To Psychoanalyst Bruno Bettelheim, "yes" is the most important word in the English language. Yes, he says, children suffering from the most severe forms of schizophrenia can be cured. Yes, he says, children who have been judged unalterably delinquent or diagnosed as mentally deficient can grow up into mature, functioning adults—even into Harvard professors. Bettelheim's principal prescription is almost total positivism. Whatever his patients ask, he usually says yes.
Bettelheim, who studied under Freud, is principal of Chicago University's Sonia Shankman Orthogenic* School for psychotic children. Dismissed as ultra-permissive by some psychiatrists, his approach has been impressively successful with the 190 children he has treated since he took over the school.
Statistics are unavoidably fuzzy because so much depends on the severity of the child's original handicap and on subjective judgment of what constitutes marked improvement. Bettelheim estimates the adjustment rate at 40% in the exceptionally severe psychosis known as infantile autism, a disorder whose victims refuse to recognize, listen, or in most cases even speak to the world around them. He puts the rate at 80% for other patients. Some psychiatrists think Bettelheim's figures may be optimistic, but concede that his results are vastly better than those achieved in most mental institutions.
Nude Super-mother. Bettelheim, who is also a University of Chicago professor of psychology and psychiatry, is now treating 53 disturbed children—an average-size group—at the Sonia Shankman School. There, restraints are totally absent. Doors are never locked. There are no bars on the windows and virtually no rules. Spankings and scoldings are forbidden. Bedrooms burst with toys and stuffed animals. A soda fountain and an unlocked cupboard brimming with cookies and candy await any child with a nagging thirst and a sweet tooth. Outside in the grassy courtyard, a concrete nude "supermother"—twice life-size—sprawls on the grass. "She takes a lot of abuse," says Bettelheim. "The children stomp on her, curl up in her arms, paint her breasts, endlessly scrub and sometimes kick her. They soon learn that the kicking hurts them more than the statue."
As do few other mental institutions in the U.S., the school reflects Bettelheim's belief that environment is a most important part of psychotherapy. "The children do not believe in what we say," he observes, "as much as in what we do. If they see that we have tried to make things extra nice for them, they will know we care." The concept is crystallized in the explicit instructions Bettelheim gives his staff, which includes four psychiatrists, two psychoanalysts, three psychologists, two psychiatric social workers, 18 counselors, and six teachers.
If a child runs away, he is not chased or stopped. He is accompanied and comforted until he himself decides to return.