Until genetics came along, conditions such as autism were blamed on mothers who were ‘too cold’ to love their children.
If, like me, you are struggling to believe in the notion of progress these days, I recommend spending a little time reading the newspapers’ science reports. You will usually come across some astonishing discovery by unsung people beavering away in white coats that will still be improving humanity’s lot decades after the politicians who are at present hurrying us to hell in a handcart have been consigned to dust.
My eye was caught this week by a piece of neuroscience that has great medical potential and is also part of a wave of discovery transforming our understanding of what makes us as we are. Scientists have found that the signs of autism are visible in babies’ brains as early as six months, long before symptoms manifest themselves outwardly. That suggests the possibility of treatment when the brain is still very plastic. It also underlines how science is changing our ideas of how our brains are formed — and damaged.
For most of the second half of the 20th century, the prevailing view of autism was that it was caused by “refrigerator mothers” — women who, according to the psychoanalyst Bruno Bettelheim, were too cold to give their children the nurturing affection they needed. So for decades parents had not only to care for their children with little support from the state, but also to bear the burden of blame for having caused the condition. Molly Finn, the mother of an autistic daughter, wrote in a review of a biography of Bettelheim, “I have nothing personal against Bettelheim, if it is not personal to resent being compared to a devouring witch, an infanticidal king, and an SS guard in a concentration camp, or to wonder what could be the basis of Bettelheim’s statement that ‘the precipitating factor in infantile autism is the parent’s wish that his child should not exist’.”
Not everyone wants strengths and weaknesses to be put down to genes
Bettelheim had much in common with Andrew Wakefield, the British former doctor who claimed that the MMR vaccine caused autism. Wakefield, who lives in America, where the “anti-vaxx” movement is thriving and appears to have support from President Trump, was in London this week publicising a film that continues to make this dangerous claim. Both men are guilty of fraud — Bettelheim falsely claimed he had medical training; Wakefield was struck off the British medical register for falsifying evidence in support of his claims on MMR — and both led parents to blame themselves for a condition that real scientists have established starts at the very beginning of life and is caused by our genes.
The deeper that scientists delve into brain science, the clearer it becomes that conditions such as autism, schizophrenia, bipolarity and ADHD have physical causes and run in families. This week a study of 3,200 Dutch children identified differences in certain areas of the brains of those with ADHD. “We hope that this will help to reduce stigma that ADHD is just a label for difficult children or caused by poor parenting,” Martine Hoogman, who led the research at Radboud University, in Nijmegen, said.
Genes are not responsible for everything that goes wrong in our heads but they do seem to explain a lot. Scientists reckon that about three quarters of ADHD and four fifths of schizophrenia, for instance, is genetically inherited. Not everybody likes genetic explanations for our strengths and weaknesses, though. Left-wingers disapprove of them because they seem to justify an unfair society. If our mental capacities are inherited, then the poor are doomed to be poor and the rich get to stay rich. Socialist nirvana looks much more achievable if humanity is a blank slate, and good and bad fortune are down to the ills of society rather than our tendencies.
Right-wingers dislike genetic explanations because they seem to let feckless families off scot-free. The right is keen on emphasising individual responsibility, and if scientists go round absolving people of blame for the behaviour of their turbulent children, then bad parents will not suffer the social opprobrium they deserve.
The more we know about a condition the better we can treat it
Psychoanalysts don’t much like genetic explanations, either. In Not In Your Genes, a book published last year, Oliver James, a pop psychoanalyst, expounds his theory that it is parenting, not genes, that causes mental illness. His argument is richer in anecdote than in evidence, and convenient for a profession whose revenues depend on clients believing that hours spent unravelling their tangled childhood memories will free them from mental anguish more effectively than pills.
The genetic explanation for mental disorders, though not very popular, has several advantages. First, a growing pile of scientific evidence, particularly studies of twins, suggests that it is true. Second, it holds out the hope of treatment. Gene therapy is advancing fast, and if scientists can use it to target other physical conditions, they may eventually be able to address those that originate in the brain. Third, it is humane, for it recognises the innocence of parents who have had to suffer not just the consequences of their children’s affliction but also bear the blame for causing it.
Genetic explanations do not mean that we should give up trying to make society fairer. They do not mean that we should stop distinguishing between bad parenting and good. They do not mean that “talking cures” are valueless. What they do mean is that scientists are replacing fraudulent explanations of what goes on in our heads with real ones, and may get better at curing us, too.