Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Summer 1-1-2017 Structure or Knot: What Phenomenology and Asperger’s Syndrome can Teach Lacanian Psychoanalysis About Subjective Constitution Shannon D. Kelly Follow this and additional works at: https://dsc.duq.edu/etd Recommended Citation Kelly, S. D. (2017). Structure or Knot: What Phenomenology and Asperger’s Syndrome can Teach Lacanian Psychoanalysis About Subjective Constitution (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/172 This Immediate Access is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. For more information, please contact [email protected]. STRUCTURE OR KNOT: WHAT PHENOMENOLOGY AND ASPERGER’S SYNDROME CAN TEACH LACANIAN PSYCHOANALYSIS ABOUT SUBJECTIVE CONSTITUTION A Dissertation Submitted to the McAnulty College and Graduate School of Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Philosophy By Shannon D. Kelly August 2017 STRUCTURE OR KNOT: WHAT PHENOMENOLOGY AND ASPERGER’S SYNDROME CAN TEACH LACANIAN PSYCHOANALYSIS ABOUT SUBJECTIVE CONSTITUTION By Shannon D. Kelly Approved May 1, 2017 ________________________________ ________________________________ Jessie Goicoechea, Ph.D. Eva Simms, Ph.D. Assistant Professor of Psychology Professor of Psychology Duquesne University Duquesne University (Dissertation Director) (Committee Member) ________________________________ ________________________________ Elizabeth Fein, Ph.D. Kareen Malone, Ph.D. Assistant Professor of Psychology Professor Emeritus of Psychology Duquesne University University of West Georgia (Committee Member) (Committee Member) ________________________________ ________________________________ Leswin Laubscher, Ph.D. James Swindal, Ph.D. Chair, Department of Psychology Dean, McAnulty College and Graduate Associate Professor of Psychology School of Liberal Arts Duquesne University Professor of Philosophy Duquesne University iii ABSTRACT STRUCTURE OR KNOT: WHAT PHENOMENOLOGY AND ASPERGER’S SYNDROME CAN TEACH LACANIAN PSYCHOANALYSIS ABOUT SUBJECTIVE CONSTITUTION By Shannon D. Kelly August 2017 Dissertation supervised by Dr. Jessie Goicoechea This research project examines Asperger’s Syndrome (now, with the DSM 5, Autism Spectrum Disorder) through the lens of Lacanian psychoanalysis and speaks to current debates in the field regarding the structural diagnosis of autism. Framed by critiques of Lacanian psychoanalysis, the project takes up autism and treatments for the disorder from within mainstream psychological approaches, from the viewpoint of neurodiversity and autistic self- advocates, and from within Lacanian psychoanalysis, with specific attention paid to the diagnostic approach in Lacanian thinking and the assumed relationship between autism and psychosis. Four published autobiographies written by autistic adults were subjected to two types of qualitative analysis in order to elucidate the experience of autistic adults, as described by them, to consider where autism fits within the Lacanian structural system, and to determine potential treatment needs for autistic adults. In order to strike a balance between autistic and iv clinical perspectives, the first examination utilized interpretive phenomenological analysis to gain a deeper understanding of the experience of autism and the potential issues at stake as they are presented by individuals on the spectrum. Following that, the second analysis compared the autobiographical material to the conceptual elements of Lacanian structural theory. The results of the analyses show that autism does not fit within the Lacanian structural definition of psychosis and also does not comprise its own, unique structural category. Using findings generated from both analyses, commonalities and divergences in lived experience as described by the authors are explored, and the potential impact of those findings on how autism is conceptualized and treated within Lacanian psychoanalysis and mainstream treatments is discussed, with special attention paid to questions of power, identity, and politics within both approaches. v DEDICATION For Brandon, my brother and best friend. We made it. vi ACKNOWLEDGEMENT I would first like to thank my patients at the Duquesne Psychology Clinic. I was lucky to have the opportunity there to work with adults on the spectrum who helped me to challenge my theoretical foundations and orient me to the questions I am asking in this project. I will forever be grateful to them for their generosity of spirit, hard work, and humor. I would also like to thank Dr. Jessie Goicoechea, whose guidance through this process has been invaluable. Her infinite patience, emotional support, and willingness to help me organize what seemed like volumes of discrete information was beyond helpful. I am also extremely grateful to my dissertation committee, Dr. Eva Simms, Dr. Elizabeth Fein, and Dr. Kareen Malone, whose close and thoughtful reading of earlier drafts of this project have enriched both the final text and my own understanding of the complicated and interesting world of autism research and treatments. Thank you to my mother and brother who cheered me on throughout the process and had faith (against all odds) that I would eventually finish. Also, thank you to Pippi, our beloved and goofy coonhound who forced me off the couch and into the woods. Her antics helped me to maintain my humor through the many months of slow and painful writing. Finally, and most importantly, I am deeply grateful and profoundly thankful for my wife, Rachel, whose love and support made this seemingly impossible task possible. I could not ask for a better partner or friend. vii TABLE OF CONTENTS Abstract…………………………………………..………….…………………….……………..iii Dedication…………………………………………...……………….………………………......vi Acknowledgement………………………………………...……………..…………………..…..vii List of Abbreviations………………………………………………..…………………..………..xi CHAPTER ONE INTRODUCTION 1 Causation………………………………………...……………………...………………………..1 Theories of (my) Mind……………………………………………………..…………………….3 Language Problems……………………………………………………………………….……..8 Special Interests, Inflexible Adherence, and Self-Stimulation……………………...………..12 CHAPTER TWO DIAGNOSIS AND TREATMENT OF AUTISM IN MAINSTREAM PSYCHOLOGY 17 Diagnosis……………………………………………………………………………………...…17 Asperger’s Syndrome vs. “High-Functioning” Autism Spectrum Disorder……………...…..18 Research………………………………………………………………………………………....21 The Medicalization of Autism…………………………………………………………...…..21 When Autistic Children Grow Up………………………………………………………...…22 Treatments………………………………………………………………………………...…….24 CHAPTER THREE THEORY AND TREATMENT OF AUTISM IN LACANIAN PSYCHOANALYSIS 27 Autism and Psychoanalysis…………………………………………………………………….28 Autism and Lacanian Psychoanalysis....................................................................................…32 Diagnosis in the Lacanian Tradition…....................................................................................33 Structure, Sinthome, Autism…................................................................................................58 CHAPTER FOUR CHALLENGES TO THE MAINSTREAM THROUGH AUTISM SELF-ADVOCACY, THE NEURODIVERSITY MOVEMENT, AND CRITICAL AUTISM STUDIES 64 Cure Culture: Erasing Autism…...........................................................................................…67 The Primary Deficits: Theory of Mind and Empathy…....................................................….68 Autistic Selves: Making Up People…....................................................................................…71 Autistic Experience….............................................................................................................….74 CHAPTER FIVE READING AUTISTIC AUTOBIOGRAPHY: METHOD AND RESULTS 79 Research Method.........................................................................................................................80 Data..........................................................................................................................................80 IPA Analysis............................................................................................................................80 Psychoanalytic Analysis..........................................................................................................84 viii Comparative Analysis..............................................................................................................85 The Authors and their Texts.......................................................................................................86 IPA Analysis.................................................................................................................................86 Table of Themes......................................................................................................................86 Narrative Descriptions.............................................................................................................86 Being an outsider...............................................................................................................87 Mistreatment prompts confusion and withdrawal........................................................87 Feeling deeply misunderstood.....................................................................................93