Forum News Interview with Dr. Martin Egge Dr. Martin Egge, child neuropsychiatrist and psychoanalyst, is the founder and director of Antenna 112 therapeutic and Antenina, residential and day treatment centers for children and adolescents with psychosis and autistic Buon Pastore Venice. She is the author treatment of autistic children in editorial Gredos. He is a member of the Lacanian School of Psychoanalysis and teacher of Freudian Institute for Clinical Science and Therapy of Rome.
chatted in Barcelona, \u200b\u200bwhere he lectured with Mari Cruz Fernández
" What is the difference between autism and psychosis?
The difference between autism and psychosis is in the precocity of the onset of autism, when he still has not developed the language, is in its infancy, has also not yet developed the imaginary question. In the psychotic subject can say that there is a breakdown of the symbolic porque este estaba ya desarrollado. El delirio es una especie de cura que construye un nudo menos angustiante. En el autismo sin embargo no hay regresión, no hay nada construido, lo que usa el autista son elementos en dos tiempos, encender y apagar; abrir y cerrar; actividades de alternancia. Los movimientos rítmicos, la estereotipia, la ecolalia ... sirven para dar estabilidad, predictibilidad, ordenar los objetos del mundo, des-angustia .
El trabajo del autismo es un intento de auto-cura; frente al caos y la angustia crean un pequeño mundo controlado, porque la angustia está detrás de cualquier rincón. De hecho cuando hay una primera apertura aparecen cosa que antes no estaban y esta apertura al mundo y al otro les produce greater distress.
The autistic creates a world where no relies more than himself, a stable and just keeps repeating that. This activity is constant and rapid, it is seized with a vertigo, which the autistic created as a defense becomes an instrument of it. For example, running in circles ever faster becomes a source of distress is the passage of real pleasure.
We know from the writings that describe autistic and "living in a war, first to put distance on the world, second to approach the world."
Something similar occurs in schizophrenia, suffer as they would like to be with others, be recognized but do not support proximity. Love may work well for distance, so do not feel alone and not invaded. The ambiguity of that distance is the main problem.
What does the autistic child? Required to be protected from other persecution, that it is not easy because the children are surrounded by the no. In general, in ordinary life when he proposes something like personal activity being told no, so amply demonstrated that what he says the other does not work or react violently. For parents is a desperate situation.
How to solve education in Italy autistic or psychotic child's grave?
In Italy in 1974 with the reform of psychiatry, all children and adolescents with such problems were sent to ordinary schools, were given a supportive teacher and sometimes an educator.
sometimes happened that such integration is not possible in regular school for them. In fact, one may ask if the person with autism can socialize. For them the world is full of rules, rules of others come to understand not only understand their own rule.
may be that the child and the teacher's classroom will be marginalized, segregated in the classroom. The problem is that teacher support is in the listening position and agrees only with the learning content, and the autistic person away because they feel persecuted and if the teacher insists the child is able to do crazy scenes to try to regulate the master that he is de-regulated.
There was a complaint in Italy that these cases many resources are spent in school, rather than on the health system. In school is the teacher support and educational support, they also have to be taking turns on the important wear is to be provided to these children.
The problem with these changes is that shift may be that no one knows the child, so there must be at least two reference teachers with each child.
Children aggressive or self-aggressive create a lot of impotence in education. To remove your child's self-punishment serves neither the charm nor the bonus, it works only sometimes. Sometimes the child accepts a bonus to not bother the other, but when he turns the child starts again.
When applying cognitive behavioral techniques, apply them who are exhausted including children and their parents. They say "I did my best", this will desculpabiliza but what is it for?.
The question is how to work with a child who is not in a position of learning? Antenna's work is to investigate precisely in this direction is how can we engage with the work of the child.
What is the logic of the Antennas work?
The Antennas are not very large spaces, there are not many players (professionals). Due to the problems of these children suffering from severe autism or psychosis, when introduced into the regular school feel lost, for them it is necessary to create a family structure that would provide security in space and time. This is an issue essential to enable them to bond with one another to give them security, bearing in mind that these are individuals who have no rules "socially" valid language, words that are the ones who pass these rules or standards, are confused in this case with his own being.
When the autistic child reaches the Antenna our job is to perceive what are the specific points of interest. The work in the workshop with the child is a meeting between the child's activity and the activity of the operator, if it becomes an obligation for the operator the child feels, this is critical. You must create the climate for installing the autistic child.
The atmosphere in the Antenna is happy, no games, irony between operators when something happens, kids are curious about, is a climate of non-exhaustion. The choice operators is very important to make it possible to establish this bridge. Alexandre
Stevens said that the autistic required as collateral to another large barred, does not seem to like is a function starts another careful and humble, "I find a guide to follow me."
How to become a partner of the autistic child then? The answer is making a guarantor, nothing happens "ugly." Make the presence of another with quiet significance. What does being perceived as a guarantor? The psychiatrist and psychoanalyst Jacques Lacan said that the cure for psychotic subject the therapist would of been a secretary of the alienated. In the meeting with the autistic is to say yes without hesitation. To say that we do need to create conditions that make this possible. When you reach the point of no, the patience of autism is over and everything restarts, do not trust. However
autistic subject is not resentful with the other, if there is a mistake, the operator can say with a great scene that I have committed error, help me and all is well. "
features are operator Antenna personal curiosity, their own likes and what is fundamental is the most alive of itself, may be singing, playing an instrument, dancing, painting, writing, .... It is necessary to sustain a semblance of closeness that is not intrusive. Nor does the transactional object, this object invades the space of the autistic child.
The operator also needs to put aside his narcissism, if not, there is no interchangeability with the other. The operators follow the same direction of the treatment on the computer each with its own style. Also need to account for why inventions do with children in the institution. Must be able to convey why and how.
All the operator does and what does it have to be very clear. Operators do not teach in Antenna, there is a wordless dialogue goes live to understand the points that children bring and workshops are organized around them. For example, one of the children danced in front of the television, not told "no dancing" became a dance workshop where you could choose the music, order CDs, write the texts of the songs. They are living links with the child's point that become regulated activities. But who regulates? The operator can not do what he wants, the child understands this, the activity remains until the child chooses.
operator can not tell because I do not want, complies with the program. The child knows that the board is part of every day what to do and with whom. Our pragmatic approach is that all operators work with all children. Working with different children is easier than ever with it.
Some children do not want to enter the institution, are afraid of being prisoners, they want to see if we are in rhythm, sometimes want to go to another shop, in this case is requesting authorization to a third party generally say yes. There are exceptions to humanize the rule. To produce a good match with these guys there is an entire operator's work is almost like a round worm.
Our practice in the Antennas known as "practice among many." To work with the autistic subject is essential interchangeability of operators, why? because when the child begins to open made a person appear a symbiotic relationship, exclusively, the same as the autistic subject's view of the world. It may happen that these features identificatory be given to an operator, and wants to be always the same, to cling to him and the rest of the Antenna is not interested.
When a first opening symbiotic carries this trait so the operator has to use its privileged relationship to continually open to other operators. When there is evidence that there is a symbiotic relationship with an operator is because there was too close because of the tendency of autistic dual relationships to control the situation. In this regard, while the other does not do what he wants, produces a duel.
is, as Jacques Lacan, to implement something that is frozen, artificially starting the signifying chain by making a human chain, the dialogue between him and the others.
What is the relationship between the institution and the parents of the children?
is essential that the working relationship established with the Antenna parents of children especially those aged 0 to 6 years. Working with them that their child may not accept the offers they make them. The subject with autism does not know that signifies a choice. These parents have to be received in their own suffering, not only as parents of an autistic child. If they blame would believe that there is determinism at work in each subject and this does not work that way.
The difference of Antennas with other devices is that their job is to produce an individual, ie show the autistic child whose word we take very seriously, for this reason in the child's entry to the device there is a decided yes what the child brings.
