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15 novembre 2011 2 15 /11 /novembre /2011 16:21

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Carole Contaut, a french mom, translated an article posted in 2007 on the website " psychomédia "


 Autism in France: psychoanalysis is denounced by ethics committee. 



Prof. Didier Sicard, President of the French Comité Consultatif National d'Ethique (CCNE), has reported the conclusions of the working group on the situation of the 350000 to 600000 people, adults and children, affected by autistic syndromes in France.

The Committee had been seized in July, 2005 by a number of family associations, who were strongly protesting against current conceptions about care for children and adult people with autism, and against the absence of teaching support for children and teenagers.

“As opposed to many other countries, particularly Anglo-Saxon and Northern European countries, France is currently experiencing a huge deficit in this respect,” the report says.

“Children and adult people with autistic syndromes and their families are still nowadays the victims of diagnostic wavering which leads to frequent late diagnosis, huge problems accessing early and specialised educational support, the shortages of places in structures adapted to them, the impossibilities for families to choose their children’s caring procedures, a lack of family support and a lack of support, care and social inclusion of adult and old people affected by this disability in France.

France has been condemned by the Council of Europe in 2004 for not meeting its obligations to provide autistic a child with education, but it still has not resulted in any significant change in the educational care provided to these children,” the report mentions.

Since the law of February 11th, 2005, their school enrolment has become compulsory. “But it’s often a fictitious scholarship, which is often reduced to a mere registering,” the Committee criticizes.

The report highlights particularly the harm resulting by the (still regrettably prevalent) psychoanalytic approach in this cause.

“The tragedy of autism is a particularly painful example of the consequences which theories may have on the causes of a disability or illness in terms of human suffering and respect for a person’s dignity. The psychoanalytic theories on autism – psychodynamic theories such as the “empty fortress” theory (1) – as they were suggested in the 1950’to explain and describe the autistic child’s inner-world, have led to questioning the parents’ behaviours, and particularly the mothers’, described as “refrigerator mothers”, “”deadly mothers”, in the development of this disability.

Since the 1980’, the international classification of autistic syndromes as “Pervasive Development Disorders” (PDD) has led to the abandon of psychodynamic theories on autism and the notion of “autistic psychosis” in almost all countries in the world, apart from France some Latin-American countries. (...)”

This old and marked opposition between the essentially psychoanalytic-oriented notions and approaches shared by a large number of psychiatrists, and the pressing demand of all families associations to have access to the therapeutic and educational approaches that have been developed worldwide, is gradually but still too slowly replaced by interesting forms of participations of psychoanalysts in multidisciplinary support and care procedures, based on educational approaches that have been recommended by international guidelines – let’s hope this change will develop in the future.

Right now families are facing a lack of choice and 2 to 4-year-old waiting lists.

Therapists in France are more likely to propose internment solutions,” Prof. Jean Claude Ameisen, rapporteur of this opinion, sums up. “Yet, ethical and human solutions are not more expensive, as the example of Sweden has shown”, in which big centres for autistic people have been closed and replaced by smaller, more human, structures.

The report also highlights the importance of supporting the person with autism throughout his life. “A child affected with autistic syndrome will become a teenager, then an adult, then an ageing person. These developments must not lead to an abandonment of the person and caring, education, housing, social and professional inclusion have to be adapted to the different age periods.”


(1) Bruno Bettelheim. The Empty Fortress : Infantile Autism and the Birth of the Self. Free Press, 1967


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