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The term refrigerator mother was coined in the 1940s as a label for mothers of autistic children. These mothers were often blamed for their children's atypical behaviors, which included rigid rituals, speech difficulty, and self-isolation.
The 'refrigerator mother' label was based on the assumption, now discredited among a majority of medical professionals, that autistic behaviors stem from the emotional frigidity of the children's mothers. As a result, many mothers of autistic children suffered from blame, guilt, and self-doubt from the 1950s throughout the 1970s and beyond, when the prevailing medical belief that autism resulted from inadequate parenting was widely assumed to be correct.
Origins of 'refrigerator mother' theory
Psychologist Bruno Bettelheim and other mental health professionals championed the notion that autism was the product of mothers who were cold, distant and rejecting, thus deprived 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.
As early as 1943, Leo Kanner, who first identified autism, called attention to what appeared to him as a lack of parental warmth and attachment among the mothers of autistic children. In a 1949 paper, he suggested autism may be related to a "genuine lack of maternal warmth." In a 1960 Time magazine interview, Kanner bluntly described such mothers as "just happening to defrost enough to produce a child."
Although Kanner was instrumental in framing the 'refrigerator mother' theory, it was Bruno Bettelheim, a University of Chicago professor and child development specialist, who facilitated its widespread acceptance by the public and the medical establishment cognoscenti in the 1950s and 1960s. Many articles and books published in that era blamed autism on a maternal lack of affection, but by 1964, Bernard Rimland, a psychologist with an autistic son, published a book that signaled the emergence of a rational counter 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, 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." Some authority was granted to this as well because Bettelheim had himself been interned at Dachau during World War II. The book was immensely popular and Bettelheim became a leading public figure on autism until his death, when it was revealed that his claims for success were greatly inflated if not wholly fabricated, and that Bettelheim himself had been involved in various cases of violent actions towards children in his clinic.[How to reference and link to summary or text]
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'." In reality, this was somewhat a whitewashing of his own history—in many of his articles Kanner does explicitly and clearly blame autism on parental behavior—but the renunciation of the idea by the person who originated it was seen as a decisive blow in any event.
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.
New explanations: filling a theoretical void
There are many contenders to replace the 'refrigerator mother' theory. After the 'refrigerator mother' theory gradually lost credibility within the medical community, autism research has focused primarily on establishing a genetic cause for autistic spectrum disorders. A twin study by Folstein and Rutter in 1977 found much higher concordance for autism in identical twins compared to fraternal twins.
However, one controversial new theory is bringing renewed life to Kanner's initial observations about the parents of autistic children. It derives from the observation that people with superior technical ability, but poor social skills, are meeting and mixing genes in high-tech enclaves, producing offspring susceptible to disorders whose traits mirror our computerized culture. Researchers have noted parents in fields such as engineering and computer science, with their particular talents and quirks, may have a greater chance of having children with autism or its high-intellect variant, Asperger's Syndrome. Now, this link is becoming a matter of public debate, resonating through the high tech corridors of Silicon Valley, New Jersey, Ottawa and the on- and off-line networks of Cambridge, Dublin and Boston's Route 128. This has been referred to as 'geek syndrome'. But there is no evidence that high incidence of autism among 'geeks' is due to their deficient parenting skills. A much more likely explanation is based on genetics; in fact, some 'geeks' clearly display a broader autistic phenotype, and many of them could even be undiagnosed high-functioning autistics.
Medical authorities, while continuing to focus on possible genetic vulnerabilities to autism since abandoning the long-held notion of refrigerator mothers, generally attribute the staggering increase of autism diagnoses to changes in diagnostic criteria and a growing awareness of the disorder.
Bernard Rimland was among the first healthcare professionals to articulate the premise that vaccines may have been the principle cause of autism, stirring controversy as a result. Critics of more recent environmental trigger theories have suggested widespread concerns about vaccines as the likely environmental triggers are simply hoaxes fostered by lawyers anxious to profit from litigation, and that such theories promote and prey upon feelings of guilt among parents, much as the discredited refrigerator mother theory fostered guilt among mothers decades ago.
Aftermath: escalating controversy
A growing number of parents, and a limited number of healthcare experts, reject the notion that autism is strictly an innate genetic disorder, noting there is no such thing as a genetic epidemic. Instead, parents seeking alternative explanations often link vaccines to the onset of autism, among a variety of other possible environmental causes.
Not satisfied with explanations offered by medical authorities, a number of parent led advocacy groups have sprung up seeking better explanations for the causes of autism. Some are loosely allied with the medical establishment, including the National Alliance for Autism Research and the M.I.N.D. Institute. Some advocacy groups, including Safe Minds, Generation Rescue and the Autism Research Institute (founded by Rimland), have stirred controversy by openly questioning the conclusions of medical authorities, calling for more extensive research examining possible environmental triggers, particularly vaccines and mercury exposure.
In response to demands for research into possible environmental causes from parents and these controversial advocacy groups, it has been suggested vaccine theories simply promote and prey upon feelings of guilt among parents, much as the discredited refrigerator mother theory fostered guilt among mothers decades ago. Most observers, meanwhile, are mystified by the conflicting explanations for the explosion in autism diagnoses.
Persistence of the theory
According to Peter Breggin’s 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 Europe and is largely believed in South Korea to be the cause of autism.
The modern consensus is that autism has a strong genetic basis, although the genetics of autism are complex and are not well understood. Although recent studies have indicated that maternal warmth, praise, and quality of relationship are associated with reductions of behavior problems in adolescents and adults with autism, and that maternal criticisms are associated with maladaptive behaviors and symptoms, these ideas are distinct from the refrigerator mother hypothesis.
- For a (very critical) discussion of the history of the "refrigerator mother" theory, see Edward Dolnick, Madness on the Couch: Blaming the Victim in the Heyday of Psychoanalysis (New York: Simon and Schuster, 1999), chapters 10-13.
- AutismConnect.org - '"Refrigerator Mother" Tosh Must Go Into Cold Storage' Adam Feinstein (editor) Autism Connect
- Autism-Watch.org - 'The "Refrigerator Mother" Hypothesis of Autism' James R. Laidler, MD
- ExpressHealthCareMgmt.com - 'Positive trends in the treatment of autism', Dr. N.P. Karthikeyen, Subathra Jeyaram
- FanLight.com - 'Refrigerator Mothers', David Simpson, J.J. Hanley, Gordon Quinn
- PBS.org - 'P.O.V.: Refrigerator Mothers'
- WashingtonPost.com - 'Refrigerator Mothers: With Mary Flanagan, June Francis and Maria Mombille' (July 17, 2002)
Pervasive developmental disorders / Autism spectrum
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- Arieti S (1974). Interpretation of Schizophrenia, 2nd, Northvale, NJ: Aronson.
- Mahler MS, Furer M, Settlage SF (1959). "Severe emotional disturbances in childhood: psychosis" Arieti S (ed.) American Handbook of Psychiatry, 816–39, Basic Books.
- Rutter M, Andersen-Wood L, Beckett C, et al. (1999). Quasi-autistic patterns following severe early global privation. English and Romanian Adoptees (ERA) Study Team. J Child Psychol Psychiatry 40 (4): 537–49.
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- Smith LE, Greenberg JS, Seltzer MM, Hong J (2008). Symptoms and behavior problems of adolescents and adults with autism: effects of mother-child relationship quality, warmth, and praise. Am J Ment Retard 113 (5): 387–402.