Lauretta Bender

Lauretta Bender (August 9, 1897 – January 4, 1987) was an American child neuropsychiatrist known for developing the Bender-Gestalt Test in 1938, a psychological test designed to evaluate visual-motor maturation in children that was used widely used for assessing their neurological function and in screening for developmental disorders. She performed research in the areas of autism spectrum disorders in children (formerly "childhood schizophrenia"), suicide and violence, and was one of the first researchers to suggest that mental disorders in children might have a neurological basis, rather than attributing them to the child's bad behavior or poor upbringing.

Lauretta Bender

This group of boys showed considerable: and consistent effects from medication with UML or LSD daily for two to eleven months. Their behavior, ward management, school-room adjustment and progress at home changed favorably with less acting out and less disturbed behavior. They not only needed no other tranquilizing, sedative, or antidepressant medication, but furthermore, unlike the tranquilizers which made them sleepy and groggy, they were generally cheerful and alert. Personnel and families noted the difference. Repeated psychiatric interviews revealed a change in fantasy material which was less bizarre, personalized or disturbing. Depressive, anxious and paranoid attitudes were focused on real objective problems. Insight was impressive. Intellectual changes, as seen in psychometric tests, indicated improved maturity, better organization and motivation with a rise in IQ which was reflected in improved school work. The Rorschach and drawing tests also showed increased maturity and control with clearer thinking.

We then gave LSD in the same doses to non-autistic schizophrenic boys 6 to 12 years of age. They were intelligent and verbal and could be tested psychologically and in psychiatric interviews (Bender et al., 1963). They were selected because they had typical schizophrenic psychosis, with flying fantasies and identification and body image difficulties, loose ego boundaries, introjected objects and voices and bizarre ideologies. They had obvious anxiety and labile vaso-vegetative functions. After administering LSD to these children we found results contrary to those reported in adults. These children became more insightful, more objective, more realistic; and in a short time they became frankly depressed for reality reasons. They noted they were in the hospital, that they were away from their family, and that they had had "crazy" ideas before.

Quotes

• Our own definition of childhood schizophrenia has been a clinical entity, occurring in childhood before the age of eleven years, which "reveals pathology in behavior at every level and in every area of integration or patterning within the functioning of the central nervous system, be it vegetative, motor, perceptual, intellectual, emotional, or social. Further more, this behavior pathology disturbs the patterns of every functioning field in a characteristic way. The pathology cannot therefore be thought of as a focal in the architecture of the central nervous system, but rather as striking at the substratum of integrative functioning or biologically patterned behavior" (1) At present the only concept we have of this pathology is in terms of field forces in which temporal rather than spatial factors are emphasized. Within the concept of field forces, one can accept some idea of a focal disorder, since no one integrated function is ever completely lost or inhibited, and since there are different degrees of severity of disturbance in the life history of any child and between two different children. This also differs with the period of onset.
  The diagnostic criteria for the 100 schizophrenic children which make up this study have been rigid. In each child it has been possible to demonstrate characteristic disturbances in every patterned functioning field of behavior. Every schizophrenic child reacts to the psychosis in a way determined by his own total personality including the infantile experiences and the level of maturation of the personality. This reaction is usually a neurotic one determined by the anxiety stirred up by the disturbing phenomena in the vaso-vegetative, motility, perceptual, and psychological fields. Interferences in normal developmental patterns and regressive phenomena with resulting primitive reactions are related to both the essential psychosis and the reaction of the anxiety-ridden personality.
  There are, of course, children in whom the differential diagnosis is very difficult. Those with some form of diffuse encephalopathy or diffuse developmental deviations in which the normally strong urges for normal development push the child into frustration and reactive anxiety may present many schizophrenic features in the motility disturbances, intellectual interferences, and psychological reactions.
  • “Clinical Study of One Hundred Schizophrenic Children", Childhood Schizophrenia, (January 1947), p. 40.

• This group of boys showed considerable: and consistent effects from medication with UML or LSD daily for two to eleven months. Their behavior, ward management, school-room adjustment and progress at home changed favorably with less acting out and less disturbed behavior. They not only needed no other tranquilizing, sedative, or antidepressant medication, but furthermore, unlike the tranquilizers which made them sleepy and groggy, they were generally cheerful and alert. Personnel and families noted the difference. Repeated psychiatric interviews revealed a change in fantasy material which was less bizarre, personalized or disturbing. Depressive, anxious and paranoid attitudes were focused on real objective problems. Insight was impressive. Intellectual changes, as seen in psychometric tests, indicated improved maturity, better organization and motivation with a rise in IQ which was reflected in improved school work. The Rorschach and drawing tests also showed increased maturity and control with clearer thinking.
  • L. Bender, L. Cobrinik, G. Faretra, D.V. Siva Sankar, "The Treatment of Childhood Schizophrenia with LSD and UML", Biological Treatment of Mental Illness, Proceedings II of the International Conference of the Manfred Sakel Foundation 10/31-11/3/1962, 1966; 2(4):463-91.

• It was hoped that these drugs might prove effective in breaking through autistic defenses, improving autonomic nervous system functioning, and modifying distorted perceptual experiences.
  There were some differences in results in the various groups. In general, the younger autistic children became less anxious, less autistic and plastic, more aware and responsive, with some changes in verbalization and qualitative improvement, on the Vineland Social Maturity Scale. The girls and older autistic boys showed similar results, but much less marked and persistent. Verbal children showed improvement in general behavior, with marked changes in fantasy and bizarre ideation to more insightful, reality-oriented, though often anxious and depressive attitudes, and improved maturity and organization.
  There were no major side effects, though a few patients on UML had muscular spasms and vasomotor changes in the legs, generally of a temporary nature. It is significant to note that while most of these patients had required tranquilizing or, other medications, they could all now be maintained only on the LSD or UML. A few patients received reserpine to control excessive activity, aggression, or biting.
  • L. Bender, L. Cobrinik, G. Faretra, D.V. Siva Sankar, "The Treatment of Childhood Schizophrenia with LSD and UML", Biological Treatment of Mental Illness, Proceedings II of the International Conference of the Manfred Sakel Foundation 10/31-11/3/1962, 1966; 2(4):463-91.

• We do not use it as a psychoanalytic tool. Our idea was to give it as a daily drug. It is our general experience that frequently the children respond to many drugs that affect the central nervous system differently than adults. This is common knowledge; at least, to those of us using drugs with children. So we were not surprised to find, in our early initial studies, that if the children were near puberty or in puberty they responded to the first dose with anxiety and disturbance, just as the adolescent boys did. But even these children could be maintained on high doses of the drug, just as the adolescent boys were, so that the drugs can be given to these children in continuing doses. What tolerance means, I don't know. Tolerance may be established in our patients. The chemical studies suggest this, and even our psychological studies indicate a slight change later on, a leveling off of response as compared to initial reaction, but the long-term reaction is still the most valuable reaction to the drug.
  • L. Bender, L. Cobrinik, G. Faretra, D.V. Siva Sankar, "The Treatment of Childhood Schizophrenia with LSD and UML", Biological Treatment of Mental Illness, Proceedings II of the International Conference of the Manfred Sakel Foundation 10/31-11/3/1962, 1966; 2(4):463-91.

• We then gave LSD in the same doses to non-autistic schizophrenic boys 6 to 12 years of age. They were intelligent and verbal and could be tested psychologically and in psychiatric interviews (Bender et al., 1963). They were selected because they had typical schizophrenic psychosis, with flying fantasies and identification and body image difficulties, loose ego boundaries, introjected objects and voices and bizarre ideologies. They had obvious anxiety and labile vaso-vegetative functions. After administering LSD to these children we found results contrary to those reported in adults. These children became more insightful, more objective, more realistic; and in a short time they became frankly depressed for reality reasons. They noted they were in the hospital, that they were away from their family, and that they had had "crazy" ideas before.
  • "Children's Reactions to Psychotomimetic Drugs", Psychotomimetic Drugs, 1970; pp. 265-273.

1954 Senate Subcommittee Hearings into Juvenile Delinquency, "Testimony of Dr. Lauretta Bender, senior psychiatrist, Belleveu hospital Newyork N.Y."

Superman represents an instinctive problem that we are all born and grown up with, that we can fly ─ after all, we can fly now; we couldn't before ─ and that we can carry on all kinds of scientific investigations, that we can stop crime, which Superman does, and that we can have a good influence on the world, and that we can be protected by the powerful influences in the world which may be our own parents, or may be the authorities, or what not.

• My God, how can you stand such things, children? They say, "Mom, don't you know it is only television, it is not real."
• There's no such thing as a normal child.
• Superman represents an instinctive problem that we are all born and grown up with, that we can fly ─ after all, we can fly now; we couldn't before ─ and that we can carry on all kinds of scientific investigations, that we can stop crime, which Superman does, and that we can have a good influence on the world, and that we can be protected by the powerful influences in the world which may be our own parents, or may be the authorities, or what not.
• So I advised them that in my experience children throughout the ages, long before Superman existed, tried, to fly, and also it has been my specific experience, since I have been at Bellevue Hospital, that certain children with certain emotional problems are particularly preoccupied with the problem of flying, both fascinated by it, and fearful of it.
  And we frequently have on our ward at Bellevue the problem of making Superman capes in occupational therapy and then the children wearing them and fighting over them and one thing or another ─ and only about 3 months ago we had such, what we call epidemic, and a number of children were hurt because they tried to fly off the top of radiators or off the top of bookcases or what not and got bumps.
• There is another reason why Superman has had good influence. That is the years of continuity of the Superman character. The children know that Superman will always come out on the right side. On that, I can give you another story about what they wanted to do. At the end of the Second World War we had the problem of a certain number of soldiers coming home as amputees.
  One of the script writers got the bright idea that we ought to prepare children for their fathers coming home as amputees by having one of the characters─ I don’t think it was Superman ─ one of the others ─ have an accident and lose his leg. They wanted to know what I thought about that idea. I said I thought it was absolutely terrible because I felt that the children loved this character and, after all, how many children were going to have to face the question of an amputee father? Certainly there are far better ways of preparing such children for such a father than to have to shock the whole comic reading children public. So I disapproved of it.
• They said, "This is good because it is history. This is real," which is another reason why it is bad.
  They also gave a picture of colonial days where the mother was being tommyhawked by the Indians, with a baby at her breast, and the baby was being dropped on the ground. Now, this was history.
  Certainly it is history, but do our children today have to be exposed to such things?
  This is not history. I see no excuse whatsoever for a parent magazine group or an approved group approving that sort of thing. It was quite contrary to the code which we eventually established for the comic people.

• Dr. Lauretta Bender "Testimony of Dr. Lauretta Bender, senior psychiatrist, Belleveu hospital Newyork N.Y.", 1954 Senate Subcommittee Transcripts.

Dialogue

I have seen children in panics, as I say, not over comics usually because they are easily rejected, but over movies. I have seen children brought to me in terrible panics, and interestingly enough most often the Walt Disney movies which do depict very disturbing mother figures.
The mothers are always killed or sent to the insane asylums in Walt Disney movies. They are among my experience for Frankenstein, the worst movies in the world for children who have had a problems of the loss of a parent.
I can speak of that within feeling because I have 3 children who lost their father when they when babies and I know the problem of exposing children to such problems as this.
It can throw them into the kind of anxiety which is distressing, but the children will leave if they can or they will not read the comics, they will reject it.

• Mr. BEASER Since delinquency does appear in broken homes as well as others, assuming this is a broken home and they depicted a broken home, would the child identify his own mother and father with the pictures in the comic book?

Dr. BENDER If he would so identify himself, then it would be his tendency again to discard the comic book or go into a panic. I have seen children in panics, as I say, not over comics usually because they are easily rejected, but over movies. I have seen children brought to me in terrible panics, and interestingly enough most often the Walt Disney movies which do depict very disturbing mother figures.
The mothers are always killed or sent to the insane asylums in Walt Disney movies. They are among my experience for Frankenstein, the worst movies in the world for children who have had a problems of the loss of a parent.
I can speak of that within feeling because I have 3 children who lost their father when they when babies and I know the problem of exposing children to such problems as this.
It can throw them into the kind of anxiety which is distressing, but the children will leave if they can or they will not read the comics, they will reject it.

• Now, I can well imagine children, and I know plenty of disturbed children from homes where they have less support than my children do, because, after all, my children have not only had the support of myself, but of our very many friends, who on occasions of these various things and, after all, there are lots of children in the world whose fathers have been killed by gangsters or who don't know who their fathers are, and who live in a gangster's world and whose fathers are gangsters killing other people ─ I don't know that crime is quite as bad in the world as we try to make it out to be, and these children I am sure will be disturbed by such things.
  If they have to be exposed to them, or are exposed to them, they should have a wise adult who can discuss the matters with them and talk it over with them.

Mr. BEASER: Many of them do not.

Dr. BENDER: Many of them do not.

• Mr. BEASER: Now, let me ask you one final question, Doctor.
  Would you say ─ I suppose you would ─ that your opinion on this subject is in no way in influenced by the fact that you are member of the Superman comics advisory board?

Dr. BENDER: Well, it is a fair question and I think you were a little bit hard on Mr. Dybwad in that regard this morning.
Actually, the amount of money I get, $150 a month, is what I can get for one lecture such as I gave yesterday. I was all day yesterday in another State attending a scientific conference at which I gave a lecture ─ and which I can give once a week without any trouble ─ and it certainly is a small part of my income.
I would say this: The act that I am in this position as far as the National Comics are concerned has two influences.
I think I have influenced the National Comics Publications to some extent, and I think my continuing presence on their editorial board may represent a continuing influence, not only on the national comics but conceivably all of the publications, to some extent.
I would say that I have been somewhat more interested in the comics. I am furnished with the comics as they come out regularly. The fact, I am furnished. with three copies of them.
And I have in recent years especially been particularly interested not only in this sort of thing, but extremely interesting new phenomena in the comics.
The comics actually, if you follow the history of the comics, and I wish Dr. Wertham could have done this, because he is a brilliant scientist, if he could only realize what could be done with them, they have gone through phases of understanding the problems that the world is being shaken by continuously.
And now, most amazingly, they have, become aware of the problems which most concern us psychiatrists, and me particularly, and that is something which is a technical phase, the concept of the body image and what can happen to it under different emotional circumstances.
These are psychological problems and the uncanny capacity for the script writers to delve down into their own unconscious and dig up these problems and depict them to me is an amazing phenomenon. I only wish that I had the time from my various other duties to sit down and do a job ─ not with these, I confess they don't interest me much ─ but with the psychological phenomena that, have occurred in the comic books and in terms of what they might mean to developing children.

Attributed

• She does not believe that Wonder Woman tends to masochism or sadism. Furthermore, she believes that even if it did-you can teach either perversion to children-one can only bring out what is inherent in the child. However she did make the reservation that if the woman slaves wore chains (and enjoyed them) for no purpose whatsoever, there would be no point in chaining them.
  • As attributed by Dorothy Roubicek in The Secret History of Wonder Woman by Jill Lepore, (Oct. 23, 2014), p. 240.

Quotes about Lauretta Bender

With regard to the purpose of these studies, all were to some extent exploring the therapeutic potential of psychedelic drugs rather than their psychotomimetic properties. This was least true of Freedman and his coworkers (1962) who viewed LSD primarily as a means of studying the schizophrenic process by "intensifying pre-existing symptomology." This orientation contrasted sharply with Bender's view. Noting that withdrawn children became more emotionally responsive while aggressive children became less so, she hypothesized that psychedelic drugs "tend to 'normalize' behavior rather than subdue or stimulate it." This basic difference in expectations seems at least partially responsible for Bender's extremely favorable outcomes and Freedman's rather poor results. ~ Robert E. Mogar and Robert W. Aldrich

• Dr. Bender was known for developing, in 1923, the Bender-Gestault Visual Motor Test, a neuropsychological examination that has become a worldwide standard. She spent many years researching the cause of childhood schizophrenia and was responsible for studies on child suicides and violence.
  • Joan Cook, “LAURETTA BENDER A PSYCHIATRIST, 88”, New York Times, (Jan. 17, 1987).

• With regard to the purpose of these studies, all were to some extent exploring the therapeutic potential of psychedelic drugs rather than their psychotomimetic properties. This was least true of Freedman and his coworkers (1962) who viewed LSD primarily as a means of studying the schizophrenic process by "intensifying pre-existing symptomology." This orientation contrasted sharply with Bender's view. Noting that withdrawn children became more emotionally responsive while aggressive children became less so, she hypothesized that psychedelic drugs "tend to 'normalize' behavior rather than subdue or stimulate it." This basic difference in expectations seems at least partially responsible for Bender's extremely favorable outcomes and Freedman's rather poor results. Regarding all forms of psychotherapy, it has become a truism that " where there is no therapeutic intent, there is no therapeutic result" (Charles Savage in Abramson, 1960, p. 193).
  • Robert E. Mogar and Robert W. Aldrich, "The Use of Psychedelic Agents with Autistic Schizophrenic Children", Behavioral Neuropsychiatry 1969 Nov; 1(8):44-50.

• Consistent with their explicit therapeutic intent, Bender, Fisher, and Simmons each offer essentially the same hypothesis based on a psychological interpretation of childhood schizophrenia: " The working hypothesis of this study is that the psychosis is a massive defensive structure in the service of protecting and defending the patient against his feelings and affectual states" (Fisher & Castile, 1963). Psychedelic drugs were viewed as a powerful means of undermining an intractable defense system and thereby making the patient more receptive to contact and communication with others.
  • Robert E. Mogar and Robert W. Aldrich, "The Use of Psychedelic Agents with Autistic Schizophrenic Children", Behavioral Neuropsychiatry 1969 Nov; 1(8):44-50.