| Summary: | To the extent the history of autism has been investigated, its object has been treated as a natural-scientific given. Its history then takes twofold shape, comprising (1) the history of the progressive discovery of more and more scientific facts about the object and (2) the history of the effects of culture on the manifestation of the underlying facts, or the politics and sociology of the autism diagnosis. Without discrediting these perspectives, this dissertation takes a different approach, in the mode of discursive history, tracing the changing semantics of the word "autism" from its invention around 1910 to the point when, in the early 1940s, it was first used in direct connection with the syndrome known as autism today. The results show that---whereas the standard narrative posits an epistemological break at the point when the modern autistic syndrome is "discovered"---in fact the development of the theory and symptomatology of modern autism was gradual and remains firmly rooted in earlier usages of the concept. What we take to be the foundational descriptions of modern autism---Kanner (1943) and Asperger (1944)---when read closely often exhibit stark differences from the picture of autism we ascribe to them. By situating Kanner's and Asperger's work in an earlier and fuller intellectual-historical context, the dissertation "makes strange" to us their accounts of autism, and in so doing allows us to see how much we ourselves have done in more recent times to make the concept of autism our own.
A principal contribution of the dissertation is to bring to light the broad and deep archive of the discourse of autism in the time period in question, revealing the full range of senses in which the term has been used. Contrary to the impression we have, the concept of autism was one of the most ubiquitous and theoretically important terms in Germanophone psychiatry from the 1910s through the 1940s and even beyond. The term entered circulation outside psychiatry as well, in such fields as cultural criticism, anthropology, and the history and criticism of art and literature. The dissertation renders a cross-section of the discourse of autism readable and interpretable for the first time.
The dissertation is divided into four chapters. The first considers the conceptual origins of autism in the work of Eugen Bleuler. Bleuler originally devised "autism" as an equivalent substitute for Sigmund Freud's term "autoerotism," which Bleuler understood as a form of thinking "turned away from the world" and "turned in on itself." Though primarily identified with Bleuler's studies of schizophrenia, his concept of autism was meant to have much broader relevance. By looking even further back in Bleuler's early writings, this chapter reveals autism to have an originary anthropological meaning: it designates what for Bleuler was the inmost tendency of the human, namely the tendency to think above and beyond the confines of reality. Chapter Two examines the discourse of autism between Bleuler and the later work of Asperger and Kanner. The trajectory of the term describes an arc of shifting assumptions. Bleuler had characterized autism as deficient in logical reasoning and driven by the affects. Over time, Bleuler's followers (including Ernst Kretschmer, Ludwig Binswanger, and Eugene Minkowski) effected a "switch in polarity" to a concept of autism defined as excessively logical and deficient in affect---the polar opposite of Bleuler's parameters. The chapter explains this shift against a countervailing movement in the ideology of science and culture, from a normative concept of community as grounded in logical agreement to one sustained by "irrational" affective harmonies. In each case, autism appears as the opposite of the norm, the subject apart.
Chapters Three and Four are devoted to readings of the foundational autism papers of Hans Asperger and Leo Kanner, respectively, in light of the results of the first two chapters. Chapter Three presents Asperger, who did his work in Vienna, as responding to and complicating the discourse of affect and empathy that had arisen in the preceding decades. Even as he lays out one of the earliest clinical pictures of what we recognize as autism, Asperger questions whether this condition can be adequately explained as a mere deficit in empathy. His more skeptical stance on this point sets Asperger apart from his colleagues and superiors, who held to a view of autism as affectively impaired and therefore "socially useless" that was endorsed by the ruling National Socialists. Asperger instead held autism to be in essence a distinctive relation to language and expression. The expressive phenomena of autism have, in his view, a unity among themselves and a particular shape that deviates from the norm but in so doing reflects all the more immediately the activity of thinking that constitutes the autistic core. The chapter shows Asperger's theory of autism to be a highly original reworking of the philosophy of Ludwig Klages, and concludes by showing that Asperger also offers a general theory of the relation between thinking and sociality.
Chapter Four takes on the work of Leo Kanner, the other founder of modern autism, who was born (like Asperger) in the Austrian empire and trained in Berlin, but who then emigrated to the United States, where his research on autism was conducted in Baltimore. There is a conventional view that he and Asperger discovered the phenomenon of modern autism in total ignorance of each other, which this chapter shows to be false. Working from archival sources, it tells how a third doctor, Georg Frankl, who had worked alongside Asperger in Vienna for many years, emigrated in 1937 and immediately joined Kanner's staff. The ideas Frankl brought from Vienna---chiefly his own original concept of "affective contact"---were critical in starting and guiding the research that led to Kanner's epochal 1943 autism paper. These findings show the transmission of autism from Europe to America in a wholly new light and allow Kanner's version of autism also to be read against the backdrop of the philosophical climate in Europe. Finally, delving into Frankl's work affords a view---not available anywhere else---of how the specific type that both Asperger and Kanner would dub "autistic" emerged in a gradual manner from earlier clinical types---foremost among them, surprisingly, the historically unique psychoses following upon the European epidemic of encephalitis lethargica in the 1920s. This is a crucial step in learning to see the emergence of modern autism less as a sudden "discovery" than as a stage in a long---and still ongoing---process of interpretation. This in turn will have unpredictable but significant effects on our thinking about autism now and in the future.
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