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自闭症作为情感交流的障碍:乔治·弗兰克尔被遗忘的角色。

Autism as a Disruption of Affective Contact: The Forgotten Role of George Frankl.

作者信息

Muratori Filippo, Bizzari Valeria

机构信息

University of Pisa, Department of Developmental Neuroscience, IRCCS Stella Maris.

Clinic University of Heidelberg, Department of Psychiatry, Center of Psychosocial Medicine.

出版信息

Clin Neuropsychiatry. 2019 Aug;16(4):159-164.

Abstract

The simultaneous description of autism by Asperger in Vienna and Kanner in Baltimore is usually considered a strange coincidence. Here we propose that the Jewish psychiatrist Georg Frankl, who worked with both Asperger and Kanner, had more than a marginal role in the early history of autism. While Hans Asperger did not recognize the talent of his superior Georg Frankl, Leo Kanner immediately recognized his merits and acumen when Georg Frankl arrived at the Johns Hopkins as a refugee. This proposal is supported by the retrieval of an unpublished Frankl's manuscript on autism which is here analysed and that deserves credit for anticipating some of the contemporary visions of autism. The manuscript deepens the distinction between 'affective language' and 'word language' that George Frankl had already developed in his previous papers in 1933 and 1943. While in neurotypical subjects the everyday language is an integration of affective and word language, autistic children register a break between them and, according to Frankl, this break is at the core of autism and can have a wide range of expression and tentatives of compensation. It is also proposed that the centrality of disturbances in affective language can be in agreement with a vision of autism as a neurodevelopmental disorder that interferes with the current notions of intersubjectivity, intercorporeality and interaffectivity. Frankl's perspective about autism can still be considered innovative today for other reasons. He proposed that autism could cover a spectrum of conditions; that it is a state of mind that is not necessarily abnormal; that it is a neurobiological condition that needs to be understood by others before of being modified. Finally the conceptualization of autism as a disturbance of affective language is in agreement with the DSM-5 which has created a sociocommunicative domain that comprises only deficits in non-verbal communication (that is affective language), putting the verbal language (that is word language) as a specificator outside the diagnostic criteria.

摘要

阿斯伯格在维也纳和卡纳在巴尔的摩对自闭症的同时描述通常被视为一个奇怪的巧合。在此我们提出,曾与阿斯伯格和卡纳都共事过的犹太精神病学家格奥尔格·弗兰克尔在自闭症早期历史中所起的作用远不止微不足道。虽然汉斯·阿斯伯格没有认识到他的上级格奥尔格·弗兰克尔的才能,但当格奥尔格·弗兰克尔作为难民抵达约翰·霍普金斯大学时,利奥·卡纳立刻就认可了他的优点和敏锐。这一观点得到了一份未发表的弗兰克尔关于自闭症的手稿的佐证,本文对该手稿进行了分析,它因预见了一些当代对自闭症的看法而值得称赞。该手稿深化了格奥尔格·弗兰克尔在1933年和1943年之前的论文中就已提出的“情感语言”和“文字语言”之间的区别。在神经典型个体中,日常语言是情感语言和文字语言的整合,而自闭症儿童则表现出两者之间的脱节,据弗兰克尔所说,这种脱节是自闭症的核心,并且可能有广泛的表现形式和补偿尝试。还提出情感语言障碍的核心地位可能与将自闭症视为一种神经发育障碍的观点相一致,这种障碍会干扰当前关于主体间性、身体间性和情感间性的概念。弗兰克尔对自闭症的观点如今仍可因其其他原因而被视为具有创新性。他提出自闭症可能涵盖一系列情况;它是一种不一定异常的心理状态;它是一种神经生物学状况,在被改变之前需要他人去理解。最后,将自闭症概念化为情感语言障碍与《精神疾病诊断与统计手册》第五版(DSM - 5)一致,该版本创建了一个社会沟通领域,其中仅包括非言语沟通(即情感语言)方面的缺陷,将言语语言(即文字语言)作为诊断标准之外的一个指定因素。

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