Affinity Therapy: The Return of a Psychodynamic Approach to the Treatment of Autism

by J.C. Maleval [1]

Affinity therapy, implemented in the case of Owen Suskind [2], brings new life to the care given to autistic individuals, dominated as it is today by the recommendations and advice of more traditional learning methods. Adherents to the latter have noted that autistic individuals are often attached to that which they refer to as “obsessions.” Some advocate fighting against these obsessions as they are viewed as obstacles to the learning process. Others teach that they should be tolerated, but only as compensation for reinforcing socially appropriate behavior. They are nevertheless given a derogatory term (“obsessions”) and viewed as a disorder. But certain clinicians have begun to use more positive terms to characterize the same condition: special interests or isolated competence; yet they do not cease to consider these “obsessions” as bizarre behaviors characteristic of the autistic syndrome. A radical leap occurred in 2013 in the United States with the emergence of a new name for them: “affinities.” It uses a more positive approach by detaching any connotation of disability from the autistic individual while also using a term not associated with psychiatry. It encourages the point of view that autistic individuals, like a lot of non-autistic people, often have passions and that these passions can be used as a therapeutic tool.

The idea is not new: for nearly 20 years, several high-functioning autistic individuals have shown that their own social integration occurred by focusing on their special interests. So why did the term “affinity therapy” emerged as a treatment method for autism in the work of an American therapist in 2013? Among the several reasons, two seem the most prominent: firstly, there has been a social change in the way autism is viewed in society, and secondly, there has been an evolution in treatment methods. The astonishing increase in the prevalence of autism as well as the mass diffusion of autobiographies of high-functioning autistics contribute to a rise of a new understanding of autism, no longer regarded as a serious mental disability, but rather as “another form of intelligence” (L. Mottron), or as a different mode of subjective functioning. On the other hand, the evolution of the major teaching methods used to improve the cognitive performance of the autistic individual stresses the importance of the individual’s affective life. Affinity Therapy finds itself at the tail end of this of progression.

The earliest forms of ABA—Applied Behavioral Analysis—originated in Los Angeles with the work of Igor Lovaas in the 1970s, even though the description of the original experiment would not be published until 1987 [3]. Like the methodical hypothesis of behavioralism, it views the mind as a black box that no attempt should be made to open so that it remains at the “ground zero” of the understanding of autism’s psychology: no cognition, emotions, or impulses are taken into account. The method only seeks to modify behaviors by applying learning techniques supposedly inherent to all human beings. “This pedagogical process is applicable to all ages and to all populations […] It is simply a good teaching method.” [4] Such a tragic dead-end for techniques in understanding cognition provokes some critics to attempt to open the black box.

In the 1970s, the TEACCH method was introduced in North Carolina by Schopler and Reichler. It proposed teaching strategies adapted to the autistic subject’s specific functioning. The lesson is structured around careful planning, on a concise installation of different stages, and by a detailed breakdown of tasks. But while listening to the cognitive singularities of autistic subjects and having trouble completely separating affects, teachers who use this method are sometimes led to ask the subject questions about his or her affective life, so that in the end, they become less insistent upon the need to cut the child off from his autistic object or from his or her behaviors of immutability. Unlike proponents of the ABA method, one supporter of the TEACCH method states that autistic subjects need their “stereotypy” and that they are entitled to them. [5] Nevertheless, the method only arouses the affects in favor of award-punishment techniques used to reinforce or inhibit certain behaviors.

The developmental program in Denver offers an extra advantage. Initially created in 1981 at the University of Colorado, it brings together educational and behavioral elements and is addressed to children of 2-6 years of age. It posits that games are the first support in the acquisition of social, emotional, communicative, and cognitive competence during early childhood. Eliciting warm, emotional, and playful interactions are at the heart of task at hand, and the adult’s role and the objectives of the games vary in connection to the learning targets. [6] The child’s motivation to engage in the learning process is crucial to this approach: if the child refuses the proposed task, another is offered to him. Like the previous two, this method privileges the technical knowledge of the teacher, and the circumstances remain predetermined: they do not leave room for the unexpected, for the subject’s capacity to invent nor for the potential development of any special interests. The program in Denver attempts to consider the affective life of the autistic subject, but it only takes into consideration its patients’ conscious motivations and uses them as a means to an end.

The three principle treatment methods for autism appeared in the same period, a time when dominant opinion in the U.S. began to consider autism as more relevant to special education than to psychiatry and at a time when its psychoanalytic dimension was being replaced by cognitive scientific models. In other words, a rupture occurred between the psychodynamic models of autism in the 1980s that forced scientists to leave behind the affective lives and the unconscious drives of autistic subjects.

It would be another thirty years before these elements would return with the emergence of Affinity Therapy, which goes further than seeking its dynamic in conscious motivations. It is considerable in its capacity to base itself entirely on the passions, which sometimes impose themselves with such force upon the subject that they are often beyond his or her control. Consequently, Affinity Therapy opens a disturbing psychic dimension where the subject is not entirely the master of him or herself.

Affinity Therapy also breaks away from recommended learning models through its ability to shift the dynamic of knowledge. In this form of therapy, the dynamic is no longer to the teacher’s advantage: it moves to the side of the autistic subject. It no longer seeks to perfect the transmission of knowledge, but rather to build on the knowledge that the subject has already acquired himself, which it then strives to develop. This form of knowledge is not found in any manual; it is only the subject who chooses it.

By taking into account these irrepressible passions, by its emphasis on subjective knowledge, and by its adaptation to the child’s own sense of temporality, Affinity Therapy ceases to be a teaching method. It constitutes a definite return to a psychodynamic model. Today, it is acceptable perhaps because it was discovered by a renowned journalist, Ron Suskind, and by a psychologist, Dan Griffin, neither of which sought to produce a theory from their discovery. They were careful enough to place it back in the hands of scientists in charge of the testing of its validity, even going so far as to connect it to cerebral plasticity. The latter posed no risk for the resurgence of a psychodynamic dimension. It appears that it does have one unfortunate flaw, however: that of resisting even the most perfected brain scans, so that it cannot easily achieve scientific legitimacy, according to dominant scientific discourses.

In addition to the limits faced by pedagogical approaches in the treatment of autistic subjects, of which even the best results—measured with favorable instruments—attest to more failures than to successes; in addition to the prudence of Affinity Therapy’s inventors to a conceptual approach to their discovery, what are the necessary conditions for a return of a psychodynamic approach to the forefront?

To answer this question, one must return to Suskind’s story of his son’s escape from autistic isolation and to other similar testimonies that are also recently gaining popularity in Anglophone media: that of Julia Romp and the passionate attachment of her son, George, to their cat, Ben, or that of Kristine Barnett who chose to explore the diverse affinities of her son, even that of light displacement in space.

George Romp.

In 2010, George’s mother began to recount her son’s incredible break from autistic confinement. They lived in London, so that even before his tenth birthday, George had already had the chance to see several specialists. They had put out immense efforts to help him, asserts his mother, but, she says, “it was Ben and no one else who would change his life forever.” When he met Ben, during the summer of 2006, Ben was an abandoned cat in a sick and pitiful. It was without a doubt this heartbreaking state that constituted one of the reasons that such a surprising encounter occurred between them. Before Ben, George had a rabbit, but the rabbit did not hold his interest for very long. So why were things different with the cat? According to George, remarks his mother, “the world was divided into two parts: on one side, there were those who acted strangely and who were responsible for problems that they blamed him for, and on the other those who needed help.” [7] Such a division of the world is frequent for autistic children: beyond a certain limit, the world is incomprehensible chaos; but within it, they maneuver a reassuring world regulated by strict rules. The immutability of their immediate environment is a way to deal with the chaos of the exterior world. In the world controlled by George, there were people who needed him: himself, of course, but also his mother who did not work and who lived on social aid, as well as his only friend, Lewis, a disabled child. George, recalls his mother, was attracted to every being who he thought needed his help.

A disabled cat did not worry George: this peculiarity only guaranteed its entrance into George’s world. When his mother began to wonder why her son, usually so indifferent, had suddenly developed this new infatuation, she came up with a hypothesis: “maybe he knew that this sad orphaned animal would have trouble finding his place in this world, a little like himself.” [8] Ben was so much like George that he was particularly apt to take the place of his double. The cat was not worrying to the autistic subject as long as he was predictable and controllable; Ben and George developed a relationship qualified as “perfectly harmonious.” Not only did they play together, at hide-and-seek and on the trampoline, but Ben followed his master everywhere when the child was not at school; he accepted everything about Ben, even when the latter pulled his tail or thumped his ears. Ben had definitely found his place in George’s secured world, even to the point of being integrated into George’s rituals. He “seemed to have understood how important routines were for George,” writes his mother, “and he assimilated them as soon as he arrived to our home.” [9] The child and the cat got along so well that each imitated the other in the range of his own capacities: the cat played children’s games while George pretended to be a cat.

The remarkable nature of this relationship was further confirmed when George began to make Ben “talk” using his own voice, lending him his own ideas as well. In order to communicate with Ben, George created a new process for voice retention: he only spoke to Ben with a voice not his own. He spoke to Ben, remarks his mother, with “a soft voice, singing and high-pitched that I had never heard from him before. It is the same tone one uses for children and babies, overflowing with affection, cooing with tenderness.” [10] George and his mother gave this form of “mommy talk” or “baby talk” a name: “cat talk.” It did not make the child anxious, because, if he gave it a voice, it was not his real voice, only that of a substitute voice—a cat’s—that was engaged. Nothing stood in the way of his willful use of it. The voice allowed him to talk easily, something he had not been able to do before. “When George talked to Ben,” observes his mother, “he resembled a Walt Disney character. His little high-pitched voice was soft and loving; it was a special voice just for Ben. I quickly understood that the cat’s presence incited him to speak: he told me where he found Ben, what he is doing, what he wanted to eat or drink…” Not only did his capacity for speech develop with his use of “cat talk”; he also began to speak to others as well while using his cat: first with his mother, then with a few relatives such as his grandmother and his uncles, who agreed to respond using the same tone. A lot of educators inspired by classical learning methods would certainly discourage this abnormal behavior. Was it a caprice that risked isolating him from children of his own age? Intuitively, Romp was clever enough to not only support her child, but also to work with his inventions. “Soon,” she relates, “I began to respond using the same tone to encourage him. I didn’t know really where our cat voices came from nor what they signified, but I wanted to put myself in his shoes because I had understood for a long time that I needed to adapt to George’s way of communicating, whatever it was.” [11] In opposition to popular methods of autism treatment that seek to adapt the child to his or her environment, Romp realized that she got better results more easily with her son by adapting to him. She quickly observed that this way of altering his voice allowed George to progress rapidly in his capacity for verbal expression. From then on, she never hesitated to adopt it: “George and I,” she writes, “used our “cat talk” everywhere and without hiding ourselves. This language allowed us to communicate joyfully, to have fun, to better understand each other in all circumstances, reasons for which Mother, Boy, Nob or Tor [his uncles] heard us speaking this way each time they came by. Instead of asking me if I had gone crazy, they began to imitate us after seeing George so at ease. […] None of us knew why this “cat talk” was so efficient, but we were definitely forced to see that it helped George say things that he had not been able to express before this point.” [12] The cat-talk permitted him to shield his own voice, so that it became reassuring and fun. “It excites me,” confirms George. This form of expression did not make him afraid that he would lose a part of himself when he spoke. [13] This “cat talk” made contact with George possible because he “began to ask questions – and to listen to responds – that he had not done prior to this point.” [14]

These “dialogues” with the cat, to which he lent his own thoughts, often yielded moments of self-reflection upon his own behavior. “You are too rough,” he said to Ben. “And you are behind in school. You don’t talk to people, you don’t like them, you aren’t social.” [15] His mother was well aware that these monologues with the cat helped him to explain his life to himself and allowed him to express and, thus, calm his anxieties. It was even possible to get George to abide by certain social rules by passing through “cat speak.” George’s mother had been disappointed that he had not acquired the etiquette rules that she had tried to explain to him several times; luckily, though, she discovered that she could go through Ben to teach them to him.

“Ben doesn’t like that,” she said one day to George after he burped during a meal.

“His face showed no reaction, and he remained silent for several seconds before asking me:

“Are you sure?”

“Yes.”

“Why?”

“Because he finds it impolite and Ben doesn’t like impolite people.”

“Really?”

“Yes. Ben is a very polite cat. He does not like burps.”

George added nothing, but a little while after this conversation, he began to leave the room running to get a piece of toilet paper each time he needed to burp. He placed the paper over his mouth, and we only heard a smothered sound. […] After having admitted that Ben is a polite cat, he told everyone who accidentally burped in front of him that it wasn’t good.

“Ben doesn’t like that,” he would say very seriously. “He finds it very impolite.” [16]

The importance of the cat’s role in the child’s improvement was confirmed by its disappearance. George fell back into his old autistic isolation: his “center” extinguished; his libidinal dynamic no longer functioned, and the solitude became once again his principle form of protection against an exterior world that was worrying and painful. He no longer wanted to do anything. He didn’t play anymore. He began to lose himself again in the labyrinth of compulsive behavior: sitting on his bed with his collection of bright objects, indefinitely and compulsively rearranging them. Other parts of his isolation reappeared as well: he refused to continue using the “cat talk,” and felt no one would ever love him again. “He was only a shadow of himself,” comments his mother, “and I had the devastating sensation that it was life itself that my child was renouncing.” [17] The loss of his dynamic double, the receiving end of his energy, left him distraught and prey to a veritable libidinal hemorrhage. But they were lucky enough to find the cat three months later, which allowed George to leave once more his isolation; he became energetic again and could continue to make progress.

Romp is a housewife who quit school at 16 years old. She does not attempt to draw any conclusions from her experience; she stops at sharing it. She hardly expresses her opinion on the management of autistic patients. She confesses that she does not always agree with the “experts decked out in diplomas,” especially when they prescribed her child a medication whose effects proved to be worse than the symptoms of the disorder, [18] an experience she still doesn’t hold against them. If there were a lesson to take from her experience, it would be to listen instead to intuition, only accessible, she maintains, through a mother’s love. [19] It is the latter that led her to bet her chances on the cat Ben and on “cat talk.” Romp doesn’t have the audacity to encourage the scientists who are beginning to explore again animal mediation in the treatment of autistic subjects. Her experience is not enough to raise suspicion around the non-reproducible testimonies, incapable of being reduced to statistics. Temple Grandin maintains that “researchers must stop being suspicious of testimonies,” [20] because despite their international audience, in the actual epistemological context of clinical rejection and its psychodynamic approaches, they have few chances to be heard. For autism specialists, Romp’s experience, rarely quoted, remains a clinical curiosity. Her abstinence from theory has allowed her to cross the barrier into Anglophone media, yet no one has emphasized the fact that, in the available material on treatment methods for autism, there is decline in the usage of learning methods, validated by statistical studies done by cohorts, suggesting a return to a psychodynamic approach relying on the knowledge and the affinities unique to each autistic child.

Julia Romp’s testimony cannot be accounted for by the patented experts of autism: it doesn’t fit into the rigid framework of contemporary science. Yet it is not an isolated curiosity: other similar testimonies have also emerged. In 2013, Jayne Dillon published Jessi-cat: The Cat That Unlocked a Boy’s Heart, [21] and in 2014, Louise Booth published When Fraser Met Billy: How the Love of a Cat Transformed My Little Boy’s Life. [22] There is no doubt that others will emerge. How many will emerge before the scientific community will take them into consideration? It is, in fact, their methodological impurity that condemns them to remain isolated cases, handed down aimlessly without ever summoning a significant change. Even if there were one hundred similar cases, it would still only be one hundred times the reiteration of a non-convincing experience. But the cats are only one of the possible incarnations of affinities that autistic subjects use to open themselves up to the world around them, most importantly by their own initiative. Numerous are the parents who have testified to this, all in diverse ways. The scientific community cannot account for the parents of autistic children who are trying to make these ever multiplying stories heard in order to advocate their belief that the affinities of their children should be the main focus of their treatment methods.

Jake Barnett.

The story of Barnett’s son, Jake, presents another perspective on the empirical return of the psychodynamic approach to the treatment of autism. Although published after the emergence of Romp’s testimony in 2013, it still presents several important similarities to it.

At three years old, Jake was isolated in a secret and silent world. He was soon diagnosed as autistic. His autistic object of choice was his brightly colored alphabet cards, and, according to his mother, he loved more than anything else in the world. They had to be pried from his hands just to put on his t-shirt, and he even would keep them with him in bed when he went to sleep at night. Even when he got to school the next morning, his mother never tried to take them from him. She hoped that their continual presence would help him learn the letters of the alphabet. Yet autism treatment specialists maintained that such use of autistic objects only served to autostimulate the child, creating obstacles to learning. During a monthly visit with a specialist overseeing a program for the development of the autistic individual’s daily life skills, the specialist implied not only her disapproval of Jake’s mother’s permissive attitude, but also the utter inutility of teaching her son the letters of the alphabet. “That which she tried to make me understand,” she says, “is that we wouldn’t need to teach him the alphabet because he would never learn to read.” [23] Some time later the specialist gently but firmly asked his mother “to stop sending Jake to school with his alphabet cards.” [24] Barnett is proof of an extraordinary courage and determination in her decision to go against the autism specialist’s opinion. “For a parent,” she writes, “it is terrifying to be suspicious of professional advice, but I knew in the bottom of my heart that if Jake stayed in a specialized program, he would sink back down […] so I took the most terrifying decision of my life. This meant going against the opinion of the specialists, and even against that of my husband, Michael. That day, I resolved to nourish Jake’s passion. Maybe he had tried to learn to read, maybe not. Whatever the case, rather than take them away, I made sure that he would have them at his disposition as much as he wanted.” [25] She adopted the practice of deliberately supporting and developing his interests—a practice she continued resolutely for several years with a brilliant success. Her son learned to read on his own, and his acquisitions proved to be spectacular. Barnett became accustomed to Jake’s spontaneous functioning, but she still respected his need to escape from time to time. She did not even protest to his interest in the colorful wool strings which caused havoc in the family kitchen. Through tolerance, she allowed him to develop that which turned out to be his “first love”: light displacement in space. [26] She noted that Jake’s concentration improved and that he was more accepting of the exercises when his special interests were taken into account. She also discovered that the cognition of an autistic individual was not independent to his affective life, so that to assuage anxiety improved the learning process. She also realized that her approach “was light years from the classical method. Most educators,” she says, “had the tendency to take away a favorite toy or a puzzle from the table so that the child could concentrate on the objectives of their therapy. Some went so far as to hide them.” But she had sat through countless sessions during which her child was too distracted by the removal of one of his autistic objects to make the least amount of progress. [27] She learned something else, too: she learned to not concentrate on his weaknesses—which often happened in a lot of learning method-based sessions—but to exploit his interests and his passions.

Jake is certainly an exception: at 10 years old, he obtained a 170 on the Weschler test. Those who receive more than a 125 are already considered “exceptionally gifted.” His stunning capacities for memorization, similar to those of Tammet, or those of Cherechevski, [28] Luria’s mnemonist, as well as his thirst for knowledge and his mathematic skills, have allowed him to become the youngest astrophysics researcher in the world. His talents, though, would have perhaps withered in an institution for children with learning disabilities if his mother had not gambled on supporting his extraordinary skills.

One could certainly object that Barnett’s method would only work for an exceptionally gifted autistic, even though some specialists assumed that her child would never learn to read. The future of an autistic, some say, is neither foreseeable nor independent of his environment: “It is troubling to observe,” notes Grandin, “that it is almost impossible to predict if the young autistic will be at a high level or not. The severity of symptoms toward two or three years old is often without a connection to the prognostic.” [29] She was also closed off in her early childhood: she could not speak, often seemed deaf, refused physical contact, had violent outbursts, drew on the walls, played with her excrement, etc. [30]It is often the case that certain children exhibiting a severe form of autism become high-functioning autistics later in life. On the other hand, however, everything seems to suggest that the capacities of certain autistic children are almost always suffocated by the strong-arm of normative education.

Barnett proves to be even more courageous than Romp when it comes to the consequences of her testimony: she asserts that there are certainly general lessons to be taken from it. First, she is not reluctant to criticize certain learning methods when they block the development of the subject’s special interests. Second, she knew that some institutions would have something to draw from her experience: she created Little Light, a nursery school where children—autistic or non-autistic—could come to develop their specific interests. That one must “kindle the natural spark of a child” is that which Barnett does not hesitate to advocate. “To celebrate the interests of children,” she concludes, “rather than redirecting them, especially when those interests don’t correspond exactly to the list of elements leading to success, can look like a leap into an abyss. It is in any case the impression that I had. But confidence is necessary if one wants our children to learn to fly.” [31]

Her testimony has seen a fair amount of media success. She says that scientists were interested in it, but that that which caught their attention was not exactly what she had hoped: for example, one specialist wanted to use the exceptional cognitive capacities of a math genius for his study “on the genetic base shared by prodigies and by autistic individuals.” [32] Barnett’s criticisms of available autistic therapy models, her plea for the active support of their affinities through methods that would focus on them and her desire to see a return to a psychodynamic approach all remain illegitimate demands for scientific research in which the eradication of the psychic dimension is considered a prerequisite to all “rigorous” forms of study.

Romp and Barnett remain moderate in their criticisms of current autistic therapy options. The latter has tried to create a space in which the affinities of disabled children are validated; but the two mothers still don’t strive to conceptualize their experiences and are not really attempting to make themselves heard by the scientific community.

Suskind’s project is different. He observed the same phenomenon as Romp and Barnett: the importance of “show[ing] a child,” as the latter says, “that we take his interest seriously, and that we want to share it with him is the most powerful catalyst in the world.” [33] Suskind is a journalist for The New York Times; he has published several works, and he won the Pulitzer Prize in 1995. His book, which tells the story of the end of his son’s autistic isolation, Life, animated [34] was published in 2014 in California and has gathered a substantial media following. Perhaps most importantly, however, is the fact that Suskind, with the help of therapist, Dan Griffin, did not hesitate to promote a new concept for the treatment of autistic children: Affinity Therapy.

Owen Suskind.

His son, Owen, was walled in silence not long after his third birthday. He was given a diagnostic of regressive autism. His main activity consisted of watching Disney films; first with his brother, then alone. He rewound and rewatched certain scenes over and over again. In fact, there were endless streams of rewinds. He seemed content and absorbed in them. Should they let him continue? His parents asked specialists who would give them a more or less measured response: “keep it limited.”

In November 1994, while he watched Walt Disney’s “The Little Mermaid”, the family could hear him insistently murmuring the same unintelligible speech: “juicervose, juicervose.” Noticing that he repeatedly went back to the same scene, his parents eventually understood that he was repeating that which Ursula, the evil sea Witch, demanded of Ariel, the mermaid, in order to transform her into a human being: “just your voice.” A little while later, they tried again to enter into their child’s isolated world. They noticed that the sacrifice of the voice in the movie resembled the silence in which Owen had been isolated since he was three. It is clear that voice retention is common in autistic patients. The voice often seems enigmatic to them and drives them to question its origins in order to grasp the reasons behind their sudden loss of it.

The speech therapist deflated the Suskinds’ enthusiasm by explaining that echolalia is a common phenomenon in children. Several months later, however, at the end of his brother’s ninth birthday party, when his brother began to cry, Owen calmly commented: “Walter does not want to grow up, like Mowgli or Peter Pan.” He had never before articulated such a complex phrase. “It is as if Owen had let us in,” says his father, “for just an instant, to glimpse a mysterious grid growing inside him, a matrix on which he affixed items he saw each day that we might not even notice. And then he carefully aligned it to another one, standing parallel: The world of Disney.” [35]

From that point on, his father created a clever strategy for connecting with him: he spoke to him through a puppet of one of Owen’s favorite characters, Iago, Aladdin’s parrot. Hardly surprisingly, Owen immediately and willingly responded to the questions asked of him under these conditions. “How does it feel to be you!?” asked his father, imitating the parrot’s voice from the films. “I am not happy,” responded Owen. “I don’t have friends. I can’t understand what people say.” His parents continued this process of “staying in character” and went so far as to communicate with their son by using dialogues directly borrowed from Disney films. They began to notice that Owen had learned the English sounds by watching the outrageous impersonations and reactions of cartoon characters in situations in which they found themselves and the manner in which they interacted.

Despite some progress at a private school for children with learning disabilities that he had been attending for five years, the Lab School of Washington, the school decided to let him go: his mind escaped too often into the parallel universe of these films, so that, in the end, to pay attention to his schoolwork was a struggle. His father really tried to make them understand that the films were tools that he used to understand the world around him, but he was still forced to change schools. At eleven years old, he had to reintegrate into Ivymount school for children with more extreme disabilities.

So Owen began to develop his tools discretely in the basement of their home through a drawing activity that consisted of reproducing some of his favorite scenes from the Disney movies. The facial expressions were gripping and often expressed anxiety. In flipping through one of his sketch books, his father was surprised to discover a few poorly scribbled phrases, one that read “I am the Protektor of Sidekicks,” and another that read “No Sidekick Gets Left Behind.” Once again adopting the voices of Disney characters, his parents tried asking him to clarify the significance of these assertions. “What is a sidekick?” asked his mother. “A sidekick,” he responded, “helps the hero fulfill his destiny.” By “sidekick,” he had understood the roles of the supporting characters in the films who accompanied and assisted the hero in his adventures. Owen insisted that he himself was a “sidekick” and that no sidekick gets left behind. His parents had no trouble understanding what he was referring to: “The sidekicks have emerged,” his father comments, “sketch by sketch, in the difficult months since his ejection from Lab. His response has been to embrace it, the pain of it, and to be a protector of the discarded.”

When he was 13 years old, Owen met with a therapist named Dan Griffin who agreed to adhere to the “therapy centered on interest,” or a therapy by affinities, developed by Owen’s parents since their discovery of his affinity for Disney films. His mother took it upon herself to homeschool him using scenarios from Disney as a way to teach him to read and to do mathematics. Griffin had the ingenious idea to encourage Owen’s learning by getting him to protect and to advise a sidekick. He decided to build upon Owen’s remark that “Zazu has a lot to learn”; Zazu, the proud and naïve hornbill charged with protecting Simba in “The Lion King.” He proposed that Owen oversee the education of Zazu. Griffin, who Owen renamed Rafiki, in reference to the wise baboon in “The Lion King,” did not hesitate to sometimes use the baboon’s voice to get Owen listen to him. By using these scenes from Disney, Owen developed the capacity to understand the dynamic of social relations.

During this time, Owen’s academic performance improved, so that by 19 years old, he had graduated from high school. He could explain how he relied on different sidekicks to solve his problems and to calm his fears. By incarnating them and by using their voices, he seemed to have succeeded in assimilating ideas that would have been otherwise inaccessible to him.

At 20 years old, Own had integrated into a university. He organized a Disney Club of which he was president. He also had his first romantic relationship there, in which the comportment of Aladdin and of Jasmine played a major role in helping him to orient himself in this new experience. He began to understand that the sidekicks existed only in his imagination; that the answers that they helped him develop were already within himself. He maintained that, like Quasimodo and his gargoyles, “he had needed to breathe life into them so he could talk to himself. It’s the only way he could find out who he was.”

From the incredible, continual, positive evolution of his son, Suskind insists on the importance of taking the special interests of autistic children seriously. Doing so helps them to feel worthy, he affirms, and “encourages them to show you more of the roadmap and the navigating tools that can help to guide their development, their blossoming.”

Edge Therapy

{{}}Does Disney Therapy constitute an advance for autism therapy? Is it fundamentally different from other types of affinity therapies? At a first glance, several of its characteristics belong to the ordinary autism clinic.

Owen’s first expressed echolalias were borrowed from a film in which the loss of the voice of a mermaid reminded him of his own. The apprenticeship of language by initially echoing the dialogues in films or television shows is rather frequent. “The development of my own everyday language,” professes Donna Williams, who was echolalic until 4 years old, “had an essential base of repetition from things I heard on a cd of fairy tales and from commercials on the television.” [36] The invention of two imaginary friends, Carol and Willie, were crucial for her passage from echolalia to distanced enunciations.

There are several examples of the use of stand-in fictional characters in the overcoming of voice retention. Williams remarks that autistic subjects often develop “substitute personalities” [37] or “masks” [38] to function socially without subjectively implicating themselves. Some use puppets or other objects as support for their voices. The fact that an autistic child such as Owen had to go through imaginary characters in order to develop his own enunciation is not surprising. An imitative adaptation is frequent: even in the absence of her imaginary friends, Williams says that she had to “rely on voices, on facial expressions, and on memorized gests.” [39] But while using these memorized models of expression, she only knew how to do certain things; she had no emotional reaction to them.

If there is an authentic part of Disney Therapy, it is in the innateness of the knowledge found in Owen’s passion: the Disney films lent themselves more easily than other forms of support to language acquisition and to the acquisition of certain social skills. Suskind reports that Walt Disney had explained to his earliest animators that the scenes should be so vivid and clear that they could be understood even with the sound cut. Moreover, it seems that Owen learned to read by attentively watching the credits slowly rolling at the end of each film. His sidekicks were not only “masks,” they were ahead of him: they knew how to behave in society. The Disney scenes brought several examples of social appropriate behavior to Owen.

But it would still be necessary to continue fine-tuning affinity therapy by considering that its efficiency resides in the quality of its pedagogical supports. Certainly, Owen had learned to read by himself thanks to the Disney films; but other autistic children have accomplished similar feats with less-adapted tools. Jake’s mother discovered that her son knew how to read at five years old. She had no idea how he had learned. She wondered if it could be because of Cat in the Hat [40] CD-ROM. But Bo Welch’s film, released in 2003, nominated for “Worst Film” in last year’s Razzie Awards and winner of the category “Worst Excuse for an Actual Movie,” probably doesn’t possess the same qualities as a Disney production. For Birger Sellin, it was by “flipping through” dozens of books that he learned to read around five years old without his parents noticing until he turned 17. [41] His mother highlights the fact that, like a lot of autistic individuals, her son mastered the written language “in passing.” The only common denominator of their diverse learning techniques lies in the exceptional interest developed by these children for objects that feature letters.

The passion for a cat or one for light displacement in space does not exhibit the exact same characteristics as an affinity for Disney films: knowledge is not intrinsic to the object. Yet the extraordinary investment of these very different objects is the principle part of the therapy and of the progress made by George, by Jake, and by Owen. Autistic subjects’ affinities are often much more than pedagogical supports. A specialist, quoted by Suskind, observed just that when he examined Owen’s journey: the most surprising part, he remarks, is not the manner in which he used films for his academic development, but rather the way in which he used them to guide his emotional development. Some would like to conclude that it would suffice to improve the autistic subject’s cognition in order to structure his or her affective life. Everything else, however, indicates that the correlation between the two is weak in praxis. Asperger believes that several were “automatons of intelligence [42],” discerning a separation between intellectual and emotional development, also confirmed by several high functioning autistics. Grandin often compares her way of thinking to that of a computer: “I recently attended,” she reports in 1995, “a conference where a sociologist confirmed that human beings do not speak like computers. The same night, at dinner, I told that sociologist and his friends that my way of thinking resembles the functioning of a computer and that I could explain the process to them, step by step. I was a little troubled when she responded that she was personally incapable of saying how her thoughts and her emotions were connected. When she thought of something, the given objectives and the emotion formed a whole […] In my mind, they are always separated.” [43]

Autistic individuals often cultivate passions at a very young age: the passions are located on an edge whose primary function is to create a protective shell against an exterior world perceived as worrying and incomprehensible. The first priority is to protect themselves from experiencing anxiety, which, as a consequence, more or less creates an impediment to the learning process. This “edge” is initially constructed from the body’s surface and the sensation shapes that it generates; later, it is complexified by becoming integrated into the autistic object, the double and the special interest. By possessing these three, the subject creates a matrix that reassures him and allows him to open up to others under his own terms and conditions. These three elements that make up the edge are more or less interdependent. For Owen, they are clearly interconnected: the Disney films constituted an autistic object very early on; in them, he found the sidekicks that he considered doubles. Finally, the intense memorization of the films permitted him to develop his special interest into a real social competence.

It is possible to make autistic individuals acquire an intellectual knowledge by forced apprenticeships, but such knowledge is rarely internalized if it is not accessed through this edge. Williams strongly emphasizes that the learning methods can modify their behavior, but an integration of change cannot occur without simultaneously mobilizing the affective life. “Some given contexts,” she writes, “allows for a rounding of angles or for the production of robots […] I don’t believe that it is possible to teach autistic individuals experience of all that they could experience. One cannot make them feel emotions for images, for “faces,” for comedies and for their repertoires as if it is a real personal expression. The sentiment inspires action. The inverse comes back to analyze the emotions that a person could feel during an action. One could find the idea of emotion; but it still would not be your own. An idea is not the same as a sentiment, simply the memory or the mental repertoire memorized from its impression. We cannot do everything backwards. Like computer files, we can mentally memorize the interplay of emotions, take them out, interpret them. The game is not yet linked to a real emotion, and one does not necessarily understand the represented emotion, except for the simple mechanism of operation and occasionally from the moment of its imitation.” [44] To deconstruct emotional life into cognitive elements in hopes that it will have an effect on her, according to Williams, is to do things backwards. Emotion is not taught; but perhaps it can be mobilized in passing through the edge: an essential condition for which is subjective learning.

Emotional life and desire only know one law—that of castration—which cannot be assimilated by the intellect, but which is sometimes summoned by the successive losses that span our existences. For the autistic individual, only the complexification of the edge, intensely invested in an autistic object, can sanction a therapy tempered of the trauma of this loss: each creative leap carries the assumed loss from an anterior element. Today, Owen has adopted Judaism and its rituals; here, he is able to invest the same degree of intensity that he once felt for the Disney movies for a new set of passions. This also seems to be a way of substituting the knowledge associated with Disney to that of the Torah [45]; there is no doubt that if he can withstand the loss of the fables of his childhood, he can gain a renewed structure to his emotional life. Williams was aware that it would be necessary to make her imaginary friends disappear in order to progress, and she succeeded in doing so. Grandin resolved much later to abandon her squeeze machine. Barnett’s evolution spans a succession of passions: from shadows to lights; from alphabet cards, colored strings, magnets, maps, numbers, to his exceptional competence for astronomy and astrophysics.

The affinities of autistics possess a common ability to create a space that simultaneously creates a need to be filled. They gravitate regularly toward either the collection of objects or at the accumulation of knowledge. Ben, the cat, was certainly not capable of delivering knowledge, but according to the child’s mother, it was a means of introducing “cat talk,” “a tool the child “used to ask questions and to listen to responses, something he had not been able to do prior to the cat’s presence.” [46] With this, George was able to assimilate certain social rules that had not previously made sense to him, under the condition that they passed first through the supposed opinion of the cat. [47] Thanks to “cat talk,” a certain dynamic was put into place that generated not only learning, but also the calming of his affective life, in which a loving sentiment for his mother could finally find its place.

Most autistic individuals capable of sharing a subjective departure from autistic isolation, not just a superficial social adaptation, describe a journey that follows the complexification of their edges, the focal points of their affinities, produced by mutations or by derivations, and going as far as to achieve its complete erasure. Learning methods and the affective life are brought together for the autistic individual in Edge Therapy.

It is not necessary to have a theory of autism to make the preceding empiric observation; it is suffices to ask high-functioning autistic individuals themselves about their use of their own affinities. “I think,” writes Schovanec, “that special interests are not the enemy, far from it, and that a prohibition, a head-on opposition is not a good solution […] These are not just completely arbitrary caprices. They contribute to the elaboration of the personality, of what we are as humans. In a few years, they could lead to a career. If the young person with autism is passionate about computer programming, he would perhaps become an computer engineer.” [48] Another autistic individual insists: if an interest serves a legitimate purpose, for example, to overcome a fear, or to better accept one’s own difference, “it should be tolerated, even if it is weird or seen as distasteful.” [49] We have seen that Joey became an electrician as an adult: he who, as a child, had constructed via his edge a cardboard electrical machine. Grandin’s passion for her squeeze machine drove her to become a specialist in cattle pens. Like Schovanec, the latter observes: “High-functioning autistic adults who are capable of living autonomously and to keep a stable job often work in the same domain as their childhood obsessions. An autistic child obsessed in his or her childhood by numbers works today in fiscal management […] Autistic children who came out did so by taking their childhood obsessions and redirecting them toward constructive ends. The most successful ones have among them a devoted friend who helped direct their fixations.” [50] From the beginning of his observations on autism, this phenomenon captivated the attention of Hans Asperger: “For the autistic individuals that we have observed,” he writes in 1944, “even more often than with normally functioning people, that some are predestined to a career that seems to emerge during their youth; that this career emerges from their constitutions like a destiny.” He gives the example of a boy, who he observed for 30 years, who exhibited severe autistic behavior, and who, very early, absolutely wanted to do mathematics “to the complete opposition of his teachers’ wishes”: “A little after the beginning of his university studies, he noticed an error in Newton’s calculations: he had chosen theoretical astronomy. His professor advised him to make this error the subject of his dissertation. From the beginning, he knew that he would make a university career for himself. After very little time, he became an assistant in university institution for astronomy and had obtained tenure.” [51] Other autistic patients observed by Asperger have become heraldry specialists, technicians, chemists, government officials, and musicians. He notes that their way of operating a restricted selection of their interests creates an advantage over others who possess a wider range of possibilities but who do not make the choice to specialize.

A specialist in Asperger’s syndrome, Tony Attwood, recommends “extreme prudence in the prohibition of special interests under the guise of punishment, because other strategies could have greater success, and because the special interest should remain a positive aspect of everyday life. To keep someone from having access to one of the rare pleasures of his life will only create problems.” [52] High-functioning autistics are unanimously in support of his opinion. Attwood also suggests that a specific interest for meteorology can lead to a career as a meteorologist; an interest in maps, a job as a taxi driver or a truck driver; a specific interest in other cultures and languages, a job as a tour guide or as a translator [53], etc.

High-functioning autistic and severe critic of the ABA method, Michelle Dawson advocates for the management of autism by the development of “implicit knowledge” and a respect for “strong points.” [54] These essential concepts, emphasizes Eric Laurent, are irreducible “to the explicit behavior and measurables of learning,” which is precisely why Dawson calls for “educational access to knowledge respectful of the autistic subject which allows him to develop his own competence.” [55]

The learning methods advocated by health officials in France are not used with the same rigor extolled elsewhere by its founders because of a lack of the required materials for the creation of proper frameworks and for adequate training. What institution is capable of providing a teacher with a framework for an autistic individual in need of 35 hours per week as recommended by the ABA method? How many professionals are trained well enough to apply the Denver program? How many TEACCH specialists are more inspired by Freinet or Montessori than by Schopler? The criticisms made of these dehumanizing approaches, while misunderstanding the anxiety and the emotional life of autistic individuals, never fail to produce a certain echo, even if it remains distant. As a result, the most common practice in institutions concerned with following the HAS (Haute Autorité de Santé) recommendations is an eclectic mix of diverse influences. The need to combat special interests no longer holds a consensus. Certain caregivers seek to give value to them, so that the dominating formula is often a mix of special interests and psychodynamic methods.

Even so, despite the semi-unanimity of autistic subjects’ self-expression, despite the multiplying number of testimonies, the majority opinion remains reluctant toward methods that advocate a therapy based on special interests. To take Affinity Therapy seriously would mean breaking away from current recommendations which promote learning methods. Furthermore, the fact that affinity therapy constitutes a return to a psychodynamic approach and that it stirs a renewed interest in the study of mental states charged with emotion also creates major obstacles to its full acceptance by the scientific community. Psychodynamic approaches remain rejected today because their conviction relies on case studies that remain unevaluated due to a lack of comparative control groups, so that, in the end, they are never considered scientific enough. The clinical monographs advocated by Jaspers and those produced by Freud are now the object of several criticisms. “Case studies can be misleading, notably when using them as a learning model for all because each case is different.” [56] The social pressure is so prevalent in the Anglophone world that even Grandin herself discredits the incredible use of Affinity Therapy a little in her latest book. She can certainly still advocate “the exploitation of strong points” [57] of autistic individuals, but, without discerning a contradiction, she conforms to current expectations, touting the merits of behavioral approaches discovered by her own mother. She is more pertinent when she denounces those who tried to take her squeeze machine away, even if several psychoanalysts were among the culpable.

Together, the paths taken by George, by Jake and by Owen, like those of Grandin, of Williams or of Dibs [58], and many others, seem to constitute a convincing succession, yet they remain exceptional curiosities and not “true” objects of scientific study for current researchers. According to current scientific discourse, there is no statistical data for experiences so unique. Even if one hundred cases were brought to the lime-light, they would still remain irrelevant to the discourse of contemporary science on autism: irreproducible in the laboratory and incomparable by control groups, these experiences are not useful to percentages; rather they represent a repetition of uniqueness that cannot be combined. They are reduced by an epistemological dictum to small stories only good for holding the attention of psychoanalysts. Yet Suskind has interested certain researchers at Yale, Cambridge, and at MIT (Massachusetts Institute of Technology) with Affinity Therapy. Those interested are neuroscience specialists who are prepared to test it. [59] They envision employing it by using the plays and the favorite films of autistic children as a structure to enrich social interaction. They will also compare it to a control group practicing a type of game therapy also guided by children’s interests. This action would not only reduce Affinity Therapy to a pedagogical support, but to test it on a group is to lose its central essence by ignoring its specificity. It would imply a choice made by the subject, which cannot be controlled and that escapes the child’s wishes. Its prescription does not guarantee its application.

The edge is in principle the major defense that autistics use to transform a wide variety of objects into passions. Animals can also useful. Several relationships have been formed by a subject’s release from his or her autistic isolation thanks to their passionate attachment to an animal. Considering these observations, some researchers become interested in this behavior and launch studies on autistic therapy assisted by animals. They encounter methodological roadblocks in its evaluation, however, because of the weak establishment of control groups, a random allocation of children from similar levels, of the animals adopted, etc. A systematic review of the scientific literature devoted to the subject, begun in 2013, has already announced what the results of the studies on Affinity Therapy will be: encouraging, but mostly in need of further and more extensive, rigorous research. [60] There is no doubt, however, that “rigorous” posterior studies will find that the method obtains remarkable results with certain autistic individuals, but that these can be deceptive for a lot of others. In the end, the findings may not be conclusive: the animal as an “edge” is a statistical exception and the affinities are diverse and changing, so that considered in isolation, these methods cannot reach completely legitimacy in the eyes of science. Perhaps specialists will begin to turn away from it, even going so far as to advise against it. A Universalist approach to scientific discourse loses valor in seeking to establish therapeutic techniques that are backed by a statistical majority. Today, it no longer seeks to validate “the brain exercise,” [61] realizing that the structuring of the subject is more complex. When learning methods don’t focus on positive affectations and on the selected objects, they fail to resonate with the subjective functioning.

Affinity Therapy emerged in an unfavorable context. The disappointing results of works relying upon the categories of DSM that eliminate subjectivity led to emphasize the biologization of research in psychiatry. The return to a psychodynamic approach for autism is still very uncertain. There is a chance that it will develop through integration into the still very minor psychiatric narrative movement. The latter has tried to gain recognition for quite some time by supporting the failure of the scientific model, prevailing since 1980. The movement emphasizes the construction of meaning, in the framework of clinical investigations, without rejecting any of the explicative models of psychiatry. It appeals to those who prove to be the most adequate for the permission of a modification of the comprehension of a patient’s problems. It constitutes a reconstruction of the patient’s past and his issues by opening new strategies for orienting himself in existence. [62] It proposes a framework sufficiently large enough that Affinity Therapy can apparently be integrated into it. In fact, this approach renews the model proposed by Jaspers in 1913 in General Psychopathology founded on the relations of comprehension. Yet the jouissance attached to the passions never ceases to overwhelm its comprehension and its assessment, so that Affinity Therapy represents a core that is impossible to integrate into the psychiatric narrative. It opens up the “inconsistent mirages” [63] in the relation of comprehension; in other words, that which seems wrong when they encounter their limits in an obscure domain where only psychoanalysis can bring some insight. Bringing about this reconciliation cannot facilitate the social diffusion of Affinity Therapy; however it might give us a better understanding of how it works.

For whatever its worth, the multiple convincing testimonies concerning Affinity Therapy do bring us to one major conclusion: that individualization is crucial to autistic therapy. Even a supporter of the most classic cognitive approaches, such as those of Mottron, will agree that it is necessary to halt the use of these methods for treating autistic individuals: “They are packaged scams,” he affirms. He believes that each autistic individual should proceed according to his or her special capacities. He observes as many others have done that it is from the special interests—that which one calls the affinities—that cognitive competence develops. “When we spend enormous amounts of time on something,” he emphasizes, “we spend less time on something else. This has been considered for a long time as a sort of fault for the autistic individual: a lack of generalization, unusable skills, etc. In fact,” he insists, “we have to take it as a fact: that is how autism works.” [64] There is one step left to take, perhaps the most difficult of all: the responsibility of not reducing the autistic individual’s functioning to that of his brain, nor to his cognitive capacities, but rather to his ability to arrive at a realization of his own unique jouissance.