Background to my interest in teaching children with autism

PSYCHOTHERAPY BEYOND THE FRINGE, continued
Before fleeing the room, he was quick enough both to notice two things, and to duck whatever it was she threw at him. The two things he noticed were that before she blew up she was holding one of her wrists as if she wanted to choke it, and that the hand of the wrist she was holding had only the thumb and the index finger on it. Since he had nothing else to go on, he decided he must have made the important observations – the purpose of his visit.
He looked up her medical records to find out about her left hand. What he found out was that some years previously it had been suspected that she had cancer, presumably bone cancer, affecting some of the fingers of her left hand. Accordingly, three fingers of her left hand had been amputated. Now what? Felicity looked bleakly at the thin collection of questionnaires in her file. A strange prickly feeling spread over him. He recognized the feeling as the precursor, perhaps an aura, of what he was going to consider to be a brilliant idea – meaning it would be a half-baked guess that any kindergarten student of psychology would be ashamed to acknowledge.
The hypothesis was: what if this young woman was experiencing pain from ‘phantom digits’ – ‘imaginary’ pain as if it was coming from imaginary fingers which no longer were there. Phantom pain was not an unheard-of phenomenon. But Sadie knew the fingers were not there. So it might just be that she considered the idea of pain from non-existing parts to be too silly an idea to tell anybody about. That would account for why she was unable to communicate her ‘problem’ to anyone. Perhaps the pain was like a terrible toothache which would not go away, or like an itch she couldn’t scratch. That ought to create enough upset within her to churn her up to throw a tantrum from time to time. Felicity thought that if he had such a problem it might irritate him enough that he might throw tantrums too.
Felicity knew that nobody would accept an hypothesis as silly as the one he had just dreamed up. After all, that would be sensible, and this was a schizophrenic patient. So, rather than explaining his thought, he made up a story. He needed to find out, or so he said, what changes were occurring in her motivation. So he would administer tests to her repeatedly to see how her scores changed in relation to her tantrums. The staff accepted that plan because, after all, that’s what psychologists did – they gave tests. But Felicity also pointed out that he might expect her to get pretty irritated at the repeated testing. And so he wanted it known that, if she became too upset, he might have to use some anxiety-relief conditioning with her to help her settle down. That plan sounded satisfactory to all the staff involved with the case.

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