In his seminal book of 1967, ‘The Empty Fortress’, Bruno Bettelheim relates the story of a boy named Joey, who was being treated at the Chicago Orthogenic school, which Bettelheim directed. It gives a good insight into the sort of treatment being offered by Bettelheim, in the 1950s and 60s, at his school, which was, and still is, a part of the University of Chicago.
The case history of Joey, tells the story of a young boys years at the school, how he was treated, by whom, and the sort of progress, often stilted, that he made. Contrary to criticism levelled at Bettelheim, no outlandish claims are made about this progress. If anything, what is described is frustratingly slow, and incomplete.
So I will attempt to describe this treatment, and what may be made of it today.
Joey is described as a severely autistic child, who had speech, but appeared to view himself as a machine. Although he was verbal, his speech was essentially non-sensical. Joey had constructed an engine out of cardboard boxes and various other things, which he would carry around with him. He had also made his bed into a machine. As Bettelheim describes it, Joey was actually unable to do anything himself, without being ‘powered’ by his machine/engine.
For example, he would come into the school’s dining room, plug a wire (string) into the wall, and generally wire himself up to his engine, and his cutlery, before he could eat. This became so impractical that they had to ban Joey from bringing his machine into the dining room, because all the wires represented a hazard to everyone else. Somehow Joey had to accept this, but was still able to bring in a token ‘tube’ (lightbulb?) with him. Everywhere else, Joey was accompanied by his engine.
Bettelheim interprets this as follows. He believed that Joey saw himself as a machine, insulated from the rest of the world. Because his parents had not provided him with the necessary comfort that parents should, Joey had constructed a machine, to take their place. Thus he was unable to function without it. Joey only existed in isolation. It was the task of the school, and its staff, to provide for Joey what his parents had failed to do. Human contact. And hopefully bring Joey out of his autism. That Joey was autistic is not disputed.
Joey would have frequent tantrums, or ‘explosions’, as he called them. This involved Joey throwing his tubes around, and being generally violent, both towards others, and sometimes himself. Apparently he put his arm through a window, on one occasion.
Throughout this time, Bettelheim gives various interpretations. These, for example, relate to Joey getting through the anal stage of his development, and some frankly far fetched interpretations of his drawings. For Bettelheim, every word had a hidden meaning. Joey’s reference to Connecticut, for example, was interpreted as having something to do with ‘connect-I-cut’, apparently conveying Joey’s separateness from the world. His drawings were largely concerning his faeces, although this is not obvious. Bettelheim seems to closely follow what he regarded as the Freudian theory of human development.
It seems unlikely that Joey’s use of the word Connecticut had such a hidden meaning. Besides Bettelheim’s interpretations, generally speaking, it seems that the children at the school were pretty much allowed to do whatever they wanted. It wasn’t so much that they were indulged, but rather they were ‘allowed’ to do anything, unless they or others were put in danger. There were certainly limits/boundaries, but the children’s behaviour was allowed free expression. If Joey wanted to shit in a wastepaper basket, then so be it. If Bettelheim interpreted this as him mastering the anal stage, then fine. Perhaps he was.
But at some point over his first two years there, he started calling people by their names, starting with his personal ‘counselor’, and gradually extending out to other staff members and other children. Previously Joey had only ever referred to people as ‘little people’ or ‘big people’. Never by name. Never as individuals. Joey was also able to dispense with his machines eventually. There was a lot of regressing, and a lot of fuss, but with patience from the staff, Joey was able to make a lot of progress.
Some people, even today are very much against Bettelheim’s ideas. But I have to say, that compared to some of todays treatments, his seem far more human. You could say that Joey would have made progress in life anyway, or that he was never really autistic in the first place. And perhaps you would be right. On the other hand, perhaps not.