I recently got a comment on one of my blogs.  It was from a staunch supporter of a psychoanalytic approach to autism, an approach which held that autism was caused by trauma in the womb or due to a difficult birth (and could be treated through ‘rebirthing‘ and the debunked 1970s autism treatment of ‘holding therapy‘.  This ‘primal pain’ theory includes the idea that the autistic child has become autistic from things as vast as chemical assaults by smoking and substance abusing mothers, by mothers experiencing mental illness or abuse or other trauma during pregnancy or who feel negativity or indifference about the child they are carrying or were effected by mother’s suffering post natal depression.  He wanted to raise with me the idea that I was actually a “broken normal”.  This is our conversation: Tommi Olanne Says:

I still don’t understand why do you insist you’re not a broken normal. You don’t really know. You only think you know.

Donna Says:

Hi Tommi,

  I understand your theories, the whole psychoanalysis and birth trauma idea, but every case of autism is different. Some people become diagnosed autistic after disintegrative disorder at age 2-3 before which development was usual. Some of these cases were encephalitis, so nothing to do with birth trauma.

There are also those with autism who have been recently found to be the offspring of first cousin marriages in which both strengths and genetic weakening were multiplied resulting in things like gut, immune, metabolic and co-morbid disorders which overwhelm development in the first years. Again, this is genetics and not birth trauma. My father’s mother was the offspring of first cousins who in turn were also the children of first cousins. Diabetes, Coeliac, ADHD, Bipolar, Dyslexia, Social Phobia, Asperger’s and Autism have all been diagnosed on my father’s mother’s side and more recently ASD has been found on his father’s side too. So he brought his own predispositions to the genetics table.

On my mother’s side there was substance abuse and she was certainly dealing with her own major traumas before and after my birth.  It’s possible she may have had untreated post natal depression on top of her existing challenges. So your theory of a child being influenced by a mother’s severe chronic stress and what her own body goes through may well be true for half of my case and there are many children with fetal alcohol effect who have autistic traits and recent research has shown that children breathing second hand smoke have poorer language processing so who knows the developmental effect yet of being born to a mother who is also a heavy smoker.  However, a strong inter-generational maternal history of familial substance abuse, suicides, agoraphobia and OCD also fail to indicate typical developmental patterns.

Added to this, I had jaundice at 6 months and chronic infections from 6 months, and was ultimately diagnosed with and treated for two primary immune deficiencies (coeliac and diabetes already ran on my father’s side and colitis on my mothers). Against that health background I was, like many children in the 60s, taken to catch measles and mumps when I was 2. But with no functioning immune system, I finally fought off the measles I’d been carrying after getting normal immune function at age 36. So 34 years of carrying measles is not good for the brain at all.

And I also then dealt with the loss of the welfare sister who’d cared for me from 6 months to 2 and a half, then the death and loss of my grandparents (who were my primary carers) at the age of 4. My view is that degree of loss has got to effect attachments, especially in a face blind, meaning deaf, immune compromised child who is already very developmentally compromised.

It may equally be a far more holistic picture in which a combination of things came together – genetic weakening including gut/immune/metabolic disorders, genetic damage which may have already effected three generations of alcoholic mothers and their children due to inter-generational substance abuse, Acquired Brain Injury from viral infection, and topped off with trauma relating to loss and abuse. So, we clearly can’t put all that down to a theory of primal pain and birth trauma.

So clearly my history is very layered, but as an autism consultant I’ve found many children diagnosed with autism with similarly layered histories none of which means those events alone caused their child’s autism.

For example it’s not unusual for me to meet a child who became progressively more ‘autistic’ after a big birthday party (that one surprised me), after a parent escaped a violent partner or the marriage broke down, after there was one of more house moves in succession, or a after younger sibling was born before they were 3.   What we may well be seeing there is how things like learned helplessness, Selective Mutism, Separation Anxiety, PTSD, childhood depression, catatonic depression, progressive Exposure Anxiety are deemed part of ‘the autism’.  And it might actually help us to  look at things like 2nd hand stress, how a young child ‘catch’ their parents untreated depression or what the impact of a parent’s anxiety disorder is upon a child who has not yet developed their own independent identity and may still feel the mother’s feelings as their own.  That doesn’t mean this would be so for all autistic children but nor can we sweepingly presume that just because someone is autistic it would not be possible for some.

Sometimes we have to dare to see more holistically, more 3D. It may well be that once we dissect out all the contributing causes which contributed to ‘autistic presentation’ and autistic patterns of development, there is nothing called ‘autism’ left except personality.

Donna Williams

http://www.donnawilliams.net