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Since attempts to impose toilet discipline often worsen emotional problems in psychotic children, Bettelheim has removed all rules about bodily elimination. Elimination any time, anywhere, is preferred to withholding or self-inflicted constipation. If a child hits, kicks or bites, he is not fought or punished but is pacified; later his therapists seek the reasons why. Argues Bettelheim: "A spanking achieves a short-range goal, but it has a price tag—degradation and anger —that I am not willing to pay. My task is to build up self-respect. And I believe people do the right thing not because they are scared to death but because their self-respect requires it."
Electric Boy. The greatest effort is made with the Orthogenic School's autistic children. Thwarted or ignored in early childhood by hostile or indifferent parents, victims of autism (from the Greek word for self) sense during infancy that their own actions cannot shape their lives. Consequently, they withdraw into a living-death fantasy existence characterized by fear and stony silence—or, at best, by unintelligible animal noises. Unwilling to admit their own existence because they fear that the outside world will destroy them, many autistics refuse to use the pronoun "I" if and when they do speak.
In his book The Empty Fortress, Bettelheim tells of Joey, a nine-year-old autistic child who believed that he was run by electrically powered machines, and therefore could not exist unless he plugged himself into imaginary sockets. At night, he could breathe only with the aid of a handmade cardboard "carburetor" hung on his bedpost. Given to maniacally destructive outbursts at first, Joey slowly quieted under Bettelheim's care. From machines, the boy switched his self-identification to eggs and chickens, which at least were living things. Literally returning to infancy during psychotherapy, he put the second fantasy to ultimate use. On the day Joey first crossed the border to the world of humans, he crawled under a blanket-covered table, cackled excitedly, flapped his "wings," then grew silent. "I laid myself an egg," he said moments later. "Then I hatched myself and gave birth to me." Joey spent six years at the Orthogenic School. Restored, he has since finished high school, and now works as a TV repairman.