"The historical matrix of events, knowledge, and professional identities that emerged out of the end of the nineteenth century set the stage for the creation and expansion of twentieth-century psychiatry, and ultimately provided the conditions of possibility for autism to emerge as a diagnostic category" (Nadesan 53). Could help also explain how autism of late 20th century part of historical matrix...
part of that "matrix": "formalization of compulsory education and the creation of the child guidance movement" (Nadesan 53)
Section of dissertation: identifying autism from 1960's and especially 1990's... Part of the conditions that enabled the definition of autism in early 20th century: "identification of childhood as a discrete phase of life," "emergence of pediatric medicine, child psychology and psychiatry," and "creation of new ways of thinking about childhood 'deviance'" (Nadesan 54).
Locke's view of the tabla rasa changes how children viewed in regard to infant's psyche... (Nadesan 54). "Between the seventeenth and eighteenth centuries, the belief that children were innocent and spiritually pure replaced the idea of children as bearers of original sin" (Nadesan 56).
"Rousseau's Emile (1762) articulated a stage-based developmental model of childhood, which borrowed from the empiricists an emphasis on (sensory) experience in the acquisition of knowledge" (Nadesan 56).
Until around age 12, children are believed to be "primarily pre-social in orientation and that knowledge is best acquired through their empirical involvement in the natural world" (Nadesan 57). Interesting that Beddleheim moves this age up to conception...
"Accordingly, the proper goal of childrearing in the socialization mode was to produce a mannered, rational adult through careful surveillance and deliberate intervention" (Nadesan 58).
"the expansion of state authority to include governance over (publicly funded) childhood education and the expansion of professional interest in childhood were expressions of new forms of social control that began in the seventeenth century but found full expression in the late nineteenth and early twentieth centuries. These new forms of control involved new methods of observing and governing populations that gradually transformed monarchical systems of governance into professional and bureaucratic ones" (Nadesan 60). As I was reading this section and thinking about why the increased awareness in autism flourish in the 1960's following Beddleheim's work and again in the 1990's following Aspergers publication, I'm also thinking how much LBJ's "War on Poverty" with the development of Head Start and Medicaide programs influenced the diagnosis of autism...
I'm reminded of this again when Nadesan notes (about the early 20th century)--taken from an 1897 text: "It is now conceded on all sides that, if we would make social progress and strengthen the foundations of good government, into the minds of this unfortunate class must be instilled principles of morality, thrift, industry, and self-reliance" (from Preston and Haines, Nadesan 61).
"Vast numbers of mobile, poor, and uneducated people who worked infrequently, according to the whims of industry or the whims of personal inclination, threatened state stability" (Nadesan 62).
Government programs, like those initiated in the early 20th century in America and Europe were "'philanthropic' in that they served a purpose in the longterm rehabilitation of the family and, simultaneously, facilitated state, economic, and social security" (Nadesan 62).
Throughout the 19th century, "government and professional efforts to monitor, divide, and sequester children expanded" (Nadesan 62).
the medical model that has prevailed encourages a "disease based metaphor' that enhanced 'anxiety' and the 'threat of contagion" (Nadesan 64).
"The social anxiety and threat that the feebleminded (and mad) posed stemmed from beliefs about their morally unfettered reproduction, the lack of economic self-sufficiency, and their purported susceptibility to criminal exploitation due to lack of moral judgment" (Nadesan 64, also discussed in Trent 16).
"the new emphasis [in the late 19th and early 20th centuries] on 'normal' childhood development did not preclude investigation into 'deviant' behavioral or cognitive development. In fact, quite the opposite was true. The emphasis on 'normality' functioned to delineate 'abnormality' as never before" (Nadesan 67).
"The new classes of child experts--pediatricians, child psychologists, and child psychiatrists--played an active role in the creation and dissemination of professional knowledge about normal and abnormal stages and processes of child development" (Nadesan 69).
"The role of the mother, in particular, was highlighted within the models of child development influenced by the psychodynamic framework that finally came into vogue in North American psychiatry in the early 1930's" (Nadesan 69).
"The popularization of these clinics and the creation of special schools simultaneously heightened public awareness of mental health issues in childhood and reduced the stigma associated with them. The sheer number of child experts coupled with changing understanding about and valuation of mental health resulted in an explosion of psychiatric diagnoses" (Nadesan 71).
Kanner identified autism as a "unique communication and affect based disorder" (Nadesan 71).
Asperger believed that patients did not have a developmental disorder; instead, Asperger believed that they had an "inherent affliction of personality" (Nadesan 75).
"Asperger was particularly intrigued by the unique manner of perception specific to his more intelligent patients. Although he may have stressed his patients' special skills to save them from eugenics policies, his accounts stress sincere interest in the form and expression of their 'autistic strengths'" (Nadesan 75).
"Asperger observed that the identification of autism as a distinct disorder was fundamentally linked with the study of affective and communication-based disorders" (Nadesan 77).
Tuesday, July 10, 2007
Drafting on the Prospectus...
...I have a very rough start to the prospectus but I've got the sections identified and I'm going to work on one each day for the next couple days. Should have a more completed draft of it come this time next week. Then, it's off to Dr. T for suggestions, recommendations, and the like.
In the meantime, keep reading. Keep blogging.
In the meantime, keep reading. Keep blogging.
Sunday, July 8, 2007
Constructing Autism--Chapter 3
"Chapter 3: Psychiatric Niche Conditions"
"Efforts to identify, categorize, and systematize differences were particular [sic] significant within the European enlightenment movement, which sough during the seventeenth and eighteenth centuries to forge clear distinctions between reason and unreason" (Nadesan 30).
"mental 'illness' was qualitatively distinguished from mental 'retardation' in the mid-nineteenth century" (Nadesan 30).
"Nineteenth-century innovations in psychiatric thought were indebted to new social and economic conditions that led to increased social surveillance and control over populations. The nineteenth century engendered new strategies for monitoring, dividing, and acting upon populations in order to foster and ensure social stability in a time of rapid urbanization and industrialization" (Nadesan 31).
"private life became subject to governmental and professional scrutiny, particularly in the extension of surveillance over populations regarded as 'deviant' and in the extension of surveillance over a person's earliest childhood years" (Nadesan 31).
"many people who are today judged as having a developmental disorder would not have been judged so before the nineteenth century and few distinctions were made between the mad and the 'feebleminded'" (Nadesan 32)
"It was not until well into the nineteenth century that 'consciousness' became a criterion used to distinguish among forms of mental illness, particularly between temporary, illness-induced delirium and pervasive insanity and that the study of psychosis was distinguished from the study of neurosis," [...] "insanity was distinguished from epilepsy, and that mental retardation was distinguished from insanity" (Nadesan 33).
Nadesan discusses the historical events that led up to the systematic efforts to identify and describe forms of psychopathology. "Enabling advances such as these were a number of historical circumstances, including the enlightenment ethos of scientific thinking and the transformation of institutions designed to house the 'insane'" (Nadesan 33). For my earlier note about the 1960's to the present, there seems to be a lack of ethos surrounding technology, medical advancements, and the government (mercury poisoning, environmental toxins, government corruption).
"madness came to be seen as the primary threat to social welfare" (Nadesan 34)--today, developmental/cognitive deficiencies/delays seem to be the threat to fear. Cultural fear of being incapacitated. Terri Schiavo as an example of this fear...
"'Governmental' power focuses both on the administration of populations and their behavioral normalization. This extension of the finality of state control to include influence over everyday affairs constitutes an important shift that [Foucault in "Governmentality" in The Foucault Effect] termed the shift from 'sovereignty' (over a territory) to 'government,' which is concerned with the disposition of things such as people, customs, habits, etc" (Nadesan 35).
"The psychiatric taxonomies [...] coupled with the transformed madhouse--the asylum--together illustrate how new forms of knowledge were concomitant with the reorganization of social space so as to divide, sequester, and administer populations" (Nadesan 35). I'm reminded here of Simi Linton's discussion on special education and the division of "normal" (nondisabled) and "special" (disabled) children in school.
"Social welfare, and the welfare of the species, demanded intensification of efforts to identify and sequester the mad and feebleminded. Thus, fearing the reproductive capacities of such 'degenerates,' the asylum took on more social import due to its ability to sequester and 'organically' mad, even while its therapeutic aspects were regarded as suspect" (Nadesan 36). I'm reminded here of my research into 19th century abortion legislation--enacted to keep the upper classes from aborting their fetuses and limiting the potential linage of moral, upstanding citizens.
"one key nineteenth-century innovation in psychopathology involved distinguishing those forms of mental illness that involved delirium and hallucinations from those that did not" (Nadesan 37).
"As interest in these disorders grew, psychiatry devised ever more strategies for distinguishing disorders characterized by 'psychosis' from more subtle abnormalities of affect, social relations, and subjective experience" (Nadesan 37).
"Bleur believed that the (schizophrenic) autistic break with reality, coupled with the other disassociations of affect and thought, ultimately leads to dissolution of personality. Personality was, in Bleur's time, understood in relation to self-awareness and subjective experience (Berrios 1996) so schizophrenia constituted a fundamental threat to the self" (Nadesan 40).
"Ernst Kretschmer, for example, distinguished between autism in which patients suppress external stimuli in order to pursue a dream existence and autism characterized by lack of emotion and affective responses to the environment" (Nadesan 40).
"autism" as a term was used often during early 20th century (Nadesan 40).
Importance of Freud to enable autism to be "psychologized" (Nadesan 42). Importance for "refrigerator mother" of 1960's: Freud's work had the "implication of bringing into focus the inner psychic life of childhood, a state whose complexities and crises demanded careful parental care guided by professional expertise" (Nadesan 42).
Mental Hygiene movement: "psychoanalytic principles and biological psychiatry in an emphasis on treatment and prevention" led to the formation of psychiatric wards (Nadesan 44).
Children missing from a history of madness and psychiatry until 19th century (Nadesan 45). 1. Children believed to no have mental illnesses. (However, "expansion of public and private schooling in the nineteenth century that children came under any systematic observation and control" (Nadesan 46). 2. Children who seemed "abnormal" or "exposed" were abandoned. (Nadesan 46)
"Efforts to identify, categorize, and systematize differences were particular [sic] significant within the European enlightenment movement, which sough during the seventeenth and eighteenth centuries to forge clear distinctions between reason and unreason" (Nadesan 30).
"mental 'illness' was qualitatively distinguished from mental 'retardation' in the mid-nineteenth century" (Nadesan 30).
"Nineteenth-century innovations in psychiatric thought were indebted to new social and economic conditions that led to increased social surveillance and control over populations. The nineteenth century engendered new strategies for monitoring, dividing, and acting upon populations in order to foster and ensure social stability in a time of rapid urbanization and industrialization" (Nadesan 31).
"private life became subject to governmental and professional scrutiny, particularly in the extension of surveillance over populations regarded as 'deviant' and in the extension of surveillance over a person's earliest childhood years" (Nadesan 31).
"many people who are today judged as having a developmental disorder would not have been judged so before the nineteenth century and few distinctions were made between the mad and the 'feebleminded'" (Nadesan 32)
"It was not until well into the nineteenth century that 'consciousness' became a criterion used to distinguish among forms of mental illness, particularly between temporary, illness-induced delirium and pervasive insanity and that the study of psychosis was distinguished from the study of neurosis," [...] "insanity was distinguished from epilepsy, and that mental retardation was distinguished from insanity" (Nadesan 33).
Nadesan discusses the historical events that led up to the systematic efforts to identify and describe forms of psychopathology. "Enabling advances such as these were a number of historical circumstances, including the enlightenment ethos of scientific thinking and the transformation of institutions designed to house the 'insane'" (Nadesan 33). For my earlier note about the 1960's to the present, there seems to be a lack of ethos surrounding technology, medical advancements, and the government (mercury poisoning, environmental toxins, government corruption).
"madness came to be seen as the primary threat to social welfare" (Nadesan 34)--today, developmental/cognitive deficiencies/delays seem to be the threat to fear. Cultural fear of being incapacitated. Terri Schiavo as an example of this fear...
"'Governmental' power focuses both on the administration of populations and their behavioral normalization. This extension of the finality of state control to include influence over everyday affairs constitutes an important shift that [Foucault in "Governmentality" in The Foucault Effect] termed the shift from 'sovereignty' (over a territory) to 'government,' which is concerned with the disposition of things such as people, customs, habits, etc" (Nadesan 35).
"The psychiatric taxonomies [...] coupled with the transformed madhouse--the asylum--together illustrate how new forms of knowledge were concomitant with the reorganization of social space so as to divide, sequester, and administer populations" (Nadesan 35). I'm reminded here of Simi Linton's discussion on special education and the division of "normal" (nondisabled) and "special" (disabled) children in school.
"Social welfare, and the welfare of the species, demanded intensification of efforts to identify and sequester the mad and feebleminded. Thus, fearing the reproductive capacities of such 'degenerates,' the asylum took on more social import due to its ability to sequester and 'organically' mad, even while its therapeutic aspects were regarded as suspect" (Nadesan 36). I'm reminded here of my research into 19th century abortion legislation--enacted to keep the upper classes from aborting their fetuses and limiting the potential linage of moral, upstanding citizens.
"one key nineteenth-century innovation in psychopathology involved distinguishing those forms of mental illness that involved delirium and hallucinations from those that did not" (Nadesan 37).
"As interest in these disorders grew, psychiatry devised ever more strategies for distinguishing disorders characterized by 'psychosis' from more subtle abnormalities of affect, social relations, and subjective experience" (Nadesan 37).
"Bleur believed that the (schizophrenic) autistic break with reality, coupled with the other disassociations of affect and thought, ultimately leads to dissolution of personality. Personality was, in Bleur's time, understood in relation to self-awareness and subjective experience (Berrios 1996) so schizophrenia constituted a fundamental threat to the self" (Nadesan 40).
"Ernst Kretschmer, for example, distinguished between autism in which patients suppress external stimuli in order to pursue a dream existence and autism characterized by lack of emotion and affective responses to the environment" (Nadesan 40).
"autism" as a term was used often during early 20th century (Nadesan 40).
Importance of Freud to enable autism to be "psychologized" (Nadesan 42). Importance for "refrigerator mother" of 1960's: Freud's work had the "implication of bringing into focus the inner psychic life of childhood, a state whose complexities and crises demanded careful parental care guided by professional expertise" (Nadesan 42).
Mental Hygiene movement: "psychoanalytic principles and biological psychiatry in an emphasis on treatment and prevention" led to the formation of psychiatric wards (Nadesan 44).
Children missing from a history of madness and psychiatry until 19th century (Nadesan 45). 1. Children believed to no have mental illnesses. (However, "expansion of public and private schooling in the nineteenth century that children came under any systematic observation and control" (Nadesan 46). 2. Children who seemed "abnormal" or "exposed" were abandoned. (Nadesan 46)
Saturday, July 7, 2007
Constructing Autism--Chapter 2
Chapter 2: "Constructing Autism: A Dialectic of Biology and Culture, Nature and Mind"
Nadesan's purpose in this chapter is to explore "how socially constructed standards of normalcy embedded in cultural values and practices not only shape our interpretations of autism but also contribute to the production and transformation of people labeled with the disorder" (9).
"biological diseases, particularly autism, are the clinical practices developed to 'cure' them are fundamentally cultural in origin and remediation" (Nadesan 9).
Over the next 3 pages, Nadesan describes how Leo Kanner and Hans Asperger developed their theory of autism and Asperger's syndrome. A good place for historical material for backgrounding discussion in dissertation. (pages 10-13)
"In 1981 Asperger's work was introduced to a wider audience through Lorna Wing's essay 'Asperger's syndrome: a clinical account' published in the journal, Psychological Medicine" (Nadesan 13). A good definition (to supplement or explain DSM's) is also provided...
"a simple answer to what autism is, that is, what constitutes its essence, is unattainable" (Nadesan 14).
"overly educated mother" (Nadesan 18)
"the emergence of autism as a diagnostic category in the 1940s must be understood in relation to a matrix of professional and parental practices marking the cultural and economic transition to the twentieth century just as the popularization of high-functioning forms of autism must be understood in terms of the matrix of practices that mark late-twentieth century and early-twenty-first century life" (Nadesan 19).
conditions rooted in "cultural practices and economy of their times" (Nadesan 19).
"This raises questions about the relationship between the biological and the cultural, about the relationship between disease and social representation" (Nadesan 19). A statement particularly relevant for autism... Also, have to know what "normal" is to know what "abnormal is"
"In the search for its essence, the being of autism, researchers debated whether autism is a psychological disorder of the ego attachment (e.g., Bettelheim 1967), a biological disorder of the brain or metabolism (e.g., later Kanner), a personality disorder (e.g., Asperger), or some combination. [...] The implicit but dominant model seems to be that there is a visual-spatial-topological autistic center that will ultimately be discovered. This view of autism implicitly invokes a model of medicine in which disease is ontological, a thing in itself, which can be distinguished from the afflicting patient whose ontological status is unrelated to the disabling disorder" (Nadesan 20). Bakhin's chronotope
"disease is represented in our everyday understanding as available to 'empirical' identification, interpretation, and intervention. This everyday understanding of disease is partially rooted in nineteenth-century 'positivistic' thought holding that humankind can identify and understand the laws of nature unequivocally through detached empirical inquiry" (Nadesan 20). DAN protocol
"Positivistic conceptions of medicine presume a mind-body dichotomy in which diseases are primarily if not exclusively located in the biological body and presume that each disease is caused by a specific and ultimately, identifiable element" (Nadesan 20). Need an agent of harm...
"David Armstrong's (2002) A New History of Identity takes a moderated social construction approach in tracing changing perceptions of the origin and treatment of disease. Armstrong is less concerned with the biological reality of disease than in the representational practices used to identify, diagnose, and cure it" (Nadesan 21). [ILL'ed]
Armstrong argues that "prior to the nineteenth century, disease was understood to be found in the weather, the soil, and various aspects of the physical environment" (in Armstrong 58, from Nadesan 21). "However, medicine in the late eighteenth and early nineteenth centuries began to localize disease in the form of a 'pathological lesion, a specific abnormality of structure (or later, function) situated somewhere in the corporal space'" (in Armstrong 58, from Nadesan 21). I noted in my margins after reading that this might also apply to current discussions on autism.
new regime that "demarcated the diseased body from its environment" (Nadesan 21).
"Armstong's account of changing conceptions about the nature and origin of disease [...] highlights how social beliefs, values, and institutions influence medical practice" (Nadesan 21).
"Is culture merely the clothing within which the diseased body appears? Or, does culture--through its practices of hygiene and diet and through its medical vocabularies and institutions--produce disease in its entirety?" (Nadesan 21).
Nadesan and Grinker (amongst others) have focused on the construction and identification of autism in the 18th and 19th centuries. Trent focuses on the construction of mental retardation in the mid to late 19th century in America. However, in my dissertation, I think a large scholarly "hole" that is missing is the "epidemic" of autism that seems to have occurred following Beddleheim's book until the present. An examination of the events that have led to this so-called "epidemic" that can be traced from the 1960's to the present. A quote that would support this statement:
A study of autism during the twentieth century notes that autism was "[d]erived in relation to schizophrenia," as such "autism was first thought to be organic in nature. However, psychoanalytic thought was becoming increasing popular in North America and Europe at the time that Kanner first identified and labeled autism. Thus, the ascendancy of psychoanalytic thought, soon after the formalized identification of autism as a distinct disorder, led to speculation that psychic distress brought on by 'frigid mothering' caused autistic symptoms. [...] Today, however, the pendulum has again swung in the direction of organic causes, although contemporary causal agents may be considered exogamous (e.g., mercury poisoning) as well as endogamous (e.g., genetics)" (Nadesan 22).
"to emphasize the biological component of autism can lead to a devaluation of psychologically based therapeutic interventions such as behavioral modification therapy [...] or 'play therapy' rooted in psychoanalysis. The social construction of 'ideas' about the origin and remediation of the 'autistic' patient is imbued with material consequences" (Nadesan 23).
The Social Construction of What? I. Hacking describes "interactive kinds" and "indifferent kinds"--"interactive kinds" are "affected by the process of classification to such a degree that classification may require eventual modification or replacement" (Nadesan 24). "Interactive kinds are classifactory systems that emerge within complex matrices of institutions and practices" (Nadesan 24). "effect of producing what was classified" (24)
"biolooping" (24)
"Psychotropic drugs increase the ability of those classified as schizophrenic to reflect actively upon their diagnoses, leading to potential transformations in their disorder through their interpretive engagement with it" (Nadesan 25). Point to note: Performative aspect of biolooping
Autism "is a particularly compelling example of the intersection of biology and culture because although it is arguably an interactive kind, it also evidences the characteristics of an indifferent kind in that its symptoms are in some way rooted in genetics or molecular chemistry" (Nadesan 25).
The remainder of Nadesan's book argues that autism is a "disorder that emerged and was created in relation to cultural practices and discourses specific to particular points in time, the transition from the nineteenth to the twentieth centuries and, more recently, the transition from the twentieth to the twenty-first centuries" (Nadesan 26).
Nadesan's purpose in this chapter is to explore "how socially constructed standards of normalcy embedded in cultural values and practices not only shape our interpretations of autism but also contribute to the production and transformation of people labeled with the disorder" (9).
"biological diseases, particularly autism, are the clinical practices developed to 'cure' them are fundamentally cultural in origin and remediation" (Nadesan 9).
Over the next 3 pages, Nadesan describes how Leo Kanner and Hans Asperger developed their theory of autism and Asperger's syndrome. A good place for historical material for backgrounding discussion in dissertation. (pages 10-13)
"In 1981 Asperger's work was introduced to a wider audience through Lorna Wing's essay 'Asperger's syndrome: a clinical account' published in the journal, Psychological Medicine" (Nadesan 13). A good definition (to supplement or explain DSM's) is also provided...
"a simple answer to what autism is, that is, what constitutes its essence, is unattainable" (Nadesan 14).
"overly educated mother" (Nadesan 18)
"the emergence of autism as a diagnostic category in the 1940s must be understood in relation to a matrix of professional and parental practices marking the cultural and economic transition to the twentieth century just as the popularization of high-functioning forms of autism must be understood in terms of the matrix of practices that mark late-twentieth century and early-twenty-first century life" (Nadesan 19).
conditions rooted in "cultural practices and economy of their times" (Nadesan 19).
"This raises questions about the relationship between the biological and the cultural, about the relationship between disease and social representation" (Nadesan 19). A statement particularly relevant for autism... Also, have to know what "normal" is to know what "abnormal is"
"In the search for its essence, the being of autism, researchers debated whether autism is a psychological disorder of the ego attachment (e.g., Bettelheim 1967), a biological disorder of the brain or metabolism (e.g., later Kanner), a personality disorder (e.g., Asperger), or some combination. [...] The implicit but dominant model seems to be that there is a visual-spatial-topological autistic center that will ultimately be discovered. This view of autism implicitly invokes a model of medicine in which disease is ontological, a thing in itself, which can be distinguished from the afflicting patient whose ontological status is unrelated to the disabling disorder" (Nadesan 20). Bakhin's chronotope
"disease is represented in our everyday understanding as available to 'empirical' identification, interpretation, and intervention. This everyday understanding of disease is partially rooted in nineteenth-century 'positivistic' thought holding that humankind can identify and understand the laws of nature unequivocally through detached empirical inquiry" (Nadesan 20). DAN protocol
"Positivistic conceptions of medicine presume a mind-body dichotomy in which diseases are primarily if not exclusively located in the biological body and presume that each disease is caused by a specific and ultimately, identifiable element" (Nadesan 20). Need an agent of harm...
"David Armstrong's (2002) A New History of Identity takes a moderated social construction approach in tracing changing perceptions of the origin and treatment of disease. Armstrong is less concerned with the biological reality of disease than in the representational practices used to identify, diagnose, and cure it" (Nadesan 21). [ILL'ed]
Armstrong argues that "prior to the nineteenth century, disease was understood to be found in the weather, the soil, and various aspects of the physical environment" (in Armstrong 58, from Nadesan 21). "However, medicine in the late eighteenth and early nineteenth centuries began to localize disease in the form of a 'pathological lesion, a specific abnormality of structure (or later, function) situated somewhere in the corporal space'" (in Armstrong 58, from Nadesan 21). I noted in my margins after reading that this might also apply to current discussions on autism.
new regime that "demarcated the diseased body from its environment" (Nadesan 21).
"Armstong's account of changing conceptions about the nature and origin of disease [...] highlights how social beliefs, values, and institutions influence medical practice" (Nadesan 21).
"Is culture merely the clothing within which the diseased body appears? Or, does culture--through its practices of hygiene and diet and through its medical vocabularies and institutions--produce disease in its entirety?" (Nadesan 21).
Nadesan and Grinker (amongst others) have focused on the construction and identification of autism in the 18th and 19th centuries. Trent focuses on the construction of mental retardation in the mid to late 19th century in America. However, in my dissertation, I think a large scholarly "hole" that is missing is the "epidemic" of autism that seems to have occurred following Beddleheim's book until the present. An examination of the events that have led to this so-called "epidemic" that can be traced from the 1960's to the present. A quote that would support this statement:
A study of autism during the twentieth century notes that autism was "[d]erived in relation to schizophrenia," as such "autism was first thought to be organic in nature. However, psychoanalytic thought was becoming increasing popular in North America and Europe at the time that Kanner first identified and labeled autism. Thus, the ascendancy of psychoanalytic thought, soon after the formalized identification of autism as a distinct disorder, led to speculation that psychic distress brought on by 'frigid mothering' caused autistic symptoms. [...] Today, however, the pendulum has again swung in the direction of organic causes, although contemporary causal agents may be considered exogamous (e.g., mercury poisoning) as well as endogamous (e.g., genetics)" (Nadesan 22).
"to emphasize the biological component of autism can lead to a devaluation of psychologically based therapeutic interventions such as behavioral modification therapy [...] or 'play therapy' rooted in psychoanalysis. The social construction of 'ideas' about the origin and remediation of the 'autistic' patient is imbued with material consequences" (Nadesan 23).
The Social Construction of What? I. Hacking describes "interactive kinds" and "indifferent kinds"--"interactive kinds" are "affected by the process of classification to such a degree that classification may require eventual modification or replacement" (Nadesan 24). "Interactive kinds are classifactory systems that emerge within complex matrices of institutions and practices" (Nadesan 24). "effect of producing what was classified" (24)
"biolooping" (24)
"Psychotropic drugs increase the ability of those classified as schizophrenic to reflect actively upon their diagnoses, leading to potential transformations in their disorder through their interpretive engagement with it" (Nadesan 25). Point to note: Performative aspect of biolooping
Autism "is a particularly compelling example of the intersection of biology and culture because although it is arguably an interactive kind, it also evidences the characteristics of an indifferent kind in that its symptoms are in some way rooted in genetics or molecular chemistry" (Nadesan 25).
The remainder of Nadesan's book argues that autism is a "disorder that emerged and was created in relation to cultural practices and discourses specific to particular points in time, the transition from the nineteenth to the twentieth centuries and, more recently, the transition from the twentieth to the twenty-first centuries" (Nadesan 26).
Constructing Autism--Introduction
Nadesan, Majia Holmer. Constructing Autism: Unravelling the "Truth" and Understanding the Social. New York: Routledge, 2005.
Chapter 1: Introduction
"The medical and scientific literatures represent autism as a biological facticity that must be explained using the positivist methods and assumptions of the natural sciences" (Nadesan 2). I think this point is important because I'm thinking that part of my discussion in my dissertation will focus on representations or identifying autism as a biological condition and a psychopathic condition.
I know Dr. T has said often that she believes that depression and mental illnesses are biological in origin. And, while I'm not looking to refute that statement, the difference between autism as biological and psychological in origin is relevant for discussions of treatment and origin--namely, do parents choose to "treat" autism with medication, dietary changes, DAN protocols? Is the "autistic condition" one that occurs to an otherwise "normal" brain in response to biological factors (like mercury, for instance)? Or, do parents choose to view autism as a neurological development (or lack thereof) and choose to "treat" autism with ABA therapy, neurological acceptance, and the like? In other words, autistic children were born with brains that functioned differently, not because of any acute biological factor, but because their brains just developed differently. The distinction then between autism as biological, environmental, and developmental is crucial in contemporary rhetorics...
In Let Me Hear Your Voice: A Family's Triumph over Autism, "autism is a biologically based psychiatric condition to be therapied, remedied, assaulted in an effort to 'save' afflicted children locked inside an autistic cage" (Nadesan 2).
Nadesan: "it became increasingly clear to me that autism, or more specifically, the idea of autism is fundamentally socially constructed" (2).
"autism has a performative component" (Nadesan 2). I find this statement particular interesting, especially thinking about Aristotle's 5th canon of rhetoric: Delivery. How much of low/high-functioning distinctions is based on the performative component of autism? Especially considering criticisms against autism bloggers like this one (link from bookmark on other computer) who are criticized for blogging about autism and appearing on CNN and how their children, based on the televised report on autism, don't appear to be all that autistic, or the criticisms against Amanda Baggs, most notably by John Best Jr., because of her performances on autism that she's able to do. Especially interesting for this discussion: Baggs publicizes her autistic behaviors in vignettes (for lack of a better word) on Youtube. (link up here)
Something to consider: performative aspects of autism on Youtube by autistic individuals. Also, criticisms of ABA therapy because of emphasis on spoken delivery. Considered by notable Anti-ABA blogger, Autism Diva, (find her name) as abuse...
"Although there is a biological aspect to this condition named autism, the social factors involved in its identification, representation, interpretation, remediation, and performance are the most important factors in the determination of what it means to be autistic, for individuals, for families and for society" (Nadesan 2).
"'autism' as an epidemic has also captured the public imagination as a disorder that is regarded simultaneously as both threatening and fascinating. Therefore, exploration of the social conditions involved in the production, interpretation, and remediation of autism is important not only for people intimately involved with autism, but also for those interested in how social institutions such as medicine, psychology, and psychiatry, and even the popular media, constitute and shape our ideas about normality and difference in the context of economic and political environments" (Nadesan 3).
"Autism, I will argue, is a disorder of the early twentieth century while the high-functioning variants of autism such as Semantic Pragmatic Disorder (SPD), Pervasive Developmental Disorder (PDD), and Asperger's syndrome (AS) are fundamentally disorders of the late twentieth and early twenty-first centuries" (Nadesan 3).
Autism as a disorder could not have occurred prior to the twentieth century because "[i]t was not until standards of normality had been formalized and narrowed and standards of pediatric screening extended to a child's earliest years that children with PDD, SPD, AS (or Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD)) could be widely identified, labeled, and therapied" (Nadesan 3).
"The history of 'high-functioning' forms of autism must be further understood in the context of new standards for parenting that emerged mid-twentieth century and new economic and social conditions surrounding the purported 'information revolution' that began in the 1960's" (Nadesan 3).
"alternative explanations for interpreting the rise of autism diagnoses must be explored. In particular, environmental discourses play an important, although somewhat marginal role, in explaining and preventing disease at the end of the twentieth-century. These environmental discourses, particularly when coupled with biomedical frameworks, play a role in the political debates surrounding the causes of autism" (Nadesan 4).
"autism reflect[s] and shape[s] societal norms and expectations and opportunities for personhood" (Nadesan 5).
"the emergence, identification, and treatment of disease are always infused with cultural practices, values, and frameworks of interpretation" (Nadesan 5).
"autism can be understood historically as a 'niche' disorder whose interpretation, representation in research practices and in the popular imagination, and remediation reflect cultural preoccupations and concerns" (Nadesan 5).
"the matrix of institutions and practices that engendered the identification and exploration of autism [...] was dependent upon the emergence of a new, early-twentieth-century psychiatric model of the medical subject that centered childhood psychopathology, personality, and social relationships/interpersonal dynamics" (Nadesan 5).
Chapter 1: Introduction
"The medical and scientific literatures represent autism as a biological facticity that must be explained using the positivist methods and assumptions of the natural sciences" (Nadesan 2). I think this point is important because I'm thinking that part of my discussion in my dissertation will focus on representations or identifying autism as a biological condition and a psychopathic condition.
I know Dr. T has said often that she believes that depression and mental illnesses are biological in origin. And, while I'm not looking to refute that statement, the difference between autism as biological and psychological in origin is relevant for discussions of treatment and origin--namely, do parents choose to "treat" autism with medication, dietary changes, DAN protocols? Is the "autistic condition" one that occurs to an otherwise "normal" brain in response to biological factors (like mercury, for instance)? Or, do parents choose to view autism as a neurological development (or lack thereof) and choose to "treat" autism with ABA therapy, neurological acceptance, and the like? In other words, autistic children were born with brains that functioned differently, not because of any acute biological factor, but because their brains just developed differently. The distinction then between autism as biological, environmental, and developmental is crucial in contemporary rhetorics...
In Let Me Hear Your Voice: A Family's Triumph over Autism, "autism is a biologically based psychiatric condition to be therapied, remedied, assaulted in an effort to 'save' afflicted children locked inside an autistic cage" (Nadesan 2).
Nadesan: "it became increasingly clear to me that autism, or more specifically, the idea of autism is fundamentally socially constructed" (2).
"autism has a performative component" (Nadesan 2). I find this statement particular interesting, especially thinking about Aristotle's 5th canon of rhetoric: Delivery. How much of low/high-functioning distinctions is based on the performative component of autism? Especially considering criticisms against autism bloggers like this one (link from bookmark on other computer) who are criticized for blogging about autism and appearing on CNN and how their children, based on the televised report on autism, don't appear to be all that autistic, or the criticisms against Amanda Baggs, most notably by John Best Jr., because of her performances on autism that she's able to do. Especially interesting for this discussion: Baggs publicizes her autistic behaviors in vignettes (for lack of a better word) on Youtube. (link up here)
Something to consider: performative aspects of autism on Youtube by autistic individuals. Also, criticisms of ABA therapy because of emphasis on spoken delivery. Considered by notable Anti-ABA blogger, Autism Diva, (find her name) as abuse...
"Although there is a biological aspect to this condition named autism, the social factors involved in its identification, representation, interpretation, remediation, and performance are the most important factors in the determination of what it means to be autistic, for individuals, for families and for society" (Nadesan 2).
"'autism' as an epidemic has also captured the public imagination as a disorder that is regarded simultaneously as both threatening and fascinating. Therefore, exploration of the social conditions involved in the production, interpretation, and remediation of autism is important not only for people intimately involved with autism, but also for those interested in how social institutions such as medicine, psychology, and psychiatry, and even the popular media, constitute and shape our ideas about normality and difference in the context of economic and political environments" (Nadesan 3).
"Autism, I will argue, is a disorder of the early twentieth century while the high-functioning variants of autism such as Semantic Pragmatic Disorder (SPD), Pervasive Developmental Disorder (PDD), and Asperger's syndrome (AS) are fundamentally disorders of the late twentieth and early twenty-first centuries" (Nadesan 3).
Autism as a disorder could not have occurred prior to the twentieth century because "[i]t was not until standards of normality had been formalized and narrowed and standards of pediatric screening extended to a child's earliest years that children with PDD, SPD, AS (or Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD)) could be widely identified, labeled, and therapied" (Nadesan 3).
"The history of 'high-functioning' forms of autism must be further understood in the context of new standards for parenting that emerged mid-twentieth century and new economic and social conditions surrounding the purported 'information revolution' that began in the 1960's" (Nadesan 3).
"alternative explanations for interpreting the rise of autism diagnoses must be explored. In particular, environmental discourses play an important, although somewhat marginal role, in explaining and preventing disease at the end of the twentieth-century. These environmental discourses, particularly when coupled with biomedical frameworks, play a role in the political debates surrounding the causes of autism" (Nadesan 4).
"autism reflect[s] and shape[s] societal norms and expectations and opportunities for personhood" (Nadesan 5).
"the emergence, identification, and treatment of disease are always infused with cultural practices, values, and frameworks of interpretation" (Nadesan 5).
"autism can be understood historically as a 'niche' disorder whose interpretation, representation in research practices and in the popular imagination, and remediation reflect cultural preoccupations and concerns" (Nadesan 5).
"the matrix of institutions and practices that engendered the identification and exploration of autism [...] was dependent upon the emergence of a new, early-twentieth-century psychiatric model of the medical subject that centered childhood psychopathology, personality, and social relationships/interpersonal dynamics" (Nadesan 5).
Work to do... Schedules to keep...
Notice the date and time posted on this blog--Yes, it's Saturday night at 11:00 and I have no life. I also have no children or boyfriend tonight, which means I have lots of time to work in peace and quiet without the "I want some more chocolate milk" and "Swiper No Swiping" interruptions that usually occur once every 20 seconds. Good thing that I've got the concentration skills of a, well, someone who's very focused.
Now, objectives for next couple days:
After 10 p.m., it's been my newfound love obsession with The Office--OMG is that show hilarious. I'm now in love with Jim. Next, the British version of The Office and the entire series of Six Feet Under and The Riches. Man, do I love my summer schedule. (But, I'm looking at my rigid schedule and I'm wondering if I'm not a little autistic myself?)
Now, objectives for next couple days:
- post on Constructing Autism
- finish posts on Foucault
- post on Burke
- finish posts on Claiming Disability
- work on prospectus--1 page/day
- work on CFP for FRS
After 10 p.m., it's been my newfound love obsession with The Office--OMG is that show hilarious. I'm now in love with Jim. Next, the British version of The Office and the entire series of Six Feet Under and The Riches. Man, do I love my summer schedule. (But, I'm looking at my rigid schedule and I'm wondering if I'm not a little autistic myself?)
Wednesday, July 4, 2007
The Birth of the Clinic--Chapter 1
While I read The Birth of the Clinic and Madness and Civilization in May, I never properly "blogged" about them in the hustle-and-bustle of Upward Bound. So, here goes:
"Chapter 1: Spaces and Classes"
"Before it is removed from the density of the body, disease is given an organization, hierarchized into families, genera, and species" (BC 4).
"Disease is perceived fundamentally in a space of projection without depth, of coincidence without development. There is only one plane and one moment" (BC 6).
"The picture resemble things, but they also resemble one another. The distance that separates one disease from another can be measured only be the degree of their resemblance, w/out reference to the logico-temporal divergence of genealogy" (BC 6).
"For classificatory medicine, presence in an organ is never absolutely necessary to define a disease: this disease may travel from on point of localization to another, reach other bodily surfaces, while retaining identical in nature" (BC 10).
"Chapter 1: Spaces and Classes"
"Before it is removed from the density of the body, disease is given an organization, hierarchized into families, genera, and species" (BC 4).
"Disease is perceived fundamentally in a space of projection without depth, of coincidence without development. There is only one plane and one moment" (BC 6).
"The picture resemble things, but they also resemble one another. The distance that separates one disease from another can be measured only be the degree of their resemblance, w/out reference to the logico-temporal divergence of genealogy" (BC 6).
"For classificatory medicine, presence in an organ is never absolutely necessary to define a disease: this disease may travel from on point of localization to another, reach other bodily surfaces, while retaining identical in nature" (BC 10).
And, need to get from the library...
Hillyer, Barbara. 1993. Feminism and Disability. Norman: University of Oklahoma Press.--Rhetoric of dependency...
Gendering Disability--"Integrating Disability"
Rosemarie Garland-Thomas in “Integrating Disability” from Gendering Disability examines the ways in which disability theory can borrow from feminist theory. She looks, specifically, at the domains that each share: representation, the body, identity, and activism.
Relevant for my research, Garland-Thomas notes that in regard to prenatal testing for disabilities as a means of modern eugenics [an issue in autism-circles--prenatal screening for autism]:
"The disability system excludes the kinds of bodily forms, functions, impairments, changes, or ambiguities that call into question our cultural fantasy of the body as a neutral, compliant instrument of some transcendent will" (Garland-Thomson 77). I wonder how much of our (collective) fixation with finding the "cause" of and "cure" for autism is related to our fear of our own diminished mental capacities? How much do we fear losing our consciousness? Our abilities to think and rationalize for ourselves? The Terri Schiavo case reflected just how much our society finds abhorrent the mentally disabled mind... And, besides that, if autism can happen to him/her, can it happen to me, too? Or, to a child of mine?
"Normal has inflected beautiful in modernity. What is imagined as excess body fat, the effects of aging, marks of ethnicity such as supposedly Jewish noses, bodily particularities thought of as blemishes or deformities, and marks of history such as scarring and impairments are now expected to be surgically erased to produce an unmarked body. This visually unobtrusive body may then pass unnoticed within the milieu of anonymity that is the hallmark of social relations beyond the personal in modernity. The purpose of aesthetic surgery, as well as the costuming of power, is not to appear unique--or to 'be yourself,' as the ads endlessly promise--but rather not to be conspicuous, not to look different. This flight from the nonconforming body translates into individual efforts to look normal, neutral, unmarked, to not look disabled, queer, ugly, fat, ethnic, or raced" (Garland-Thomson 83). While Garland-Thomson is discussing, it seems, the physically disabled body, I think her observations apply equally to the mentally disabled mind (that's redundant, I know). While seemingly praised for their individuality of mind, autistics are still seen as mentally "abnormal"--a mind needing to be "cured" or fixed. We praise the unique abilities and/or characteristics of some autistics but still seek to normalize their thinking and mental processes.
A quote for my ultrasound images paper (that I would like to submit for publication at some point after developing it more with a section on disability): "The beautiful woman of the twenty-first century is sculpted surgically from top to bottom, generically neutral, all irregularities regularized, all particularities expunged. She is thus nondisabled, deracialized, and de-enthinicized" (Garland-Thomas 83).
Relevant for my research, Garland-Thomas notes that in regard to prenatal testing for disabilities as a means of modern eugenics [an issue in autism-circles--prenatal screening for autism]:
“[W]e cannot predict or, more precisely, control in advance such equivocal human states as happiness, suffering, or success. Neither is any amount of prenatal engineering going to produce the life that any of us desire and value. Indeed, both hubris and a lack of imagination characterize the prejudicial and reductive assumption that having a disability ruins lives. A vague notion of suffering and its potential deterrence drives much of the logic of elimination that rationalizes selective abortion (Kittay 2000). Life changes and quality are simply far too contingent to justify prenatal prediction.”
Also, relevant: "disability has four aspects: first, it is a system for interpreting and disciplining bodily variations; second, it is a relationship between bodies and their environments; third, it is a set of practices that produce both the able-bodied and the disabled; fourth, it is a way of describing the inherent instability of the embodied self" (Garland-Thomson 77).
"The disability system excludes the kinds of bodily forms, functions, impairments, changes, or ambiguities that call into question our cultural fantasy of the body as a neutral, compliant instrument of some transcendent will" (Garland-Thomson 77). I wonder how much of our (collective) fixation with finding the "cause" of and "cure" for autism is related to our fear of our own diminished mental capacities? How much do we fear losing our consciousness? Our abilities to think and rationalize for ourselves? The Terri Schiavo case reflected just how much our society finds abhorrent the mentally disabled mind... And, besides that, if autism can happen to him/her, can it happen to me, too? Or, to a child of mine?
"Normal has inflected beautiful in modernity. What is imagined as excess body fat, the effects of aging, marks of ethnicity such as supposedly Jewish noses, bodily particularities thought of as blemishes or deformities, and marks of history such as scarring and impairments are now expected to be surgically erased to produce an unmarked body. This visually unobtrusive body may then pass unnoticed within the milieu of anonymity that is the hallmark of social relations beyond the personal in modernity. The purpose of aesthetic surgery, as well as the costuming of power, is not to appear unique--or to 'be yourself,' as the ads endlessly promise--but rather not to be conspicuous, not to look different. This flight from the nonconforming body translates into individual efforts to look normal, neutral, unmarked, to not look disabled, queer, ugly, fat, ethnic, or raced" (Garland-Thomson 83). While Garland-Thomson is discussing, it seems, the physically disabled body, I think her observations apply equally to the mentally disabled mind (that's redundant, I know). While seemingly praised for their individuality of mind, autistics are still seen as mentally "abnormal"--a mind needing to be "cured" or fixed. We praise the unique abilities and/or characteristics of some autistics but still seek to normalize their thinking and mental processes.
A quote for my ultrasound images paper (that I would like to submit for publication at some point after developing it more with a section on disability): "The beautiful woman of the twenty-first century is sculpted surgically from top to bottom, generically neutral, all irregularities regularized, all particularities expunged. She is thus nondisabled, deracialized, and de-enthinicized" (Garland-Thomas 83).
Thoughts by the pool...
I was thinking about some of the negative sentiments that are offered in regard to autism and mental disabilities posted at Autismvox by some commenters and by John Best at HatingAutism (a disgraceful website if I've ever seen one--"hate speech" if there ever was a more fitting example) and I've been thinking today about the different meanings for "autism," "mental retardation/disability," and "pervasive developmental disorder." I don't read articles referring to the "epidemic" or militaristic metaphors of "armies of mentally disabled children" like I've seen in print before. There are no committees and trials investigating the links between mental retardation and mercury or toxins.
Why "autism"? What about "autism" as a term, a medical diagnosis, leads to the rhetoric of "cure," "intervention," and "harm"? Why do we accept someone as "mentally disabled" but argue that a "normal" person exists somewhere beneath the surface of the autistic person? Maybe because those with Fragile X, Down Syndrome, or FAS, for instance, show some physical representations of their mental retardation? After all, I haven't found any "HatingDownSyndrome" websites dedicated to eradicating those with extra chromosomes. No "Hatingthementallydisabled."
I wonder if the difference between the mentally disabled and the autistic individual is that many individuals with autism don't really "look" any different than anyone else? If an autistic adult was not gazing at the ground and was making eye contact, he or she might "look" like any other "normal" person... There are no definitive "visual" markers of an autistic individual to differentiate him/ her from the "normal" population. Perhaps, this is why it's hard to believe that there isn't a "normal" child inside the autistic one? After all, he/ she looks "normal."
Not to mention the fact that "autism" seems more acceptable than "mentally retarded." (Roy Grinker discusses this in his book Unstrange Minds.) Media representation of autistics as "geniuses," perhaps? After all, "Rain Man" could do cool "tricks"--an interesting oddity--but if someone is just "mentally disabled," what's "cool" or "interesting" about that? (God, how many times have I heard someone ask, "What talent does Tobey have?" "Is Tobey really good at math, too?" Pu-leaze. Try explaining why 2 + 2 = 4 for the 100th time.)
I suppose this discussion might fit in my chapter on the "gaze" and definition of autism...
Why "autism"? What about "autism" as a term, a medical diagnosis, leads to the rhetoric of "cure," "intervention," and "harm"? Why do we accept someone as "mentally disabled" but argue that a "normal" person exists somewhere beneath the surface of the autistic person? Maybe because those with Fragile X, Down Syndrome, or FAS, for instance, show some physical representations of their mental retardation? After all, I haven't found any "HatingDownSyndrome" websites dedicated to eradicating those with extra chromosomes. No "Hatingthementallydisabled."
I wonder if the difference between the mentally disabled and the autistic individual is that many individuals with autism don't really "look" any different than anyone else? If an autistic adult was not gazing at the ground and was making eye contact, he or she might "look" like any other "normal" person... There are no definitive "visual" markers of an autistic individual to differentiate him/ her from the "normal" population. Perhaps, this is why it's hard to believe that there isn't a "normal" child inside the autistic one? After all, he/ she looks "normal."
Not to mention the fact that "autism" seems more acceptable than "mentally retarded." (Roy Grinker discusses this in his book Unstrange Minds.) Media representation of autistics as "geniuses," perhaps? After all, "Rain Man" could do cool "tricks"--an interesting oddity--but if someone is just "mentally disabled," what's "cool" or "interesting" about that? (God, how many times have I heard someone ask, "What talent does Tobey have?" "Is Tobey really good at math, too?" Pu-leaze. Try explaining why 2 + 2 = 4 for the 100th time.)
I suppose this discussion might fit in my chapter on the "gaze" and definition of autism...
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