Music...Autism...The Violence of Institutions

By Maria Gabriella Fornero

A musician and a psychologist have got the sphere of listening in common, sonorous/harmonic the former,  empathic the latter. The author underlines the importance of being able to listen to a person in order to catch the harmonic completeness or to search for the dissonant sound which makes the whole discordant, with the aim of remedying it. Listening involves respect and acknowledgment of silence as well as acceptation of a new significance that can emerge. 
Both the psychologist and the musician can pose emotions centre stage and can welcome them in their entire expressive range. They can listen to them, elaborate and interpret them in a constant dialogue. Not only does Dr. Fornero talk about children diagnosed with autism, but also the Institutions where they live. She has observed the dynamics of their families, she has met teachers, educators, assistants and has attempted a confrontation with their neuropsychiatrists. After which she describes how, with time, the sufferance of the child on the one hand and the blindness of Institutions on the other, have emerged, but also the results achieved and the opening of communication channels. 
This work has the aim not to be only critical, but most of all proactive and inviting reflexion in order to to encourage new interventions.

Maria Gabriella Fornero, a Clinical Psychologist, Musician and Music Therapist, works in the province of Turin, mainly in the area of Pinerolo and in the Chisone and Pellice valleys. She runs training courses and for years has dealt with the rehabilitation of adults and children with neurological damage of various types and origin. 

She published "I colori dei suoni, la musica nella riabilitazione fisica e psichica" (ed. Antigone,To, Italy) in 2012. "La musica nascosta di Leonardo da Vinci" (ed. Araba Fenice, Cn, Italy) in 2017. "Musica...Autismo... La violenza delle istituizioni" (Streetlib) in 2018.

• Language: English
• Publisher: Maria Gabriella Fornero
• Release date: Mar 22, 2021
• ISBN: 9791220281515

Book preview

Bibliography

Preface

I have read with a lot of interest this new book by M. Gabriella Fornero, who l thank for the respect she has shown by asking me for this preface, because it deals with very delicate issues starting from the description of stories of therapy with children bearing pervasive disturbances of development. I mean children with that variety of pathologies that until some time ago were known under the generic category of Autism.

It is a common experience of whoever reads newspapers to periodically face some of the several legends invented to explain the genesis if these disturbances. The last one is the negative effect of vaccination, without any scientific evidence. Therefore tests like this are welcome, which face the problem with scientific rigour without forgetting to conjugate them with creativity that is a precious ingredient, especially in the relationship with children.

Those stories of therapy question us on various levels. First of all they make us have a serious reflection on the reasons why these so complex disturbances with such a heavy suffering for little patients and their families, find either excellent answers or an absolute desert that depend on good or bad fate. A delicate and complex problem is certainly that of the families and of their pain, which isn't often listened to by anybody. But this suffering should be considered instead even in order to avoid it becoming an obstacle to the change beyond best intentions.

It comes out clearly, from some of the cases treated by M.Gabriella Fornero, the limit of basic institutions such as schools whose teachers aren't often very well informed to understand, to welcome and support the peculiar characteristics of these more fragile and vulnerable pupils. Such as Child Neural Psychiatry and social services which have always suffered from inadequate resources and, in addition, have dramatically faced a reduction of their power of intervention. A condition that causes frustration and demotivation, with the risk of favouring retreat and refusal instead of stimulating a dialogue and gathering their few resources into a network.

It comes out clearly, from the pages of this book, that a lot can be done to improve the level of life of these people with qualified interventions, capable of building relevant relationships.

Specifically, the use of the universal language of music linked to the knowledge of the complexity of our brain and our mind, which represents its highest epiphenomenon, opens spaces to interventions and opportunities of work that seems to me of great interest.

Once more it seems to me that the peculiar aspect and the content of this work is that of always looking for building hypothesis which are grounded in a constant evolution of scientific proofs. At the same time the aim of this work is not to disregard the questions put by our social organization about the duty to undertake responsibility to offer full citizenship rights and opportunities of positive growth even to the weakest people.

Good reading!

Doctor. Emanuele Fontana, neural psychiatrist and psychotherapist, Director of Neural Psychiatric Services, Asl To3 of Pinerolo and Vales (Italy).

Presentation

In this book Doct. Fornero resumes the main topics of dynamic psychology, considering the person in the complexity of her/his mental life, with the dynamic powers which manifest themselves and can be caught only if we are inclined to listen…listening to people, words, sounds, silence. A total listening that respects the person who needs a relationship. That is the magic word which is to be underlined: relationship, ties, mutual relationships, interconnection.

The most striking thing while reading the book is the author's genuineness, without academicism and capable of authentic listening towards the children and their families' suffering. The book offers tangible evidence of how powerful the influence of the child experiences can be. In the precocious building of the connection with the caregiver everybody's relational ability is being created and a contact with one's own mental skin is being made. Our Self needs meetings in order to develop and grow. There are family situations where rationality does not develop, or it develops in a very rigid form.

The developing brain appears influenced and hit by the exposure to various forms of adversities, not only linked to a heavy physical mistreatment or to sexual abuse, but also to the exposure to a dysfunctional relationship with the nursing figures. The mistreatment described by M.G.Fornero crosses the continuous exposure to relationships which are full of projections of the mother's divided parts, projected onto her child, with the father's collusion. Neuroscientists are now describing the mechanisms that develop as a consequence of mistreating relationships during childhood. Various studies witness how exposure to early traumas is linked to a certain number of structural anomalies at brain level. Substantial evidence is available about a reduction of the middle-sagittal area of the corpus callosum. In the same way there are solid results which indicate a reduction of the hippocampus volume. The result that the exposure to reiterated episodes of relational violence considerably reduces the volume of the grey matter in the occipital cortex and in the left fusiform circle and in the right lingual circle is particularly striking.

Unfortunately, and notwithstanding these results, the psychosocial model and the medical model of psychiatry remain in conflict rather than strengthening each other. The consequences of exposure to early traumatizing relationships are rarely recognized. Therefore, they are undervalued, instead of being considered as etiological mechanisms. These experiences are lost in time and hidden by shame, secretness and social taboos which are contrary to the exploration of certain ambits of the human experience.

The author of the book describes how getting into a musical dimension allows the birth of the discovery of a communicative and relational ability where a person can express the desire to listen to her/his interior sounds and to reproduce them or to identify her/himself with the ones produced by the musician. So these children, seen and felt as fragile and suffering, have been able to listen to their own emotions, to communicate and share them with someone who could welcome, elaborate and give them back in order for them to handle them, overcoming the defenses created by the children themselves, by their families, and/or by the institutional workers, allowing themselves the possibility to live and grow up.

The author's results provide a credible basis for the definition and the sharing of a model which guides public health and social service practices which start with a psycho-relational evaluation of all patients. The potential advantage is enormous, as well as the probable resistance of some clinicians and institutions to this change.

Our colleague opens up a void in the opportunities offered to children and their families by the psychotherapist's care. Moreover, facing the theme of trans-generational transmission, she affirms how it is indispensable, on the part of institutions, to place oneself from the point of view of prevention and not only that of diagnosis and symptom treatment. Becoming parents is a difficult path, particularly when you get to this stage after having crossed dysfunctional relationships with your caregiver during childhood. Distant relationships but still burdened with pain that reactivate when you become parents. Parents inwardly bear the child they were, but even the parental figures with whom their primary relationships were established with.

The book offers a lot of interesting points of reflection and leans its theory on the evidence of neurosciences. The human being is interwoven of relationships, starting from a relationship a mother establishes with her fetus. How important it would be to start from before the birth, from the very performances of the child, the investment on the parenthood, the contact with one's own emotional experiences. Prevention is put aside in many sectors, as a mere aim of immediate saving, without even the ability to think about the expenses that must be faced afterwards considering the economic point of view. Families and not only children must be looked after. A child does not exist without her/his parents, the whole world revolves around them.

With the strength and the courage that marks her out, M.Gabriella Fornero denounces the damage institutions can cause by accepting to identify that child with a diagnostic label.

Docts. Daniela Ghiano, Mariangela Giustetto, Elisa Saracco, Psychotherapist Psychologists.

Introduction

Once more I'm going to write about psychological problems and about music, as in my work of psychology I should quite justify the use of the second in favour of the first ones. And so, even in the following pages, l've written how I took the chance to approach two cultural and professional aspects which seem to be very far away, but that my experience has taught me they could be very close instead.

A musician and a psychologist have the dimension of listening in common, sonorous-harmonic for the former and emphatic for the latter: being able to listen to the other in order to catch the harmonic wholeness or to look for the dissonant sound which makes discordant the whole with the aim of finding a remedy. Listening involves respect and recognition of the silence as well as the acceptance of the new which can emerge and the underlying meaning.

Psychologists and musicians have in common even putting emotions in the middle of the scene, receiving them in their total expressive range, listening, accepting and returning them after having been elaborated and interpreted in a constant dialogue. This is, in synthesis, the reason why I see these two dimensions of the work as being very close.

While writing I found myself reporting about children with a diagnosis of autism, about music, but even about institutions where these young people's life takes place. I asked myself whether I should have chosen only one field and if it would have been possible, but the answer was: no.

These topics, in my opinion and in this case, should be faced together in order to describe my experience and explain the path I followed, the conclusions achieved and how I explain them.

Over the years, l've always found great interest in everything that could be, even remotely, led to the use of music in therapy and I've found very interesting theoretical and popular writings, but when I asked myself what a therapist could effectively find useful when facing certain problems, that is whether using music, in what occasions and how,...I did not find the answers I was looking for! Now, without the conceit to have teachings for other people, I'll try to tell you how l used the sound with some children, what happened, what l reached through this exploration. Here is the reason why l' m going to give my contribution hoping it could be useful to other colleagues, but most of all I wish to prove how music could be a great ally in the profession of the psychologist.

In my previous book (I colori dei suoni Antigone 2012) l described how l utilized the sonorous stimulus with patients of multiple sclerosis, with the blind and deaf, with people in a coma, with neurological damage, with psychiatric patients; now it's the case of children who have been brought to me with a diagnosis of autism. The sound has been utilized in a different way for each of them, and here l'll try to tell how and why that method has been useful.

In this path it was unavoidable and important to meet the institutions which surround the child. I observed the dynamics of families, l listened to their members; l met teachers, educators and assistants; l tried a comparison with neuropsychiatrists. Then l wrote how the child's suffering on one hand and the blindness of the surrounding world on the other hand slowly materialized. In the end l found myself to be critical, even though a little heavily, but my arguments have always had the purpose of being constructive and inviting of reflection.

The suffering l have met is so heavy that l wish l will manage to render it for what it really is. How great it would be to solicit new attention and useful interventions.

An aspect that should always be duly considered is that related to the close interdependence between the mind and the body, which has always been demonstrated.

I keep on reasserting how organic aspects can't be considered totally separated from the psychological ones. Nevertheless, mental dynamics can't be observed without lending an ear to what our body tells us with its symptoms. Moreover, our brain enjoys a big plasticity and this fact cannot allow us to consider the age of development of all children with problems, even the most serious cases, in a perspective of inactivity. I mean that every human being deserves that some ways have to be found, some paths have to be followed; not with a conceit of a total remission of the symptoms or recovering, but the name of the humbleness which make us willing to improve the quality of their life. Only in this way can we meet those results which seemed unimaginable, which make us go along the path of psychological growth and make relational situations better. Faced with these results, it occurs to us that a sort of non chronicity in the chronicity can exist.

I think it could be useful to start the exposure of my experience by outlining my meeting with seven children and making reflections on it later.

I'm going to underline that l had no intention to get to the heart of the causes of autism, l consider it a very wide and complex field and l leave it to more competent people than me. I confine myself to giving my modest contribution and my observation in the case they could be useful.

An outline about autism

When talking about autism the first name that occurs is Kanner, we can say that Leo Kanner and Hans Asperger have been the two pioneers as regards this topic. With their publications, Kanner in 1943 and Aspenger in 1944, were the first who tried to describe the characteristics of this pathology and its more familiar symptoms. They both traced it back to the neonatal stage.

In the beginning of the 20th century Psychiatrist Eugen Bleuler introduced the word autism, then spontaneously used both by Kanner and by Aspenger. It was first referred to a manifest disturbance of schizophrenia, this word also coined by Beuler. With the word autism it was meant a relational narrowing with the external world that is so big to exclude every relationship with people confining the patient to him/herself. Autistic, from the Greek autos self'. At the beginning of the 1920s we talked about childhood autism in order to almost distinguish it from the adults' one. But, above all, the wrong impression was given, that while growing up they could recover, for this reason, little by little, this wording was abandoned by choosing autistic or autism.

Aspenger worked in Vienna whereas Kanner in Baltimore, but they both observed autistic children and identified some characteristics which made them separate this concept from the one that describes the pathology of schizophrenia. Autism, unlike schizophrenia, wasn't characterized by a progressive worsening, but, on the contrary, it seemed possible for an improvement during the growth and learning.

In 1943, in an article titled Autistic Disturbance of the Affective Contact, Kanner wrote: "Since 1938 a certain number of children came to our attention whose condition differs, in a clear and striking way, from anything else reported so far. That is that each case deserves- and I hope it will- to