A singular space for the treatment of autism

 

Pedro Gras. Director

“Torreón”. A space for the fostering and treatment of children and families

 

María (an alias) is a young, six year old autistic girl who barely says a few words. It is time to leave and she has come down on the elevator with Teresa, the instructor of the Library workshop. In the ground floor there is the typical din of children reencountering their parents after two and a half hours of activities. Despite the sweet and affectionate words of Teresa, María does not leave the elevator.

The girl does not say she does not want to go, she remains “rooted”, paralyzed, and does not answer Teresa’s words.

Another member of the team who witnesses the scene intervenes, saying emphatically: “Teresa, what are you still doing in the elevator? Don’t you know that María has the right to go quietly with her mother?”

Teresa, theatrically serious, responds to this statement apologizing for her mistake; the girl then exits the elevator on her own and is able to meet her mother without difficulties.

This small vignette of our daily functioning, in line with what Jacques-Alain Miller called “pratique à plusieurs”, developed by the psychoanalyst Antonio Di Ciaccia in the Belgian institution Antenne 110, helps demonstrate the basis of our work with these children at Torreón.

Jacques Lacan indicated that “No subject can exist without the Other”. That is, there is no subject of the unconscious without the Other and consequently, there is no subject without a symptom.

Thus, an institution oriented by the “pratique à plusieurs” modality is an institution characterized chiefly by not interpreting symptoms as a deficiency, renouncing any type of violence or forcing.

We understand that these children, with their games of alternation, their stereotypy, etc., are at all times attempting a treatment of their Other as well as endeavoring to produce an inscription in the real that would make up for the failings in the symbolic function. The problem is that they cannot accomplish this operation by themselves. For this to be possible, the children need partners who are permanently associated to the realization of their act.

Jaime (an alias), a five year old autist, incessantly spins a psychomotricity disc. It is a stereotypy which can occupy long periods of his time. He knows and likes the monitors who work in the therapeutic games group workshop. Suddenly, one of them slaps Jaime’s disc and says: “Disc game!” and a game ensues where everybody follows the disc on the floor, passing it from one person to another.

Jaime, who is at first surprised by the monitor’s action then joins the game. After many days repeating the same operation, Jaime takes the disc, looks at the monitors and yells: “Disc game!”, inviting everyone to play with the object who once isolated him in his stereotypy.

Now, given that we do not know how and when such an occasion will arise with an autistic child, every member of the team must be available at all times to occupy a place as the child’s partner. That is, be willing to be associated by the children to their treatment of their Other, a treatment that will enable them to establish themselves as subjects.

Furthermore, as the obstacle of a very intense transferential fixation may occur, it is necessary that the institution promote a diffraction and multiplication of the transference to all members of the team who work with the children.

Another important characteristic that must be taken into account is that the Other has a dimension that is real and experienced as persecutory. Looking after these children entails the question of how to position oneself so as not to incarnate this persecutory Other.

The adults in charge of these children must be willing -and it must be said, in a very theatrical manner- to incarnate a docile Other for the child, incomplete and regulated. Terese, as per the intervention of her colleague, agrees to occupy the place of the Other who impedes María from leaving the elevator and by admitting her mistake, shows herself to be a divided Other, limited and above all regulated. The effect is immediate.

It is not that Teresa ought to have a knowledge of how to extract María from that situation by incarnating the Other of knowledge. The autistic child looks for a partner who is not in a position of knowledge, and the participants must therefore “know to not know” what is convenient for the child and be available at all times for the appointment that he will give.

Carlos (an alias), nine years old, cannot tolerate waiting for a computer to turn on and becomes anxious. We know it is important that Carlos eventually be able to wait without anxiety but it is necessary to recognize the personal situation he experiences, which does not only occur in relation with computers. Together with an educator, they go the Director, to indignantly formulate a formal complaint about how unbearable that period of waiting is; the educator explains that it is outrageous that this should happen and that they think that the computers who are slow and bothersome should be replaced.

The director, imbued with a more powerful title due to the position he occupies, also appears as an incomplete Other and responds -quite theatrically, as well- that it is of course unjust that Carlos should have to face such an unwelcome situation… but that he cannot take such an important decision alone and will therefore emphatically communicate this matter that so disturbs Carlos at the team meeting, so it can be addressed and resolved. The boy, fully appeased, can now resume his activity in the workshop.

This is not only about an active wait but also about making an Other of language function in such a way that children can be extricated from their moments of anxiety.

Leo (an alias), nine years old, has a bad time at the art workshop. He tries to make drawings that are beyond his abilities and the poor result exasperates and vexes him. Multiple maneuvers have been tried to lighten his exigence for perfection, such as proposing that he make copies of the drawings he obtains from the computer at the tracing table, that he instruct the monitor on how to make the drawing, he is charged with selecting music, he is quite an expert for his age… But although there is a certain relief, he continues to be affected by his bad results. Until a participant in the workshop introduces the concept of “sketch” and explains how artists make sketches that are not perfect before the definitive work, that museums even exhibit sketches and says of Leo’s current drawing: “This can be a sketch”.

From the moment this signifier is introduced, Leo not only admits imperfections in his drawings but now, when something does not turn out with the exactitude he once required, instead of erasing it he says: “¡I will not erase it, this is a sketch!”

As Bernard Seynhaeve, former director of Le Courtil -a Belgian institution that also works with a “pratique a plusieurs” modality- indicates, this is about inventing unprecedented ways of saying: an institution that works with the “pratique a plusieurs” modality is “an institution in which the the educators are subject to the law before imposing it on the children; an institution where the educators are resolute and advised, because they know the are not all powerful.”

Translation: Soledad Székely