Le Packing – Pack it in
When Bruno Bettelheim proposed his theory, inspired by Leo Kanner, of the refridgerator mother, predictably, therapies were devised to “thaw” the autistic child. One of those was holding therapy also known as attachment therapy. Basically, this is forcing a child to be held as tightly as possible by the parent/carer/therapist and fiercely resisted should the child struggle. Even at its most benign, this can be akin to torture for hypersensitive individuals for whom even light touch can be perceived as pain. Sadly, this isn’t the only problem with this therapy. Holders and holdees can and have been seriously injured in what is little more than a one-sided wrestling match and children have even been suffocated. See Advocates for Children in Therapy for the names and details of the children lost to such pseudoscience which also includes children who were deemed to suffer from attachment disorders (many of them neurotypical adopted children) as well as autistic children.
In most, mainstream practices, such treatments are, thankfully no longer used relying, as they do, on Bettleheim’s post Freudian, psychogenic theories of the cause of autism. It is hard to believe that an even more barbaric and potentially dangerous variant of holding therapy called packing is practiced in more than 300 establishments including residential institutions to this very day in that most advanced and civilised of nations, France.
So, what happens during a packing session?
Basically children are stripped and wrapped very tightly in cold wet sheets (around 50 degrees F, that’s 10 degrees C). Some practitioners of this cruel treatment will even refrigerate the wet sheets to make them colder still. The sessions of around 45 minutes may be repeated daily. For a photographic breakdown of a packing session click here.
As discussed the rationale behind this therapy is flawed to the point of being just plain wrong. Autism cannot be remedied, treated, cured or alleviated by the tools of psychoanalysis and certainly not by, what amounts to, torture. The aims of packing are to:
- improve/restore child’s body image;
- improve relationships with parents especially in terms of physical contact;
- reduce self-harming behaviour;
- reduce repetitive behaviour and stimming;
…and the evidence that it does so? None.
Opponents of packing have called for, but been refused, a moritorium on the practice. They cite many objections to this supposed therapy including that it may make autistic children more suseptible to sexual abuse as,
the child, accustomed to being in their underwear in front of adults for an activity they do not understand, loses the ability to distinguish between strangers and their carers and parents. At best, they might simply be confused. At worst they will find it normal to undress in front of adults who may wish to harm them. How can these children ever learn the basic social signposts to be able to protect themselves from sexual aggression? – Support the Wall – Autism
Tragically, calls for change have gone unheard and somewhat unsupported. Parents of institutionalised children fear their children being returned should they object to the regime at what is their child’s home. The numbers of children institutionalised in France was, in 2007, around 108,000 compared to just 2,245 children in the UK.
Indeed, France is certainly lagging when it comes to autism diagnosis and services. Fewer than 20% of autistic children regularly attend school of any kind and the vast majority of people with an ASD diagnosis receive it after the age of six. On the other hand, childhood schizophrenia and childhood depression are still relatively common diagnoses. The state, it seems, supports the use of packing and it is practiced in institutions it funds. In February 2010, France’s High Council for Public Health decalred,
“given the absence of notable risks identified to date, the practice of Packing presents no risk which would justify its prohibition.“
The fact that it may cause suffering to a child upon whom this is inflicted seems entirely lost upon them. The same can be said for the French National Authority for Health who state:
“For psychoanalysts, autistic processes, whatever their cause, are linked to the archaic anguishes found in children presenting invasive developmental disorders. These anguishes lead them to react using defensive mechanisms which progressively isolate them. The different measures proposed aim at enabling the expression of these archaic elements in a relationship with a therapist.“
The fact that the poor (even for the time) psychoanalytical model of autism has been dead and buried for decades has passed them by. in 2009 a consensus statement of autism experts stated,
“We have reached the consensus that practitioners and families around the world should consider [packing] unethical. Furthermore, this “therapy” ignores current knowledge about autism spectrum disorders; goes against evidence-based practice [and] poses a risk of preventing these children and adolescents from accessing their basic human rights to health and education.”
signatories include Michael Rutter, Simon Baron-Cohen and Eric Fombonne.
There is (unbelievably!) a study underway looking at the effectiveness or otherwise of this technique that is gaining popularity for use with adults displaying psychosis (for example in neurogenerative conditions such as Huntington’s and Parkinson’s diseases) and even the elderly having such episode. How the researchers got ethics board approval is beyond me.
Thank you to commentor, Carine, for sharing this video:
Packing is nothing new and has been in routine use on the continent for over thirty years (actually various forms for much longer – thanks Childmyths for the info). France, however is one of the few countries to still use it on such a routine basis. With 2012 being the year that France has declared autism to be its “National Cause of the Year” let’s hope – and act – to ensure this country, so wonderful in many ways, outlaws the torture of autistic people in their care.
For much more on this topic and how to support the fight to get this barbarism outlawed go to Support the Wall – Autism and sign the petition here
(the two name boxes are 1st name then surname in that order – Google Translate isn’t perfect!)
For an excellent summary of the history of such treatments please visit CHILDMYTHS