José Ignacio Schilling: "There are many autisms".
Psychologist José Ignacio Schilling talks to us about Autism Spectrum Disorders.
Autism Spectrum Disorders are a reality that reminds us how complex the human mind is.
Psychological abilities and predispositions that are so natural to us that we take them for granted, may be absent or greatly modified in a small segment of the population: people with ASD.
And although in some cases these psychological alterations are mild, in others they imply the need for constant psychotherapeutic assistance, parenting strategies and parental behavior adjusted to the needs of these individuals, and cultural changes to make society a more welcoming and inclusive place. In this interview with psychologist José Ignacio Schilling, member of the therapy center Enmente, we will talk about what is known today about ASD. .
Interview with José Ignacio Schilling: the Autism Spectrum Disorders
José Ignacio Schilling Richaud is a psychologist with almost 20 years of professional experience in the care of adults, children and adolescents, and a member of the Enmente psychology center, located in Providencia. In this interview he talks to us about the particularities of Autism Spectrum Disorders and the implications it has on the lives of people who have developed them.
To what extent is it appropriate to talk about autism in the singular?
Autism is a condition produced by disturbances in early development, where significant gradations are observed.
It is not the same thing to speak of autism as described by Kanner, whose symptoms appear from the beginning of life and which is basically a total disconnection with the environment, as the so-called autism spectrum disorders, whose symptoms occur after a period of normal development. So, we could say that there are many autisms.
This makes it necessary to think of autism in a broad way, from Kanner's autism, which does not exceed 10% of cases, to Asperger's syndrome. The autism spectrum is a broad notion, suggesting the existence of the same subjective mode of functioning behind a great variety of clinical pictures.
This characteristic mode of functioning is associated with difficulty in acquiring simple skills in the domain of practical life and social adaptation.
What are the myths about Autism Spectrum Disorders that you consider most harmful?
I think the most harmful is to believe that there are no possibilities for development or integration.
During our history, human beings have surprised us on countless occasions with their abilities and possibilities of development when the necessary conditions are met.
In the same way, I believe that there is no diagnosis that can fully predict a person's future.
We will never be able to know how far he/she could develop with his/her basic difficulties, but there are always possibilities to obtain progress that would contribute to his/her well-being, no matter how minimal they may be.
Is it essential to know the causes of an alteration such as Autism Spectrum Disorders in order to be able to treat patients with this condition?
I do not think so. In fact, its causes are still a matter of discussion.
For its treatment it is important to understand the mental functioning of the person and the difficulties that each individual has developed in particular. Knowing their history and situation in depth are fundamental aspects to understand the particularities of each case.
What is the most important thing that psychology can do to help people with Autism Spectrum Disorder?
Psychology can do a lot to help.
Although the treatments are prolonged and the prognosis varies according to each case, we can help the patient to interpret reality in a less threatening way, to integrate into a group or community and to understand their particular difficulties, which would allow them to reduce stigmatization and the possibility of building affective bonds, which are the support of our mental health.
Today, people with ASD are more and more frequently subjected to re-education techniques that are mainly aimed at their obedience, with the result that their psychic suffering is not taken into account.
That is, their fears and anxieties are ignored, and this is something that psychology, particularly psychoanalysis, has taken care to include, noting that people with ASD often feel unloved, null and void by their environment.
And the most important thing that can be done to help their families?
Helping their families is indispensable, as it is particularly difficult for parents to find comprehensive institutions, where treatment is adapted to the individual's pace, and where distress is taken into account rather than fought against.
They require a lot of support to understand the patient's difficulties. Connecting and sharing with other families with similar difficulties is usually of great emotional support, it is configured as a network that sustains and counteracts the feelings of loneliness and incomprehension that are experienced with respect to society as a whole.
Families often feel very misunderstood, with very little support and tend to isolate themselves, which generates other concomitant difficulties.
What are the aspects of Autism Spectrum Disorders that you consider to be the highest priority for further research?
I believe that it is essential to research on specialized interdisciplinary clinical intervention modalities in the field, due to the complexity of both the diagnosis and the appropriate treatments. I mean that research is needed on more effective intervention models.
Due to the multiple difficulties associated with people suffering from an autism spectrum disorder, interdisciplinary intervention models are required to address the problem as a whole, with all its intervening variables and to think of them in an integrated manner.
Currently, each specialist usually approaches these issues from his or her area of expertise, fragmenting the problem, without achieving a Gestalt of both the patient and his or her particular reality.
(Updated at Mar 28 / 2023)