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Autism and Representation
Case Western Reserve Univ
Cleveland, Ohio
28-30 October 2005



Katherine DeMaria Severson, Denise, Jodlowski, and James Arnt Aune
Texas A&M University

Do not cite without permission of author.

"Bruno Bettelheim, Autism, and the Rhetoric of Scientific Authority"

In 1967 Bruno Bettelheim published The Empty Fortress: Infantile Autism and the Birth of Self, forever affecting the world's view of autism.1 Hailed by the popular press, the book showed how three children with severe autism were effectively treated at the University of Chicago's Orthogenic School through Bettelheim's application of psychoanalytic theory and milieu therapy. Children who once exhibited bizarre anti-social behavior were, in some cases, completely cured. No one had ever been so successful with this enigmatic disorder. Although Bettelheim's book did have its critics, the voices of the few detractors were effectively drowned out by the overflow of praise from Bettelheim's advocates.2 As a result, Bettelheim's thesis, that the source of autism was the infant's relationship with her "refrigerator mother," soon became the accepted explanation of the cause of autism in popular and, in some, professional circles.3

For the next twenty-three years the writings of researchers, parents of children with autism, and adults with autism served to help discredit Bettelheim's claim of maternal causation. However, shortly after Bettelheim, a Holocaust survivor, committed suicide in 1990 at the age of 89, the world suddenly had reason to question more than his hypothesis. Letters began to pour in to newspapers from former students of the Orthogenic School. Bettelheim, the staunch advocate of safe and comforting environments for children with emotional disabilities, allegedly had physically and emotionally abused the children in his care.4 Some of the adults that Bettelheim had claimed to have "cured" of severe developmental disabilities, including autism, claimed that they had entered the school with nothing more than behavioral problems. Even more surprising was the discovery that Bruno Bettelheim had neither a degree in psychology nor therapeutic training. Instead, he wrote his dissertation on aesthetics and while in Vienna, he was a lumber merchant.

These and many other posthumous revelations about Bettelheim prompt serious questions for academics and lay people alike. How did Bettelheim acquire a directorship at a school for children with psychological disorders at a major American university, without a degree in psychology? Moreover, how did he escape the supervision of an administrative governing board during his entire twenty-nine year tenure as director of the School? How did he convince so many to give so much to fund the School and his research? Why did none of the several individuals in the psychoanalytic field who knew of Bettelheim's false credentials bring this fact to light? If anything is certain, it is that the truth, for Bettelheim, was relative.5

Despite the overwhelming evidence against both Bettelheim's character as well as his account of the etiology of autism, true believers still exist. Peter Hobson, a prominent English psychologist, affirms the "refrigerator mother" hypothesis in his 2002 book The Cradle of Thought.6 Alfred A. Knopf, arguably one of the most prestigious publishers in the U.S., published in 2002 a biography of Bettelheim by his longtime literary agent Theron Raines. The book takes Bettelheim's account of his career at face value.7 Jacques Bénesteau's 2002 book Mensonges freudiens: Histoire d'une désinformation séculaire (Freudian Lies: A History of a Century of Disinformation) documents the damage still caused in France by the popularity of Freud and Lacan. Some 70% of French psychiatrists continue to treat autism and Tourette's disorder, as well as depression, with psychoanalytic methods.8 Lacanian psychoanalysis remains a significant force in literary and cultural studies, despite the consistent failure of its scientific claims.9 Parents of autistic children, including the senior author of this paper, can attest to the widespread belief by social workers and other ostensibly educated professionals that autism results from a failure in maternal bonding.10

The purpose of this paper is to investigate a little-studied phenomenon in the rhetoric of science: the persistence of false beliefs in an ostensibly scientific community. We proceed by analyzing generally how Bettelheim's "ethos" was constructed during his lifetime, and then focus more narrowly on the specific rhetorical strategies used by Bettelheim in his response to Bernard Rimland at the end of The Empty Fortress.

Context, Ethos, Audience

The success of Bettelheim in American academic circles and The Empty Fortress as a text must be understood within the historical context within which both were situated. Bettelheim's success was a result of the state of American university in the 1940's and his fabricated credentials. The Empty Fortress benefits from Bettelheim's ethos as well as the American fascination with the Holocaust and psychoanalysis.

American academe in the 1940's still was greatly prejudiced in favor of European intellectuals. The influx of immigrants driven from Europe by World War II helped build the growing university system. Access to higher education was being granted to a larger portion of the public and the sudden interest in the education system itself facilitated the expansion. Bettelheim's first obstacle to attaining the academic acclaim he craved was getting his first foothold into the American university, which he achieved initially with his own credentials, and later through lies, exploitation of social connections, and his perceived European mystique.

Bettelheim received his first academic position teaching art history at Rockford College in Illinois and participating in the Eight-Year Study, which examined art education in American schools. These two positions would be spring boards for Bettelheim into the Orthogenic School. It was also at this point that Bettelheim first embellished his credentials, calling himself a psychologist and claiming to have treated a child with autism while he was living in Vienna. Consequently, when the University of Chicago was seeking a qualified individual to take over the failing Orthogenic School, one of Bettelheim's colleagues from the Eight-Year Study suggested his name.

The effectiveness of The Empty Fortress in 1967 was, in large part, due to the social context and intellectual fads of the era in which it was published. Indeed, many of the preliminary questions of how Bettelheim became an influential voice in the public sphere and how he managed to succeed in eluding devastating censure from the psychoanalytic community is a direct result of the historical situation. As Pollock has noted, Bettelheim arrived on the academic scene at a time when " 'the cause' so transfixed the populace that in 1941 a singing analysand and her dreams starred on Broadway in Lady in the Dark."12 Freud had become so popular that his theory had reached into American mainstream culture.13 However, the fact that the American audience was captivated by psychoanalysis and the Holocaust is not enough to explain Bettelheim's ascendancy to the fore of child psychology.

Bettelheim was proactive in creating his own myth. It was Bettelheim's first academic essay, "Individual and Mass Behavior in Extreme Situations," published in 1943 that really gave him his authority in psychology and his mystique in the public arena.14 "Extreme Situations" was the first widely read essay in the United States on the Nazi concentration camps.15 In this essay, Bettelheim gave a psychoanalytic account of the mental deterioration of the camp prisoners at the hands of the SS guards. This essay made Bettelheim an "expert" on the camps and made his name in psychoanalysis. It was also in writing "Extreme Situations" that Bettelheim first used "science" to lend credence to his assertions.16 Although he continued to write for academic journals for the next decade, these pieces were primarily co-authored with the Orthogenic School's original psychologist, Emmy Sylvester. His solo academic career was far less notable.

Upon finding that legitimate scholarly journals would not accept his "science" merely on his word, Bettelheim turned his attention almost entirely to writing for a mass audience.17 He wrote a column for Ladies Home Journal from 1965-75. His mass audience grew from the early sixties onward, devouring his articles in: Redbook, Parents, Harper's, the Saturday Evening Post, Scientific American, and Playboy.18 Bettelheim had something to say about everything from "Why Working Mothers Feel Guilty" to "Speaking Out: Stop Pampering Gifted Children."19 Bettelheim recycled a great deal of his material. For example, an abbreviated version of the story of "Joey the Mechanical Boy," one of the case studies in The Empty Fortress was originally published in Scientific American.20 These and other essays made Bettelheim a household authority in psychology in the 60's. Although he criticized others for using their patients to make them famous, it was his hallmark.21 Bettelheim's celebrity was augmented by the publishing of several books about parenting and the children at the Orthogenic School prior to the publication of The Empty Fortress.

One of the main reasons Bettelheim was such a popular public author was his insistence on the accessibility of scholarly prose.22 He employed Encyclopedia Britannica editor Ruth Marquis to make his text more readable. As an encyclopedia editor, writing for a mainstream audience was her forte. In addition to the vividness and clarity of writing in his books and articles, Bettelheim used pictures, films and the students' illustrations in many of his public presentations. He hired professional photographers and filmmakers to capture the students in action, which he would then conveniently interpret for his audience to show the students' progress. These films, illustrations and pictures were a mainstay of his fundraising campaigns. Their success is evident in the fact that Bettelheim was a leader in donation solicitation for the University of Chicago.

By 1963, Bettelheim's colleagues felt that he was so "well known and respected by the lay public that any challengers risked being accused of sour grapes."23 It was the same fear that kept Bettelheim's ex-wife, Gina Weinmann from telling anyone that it was she who had treated the young "autistic" girl, Patsy, not Bettelheim. He had probably been given quite a bit of leeway by the psychoanalytic community initially for his shabby scholarship on the basis of the subject-matter of "Extreme Situations," since the majority of the early psychoanalytic community in America consisted of exiled Viennese and German Jews. Additionally, Bettelheim's public success helped to disseminate psychoanalysis to a wide audience. However, by the height of Bettelheim's popularity, when his lack of theoretical framing and questionable methodology could do the most harm, it was too late for the community to begin to criticize him. Instead, the psychoanalytic community never allowed Bettelheim into the fold, excluding him almost entirely from all associations, a fact that would trouble him to his dying day.

Bettelheim's ethos, then, stems from a conjunction of factors: post-WWII fascination both with Freud and the Holocaust, his careful management of his public image, his careful attention to writing for a general, educated audience, and a generalized anxiety about the family in 1950's and 1960's America. A larger question beyond the scope of this study is: why did so many mothers and medical and educational professionals in post-WWII America become so obsessed with the image of the "bad mother"? It may be that some aspects of classical Freudian theory remain useful, not for individual psychology, but for collective psychology. Lynn Hunt, for example, makes a persuasive argument about the dominant role of maternal and paternal imagery in the discourse of the French Revolution. There may be a similar "family romance" worth investigating as part of the context of Bettelheim's work.24

Bettelheim's Critique of Kanner and Rimland

We now turn to an examination of Bettelheim's strategies in dealing with his primary scientific opponent, Bernard Rimland, in the final part of The Empty Fortress. Bettelheim states that the purpose of this section is not to review everything that has been written about autism since it "would fill a tome many times larger than this one" (385).25 Rather, Bettelheim states that his purpose in this book was to set forth the experience of a group of people who have worked intensively for many years with autistic children, to tell what we learned from it about the nature of the disturbance, about treating such children, and about early personality development" (385). Because he addresses so little of the available literature on autism, Bettelheim's discussion becomes argumentatively self-serving, best illustrated in the presentation of his two primary opponents, Kanner and Rimland.
According to Bettelheim, Kanner's original error was in viewing autism as a biological disorder. In so doing, Kanner ignored one of Freud's greatest lessons. By not questioning the underlying motivations driving an individual's behavior, to believe that an individual acts without thinking at least on some level, we easily fall into the trap of attributing cause to an inherent personal defect. Bettelheim argues that Kanner had access to the necessary information to make a more thoughtful conclusion than assuming that autism was an innate disorder.

In his inaugural paper on the subject, Kanner had stated that children with autism do not relate to others. However, in a later paper Kanner notes that "emotional refrigeration has been the common lot of autistic children" (389).26 Kanner speculates further that it would be difficult to conclude that the child's emotional environment did not have some affect on his behavior even if the reported "emotional refrigeration" was not the original cause but the parents' reaction to having a child with autism. Bettelheim argues that it is contradictory to state that children with autism do not relate to others and yet affirm that the child's emotional environment could be a factor in the child's condition.

In fact, Bettelheim says that he is thankful that his first encounter with autism came before Kanner had identified the disorder since his work was not corrupted with the belief that this child could not form affective contact.27 Upon discovery of Kanner's paper in the 1940's, Bettelheim was surprised to find that he had indeed been treating a child with autism but "by that time [he] could not accept his conviction that for her and others like her it was 'an innate inability to form affective contact'" (392).28

Bettelheim finds Kanner's hypothesis that autism is a disorder existing from birth equally troublesome. Although some parents have reported that their children had shown signs of autism as early as a few months old, Bettelheim says that, upon scrutiny, none of these reports hold up. In fact, most reports have found that autistic symptoms become apparent around the age of two, a finding with which Bettelheim states is consistent with both his theory and experience: "since I also believe that autism is basically a disturbance of the ability to reach out to the world, it will tend to become most apparent during the second year of life when more complicated contact with the world would normally take place" (393).29

Even though autistic symptoms may not be detectable until the age of two, Bettelheim argues that this does not mean that the original damage had not occurred much earlier. For example, studies have found that in the later months of pregnancy if the mother's stress level is raised so is the level of fetal activity. Additionally, children who have been raised in environments lacking in stimulus, like many institutions, have often been found to have serious mental and emotional scars. So although Bettelheim does not believe that autism exists at the moment of birth, the event which caused the autistic withdrawal in the child could very well have occurred immediately thereafter.

Like Kanner, Rimland's neurological theory of autism also presupposes that autism is an innate disorder. Rimland holds that autism is caused by a dysfunction in the reticular formation of the brain stem; the portion of the brain responsible for arousal. In response, Bettelheim argues that even if a neurological source of autism is definitively discovered, it does not preclude the psychological explanation. It quite possibly could follow that there exist certain periods during which certain neurological systems must by stimulated to maintain normal development. If, as Bettelheim has argued, the emotional environment of the child is poor, it may explain why the central nervous system becomes dysfunctional.

Moreover, Rimland's argument that autism is caused by a dysfunction of the area of the brain responsible for arousal is contradictory to the behaviors exhibited by these children. If Rimland is correct, Bettelheim posits, then it makes no sense that many children with autism will plug their ears, close their eyes, and even scream in the attempt to shut out stimuli? Instead, Bettelheim believes that "[t]hrough their shutting out of sensation they [avoid being] confronted by a frustrating reality" (402).
Bettelheim does agree with Rimland that nothing is to be gained by blaming parents. Instilling a sense of guilt in the parents of these children is useless since whatever they may have done to cause their child's disorder, Bettelheim says we can be certain that "they did [it] because they could not help themselves to do otherwise" and "[t]hey suffer more than enough in having such a child" (404). Keeping this in mind, we still should not cease searching in the parent/child relationship for anything that may be helpful to our understanding.

According to Bettelheim, "what counts from a human point of view is which theory of causation offers the better chance of relieving the distress of children who suffer from [autism] today" (413). To this end, Bettelheim compares the results of Eisenberg's long-term study of patients with autism with his own.30 Eisenberg divided the patients into three categories; "poor," those who had not emerged from their autism at all, "fair," those who had taken some classes at their appropriate age level, had meaningful contact with others yet still would be identified as deviant, and "good," those who were successful socially and academically and who would have been accepted by their peers even though they may still be considered a little odd. For the sake of comparison, Bettelheim keeps Eisenberg's categories. Bettelheim says that although they had worked with forty-six autistic children, six were eliminated from the study for not having been at the School long enough or as in one case, having been previously exposed to electroshock therapy. Bettelheim reports the product of the comparison as:

[T]here were eight in our forty for whom the end results of therapy were "poor" because, despite improvement, they failed to make the limited social adjustment needed for maintaining themselves in society. For fifteen the outcome was "fair" and for seventeen "good." Thus while Eisenberg reports only 5 per cent good outcome, our experience shows that intensive treatment can raise this figure to 42 per cent. While he reports only 22 per cent fair improvement, we can report 37 per cent. Most important, while he found 73 per cent poor outcome, we had only 20 per cent poor results. (414)

For Bettelheim, the discrepancies between his results and those reported by Eisenberg are conclusive evidence that because the psychoanalytic approach to therapy has been more successful, the ultimate claim of causation is more likely psychological than physiological.

Kanner noted that children with autism avoid using the pronoun "I" in favor of the pronoun "you." Kanner concluded that this reversal of pronouns like the autistic child's tendency to memorize long lists of information is symptomatic of the fact that language holds little meaning for them. Kanner and Rimland both agree that the child with autism is able to repeat words without acquiring understanding.

Bettelheim states that "Rimland, a psychologist seems uninterested in the psyche of autistic children, since he did not study them as persons but inquired only into the neurological structure of their brains"(433).31 Had both Rimland and Kanner been more astute, they would have realized that the child with autism does not use the pronoun "I" for several reasons, none of which is a lack of understanding of language. The autistic child may avoid using the pronoun "I" so that he can hide his innermost thoughts. In some cases, it could also be "either a denial of selfhood or denotes an absence of awareness of selfhood - while the substitution of "you" shows some awareness of the selfhood of others" (427). But primarily the child who avoids the "I" "is complying with what he considers a parental wish that he should not exist" (429). Finally, the autistic child conducts the aforementioned feats of memory, not as exercises in repetition, but to indicate to the world that he is not feeble minded. Because these children are too afraid to "speak freely" they must covertly prove to the world that they are indeed intelligent (430).

Analyzing Bettelheim's Rhetorical Strategies

Bruno Bettelheim's The Empty Fortress has been called "the empty book;" Bettelheim himself has been called much worse. However, if The Empty Fortress were so devoid of value and Bettelheim such a monster, how is it that his arguments gained credence and he is still revered in some circles? This apparent contradiction can be negotiated first through the critical application of three classical rhetorical tests: Aristotle's ethos, and Cicero's invention and arrangement. Secondly, the more recent rhetorical theory of Chaim Perelman offers a discussion of the evidentiary value of example, the differentiation between the universal and particular audience, and "presence," the rhetorical function of information selection.32 Because Bettelheim's claims of scientific validity were influential in the credibility assigned his conclusions, it is important to look at The Empty Fortress as not only a rhetorical narrative, but also as a scientific work. As Alan Gross has revealed in The Rhetoric of Science, even the sacredly objective fields of science use these traditional rhetorical strategies to persuade.33

Gross argues that the use of rhetorical strategies in the scientific fields necessitates the viewing of rhetoric as epistemic. That is, rhetorical methods not only help communicate knowledge, they help us acquire knowledge in the first place. R.L. Scott elucidates the theory of a rhetorical epistemology.34 As Scott has argued, to view rhetoric as epistemic requires that one relinquish the possibility of definitively knowing the "truth." Nonetheless, understanding can be and is achieved within traditions and communities. These communities act as check and balance systems for those arguing within their tradition. As a result, if the understanding achieved within a specific tradition is consistent with their standards and knowledge, it is "true" for that community. Scientific communities must police their own.35 The specialization of knowledge and language has created a gap in the laity's ability to criticize much of what comes out of science. It is precisely this chasm of expectation and knowledge that Bettelheim exploits in The Empty Fortress. Thus, an analysis of Bettelheim's The Empty Fortress offers a new chapter to the evolving field of the rhetoric of science.

In The Empty Fortress, Bettelheim had two goals. First, Bettelheim wanted to prove that autism was a parallel condition to the "moslems" in the concentration camps caused by an "extreme situation," namely the child's parents. Second, Bettelheim attempted to create a stage theory of infant development that paralleled Erikson's adolescent developmental theory.

That Bettelheim's theory of development didn't gain acceptance is no real surprise. First, Bettelheim spends little effort in pursuing this argumentative avenue. Second, developmental theory has always been under the authority of child psychology. Although Anna Freud had for some time been using psychoanalysis to evince child behavior, it was not generally accepted in the more rigorous divisions of psychology. Bettelheim was essentially dismissed by those in classical psychology for his lack of scientific rigor, his ties to psychoanalysis, and his intentionally sensationalistic prose. When they chose to speak out against him it was in academic journals and out of sight from the popular media. Nonetheless, Bettelheim aims for acceptance with the community by utilizing scientific terminology, form and, "statistics," while still violating scientific standards. Because Bettelheim attempts to embrace two approaches to psychology with two distinct methodologies and traditions, he escapes the censure of both.

As Gina Weinmann has stated, by the time Bettelheim had published The Empty Fortress, those in the psychoanalytic community who knew of his falsified credentials were hesitant to reveal them in fear that they might be assumed jealous of his stardom. In fact, Bettelheim had played a major role in increasing the popularity of psychoanalysis to a mass audience. To argue against Bettelheim could not only make others appear to be exhibiting "sour grapes," it would show a fissure in the community and in turn show that psychoanalysis was not exactly a "science." But Bettelheim could not relinquish his ties to psychoanalysis. Without a psychoanalytic view he never could have made the interpretations of the children's behavior that led him to his stage theory of development. In addition, his rationale for viewing the prisoners in the concentration camps as an explanatory analogy and source for his theory came from "introspection," which, while acceptable in psychoanalysis it is denigrated in psychology.

Hence, if one asks who was Bettelheim's community, it was the lay audience and those on the border of science: social workers, school counselors, and administrators. Bettelheim geared his message to them in form and content, but always with an eye towards achieving the ever elusive scientific legitimacy. So although Bettelheim was striving to achieve the adherence of two particular audiences, the psychological and psychoanalytical communities, he too wrote for what Perelman has called the "universal audience," the ideal reasonable audience.

Each particular audience is united by common beliefs. It is the burden of the rhetor to maintain the integrity of his arguments while still shaping them to the belief system of the particular audience in order to maximize persuasion. However, as Perelman has noted, the rhetor can not ignore the larger universal audience, the ideal reasonable audience. Because particular audiences can occupy such narrow intellectual space thereby encouraging bias (the preacher preaching to a room of believers) for his arguments to truly add to knowledge, the rhetor also must persuade the universal audience. In this configuration, the particular audience offers the rhetor the less difficult playing field: perspective is de facto limited, rules are apparent, and beliefs are shared. The universal audience presents a much different rhetorical challenge.

The universal audience is a construct of the rhetor's mind. As Perelman states: "Everyone constitutes the universal audience from what he knows of his fellow men, in such a way as to transcend the few oppositions he is aware of. Each individual, each culture, has thus its own conception of the universal audience."36 The rhetor's conceptualization of the universal audience affects the nature of his arguments to the extent that they "must convince the reader that the reasons adduced are of a compelling character, that they are self-evident, and possess an absolute and timeless validity, independent of local or historical contingencies."37 In effect, the rhetor's construction of the universal audience is telling since it is through his use of arguments appealing strictly to the reason of this imaginary audience that he reveals what it is that he believes to be self-evident.

Oddly, in this case, Bettelheim succeeds in persuading his conceptualization of universal audience while failing with the particular audiences. Bettelheim's primary appeal to the reason of his audience is that autism, in both its source and symptoms, is parallel to the condition of the "moslems" in the Nazi concentration camps. Yet it is not enough for Bettelheim to simply argue the parallel case; his study must also appear to be scientific, lest he be accused of simply projecting his major frame of reference, his experience in the concentration camps, onto his theory of autism. To that end, Bettelheim imitates the structure, form of reasoning, and methods of proof used in science. But Bettelheim's "science" is tainted by his psychoanalytic background both in his rationale and methodology, as well as his utilization of the case study. Nonetheless, it is this strategic patchwork of theory and methodology that Bettelheim uses as a foundation for "proof" of the parallel between those with autism and the "moslems." Bettelheim's conclusion, that autism is a condition parallel to the "moslems" in the concentration camps, is dependent on the success of the rhetorical strategies that he used in an attempt to gain the adherence of his two particular audiences. So ironically, it is with the arguments rejected by his particular audiences that Bettelheim is able to exploit the ignorance of his universal audience.

Each scientific field has its own conceptualization of how theory, methodology, and proof interact to make a compelling argument. But science is a rhetorical community and hence shares communal values relevant to Bettelheim. Hallmarks of good science include: the privileging of inductive over deductive reasoning, following a standardized report format, and using case studies as illustration.38

The most damaging of Bettelheim's violations of the scientific method is his approaching the problem of autism deductively. Science's purposeful privileging of inductive over deductive reasoning is a check for objectivity in invention.39 Traditionally, invention is "where" one looks for arguments. To reason inductively is to look toward the observed phenomenon to make the arguments; to reason deductively is to seek in the phenomenon rationalization for existing arguments. Although never a certain outcome, objectivity is better served through induction.

As indicated by his grant application and his comments to friends, Bettelheim sought the cause of autism in the parents. Before he had admitted one student with autism, Bettelheim had determined the source of the disorder. In doing so, Bettelheim committed himself to viewing autism as a psychological disorder rising out of environmental causes while precluding any other possible explanation. This step would later allow Bettelheim to make the damaging parallel between children with autism and those interned in the concentration camps and further, between the mothers of children with autism and the SS guards.

This first deductive leap opens a Freudian back door for Bettelheim into the science of child development. If autism has an environmental cause, rather than a physiological cause, Bettelheim might be able to find clues to normal infant development through the recovery process of children with autism. How severely afflicted the child was would determine when the child first turned inward. In order to show the stages of development the most clearly, Bettelheim selects the most "hopeless" of his students for his case studies; those who are most like the "infant."40

Bettelheim's deductive reasoning is also demonstrated in the arrangement of his arguments. The persuasive value of arrangement first taught by Cicero, has been modified by the sciences to mimic the process of induction so that the experiment (discovery process) is described first followed by a results/discussion section (what was proved). In the scientific article, it is standard to review the topic literature, indicate a contradiction or a space for further research, show how the particular study will contribute, and then fill the intellectual space created (including a description of the theory, rationale, and methodology to be used).41

On its face, The Empty Fortress appears to maintain the scientific format. There is an introduction in which Bettelheim describes his theory, methodology and rationale. Bettelheim then situates himself and his theory within the literature and utilizes the case study. He has a conclusion and talks about the implications of his study. But that is where the similarities end. In both arrangement and content, Bettelheim's format is inconsistent with the accepted scientific norm.

First, his rationale for his theory and methodology in his introduction is his own introspection. This is a particularly suitable approach since, according to Bettelheim, the restraints of science make it impossible to examine the human mind in all of its complexity. This rationale is both an appeal to the psychoanalytic audience and to the humanity of the universal audience. The conclusion of Bettelheim's introspection is that autism is a parallel condition to the "moslems" in the concentration camps caused by exposure to an extreme situation. Moreover, because Bettelheim had personally experienced the "inescapability" of the concentration camps, he is uniquely qualified to examine the parallel problem of autism.

Anticipating that he might be accused of operating out of personal bias, Bettelheim invokes the "scientific" claim that the conclusions contained in the book have been verified by his team of researchers. Because, as Bettelheim states, "the uses of introspection for understanding others would be a projection of one's own experience, with little scientific merit."42 However, as his multiple biographies have exposed, Bettelheim trained each of his otherwise unqualified therapists thereby calling into question the objectivity and capability of these women to either vouch for or to invalidate his hypothesis. It is on the basis of this balancing act that Bettelheim claims his conclusions are informed, yet scientific; experiential, yet objective.

Bettelheim's theoretical rationale is no more suspect than his methodology. Bettelheim describes his "milieu therapy" essentially as a journey without a map:

[O]ur task as we see it is to create for him a world that is totally different from the one he abandoned in despair, and moreover a world he can enter right now, as he is . . . Each of us is implying in his way that one cannot help another in his ascent from hell unless one has first joined him there, to whatever degree. There is no "direct confrontation" available to the sick child, unless somebody offers himself for the confrontation. This will always, to some degree, mean a descent to one's own hell . . . At the same time there is no purpose to such a venture if all that happens is our offering to accept the child in his desolation. What we also have to demonstrate is that together we can make a go of it, even down there - something that he alone at this point cannot do . . . Hence at the heart of our work is not any particular knowledge or any procedure as such, but an inner attitude to life and to those caught up in its struggle, even as we are.43

Although appealing in that it is a sympathetic and moving view of how to approach a child with a severe mental disorder, Bettelheim's "milieu therapy" lacks precision and even the most general of guidelines. Again, the lack of rigor in Bettelheim's "milieu therapy" would likely be ignored in the psychoanalytic community in which the analysand/patient guides the treatment and "knowing the other" is contingent upon "knowing the self" (3).44

Thus, if the introduction to the scientific article is the point at which the researcher situates himself within a community of knowledge, it still remains unclear precisely in which community Bettelheim chooses to locate himself. It is at this point that his construction of his universal audience takes form. If knowledge is contingent on communal agreement, it is in the diversity of appeals, to the communities of science, psychoanalysis, and those transfixed by the horrors of Nazi Germany, that Bettelheim creates his universal audience and hence his grounds for understanding.

Bettelheim continues to develop his theory of causation in the following two chapters. Although he situates himself within the literature, it is not within the studies done on autism, of which there were many. Bettelheim reserves his discussion of the studies on autism to the end of the book, in which they occupy the argumentative space of rebuttal. Instead, Bettelheim manipulates animal behavior studies and research findings on both normal children and children with a variety of psychological disturbances to suit his needs. Bettelheim's purpose in using alternative studies to establish his theory serves several functions. First, Bettelheim is able to retain the "guise" of science by backing up his claims with scientific research findings. Second, Bettelheim is able to develop his hypothesis of the cause of autism without having to deal with any counter-explanations. Finally, the alternative literature that Bettelheim selects as foundational to his theory implicitly turns his audience's attention to viewing autism as a disorder of "nurture," since each of the subjects concerned in these studies at least began a life as "normal." For anyone unfamiliar with child development or autism, Bettelheim's theory sounds groundbreaking. Thus, the reader is fully immersed in Bettelheim's theory then courted by the presence of the case studies long before Bettelheim concerns himself with the major works on autism.

Additionally, since the purpose of the literature is to create a "research space," in circumventing the studies done on autism, Bettelheim is able to mold from the alternative studies the space he needs to reify his deductive claims. In "Where the Self Begins," Bettelheim argues that there is a point in a child's development when he is particularly vulnerable to his outside environment. In "Strangers to Life," Bettelheim "fills" the research space that he created in "Where the Self Begins" to show the specific ways a destructive environment, or "extreme situation," affects the child. It is here as well that Bettelheim lays the groundwork for his defunct stage theory of development. In attesting that he is attempting to discover the stages of early infant development, Bettelheim is able partially to rationalize the extensiveness of these two sections as well as his limited selection of literature to review.

So not only does Bettelheim fortify his deductive claims through his literature selection, but he places his "findings," his theory, before his discussion of his "experiments," the case studies. In inverting the standard scientific process, Bettelheim reconstructs his deductive reasoning. Yet this arrangement is necessary to give "scientific" credibility to his Freudian interpretations of the children's behavior. For instance, under this arrangement, Laurie looking upwards toward elusive "good breast" is made far more reasonable since Bettelheim has already shown that nursing is "the nuclear experience out of which develop all later feelings about oneself and other persons…" (19). Bettelheim is not just another Freudian obsessed with breasts. Instead, he has already indicated in his theory how it is in feeding that the infant begins to develop a sense of self and this frustrated yearning for the breast is the autistic child acting out his frustrated sense of self.

Circularly, while the theory section helps validate Bettelheim's interpretations, his interpretations help validate his theory. The interplay between his theory and interpretations can best be understood through Perelman's concept of "presence." Perelman describes this strategy as: "one of the preoccupations of a speaker is to make present, by verbal magic alone, what is actually absent but what he considers important to his argument or, by making them more present, to enhance the value of some of the elements of which one has actually made conscious."45 Bettelheim has already "made conscious" to the audience that a child is vulnerable to the environment and if something in the environment constitutes and extreme situation he will react similarly to the "moslems" in the concentration camp, a disorder in children called autism. The case studies of Laurie, Marcia, and Joey recreate actual instances of his theory, hence "enhanc[ing] the value" of his theory. In fact, there is not one behavior exhibited by these children that had not previously been accounted for in Bettelheim's theory. But, Bettelheim does not simply describe these children's behavior, he interprets their behavior through the framework of his theory. As a result, he makes present "what was actually absent" in these children's behavior through his interpretations. Because the behaviors exhibited in the children of the case studies are so bizarre, his interpretations within the frame of his study begin to make sense as the only means of explaining these deviancies. Yet the fact that none of these behaviors goes unexplained is rather suspect. In essence, this is another instance of Bettelheim's deductive reasoning. The case studies act as evidentiary examples of Bettelheim's deductive theory rather than as illustrations of inductive findings.

When Bettelheim finally turns his attention to the arguments of Kanner and Rimland it is to refute the claims that autism is an innate disorder. In his "rebuttal" it becomes apparent why Bettelheim did not originally situate his theory within the literature of the studies done on autism. Bettelheim takes these theories to task on two points: 1) they are unable to explain the autistic child's inability to differentiate the "I" and the "you" in language use and 2) they cannot explain why autistic children would shy away from stimuli, if it is a disorder of the part of the brain dealing with arousal. Only Bettelheim's theory is able to explain these issues. Nonetheless, Bettelheim argues that even if a neurological or organic problem is found to correlate with autism, it could have been a result of the early environmental damage that caused autism, not the source itself. Thus, these studies can never refute Bettelheim's claim of causation until a test is constructed that can detect the biological existence of autism at birth; thus his claim is proven because it cannot be disproved. Bettelheim's conclusion is that both Kanner and Rimland have viewed autism as a problem to be solved while ignoring the human element. Rimland "did not study them as persons but inquired only into the neurological structure of their brains" (433). Kanner, for his part, argued that children with autism cannot relate to others. Bettelheim says that they do relate, but in their own fashion.46

Finally, Bettelheim decides to meet the scientists on their own grounds. In characteristic fashion, when Bettelheim believes his findings are in doubt, he invokes "science." Bettelheim argues that the theory that best explains the cause of autism should be able to be determined by how effective the method of treatment driven by that theory is. Bettelheim is not satisfied that his theory should be accepted by default. As a result, he engages in a statistical comparison with the only long-term study done from Kanner and Rimland's position. According to Bettelheim, the statistical improvement in his patients is significantly better than that resulting from the other approaches. Because Bettelheim's methods of treatment, based on his theory, create better results, his theory must be right.

However, Bettelheim's statistics are problematic. In his grant application he states that he is planning to admit twelve children with autism for his study. The school records show that he admitted ten, only two of whom had entered with the diagnosis of autism. Yet, Bettelheim gives a base number of forty-six, forty of which will be used for comparison. Where are these children? Even if the numbers might be troublesome, Bettelheim is safe in making his success rate claims since the children's records are sealed. No one will ever know how successful Bettelheim's "milieu therapy" really was. Additionally, Bettelheim never gives Eisenberg's base numbers nor does he discuss what, if any, sort of therapy Eisenberg's children have undergone. The comparison and hence Bettelheim's conclusion arising out of the comparison is faulty.

But, according to Bettelheim, he is the only researcher who has viewed autistic children as people. Bettelheim's rhetorical ethos, the credibility assigned a rhetor as a result of his arguments, is particularly geared to establish this image and the image of utter competency throughout the book. For those unfamiliar with his history, Bettelheim reviews in the introduction that he has written extensively on the subject of child psychology. He also establishes his credibility as a Holocaust survivor. He is the only one capable of truly understanding the cause of autism, having first hand experience of the extreme situation. His insights into the children's behavior, his "milieu therapy," his expressed sympathy for the children ravaged by autism, all further his image of the "good doctor." While we have barely scratched the surface of Bettelheim's rhetoric in this paper, it is perhaps this fundamental need to believe in the figure of the "good doctor" that underlies the mythic rhetorical structure of the persistent belief in the maternal-cause theory of autism. Viewed in hindsight, it appears that Bettelheim's work, like that of Freud himself, was less that of a modernist effort to replace religion with science than that of an effort to preserve a space for traditional, allegedly "humanist" values. It was an attempt, finally, to affirm that we have "minds" and "souls" rather than simply "brains." That a more humane treatment for autistic persons would come from focusing on their neurology rather than on the "meaning" of their lives is but one of the many ironies of the career of Dr. Bettelheim.


1. Bruno Bettelheim, The Empty Fortress: Infantile Autism and the Birth of Self (New York: Free Press, 1967).

2. Although some had begun to doubt Bettelheim's methods before the publication of his book, most of the comments appeared in academic journals and were ignored by the popular press. See Jacques May's letter to Scientific American, 200 (May 1959): 12; Norris Haring & E. Lakin Phillips, Educating Emotionally Disturbed Children (New York: McGraw-Hill, 1962): 21; and C. Gary Merritt's, review of The Empty Fortress, American Journal of Orthopsychiatry 38 (Oct. 1968): 926-930.

3. This hypothesis was originally hinted at by Leo Kanner. Although Kanner allowed that the child's psychological environment could be influential he believed, though, could not prove, that autism was a disorder with which one was born. See Leo Kanner, "Problems of Nosology and Psychodynamics of Early Infantile Autism" American Journal of Orthopsychiatry, 19 (July 1949): 425.

4. The first letter appeared in the Chicago newspaper, the Reader on April 6, 1990. Although it was unsigned, it was later attributed to Alida Jatitch. Charles Pekow, also a former student, accused Bettelheim of making incorrect diagnoses and of abuse in the Washington Post on August 26, 1990. Graduate student Ronald Angres, another of Bettelheim's students diagnosed with autism, took his turn in the October 1990 issue of Commentary. Bettelheim biographer Nina Sutton and others have argued that many of these former students were upset that Bettelheim had committed suicide and were lashing out in hurt and anger. Others commented that since these former students were now such functional adults, Bettelheim's therapeutic method must have been effective. Some discounted the students' claims by arguing that when under Bettelheim's care they were considered "troubled" and thus their recollections are questionable at best. Yet, in light of the other posthumous revelations about Bettelheim, the students' story seems feasible.

5. It would seem that Bettelheim believed in relative truth concerning his credentials since, according to Sutton (1996), he worried about the possibility of the discovery of many of the half-truths and outright lies he used to bolster his credibility. However, it should be noted that Bettelheim never doubted the truth of his scholarly claims.

6. Peter Hobson, The Cradle of Thought (London: Macmillan, 2002).

7. Theron Raines, Rising to the Light: A Portrait of Bruno Bettelheim (N.Y.: Alfred A. Knopf, 2002).

8. Brussels: Mardaga 2002. Chapter 15 discusses autism.

9. Here is a typically obscure remark by the Master on autism: "Autism's weight of words corresponds [...] to a serious slowing down of language serial games - and not to a state of the infans being - a slowing down which may go as far as to seal itself in a deathly silence. The absolute Master, death, submits the serial to a law which organizes it, whereas seriousness ordains that there be no possible mistake about the Master; in this sense it does not deceive." (downloaded 10/26/05).

10. A social worker in Rice County, Minnesota, in the 1990's was notorious for pulling autistic children from their homes on the ground of child abuse.

12. Richard Pollak, The Creation of Dr. B: A Biography of Bruno Bettelheim (New York: Simon & Schuster, 1997): 127.

13. Freud had become even more popular by the 1960's. For a discussion on Freud in America see: Nathan Hall, The Rise and Crisis of Psychoanalysis in the United States: Freud and the Americans, 1917-1985 (New York: Oxford UP, 1995). For a feminist take on the abuse of Freud, see Molly Ladd-Taylor and Lauri Umansky, "Bad" Mothers: The Politics of Blame in Twentieth-Century America. (New York: New York University Press, 1998).

14. Bruno Bettelheim, "Individual and Mass Behavior in Extreme Situations," Journal of Abnormal and Social Psychology 38 (Oct. 1943): 417-452.

15. Two other essays on the camps had been published in England, but received little attention in the U.S. (Pollock 116).

16. In "Extreme Situations," Bettelheim states that he interviewed over 1500 prisoners while in the camps and had resided in 5 different bunkers. The former assertion is, by all accounts, highly unlikely. The latter is categorically untrue. In his introduction of The Empty Fortress, Bettelheim asserts that the scientific method is likely unsuited for psychological studies (3). Nonetheless, he utilizes statistics and scientific language in all of his major works to gain credibility.

17. His last contribution to a major psychoanalytic journal was in 1950. In 1961 he submitted an article about an autistic girl to the Journal of the American Psychoanalytic Association. The editorial board said that it read "almost like a novel" (Pollock 225) but that they would like it if he "would supply more details as to how he rea[c]ed his formulations (letter from John Frosch to BB, Jan. 12, 1961, Max Gittelson papers, Library of Congress, cited in Pollock 225). Bettelheim made a rather acerbic reply and subsequently discontinued writing for academic journals.

18. See Sutton's biography for a near exhaustive list of Bettelheim's life publications.

19. The first was published in the March, 1966 ed. of Redbook, the second in the April 11, 1964 ed. of the Saturday Evening Post.

20. This article first appeared in the March 5th, 1959 edition of Scientific American. In typical Bettelheim style, it was fully illustrated with "Joey's" drawings showing his progress.

21. Bruno Bettelheim to Daniel Karlin, Nov. 4, 1974, cited in Pollock 328.

22. In writing for the magazine Politics in 1948, the editor told him that "for a general magazine, (heavy scholarly prose) … is not necessary, and just loses the reader's attention." Dwight Macdonald to Bruno Bettelheim, from the Dwight Macdonald papers, Manuscripts and Archives, Sterling Library, Yale University, cited in Pollock, 169. He not only learned his lesson, he later criticized others for the same thing. "In reviewing a book for the College Art Journal, Bettelheim criticized the author for making his text 'forbidding for the college student.'" Bruno Bettelheim review of "The Aesthetic Process" by Bertram Morris, College Art Journal 3 (May 1994):166, cited in Pollock 126.

23. Pollock 224-225.

24. Lynn Hunt, The Family Romance of the French Revolution (Berkeley: University of California Press, 1992).

25. In making this admission, Bettelheim directly contradicts his statement in his grant application. Bettelheim had stated that there weren't any long-term studies done on the subject of autism, yet the first researcher Bettelheim contends with is Kanner (with Eisenberg), who had conducted an extended study on autism before Bettelheim had begun his project.

26. L. Eisenberg & L. Kanner, "Early Infantile Autism, 1943-1955," American Journal of Orthopsychiatry 26 (1956): 556-566, cited in Bettelheim (1967) 389.

27. The child to whom Bettelheim is here referring is Patsy. Not only was Patsy never actually diagnosed with autism, but as stated earlier, by all accounts Bettelheim had little to do with her care.

28. Bettelheim is again contradicting himself here. Earlier he stated that the reason he and the counselors had originally misunderstood Laurie's second collapse was because they had just started to work with children with autism and were still unduly influenced by arguments that these children could not form emotional relationships.

29. Bettelheim conveniently omits this portion of his theory in his review of Laurie's history. For Laurie, the autistic withdrawal was brought about by the desertion of her first nursemaid.

30. L. Eisenberg, "The Autistic Child in Adolescence," American Journal of Psychiatry 112 (1956): 607-612, cited in Bettelheim (1967): 413-416.

31. This is a particularly biting comment since Rimland's own son suffers from autism.

32. Aristotle, On Rhetoric: A Theory of Civic Discourse, Trans. George Kennedy (New York: Oxford UP, 1991); Chaim Perelman & Lucy Olbrechts-Tyteca, The New Rhetoric: A Treatise on Argumentation, Trans., J. Wilkinson & P. Weaver (London: University of Notre Dame Press, 1969).

33. Alan Gross, The Rhetoric of Science (Cambridge MA: Harvard UP, 1990).

34. Robert L. Scott, "On Viewing Rhetoric as Epistemic" Central States Speech Journal (1967), and R. L. Scott, "On Viewing Rhetoric as Epistemic: Ten Years Later," Central States Speech Journal (1976).

35. Gross (129-143) elaborates on this in his analysis of the peer review process. Gross views peer review as a conjunction of speech act theory and Habermas' ideal speech situation so that editing and revising becomes an ideal interaction. Gross does, however, omit that the peer review process also encompasses the more specific audience issues referred to here. In scientific communities, Perelman's conceptualization of the universal and the particular audience are very nearly one and the same. In turn, this audience's acceptance of an argument validates that argument whereas the rejection acts as invalidation - the policing function of the communal audience.

36. Perelman 33

37. Perelman 32

38. Gross (85-96) has argued that the purpose of the scientific method is to induce cause and effect in order to generalize to a natural law. As a result, these tenants of "good science" are a reflection of Bacon's insistence on "true induction" as the only means of creating objective knowledge in the experimental sciences. Objectivity and induction are thus necessarily concomitant ideals in the sciences. To insure that studies are objective and hence inductive, they must be replicable. As a result, science privileges clear methodologies which include signs of objectivity checks like agreement among researchers. If a researcher is able to replicate the methodology used, they too should be able to discover similarly objective results, typically shown as statistical data.

39. To say that science privileges inductive over deductive reasoning does not mean that a researcher engages in a study without a theory or a methodology. In most cases, a researcher examines the available methods and theories for the phenomenon to be studied and honestly reveals her selection and the reasons for making it. Often, as research proceeds, theory and method are revised per the particulars of the specific phenomenon. This revision typically does not compromise the integrity of the study. It is built in to the scientific method to allow for the best possible understanding to be achieved.

40. Bettelheim says that he could have selected some of his students who have completely recovered after his treatment of which he gives several examples, perhaps the most impressive of which is the man who received his Ph.D. from the U. of Chicago. These testimonials help improve the credibility of his theory and methods. Nonetheless, he selected the most difficult of cases because they "showed [the] deepest arrest in personality." Bettelheim 9-10.

41. For a discussion on the reenactment of the inductive process see: Peter Medawar, "Is the Scientific Report Fraudulent? Yes; It Misrepresents Scientific Thought," Saturday Review 47 (August 1, 1964): 42-43. For a commentary on the introduction of the scientific article see: J.M. Swales, Gene Analysis: English and American Research Settings (Cambridge: Cambridge UP, 1990).

42. Bettelheim 8

43. Bettelheim 10-11

44. It is also interesting to note that Bettelheim considered himself the students' "super ego." He was the "somebody who offer[ed] himself up for the confrontation." As the statements of former students have attested, Bettelheim's confrontation was often physically and mentally abusive. This contradiction between Bettelheim's statements and actions makes his therapeutic methodology even more suspect. (Pollock, 191-211)

45. Perelman 29

46. Bettelheim is quite right about this. Most researchers at the time, including Kanner, believed that people with autism did not relate to others.



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