Bettelheim, Bruno 1903-1990

BIBLIOGRAPHY

The lifework of Austrian-born American psychologist Bruno Bettelheim was devoted to what he called “helping others in their becoming”—improving the treatment of severely disturbed children (1950, 1955, 1967, 1974) and the parenting of all children (1962, 1976, 1987, 1993) through careful attention to their inner experience and developmental needs. His greatest achievement was his pioneering work in milieu therapy, developed when he served as director (1944–1973) of the University of Chicago’s residential Orthogenic School, whose philosophy and functioning he first described in Love Is Not Enough (1950).

Bettelheim’s thinking was strongly influenced by his experience as a concentration camp prisoner in Germany during the late 1930s (see The Informed Heart 1960). He coined the term extreme situation to describe the self-disintegrating trauma of the camp experience, where prisoners knew they might be killed any moment at the whim of the guards, but they were unable to take meaningful action because there was no predictable relationship between the prisoners’ behavior and how the guards treated them. Experiencing his own personality disintegrating under these dehumanizing conditions, Bettelheim understood that the Nazis were trying to destroy individuality—in the camps and in Germany generally—and he began to realize the centrality of autonomy in mental health. If an environment designed to promote terror, unpredictability, helplessness, and hopelessness could destroy personality, he reasoned that a therapeutic environment designed to promote safety, predictability, autonomy, and hope (“love is not enough”) could heal personality. This became the model for the Orthogenic School.

Recognizing that the “symptoms” prisoners developed—often resembling those of schizophrenia and autism—were actually survival mechanisms, Bettelheim developed an overall adaptational viewpoint that stresses active mastery and that views symptoms as adaptations to complex internal and external conditions rather than pathological dysfunctions. In The Empty Fortress (1967), his groundbreaking study of autism, Bettelheim outlined a formal developmental theory that regards autonomy as one of the two core needs of the self (along with intimacy), adumbrating an original “self-psychology” significantly different from that of Heinz Kohut (1913–1981) (Frattaroli 1994).

Bettelheim’s important contribution to the phenomenology and treatment of autism has unfortunately been overshadowed by the controversy over his theory of etiology. He viewed autism as the child’s adaptive response to the mortal terror and powerlessness of growing up in an extreme situation created by inadequate or pathological mothering. He emphasized, however, that “it is not the maternal attitude that produces autism, but the child’s spontaneous reaction to it” (Bettelheim 1967, p. 69). He thought that autistic children might have a neurologically based hypersensitivity to sensory and emotional stimuli, such that they experience ordinary negative emotions (including their own anger) as overwhelming and life-threatening. They then “try, in defense, to blot out what is too destructive an experience for them” (Bettelheim 1967, p. 398) by withdrawing into the self-protective “empty fortress” of autism.

Contrary to modern theories that autistics are neurologically impaired in their ability to recognize emotional cues, their hypersensitivity to emotions is now well documented. As Karen Zelan (2003, 2006) describes, this is much more hopeful for treatment. A collaborator with Bettelheim in his study of autism, Zelan has built on his positive contribution in her subsequent work with autistic children, but she rejects his ideas about bad parenting. Autistic children feel overwhelmed by—and need to withdraw from—any sensory and emotional stimulation, whether from the outside world or from within. Their development is stalled when they cannot tolerate the over-stimulating presence of the very people they love—their parents. Parents may develop negative attitudes in reaction to the autistic withdrawal, but once they understand the underlying problem of hypersensitivity, Zelan finds that most parents are quite sensitive to their children’s needs and become crucially important partners in the treatment.

Shortly after Bettelheim’s death, several former students alleged that he was a sadistic tyrant who had beaten them abusively (Sutton 1996, prologue). They were students during Bettelheim’s last years at the Orthogenic School, when he was preoccupied with medical problems that forced his retirement and was worried about the school’s survival. As Sutton suggests, they may have felt cheated by his withdrawal and emotional disengagement during those years. Perhaps they felt betrayed when he killed himself after a life of preaching hope. And perhaps in the heat of these understandable emotions, they reacted, in a one-sidedly negative way, to real experiences with Bettelheim, who could be autocratic, impatient, and intimidating, and who did hit the children.

Ironically, Bettelheim’s therapeutic rationale for hitting children was to make himself a frightening but manageable object for just this sort of extreme negative emotion, so that staff members could maintain their vital positive role in the children’s lives. Psychological healing requires an atmosphere of safety, in which staff treat children with respect, acceptance, and understanding. But in any residential setting, the atmosphere will be charged with the children’s intense negative emotions—rage, hate, paranoia, shame, guilt, self-loathing, and so on—and with tension generated by their impulsive, potentially destructive or self-destructive acting-out of these emotions. In such an atmosphere, staff can easily lose their therapeutic attitude, reacting to patients’ negativity and acting-out with their own negativity, provoking further acting-out and creating an unsafe atmosphere. To protect staff members from being overwhelmed in this way, Bettelheim intentionally made himself the focus of all the negativity by assuming the role of feared and hated “big bad wolf” disciplinarian (Sutton 1996, chap. 14).

The perspective expressed in this article reflects the professional and personal experience of the writer, who was inspired to become a psychiatrist and psychoanalyst through working with Bettelheim during Bettelheim’s last years at the Orthogenic School (1970–1973). He experienced the school under Bettelheim’s direction as a loving, magical, transformative place, very much the “home for the heart” described in Bettelheim’s 1974 book (Frattaroli, 1994). He has also written about Bettelheim’s contributions to psychoanalytic theory, as well as his clinical teaching and therapeutic philosophy (Frattaroli 1992; 2001, chaps. 5, 6).

The writer saw Bettelheim hit children many times, but never maliciously or abusively. He hit them when their behavior was unsafe or threatened the staff’s ability to manage groups. Bettelheim’s practice of hitting was deliberate, controlled, predictable, and safe.

As former student Stephen Eliot (2003, chap. 7) describes, the children knew exactly what to expect from Bettelheim, an open-handed slap on the face that was humiliating enough to be a deterrent, but not physically harmful.

Bettelheim often said that because his hitting of children was not done in anger, it was much kinder than what the children would otherwise have done to themselves—out of guilt and self-hatred—or what they may have provoked staff to do to them in anger. Bettelheim’s regular practice, immediately after hitting a child, was to talk with staff members about the situation that had required his intervention, pointing out where they had missed or misunderstood important signals that could have told them what the child needed. His keen sense of the children’s needs and vulnerabilities in these discussions confirms that he was not angry with them. One cannot be in an abusive rage at a child one minute and show a thoughtful, empathic respect for that child the next minute.

Standard methods of behavioral control used in hospitals nowadays—any of which can become abusive in the angry impulse of the moment—include leather restraints, locked and padded seclusion rooms, and powerful psychotropic drugs, often used indiscriminately, always without regard for their long-term impact on growth and development (about which nothing is known). Having experienced all these methods in action as a psychiatrist, this writer considers Bettelheim’s approach to have been more humane and less destructive to patients’ trust and self-esteem. The writer does not advocate such a treatment approach for anyone else, but it was appropriate for Bettelheim and the unique conditions of the Orthogenic School, which functioned more like an extended family than a hospital.

The above account is entirely this writer’s, but it is consistent with Sutton’s (1996, chap. 14) more detailed and well-documented discussion of Bettelheim’s practice of hitting. At stake in this controversy is arguably the most important twentieth-century contribution to the wise, humane, ethical, and effective treatment of severely disturbed patients.

BIBLIOGRAPHY

PRIMARY WORKS

Bettelheim, Bruno. 1950. Love Is Not Enough: The Treatment of Emotionally Disturbed Children. Glencoe, IL: Free Press.

Bettelheim, Bruno. 1955. Truants From Life: The Rehabilitation of Emotionally Disturbed Children. Glencoe, IL: Free Press.

Bettelheim, Bruno. 1960. The Informed Heart: Autonomy in a Mass Age. Glencoe, IL: Free Press.

Bettelheim, Bruno. [1962] 1971. Dialogues with Mothers. New York: Avon.

Bettelheim, Bruno. 1967. The Empty Fortress: Infantile Autism and the Birth of the Self. New York: Free Press.

Bettelheim, Bruno. [1974] 1985. A Home for the Heart. Chicago: University of Chicago Press.

Bettelheim, Bruno. 1976. The Uses of Enchantment: The Meaning and Importance of Fairy Tales. New York: Knopf.

Bettelheim, Bruno. 1987. A Good Enough Parent: A Book on Child-Rearing. New York: Knopf.

Bettelheim, Bruno, and Alvin Rosenfeld. 1993. The Art of the Obvious: Developing Insight for Psychotherapy and Everyday Life. New York: Knopf.

SECONDARY WORKS

Eliot, Stephen. 2003. Not the Thing I Was: Thirteen Years at Bruno Bettelheim’s Orthogenic School. New York: St. Martin’s Press.

Frattaroli, Elio. 1992. Orthodoxy and Heresy in the History of Psychoanalysis. In Educating the Emotions: Bruno Bettelheim and Psychoanalytic Development, ed. N. Szajnberg, 121–150. New York: Plenum.

Frattaroli, Elio. 1994. Bruno Bettelheim’s Unrecognized Contribution to Psychoanalytic Thought. Psychoanalytic Review 81: 379–409.

Frattaroli, Elio. 2001. Healing the Soul in the Age of the Brain: Becoming Conscious in an Unconscious World. New York: Viking.

Sutton, Nina. 1996. Bettelheim: A Life and a Legacy. Trans. David Sharp. New York: Basic Books.

Zelan, Karen. 2003. Between Their World and Ours: Breakthroughs with Autistic Children. New York: St. Martin’s Press.

Zelan, Karen. 2006. Amazing Stories of Families with Autistic Children. Unpublished manuscript.

Elio Frattaroli

BETTELHEIM, BRUNO (1903-1990)

The psychoanalyst and educator Bruno Bettelheim was born in Vienna on August 28, 1903, and died on March 13, 1990, in Silver Spring, Maryland.

The son of a wood merchant from the assimilated Jewish middle class, Bettelheim had to give up his studies when his father died of syphilis. He was twenty-three and remained scarred by his father's "shameful" death. He returned to his studies in philosophy ten years later and in February 1938 was one of the last Jews to earn a doctorate at the University of Vienna before the Anschluss. His thesis was entitled "The Problem of Beauty in Nature and Modern Esthetics" and was supervised by the famed Karl Bühler, director of the Institute of Psychology and a pioneer of Sprachtheorie (theory of language).

In 1930 Bettelheim had married a schoolteacher who was a disciple of Anna Freud, but he was unhappy. He saw reflected in his wife's eyes the ugliness that had obsessed him since he first saw it in his mother's eyes. In 1936 he entered analysis with Richard Sterba, then secretary of the Vienna Society and the only non-Jew on its Committee. At the time of the Anschluss, Sterba abruptly abandoned all his patients, preferring exile to the risk of being called upon by the Nazis to rid the society of Jews.

When Bettelheim was arrested by the Gestapo on May 29, 1938, he was thus in the midst of his analysis. The ten and a half months he spent in Dachau, and later in Buchenwald, had a decisive influence on him. To escape madness, he studied the effects of the camps on the other prisoners, the prison guards, and himself. Whenever he could, he shared his observations with Paul Federn's son Ernst.

Bettelheim was liberated on April 14, 1939, and arrived in the United States three weeks later. He had lost everything. His wife left him. His first job was to devise a test for evaluating knowledge in the plastic arts that is still in use today. Between 1941 and 1944 he taught art history, German literature, and psychology. Above all, he sought to publish the article on the concentration camps that he had been working on since his release.

Rejected several times on the grounds that it was nonobjective or "anti-German," the article finally appeared in October 1943 in the journal of the Harvard psychology laboratory. "Individual and Mass Behavior in Extreme Situations" is a study of the deportees that makes particular use of Anna Freud's concept of "identification with the aggressor." In 1945, General Eisenhower had the article distributed to American officers in Europe, who were ill-prepared for the opening of the concentration camps.

In 1960 Bettelheim returned to this text in The Informed Heart: Autonomy in a Mass Age, the first book in which he made a connection between his experiences in the camps and the Freudian-inspired "milieu therapy" he established at the University of Chicago's Orthogenic School, of which he became director in 1944. This connection can be summarized as follows: Having witnessed mentally sound people go insane because of the effects of the camps, Bettelheim attempted to remedy the problems of severely disturbed children by creating an environment that was totally responsive to their needs and symptoms. This approach remained Bettelheim's trademark and established the reputation of his school worldwide.

In 1973 Bettelheim retired to California. He conducted seminars, supervised therapists in training, wrote, and was a sought-after lecturer. In 1984, the death of his second wife, who was also from Vienna and had borne him three children, plunged him into a deep depression that he struggled against for another six years, pursuing his activities despite health problems. After the publication of Freud 's Vienna and Other Essays in January 1990, he moved to a retirement home near Washington, D.C. Two months later, he committed suicide by ingesting barbiturates and, to ensure that he would not be "saved," putting a plastic bag over his head. Fifty-two years earlier, on the same night, the Nazis had entered Austria to the cheers of a crowd shouting "Death to the Jews."

Bettelheim was a good storyteller and popularizer of Freud's ideas, and his books sold very successfully. He recounted his clinical experience in three books about the Orthogenic School, Love Is Not Enough: A Treatment of Emotionally Disturbed Children (1950), Truants from Life (1955), and A Home for the Heart (1974), and in The Empty Fortress (1967), which studies three cases of autism. With regard to theory, he was a maverick. He initially conceived of his school as "putting Freud's concepts into action." He then distanced himself from Freud to flirt with culturalism in Symbolic Wounds: Puberty Rites and the Envious Male (1954). After moving closer to the ego psychology that predominated at the Chicago Institute headed by Franz Alexander (The Informed Heart ), he returned to Freud by way of the self-psychology advocated by his friend Heinz Kohut (The Empty Fortress ), and he ended up writing a long polemical essay denouncing the ways in which Freud had been betrayed by his English translator, James Strachey (Freud and Man 's Soul, 1983). A careful reading of Surviving and Other Essays (1979), a collection of Bettelheim's writings on Nazism, gives a glimpse of the painful self-analysis by which he continued, first in the camps and then for the rest of his life, the work that had been interrupted by the Anschluss.

The Uses of Enchantment: The Meaning and Importance of Fairy Tales (1976), a study of the role of fairy tales on the development of the unconscious, is Bettelheim's best-selling book. He also wrote a book on education in the kibbutzim, The Children of the Dream (1969), and many other works on children's education (Dialogues with Mothers, 1962; A Good Enough Parent, 1987; and numerous articles).

Bettelheim's suicide was immediately followed by a furious scandal, with former patients and students denouncing him as a liar, a brute, and a despot who was all the more hypocritical because he had preached respect for children. Beyond what it reveals about the confusion ensuing from the suicide of such a man, this scandal is interesting because it goes to the heart of Bettelheim's clinical genius: an almost infallible intuition about what causes a child to suffer and the ability to confront his patient's most destructive impulses. He often compared his role to that of a lightning rod, attracting lightning and thus proving that it had not killed anyone—not even him.

Too often catalogued as a specialist in autism, Bettelheim was above all a master teacher who continually succeeded in getting the therapists under his supervision and the educators in his school to recognize the part of themselves that was put at risk by their patients' madness. That said, his depictions of the most disturbed students in his school, including some autistic patients, were so vivid, so focused on what these children were doing—and not on their deficiencies, as was common practice—that his work had a decisive influence on the way young psychotic patients are treated in psychiatric hospitals around the world.

Nina Sutton

See also: Autism; Ego; Empty Fortress, The ; Infantile schizophrenia.

Bibliography

Bettelheim, Bruno. (1960). The informed heart: Autonomy in a mass age. New York: Alfred A. Knopf.

——. (1990). Freud 's Vienna and other essays. New York: Alfred A. Knopf.

Bettelheim, Bruno, and Karlin, Daniel. (1975). Un autre regard sur la folie. Paris: Stock.

Jurgenson, Geneviève. (1973). La Folie des autres. Paris: Robert Laffont.

Pollak, Richard. (1997). The creation of Dr. B.: A biography of Bruno Bettelheim. New York: Simon and Schuster.

Raines, Theron. (2002). Rising to the light: A portrait of Bruno Bettelheim. New York: Alfred A. Knopf.

Sutton, Nina. (1995). Bruno Bettelheim: The other side of madness (David Sharp, Trans.). London: Duckworth.

Bruno Bettelheim

Bruno Bettelheim (1903-1990), a controversial Austrian-born American psychoanalyst and educational psychologist, pioneered in the application of psychoanalysis to the treatment of emotionally-disturbed children

On Aug. 28, 1903, Bruno Bettelheim was born in Vienna. He received his doctorate from the University of Vienna in 1938. When Austria fell to Hitler, Bettelheim was sent to a concentration camp, but was able to go to the United States in 1939, becoming a citizen five years later.

During his formative years in Vienna, Bettelheim was influenced by World War I, the Bolshevik Revolution, and Sigmund Freud. Like other Viennese intellectuals, he could not accept the optimism and complacency of preexisting Western European ideals. In their search for new pathways, his generation chose between the new social changes reflected in Russian communism and later National Socialism, and the excitement of the new psychoanalysis pioneered by Freud. Bettelheim opted for psychoanalysis, yet his work always reflected interest in the impact of social systems on individuals.

Achieved Fame in the United States

Bettelheim married Trude Weinfeld in 1941, and they had three children. Except for two years at Rockford College in Illinois, he worked principally at the University of Chicago, where in 1963 he became Rouly professor of education and professor of psychology and psychiatry.

Bettelheim won fame from his books and articles in both the scientific and popular press. His passionate, intensely personal, and anecdotal style drew some criticism from the scientific community, though few questioned his talent for conceptualization and for developing provocative, imaginative ideas.

His major contributions came from his work at the Sonia Shankman Orthogenic School of the University of Chicago, a residential treatment institution for rehabilitating children with severe emotional disturbances, where he became principal in 1944. In Love Is Not Enough (1950) and Truants from Life (1955), he described the school's educational and therapeutic philosophy, largely his own creation. These ideas are elaborated, with case material, in The Empty Fortress: Infantile Autism and the Birth of the Self (1967). He viewed the behavior of severely withdrawn children as resulting from overwhelmingly negative parents interacting with infants' susceptibility during critical early stages in their psychological development. The children hold themselves responsible for external catastrophes and withdraw into fantasy worlds as if to prevent further destructive behavior. Bettelheim likened this destructive dehumanizing of a child to the effects of Nazi concentration camps on the inmates, deriving many of these ideas from his own experience, described in The Informed Heart (1960). His treatment method involved an unconditional acceptance by the school's staff of all such children's behavior. For these theoretical and therapeutic views he had followers and critics. For example, Bettelheim's assumptions on autism have since been dismissed. It is widely acknowledged that autistic and emotionally-disturbed children are not the same.

A popular speaker, Bettelheim traveled widely in his work. The Children of the Dream (1969) reports his studies on an Israeli kibbutz of the methods and results of communal child rearing, which he felt had important implications for American education. His 1976 book, The Uses of Enchantment, was a popular psychoanalytical look at fairy tales.

Controversial Even in Death

In 1990 Bettelheim committed suicide. Soon after, allegations arose that he had falsified many of his credentials and had been physically abusive to the children in his care. Many feel his suicide is proof that the allegations were true, but others staunchly defend Bettelheim's work. Regardless of which interpretation is correct, Bettelheim's impact cannot be denied.

Further Reading

Pollak, Richard, The Creation of Dr. B: A Biography of Bruno Bettelheim (1997).

Sutton, Nina, Bettelheim, A Life and Legacy (1996). □

Bruno Bettelheim

1903-1990
Austrian-born American psychologist known for his treatment of emotionally disturbed children, particularly autistic children.

Bruno Bettelheim was born in Vienna in 1903. He was trained as a psychoanalyst, receiving his Ph.D. from the University of Vienna in 1938. In the same year, the Nazis conquered Austria, and Bettelheim was interned in the Dachau and Buchenwald concentration camps. He was released in 1939 and emigrated to the United States, where he first became a research associate of the Progressive

Education Association at the University of Chicago, and then an associate professor at Rockford College from 1942 to 1944.

In 1943, Bettelheim gained widespread recognition for his article, "Individual and Mass Behavior in Extreme Situations," a study of human adaptability based on his concentration camp experiences. In 1944, he was granted a dual appointment by the University of Chicago as assistant professor and head of the Sonia Shankman Orthogenic School, a residential treatment center for 6 to 14-year-old children with severe emotional problems. Here he successfully treated many children unresponsive to previous therapy, using the technique—which has been both lauded and criticized—of unconditionally accepting their behavior. Bettelheim was also concerned with the emotional lives and upbringing of normal children, and with applying psychoanalytic principles to social problems.

In three decades as an author of works for both scholarly and popular audiences, Bettelheim covered a broad range of topics. Love Is Not Enough (1950), Truants from Life (1954), and The Empty Fortress (1967) are based on his work at the Orthogenic School. The Informed Heart (1960) deals with Bettelheim's concentration camp experiences. Children of the Dream (1969) analyzes communal childrearing methods on an Israeli kibbutz and their implications for American family life. The Uses of Enchantment (1976) argues for the importance of fairy tales in a child's development. Bettelheim's later books include On Learning to Read: The Child's First Fascination with Meaning (1981) and Freud and Man's Soul (1982). A full professor at the University of Chicago from 1952, Bettelheim retired from both teaching and directorship of the Orthogenic School in 1973. Following the death of his wife in 1984 and after suffering a stroke in 1987, Bettelheim committed suicide in 1990.

See also Adaptation; Autism

Further Reading

Sutton, Nina. Bettelheim, A Life and a Legacy. New York: Basic Books, 1996.

Bruno Bettelheim , 1903-90, American developmental psychologist, b. Austria. He received his doctoral degree (1938) from the Univ. of Vienna. He was imprisoned in the Dachau and Buchenwald concentration camps during the Nazi occupation of Austria. After emigrating to the United States in 1939, he published (1943) a highly influential essay on the psychology of concentration camp prisoners. He taught psychology at the Univ. of Chicago (1944-73) and directed the Chicago-based Orthogenic School for children with emotional problems, placing special emphasis on the treatment of autism . Bettelheim believed that autistic children had been raised in unstimulating environments during the first few years of their lives, when language and motor skills were developing. Although his theories on autism have been largely discredited, he authored a number of influential works on child development, including The Informed Heart (1960), The Empty Fortress (1967), and The Uses of Enchantment (1976).