A proposal to modify...

A proposal to modify the psychotherapy of Bruno Bettelheim

Budimir Rogovoy,Ph.D. (Russia)

Splendid results of the psychotherapy of Bruno Bettelheim, first against children schizophrenia and then also against autism, have been attested by a number of independent observers; v., e.g., W. Crain- “Theories of Development: Concepts and Applications”, Prentice-Hall, 2000, ch. 14.
Nevertheless, this psychotherapy has not gained any wide acceptance, which to a large extent can be explained by the fact that it was practiced in a hospital (called by B. Bettelheim “The Orthogenic Scool”) whereas autistic children live mainly in family settings.
Our proposal is aimed at the modification of the therapy of Bruno Bettelheim to make it suitable for family setting.
We preserve the main therapeutic principles of B. Bettelheim, which are, in our opinion, the following:
1/ Wide gratification of patients as the back ground of the therapy.
“We feel,- says B.Bettelheim,- that before anything else a child has to be utterly convinced that- contrary to his past experiences that world can be a pleasant one, before he can feel any impulse to get along on it.” (B.Bettelheim- “Love is not Enough”, Glencoe, 1950, p.27).
2/ Inducing, without pressure, spontaneous activity of patients giving them immediate pleasure.
“They returned to life,- says B.Bettelheim,- only when we could create conditions or be a catalyzing force which induced them to act on their own behalf” (B. Bettelheim- The Empty Fortress. Infantile Autism and the Birth of the Self”, N.Y.: Free press; L.: Collier- Macmillan, 1967)
3/No flinching to from therapeutic regressions.
“…Our work,- says B.Bettelheim,- is made up of a long series of ups and downs, but… by and large each new low is less deep, and each high that follows is both higher and better than the one that preceded it”. (Bettelheim – “Love is not Enough”, p. 229)
The salient proposed difference from the original psychotherapy of B.Bettelheim is the therapeutic use of much nearness of the child to his parents and first of all to his mother, incl. bodily nearness.
This innovation is based mainly on our analysis of the healing forces in the psychotherapies of Bruno Bettelheim and Marguerite Sechehaye made in our paper written in English and published in the German Journal (Dynamische Psychiatrie, 1994, Bd. 27, S. 206-219) and of the holding technique. Our analyses of the psychotherapies of B.Bettelheim and M.Sechehaye and of the  holding technique were summarized in our latest paper “The Therapy of Gratification against Autism” sent by us to the journal “Autism” of the National Autistic Society of England in 2004.