Refrigerator mother theory

For the documentary film, see Refrigerator Mothers.

Refrigerator mother theory is a discarded theory that autism is caused by a lack of maternal warmth. Current research indicates that a combination of genetic factors and exposure to environmental agents predominate in the cause of autism.

The terms refrigerator mother and refrigerator parents were coined around 1950 as a label for mothers and parents of children diagnosed with autism or schizophrenia. When Leo Kanner first identified autism in 1943, he noted the lack of warmth among the parents of autistic children. Parents, particularly mothers, were often blamed for their children's atypical behavior, which included rigid rituals, speech difficulty, and self-isolation. Kanner later rejected the "refrigerator mother" theory, instead focusing on brain mechanisms.

Origins of theory

In his 1943 paper that first identified autism, Leo Kanner called attention to what appeared to him as a lack of warmth among the fathers and mothers of autistic children. In a 1949 paper, Kanner suggested autism may be related to a "genuine lack of maternal warmth", noted that fathers rarely stepped down to indulge in children's play, and observed that children were exposed from "the beginning to parental coldness, obsessiveness, and a mechanical type of attention to material needs only.... They were left neatly in refrigerators which did not defrost. Their withdrawal seems to be an act of turning away from such a situation to seek comfort in solitude." In a 1960 interview, Kanner bluntly described parents of autistic children as "just happening to defrost enough to produce a child." In Kanner's original paper, however, only one set of parents were described as "cold", with many family members appearing to be from one neurological minority or another upon close reading of the text.

Bruno Bettelheim at University of Chicago was instrumental in facilitating its widespread acceptance both by the public and the medical establishment, even though Bettelheim was a fraudulent child psychologist who had greatly misrepresented his credentials.

In the 1950s and 1960s. In the absence of any biomedical explanation of autism's cause after the telltale symptoms were first described by scientists, Bettelheim as well as actual psychoanalysts championed the notion that autism was the product of mothers who were cold, distant and rejecting, thus depriving their children of the chance to "bond properly".

The theory was embraced by the medical establishment and went largely unchallenged into the mid-1960s, but its effects have lingered into the 21st century. Many articles and books published in that era blamed autism on a maternal lack of affection, but by 1964, Bernard Rimland, a psychologist who had an autistic son, published a book that signaled the emergence of a counter-explanation to the established misconceptions about the causes of autism. His book, Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior, attacked the refrigerator mother hypothesis directly.

Soon afterwards in 1967, Bettelheim wrote The Empty Fortress: Infantile Autism and the Birth of the Self, in which he compared autism to being a prisoner in a concentration camp:

The difference between the plight of prisoners in a concentration camp and the conditions which lead to autism and schizophrenia in children is, of course, that the child has never had a previous chance to develop much of a personality.

After his death in 1990, it finally came out that Bettelheim had misrepresented his credentials. His degree was in either art history or philosophy (aesthetics), and he had only taken three introductory classes in psychology. He stated that Freud had praised him as a person psychoanalysis needed to grow and develop. Bettelheim had, in fact, never met Freud. Most of what Bettelheim knew of psychoanalysis, he seemed to have been learned as a client.

Bettelheim was hired in 1944 to be the director of the Orthogenic School for Troubled Children at the University of Chicago as a residential treatment milieu for such children, who he felt would benefit from a "parentectomy". This marked the apex of autism viewed as a disorder of parenting. Some authority was granted to this as well, because Bettelheim had himself been interned at the Dachau concentration camp before World War II.

In 1969, Kanner addressed the refrigerator mother issue at the first annual meeting of what is now the Autism Society of America, stating:

From the very first publication until the last, I spoke of this condition in no uncertain terms as "innate." But because I described some of the characteristics of the parents as persons, I was misquoted often as having said that "it is all the parents' fault."

Other notable psychiatrists

For Silvano Arieti, who wrote his major works from the 1950s through the 70s, the terms autistic thought and what he called paleologic thought are apparently the same phenomenon. Paleologic thought is a characteristic in both present-day schizophrenics and primitive men, a type of thinking that has its foundations in non-Aristotelian logic. An autistic child speaks of himself as "you" and not infrequently of the mother as "I". The "you" remains a "you" and is not transformed into "I".

For Margaret Mahler and her colleagues, autism is a defense of children who cannot experience the mother as the living primary-object. According to them, autism is an attempt at dedifferentiation and deanimation. The symbiotic autistic syndrome used to be called the "Mahler syndrome" because Mahler first described it: The child is unable to differentiate from the mother.

Arieti warned that an autistic tendency is a sign of a kind of disorder in the process of socialization, and that when autistic expressions appear it should be assumed that there is a sort of difficulty between the child and his parents, especially the schizogenic mother. Children who use autistic expressions, Arieti observes, are children who cannot bond socially.

In Interpretation of Schizophrenia Arieti maintained that for a normal process of socialization, it is necessary for the parent-child relations to be normal. Loving or non-anxiety parental attitudes favor socialization. Arieti not only maintained that the parent-child relations are the first social act and the major drive of socialization, but also a stimulus to either accept or reject society. The child's self in this view is a reflection of the sentiments, thoughts, and attitudes of the parents toward the child. Autistic children show an extreme socializing disorder and do not want any sort of relationship with people. They "eliminate" people from their consciousness. For Arieti the fear of the parents is extended to other adults: a tendency to cut off communication with human beings.

Persistence of the theory

According to Peter Breggin's 1991 book Toxic Psychiatry, the psychogenic theory of autism was abandoned for political pressure from parents' organizations, not for scientific reasons. For example, some case reports have shown that profound institutional privation can result in quasi-autistic symptoms. Clinician Frances Tustin devoted her life to the theory. She wrote:

One must note that autism is one of a number of children's neurological disorders of psychogenic nature, i.e., caused by abusive and traumatic treatment of infants. ...There is persistent denial by American society of the causes of damage to millions of children who are thus traumatized and brain damaged as a consequence of cruel treatment by parents who are otherwise too busy to love and care for their babies.

Alice Miller, one of the best-known authors of the consequences of child abuse, has maintained that autism is psychogenic, and that fear of the truth about child abuse is the leitmotif of nearly all forms of autistic therapy known to her. When Miller visited several autism therapy centers in the United States, it became apparent to her that the stories of children "inspired fear in both doctors and mothers alike":

I spent a day observing what happened to the group. I also studied close-ups of children on video. What became clearer and clearer as the day went on was that all these children had a serious history of suffering behind them. This, however, was never referred to....In my conversations with the therapists and mothers, I inquired about the life stories of individual children. The facts confirmed my hunch. No one, however, was willing to take these facts seriously.

Like Arieti and Tustin, Miller believes that only empathetic parental attitudes lead to the complete blossoming of the child’s personality.

The refrigerator mother theory, widely discarded in the United States, still has some support in France and Europe and is largely believed in South Korea to be the cause of autism. The academic psychologist Tony Humphreys of University College Cork is a leading Irish proponent of the theory of frigid parenting, despite censure by the Psychological Society of Ireland.

Modern alternatives

The modern consensus is that autism has a strong genetic basis, although the genetics of autism are complex and are not well understood. Moreover, fetal and infant exposure to pesticides, viruses, and household chemicals have also been implicated as triggering the syndrome.

Although recent studies have indicated that maternal warmth, praise, and quality of relationship are associated with reductions of behavior problems in autistic adolescents and adults, and that maternal criticisms are associated with maladaptive behaviors and symptoms, these ideas are distinct from the refrigerator mother hypothesis.

Documentary film

In 2002, Kartemquin Films released Refrigerator Mothers, a documentary that takes a look at American mothers of the 1950s and 1960s and the blame leveled by the medical establishment for the mothers causing their children's autism. The premiere was braodcast in the summer of 2002 by United States' PBS, which the PBS website has described as "Though wholly discredited today, the 'refrigerator mother' diagnosis condemned thousands of autistic children to questionable therapies, and their mothers to a long nightmare of self-doubt and guilt. In Refrigerator Mothers, the new film by David E. Simpson, J. J. Hanley and Gordon Quinn, and a Kartemquin Educational Films production, these mothers tell their story for the first time."

See also

• Maternal deprivation
• Pit of despair, an apparatus used in social isolation experiments on infant rhesus macaques

Further reading

• "Bias, Bettelheim and Autism: Is History Repeating Itself?" Lynne Soraya, Asperger's Diary, Psychology Today. 10 January 2010. "For Anglo families eligible for Medicaid, it usually takes three or four doctor's visits to get a diagnosis for their children, according to a 2002 article in the Journal of the American Academy of Child and Adolescent Psychiatry. For the Latino families studied, it took more than eight."