Like thousands of French children whose parents believe that they have autism, Rachel’s six-year-old son had been placed by the state in a psychiatric hospital day unit. The team there, adherents of post-Freudian psychoanalysis, did not give a clear-cut diagnosis.
Rachel, who lived in a small village outside the alpine city of Grenoble, said she would go elsewhere to have all three of her children assessed, but the hospital called social services, who threatened to take the children away from her.
A consultant psychiatrist said Rachel was fabricating her children’s symptoms for attention, that they were not autistic, and that she wanted them to have autism spectrum disorder to make herself look more interesting.
Illustration:Constance Chou
Rachel’s children were taken and placed in care homes. The children were subsequently diagnosed with autism and other issues, proving Rachel right, but despite a high-profile court battle in which parents’ groups denounced the “prehistoric vision of autism in France,” Rachel, who herself has Asperger syndrome, has still not won back custody of her children two years later. They remain in care with limited visiting rights. Local authorities insist the decision was correct.
“I’m condemned to stand by powerless at the loss of my family,” Rachel wrote after their latest visit to her at Christmas, fearing her children had regressed in care. “I’m destroyed. My children are destroyed.”
The “Rachel affair,” entering another courtroom appeal battle this summer, has become a symbol of what parents’ groups call the “state scandal” of the treatment of autistic children in France. The crisis is so acute that the centrist French President Emmanuel Macron has deemed it an urgent “civilizational challenge,” promising a new autism action plan to be announced within weeks.
The UN stated in its most recent report that autistic children in France “continue to be subjected to widespread violations of their rights.”
The French state has been forced to pay hundreds of thousands of euros in damages to families for inadequate care of autistic children in recent years.
The UN found that the majority of children with autism do not have access to mainstream education and many “are still offered inefficient psychoanalytical therapies, overmedication and placement in psychiatric hospitals and institutions.”
Parents who oppose the institutionalization of their children “are intimidated and threatened and, in some cases, lose custody of their children,” the UN said.
Autism associations in France complain that autistic adults are shut away in hospitals, children face a lack of diagnosis and there is persistent use of a post-Freudian psychoanalytic approach that focuses not on education but on the autistic child’s unconscious feelings toward the mother.
A 2005 law guarantees every child the right to education in a mainstream school, but the Council of Europe has condemned France for not respecting it. Pressure groups estimate that only 20 percent of autistic children are in school, compared with 70 percent in England.
“France is 50 years behind on autism,” said Sophie Janois, Rachel’s lawyer.
Janois’ book, The Autists’ Cause, which was published this month, sets out to raise the alarm on the abuses of autistic people’s legal rights.
“Parents are told: ‘Forget your child, grieve for your child and accept the fact that they will be put in an institution,’” Janois said.
“Underlying this is a cultural problem in France,” Janois said. “France is the last bastion of psychoanalysis. In neighboring countries, methods in education and behavioral therapies are the norm and psychoanalysis was abandoned a long time ago. In France, psychoanalysis continues to be applied to autistic children and taught in universities.”
She said parents were forced to fight a constant administrative battle for their children’s rights.
“There are suicides of parents of autistic children, at least five in the last couple of years,” Janois said.
The row over post-Freudian psychoanalysis and autism in France has been bitter. Eighteen months ago, a group of deputies tried and failed to make parliament ban the use of psychoanalysis in the treatment of autistic children, claiming that the “outdated” view of autism as a child’s unconscious rejection of a cold, so-called “refrigerator” mother was denying children educational support.
Psychoanalysts, who have a powerful, leading role in French mental healthcare, criticized the campaign as “harmful” and defamatory.
In 2012, the French health authority stated that psychoanalysis was not recommended as an exclusive treatment method for autistic people because of a lack of consensus on its effectiveness, but most state hospitals still use the methods.
In addition, the UN warned in 2016 that a technique called “packing” — in which an autistic child is wrapped in cold, wet sheets — amounted to “ill-treatment,” but had not been legally banned and was reportedly “still practiced” on some children with autism.
The then health minister issued a memo advising that the practice should stop.
Parents insist that excellent professionals are present in France, but they are few and in high demand, with services patchy and varying by area.
“I was told by local authorities: ‘Why are you insisting on school? Put him in an institution,’” said one mother near Tours of her high-functioning autistic seven-year-old, who is now doing well academically. “In France, there is the autism of the poor, and the autism of the rich. If I didn’t have money and the skill to fight, my son would have ended up in a psychiatric hospital.”
Catherine Chavy’s son Adrien is 20 years old. As a small child he was treated part-time at a state psychiatric hospital that used a psychoanalytical approach. His autism went undiagnosed for years. Chavy fought for a diagnosis and entry to an elementary school, later finding a center that used educational and behavioral methods, where Adrien flourished.
When her son reached 15, there were no provisions at all. She privately organized permanent support for him at home.
“He cooks, plays sports, goes to his grandma’s for lunch — he has a lovely life, going out every day. If I hadn’t done this on my own, I think he would be in an adult psychiatric hospital, tied up and on medication,” she said. “The situation in France is a health and education scandal.”
Pascale Millo set up an association for parents of autistic children in Corsica. She has a 14-year-old son, also called Adrien, with high-functioning autism and dyspraxia. The state put him in a psychiatric hospital day unit for years, but Millo did not get a diagnosis until he was nine. Adrien is academically strong, but she has had to fight for his right, as someone with dyspraxia, to do all his schoolwork on a computer, taking on the training and support herself and never sure whether, from one month to the next, lack of support in the education system will mean his studies are cut short.
“In theory, France has everything: state finances and laws to protect us,” she said. “But those laws are not being respected.”
Vincent Dennery, who heads a collective of autism associations, said he hoped for concrete, practical measures in Macron’s autism action plan, as well as a move from a medicalized approach toward education.
“There are still thousands of autistic children in psychiatric hospital day units who have no reason to be there, but their parents can’t find any other solution,” he said.
Dennery said he felt society needed to shift.
“Culturally, French society has been a place of exclusion,” he said. “A large number of societies deinstitutionalized disability or difference and moved to include people in ordinary life, but France has not.”
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