unusual schizophrenia-like features of the children in his study by focusing on their parents as well. In summarizing his findings, Kanner emphasized that the parents tended to be highly intelligent but also suggested that:
"In the whole group, there are very few really warm-hearted fathers and mothers. For the most part parents, grandparents... are limited in general interest in people. Even some of the happiest marriages are rather cold and formal affairs. The question arises to whether or to what extent this fact has contributed to the condition of the children."
While Kanner didn't place the blame for autism exclusively on parents, he expanded on his theme of "parental coldness" in later papers where he suggested that autistic children were raised in isolation from the very beginning, with no access to warmth from their mothers and fathers. In a 1960 interview, he described parents of autistic children as "just happening to defrost enough to produce a child" (and is believed to be the source of the "refrigerator parent" label). He was hardly the only authority to blame autism on poor parenting though. Child development specialist, Bruno Bettelheim and other psychoanalysts also stressed the role of "cold and distant" parents (usually the mother) in causing autism in children. And so the "refrigerator mother" hypothesis was born.
Throughout the 1950s and 1960s, mothers and fathers dealing with their autistic children were often forced to deal with a double burden. Not only did they have to cope with their autistic children and the lack of real treatment options available at the time, but they were also saddled with the blame for making them autistic to begin with. Since autism had no obvious physical cause, psychoanalytic explanations remained popular. While the refrigerator mother hypothesis came under attack beginning in the early 1960s, (and Kanner himself eventually backtracked on his original position), Bruno Bettleheim continued to defend it.
Bettleheim even went so far as to compare autistic children to prisoners in concentration camps saying, "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" (that Bettleheim had been a Holocaust survivor himself gave his words an extra poignancy).
Along with Bettleheim, other psychiatrists took up the cause of protecting children from their "refrigerator parents." Autism was often compared to the environmental retardation seen in neglected children and psychoanalysts such as Margaret Mahler weighed in with their own theories on how autistic children were unable to separate themselves from their mothers.
As early as 1964 though, parents of autistic children began fighting back. Bernard Rimland, a psychologist and a father of an autistic child, wrote a book debunking the refrigerator parent hypothesis and the various misconceptions surroundings the causes of autism (Leo Kanner wrote the foreword for the book). Along with his own research into autistic children, Rimland became a spokesperson for parents of autistic children and helped found the Autism Society of America.
While the refrigerator parent theory of autism was largely abandoned during the 1970s, there are still a few die-hard supporters across Europe and South Korea. Not surprisingly, parents of autistic children still react angrily to any suggestion that flawed parenting causes autism. In a recent statement, Irish Minister of Health James Reilly publicly attacked psychologist Tony Humphreys over a column in the Irish Examiner suggesting that children developed autism to "defend themselves against the absence of expressed love and affection and emotional receptivity." Dr. Reilly, the father of an autistic child, blasted Dr. Humphreys saying that his remarks were "utterly outrageous. The hurt that he caused people is absolutely astonishing." In France, as Sophie Roberts' film graphically demonstrates, psychoanalytic theories relating to the cause and treatment of autism continue to cause untold harm to autistic children and their parents.
And the professionals are fighting back. A recent decision by a French court has banned Roberts' film and ordered her to remove it from YouTube and other online sources with heavy penalties if she and her film company fail to comply. She is also required to pay the plaintiffs at least 40,000 euro for damages and legal fees. While the decision will likely be appealed, the saga of the refrigerator parent is not over yet.