Impaired interactions triggering defense or exposing deficit: exploring the difference between the withdrawn and the "undrawn" autistic child. Commentary on "An integrative model of autism spectrum disorder: ASD as a neurobiological disorder of experienced environmental deprivation, early life stress, and allostatic overload" by William M. Singletary, M.D. Issue 1 (2nd January 2016) - Alvarez, Anne
Abstract : The author suggests that Singletary has tackled brilliantly the complexity both of the etiology and of the treatment of autism. She suggests we should be grateful for the careful way in which he illuminates the non-linear nature of the neurobiological vicious circles that may lead to the disorder. She goes on to enlarge on two of his points, one of which concerns the heterogeneity of the disorder: first, she stresses the difference between the avoidant, aloof, and withdrawn autistic state, and the more vacant, empty "undrawn" state. She suggests that the latter may require a more intensified, vitalizing technique of psychotherapy, where the child is "reclaimed" or claimed into connectedness. Secondly, she amplifies on another etiological point – that regarding a further non-linear cascading vicious circle, where a possibly inexperienced mother may begin to respond too acceptingly to the lack of responsiveness of an apparently indifferent and weakly connected infant, and amplification of this interaction may lead to ever increasing lack of connectedness between them.