Deficits in social skills are a key diagnostic factor in autism, but the exact opposite is seen in psychotic savants. Bruno Bettelheim (1903-1990) is a paradigmatic case. Although Bettelheim arrived in the USA a penniless refugee and had no qualifications whatsoever in psychiatry or psychotherapy he was appointed the Director of the University of Chicago’s Orthogenic School for disturbed children, and in 1956 he successfully applied to the Ford Foundation for a research grant of the then-enormous sum of $342,500. Such achievements speak for themselves where social skills and self-presentation-ability are concerned.
Autistics find any kind of lying or dissimulation difficult, and often have serious deficits in self-expression which compound the problem. Psychotic savants, by contrast, are characteristically smooth talkers who show all the opposite tendencies: sensitivity to their protagonists’ wishes and feelings; understanding of their listeners’ interests and knowledge; and ready complicity with their audience’s prejudices and pre-occupations. Indeed, such quintessential mentalistic skills can also make them proficient and practiced liars. According to the testimony of Jacquelyn Sanders, Bettelheim's primary assistant and successor at the Orthogenic School, “you couldn't believe anything Bettelheim said.” Despite having only a single doctorate in philosophy without honours, Bettelheim claimed to have passed doctoral degrees summa cum laude in three subjects, adding psychology and art history. Additionally he falsely asserted that he had “training in all fields of psychology,” and even to have “studied with Freud.” (Anna Freud told me that her father had never so much as met the man!)
Another key aspect of mentalism exploited by psychotic savants which is lacking in autism is subjectivity. Often psychotic savants claim privileged insights into reality from their personal experiences, and consequently tend to build cults of personality around their inflated egos. Bettelheim had been incarcerated in Dachau and Buchenwald for ten and a half months in 1938-9 and believed that he saw a valid parallel between autism and the behaviour of prisoners who had given up all hope, avoided all eye contact, refused to eat, and become completely passive and zombie-like. If autistic children resembled them in these respects, it could only be because their homes were the equivalent of concentration camps, and their parents—mothers especially—that of the cruel, persecuting guards. Translated by the American press into Sound-bite, this became the notorious refrigerator mother theory of autism.
Autistics are symptomatically poor at interpreting others’ behaviour in mental terms, but Bettelheim was outstanding to the point of paranoia. On one occasion he suddenly slapped a child across the face after a comment from her teacher, Nina Helstein, who was deeply shocked. Later Bettelheim blamed Helstein for his behaviour remarking, “So when a child is upset, why would you have me hit her?” When recounting the story later she added, “It was insane. A lot of what went on at the school was, and the staff members went along with it.”
Psychotic savants could be seen as high-functioning psychotics who only escape recognition thanks to the relative mildness of their symptoms and their compensating inter-personal and political skills. Jacquelyn Sanders later admitted that “we became abusers of abused children;” that “children who had aggressive tendencies identified with this aspect of our approach;” and that “we became actors in sexual-sado-masochistic fantasies.” The biographer who published these findings concludes that “physical and emotional abuse was a part of everyday life at the Orthogenic School,” with children feeling like frightened prisoners, some of whom were incarcerated for longer than Bettelheim himself had been.
By contrast to autistic savants, who have mentalistic deficits, psychotic savants have parallel mechanistic ones. In Bettelheim’s case the most serious manifestation of this was his complete ignorance of and total lack of interest in the genetic, medical, and constitutional factors in autism which were apparent to Hans Asperger when he first described the syndrome now named after him in the 1940s.