Background to my interest in teaching children with autism

PSYCHOTHERAPY BEYOND THE FRINGE, continued

            While struggling to control his jelly bowl’s spasms and regain his clinical manner, Felicity noticed something quite unusual in the test material.  The Rorschach (sometimes pronounced Roar-Shack) contained a series of related oddities in the chains of responses.  A surprising hypothesis formed itself in what we will loosely refer to as Felicity’s mind.  It was enough to return him to Alton and the serious business at hand.  He inquired into the presenting complaints and their history.     

            Alton was indeed a very successful businessman.  He had many investments.  He commanded an impressive income.  He was married and lived in a big house in an very well‑to‑do neighbourhood.  He had a good relationship with his wife and they spent much of their  time together in enjoyable and interesting pursuits.  They spent a great deal of time on their yacht and at their yacht club in the summers, and travelling to a variety of skiing destinations in the winters.  He did say that there were two things which marred their relationship.  Of course, one of these was his homosexuality.  But he made almost as much of the fact that he was constantly tired, to the point that he would frequently nod off to sleep in the middle of an activity.  Indeed, it was hard to imagine how he could be successful in the business world.  Throughout the history taking, his eyelids drooped and blinked as if he was about to fall asleep.

            In his middle twenties, fresh from university and from a marriage which he considered to be both socially advantageous and a union of love, he ‘discovered’ that he was gay.  He started to use up a great deal of time hanging around bars trying to make gay contacts.  He spent a lot of money buying gay porn.  When his gay contacts started to invade his straight life, he decided that he would have to shift his activities to male prostitutes.  They, however, made heavy demands for payments, not only for their services but also to insure their silence.  In spite of these deterrents, what he referred to as his “compulsive homosexual activities” increased steadily.  Finally, he consulted the referring psychiatrist out of sheer desperation and financial need.

            Felicity feigned the social grace of paying attention to this recitation.  He had already made up his mind about how he would proceed in this case.  When Alton seemed to have reached an end to his story, Felicity said he feared that Alton would think he was about to get a run‑around since Felicity wanted to send Alton to an EEG lab for an investigation.  Alton drowsily acceded to this request, and arrangements were made at once with a neurologist for an appointment for a diagnostic EEG (‘brain waves’ test).  Alton seemed surprised at the brevity of the interview with Felicity, but he was reassured when he learned that the fee would be proportional to the time used in the contact.  It was agreed that the next appointment with Felicity would await the outcome of the EEG.     

            The hypothesis which Felicity had fabricated was that Alton was unusually uncomfortable, even fearful, in the presence of dirt. But dirt* was encountered everywhere, so that he was unable to protect himself from exposure to his phobic stimulus by any usual avoidant means.  Although unaware of why it happened, Alton had found a means by which to reduce his awareness of this pervasive phobic substance.  He was able to lower his level of consciousness and became drowsy from time to time when he noticed dirt around him or thought about anything he considered to be dirty. 

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