Ann Bauer wrote a compelling piece about her wrenching decision to press charges for auto theft against her autistic son, Andrew, who developed schizophrenia in late adolescence. Anyone who has spent a significant amount of time trying to comprehend the mind of a higher functioning autistic person will recognize the difficulties with theory of mind, point of view and social reality:
Growing up with his younger brother and sister and me in the years after his father left, Andrew was a child with language-processing difficulties. It took him a long time to respond to even simple questions. Instead of tightening his face in concentration, he let everything go soft — eyes unfocused, mouth slack.
Finally, after sifting through the superfluous memories in his brain and random shreds of human dialogue he was driven to repeat (called echolalia), Andrew would straighten, victorious, and blurt out an answer you could count on being the truth.
Back then I would have said children with autism are incapable of telling lies. They don’t, as a rule, participate in games of make-believe. At 10, Andrew loved board games and vintage rock ’n’ roll, but he hung on the edge of the group when I read fairy tales before bed, disapproving because what happened in the stories wasn’t real: talking wolves, a spinning wheel killing someone, finding one’s way based upon a trail of bread crumbs. Andrew dealt solely in facts.
I saw this as a major deficit. My older son couldn’t make the leap between his own experience and the whimsy of others, or lose himself in fantasy.
Yet neither could he fit into the real world with its nuances and rules that kept bending. He liked things rigid and predictable. Rules were rules. He did his homework on time. When it was his turn to clean up after dinner, he rinsed and stacked and polished until the kitchen sparkled.
For years I tried to engage Andrew in stories and movies, anything that might spark his ability to follow narrative and identify with other people.
As if autism didn't present enough difficulties, when Andrew's schizophrenia appeared, it was accompanied by a loss of ability to control his impulses. He would eat and steal compulsively despite steadfast efforts to limit his behavior. In the face of these disturbing aspects of Andrew's illness, Bauer entertained the hope that another change schizophrenia brought―the development of an active fantasy life―might actually cure Andrew's autism. That might sound far fetched to someone who isn't intimately familiar with autism, but it's an understandable hope.
What is even more interesting to me is Bauer's take on pressing charges against her son after he eloped from a group home and stole her car. He needed and wanted the prosecution, she believed, as a recognition that he is an adult. I don't know if Bauer's take was right or wrong in this instance, but her general approach is a good one. She doesn't treat Andrew's mental disorders as germ-like entities separate from her son and treatable solely based upon some cookbook treatment recipe.
The decision to allow Andrew's prosecution doesn't represent a general recommendation for crimes committed by people with mental disorders. To be clear to any "lock 'em up" types who might be reading this, do not take this as encouragement in the least for your own one-size-fits-all, tough-love, version of treatment. Bauer's decision was specific to her son, based on her effort to understand the meaning of the crime and the meaning of the prosecution to her son and only to her son. There is far too little of that kind of thinking in modern mental health treatment. Attacking symptoms with complete disregard for their meaning to the patient often makes things worse in dealing with what can be a Sisyphusian challenge even under the best of circumstances.
Read the entire article (NY Times).
Ann Bauer is the author of A Wild Ride Up the Cupboards