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Monday, January 22, 2018

Autism, France, and Psychoanalysis

In The Politics of Autism, I describe the need for comparative perspectives on the issue. In The Independent, Marta Zaraska writes:
France lags about four decades behind countries such as the United States and the United Kingdom when it comes to diagnosing and treating autism, says Danièle Langloys, president of the advocacy group Autisme France. ... One 2015 study pegs the prevalence of autism in France at 0.36 per cent, well below the 1 per cent reported in the UK and roughly 2.5 per cent reported in the US. Among children who are diagnosed with autism, only about one in five attends a mainstream school.
The French government has been taking small remedial steps but huge problems remain. Psychoanalysis dominates psychological treatment in France, but it does not work for autism.
Psychoanalysis is a “dictatorship of thought” in France that, over the past 40 years, has become part of the national culture, Langloys says. In the 1950s, there were only about 150 psychoanalysts in France, compared with thousands in the US. By the early 21st century, though, the number in France had soared to about 10,000 – with a sharp increase during the late 1960s connected to a rise in anti-establishment politics.


In a 2012 survey of 1,000 French adults, 22 per cent claimed that some kinds of parent-child interactions can cause autism, and another 23 per cent said the condition can result from stressful life events. These disproven ideas are also common among psychoanalysts in France. “There are still groups that resist scientific information on autism and who continue saying that with a developmental and behavioural approach, you are doing ‘dressage’ of children,” or training them like horses, Rogé says. “They say [psychoanalysis] is a very humanist, flexible model, but I think it resembles more a sect, a religion, because it is based on faith and not on scientific facts.”
 In 2011, a large, systematic meta-analysis of early interventions for autism found no evidence supporting a psychoanalytic approach for the condition. Yet if French parents oppose it, they can face dire consequences, including the forced removal of their children to institutions or foster homes. Langloys says social workers can label a family as troublesome just for seeking out a second opinion. “Social workers know nothing but psychoanalysis, so for them the mother is always too fused or too cold,” she says. To them, she says, “it’s normal to take away her children.” Her association has counted several hundred cases of children being separated from their parents in the past 15 years. In 2014, Autisme France began offering its members access to legal aid services to help families facing court proceedings to remove their children