On the Trail of Fetal Alcohol Syndrome

   1926.   In 1926, a professor of psychology at Harvard College, Dr. William McDougall, discussed the issues of cause in his book, An Outline of Abnormal Psychology  published by Metheun and Company, London.  In his introduction, Dr. McDougall states, "The whole field of of abnormal psychology falls into two corresponding divisions, concerned, respectively, with the organic and functional disorders."  He goes on to say, "Owing to the immense difficulties of research in the organic division... The functional division is, at the present time, much more profitable for the student of human nature."  His book therefore deals mainly with the functional division of abnormal psychology. 
    What, then, is the organic division?  The organic division of psychology believes there is a physical cause for behavior.   This would include changes in the brain due to the environment or genetics, such as lead/mercury poisoning, and alcohol consumption during pregnancy or the inherent damage might be found in the genes.  Modern psychology's tools for finding "organic" causes have only begun with the advent of functional MRIs, gene studies and increasingly sensitive tests for chemical imbalances and absences.
    The functional division of abnormal psychology believes "...there is something besides that permits the nervous to take refuge just in disease, while there are other means of evading difficulties."  In other words, the brain is normal but events and situations cause it to revert to unhealthy techniques for coping.  The implication for treatment is the recognition of the impropriety of the behavior and then the modification of that behavior. 

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     1927.  Feldman, W.M.  "Alcohol in Ancient Jewish Literature."  British Journal of Inebriety.  

     1931.   Dr. Franz Alexander and Hugo Staub in Germany wrote The Criminal, The Judge and the Public. which described the neurotic criminal.  
    "Not infrequently, he rejects the crime unconsciously and this rejection is brought to light through irrational self injury, which serves the purpose of self punishment."
    "...the transgressions are acompulsive nature."
     "Kleptomania, hydromania, compulsive lying and betrayal, belong to this type of crime."
    "...unable to give a very definite account as to why he committed a given crime." 
    "(Freud described) 'individuals who break as a result of success.'" 
    "...irrational behavior, which is motivated by unconscious causes..."
    "...totally lacks insight into his illness." 
    "...tendency to self injury..."
    "...suffers from a neurosis without symptoms..."
    "...impossible to classify him in accordance with existing diagnostic tables."
    "These individuals have a very dramatic fate: they are driven through life by a demonic impulse..."
    "...they always succeed in being punished quite unjustly (unjustly a least from their subjective point of view)..."
    "...the punishment with which he is threatened cannot intimidate him and therefore deter him from his behavior, because...he feels the need of punishment and therefore welcomes the severity of the law; quite often he even actively seeks punishment..."
    "To punish such individuals is psychologically meaningless and sociologically harmful."
 Alexander states that these people are very curable.  However, he does not state if the "cure" was observed over a long term period nor if the patients were ever re-examined.  As many FAS families can attest, it is common for their children to convince therapists that they can understand their behaviors and can also change them accordingly but return to their previous behavior within a short time span.
 [Franz Alexander's work is also discussed in Karl Menninger's work, Man Against Himself, published in 1938.]
 
               G.P. Fretz in Alcohol and the Other Germ Poisons.  The Hague, the Netherlands:  Martinus Nijhoff.  Quote from Streissguth's Fetal Alcohol Syndrome:  A Guide for Families and Communities:  "The germ injurious effect of alcohol is accepted by most authors, doubted by some, and denied by a few."

    1932.  Durham, F.M. and Woods, H.M.  Alcohol and Inheritance:  An Experimental Study.  (Medical Research Council, Special Report Series No. 168)  London:  H.M. State Office.

******************************************************************************    1932:  Charles R. Stockard on "The Effects of Alcohol in Development and Heredity."  Alcohol and Man.  Ed. H. Emerson.  New York:  MacMillan.  At this time, Stockard had changed his 1910-1914 stance on maternal consumption of alcohol and instead declared that there was no connection between maternal drinking and harm to the fetus.  It is believed part of this stemmed from the criticism of his experimental animal subjects whose purebred genetic backgrounds were believed to be prone to natural degeneration.

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    1938.  Man Against Himself by Karl Menninger.  Dr. Karl Menninger was a psychiatric icon in the Midwest, most importantly known for his Menninger's Clinic, formerly located in Topeka, Kansas.  His Man Against Himself was written in the hope of applying an intellectual methodology toward solving some of the more unusual problems in psychiatry.  Menninger discusses several types of self destructive behavior including suicide, hypochondria, self mutilation, sexual dysfunctions, and alcoholism.  However, he also describes a type of anti-social personality which he calls the Neurotic Character.
     In Chapter Four of the Antisocial Personality, Section A of the book that deals with alcohol and addiction, Menninger describes the "Neurotic Character"  as "...(a) form of chronic self destruction, disguised aggressive behavior, is quite similar to alcoholism except that the individual ruins himself in inexpedient conduct ..."
    Menninger goes on to describe this person more completely:
    "...not a single injurious act but a certain consistent addiction...to 'bad'...behavior."
    "...always successful in failing"
    "In older psychiatric categories these patients were called psychopathic personalities and by this term, they are still known by the majority of psychiatrists."
    "..on account of their provocativeness, aggressiveness, and inexplicable bad judgment..."
    "...driven by their consciences to bring about a punishment which a more normal person would  avoid."
    Menninger goes on to describe a case that had been previously researched by Franz Alexander, a German contemporary, who, Menninger felt, was the most thorough expert on the neurotic character:
    "...son of wealthy and aristocratic Boston parents who were the chief victims..."
    "By the age of seven he had already done considerable petty stealing...and spending it on candy."
    "He was expelled (from school) repeatedly."
    "He began sexual activities at a very early age..."
    "...when admitted to a second preparatory school defied the authorities and his parents by refusing to study....this was not on account of any intellectual defect was clearly shown by subsequent psychometric tests which indicated his intelligence to be definitely superior."
    "He admitted with engaging candor that he did not know why he persistently got himself into so much trouble..."
    Menninger attributes the young man's behavior to an early parental preference for the sister over the baby brother (Alexander's patient).  It is to be noted however, that his mother was an extreme disciplinarian and was given to dressing him in girls clothing and allowing his hair to grow long and curly.  Such revelations however, failed to curb the young boy's tendencies and he continued to commit petty crimes into adulthood.
    "All of his drinking, stealing, forging, raping, car smashing, fighting, and so on failed to achieve for him any substantial gain."
    "He was constantly in trouble, actually unhappy."
    "...how he deliberately arranged to punish himself, he would vigorously deny that he had even so much as a sense of guilt..."
   Another case of Franz Alexander's was cited by Menninger in which the child was also from a well to do family and was also "compelled" to steal although, "He stated frankly that something he did not know what, drove him to steal and that his behavior was a puzzle to himself."  After a series of stays in correctional facilities, he distinguished himself by a heroic act in a prison catastrophe and was granted a pardon....only to "...(run) away and soon was implicated in a series of thefts and burglaries in another state."  A psychiatrist who examined him at a later date said he did not have normal criminal impulses but "..committed criminal acts because of an inner compulsion."
    A subsection to Section A of the Neurotic Character is titled "Passive Neurotic Aggression".  In this section Menninger describes individuals who fail at nearly every opportunity in life.  Given large amounts of money and property by relatives and friends, these people nevertheless tend to lose the money and/or property due to bad judgment calls and inadequately thought out decisions.  In the end, "...he has the mad satisfaction of many a wild, impulsive fling...a throwing away of life for momentary satisfactions."
    Menninger never did ascribe the cause of these personality problems to maternal drinking. 
    [Note:  personality disorders are included in the Axis II section of the DSM.]

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