Loners Loners describes a unique group of solitary children who were unable to adapt to the social and educational demands of school life. All were seen in a child psychiatric setting over a twenty-year period. Some of these children were gifted; most coped better once they had left school. Sula Wolff brings together the results of a number of studies of these ‘schizoid’ children and illustrates the findings with detailed case histories. The condition of the children is thought to represent a constitutional deviation of personality development. It is discussed in relation to Asperger’s original description of autistic psychopathy of childhood and in relation to current diagnostic practices in child and adult psychiatry. Loners makes the case for the clinical recognition of such children although they are on the whole not nearly as impaired as those children who are currently given a diagnosis of Asperger’s syndrome. Even when mildly affected, they and their parents need a treatment approach which differs from that for children with disorders due to adverse life experiences. Loners will help psychiatrists and other professionals towards a realistic approach to the treatment and education of people with this condition, both children and adults. Sula Wolff, a child psychiatrist, formerly at the Royal Hospital for Sick Children, Edinburgh, is Honorary Fellow at the University of Edinburgh Department of Psychiatry. She is the author of Children under Stress (1968; 2nd edn 1981) and Childhood and Human Nature: The Development of Personality (1989). Recent reviews: ‘Sula Wolff’s new book marks a refreshing step forward…it should be read by everyone clinically or educationally involved with unusual children’ European Child & Adolescent Psychiatry ‘This book is an excellent example of the value of long-term clinical follow-up. It should help all child guidance staff, including educational psychologists who first meet these children at school, to have greater confidence in their response to parents and teachers faced with these unusual children’ Young Minds Magazine ‘This book is eminently readable and holds the reader’s interest’ Lancet (North American Edition) Loners The Life Path of Unusual Children Sula Wolff London and New York First published 1995 by Routledge 11 New Fetter Lane, London EC4P 4EE Simultaneously published in the USA and Canada by Routledge 29 West 35th Street, New York, NY 10001 Routledge is an imprint of the Taylor & Francis Group This edition published in the Taylor & Francis e-Library, 2003. © 1995 Sula Wolff All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. Library of Congress Cataloguing in Publication Data A catalogue record for this book has been requested ISBN 0-203-35939-9 Master e-book ISBN ISBN 0-203-37195-X (Adobe eReader Format) ISBN 0-415-06504-6 (hbk) ISBN 0-415-06665-4 (pbk) Contents List of illustrations vi Foreword Leon Eisenberg vii Acknowledgements ix Author’s note x Introduction 1 1 Early observations 4 2 In search of a diagnostic label 12 3 A closer look at the childhood picture 30 4 The personality of loners in later life 37 5 The later life adjustment of schizoid boys 50 6 Schizoid girls in childhood and later life 62 7 What is the risk of later psychiatric disorder? 80 8 Is there a link with antisocial conduct? 96 9 Intellectual interests and giftedness 110 10 How can we best understand the condition? 122 11 How can we intervene most helpfully? 136 12 Schizoid personality, pretence and genius: two extraordinary people 150 Appendix 171 References 173 Name index 184 Subject index 186 v Illustrations 1 Two of numerous architectural drawings made by a 9-year-old boy with schizoid personality traits 115 2 Twisborough Old Mill drawn by Thomas in adult life 116 3 Pictures by a 7-year-old boy with schizoid personality traits (a) The family at dinner 117 (b) Musical instruments 118 (c) A fish 118 4 Opal Whiteley’s diary manuscript 152 5 Opal used this picture on a poster publicizing a nature lecture which she gave while state president of the Junior Christian Endeavor. One of these posters was discovered thirty-three years later among her effects left at the University of Oregon 155 6 Opal, at about 18, ready to take a nature study class 159 7 The infant Ludwig Wittgenstein 162 8 The house Wittgenstein designed for his sister 165 9 Ludwig Wittgenstein aged 40 166 vi Foreword Loners is destined to be a clinical classic. Sula Wolff has described a group of youngsters with socially isolated personalities and unusual interest patterns who do not fit criteria for other established clinical entities. Her analysis is based on remarkably broad personal experience, not only with the initial evaluation of such youngsters, but with the course of their development into young adulthood. The syndrome she has described is important because the clinical management of youngsters with this personality pattern is distinctly different from that appropriate for others. Customary approaches based on psychodynamic investigations and therapies aimed at altering intrafamilial relationships are contraindicated. Parents need to be helped to understand that the prognosis, for the most part, is relatively good; that these youngsters need support at school and at home to cultivate the assets they have; and that pressure for socialization by joining clubs and groups is likely to be counterproductive. The last chapter of this book is no less fascinating than the rest. In particular, Dr Wolff suggests that Ludwig Wittgenstein may well have been such a loner. I, for one, am persuaded by the evidence she presents, though, of course, it suffers from being limited to a retrospective search for data. Not many loners will grow up to be Wittgensteins, though I would not be surprised to find his counterparts among mathematicians, philosophers, lighthouse keepers and forest rangers— individuals who have chosen careers which usually limit their social interactions. Let me at once confess that I do not know, either socially or professionally, any lighthouse keepers or forest rangers; I do know academics who fit the pattern! In the Preface to his Tractatus Logico-Philosophicus Wittgenstein (1922) wrote that the whole meaning of his book could be summed up in the following words: What can be said at all can be said clearly; and whereof one cannot speak, thereof one must be silent. Wittgenstein does not seem to me to have lived by his aphorism; the Tractatus is not always clear and it was not always persuasive even to Bertrand Russell, his mentor. Sula Wolff, on the other hand has observed his injunction with great fidelity. What she says, she says clearly. Her style is simple and direct. And whereof she cannot speak, such as the causes of the syndrome, she is silent as all must be until these are uncovered. vii viii Foreword In the more than forty years I have been an academic child psychiatrist, I have emphasized to trainees the importance of clinical descriptive and phenomenological research. Most demur on the grounds that ‘everything has already been described’. Loners proves them wrong. The task of separating out new clinical syndromes is not easy. It takes a good clinical eye; it requires being willing to stick by families and support them even though one is frankly puzzled about the best tack to take and uncertain about outcome; it takes a mind that is not hobbled by conventional modes of thought. The notion that children may differ in personality for reasons which are not experiential is no longer radical. It was very much so when Sula Wolff began her clinical work. Psychodynamic furor therapeuticus was ubiquitous. Watchful waiting has never been easy for doctors; it is, however, the only safeguard against iatrogenic disease when uncertainty abounds. I wish I had had Loners to read when I began my career. I would have avoided clinical errors I made and only remedied after reading Dr Wolff’s earlier papers on the subject. I commend this book to all those starting out on their mental health careers as an insightful portrait of an important condition and as a standard of clarity and brevity for their own research and writing. I commend it as well to mature clinicians whose understanding will be sharpened by studying its contents. This monograph demonstrates the importance of careful clinical longitudinal observation and incisive thought for the provision of appropriate psychiatric care for children and their families. Leon Eisenberg, MD Harvard Medical School Boston, MA REFERENCE Wittgenstein, L. (1922/1981) Tractatus Logico-Philosophicus, Translated by C.K.Ogden. London: Routledge and Kegan Paul Ltd. Acknowledgements The researches summarized in this book were supported by grants from the Scottish Home and Health Department and from the McGhie Fund for Research into Mental and Nervous Disorders. My special gratitude goes to a number of colleagues who actively participated in the work: Jonathan Chick, Ralph McGuire, Anne Barlow, Ann Cull, Lorraine Waterhouse and Douglas Blackwood. I want to thank Rose Townshend, who did most of the research interviews, and Andy Ginsborg, Barbara Moyes, David Weekes, Eunice Urquart and Louise Mountford, who also took part in the studies. Most of all, I want to thank the many former child patients and their parents who told us about themselves and their lives and often made us welcome in their homes. Their readiness to keep in touch, sometimes for very many years, helped us to gain a new understanding of important aspects of personality development. Lionel Hersov and Henry Walton read an earlier draft of this book. Their critical comments but also their encouragement were invaluable. Permissions were kindly given by the Association for Child Psychology and Psychiatry to quote from an article by Wolff and Barlow and by Oxford University Press to quote from Ludwig Wittgenstein: A Memoir. Copyright on Miss Whiteley’s works is held by the University of London Library and permission to quote from her Diary is acknowledged. The quotation from articles by Princesse de BourbonOrleans (Opal Whiteley) are reprinted from Queen magazine, courtesy of the National Magazine Company. ix