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The Creation of the Self and Language

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'This book, with its accompanying DVD, "NOW I AM A REAL KID" has made it possible for us to witness what David Rosenfeld's treatment of Benjamin, a young boy with a diagnosis of autism, was actually like. We can see for ourselves what was done, what was said; we can follow the steps by which Benjamin moved from being a child without language, in a state of perpetual panic-stricken screaming and flailing about, to being a "real kid" with friendships, doing well at an ordinary school. Witnessing this transformation is a profoundly moving experience. So is hearing the testimony of Benjamin's parents, who had been told repeatedly that there was no future for their son. It was their wish that his therapy should be more widely known about, in the hope that professionals could learn from it so that other families' lives might be transformed as theirs had been through "Dr David's" intervention. Everyone concerned with children with autism is in their debt.'- From the Introduction by Maria Rhode, Emeritus Professor of Child Psychotherapy at the Tavistock and Portman NHS Foundation TrustThe DVD is available in both PAL and NTSC formats. Please specify which format you require when placing your order. If no format is specified we will supply PAL format.Please note the Ebook version of this title does not include the DVD content.

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6 Chapters

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1. Introduction

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In this book, I develop models and hypotheses about the mech anisms of the origin of language and the self, along the following lines:

1. A return to Freud for a theoretical review of autistic mechanisms

2. The concept of self

3. The possible disappearance of introjections

4. The concept of body image

5. Autistic encapsulation to achieve preservation

6. Treatment technique

7. Four years of flming

In his “Project for a Scientifc Psychology”, Freud (1950 [1895]) describes how the frst contact of the child with the outside world—as in the case of a baby at his mother’s breast—is of a sens ory nature. As I show below, the frst hallucination is a repetition of this early sensory feeling: the mouth on the breast.

When we watch a baby moving his mouth, imagining he is suckling at the breast, this hallucina-tion—“the frst psychological mechanism”—is also a “communication”. The communication will only be useful if it is interpreted—in other words, if the message is received and understood by the mother.

 

2. Revisiting Freud from the standpoint of his writings on aphasia

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In his work on aphasia, Freud interprets mental space through language and representation levels (Freud, 1891, 1911; Grubrich-Simitis, 2003).

Although the loss of language in the autistic child is not exactly a neurological aphasia, it is possible to formulate a hypothesis according to which the therapist achieves the recuperation of words via sensory stimulus by naming each object as the subject touches it with his or her hand or tongue.

Ricardo Avenburg (1974, 1995) considers that aphasias reproduce a state that existed in the normal course of learning to speak: when the child learns to read and to write, he tries to appropriate for himself the visual image of the word, evoking all the other acoustic and kinaesthetic images associated to that image (Avenburg, personal communication, 2010).

I personally emphasize, with Tustin (1986, 1990), the sensory contact with the lips and the mouth’s mucosa, as can be seen in the video, Now I Am a Real Kid.

Our task as psychoanalysts is to recreate the mental apparatus and language. We know today that brain functions and the connections of neural den-drites can be amplifed and recreated, as is shown in the research of Dr Levy Montalcini (2009), winner of the 1986 Nobel Prize for Medicine. It is interesting to rethink aphasias as an interruption of associations; in the autistic child, there is also an interruption of language.

 

3. Some modern psychoanalytic theories on autism

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I develop here the theories of Frances Tustin (1986, 1990), as discussed by Sheila Spensley (1995).

Like Margaret Mahler, Tustin views autism as a sensation-dominated state of being, with an accompanying impoverishment of emotional contact. Mahler stressed the importance of bodily sensations as the “crystallization point of the ‘feeling of self’, around which a ‘sense of identity’ will become established” (Mahler, Pine, & Bergman, 1975, p. 47). A sensory– emotional conjunction is required for sensation states to make way for feeling states. Normally, this takes place within the context of the earliest relationship with the child’s caregiver. However, many children who later develop autism may avoid contact from the beginning, or their signals may be diffcult to read, so that devoted parents fnd themselves unable to get through to them.

Mahler saw the necessity of a symbiotic experience from which the psychological birth takes place, enabling the infant to enter into the mental world of the psyche. There may even be a critical time for this, but, without the emotional bond that makes possible a personal empathic and essentially human relationship with another mind, intellectual growth and development can be fundamentally and seriously impaired.

 

4. The child’s relationship with the Other and with language: some concepts of Merleau-Ponty and Henri Wallon

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In the language of Jean Piaget, it would be necessary for the child, at some point in his development, to learn to think in terms of reciprocity, to de-centre. I believe that for Piaget, to de-centre is to differentiate. Merleau-Ponty (1960) underlines that this process of de-centring is lived not only intellectually, but also emotionally. Perception of the outside world is profoundly modifed by the child’s personality and by his interpersonal relations. For the acquisition of language, there is also a close and profound connection between the development of language and interpersonal relations.

Language acquisition is a similar process to the child’s rela tionship with his mother, a process of iden-tifcation through which the subject projects onto the mother what he feels and incorporates his mother’s attitudes. Learning to speak is learning to enact a series of roles, to assume a series of behaviours or linguistic gestures (Ciccone, 2011; Resnik 1973).

Merleau-Ponty underscores that the intellectual elaboration of our experience of the world is achieved through the elaboration of our human relations. The use of some linguistic instruments by the subject depends on the position the child adopts at each moment in the feld of forces of the family and human environment that surrounds him. Hence, linguistic progress is explained by progress in the realm of affects.

 

5. Testimonies

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Benjamin, aged 3 years and 7 months, was brought to me by his mother for a consultation. She said he had been diagnosed at the Hospital Nacional Prof essor Alejandro Posadas, as well as at six other medical centres, as having a severe autism with no possibility of cure. “Absolutely no hope” was the conclusion from the previous seven medical consultations.

You will see his autistic behaviour in the frst minutes of the flm. He does not look at the eyes of the other people, he shouts and screams, he has tantrums, throws around all the toys off a small table, hits his head against the wall, and with no consciousness of danger climbs dangerously high places.

The mother told me that Benjamin had been well until he was about 2 years old, when he developed severe autistic mechanisms following a traumatic event in the family: the sexual abuse of his sister, who was 6, by a teacher at her kinder garten.

From this time on, Benjamin started to isolate himself, to disconnect, to be aloof, to shout, to yell, to not sleep, and to bring any object to his mouth; he also didn’t speak.

 

6. Transformation

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