The drama now playing out at Loyola hospital in Chicago, as detailed in Contributing Editor Lisa Goes' superb reporting for Age of Autism, is a stark case in point of what so many autism families face -- and so many more will -- as this epidemic unfolds. Uncomprehending doctors, a community not yet organized to intervene effectively, profoundly disabled young men no longer suited for cutesy ad campaigns, a media scared away by their reluctance to challenge medical authorities ... all can be seen in this sad saga.
But another part of the story is as old as autism itself: blaming mom.
The fact the hospital seems to be treating her as trouble is par for the course. But I've been quite surprised and a little disappointed by the feedback in our community that there is something wrong with this picture, namely, the mom. Why is she letting Alex languish with no treatment? Why hasn't she tried biomed, if she hasn't? Who is she taking advice from, and if it's not the right advice, why doesn't she get better advice? Why is she going public when maybe a more discrete and decorous handling of the matter might have been better for Alex? (An answer from a fellow AOA editor: "That's probably right about the bulk of the situations from a practical perspective. But this crap goes on all the time. And sometimes we need to put a spotlight on it.")
All this reminds me of a sarcastic comment my father, a Roosevelt Democrat, made to lampoon criticism of the poor by the privileged: "If they don't like living in the ghetto, why don't they just move?" I'm half expecting someone to tell me that, Psssstttt, the mom was turned down for the Junior League because, well, she's just not our kind of girl, don't you know?
I feel a little like Hillary Clinton testifying to Congress, waving her arms in exasperation and saying (about Benghazi): "What difference at this point does it make?" The evidence, visual, eyewitness, documentary, is overwhelming that this child's medical needs are not being properly addressed. What more at this point do we need?
Blaming mom, of course, is the oldest trick in the autism playbook, perfected by Bruno Bettelheim (in Chicago, where Alex now languishes), who said infants retreated into the "empty fortress" of autism because they correctly deduced their mother's homicidal wish for them to be dead.
Brian Deer deceived and savaged the Lancet 12 moms, suggesting they were in it for the money, Andy's willing dupes, and Munchausen-by-proxy head cases. Theresa Cedillo, in the Omnibus rulings, was portrayed as the gullible tool of money-grubbing lawyers, a parent so inattentive she missed the earlier signs (earlier than the MMR! far far earlier!) that her child was descending into autism, and couldn't keep her chronology straight.
But this has all come from the other side. Here's hoping we don't pick up their bad habits.
What to make of the new study that shows kids with autism have a considerable risk of suicide? The key finding for our community -- the community that believes autism is an environmental illness and biomedical treatments can help -- may be that in children with autism whose parents considered them depressed, 77 percent had considered or attempted suicide, according to the Fox News account.
Kids with autism who weren't subject to mood disorders were very unlikely to have done so.
So poor mental health, not autism per se, is the risk. Of course, autism as presently treated by mainstream medicine (see Alex, above) is a risk for mental health "co-morbidities," given the lack of support and the tendency to pour toxic psychotropic drugs into kids with unexamined medical conditions (ditto). Many, many kids with autism have problems from GI issues to food and skin and sensory sensitivities that would depress any human being, however neurotypical.
Yet the hospital tells Alex's mother: "We have to heal the mind first and then the mind is going to heal the body."
What's more -- to my mind, anyway -- autism makes people prone to psychiatric issues because the causative factor in many cases -- exposure to organic mercury through vaccines and the environment -- also causes depression, irrational anger, and suicidal thinking directly. It's a vicious circle, and the failure to understand it is a catastrophic mistake we can trace back to the very beginnings of psychiatry.
In 1900, in Vienna, Austria, an 18-year-old named Ida Bauer wrote a suicide note that would help shape modern psychiatry.
"One day her parents were thrown into a state of great alarm by finding on the girl's writing desk, or inside it, a letter in which she took leave of them because, as she said, she could no longer endure her life." The father was understandably shaken; soon after that, she fainted during an argument, and he decided to take her to a doctor named Sigmund Freud.
Those are Freud's words, in fact, describing how the young woman he named "Dora" came to see him. Over three months of applying "the talking cure" to what he diagnosed as her hysteria, Freud refined and expanded some of his key concepts. After "Dora,'" writes Freud biographer Peter Gay, "psychoanalytic technique was never the same."
I've been thinking of Dora recently as the issue of suicide has come to the fore in the media, seeming to crescendo day after day and week after week, from the intractable suicide rate in soldiers and veterans, to the deaths of the nurse who answered the prank call when Kate Middleton was sick, to a seasoned Delta force commander in Afghanistan, to Aaron Swartz, one of our best and brightest tech kids.
Lately, murder-suicides have been at the top of the news, although the horror of killing others often overwhelms the obvious truth that the perpretator was willing, frequently wanting, to die along with those he took first; they're murder-suicides, too. The phrase "suicide by cop" has become common parlance.
Yet nobody wants to die; nobody in their right mind, nobody with a reasonable hope of extrication from even the most excruciating circumstances. When you get right down to the particulars, being alive is so inarguably better than being dead that whenever we hear a rationalization for the latter -- whether meeting 40 virgins in heaven or mitigating the pain of a romantic failure or business catastrophe -- we dismiss it as grotesquely unworthy of the gesture. We're biased, of course. We choose to be here now. But this is a bias built into humanity by long experience of the consequences on those left behind and the wisdom that, despite how dire things are, they must pass. The alternative is literally unthinkable.
Religions, the traditional expression of collective wisdom, know this and find their own way to counsel against self-sacrifice. In Catholicism it's a sin; in Buddhism it's an unskillful way of leaving unfinished karma that you'll just have to expiate in the next lifetime (so why not wrap it up this time around and get a fresh start?). In our culture, we say "let the dead bury the dead" -- let go of them and keep living, to be blunt -- and in Japan they grieve the departed for a brisk 45 days, then let them move on (except when the ancestors come back to the mountaintops for four days once a year, a custom we would do well to adopt).
What is too often overlooked is the role of the environment -- in the sense of biological assaults on the physical body that can weaken the mind and its judgment, as well as the body and its strength.
As Mark Blaxill and I wrote in The Age of Autism -- Mercury, Medicine, and a Man-made Epidemic, we believe that was the case with Dora, perhaps the prototypical suicidal psychiatric patient. As we looked more deeply into the circumstances surrounding her arrival in Freud's office, we encountered something we never expected.
Dora, we believe -- along with a critical mass of other early Freud case studies -- was actually made physically and mentally ill not by her family drama but by her involvement with her father's illness. He had syphilis and was starting to show the symptoms of its worst outcome, general paralysis of the insane, at the same time Dora had her first symptoms.
These symptoms, as we show, were as much physical as mental, entirely consistent with poisoning from the mercury rubs that were then the prime treatment for syphilis. ("In some of these illnesses," Freud wrote of father and daughter, "he would allow no one but her to discharge the lighter duties of nursing.") Freud, in fact, had prescribed "energetic" anti-syphilis treatment to her father at the time of Dora's first major symptoms -- migraines, sporadic inability to speak, piercing gastric pains, a persistent cough, a dragging foot, depression, fatigue ... suicidal thinking. This child was physically sick; it is tempting to say that only a psychiatrist of Sigmund Freud's caliber wouldn't see it.
Compounding his blindness, Freud even noted that the majority of his most severe hysteria patients had fathers with syphilis. And a lot of the rest were professional nurses just as mercuric chloride came into universal use as an antiseptic.
We found clues to mercury poisoning as a probable factor in several more of Freud's key patients, enough for us to question whether Freud's theories of "psychogenic" illness -- induced by repressed emotional conflicts and trauma, especially from childhood -- were actually rooted in misdiagnosis of physical illnesses that needed treatment, not talk. Before you guffaw too loudly, please check out "Chapter 2: The Age of Hysteria", in our book.
But back to 2013. With our discoveries about mercury and hysteria in mind, I've become more cautious, and at the same time more curious, about what triggers any individual mental illness, or subsequent suicide. Yes, genetic predisposition to depression, mania, or other mental illnesses are often undeniable factors; true, a tumultuous life can exacerbate that; of course, lack of social support, real or imagined, may leave a person feeling they have no exit but to exit.
Yet, to borrow a phrase, while all that loads the gun, we need to realize the environment in the broader sense I'm talking about may pull the trigger in far more cases than generally understood or acknowledged. I'm calling this lack of understanding "the hysteria hangover" -- the general inability to grasp the role of environmental triggers in mental illness and its most dire outcomes, harm to self and others.
It starts with failing to understand that a good many "mental problems" are the body and the mind in biomedical crisis. Bad food, bad chemicals, bad medicines can all play a role, whether the purveyors of those compounds want to admit it or not (not). The denial and suppression leads to useless discussions like whether Adam Lanza focus had Asperger's or was off his meds (whatever they were), rather than whether being on those meds in the first place was a trigger, and why he "needed" to be on them in the first place.
Even Aaron Swartz -- seemingly an obvious case of a young man facing prison time and choosing suicide -- is not clearcut, a topic I'll take up next week..
We are not going to stop every suicide. But we could look a lot harder at perhaps the most malleable factors -- toxins, medicines, socially sanctioned addictions.
It is not surprising -- and it is very encouraging -- that some within our community are starting to broaden their reach to this topic. The psychiatric community would do all of us a favor by welcoming the help, and getting past its hysteria hangover.
It was not, Dr. Freud, all in Dora's head. Nor in Alex's, nor his mother's.
Dan Olmsted is Editor of Age of Autism.