◎This article comes from an interview with Zhu Huilin, the teacher of the "Dianjinshi Project" series of courses of the Oriental Institute of Psychoanalysis. Teacher Zhu Huilin has many years of research and clinical experience in autism, and also has in-depth learning and work experience in the field of analytical psychology, so we have a special dialogue with Teacher Zhu Huilin on topics such as the discovery and intervention of autism, the effectiveness of sandplay for children with autism, psychological analysis and science, and the relationship between clinical work and research.
Zhu Jilin
Ph.D. in Psychology, South China Normal University
Full-time researcher of the Center for Child Development and Behavior of the Third Affiliated Hospital of Sun Yat-sen University
Analyst Candidate of the International Society of Analytical Psychology (IAAP).
His research interests include the nervous system of children with autism, psychoanalysis, dreams and imagery, and sandplay
“
1
Early detection and intervention of autism:
Note: Autism is synonymous with autism
Video 1: Autism Topics – Discovery and Intervention
Interviewer: You are an expert in autism spectrum disorder (autism), and in your experience, what manifestations of children can we detect and pay attention to early?
Zhu Jilin: In fact, I can't talk about being an expert, the doctors in our center (the Center for Child Development and Behavior of the Third Affiliated Hospital of Sun Yat-sen University) are experts, especially professor Zou Xiaobing, the leader of the discipline, is the pioneer in this field, who put forward the "five noes" principle of early detection of autism, when we find that a child has these "five noes" characteristics in the early stage, parents may need to pay more attention to and pay more attention to the development of children. These "five no's" are not to see, not to refer to, not to be, not to say, and not to be improper.
The first "no" - "do not look", that is, the child's eyes do not look at people. We know that the core of a child's social development is the look in his eyes, just as we now (talk) are paying attention to each other. But if you find out early on that he likes to look at objects and doesn't like to look at people, or that when you look at him, his eyes are avoidant and fluttering, then we may have to worry about whether he is at risk of autism.
The second is "not referring". We know that a normal child can do the index finger at about six or seven months, and he will point his finger or reach out to point to what he wants. So if a child doesn't behave like this at the right age, or doesn't use his index finger even at the age of one or two, we also worry about whether he is at risk of autism.
Third, we often hear parents say "My child ignores me, I call his name he also 'ignores'", as if there is a hearing problem, but really gave him a hearing test, but found that his hearing is normal, this is "should not". So if the child has such behavior, especially by calling his name, he ignores, does not respond, does not look at you like other children, and responds "eh", then we may also need to worry about the possibility of his autism.
The fourth "no" - "do not say", that is, the child does not speak, which is a language problem that many parents are more likely to pay attention to. Usually we expect children to have some ability to say words by the age of one, and to have meaningful words other than "dad" and "mom" – adults can understand what he means by these words. And if he doesn't have the ability to say a word by the age of two, or if he says fewer words, and relatively speaking, you don't understand what he means, we may have to consider whether there is a possibility of autism behind his problem of not speaking.
The last "no" is "inappropriate", which is some of the child's misconduct. When children appear to be in some places, such as walking in circles, walking on tiptoes, or some behaviors that seek sensory stimulation, such as some children will always take something in their mouths, lick, smell, or always get close to see things, these relatively inappropriate behaviors, or parents feel strange behavior may also be worth worrying about.
Grasping these "five no's" has actually been able to discover some of the early risks of most children with autism spectrum disorder. If a parent or other professional sees these signs, we recommend that he take his child to a developmental and behavioral pediatrics clinic as soon as possible.
Interviewer: Do we have a definition or standard for this "early" of early detection?
Zhu Jilin: Under normal circumstances, we will carry out a routine health care 42 days after the birth of the child, and at 6 months, we will actually recommend that the child be screened for this kind of autism early, which is a relatively common guideline in the world.
Therefore, we can also infer that at 6 months, in fact, we can already make some early observations and assessments of the child to understand whether he has the risk of this autism. This is a definition of "early detection".
Of course, scientific research has found that at an earlier time, such as two months or even just after birth, the baby's brain may have some abnormal indicators, or behaviors such as "eye movement" may have some abnormal performance, and this earlier indicator may require some more sensitive instruments to detect.
Interviewer: Do you have any advice for families with children with autism?
Zhu Jilin: This is actually a very good problem, because a child with autism spectrum disorder may bring some heavy burdens to a family, and many parents will have a strong reaction to this situation.
On the one hand, I think parents can have a more scientific understanding of autism, and parents of autistic children can help their children by providing them with early family interventions. If parents can give him more appropriate support and help in the process of children's growth, many children can actually integrate into the surrounding environment, enter mainstream schools, or be able to achieve self-care in the future, and even some children will have some very good achievements. So first of all, I hope that parents can have confidence in their children and have confidence in themselves.
Second, I hope that parents should learn more about the family intervention part, rather than pinning their hopes entirely on some biological therapies that currently have no evidence-based scientific basis, and I will not list these biological therapies. These biological therapies are very popular at home and abroad, but I hope that parents can be more cautious about such therapies. Parents can learn some courses or methods and theories that can really help them improve their parenting skills, which will help children in the long run, rather than blindly believing in some so-called biological therapies.
Third, I also want to do an advocacy, that is, I hope that the society can have more understanding and acceptance of children with autism spectrum disorder.
The so-called "high function" is that these children's learning ability and cognitive ability are normal, they can go to mainstream schools to learn, but they are often discriminated against by their classmates in school, some of them will encounter the phenomenon of school bullying, and even their existence itself is not accepted by other parents, which has brought adverse effects to children, so I hope that all teachers and parents can understand and accept these children more.
Some of these children's behaviors are not out of their subjective will, but because of the unique challenges brought about by their own difficulties, so what they actually need is to be more inclusive to create an environment that is conducive to them. Therefore, I also hope that the teachers of mainstream schools and the parents of children can know more about and accept these children, and then the society needs to care more about these parents.
2
Effectiveness of sandplay in children with autism:
Video 2: Autism Theme - The Effectiveness of Sandboxes
Zhu Jilin: This is a very interesting topic. I remember in 2017 and 2018, I told the students of the two-year or three-year class (Note: the "2+3" course of the Oriental Institute of Psychoanalysis) about the scientific nature of sandplay, and at that time I specifically mentioned the part related to autism, and I felt that the use of sandplay in autism faced some challenges, and we needed to know its limitations.
For example, I think for children with autism who are too young or moderate to severe, sandplay is actually not applicable, because we know that sandplay uses imagery and symbolism to work, but there are many children with autism, especially moderate and severe or younger children, who do not have the ability to imagine or symbolize, so in some case work, the role that sandplay itself can play may be relatively limited. But the child may benefit from the personality of the sandbox analyst, or his companionship, or even this close interaction with the analyst, which may be what really helps him at work.
So if you think about it from this perspective, the sandplay analyst needs to know very clearly what autism is, and there needs to be a process of therapeutic assessment of the child – is the child suitable for the sandplay method?
Professor Brian Feldman, one of my former analysts, has talked about a lot of methods that can be used to assess whether the child can receive psychoanalytic treatment, such as graffiti tests, or trying to interact with him for empathy, anti-empathy, and then assess whether he has the ability to build relationships, whether he has the ability to use imagery and symbolism to express, and he has the ability to do this treatment.
If he doesn't have that ability himself, then I think social interaction or social therapy is more urgent for them. So sometimes, although we may see the progress and improvement of this child's case, the real healing factor may not lie in the technology of the sandbox game itself, but in the relationship between the child and the analyst, because the analyst provides him with a very inclusive, rich, mother-like interactive space, so that the child can grow again, then no sandbox can actually play a role.
3
On Psychoanalysis and Science:
Video 3: Teacher Zhu Huilin talks about Jung and the road to psychoanalysis
Interviewer: You are a senior scholar of Jungian analysis in China, and you are also engaged in brain science research. Recently, there is a hot topic about Jung in Zhihu, thinking that Jung is not scientific enough, can you talk about your opinion?
Zhu Jilin: I'm glad you asked me this question. When I was about to graduate from college and my junior year of college, I wanted to apply to Come to Mr. Shen's side to study psychoanalysis, and then my then head of department asked me, "Why do you want to study psychoanalysis?" Why did you study Jung? They are not scientific at all. "I was stunned when I encountered this question, and after some thought, I responded like this:
Jung was not unscientific—we know that Jung was scientifically, systematically trained, a psychiatrist; Freud was also a physician, he had performed surgery, he was a neurologist. Jung was very active in the early years, when he was studying in Zurich in the 1900s, and he was very active in using a device called the physiological multiconductor to study the word association test, which was inspired by the psychology of science, and he can actually be said to be the pioneer of the scientific community at that time.
It was in the process of researching the word association test that he discovered the phenomenon of "complex" with an emotional tone, which laid a very important foundation for establishing his position in the field of psychology, and he wrote a thesis based on this research finding, which obtained an honorary degree in law, and then was invited to give a lecture at Clark University in the United States, all because he had this scientific spirit of exploration.
However, I think that each individual has his own theoretical pursuits, and although Jung had such scientific attempts in the early days, when he found that there were some phenomena that could not be systematically studied by scientific means at that time-for example, he encountered some phenomena that interested him, such as hallucinations and dreams of mentally ill people, and there was no scientific paradigm, method or technology at that time to satisfy his curiosity and theoretical pursuit of these phenomena, so he gave up the methods of the time and turned to some religions, myths and legends to find counterparts He then began his later exploration of deep psychology.
From a historical point of view, the origin of psychoanalysis is scientifically rooted in the strict sense, but limited by the technical limitations of that era, Jung did not continue scientific exploration, but in fact, many post-Jungian scholars, or some later international Jungian analysts, they themselves were also scientifically and systematically trained, like myself, I actually received training in scientific psychology in college.
We also know that today's research methods are very different from a hundred years ago, so "Jung" is not an excuse for us to give up exploring psychoanalytic phenomena through the scientific method, now we are completely conditional and have the opportunity to do more exploration, such as the development of various technologies in cognitive neuroscience has actually provided us with some good opportunities.
So I don't think it's Jung's problem, nor is it Jungian psychology' problem, it's all about how everyone who studies psychoanalysis chooses a way to pursue the truth that interests him, it's a matter of personal choice.
Interviewer: As the head of the Guangzhou group of the International Society for Analytical Psychology (IAAP), do you have any experiences to share about the systematic training and practice of Jungian analytical psychology?
Zhu Jilin: I think the Guangzhou Development Group is still very lucky, because in Guangzhou, it is very close to Mr. Shen, and we often have the opportunity to meet many very good teachers who have been invited, so we have a lot of such learning opportunities. In fact, I applied to become a candidate psychoanalyst of the International Society of Analytical Psychology (IAAP) during my studies with Mr. Shen, and I think that the Oriental Institute of Psychoanalysis is relatively complete in terms of training system.
Now I work in the hospital, I will also do some research, as my own, what I learned in the hospital may be more related to the identification and judgment of mental illness, I think this part of the content is also very helpful to my clinical work, especially the work of psychoanalysis.
On the one hand, psychiatry is also an important basis for psychoanalysis. Now in some of our usual group supervision or individual supervision, when the counselor finds that there are clients with some peripheral psychotic symptoms or other mental behavior problems such as auditory hallucinations, hallucinations, or even fantasies, as counselors, we need to weigh whether we should continue to work with him or need referrals.
On the other hand, due to the increasing prevalence of mental illness, we will also encounter many visits from hospitals who are referred to the hospital for psychological counseling, such as bipolar disorder, depressive disorder, some children and adolescents.
So I think we first need to have an understanding of the disease itself – which end of the mental illness is he in? When should he go to the doctor and take medication; when should his symptoms not actually be psychotic, but due to emotional disorders? These parts, if the counselors themselves have more experience and understanding, we will feel more psychologically at ease with our clinical work, which will also have an impact on our actual work.
Teacher Shen will also create a lot of practical opportunities for us, so if you have such an opportunity, you can also practice in the hospital. In the hospital, we can meet all kinds of people, so that we can quickly increase our perceptual understanding of this part while systematically learning the knowledge of psychiatry. I believe that through the improvement of these two aspects, everyone can better face the difficulties and challenges encountered in the process of practicing in the future.
In addition, I would like to say that professional qualifications have a certain sanctity, and this industry needs to have a certain threshold of entry. Similar to the corresponding qualifications required by doctors to practice medicine, engaging in psychological counseling or psychotherapy also requires systematic training, which is not easy to obtain.
In foreign countries, it is actually more difficult to obtain the qualification of a clinical psychologist, I am more supportive of the domestic to take this standardized road, not recommended for people who have not been certified, or do not have professional qualifications to carry out clinical practice, because this itself is not in line with our professional ethics, for patients is very unfavorable.
Of course, the current domestic industry situation is relatively in a transitional period, and the current situation may only break the old industry order that was not very standardized before, but it has not yet established a new norm. Therefore, at this stage, I think that learning psychoanalysis and learning our Chinese culture may not be more than just the pursuit of a certification or professional qualification, and this learning process may have greater significance for our own growth, for our understanding of human nature, and for our exploration and understanding of ourselves.
Sometimes, you may not be able to really meet the actual professional qualifications through this kind of learning, but you have the ability to reflect, insight, or understand yourself, and I think this is a valuable asset that can accompany you for a lifetime, not to say what will happen if you get a certification. There are many people who, despite the certification of a counselor, will not practice, and will not really apply it to helping themselves or those around them, I think it may not be too utilitarian to make such a learning process too utilitarian.
Of course, after the establishment of a standardized system in China in the future, if we want to engage in this profession, we still have to take this certification seriously.
4
Brain Science Research and Psychological Clinical:
Video 4: Professor Zhu Huilin talks about the relationship between research and clinical practice
Interviewer: You are engaged in brain science research and have a wealth of clinical psychological experience, can you please talk about how you think about the relationship between research and clinical practice?
Zhu Jilin: I actually went through a very interesting transformation process. I remember when I was studying autism at the doctoral level, the research on the subject of my graduation thesis was done at a special school for autism (Guangzhou Connor School, that is, Guangzhou Children's Autism Rehabilitation Research Center). I met forty or fifty kids with autism, did some brain function testing on them, and then I thought I'd met so many kids, and I could have reversed the definition of autism, and I thought I already knew about autism.
But after graduation, I went to the Zhongshan Third Hospital (the Third Affiliated Hospital of Sun Yat-sen University) to work, where I came into contact with more autistic children, from one end of the spectrum to the other, from very young children to adults, at this time you ask me what is autism, what is its cause? I don't know how to answer because I find it difficult to define it with a single label.
In fact, when I have more clinical experience, after meeting more autistic children and their families, and then think back to my previous research in so-called science and lack of clinical experience, I will find that some of my ideas are actually very narrow - I just know a definition, see forty or fifty children and some of their behavior, and think I understand autism, so now I feel that clinical experience is irreplaceable.
A lot of scientists may have the kind of problem I had at the time, and what I reflected on myself is that maybe we've never been in contact with any of the patients, we've never seen a child with autism, but we can write beautiful articles by analyzing some brain imaging data.
I think such a disconnected approach to scientific research is not desirable, although some perceptual experience may not be worthy of attention for scientists, they may pay more attention to logical reasoning, deduction process, and can do it very completely, but if there is no relevant clinical experience, his conclusions and even his hypothesis may be problematic, and this part of the problem may require a very deep, long immersion in the clinical field to discover.
Later, through working in the hospital, studying with our director and other doctors in the center, I realized my limitations, especially the limitations of scientific research.
So I think there needs to be more dialogue between research and clinical work, where scientists can learn more from the practical experience of clinicians, and clinicians can try to focus on problems like scientists to better discover some breakthroughs.
I myself have not fully integrated these two parts in my research and clinical work, and now I may be more interested in the clinic - the clinical phenomenon is really too colorful, and in the clinical work, I have a lot of opportunities to interact with these children, do assessments, which is a process that I enjoy very much.
Interviewer: Do you have any advice and messages for our younger generations who are studying psychoanalysis?
Zhu Jilin: I think the current generation is really lucky, and now many books have been translated by very good scholars for us, and they can be read directly. I remember when we were studying, a lot of books hadn't been translated into Chinese, so a lot of times we had to nibble on the originals ourselves, and sometimes we would form a mutual aid group, and everyone would translate a few chapters and share them.
In retrospect, although the learning efficiency was not very high at that time, and the learning was painful—Jung's writings had too many technical terms—I think that the process was still very valuable. I learned a lot of English in this way, and I also had the opportunity to be exposed to more authentic expressions than the translated works, so I still suggest that you can try to read more original works.
In addition, during the current epidemic, many foreign Jung Institutes have launched some online courses, and if you have the opportunity, you can go to some related courses other than our institute, which I think is also a good learning opportunity.
Finally, the three parts of personal analysis, practice and supervision require more energy and effort. When we were studying, we had a lot of opportunities to practice, going to kindergartens, going to welfare homes, going to colleges and universities, and also taking over individual cases, which is a pure process of learning and paying, and there is not much remuneration, but for me who just tried to work as a therapist, that experience is still very important, so it is recommended that you practice more.
Interviewer: Feng Xiaoling