Hans Asperger - "Autistic Psychopaths" in Childhood - 10 pages

From the University Children's Clinic of Vienna

(Director: Professor Franz Hamburger)

"Autistic Psychopaths" in Childhood

By Lecturer (Privatdozent) Dr. Hans Asperger,

Head of the Therapeutic Pedagogy Department of the Clinic.

(Received on 8 October 1943)

Notes on Terminology

• Universitäts-Kinderklinik = "University Children's Clinic" (often translated as "University Pediatric Clinic").
• Vorstand = head/director/chair of the clinic.
• Doz. Dr. is short for Privatdozent Dr., an academic qualification roughly equivalent to an independent university lecturer authorized to teach.
• Heilpädagogische Abteilung is difficult to translate exactly. "Therapeutic Pedagogy Department," "Curative Education Department," or "Special Education Department" are all used in scholarship. "Therapeutic Pedagogy" is probably the most literal.
• Autistischen Psychopathen does not mean "psychopaths" in the modern English sense of antisocial personality disorder. In German psychiatric usage of the period, Psychopathie referred broadly to a constitutional or personality abnormality. A more interpretive translation would be:
  • Autistic Personality Disorder in Childhood
  • However, Asperger's actual title literally says:
    • Autistic Psychopaths in Childhood
  • Most historical translations therefore preserve the term despite its misleading modern connotations.

Problem Statement

Order and knowledge of the structure of things is one of the ultimate goals of science. In the abundance of life's phenomena, which are full of contradictions and merge into one another with blurred boundaries, thinking people seek to find a firm standpoint by giving individual phenomena a name, delimiting them against other phenomena, establishing connections, similarities, and oppositions—in short, bringing things into an order, into a system. This work is an essential prerequisite of cognition.

The science of man had to take similar paths. But nowhere are the difficulties greater than here:

Every human being is a unique, unrepeatable, indivisible being ("individual"), and therefore ultimately incomparable with others. In every character there are seemingly contradictory traits—indeed, life lives precisely from oppositions and tensions.

Finally, man is the most enigmatic creature on earth; the innermost essence of a personality is revealed neither to the one who seeks to know himself, nor to the gaze of the one standing opposite who wishes to penetrate another.

Habilitation thesis, submitted to the Medical Faculty of the University of Vienna.

1

Despite, or perhaps precisely because of these difficulties, it has been the ardent endeavor of thinking people since time immemorial to know human beings and also to classify them, to establish a series of images of human characters and to delimit them against one another—that is, to arrive at a typology that does justice to the multiplicity of life.

Attempts at a classification of human phenomena proceed mainly in three directions:

1. One seeks to apply a pair of opposites as an ordering principle: above all Kretschmer (for even if he recognizes three or four types, for him everything essentially resolves from the polarity of schizothymic and cyclothymic) and, despite various broadening differentiations, Jaensch (integrated-disintegrated) and Jung (introverted-extraverted).
3. Then the actual typological doctrines are to be cited here. An attempt is made to characterize and classify personalities, especially psychopathic personalities, according to a single, "leading" trait. It is impossible here to go into a discussion of the numerous existing typological doctrines, not even the typologies of psychopathic characters. Only the best-known and, for practical work, most useful classification, that of Kurt Schneider, shall be mentioned as an example for all.

Schneider distinguishes: hyperthymic, depressive, self-insecure, fanatical, attention-seeking, mood-labile, explosive, callous, weak-willed, asthenic psychopaths and describes the personality pictures convincingly from rich psychiatric experience.

Against such a way of looking at things, Paul Schröder and his school have raised weighty objections; it is a quite impermissible impoverishment to characterize personalities only according to a single trait and to disregard all others that equally give them their stamp.

1. Thus Schröder arrives at his classification of characters, especially of childhood characters.

If one succeeds in describing in a human being all essential sides of his psychic life, which in every individual are "alloyed" in different quantitative distributions into a whole, then a clear picture of this human being must emerge, which allows all his reaction patterns to be determined, from which one can also derive educational behavior and, not least, social prognosis.

Psychic abnormalities (the word "psychopathy" is rejected by Schröder because one might conclude from it that a psychopath is a half- or quarter-fool, which is true neither with regard to the clinical picture nor in a genetic-biological sense) do not consist in one of these sides being absent or a new one being added.

Thus Schröder describes, alongside the intellect, among the psychic sides: drive (spontaneity), stability, ambition, imagination, and, probably the most important of all these sides, the heart (Gemüt).

Not one side, but the harmony of all decides human fate.

Undoubtedly, this characterological approach is especially practically-pedagogically useful—it comes entirely from understanding and loving work with children and adolescents—also for assessing the necessity and type of welfare measures, certainly better than any of the current typologies, especially the systematic typologies.

But even against Schröder's approach, objections could be raised from both a fundamental and a practical standpoint.

How is it that the pictures of childhood personalities described by the Schröder school often still do not seem fully plastic and vivid?

Although this approach—with Hecht—claims for itself, in contrast to other one-dimensional systems of human assessment, to be multidimensional, one nevertheless often has the feeling, especially when one strives to apply this system to people oneself, that Schröder's "dimensions" or sides are insufficient, that there are still others not provided for in this system.

And a second, even more essential objection: all too easily, whoever applies this system of personality assessment may fall into the belief that the human personality can be explained as a sum of parts, as a sum of givens constant in themselves, which, differing only quantitatively in different cases, yield a whole through simple addition.

But a living thing, and especially the most highly organized living thing, man, is precisely not to be seen as a sum of parts, if one wants to do justice to his essence at all.

The human personality is an organism, which is to say: each of its essential traits is related to the other, receives its specific coloring from all others, and itself casts a specific light on all others.

Two examples should make this idea clearer.

Even if one admits that certain character traits cannot be considered detached from the others, this possibility seems at least to be given for intelligence.

But it can be shown that there is no such thing as intelligence per se, which differs only quantitatively in different people.

A second example: A central importance in Schröder's work is occupied by the assessment of the heart (Gemüt), that psychic side "whose content is the relationships to other people, which possesses the ability to take part in others, to sympathize, to be with them."

Precisely from the fact that the evaluation of the heart has such decisive importance in Schröder, we believe we recognize the greatness of Schröder's work.

In the same way, one could also demonstrate with the other psychic sides of Schröder's characterological system—as incidentally with other characterological systems, for instance that of Klages—that these sides exhibit great qualitative differences in different people.

Experience has shown us that the endeavor to grasp personalities according to pre-established points of view narrows the view, harbors the danger that one overlooks precisely the unique—and thus the essential—of this person.

Our path proceeds from intuition, from the attempt to grasp the organizing principle of the personality; we seek to point out the traits from which the personality to be assessed is thoroughly organized.

We owe the scientific foundation of this path to Ludwig Klages: it is the expressive phenomena of a person that reveal his essence to us.

The impression these phenomena make on us allows us to form an image of the personality standing before us.

This path from expressive phenomena to essence consciously renounces any system given in advance.

It consciously proceeds from the individual, seeks to comprehend his personality in its uniqueness, seeks the lawful correspondence of outer and inner, of physical constitution and psychic essence, of motorics, facial expression, gesture, of vegetative phenomena (on which the psychic "plays itself out"), of speech modulation and manner of speaking—and characterological givens.

At this point, an important objection must be addressed: If, in the manner described, renouncing any pre-given systematic approach, one focuses on the individual person and seeks to interpret his essence according to his expressive phenomena, according to his behavior in the real situation—does one not, in this kind of assessment, stand before nothing but individual personalities that have nothing to do with one another?

This is not the case.

Although every person is unique and unrepeatable in the core of his personality, individual characters nevertheless again and again arrange themselves into groups, into types.

The goal of this approach is likewise a typology, but one that even more explicitly than Schneider and others renounces a system built according to logical points of view, since such a system seems to us not to correspond to the reality of life.

This work has set itself the goal of demonstrating, through an example, the correctness and usefulness of the ideas developed above.

In what follows, a type of child shall be described that seems to us worthy of interest in many respects:

A uniform fundamental disorder, which expresses itself quite typically in the physical, in the expressive phenomena, in the entire behavior, causes considerable, very characteristic difficulties of social integration; and even if failure in the community stands in the foreground in many cases, it is nevertheless compensated in other cases by a particular originality of thought and experience, which often also leads to special achievements in later life.

The demand that exceptional people who fall outside the average framework also need a special pedagogical treatment adapted to their particular difficulties can be well substantiated with these psychopaths.

And finally, it can also be demonstrated here that even abnormal people are capable of filling their place within the framework of the great social community, especially when they find understanding and loving guidance.

There are thus enough reasons that justify the more precise description of precisely this group of abnormal children, especially since the questions touched upon here lead into central problems of psychology and pedagogy.