THE CONSTITUTIVE FUNCTION OF VOICE AND THE POWER OF MUSIC IN THE TREATMENT OF AUTISM

ABSTRACT.

Based on a research experience regarding the psychoanalytical group treatment of autistic children, the article reflects on the presence of more than one analyst in the setting. The interaction between analysts favors a non-directive approach, enabling the child to take action spontaneously, without being forced to a contact that can be extremely unsettling for the autist. Furthermore, one observes the effects of voice as a support for the caretakers, who talk, play and sing with each other, eliciting a libidinal excitement able to involve the autistic child. The music that reverberates through the circle games transmits both the symbolic aspects of culture and the real of la langue’s jouissance. In a particular case, the singing prosody revealed itself to be a specific imaginary way to treat the real of voice which invades the autistic subject. Using folk songs as mediation objects, it was possible to conceive a treatment direction that took into account a solution that sprung from the subject, who, anticipated in this act, can hear the invocation to arise. Thus, one evidences, also in autism, the role of voice as pulsional object in the subjective constitution.

Keywords:
Autism; psychoanalysis; invocative drive

RESUMO.

O artigo parte de uma experiência de pesquisa sobre o tratamento psicanalítico em grupo de crianças autistas, para refletir acerca da presença de mais de um analista no setting. A interação entre os analistas favorece uma abordagem não diretiva, permitindo à criança que ela se aproxime espontaneamente, sem ser forçada a um contato que pode ser sentido como extremamente angustiante pelo autista. Ademais, constatam-se os efeitos da voz como suporte para os próprios interventores, que dialogam, brincam e cantam entre eles, suscitando uma animação libidinal capaz de mobilizar a criança autista. A música que circula nas brincadeiras de roda veicula tanto aspectos simbólicos da cultura quanto o real do gozo de alíngua. Em um caso particular, a prosódia do canto mostrou-se uma forma imaginária específica de tratar a dimensão real da voz que invade o sujeito autista. Servindo-se de canções populares como objetos de mediação, foi possível orientar o tratamento a partir de uma solução que veio do próprio sujeito, que, antecipado neste ato, pode ouvir a invocação para advir. Evidencia-se assim, também no autismo, o papel do objeto pulsional voz para a constituição subjetiva.

Palavras-chave:
Autismo; psicanálise; pulsão invocante

RESUMEN.

El artículo parte de una experiencia de investigación sobre el tratamiento psicoanalítico en grupo de niños autistas, para pensar se a propósito de la presencia de más de un analista en el setting. La interacción entre analistas favorece un abordaje no directivo, permitiendo que el niño se acerque espontáneamente, sin ser forzado a un contacto que puede ser extremadamente angustiante para el autista. Además, se constatan los efectos de la voz como soporte para los propios interventores, que dialogan, juegan y cantan entre sí, evocando una animación liminal capaz de movilizar el niño autista. La música que circula en las cirandas transmite tanto los aspectos simbólicos de la cultura cuanto el real del goce de la lengua. En un caso particular, la prosodia del canto se ha mostrado una forma imaginaria específica de tratar la dimensión real de la voz que invade el sujeto autista. Haciendo uso de canciones populares como objetos de mediación, fue posible guiar el tratamiento a partir de una solución proveniente del propio sujeto, que, anticipado en este acto, puede escuchar la invocación para venir a ser. Se evidencia así, también en el autismo, el papel del objeto pulsional voz para la constitución subjetiva.

Palabras clave:
Autismo; psicoanálisis; pulsión invocate

Introduction

Cada um no seu canto com seu canto nos chamou. E nenhum de nós, nunca mais, ficou sozinho

(Machado, 2018).

Psychoanalysis introduces important elements based on how it understands the subject’s constitution, transference and treatment direction. Lacan (1998a) is quite precise in pointing out that directing the treatment does not mean directing the patient. Attentive to the place he/she should occupy in the transference game, the analyst puts his/her feelings out and is better placed in his/her lack of being than in his/her being, marking a fundamental divergence between the exercise of psychoanalysis and therapeutic conducts based on reeducation. It is driven by his/her own desire that makes it possible for the analyst to occupy this place, which is said to be empty and which supports the subject’s emergence.

This article arises, therefore, from the need to reflect on a fundamental aspect that we were able to delimit from an experience of psychoanalytic care in groups with children: the presence of more than one analyst in the setting. It should be noted that the formation of therapeutic groups for children is a recurrent practice in institutions focused on mental health for children and adolescents, without necessarily having all members presenting the same diagnosis. It was even from a post-doctoral internship at the Centre Médico Psychologique Périnatalité et Petit Enfance Tour d’Auvergne that we set up our proposal.

At the French public institution, the so-called Groupe Relais is composed of three health professionals (special educators - specific mental health training in France or nurses), three autistic children between three and four years old, a psychology intern (graduated and in psychoanalytic training) and a supervisor, PhD. Marie-Christine Laznik. Educators take turns caring for children, seeking to facilitate interaction between them; the intern is in charge of filming the sessions and editing the videos for supervision; and the supervisor listens and guides the work of educators and intern. For two hours, autistics are free to choose their games and end up taking an interest in each other’s activities or seeking some interaction. There is no compelling collective activity proposal in this group, except in the final thirty minutes, when everyone gathers around the table for a snack. No conceptual elaboration work on this experience has been formalized, but the analysis of the videos allows to verify the children’s progress. When this model is reproduced in Brazil, we affirm the commitment to offer some parameters to the French teams, as well as to publicize a work that deserves full recognition.

Following this model, therefore, a research and extension project was proposed on ‘The use of objects in the direction of psychoanalytic treatment of autistic children’, involving the Federal University of Espírito Santo (UFES) and a municipal public health service for children and adolescents (Psychosocial Care Center of Vitória - state of Espírito Santo). Believing that this partnership could favor the expansion of care for children diagnosed with or suspected of having autism referred to CAPSi and that the effects of this experience could be transmitted to other services, this research was submitted and approved by the Ethics and Research Committee of UFES (CAAE: 62447816.0.0000.5542).

Thus, our group had three children between three and four years old diagnosed as autistic, users of CAPSi, five psychologists and two psychology students, all undergoing psychoanalytical training. The two hours of duration were kept, reserving the final thirty minutes for the snack, and the format of one adult for each child, without previously establishing these ‘pairs’. We understand that this format is consistent with the bet that the children can manifest themselves in the choice of the intervener with whom to interact and that something from a subjective position appears in that choice. In severe child psychopathologies, as Vorcaro (1999) points out, it is necessary to suppose a subject, in an act of anticipation, before there is one. Unlike Groupe Relais, in this project, we had an extra intervener both for support in the most difficult moments, and for recording images. Furthermore, the students were not responsible for editing the videos, but the professionals. Thus, whoever filmed was not the same person who reviewed the scenes and the psychologist who took care of the cuts was the one who should conduct the supervision. Filming was our first story and, it is worth mentioning, it already brought the eyes of the one who filmed. Sometimes, the role of agent of the film circulated among the interveners, but what always stood out was the fact that not everything was filmed: there was a single camera, moved from the choices made by those who took care of it during the sessions. Involved in the scene, both the filmmaker and the other members needed to endure being filmed/seen (by others during sessions), seeing themselves (in supervision) and also dealing with the fact that not everything was recorded - something is always lost. The camera never had the role of guaranteeing objectivity, neutrality, so that a posteriori was used as a guarantee of the veracity of facts that occurred in the group. With Lacan (1998b), we learned that the truth can only be ‘half-said’ and, if the filming enabled a return to what happened or the capture of certain subtleties, unnoticed at the time of the group, this only makes sense for what it caused in each member of the team at the time of supervision, in which what was said also brought a new look at video editing. The speech of each person continued to be the main element of supervision, so that look and voice appear side by side.

The effects of one child on another in group care, the use of objects and, more directly, the camera object, where the scopic drive touches, were themes developed in other works. The issue of diagnosis also always appears when dealing with childhood psychopathology, because if we understand that the child is developing, that time is still open to other inscriptions:

The child’s potential to become a subject inhabited by language and who can share the social discourse, making ties with similar ones, is not static as a diagnosis presupposes, whatever it may be. If the subject changes, the diagnosis can also change. He/she does not have to accompany the child for life. Childhood is the most plastic period of life, it is the time for the development and maturation of the central nervous system, the time for the construction of subjectivity, a work in progress (Sibemberg, 2015, p. 105).

Even Lacan (1985, p. 134) asserts that “[…] the diagnosis of psychosis in children is discussed and debatable […]”, asking whether it would be appropriate to use the same word for psychosis in children and adults, since “[…] psychosis is not structural at all, in the same way in children and adults” (Lacan, 1985, p. 135). Without entering into the debate about autism as a fourth structure or as a clinical variation of psychosis, we would like to note that of the three children we received diagnosed with autism, only one showed persistent relational closure, which immediately characterizes this clinical condition. At first, they all had the typical symptoms of Autistic Spectrum Disorder: difficulty in verbal communication, absence of eye contact, relational closure, stereotyped language or stereotypies, among others. However, two of these children respond more quickly to our interventions, suggesting that either the initial diagnosis was wrong or autism is not an irreversible syndrome. Anyway, we emphasize the great plasticity present in childhood, facilitating new inscriptions. We will see these cases briefly, paying special attention to the child who effectively occupies an autistic position in relation to speech and language, making use of music to express her subjectivity.

Also in this article, we are interested in looking more specifically at the effects of the presence of several analysts in group clinical practice, based on some directions and questions: what ‘management among several’ produces in the analysts themselves, that is, what can an analyst do for the other in caring for children diagnosed with autism? And yet, what does this clinical configuration produce in the children’s experience? When situating these issues, we observe how the voice that circulates among analysts constitutes an important element of mediation. Then, we saw how this drive object points to the treatment direction of the autistic child, especially when articulated to the mediating effect of music.

Voice, interpretation and mediation

Playful activity is considered by psychoanalysis as an insistent work of elaboration with regard to the care of children. This work organizes the signifiers received from the Other. When these milestones, coming from the Other, however, do not support themselves or allow the child to “[…] unfold play until its last consequences” (Coriat, 1997, p. 193), an analyst can integrate some element in this place of the child’s Other. The interpretation that transference allows, in severe child psychopathologies, requires, after all, an assumption of subject, by the analyst, before there is one. For this to be possible, the analyst’s desire is supported by this imaginary bet that, according to Vorcaro (1999, p. 99) “[…] stretches the signs in which the child is harnessed, until the production of a sentence, of saying”. This is exactly what leads it to the hypothesis that the analyst reads the child’s manifestation with his/her imaginary:

It is with an imaginary text that the analyst conveys the symbolic, unbuttoning the signs to which the child is attached, to make them significant. It is with this text that he/she calculates the interpretation, understood as the metonymic extension in which the analyst involves the child in a discursive network. The analyst engages in the child’s manifestation, extending the significant production, relying on his/her imagination that: repeats, in action, the child’s manifestation; it becomes an address for the child’s action, taking it as a subjective act; re-addresses the child; produces a condition of impossible reproduction that forces the child to respond in another way (Vorcaro, 1999, p. 99).

The same author does not fail to alert, however, to the fact that the analyst cannot read the child’s manifestation from his/her imaginary loan in a bijective correspondence relationship. By privileging the child’s manifestation, he/she inserts him/her in different networks; in the case of autism, as we said, anticipating and constituting a logic that does not yet exist (Vorcaro, 1999). It is, by the analyst, lending his/her voice, to ensure the recognition of this manifestation, highlighting it as significant and thus making a bet, an assumption of knowledge, even if without a subject.

The analyst should be “[…] available without invading” (Jerusalinsky, 2015, p. 89), in order to be able to function as a regulator of this relationship. Different from the autistic objective or transitional object, the ‘object of mediation’ can be collected in clinical experience, as it is often offered in the institutional context. Such an object would allow a possible opening to the Other and a relaunch of the drive expression, from a position of the therapist that would consist of erasing his/her presence behind the object, in a concealment operation, which would make the object itself a mediation [truchement] of the relationship with the subject. This way of working was privileged in the mentioned research and we intend to extract even more consequences from the notion of mediation. See how Lacan (1999) uses the term truchement in his Seminar 5:

The introduction of the subject to any reality whatsoever, is absolutely not conceivable in terms of a pure and simple experience of whatever it is that is in question, a frustration, a discordance, a knock, a burn, of whatever you like. There is no step by step spelling out by man of an Umwelt, which is supposed to be explored in an immediate, and if I may say tentative fashion, except that for an animal, thank God, instinct comes to his aid, because if it were necessary for an animal to reconstruct the world, his whole life would not be long enough to do it, so that why would you want man, who has instincts that are very badly adapted, to experience the world, as it were, with his own hands? The fact that there is a signifying dimension is absolutely essential, and the principal mediation [truchement] of his experience of reality - is almost a banality, a folly to say it - is, despite the regrets, the voice. The teaching he receives comes essentially from adult speech (Lacan, 1999, p. 230-231).

The meaning of the word truchement, according to the dictionary Le Petit Robert (2014), is that of an interpreter; ‘spokesperson’ [porte-parole]; one who speaks on behalf of another, expresses his/her thought. In the above quote, it is emphasized that the subjective constitution depends, on the one hand, on the signifier placing him/herself as an intermediary in the subject’s relationship with reality, and, on the other hand, on whether this signifier is transmitted by voice, by the speech of an adult. The modes of treatment that intend for autists to have a gradual approach to reality disregard that these children can make a shared use of our symbolic universe through the word of the Other. It is as if the condition of subject of the autistic person was, in fact, obliterated, however, without any instinct to help him/her, since nothing makes a human being inscribed in language a creature compared to an animal.

One of the children treated in our group could well have incurred an organic comorbidity, for example, Fetal Alcohol Syndrome, due to the enormous difficulties in behavior and understanding. Agitated, clumsy, initially his activities in the group were restricted to popping balloons. From this noise came the signifier ‘pow’, which he emitted as soon as he saw one of the group’s analysts. ‘Pow’ is then heard as a demand to fill balloons to be popped. Then, Paulo begins to imitate the movement of blowing to fill the balloon. This breath takes us back to the story of the Three little pigs, and Paulo will soon howl. At least, that was what another analyst heard, suggesting that there was a big bad wolf wanting to enter the room. Everyone in the group was surprised by this possibility and another child joins the game.

Alberto is encouraged to face a wolf with a plastic duck, as well as is encouraged to hide from him, calling everyone to follow him. Insistently, he gets the engagement of Paulo, his most dispersed colleague, who, aided by one of the interveners, follows Alberto to the hiding site and contains his screams, so that the group is not found by the wolf. Also diagnosed with autism, but very close to a condition of childhood psychosis, Alberto had great body fragility, with difficulty using his hands to knead the modeling clay or tear a sheet of paper. Note that a duck would need to be quite fierce to compete with a wolf! In the case of Alberto, Paulo and his, so to speak, expansive ways, were extremely important, but the presence of more than one analyst also produced effects. So much so that analysts go from ‘aunts’, in general, that is, Alberto called any participant ‘aunt’, to ‘aunts’ who have a name. It is clear that ‘Aunt Renanda’, who amalgamated the name of two analysts, as in the holophrase, still needed to be ‘cool’, as well as in the joke undertaken by one of them to ‘detach’ Alberto from the intern in whom he ‘stuck’. Also, at this point, the presence of a third party intervening in the game of hugging and meddling in the other’s body proved to be essential.

Well, if in the game of the wolf the presence of everyone was indispensable to follow the movements and reactions of Alberto and Paulo, we also see the importance of the presence in pairs when one of the analysts proposes a seemingly simple game, in which a balloon was thrown at the count ‘one, two, three and…go’, and the other responds by offering support (this time bodily) so that the child can be there: sitting on the floor, positioning his/her body as a dorsal screen and assisting Paul in his movements of receiving and throwing the balloon. Of the children in the group, Paulo is the one most committed to his bodily organization. Although in some moments he manages to direct his motor action and gestures with great strength and precision, in most encounters we need to be careful with the boy’s movements: he runs and trips, bumps and knocks objects, hits his head or parts of his body on tables and chairs, step on other children’s games without seeming to notice, even sit on top of another person (adult or child) as if they were not there.

We know how much a child affected by a psychopathology shows, with the bodily (dis)organization, that, for the human, the constitution of the edges of the body is not a consequence of a maturation process but depends on inscriptions arising from the relationship with the Other. Julieta Jerusalinsky (2014) shows how all intense maternal work introduces a border of the subject’s body, while still a baby, which establishes itself in relation to the surface and its holes, eroticizing and spatially delimiting the areas in that body, also inscribing a rhythm, a temporality of functioning. In the scene we just described, we followed the evolution of the ‘pow’, initially linked to the immediate bursting of balloons - as we have already said, but which, we also came to know, referred to the rockets in the favela where Paulo lives - and we tried to slowly introduce new elements, which could favor and stretch playing: games of filling and emptying, throwing the ball to the other, making baskets, goals, etc. Here, the proposal to offer support so that it was possible for Paulo to throw the balloon, based on the count ‘one, two, three and... go’, part of an attempt, where it was not possible, to build a border/timing:

It is about placing the voice and its modulation, articulated as a word or as an onomatopoeia, at the moment when it can really interest the child: at the moment of discontinuity of the action that the child is doing or observing, as a way of calling him/her to engage, to connect the affection that affects him/her in his/her body, to the game of a series that we try to sustain for him/her and of which we situate him/her or place us as a recipient (Jerusalinsky, 2014, p. 266).

In this game, facilitated by the presence of the two analysts and their lively voices, the time of waiting and precipitation, expectation and fulfillment is present, demanding from the child a minimum organization of movements and intentions. With the support and bet of the analysts, Paulo manages to extend a game that, before, seemed to be restricted to an autistic enjoyment, like a short circuit of the drive in which it is very difficult to collect some pleasure.

The voice that echoes among analysts: a song?

The recognition of the defenses built by each subject and, therefore, his/her unique inventions, serve as an important clinical direction. It is precisely at this point that, in the group experience that this work gives news, we question what an analyst is able to do for the other in sustaining the specificity of his/her place in front of the autistic child, and, of course, for the latter, to whom interventions are for. Usually, psychoanalytic care for these children is carried out individually, even under the justification of the difficulty of interaction so marked in their diagnoses. Right away, a challenge is posed: how to group children who, through the experience of the diagnosis, build their defenses precisely at this point of sociability, of the relationship with the other?

Despite the challenges posed, we bet on group work as an interesting clinical device, since it allows approximations between these children and makes it possible for analysts’ interventions to be less invasive and targeted. In addition, privileging the aspect of the relationship between analysts (which one can do for the other), which we are interested in here, we raised the question of whether group work favors the drive activity to be maintained in professionals despite the refusal of children, insofar as analysts would help themselves to ‘not be discouraged’ in the face of the lack of response from autistic subjects, as is common to see happening with parents.

We will now accompany some of these effects from more session records. In the section that will be brought up next, Estela is oblivious to the calls of analysts, who decide to draw using the colored glues that she likes so much [it is worth saying that the glues, which start to be lined up by Estela and later become, in our eyes, jumping characters in a pogo stick, inspired by the fact that we notice her animation when we sing ‘Jump little popcorn’, are already a displacement of clay balls, which served only a stereotyped and individual game of placing and removing from the truck, the box, etc.]. The analysts, in this scene, discuss the aspects of the drawing among themselves: a kitten, who will make ‘meow’ - a signifier that we borrowed from the song ‘I threw the stick at the cat’, with which we played with Paulo minutes before, getting some attention of Estela. While they talk about the drawing, Estela, who was in the corner of the room, approaches, leaves the colored glues on the table, observes the drawing, smiles and emits a loud ‘meow!’. Could we suppose that it is easier for the child to direct her gaze or even accept to participate in a game when the address is from one analyst to another, and not directly to her? Ferreira and Vorcaro (2017) consider that the ‘diluted transference’ between several can appease the subject, defending her from an invasive Other. Furthermore, could we also assume that the pleasure shared ‘in parallel’ has, in effect, small degrees of openness in the child’s relationship with the other? Or, still, could we think that it was something from the relationship established with another child that aroused Estela’s interest, in the wake of what we can suppose about what one child can do for the other? Would music have a facilitating function in opening to interaction with others? On this day, Estela not only dwells on the drawing, on the image of the cat, but says ‘meow’.

Since the beginning of the consultations, our strategy has been to take advantage of her interest in music to transpose certain elements to modeling clay, that is, to model the ‘yellow chick’ and the ‘butterfly in the kitchen’, changing the lyrics of the song for setting situations. That was how in the movement of filling the truck with clay balls, we sang that the ‘chick was very afraid of the truck’, and not ‘of the hawk’, as in the original song. This change triggered an immediate action by Estela to pick up the chick and put it in the truck, a guest she had repeatedly rejected when it came from us.

Small displacements allowed the replacement of the balls by the hydrographic pens, when it became a little easier for Estela to move around the room and, in our eyes, perhaps in an ‘anticipatory hallucination’, address herself to the other: with a very mischievous aspect, she tried to doodle the walls, to which we reacted by setting limits. Estela seemed to ignore us and we could have taken more severe measures, had we not been warned of the negation mechanism, already used in the ‘chick’ scene. We understood, then, the adjective that her mother used to describe her: ‘naughty’. Specularly, we also continue to insist on our interventions.

New objects joined the game. With the pens and then with the colored glues to which Estela clung, we tried to insert new elements - modeled by the clay or drawn with the glues - that had some relationship with whatever it was, at some point (in the sessions, at home, at school) attracted her attention and interest. Thus, if a round song attracted the eye, albeit fleeting, of Estela, that was enough to mobilize action in the analysts. The stars drawn on the hands or made with clay, from the song ‘twinkle, twinkle little star’ managed to remove Estela from an isolation that prevented her even feeling the contact of one of the analysts who touched her arm lightly. In fact, it was in these musical moments that we got some response, demonstrating the necessary desiring implication of those who occupy this role with children with severe psychopathologies.

We saw the opening time for the other being extended at the countless birthday parties created for dolls, stuffed animals and even for colored glue ‘friends’. In one of the sessions, during the song Happy birthday to you, Estela vocalizes all the time. She gives in with her voice, accompanying the music, and she gives in with her eyes, directing it to all those present, and then playing with a delicious cake made of clay by one of the analysts. From then on, not without surprise, Estela accompanies one of the participants in a fun dance for both of them.

The contact with Estela, in fact, was facilitated by an indirect approach and mediated by music. Thus, sometimes analysts played with each other, but precisely with those elements that supposed to attract the girl, sometimes transforming the sound objects of her favorite songs into concrete objects made of clay, drawings and toys, sometimes using songs to give meaning and animate repetitive movements (stereotypies) and, for us, dull, from Estela.

In fact, music was present in the group, in general, whenever we started playing in a circle (wheel). If, at the beginning, Estela seemed touched by the animation of the other children when they made a circle, we observed that it was also very difficult for her to participate. It took some time for Estela to first accept to enter the circle, as if she does not care about it, extending a hand without even looking at us. A few seconds on the wheel, Estela’s body was already withdrawing, but her gaze remained in play. That time stretched more and more until the day that Estela could run to the others, hold in their hands since the beginning of the game, rotate to the rhythm of the music, squat on the final verse and, smiling, applaud. It was necessary for the wheel to keep turning for Estela to engage. Without any force on our part, that movement was able to mobilize something in her body that could be shared with others.

Still thinking about the function of the ‘object of mediation’, the possible intertwining between the patient’s interest and the therapist’s desire should be guided ‘by’ the object, and not ‘for’ the object. The child’s interest in music was certainly a facilitator in addressing ‘to’ and ‘from’ the autistic subject. When we sing, the real of the language is covered by the imaginary dimension. The musical phrasing would be an imaginarization of the voice, in which scansion and the body tend to be annulled. With the musical phrasing, the autistic person starts to play with the timbre to make an adjustment in the distance that he/she must keep from the Other. The hypothesis according to which, in order to become a speaker, the subject must acquire a specific deafness in relation to the real of the Other’s voice, places the ‘deaf point’ as the place where the subject, to come as a speaker, must be able to forget that he/she is the receiver of the original timbre: he/she must be able to become deaf to the primordial timbre to speak without knowing what he/she says, that is, as a subject of the unconscious. The autistic person is one who does not accept the loss of this drive object that is the voice. Voice, then, remains a non-separated object ‘a’ and regularly manifests itself in the screams of people with autism. In this case, we can say that nothing of the signifier competes for one for a signification effect. Nevertheless, the autistic person can build a sound dimension for this voice, thus opening the possibility of knowing how to do with that object. Popular children songs are the artifice that Estela uses to deal with her and others’ ‘natural’ voice.

According to Calzavara e Vorcaro (2018, p. 45), “[…] the work in the clinic with autistic people should follow a particular way of treating the Real that invades it”. Thus, like the machinic voice, the musical phrasing would be a possible treatment for the autistic’s specific relationship to the vocal presence of the Other. In the case of the machinic voice, we would have the expression of a speech without subjectivity; in music, however, the expression of subjectivity outside speech is at stake. It is this radical disjunction between the saying and the said that is sought by the autistic person, allowing us to understand how the machinic voice and the musical phrasing are the two sides of the same coin: the machinic voice tends towards a said without saying (a statement without enunciation), while the musical phrasing tends towards a saying without said (an enunciation without any meaning). By these two approaches, the autistic person would try to protect him/herself from the resonance effects of the language, either by articulating them in the singing prosody, in the imaginary way, or, on the contrary, in the symbolic way, stripping them of all prosodic envelope, with the machinic or monochordic voice, which consists of the binary encoding of the language.

In the analytical work with autistic children, when the child is stuck in this sonic question, an orientation for the treatment is to start a game with the dimension of the timbre so that a ‘distance’ from the resonance is possible and can attenuate the deadly attraction that the real of the voice exerts on the autistic person. Using a robot invested by the autistic child or tuning in to his/her musical phrasing allows him/her to find the acceptable resonance frequency for him/her. This resonance frequency would correspond to the ‘subject weight’ that the child could bear, neither more nor less. If it is above the tolerable, the autistic person will close his/her ears, if it is below, he/she will continue to be indifferent to our presence. This adjustment, which can only be done singularly, in a clinic of detail, should allow a new link between imaginary and symbolic as a defense against the real.

If the autistic structure has as distinctive characteristics the retention of the voice and the primacy of the sign (Maleval, 2015), in the case of Estela, music circulated a symbolic universe that was mostly rejected by the child. Popular songs, which crossed the childhood of the group’s analysts, revealed their lalangue aspect to each marked mistake and provoking a surprise: ‘it is not that!’; ‘Do you sing like that?’; ‘I always sang in another way’; ‘In my city, the song is different’; ‘This is not your time!’. Didier-Weill (1999, p. 66) states that “[…] when the voice sings, it is immediately the voice of the Other that, through the subject, makes itself heard”. When singing, the analysts unconsciously relived the transmissibility of the symbolic at play in the mother’s voice - they put repressed signifiers on the scene, without realizing their never-revealed mistakes.

Still Didier-Weill (1997) points out that if we happen to be shaken by what appears to us as so ‘familiar’ in this musical nostalgia, it is precisely because we do not recognize music, but we are recognized by it:

As if, suddenly, the listener in us passed to the other side and began to listen to us. Listening to this impossible love which, by being sung by the Subject, will be able, as it is revealed to ourselves, to take the flight of a transference-love: since it is no longer we who hear the music, but it begins to hear us, we constitute it as a Subject supposed to know upon which we transfer our love (Didier-Weill, 1997, p. 76).

It is in the passage from the position of Listener to that of ‘singing’ Subject that the essence of transference would be located, because “[…] when we sing, the transferential relationship is established with the Other, instantly evoked, where the Other is situated as a good listener” (Didier-Weill, 1999, p. 63). It is precisely because we are able to make such a conjunction for love that our desire can stop being distressing for the Subject. For Didier-Weill (1997, p. 71, author’s emphasis), what is distressing about che vuoi? it is not so much that the Other expected something about which we know nothing, but that “[…] we lived the Other as imputing to us the possibility of recognizing and granting it this ‘thing’ that it expects of us”.

Without speaking, therefore, we were able to experience what Didier-Weill (1999, p. 153) calls “[…] power of reversing foreclusion […]” held by music, linked to the possibility that it has of “[…] putting the invocative drive circuit back into play”. Music, in fact, allowed the lack of analysts to appear in the setting from a desiring production: “Accepting to let yourself be confused, stupefied is the mark of the lack in the Other” (Laznik, 2000, p. 90). It is worth saying that amazement and joy are the characteristics of the prosody of baby talk, whose main mark is not to reject a noise, a babble, a defective word formation, an unintelligible, incomprehensible, enigmatic sound emission, as elements outside the language code, but, after a time of surprise, let yourself be carried away by the illumination and recognize a joke there. It was with music that we tried to cheer ourselves up and make some pulsating activity attract Estela. The mother alerted us to this feature and told us about Estela’s pleasure in dancing. With her body, therefore, and mediated by music, Estela expressed her subjectivity outside of speech. Welcoming this singularity, it was possible for Estela to share her movement with others, either through dance or music. Regarding dance, Didier-Weill (1999, p. 17) points out that it is a way for the subject to be without expecting the Other to respond to his/her existence. “Everything happens, in fact, as if at the very moment he/she started dancing, he/she knew where he/she had to go, without having any more, from then on, to ask anyone why he/she should go there, or how should do it”.

In the work developed in a music workshop, Lima e Lerner (2016) allude to the ‘clinical value of surprise’. Since her research on baby talk, Laznik (2011) also emphasizes surprise and pleasure as fundamental elements in the treatment of autism. Using this specific prosody, this psychoanalyst is able to mobilize affections in babies with relational withdrawal, which may indicate an autistic referral. These babies express the effects of that speech on their bodies, just as Estela could do through her dance. This shows that the autistic person is not alien to speech and language, and can even enjoy the jouissance of lalangue - as the absence of the deaf point also allows to glimpse. Perhaps the challenge is often not to play the game of demand - seeking to find a point of sharing in a subjective position that seems to dispense with the Other, by vehemently refusing it - but to make the dimension of desire emerge through a speech that summons the subject to become. With Didier-Weill (1997), once again, we attest that it is an indisputable fact that, clinically, music returns the use of the signifier to a subject who has lost his/her disposition for that. Around music, it would be possible to precisely follow the metamorphosis of the Other’s message into a message of the Subject.

An invocation

Believing that the constitution of the own voice may happen during the treatment, Catão e Vivès (2011) indicate that the possibility of an exit from the autistic position implies a management by the analyst who accepts, in his/her interventions, the defense constructed by the subject and take into account the dimensions of the call and address characteristic of the invoking dynamics:

[…] let him/her offer him/herself as an Other that is not very present, a little incomplete, bored, that demands nothing. Or, then, that demands on the side, but that is secretary of the child’s inventions and that legitimizes them as the production of a supposed subject. Listening to the autistic child is not only possible, but always implies less than we suppose: an emptying of jouissance also on the part of the analyst (Catão & Vivès, 2011, p. 89).

If the voice that echoes among analysts resonates the libidinal animation necessary for this clinic, in which the body is put to work, after all “[…] the drives are, in the body, the echo of the fact that there is a saying” (Lacan, 2007, p. 18), Vivès (2009) reminds us that Lacan, in giving invocation, as in looking, the status of drive, proposes a new dialectic of drives. Together with the oral object and the anal object, articulated to the demand (demand to the Other and demand of the Other, respectively), he introduces the look and the voice, which concern the desire - the look appears associated with the desire ‘to’ the Other, while the voice appears associated with the desire ‘of’ the Other. This author helps us to understand demand as “[…] an absolute demand made on the Other to manifest itself, here and now” (Vivès, 2009, p. 330). On the contrary, the invocative subject would escape this dependence, since it would not be a demand directed at another who would be there, but “[…] an invocation that supposes that an alterity may come from where the subject, pure possibility, would be called to become” (Vivès, 2009, p. 330). Vivès, thus, touches on what, in this work, awakens us about the analyst’s desire and his/her place in the clinic, since

This issue of invocation allows to rethink the motives of the subject-supposed-to-know that in this process becomes subject-supposed-to-know-there-is-a-subject and, assuming this, calls him/her to come. The psychoanalyst’s assumption is then reduced - but in this reduction the whole ethics of psychoanalysis is condensed - to the fact that, despite the symptoms that enter the patient, there is a subject who is called to ex-exist (Vivès, 2009, p. 330).

If, when it comes to the clinic with the child, especially the autistic child, it is up to the analyst to take responsibility for the authorization he/she gives to respond to a demand for help, which always comes from someone else (whether the parents or the school), we are interested in thinking about what the desire of analysts implies when they work together, inserted in an institution, so that, in the exercise of their function, they consider the ethical requirements of psychoanalytic practice.

We believe, according to Di Ciaccia (2005, p. 46), that these analysts are sustained by the desiring Other, “[…] even if regulated and limited, making no concession to an overflow that would go towards an Other that would enjoy the subject”. To this end, this author highlights as a condition that each professional knows how to behave “[…] in his/her own name, with his/her own style, with his/her own abilities, knowing how to put his/her own image, presence and absence at stake, his/her own interests, the theatrical relationship with life, body and desire” (Di Ciaccia, 2005, p. 47). Di Ciaccia will say that putting oneself into play means taking responsibility in the first person for the invention of ways of becoming a partner of the child, so that it is possible “[…] the invention of the chaining of a work already started by the own autistic child, based on the manipulations he/she makes with his/her own body and with the objects that complete it, elevating them to the dignity of signifiers” (Di Ciaccia, 2005, p. 45).

These are some necessary articulations to relate the dimension of voice, its implication in the subjective constitution and the possibility of developing new clinical strategies for the autistic child, that are increasingly distant from prefabricated therapeutic recipes and that value care that considers the time and place of the word. Furthermore, we observed the effects of this treatment direction also in children with suspected diagnosis of autism, but who certainly met the criteria of severe childhood psychopathologies. Group care does not need to be linked to a diagnosis, because, often, the diversity of children contributes to constitutive effects among them. The scream of one echoes in the ear of the other, produces an echolalia, turns into music, turns and dances. The bad wolf blows a balloon, breaks down a wall and ‘down the road’ no one goes alone anymore. Signifiers circulate in the group and every hour they appear in someone’s mouth or play. Each group has its uniqueness and its way of operation. Therefore, the transmission of this method cannot be done without resorting to the cases attended to. At Groupe Relais, other children and interventions were the protagonists of several experiences, in each group formed. However, what unites both experiences is the consideration of knowledge by children (Orrado, 2017), as we recognize the important function of protecting the defenses they have built. Only in this way is it possible to think of a mediation for each one and an orientation for the group that is guided by the subjects in care, and not by an ideal normalizing model

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Publication Dates

• Publication in this collection
  22 Feb 2021
• Date of issue
  2021

History

• Received
  24 May 2019
• Accepted
  24 June 2020