by John Donvan
An expert quoted near the end of the story offered up the image that would define most public discussion of autism for the next two decades. It was his metaphor for the fate met by these young, “pathetic patients,” as Time called them, at the hands of their flawed, icy mothers and fathers. These children, said the expert, were “kept neatly in a refrigerator which didn’t defrost.”
Over time, the discussion about blame would start to look past the role of fathers and focus almost entirely on mothers. The “refrigerator” metaphor stuck to them, transforming sympathy for their difficulties into contempt. Almost the entire apparatus of American psychiatry participated in this ostracizing and debilitating portrayal of the refrigerator mother. One expert in particular, however, took the concept to such an extreme that his name became synonymous with mother blaming: Bruno Bettelheim.
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PRISONER 15209
He was called Dr. Bruno Bettelheim, sometimes just Dr. B, although he wasn’t actually a doctor, not in the sense of someone who went to medical school or earned a degree in psychology. A former Austrian lumber merchant, he had earned his doctorate in art history. Still, in the 1950s and ’60s, he somehow became the nation’s most beloved, respected, and trusted dispenser of insight on the human psyche.
Bettelheim, by his own forlorn admission, was ugly to look at, to an extent that bothered him all his life. He acquired English late, in his thirties, when he first set foot in the United States. But he had wit, charm, intelligence, and drive, and on the strength of those qualities and a Viennese accent, he talked his way to the top of American popular culture. His books, though not easy reads, became bestsellers. He wrote cover stories for magazines, and magazines wrote cover stories about him. Chicago Magazine’s front-page profile called him “The Man Who Cares So Much.” A BBC documentary placed him among the world’s “greatest living child psychologists.” He was a Today show guest, a “get” on late-night television, and, when Woody Allen was casting his mock documentary film Zelig, which came out in 1983, he contacted Bettelheim to tell him he had written in a cameo appearance for him, playing an authority on the human mind. Bettelheim took the part. After all, he had been playing it for thirty years.
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PRISONER NUMBER 15209 stood before the desk of a young Gestapo captain, who gestured to the prisoner to help himself to a chair. The prisoner, who was Jewish and knew how the captain felt about people like him, declined the invitation. Despite the snub, the Gestapo officer produced a rubber stamp and, after asking a few preliminary questions, brought it down, with a proper and precise thump, onto the official document that released the prisoner from incarceration in the Buchenwald concentration camp. The stamped paper gave the freedman a limited number of days to depart Austria for the United States, with the strict condition that he never return. It was April 1939.
That was how Bettelheim told the story. As his version would have it, he was the prisoner, and the young captain was an up-and-coming Nazi named Adolf Eichmann. Such a chance encounter, between the future star of American pop psychology and the Nazi destined to hang for engineering the machinery of the Holocaust, seems almost too improbable to be believed. Perhaps it was.
As shown by Richard Pollak, his most critical biographer, Bettelheim was a prolific embellisher of the truth. Pollak’s extensive research found instance after instance over several decades in which Bettelheim exaggerated or left out important facts about his work and life. For example, Pollak discovered that Bettelheim had told parts of the prisoner story on numerous occasions, but only once did he talk about facing down the engineer of the Holocaust. On all other occasions, according to Pollak, “Eichmann made no appearance.” Pollak concluded that Bettelheim almost certainly never met Eichmann.
It is true that Bettelheim spent eleven months as a concentration-camp prisoner. He was picked up in a general roundup of Jews in Vienna in May 1938 and shipped off to Germany’s first concentration camp, Dachau, in a cattle car. His first few months, he survived basically blind, for he was severely nearsighted, and one of the guards had smashed his thick-lensed eyeglasses.
At this stage, after Germany had annexed Austria, but before World War II began, the camps did not yet serve primarily as death factories. For Jews, the camps were a tool used to terrorize them into fleeing the Reich. Treatment was brutal, beatings were frequent and random, and prisoners died daily of disease, malnutrition, and summary executions. Buchenwald, where Bettelheim was transferred after four months, was even harsher. Yet there was, for Jews in particular, the real possibility of release in those early days, on the condition that a prisoner leave the Fatherland for good, abandoning his property to the state.
Bettelheim, upon his release, was given a week to leave the land of his birth. In May 1939, he landed in New York—traumatized, severely underweight, missing several teeth, and stripped of the better part of his life’s savings. He had no job, little English, and, as far as credentials, only that doctorate in art history from the University of Vienna, which he had earned over seven years while running the family lumber business. It was not, on the face of it, the key to finding paying work in a foreign country.
He had nothing but his freedom and temporary permission to reside in the ultimate land of second chances. He made everything of the opportunity. Ten years later, he was on his way to fame, having created a new life and constructed, for public deployment, a new self. The “Dr.” in front of his name was now a permanent part of his identity.
In 1950, the University of Chicago placed Bettelheim in charge of the Sonia Shankman Orthogenic School, which functioned as a working laboratory for developing new methods in the treatment of disturbed children who lived full-time within its walls.
In short order, Bettelheim was reporting extraordinary success in healing mental illness in the students under his charge. This in turn created a huge demand for his pronouncements on the best approach to raising “normal” children.
For years, in addition to writing advice articles for parenting magazines, and taking calls from reporters needing a quick quote on deadline for anything related to psychiatry or mental health, Bettelheim also held monthly sit-downs with young Chicago mothers, focused on telling them how to raise their children correctly. Forty or so women at a time would cram into a seminar room at the university in the evening, after their children were asleep, and the conversation would unfold for hours.
“He was God, we idolized him,” one mother told Richard Pollak, who later interviewed as many of them as he could track down.
At least three full-length biographies of Bettelheim, ranging from hostile to sympathetic, have taken on the question of how an Austrian lumber merchant with a doctorate in art history became recognized as an eminent child psychologist and the world’s leading expert on what causes autism. The answer remains elusive. Part of the explanation may be that Bettelheim actually did acquire, on his own, a meaningful knowledge of psychoanalysis, which fascinated him. He was a denizen of Jewish Vienna, where psychoanalysis was born, and where it wove itself into the fabric of intellectual discourse, affecting drama, literature, politics, and art—something Bettelheim did know a good deal about. At the University of Vienna, it appears, he took at least two psychology courses, and he read widely in the field throughout his life.
With a few clever adjustments here and there, Bettelheim nudged and stretched his life’s narrative into a seductive curriculum vitae. No one, it appears, bothered to fact-check these adjustments, even as they opened doors for Bettelheim into ever-higher reaches of academia. Ultimately, Robert Hutchins, the president of the University of Chicago, would be one of his most enthusiastic patrons.
Bettelheim’s ace card was his history inside the Nazi camps. On this subject, he had credentials and authenticity no American academic could match. When he wrote that Europe’s Jews were partially to blame for the Holocaust—for being too unwilling to assimilate before it began, and too unwilling to put up resistance after—he felt he had the right to do so, due
to the fact that he had been there and had made it out alive. American Jewish audiences who heard him say these things exploded with shock and outrage, but he never backed down.
As a survivor living in the United States, he was appalled that few Americans knew about the camps or seemed to believe the few incredible scraps of information that leaked out from time to time. He was driven to prove that what sounded unbelievable was true, and in 1942, after working on it for more than a year, he completed an essay on what he had witnessed during his imprisonment. He wrote not only about the conditions inside the barbed wire, but also about the psychology he had seen in play: why some prisoners were able to mentally withstand the nightmare, while others wilted and gave up. It was another year before he could persuade anyone to publish it.
When at last his piece, entitled “Individual and Mass Behavior in Extreme Situations,” was printed in The Journal of Abnormal and Social Psychology, it startled readers. Soon, other, more widely read publications were reprinting large chunks of the article or reproducing it in full. Bettelheim’s standing soared. For several years, it stood as the definitive account in English of the atrocities the Nazis were attempting to carry out in secret, as well as an analysis of the psyches of the prisoners. True, the author wasn’t a psychiatrist; in fact, when one publisher called him that, Bettelheim wrote a short note to correct him.
By coincidence, Bettelheim’s piece was published only a few months after Leo Kanner wrote for the first time about Donald and the other ten boys and girls he was seeing at Hopkins. While few Americans knew much of the camps, virtually none knew anything about autism. A decade was to pass, during which the condition remained obscure, familiar only to a small circle of psychiatrists who read Kanner and thought perhaps they were seeing cases in their own practices.
Then Bettelheim decided autism deserved his attention.
In 1955, Bettelheim applied for a grant from the Ford Foundation to bring a handful of children with autism into the Orthogenic School for a period of seven years. He proposed to track their development while figuring out the best ways to reach them, and he pointed out that the lessons learned could have wider applications. “From these children who have never made a normal emotional adjustment,” he wrote, “much could be learned about both normal emotional adjustment and adjustment through mental illness.” He received the funding.
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TO BE SURE, Bettelheim did not intend to study the brains of these children. It was the wrong era for that sort of approach. The brain was an organ, and mainstream psychiatry put little stock in the notion of organic causes of mental misbehavior.
For Bettelheim, an autistic child, especially one who could not speak, was the perfect canvas upon which to scrawl a Freudian interpretation of behaviors. Consider, for example, his explanation of why children with autism have a hard time going to the dentist. Ask any parent of a child with severe autism: this is a classic struggle. The dentist’s chair has everything wrong with it. It’s unfamiliar, it’s confining, it moves, it may even vibrate. Blinding lights hover. Equipment screeches and squeals. A stranger in strange clothing comes to poke strange instruments into the child’s mouth. Sometimes there’s pain.
Inspired by Freud, Bettelheim had an explanation: “From what we know of autistic children, their main anxiety is that the dentist will destroy their teeth in retaliation for their wish to bite and devour.”
His theories on dentistry and autism appeared in The Empty Fortress, the 1967 book that catapulted him to the top of the list of autism’s explainers. The book is constructed as a guided tour through a weird, wondrous corner of the “fascinating” human condition known as autism. In a detailed sketch of a handful of children under his care at the Orthogenic School, he offers their strange behaviors and obsessions as clues—clues that explain why these children might choose to run from reality.
Critics were awed by Bettelheim’s devotion to helping autistic children and called the book “brilliant.” The New Republic anointed him “a hero of our time.” Eliot Fremont-Smith of the New York Times called The Empty Fortress “as much a philosophical and political book as it is a scientific one.” He felt that Bettelheim, in discussing the challenge of reaching children with autism, was examining the universal challenge of communicating across barriers of all sorts. “It is inspiring,” he wrote, as evidence that “the alienations in our age…need not be accepted as the permanent condition of man.”
Bettelheim’s descriptions of the children were vivid and compelling. Marcia, for example, was obsessed with the weather. “She studied it with intense fascination,” Bettelheim wrote, “and for a long time it was the only thing she would talk about.” People with autism can become entirely fixated by, and trapped inside, a single obsessive interest that takes over their lives. But weather had a special significance for Marcia, he explained, which could only be understood when the word itself was broken into the three smaller words it contains: “We/eat/her.” Bettelheim explained that the girl’s obsession with the wind, temperature, and precipitation grew out of a deep fear that her mother “intended to devour her.” He reported that, after working with him, the girl “was well on her way to complete recovery” from autism.
A second, more discussed, case in The Empty Fortress was that of “Joey, a Mechanical Boy.” Bettelheim had written previously in Scientific American about this same child—how, because he had been “completely ignored” by his parents when he was little, he had developed an image of himself as a piece of machinery, which in turn belonged to a larger machine, which was the world. Joey was interested primarily in mechanical things, especially fans, while avoiding contact with people.
Why fans? Because they rotate, Bettelheim theorized, and circles have a special symbolic meaning to children with autism. “I believe it to be that they circle around and around, never reaching a goal,” he wrote. “The child longs for mutuality. He wants to be part of a circle consisting of him and his parents, preferably with him as the center around which their lives revolve.”
Bettelheim reported that Joey broke out of “the vicious circle” on the day he spontaneously crawled under a table and imagined laying an egg that contained himself. When he symbolically pecked his way out, he was reborn and was suddenly many steps closer to a cure. “He broke through and came into this world,” Bettelheim wrote. “He was no longer a mechanical contrivance but a human child.” As to what was really going on, Bettelheim believed: “If the mother is the crucially dangerous person, then to be nursed by her is like being poisoned….Thus a birth entailing nursing might have seemed too dangerous to Joey. But if he were born out of an egg, he could fend for himself the minute he crawled out of his shell. There would be no need to nurse from the breast.”
Joey too was reported to have “recovered,” returning home after nine years at the Orthogenic School, then successfully attending and completing high school.
Vicious. Dangerous. Devouring. These were some of Bettelheim’s favorite expressions for conveying the causes and effects of autism. Autism, as he saw it, was a decision children made in response to the cold, nasty, threatening world in which they found themselves. Babies arrived fine and healthy, took a look around their lives, and realized they couldn’t handle the ugly circumstances into which they’d been born. Before long, they “deliberately” proceeded “to turn their backs on humanity and society” in order to survive.
Bettelheim believed he had witnessed this firsthand, not in children, but in grown men, who had found themselves trapped inside one of the most vicious and devouring habitats ever constructed—the Nazi concentration camps. Symptom by symptom, Bettelheim matched the ways he saw men break down at Dachau and Buchenwald with autistic behaviors in youngsters. Children with autism often avoid eye contact? He had seen it before. “This is essentially the same phenomenon as the prisoner’s averted gaze,” he explained. “Both behaviors result from the conviction that it is not safe to let others see one observing.” He had also seen prisoners fall into the paralys
is of daydreaming. This, he knew, “was a close parallel to the self-stimulation of autistic children, as in their repetitive twiddling.”
And on it went. Prisoners given to memorizing lists of names or dates to maintain their sanity were like autistic children who compulsively memorize train timetables. Inmates who clung to the hope of returning to the world that existed before their lives were destroyed evoked the autistic child’s need for sameness. And so forth.
The behaviors matched up, perhaps, for readers who had no personal experience of autism and found Bettelheim’s analogies intriguing. There was also the satisfaction of feeling privy to something esoteric. Above all, readers felt they had learned a brutal but necessary truth: Mothers cause their children’s autism. This was, after all, the logical extension of his argument linking autism and the camps. If it was the Nazis who crushed the spirit of those grown men, then it was mothers who broke their children. The analogy was complete: Mothers as camp guards. Mothers as Nazis.
Bettelheim was aware of how harsh his indictment sounded. In the years to come he would take pains to point out that he never once called mothers Nazis. That was a distortion put forward by unfriendly critics, he said, repeated by people who had never actually read his book. For that matter, he personally never invoked the term “refrigerator mother,” though this coinage would be attributed to him often.
Indeed, while Bettelheim became the most eloquent mother blamer, he could always argue, truthfully, that he was not the first. That distinction belonged to the expert quoted in Time back in 1948—years before Bettelheim became involved—the one who described children who “never defrost.” It was then that the refrigerator-mother metaphor was born, and its author was a man whose respectability, and whose standing in child psychiatry, was unquestioned. That man was Leo Kanner.