ASD and the Human Spectrum
ASD and the human spectrum:
Adverse childhood experiences, closed system functioning, and the refusal of love
Discussant: Timothy Rice, MD
Tuesday, November 12, 2024 at 8 PM
Location: Columbia University Faculty House, 64 Morningside Drive
(enter via 116th St. click here for directions)
or via Zoom
All humans, autistic and non-autistic, have a common need for trust and caring social connection, which provides a sense of safety. In Autism Spectrum Disorder (ASD), neurobiological factors lead to adverse childhood experiences which disrupt the infant’s capacity to engage in reciprocal interactions with caregivers. Without this back-and-forth engagement, the infant experiences an ongoing sense of danger and stress overload. Feeling alone in a dangerous world, to survive, the child resorts to closed system functioning characterized by a protective stance of mistrust, isolation, power, anger, and excessive control, which blocks out positive experiences and the needed help of caring others. The child’s maladaptive internal structure which involves the refusal to experience and use available loving connections hardens and stabilizes. The cornerstone of treatment involves work focusing on the patient/therapist interaction – moving from closed system functioning to open system functioning and becoming able to tolerate and make use of and not refuse available love experienced in therapy. This formulation and the process of treatment are illustrated by the drawings from the therapy of a young boy with ASD. He considered these drawings to elucidate the “missing piece of the autism puzzle.” This clear developmental process in autistic children serves as a model for non-ASD infants and young children who may respond in a similar manner to adverse childhood experiences, develop closed system functioning and, over the entire lifespan, refuse the love which is offered. Perhaps this is the “missing piece” of the non-autism puzzle.
William Singletary, MD, is a child, adolescent, and adult psychiatrist and psychoanalyst, a member of the faculty and child analytic supervisor of the Psychoanalytic Center of Philadelphia, and President of the Board of the Margaret S. Mahler Child Development Foundation. He is in private practice in Philadelphia, PA, and has worked in intensive psychotherapy with children and adults with ASD for over 30 years. A major focus of his work has been on how building relationships contributes to changing the brain. His paper, “An Integrative Model of Autism Spectrum Disorder,” a Target Article in Neuropsychoanalysis, describes the pathological role of stress in ASD on both the neurobiological and psychological levels and the importance of the development of loving relationships and emotional regulation in its alleviation.
Timothy Rice, MD, is a child, adolescent, and adult psychiatrist and psychoanalyst in practice in New York, NY. He is Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai and Co-Chair of the Child Division at the Columbia University Center for Psychoanalytic Training and Research.
