Psychiatry and Art. Proc. IVth Int. Coll. Psychopathology of Expression,
Washington, D. C., 1966; pp. 61-67 (S. Karger, Basel/New York 1968).
The Compulsive Use of Non-verbal Expression by Three Very Disturbed Young Children
MADGE GERBER
California State College, Los Angeles, Calif., USA
Introduction
A well-known Hungarian painter, George Szánto, became blind. In his book, ‘My Black Years’, he describes this horrible experience and tells how he exchanged the brush for a pen. He became a famous writer and demonstrated that when a person has this overwhelming need for self-expression, he will somehow find a way.
This self-realizing drive can be equally great in the malfunction ing disturbed child, but his capacity to find and use a medium for expression is often thwarted. His attempts at communication too often appear as a stereotyped pattern of eruptive ‘acting out’ behavior that arouses anger rather than understanding. So it bebecomes the therapist’s task to try to understand his ‘language’. This may be movement or music, painting or drawing, modeling in clay, play, or merely bizarre behavior.
As a child therapist, I have no commitment to any of these modes of expression. My task is to provide a variety of materials and allow the child to make his own choice. Too often, however, a disturbed child is unable to make a free choice. He may repeat over and over a specific movement, action, or word. We, as therapists, are challenged to capitalize on this sole expression available and use it as a bridge from the child’s inner world to the outer world.
Such was the situation for three children whose cases will be presented here. None of them had any particular artistic talent.
Viewed chronologically, however, Mike’s pictures are most representative of the peculiar development of these children; and so I shall present him in most detail.
Mike**
When I first met him, Mike was a healthy-looking sturdy two-year- old; healthy-looking, that is, except for a large head full of bloody bruises. He showed no emotional reaction either to his mother’s abrupt leaving him with me, or to my presence in a new environment.
The natural maturational preoccupation of infants watching their hands took peculiar form in Mike. Stretching out his hands, he would try to find and follow their shadows for hours. Much more disturbing was his other habit – excessive head banging that caused the bloody bruises on his forehead. Mike’s attempt to learn about himself and the world was by throwing things; by withdrawing into the distance of the shadows; and by painful banging of his head on the wall, floor and furniture. There were objects, shadows and hard surfaces, but no people!
He did not like to be touched or disturbed in any way. The only way that I could make contact with him was to intrude the shadow of my hand into the shadow of his hand. At first he would push my hand aside, but ultimately he enjoyed our shadow battles, and so our shadow relationship began. Watching his shadow configuration, Mike learned about shapes; but he perceived details rather than wholes.
Once I was witness to a most dramatic episode. Mike was playing with his mother’s toes, fascinated by her red nails. His eyes slowly wandered up to her head. The happy noise, the grin on his face made us know that he had finally pieced his mother together. From this time on he no longer ignored her; eventually he ran to her, even hugged her, and snuggled up in her lap for seconds.
Fig. 1. A collection of the themes of obsessive drawing periods: ‘windows for houses’, ‘mail boxes’, ‘real house’.
Fig. 2. ‘Choice of colors’. Left window shades of blue and purple. Right window shades from light yellow to orange.
This ‘a-ha’ type of experience was typical of Mike’s learning pattern: long compulsive and repetitive preoccupation followed by sudden discovery. He used mountains of paper, walls, floors, furniture for his rubbing, smearing and painting. He went through long periods of drawing the same themes over and over again. Vertical lines first, then windows, houses, mail boxes, letters, numbers, calendars, clocks, and finally – trees, animals, and people. He did not go through the usual slow gradual learning process that we know with normal children. He drew the same subject hundreds of times and then, quite suddenly, new content would appear.
Mike had a passion for colors. At age two, this was manifested by his choosing certain crayons and throwing them. Later he would rub them on paper. He covered the walls of his room with colors and subject matter with which he was preoccupied at the time. While coloring, he never chose at random. He was persistent in his decision-making and selected only the right one. When he said, ‘I need an orange-red’, he sounded like one starving for food.
When he ultimately learned to read, he took great delight in picking up the blue-violet crayon, for example, and reading the label to verify ‘blue-violet’. When painting, he was fascinated by the mixing of colors.
Mike showed no language development until he was two and one-half years old. It was not surprising that his first words were ‘yellow’, ‘blue’, ‘red’, and ‘green’.
No one could make Mike do things, but whatever interested him he would do with great motivation and apparently with pleasure, yet there was a computer-like quality about him.
After years of accepting his ways of self-expression, I decided to become more intrusive and to attempt to inject a human touch into his mechanical behavior. When Mike was obsessed with the color of crayons, for example, I suggested to him to look at the color of people’s eyes; when he was obsessed with forms, I suggested that he discover the shapes of the human body instead of concentrating on his squares and circles and objects. Mike’s mechanical interest, moving from numbers, to clocks, to calendars taught him an accurate sense of time. Eventually we could fill this abstract concept of time with the real events in his own life. Toward the end of his therapy, he even made his own calendar:
1957 – “I bang in mommie’s stomach” (previously he had an infantile autistic idea that he was in his own stomach)
1958 – “I jump out”
1959 – “Sister is born”
1960 – “Meet Madge”.
From then on his life calendar became more elaborate and reflected his broadening world. His interest moved from the inanimate to the living. He even developed a strong attachment to a cat family living in his home, to animals in the zoo, and finally to people. But he would draw human figures only when he was prompted to do so.
As Mike became more verbal and more ‘human’, his drawing and ‘acting out’ were no longer his sole methods of self-expression and relating to people. Dramatic play became a new aspect in therapy.
True, we had to repeat the same ‘play’ many, many times, gradually adding new details to the script. Like all our activities, this was initiated by Mike. First, he would hide in a closet and then jump out of it crying like a newborn baby. I had to bottle-feed and diaper him.
Mike: ‘What color are the b. m.’s in my diaper?’
I: ‘Black’. (I had once told him that the first b. m.’s of a new born baby were black.)
As we had to repeat diapering during another ‘play’, Mike repeated the question. I had to go through the color changes from green to greenish-yellow to yellow (which meant that he was a healthy breast-fed baby on his way).
Then Mike would hide again and jump out, pretend to sit on a toilet and insist that I say that his b. m.’s were brown like those of a ‘regular boy’. Thus, Mike’s therapy became colored by colors, from the time he threw crayons to the time that he felt like a ‘regular boy’.
Fig. 3. Summary of the therapeutic process: Past = ‘funny boy’, present = ‘regular boy’, future = ‘real boy’.
**This story is also described in ‘The habilitation and education of the autistic child in a therapeutic day school‘ by Mrs. BELLE DUBNOFF. J. School Psychol. Vol. 4, pp. 52-59 [1965].
Harry
When I first met him, Harry was six years old – a small, tense, fearful, unbelievably messy boy. He started life as a premature twin; his brother died shortly after birth. Harry, the smaller of the twins, weighed 2 pounds 7 ounces. Although hampered by speech and learning difficulties, and by the bizarre manifestations of his emotional problems, Harry had developed at a slow but steady rate. Physically, he clung to people (mostly his mother), but emotionally he was a loner and lived in a world of grass, plants and trees.
Only after I learned to understand his incessant, almost unintelligible speech, and deciphered his metaphoric language did I gain entrance into his anxiety-ridden fantasy world. He was a weed! The bad seed which killed the grass. The trees were the good and bad adults to climb on and cling to. Harry had no way of expressing his aggression except through an inappropriate grin-like smile which embarrassed those around him; bizarre counter-phobic acting out’ behavior which frightened the unwary; and messiness which disgusted and repulsed people.
At one stage, he changed the green world of nature for the in-animate world of roads. For years he covered endless rolls of paper with roads: double lanes with red and green lights, and parking lots. For him the color black was ‘Tarman’ – the evil aggressive destructive force; red stood for taboos. His morbid roads led to fires, to avalanches, floods, crushing ocean waves, icy coldness, burning heat – Death Valley.
Slowly as Harry could accept some reality, the names of his fantasy roads became mixed with real ones and the endless roads of hopelessness started looking more like real maps.
Presently, Harry is 14 years old. He is still ‘different’ but he is acknowledged as an expert in geography and history. His emotional problems are far from being solved, but he can learn and function in an understanding environment. Fortunately he has been able to find such a tailored classroom with his peers in the ‘Learning and Behavior Problems Project’ which is going on at California State College in Los Angeles.
Robin
Robin had been diagnosed ‘schizophrenic’. He came to me at age 4. He is a beautiful child, but a magical tyrant – violently impulsive. If his desires were not met almost before they occurred, he had a catastrophic reaction or he withdrew into rocking, jumping, or some other autoerotic rhythmic activity.
Robin had no speech, but he could hum clearly any music he liked. He wanted the same record to which we had to perform the same ritualistic activities for more than a year. He performed to the same record by rolling on the floor, kicking, shaking – typical of infant movements. Music was the key to his language development. His first words were echoing rhythmical words from the music, or unrelated phrases he had heard. Once he became frantic because he wanted to hear one special record and his mother was unable to guess which one. Robin suddenly said ‘Chopin’. Indeed, that was the record he wanted.
Discussion
I have presented the cases of three children who chose three different methods of self-expression. We can ask ourselves: Why was Mike’s choice colors? Why did Harry fix on roads? Why did Robin rivet on rhythm? We can only speculate. But what they all three had in common was the great need for prolonged obsessive compulsive repetition of a mode of activity before they could move to another way of self expression. Thus behind the facade of long periods of stagnation, inner learning took place, the result of which was the spontaneous burst of new knowledge.
