I prefer to think of myself as an active participant in an imperfectly creative universe, rather than an impotent observer of a mechanical reality. 

bertvan@aol.com  

Revised as of June, 2013

Mothers of autistic children are no longer accused of rejecting their children and subjected to psychiatric treatment, and doctors are no longer allowed to conduct “scientific studies” upon patients without their knoweledge and consent.  However psychiatric treatment for “mental illness” other than autism has remained basically unchanged.  Patients are either drugged, or a therapist tries to talk them out of being mentally ill.  As for “scientific studies”, psychiatry has learned not to even try to determine the relative effectiveness of their treatments.

I was suddenly and traumatically plunged into the quagmire of mental illness when my son was diagnosed autistic. At that time the psychiatric profession had declared autism to be caused by “maternal rejection”, and psychotherapy for mother was the treatment. I also suspect we were unknowingly involved in a "scientific study". Today a law has been passed making it illegal to involve people in research without their knowledge and consent, but during the early 20^th Century, the height of scientific materialism, just about anything scientists wanted to do was considered ethical - after all, they were the priests of our modern religion, and whatever they did was for the good of mankind.  In 1961, Kennedy, with a mentally disabled sister (who had been scientifically lobotomized), was our new President, and money was available for research on defective children.  A generation of enthusiastic, young therapists had just completed training and were eager to display their wondrous, new, scientific power to cure. There was a problem. Most therapists were men in those days (as were most doctors), and those nice young men were reluctant to be explicit. Maternal rejection is a pretty offensive concept, and how could they convince women it was nothing more serious than a mild, easily cured infection? How could they slip Mother a dose of psychotherapy without explaining exactly what they were doing? It took several decades, but eventually it was the therapists themselves who were cured of their bizarre thinking, rather than mothers of autistic children. Psychotherapy was finally abandoned as a treatment for the most serious mental illness, such as schizphrenia.  Although psychotherapists did retain it for such things as neurosis, which some people might regard as mere varialtions of normal.

In spite of all the effort devoted to treating mental illness, there are still no cures.  Autism is even recognized as having increased dramatically.   Could  mental illness merely be an aspect of evolution -  examples of Nature's tentative, imperfect, incomplete, evolutionary responseses to a dramatically changing lifestyle?

For well over a century our understanding of evolution was stagnated by Darwin's randon-mutation-and-natural-selection mechanistic formula.  However, some scientists are beginning to view evolution - not as  natural selection doing something to a collection of random mutations (DNA accidents) - but rather as a vibrant, creative process of intelligent, purposeful response to  changing environments.   When environments remain stable, there is little need for innovation. However a changing environment begs for innovation.  And science has learned that environmentally challenged organisms do increase their rate of mutation.   Homo Sapien's environnment has changed dramaticaly in the past few centuries, and each effort by an egg to join with a sperm and organize themselves into a unique, new, living entity could be seen as just one more individual attempt to create a new adaptation. 

This story is true. The names of the professionals have been changed to protect the guilty. There are no correct answers to most of the questions. Answers proposed by professional philosophers to such religious and philosophical concepts would be no more scientific than anyone else's speculations.

A Few  Autistic Questions

About Freud, Marx and Darwin

Question 1

Is any segment of society immune from silly ideas? 

"Tell me about yourself," suggested the young pediatrician.

What a strange thing for a pediatrician to request!  Especially a pediatrician at a busy Army clinic, where no one had time for idle social chatter. Wearing a starched white coat over his Army uniform, the doctor sat behind his desk regarding me gravely through horn-rimmed glasses. I stared back, baffled. What did he expect me to respond? That I was an Army wife? But that was obvious, wasn’t it, since this was Army hospital? Such a request sounded like something a psychiatrist might make, not a pediatrician. Having never even met a mentally ill person, I had only vague ideas about psychiatry. But while uncertain about what psychiatrists actually did, I was pretty sure I had no need for one. The silence became uncomfortable. The partitions of the clinic were flimsy, and I could hear a buzz of activity out in the crowded waiting room.

In those days we didn't consult a doctor for colds and minor problems. I often felt the obligation to convince them my medical problem was sufficiently grave, but on this particular occasion no one was sick, and I hadn't arrived at the pediatrician's office in my usual state of anxiety. I did feel a little self-conscious about my reason for consulting a doctor. I'd brought Tony to the clinic, not because I thought something was wrong with him. I actually admired my handsome, independent little three-year-old. I was here because a neighbour had suggested it. I would have felt foolish admitting I'd consulted a doctor just because a neighbor disapproved of my child, so I explained that Tony didn't talk much, was still in diapers, and maybe he should have a check-up. But to my bewilderment, instead of examining Tony, the doctor kept trying to initiate personal conversation.

“How do you like the new administration in Washington?” he asked.

“It's exciting, isn't it?”

“Society will be in trouble unless people start taking responsibility for their own lives,” the doctor said disapprovingly. “People expect the government to do everything for them.”

I was a political liberal who believed some of mankind's most magnificent accomplishments were achieved collectively, through government action. The abolition of slavery and the end of segregation were bitterly contested at the time, but most of us are proud of such achievements today. Establishment of an education system and Social Security were less controversial, but nostalgia for a more primitive society always seems to ensure that all innovation faces some opposition. So I admired Kennedy, our new, liberal, young president, but I also realized some conservatives appear to feel a near religious reverence for private-enterprise and believe government should never interfere with the survival-of-the-fittest. (And the eradication of the less fit, I presume.) Apparently this doctor and I would disagree on politics, I decided, but a doctor's office didn't seem an appropriate place for such a discussion. I sat silently waiting for him to begin examining Tony.

“So now, why don’t you tell me about yourself,” the doctor again suggested, with a little self-conscious smile. He spoke rather hesitantly, as though he realized that his request was somewhat unusual for a pediatrician.

I looked at Tony, busy examining the contents of the wastebasket. "Tony sometimes has a rather violent temper," I finally managed to offer, hoping to return the doctor's attention to his patient. Maybe one of Tony's glands needed adjusting or something.  (My understanding of biology was obviously limited.)

“Does he understand what you say to him?” the doctor asked

“I'm never sure. He rarely does what I tell him but he's independent and stubborn.”

Tony was on his knees, his little blue-jean-clad rear-end up in the air and his head on the floor, trying to see under a partition into the next office. If anyone were on the other side of that partition, they'd probably feel uncomfortable to see his bright, inquisitive little face peering up at them. I picked him up and held him on my lap.

“How does he get along with other children?”

I thought a moment. “I don't think I've noticed him play with other children.”

“Does he have opportunities to be around them?”

“Off and on, I suppose. Actually, he doesn't play with his brother and sister very much.” I admitted.

“Where do you live?”

“In a big old house on a hill behind San Rafael.”

“You own your home?” I nodded. “You are lucky to own property in such a valuable area,” he continued.

He seemed to expect a response, so I tried to think of one. “The house is a hundred years old and has termites,” I said. “In the coming depression it probably won't be worth what we paid for it.”

“We don't have depressions anymore,” the doctor scoffed.

Many of us who grew up during the thirties, sometimes accused of having depression mentalities, didn't really trust prosperity, but the doctor's comment seemed condescending. “You are probably too young to know what a depression is,” I said.

The doctor frowned. I was startled by my own impertinence. I didn’t usually come out with such retorts. Suffering from shyness, I was rarely rude or impudent. Perhaps the doctor was just making an effort to be friendly. Army doctors were not known for their bedside manner though, and I'd never encountered one with time or inclination for this kind of  personal conversation.

"Tell me about your husband," he suggested, ignoring my comment.

Tony slid off my lap to examine the scales. Again, I was baffled. I couldn't imagine why our personal lives might be of concern to this pediatrician. Surely he wasn't interested in Ike's vital statistics, such as height, weight or eye-color.

“He's stationed in Greenland at the moment,” I finally offered.

“Uh-oh! That's bad.” Another strange reaction for an Army doctor. There was nothing unusual about overseas duty for military families. I couldn't think of a response, and the doctor continued. “How do you feel about your husband's absence?”

"Well he'll be home in a couple of months."

The doctor glanced at Tony. After trying to turn the valves under the sink, Tony had crawled onto a bookcase. With a self-satisfied smile, he crouched on the bottom shelf like a life-sized bookend. We talked some more, and the doctor continued to try to discuss everything except Tony.

"Ever since you came your little boy has been running around the office examining the equipment," he finally said, as he watched Tony leave the bookcase and crawl under the desk. "He's paid no attention to me. Why he's hardly aware I'm in the room!"

Why should Tony pay attention to you, I wondered. You haven't done anything but talk, and Tony doesn't understand much of that. However I wasn't accustomed to challenging doctors, and I nodded.

"Your child is not normal," the doctor said.

"You really think so?" I murmered.

His words seemed to have no impact upon me. After all, he hadn't paid much attention to Tony. He hadn't even examined him. For some strange reason, that pediatrician acted as though his purpose was to cross-examine me, Tony's mother! I listened to the doctor make another appointment for us, but I was busy puzzling over what on earth this peculiar doctor had been up to for the past half-hour.

Ask a silly question and you get a silly answer, I thought as I left the doctor's office.   Whatever that pediatrician had been up to, that's what I got for taking my child to a doctor when  there was nothing wrong with him, I mused with chagrin.

I always dreaded talking to doctors. Like many people, I felt intimidated by the medical profession. Perhaps some doctors have become accustomed to such an attitude, and expect patients to exhibit proper respect for their authority, maybe with the assumption that such diffidence is an aspect of the healing process.  And it probably is. I suppose faith in the infallibility of the medical profession could have a placebo effect.  So it would never have occurred to me to openly challenge his pronouncement that Tony was not normal. Every child is a unique personality, but I'd never noticed anything about Tony's personality that struck me as abnormal. He obviously had more imagination than most children. And his curiosity was monumental. He was slow to mature, but  my other son had also been a “late bloomer”.   For some reason I viewed the doctor's pronouncement that Tony wasn't normal as bizarre rather than alarming.  The pediatrician's attempts at personal conversation seemed to suggest a psychiatric interest. Psychiatric evaluations not being a pediatrician's specialty, his manner may have been a little clumsy, but whatever a psyche consisted of, I was confident there was nothing wrong with mine.

Many of us had only a vague understanding of psychiatry, this new technology for repairing malfunctioning psyches. Today some scientists are pondering the nature of consciousness, but even without defining it, the psychiatric profession had already divided it up into imaginary ids, egos and superegos, and declared their ability to repair them.  If we laymen didn't understand the details - well we didn't understand the atom bomb, or how penicillin worked either.  My ignorance of psychiatry would soon be remedied, as our family underwent psychiatric treatment,  I had never heard of autism.  Nor was I aware that Bruno Bettelheim, a psychologist at the University of Chicago, had convinced the medical profession  it was a mental illness caused by "maternal rejection".  Treatment consisted of a therapist (generally men) conducting an investigation into why mother was rejecting her child. The theory being, that once she understood the reason (usually some convoluted, psychoanalytic tale about an unhappy childhood of her own), mother would cease to reject and become a loving parent.

  ***

Neo-Darwinism proposes that biological innovations result from the ability of natural selection to retain "random mutations".  We don’t yet understand all the details of life's complexity, but what science has been able to learn about the process fills many, many volumes. (Can anyone imagine a new complex biological feature appearing in one of those books as the result of retaining meaningless, typographical errors?) Survival-of-the-fittest had been eagerly accepted by 19th Century scientists, probably because scientists of that time were struggling against a rigid religious orthodoxy. A hundred and fifty years later, a rigid materialistic orthodoxy had replaced religion for many scientists. RM&NS is the only mechanistic explanation anyone has been able to devise for biological innovation, the only explanation that excludes any hint of purposeful intelligence. Anyone expressing skepticism of the creative power of "natural selection" was scornfully denounced as an "ignorant religious creationist". However one does not even have to be religious to view volition and intelligent organization as natural aspects of reality. The truth is, any form of purposeful organization suggests intelligent design, and such purposeful organization need not be "supernatural".  Certainly, there is nothing supernatural about our own purposeful, conscious, human intelligence. Whatever the organizing force in living systems is labeled, evo-devo, biocentrism, self-organization, epigenetics, intelligent design, quantum biology, phenotype plasticity, James A Shapiro’s genetic engineering, -  or a phrase that encompasses them all: cognitive biology - in all of them, the participation of some deity can be neither confirmed nor denied. Evangelical atheists will eventually have to learn to live with the unwelcome possibility that no religion, no view about the ultimate nature of reality, can be either scientifically proved or disproved - and that includes the religion of Atheistic Materialism.