Autism therapy and the link to conversion therapy

By Camilla Asra Engelby, AuDHD
Photo: Caleb Woods via Unsplash

Trigger warning: This article discusses abuse and suicide. If you need help, please call Livslinien on +45 70201201.

ABA is a type of autism therapy and is short for Applied Behaviour Analysis. It’s a form of behaviourism. Its purpose is to change the natural behaviour of autistics through a rigid training regimen that trains autistics (primarily) children to mask their autistic identity aka appear “normal”. Often the training goes on for several years for up to 40 hours a week.

ABA is highly controversial and is widely condemned by the autism rights movement as constituting abuse, resulting in life-long trauma. Practitioners of ABA are not required to learn about autism in order to gain certification. The emphasis of this form of autism therapy is on indistinguishability instead of much needed acceptance and inclusion. ABA has a history of the use of aversives such as electric shocks (currently legal in the USA and labeled by the UN as torture). Furthermore, ABA is controversial due to its relatively weak evidence base and researchers’ failure to investigate possible harms and disclose conflicts of interest.

ABA is extremely traumatising

A study from 2018 examined perspectives of autistic adults that received ABA as children and found that the overwhelming majority reported that “behaviourist methods create painful lived experiences”, that ABA therapy led to the “erosion of the true actualising self”, and that they felt they had a “lack of self-agency within interpersonal experiences.”

The study also found that nearly half of autistic adults that received ABA as children developed PTSD.

Without ABA roughly 28% autistics still develop PTSD, often contributed to by the trauma of growing up autistic in a world that does not accept and include us as we are.

ABA and the link to conversion therapy

Norwegian-American clinical psychologist Ole Ivar Lovaas is widely recognised as the founder of ABA. But Lovaas’s crusade to “normalise” deviance was not limited to autistic children. In the 1970s, he lent his expertise from autism therapy to a series of experiments called the Feminine Boy Project. The aim of the project was to see if operant conditioning (a method of learning that uses rewards and punishment to modify behavior, WebMD) could be employed as an early intervention in cases of “gender confusion” to prevent the need for surgery in the future. The project’s most celebrated success story was Kirk Andrew Murphy, who was enrolled in the government-funded experiment at UCLA by his parents at age five.

To nip the little boy’s “inappropriate” behaviour in the bud, a programme of total immersion based on Lovaas’ work on autism was devised.

This time, instead of stimming, avoiding eye contact and other common autistic traits, the behaviours targeted for extinction included playing with dolls and being effeminate.

The tragic consequences

Murphy was primarily treated by doctoral student George A. Rekers. Rekers went on to become a founding member of the Family Research Council, a faith-based organisation that lobbies against LGBTI+ human rights issues. Rekers was also on the board of the National Association for Research and Therapy of Homosexuality (NARTH), an organisation of scientists that says its mission is to offer treatment to those who struggle with what they call “unwanted homosexuality”. Rekers resigned from NARTH in 2010 after being involved in a scandal where he was accused of having an affair with a male escort hired from rentboy.com. Rekers denied that the relationship was inappropriate, saying the man was his “travel assistant”.

After 10 months of formal treatment, which similarly to the original ABA included physical punishment, Rekers said Murphy no longer exhibited feminine behaviour and had been successfully treated.

Kirk hanged himself in 2003 at age 38, following decades of depression. His family attribute his suicide to his participation in the project. When CNN informed Rekers that Murphy had killed himself, he expressed his sympathy but said there is no evidence to support that the (ABA-based) programme was related to his death.

Let’s make a better world without ABA or any other form of conversion therapy

Both projects – ABA and the Feminine Boy Project – involved systematic attempts to slap, shout, reward, shock, and ignore autistic and gender non-conforming behaviours out of children. Like conversion therapy ABA can inflict long term damage such as PTSD, severe depression, or anxiety. And while there are currently 15 countries with some form of national ban on conversion therapy, ABA is flying under the radar and is even being endorsed by some autism charities.

When asked why she enrolled her son into the programme Kaytee Murphy said she “wanted Kirk to grow up and have ‘a normal life’”. The very same argument I often experience autism parents make to justify subjecting their children to ABA. The fear that their children won’t be able to make it in this super neurotypical and ableist (as well as cis, hetero and gender normative) world we inhabit.

But as both a neurodivergent person and a member of the LGBTI+ community I say; if the world is not fit for purpose, let’s instead transform the world into an inclusive and accepting place where autistic and LGBTI+ people won’t have to mask their authentic selves. Rather than subjecting individuals to excruciating therapy with potential harmful or even lethal consequences.

Dictionary:

Autism: Autism spectrum disorder (ASD) is a developmental condition caused by differences in the brain. Autism is generally understood as a spectrum disorder, which means that it can manifest differently in each autistic individual.

Behaviourism: A theory that all human behavior comes from conditioning, which in turn is a result of interacting with the environment.

Identity-first language: Examples: “I am autistic”, “they are autistic”.

Person-first language: Examples: “I have autism”, “they have autism”.

Stimming: Self-stimulatory behavior such as hand-flapping, humming, spinning or fidgeting. Stimming is often used by autistics to calm themselves when overstimulated but can also be an expression of excitement.

Masking: Autistic masking, camouflaging, or compensating is a conscious or unconscious suppression of natural autistic responses. Masking is often extremely draining and can contribute to autistic burnout.

Sources:

Kupferstein, H. (2018), “Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis”, Advances in Autism, Vol. 4 No. 1, pp. 19-29. https://doi.org/10.1108/AIA-08-2017-0016 No. 1, pp. 19-29. https://doi.org/10.1108/AIA-08-2017-0016