The compensation of autistic features during a little boy’s second year: overcoming pain through the development of attachment (continuation)

In fact, the majority of the babies exhibit fairly even emotional delay during their first year. Some isolated reactive autistic features are common, but they are not firmly established and they cease rapidly with just a little help from an adult. The second year of life is more critical for the formation of a ‘distorted’ autistic type of emotional development.The emotional work which a child with autistic features would normally have done together with an adult during this year can free his development significantly. Nevertheless, even if an adult tries hard to help such a baby, the result depends more on the baby’s own involvement. Some give up too soon and are sent to special institutions; a few babies manage to compensate their emotional deficit (Bardyshevsky 1997).

Serioja, whose development I describe in this paper, exemplifies the problems experienced by other emotionally deprived children, but in an accentuated form rarely met with at the orphanage. In discussing my observations of him, I shall attempt:

1. to trace the age dynamics of his emotional development during his second year in terms of the, evolution of attachment behaviour, autistic behaviour and corresponding emotional states; 2. to illustrate his direct struggles with what I call his ‘primary emotional deficit’, namely, his experience of great pain in the context of emotional contact with an adult, and the level of progress achievable by such ‘frontal’ means;    

to describe his more roundabout devices for alleviating or transforming this pain, and thus gaining energy for further development.

Methodology

I used both the ethological method of observation and Esther Bick’s method to obtain material for a fine analysis of Serioja’s development. The observations were ‘participant’ in the sense that I interacted with Serioja. This was both in response to his urgent need for emotional help, and out of scientific interest in the question of whether following ‘from inside’ the process by which such a child forms attachments would prove the possibility of overcoming his autistic behaviour patterns. The orphanage staff were able to help Serioja to develop a richer relationship with them only after they learnt to trust me and had witnessed the way his relationship with me developed.

1. The ethological method was used to document which insufficiently developed attachment behaviour patterns were primarily replaced by autistic-like patterns; which behaviours, genetically related to attachment, suffered ‘secondarily’; and how these interrelationships changed in the course of Serioja’s development during his second year. Although the aim of this method is to describe the development of behaviour with regard to its ’causes’ (the specific conditions influencing the behaviour under consideration), its mechanisms and its adaptive meaning, the corresponding emotional states are also taken into account, as internal correlates of expressive emotional movements (Lorenz 1966). Thus, by attachment behaviour we understand here the child’s emotional activity, which is clearly expressed in behaviour which has the purpose of eliciting, facilitating and sustaining the manifestations of maternal behaviour (affective care) in an adult.

Like Esther Bick’s method, the ethological method is naturalistic: the observation is done as fieldwork, and the observer is supposed to be open to new phenomena. In both methods, the observer is attentive to shifts in a child over different periods of time and in different contexts: within  a specific instance of interaction with another person, but also over a single observation and during the weeks and months of the course of a whole observation.

What is different is the focus of observation. From the ethological point of view, the processes of development are patterned in certain logical sequences, which are reflected in age-specific shifts in the child’s behaviour (Ainsworth 1994). The ethological observation of children thus mainly focuses on following two principal interacting trajectories of development:

1. the process of differentiation of basic undifferentiated behavioural patterns. This is considered to be the main thrust of development (for example, the development of the capacity to perceive and understand facial expressions of emotion).

2. the process of integration of basic patterns into new complex structures (for example, coordination of eye contact with speech. (BernsteinT947; Bower 19-74).

The inclusion of internal events in objective observational studies has been suggested (Ainsworth 1994), but this obviously requires a modification of the procedure. The use of Esther Bick’s method to complement the ethological method provided me with a heuristic approach to finding a balance between the two focuses of observation: directly observable forms of behaviour and corresponding inner emotional states. (For a more detailed discussion, see Michael Rustin’s beautiful comparision of Bick’s method with more objective observational studies (Rustin 1989)).

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