Wednesday, September 30, 2009

Autism Manga!

I finally got my hands on the first volume of Keiko Tobe's ongoing manga series, With the Light: Raising an Autistic Child, which I think does a wonderful job of showing how its protagonist (the young mother of an autistic boy, who in this first volume grows from a newborn to an elementary-school-aged kid) adjusts to the discovery that her son's life probably won't go the way she had fantasized before he was born.













Near the beginning of the story, when Sachiko (the protagonist) first learns that her fussy, temperamental baby boy, Hikaru, is autistic, she goes through a period of mourning.


She cries when she sees other people's cute, talkative, well-mannered toddlers (like the one shown at left) and thinks to herself that Hikaru will never be like that.
Particularly, she wishes he would call her "mommy." Hikaru doesn't speak, you see.


He also won't make eye contact, and avoids directly interacting with anyone.
This makes Sachiko miserable at first --- she feels like Hikaru is rejecting her, and at the same time her marriage is suffering because her husband, Masato, works long hours and gets angry with her when he comes home and Hikaru is having a tantrum and can't be calmed down, which happens often.
Sachiko is loneliest in this first part of the story, when she doesn't yet feel anything but grief toward her son, and she's estranged from her husband, and her husband's family thinks she's a lousy wife and mother, and she can't bear to be with her friends anymore because their typically-developing children depress her.


The only person in her life who offers her a sympathetic ear is her frail, elderly mother, from whom she keeps most of the less-pleasant parts of her life secret for fear of making her worry.


But the story doesn't stay in this rut for very long; little by little, Sachiko learns to spot the signs that Hikaru loves her, and since love is the main thing she wanted from him, this makes her happy.


Here's the scene that represents this turning point:





































As sugar-coated as this might seem (Oh, he really does love me! He picked me some flowers!!), most of what happens after this point (as well as all that's come before) makes it clear that Sachiko's life is not easy. (Neither is Hikaru's, though --- that's one of the things I like most about this portrayal of a family with an autistic member: the author/artist clearly empathizes with Hikaru as well as Sachiko, and neither pits one against the other nor treats one as an extension of the other).


One of the major things that changes, once Sachiko realizes she loves Hikaru, is that she starts to notice external, systemic barriers Hikaru faces, and fights to change them. That's another thing I really like about this book --- it explicitly places Hikaru's autism, and Sachiko's efforts to get his mainstream elementary school to admit and accommodate him* in a wider context of societal ableism. Characters who are initially hostile to Sachiko and Hikaru showing up at their child's school or day care are often shown to have a disabled family member of their own (in one lady's case, an elderly mother who has trouble walking and needs physical therapy) whose struggles to get their needs met in a society that doesn't see them, and isn't built with them in mind, brings the initially hostile character around to Sachiko's side.


Hikaru does learn to thrive in his new environment, but it's very much a team effort that allows him to do so. His mother, his father, his special-ed teacher, the other teachers in his school (who have all had a crash course in Understanding and Dealing with Hikaru Azuma, courtesy of the principal), and his classmates all do their part in keeping Hikaru safe and happy, and in teaching him, little by little, to talk, to play with other children, to share, and to be polite and friendly.
The main reason Hikaru does so well, it seems, is that other people are willing to meet him halfway: find out what he understands, what he wants, and start there.


If you're a manga reader, you might want to pick this one up. While it's true that Sachiko, and not Hikaru, is the point-of-view character, and as such we see Hikaru primarily through her eyes rather than his own, I still think there's a lot in this story for autistic readers to appreciate. For me, the radically pro-disability-rights sentiments expressed in this story (in Sachiko's growing conviction that her son should be able to participate in society as fully as he can, and that, to make that wish come true, she'll need to enlist many other people's cooperation) and the explicit tie-ins to other disabilities, made With the Light a lot more interesting than most raising-an-autistic-child memoirs.


It was also interesting to see some indications of how people in Japan think of autism, particularly which misconceptions are common there. It seems like the Japanese lay understanding of autism is rooted a lot more in folk psychology than it is here. In America, I think we mostly think of autism as a disease, and a very big, scary one at that. In Japan, I got the impression from With the Light --- and its helpful Translator's Notes! --- that autism is seen as an extreme manifestation of introversion. (The Japanese term for autism, I read, translates roughly to "self-closing syndrome" or "cloistering syndrome").


*This book gave me the impression that the usual practice in Japan is for disabled students to go to their own specialized schools, though sending disabled students to mainstream schools isn't unheard-of, either. In the U.S., it's a lot more common for disabled students to go to the same schools as everyone else, even if they stay in separate special-ed classrooms all day.

Monday, September 28, 2009

Conservautism, Revisited

(Ha ha, I made a portmanteau!)

The article I posted about yesterday is not the original use of "autistic" to describe Republicans. It refers in the first paragraph to this Air America radio broadcast [audio clip - will start playing if you click the link] by Jack Rice, in which Rice compares Republican rhetoric to autistic self-calming routines (particularly echolalia/autoecholalia, in which you repeat a phrase over and over again).

Transcript of clip (edited somewhat for clarity):
Where will the Republicans go now?

You know, I almost feel sorry for them. I mean, not really, but I almost do! I almost do because of where they've put themselves --- where they have boxed themselves. Financially bankrupt, morally bankrupt, intellectually bankrupt, and it's almost as if they have nothing else that they can do.

You know what it's sort of reminiscent of for me? What it reminds me of is ... people with autism. --- And I have family members who have autism, so this is something that's very personal for me --- but one of the things that happens [when] people who have autism ... have to struggle, is, when they get ramped up, when they get overstimulated, they will use catchphrases. They will use certain words or certain phrases and they will use them over and over again, and it helps them relax and find their core, find their center again --- and that's a great thing, for people to be able to do this --- and I hate to make this comparison, but I think it's apt here: that Republicans are like people with autism.

Actually, I think that's incredibly offensive. It's offensive for people with autism to ever be considered, or compared to, Republicans. Nobody should ever be compared to a Republican!
(Okay, I laughed at that part.)
So let's push the autism concept away from it for only a second, but I want to stay with this idea of repeating lines over and over again: trying to find your core, trying to find that center that helps you.

(Begins speaking in a low monotone, sounding like a cross between a zombie and someone meditating using a mantra) "Com - mu - nist ... So - cial - ist A - gen - da ... gay marriage ... what about the chillll-dren?"

(Speaks in normal voice, but still in character) "Oh, I feel a little better now. Wait, what do you mean the country is going bankrupt? What do you mean we're in the middle of two wars? What are you talking about? Who cares? What do you mean it doesn't change anything when 48,000 marriages between gay and lesbian [partners] in California hasn't done anything? What do you mean that 92% of the people of Iowa said that it doesn't seem to change anything with gay marriage [being legalized in that state]? Hmmm, uhhh .... (Quickly picks up the Zombie Mantra Voice again) Whaaaaat about the chilllll-drennn? ... So - cial - ist a - gennn -daaaa ..."

(Breaks character) You think I'm joking.

Well, what is missing now? Oh, I know the one I'm missing!

This one: (Monotone) What about the troops? We gotta support our men and women in uniform who are in harm's way.

(Normal voice) Listen to [South Carolina Senator] Jim DeMint whine:
[Audio clip of Sen. DeMint, appearing on ABC News] The problem is, the war in Afghanistan and our economy are our two biggest issues, but he [President Barack Obama] is working on other issues such as health care and he's putting off the decision on Afghanistan, which I think puts our troops at risk! So he needs to focus on priorities right now, and not try to ram so many things down our throat here in Congress.
(Monotone) Troops at risk .... troooops ... at ... rissssk ....
You see? So now, all of a sudden, it's the Socialist Agenda! It's the gays! What about the children? What about the children? Our troops are at risk. You see, this is all about that soothing language to try and make you feel better about yourself --- remember the mantra, over and over and over again.
While Rice's clowning is a bit confused --- the metaphor shifts from "Republicans are autistic" to "Republicans are like New Age, meditating types who are finicky about negative vibes", frequently occupying a hazy middle ground --- the "Republicans are autistic" part of his segment seems to translate into "Republicans, like autistics, hate change and will often shut down completely in the face of it. To calm themselves in the face of overwhelming cognitive dissonance, which is scary to a rigid thinker like a Republican/autistic person, they must retreat into themselves, repeating familiar phrases to drown out what's scary and new."

(As a side note, I was surprised by the degree of empathy and understanding he showed for autistic people, even while he was using us to mock his political opponents. Rather than talk about meaningless "stereotyped" or "repetitive" behavior, he talks about calming rituals. He talks about how agitated we can get when we're "overstimulated." It's not much --- again, we're still in the context of mockery here --- but at least he seems to appreciate that we have minds, and feelings, and that our often-incomprehensible behaviors make perfect sense when you look at them as coping strategies instead of symptoms).

Saturday, September 26, 2009

More on Disagreeing by Diagnosing

Via dkmnow on the Autism Hub email list, I found this odd article on CommonDreams.org, provocatively titled "Are Republicans Autistic?"

The usage of "autism" in this context --- by a left-leaning website, seeking to explain behavior (by Republicans) that seems bizarre to that website's audience (Democrats, other miscellaneous liberals and progressives) --- did not fill me with hope for an unbiased, unsensationalized portrayal of autism. Not at all. Indeed, from the title alone I expected a conception of autism heavily influenced by stereotypes, particularly the eternal-child stereotype, the lost-in-our-own-worlds stereotype, and the fallacious notion that atypical development means no development at all.

I was not far off:

The word autism was first used in 1911 to describe human behaviors so self-centered as to suggest failure to process the realities of the outside world in language, and an inability to relate to other humans. In the 1940s the symptoms were defined further as social withdrawal, difficulty in communicating, extreme self-absorption, and repetitive or stereotyped behaviors.

Now called Autism Spectrum Disorder (ASD), it is generally agreed that people with ASD have few linguistic, social, cultural or logical constraints to manage their lives. A current definition adds "... people with ASD have difficulty seeing things from another person's perspective. Most 5-year-olds understand that other people have different information, feelings, and goals than they have. A person with ASD may lack such understanding. This inability leaves them unable to predict or understand other people's actions."

Historically, severely afflicted individuals have been burnt as witches, honored as shamans, hanged or incarcerated for crimes, or celebrated as geniuses. Adolph Hitler, Thomas Jefferson, Hans Christian Anderson, Charles Darwin, Wolfgang Mozart, Jeffrey Dahmer, Ted Kaczynski, Michelangelo, Isaac Newton, Nikola Tesla, Charles Richter, and Ludwig Wittgenstein have all been labeled autistic by one or another critic.

The language used in this passage --- citing "self-centered"* behavior as the characteristic feature of autism, for example, or saying autistic people lack "linguistic, social, cultural or logical constraints to manage [our] lives " --- draws strong, if implicit, parallels between autism (a neurological condition) and selfishness (a moral quality).

This rhetorical sleight of hand is more pronounced when consider how the title question --- "Are Republicans Autistic?" --- fits into a tradition of progressive critique of conservatism by seeking to explain the psychology of conservatives. The best example I can think of is Erich Fromm's (and, later, Theodor Adorno's) work on the "authoritarian personality," which postulates that the people who have the most difficulty dealing with personal freedom will tend to seek security in a strong leader, who will make all the hard decisions for them. (While Fromm thought this anxiety in the face of freedom was something everyone felt, to varying degrees, and that authoritarian character types could be found within all political ideologies, some of the theorists who came after him linked authoritarianism specifically with right-wing politics).

So, bearing all that in mind, the simple question "Are Republicans Autistic?" morphs into this string of propositions:
  1. Republicans are selfish, blinkered, disconnected and unempathic.
  2. Republicanism is no longer an ideology to which a mentally healthy person could subscribe.
  3. Because Republicanism is crazy, Republicans must be crazy as well, or they'd leave the party.
  4. Autism is a pathologically extreme form of self-absorption.
  5. Self-absorption characterizes the Republican psychosis; ergo, maybe Republicans are autistic!
Believe it or not, the article's handling of autism only gets worse from there:
Last winter the Kent community was rocked by the terrible tragedy of an 18-year-old youth named Sky Walker beating to death his mother, Trudi Steuernagel, a distinguished professor at Kent State University.

Apparently Trudi did things right - loved Sky unconditionally, got the best professional help available, offered extraordinary opportunities for Sky to be in situations he could handle and among people he could function with.

The horror is that Trudi survived for a week after the attack, probably aware that she was suffering and dying at the hands of the child she had tried to do right by. She had protected him from the consequences of his actions for 18 years, unable to control his behavior. Reality intervened.
So, not only are autistics utterly self-absorbed and practically insensate, we are also unpredictably violent, stone-cold killers.

Lovely.

*It's true that "autism" does actually come from the Greek word for self, autos, and that the word was initially coined to describe a pattern of slowly closing oneself off from other people and the external world that the word's creator, the early 20th-century Swiss psychiatrist Eugen Bleuler, noticed in some of his schizophrenic** patients. But expert understanding of what autism is has changed a whole lot since Bleuler's day --- sometimes even in response to what actual autistic people have told the experts! --- and I don't think the article reflects that.

**Bleuler invented that word, too.

Thursday, September 17, 2009

What Is Empathy?

I've thought for a while now that the concept of "empathy" most commonly used when talking about autism is excessively narrow.

Autistics --- especially Asperger's autistics --- are often said to lack empathy, which usually means two things: we can't infer a person's emotional state from their facial expression, body language, tone of voice or whatever other indirect cues they may be sending out, and we don't respond emotionally to other people's emotions, even when they are clear to us.

Here's Simon Baron-Cohen's definition of empathy, taken from the first chapter of his book The Essential Difference: Male and Female Brains and the Truth about Autism*:
Empathizing is the drive to identify another person's emotions and thoughts, and to respond to them with an appropriate emotion. Empathizing does not entail just the cold calculation of what someone else thinks and feels (or what is sometimes called mind reading). Psychopaths can do that much. Empathizing occurs when we feel an appropriate emotional reaction, an emotion triggered by the other person's emotion, and it is done in order to understand another person, to predict their behavior, and to connect or resonate with them emotionally.
In a later chapter, Baron-Cohen breaks the act of empathizing into two parts: a "cognitive component," in which you infer another person's likely mental state, and an "affective component," in which you feel something in response to what you either perceive or infer another person to be feeling. (Baron-Cohen gives an example of a homeless person standing in the street on a cold day, and people who see him being moved to feel a range of emotions: pity, guilt, or even anger at a political and economic system that allows such poverty to exist within a wealthy nation).

This two-fold conception of empathy grows out of an earlier idea, which Baron-Cohen has also written about: Theory of Mind. Theory of Mind seems to be more or less equivalent to the cognitive component of empathy described above:
A full-fledged theory of mind ... requires a representational system. This permits the representational mapping of others' emotional states in a manner that is different from picking up their emotions directly. For instance, an intention can be mapped onto a representational emotional topology, going from "the fox is chasing the chicken" (goal-directed) through "the fox is trying to catch the chicken" (intentionality) through "the fox wants to eat the chicken" (motivational) to "the fox is chasing the chicken and trying to catch it because it is hungry and wants to eat it" (emotional). Similarly, for the chicken: it is running (goal-directed) away from the fox (intentionality) because it is afraid (emotional) of being eaten (motivational).
As you can see here, there's a lot of different things feeding into a Theory of Mind. It's not just answering the question "What are they thinking/feeling?" --- that question can be further broken down into a whole string of smaller questions, as with the fox and chicken example above.

I also think that, for each step in that modeling process, there are two very different tasks involved in attributing a motive to another sentient being: first, you have to use your imagination to come up with a range of possible explanations for their action, and then you have to judge which explanation seems most likely. To do that, you draw both on what you actually know about the person and hir circumstances, but also on a general idea of what most people are like, and what most people would do in that person's shoes. (Or, if it's an animal whose behavior you hope to explain, you draw on whatever general knowledge you might have about that kind of animal).

It's in this stage that an alternative explanation for differences in empathizing begins to suggest itself: people from radically differing circumstances are going to have radically differing ideas of what most people would do in a given situation. Class and race are some obvious potential confounds here: middle-class white people are often at a loss to explain the actions of poor people of color, so they fall back on explanations that don't tax their imaginations too much --- i.e., those people are just stupid, lazy, criminal etc.

Gender also enters into it --- feminists have addressed this in their calls for a "reasonable woman" standard in law.

Given this, it shouldn't be too big a leap to suggest that some autistics might have trouble predicting how non-autistic people will react because they've figured out that their own responses to things are vastly different from most non-autistic people's responses. Thus, most of the time just putting oneself in another's shoes is not enough; one also has to imagine one's self greatly altered. This is hard to do, and without a whole lot of knowledge of a range of NT personalities and temperaments, you still won't have anything to put into your mental simulation where you used to be.

Several other autistic bloggers have made this point: that the empathy barrier goes both ways, and arises not from autistic insensitivity to emotion in general, but from the wildly divergent ways in which autistics --- and other neurological minorities --- and NTs experience emotion in the first place.

Like Bev says,
Autistic empathy is different from what the typical person experiences. It is no less real, no less deep or emotional. And I would argue that it's no less useful to society. Some people give hugs; others get the tissue.
Conversely, autistics are often perfectly adept at reading the emotional or intentional content of other autistics' "meaningless" behavior, because the mental state of the other autistic is likelier to be one they've experienced themselves.

*I've already posted about the problems I have with this theory of autism, so I won't revisit them here. I use his conception of empathy because I think it's the one

Tuesday, September 15, 2009

"The Next Step in Evolution"

(Cross-posted to Turner & Kowalski)

Over at John Elder Robison's blog, there's a two-part guest post on what it's like to be a woman with Asperger's. The guest blogger's name is Deborah McCarthy, and she is 49 years old, a vegan, an animal-rights activist, a Christian, and lives in Oregon.

While most of her writing just deals with her own experiences, particularly the differences she's identified between the way she thinks, feels, and perceives the world and the way most people do (and therefore often expect her to be that way, too), there are a couple of instances where she decides to make general pronouncements about things she really doesn't understand all that well. The statements she makes are inflammatory, hurtful (one more than the other, but neither is totally innocuous) and scientifically illiterate on a grand scale.

First, there's this:
Everybody says Asperger's' main symptom is a lack of empathy but I don't think that's true. Women exhibit differently from men. I'm sure conditioning has a lot to do with it but also women are predisposed from birth to be more empathic I think. I know I cry at the news very often. So I wanted to look at this and other characteristics to get clear on just what I can claim as mine and what just doesn't belong.

Empathy - I'm extremely empathic when it comes to the underdog, animals, children, the poor, the starving, etc. I have no sympathy whatsoever for the obese. Maybe that's from being bullied by my huge family members I don't know. Probably contributed. But for me it symbolizes greed and selfishness at the expense of another. After all, you don't get fat from veggies, you get fat from the flesh and mother's milk of another. Taking what doesn't belong to you. Taking more than your share. Taking more than giving. I have issues regarding fat. I admit it. Try not to hate me for it. I'm just being honest.
There are a lot of things wrong here, but since Sarah has already dealt with this part of the essay I will be brief, and stick to what is factually wrong with this paragraph, since Sarah focused on the failure of empathy involved. (Yes, I noticed the irony in such a massive display of bigotry cropping up as its author is trying to argue that autistics are fully capable of empathy. As they say at Shakesville, *lolsob*).

First: demographically speaking, poor women in America are much likelier than their richer counterparts to be obese. (The picture isn't as clear for men: some studies find that men of all classes are equally likely to be fat, while other studies find a relationship between low socioeconomic status and higher body weight that's significant, if not as pronounced as the corresponding trend among women). Second, it is possible to be fat and malnourished. We've all heard about how various systemic factors (agricultural subsidies making starchy, fatty, processed foods cheaper than produce and whole grains; lack of access to well-stocked grocery stores; lack of time to cook healthy meals, etc.) mean poorer people (who, as I mentioned, are fatter overall than richer people) tend to get a lot fewer nutrients out of their food, even when they're getting enough calories. There are also --- yes, even in the U.S. --- people so poor they can't always afford enough food. And, when bodies aren't getting enough energy, nutrients and raw materials (i.e., sugars, proteins, fats, starches), they start changing their metabolism to compensate for the scarcity. They become thriftier, hoarding more and more of the food they consume as fat.

As Kate Harding puts it:
Poor people are a lot more likely to go through cycles of eating too few calories followed by bingeing --- which, when it's known as "dieting," instead of "only being able to afford enough food sometimes" --- has indeed been shown to make people fatter in the long run.
You also cannot extrapolate whether someone is a meat-eater from their degree of fatness. There are fat vegans and vegetarians, and there are rail-thin omnivores. You can't look at someone's body and reliably predict what they eat. There are too many variables at work for there to be such a cut-and-dried relationship.

And attempting to judge a person's moral character by the shape of hir body? That belongs in the intellectual trash bin with all the earlier pseudosciences conceived along such lines.


Anyway, on to the second thing I found deeply problematic:

I, and others, don't feel that Asperger's is a disorder. I feel it is a neurological difference. You can SEE the difference on a brain scan. We are literally hard-wired differently than a neuro-typical person. (How many times have I said I'm just not wired that way!!) I believe we are a leap in evolution. Leaps like this occur in nature all the time. I believe a more childlike and pure sort of human is on the horizon. One that is less caveman-like and more angelic-like. More ethereal, less dense.

This idea --- that evolution is a linear progression from simple to complex, or primitive to advanced, "caveman" to "angel" --- is very common, but wrong.

The outcome of evolution is not any one species; it's biodiversity itself. It's change in populations over time. Individual variations arise, natural selection acts on them; organisms either propagate their genes or they do not. Intelligence, morality, free will --- or any other objective Good you might be tempted to see (human) evolution as trending toward --- doesn't enter into it.

Evolution is also not hierarchical. Every kind of creature that exists now is equally "evolved," and each constitutes an equally viable solution to the particular bio-engineering problems that shaped its unique evolutionary history.

In other words, there is no Great Chain of Being.

Finally, evolution is not a succession of different attempts to solve the same problem; it's a succession of solutions to a succession of problems. The natural environment is not static: climates shift, continents move, mountain ranges rise up and are worn down, natural barriers isolating potentially interbreeding populations from each other arise or disappear. The selective pressures that act on one generation won't be exactly the same as the pressures that will act on the next generation.

Here's a relatively simple explanation of what evolution is from my college introductory-biology textbook (Biology, Sixth Edition, by Neil A. Campbell and Jane B. Reece):

In the Darwinian view, the history of life is like a tree, with multiple branching and rebranching from a common trunk all the way to the tips of the youngest twigs, symbolic of currently living organisms. At each fork of the evolutionary tree is an ancestor common to all lines of evolution branching from that fork. Closely related species, such as the Asian elephant and the African elephant, are very similar because they share the same line of descent until a relatively recent divergence from a common ancestor. Most branches of evolution, even major ones, are dead ends; about 99% of all species that have ever lived are extinct.

...

We can summarize Darwin's main ideas as follows:

Natural selection is differential success in reproduction (unequal ability of individuals to survive and reproduce).

Natural selection occurs through an interaction between the environment and the variability inherent among the individual organisms making up a population.

The product of natural selection is the adaptation of populations of organisms to their environment.

Thus, there are as many outcomes of evolution as there are ecological niches to be filled.

I also like this image of a circular Tree of Life, in which all currently-extant taxa (er, categories of organisms, for the nonbiologists reading!) radiate out from the single hypothesized common ancestor of all. It conveys the never-ending, multifarious nature of evolution much better than any other drawing I've seen.

It will probably not strike regular readers of this blog as news that such a teleological, hierarchical view of evolution has acted as (pseudo-)scientific justification for race- and class-based oppression. This thread has been particularly noticeable in the history of racism: people of African descent have historically been seen as ape-like and "primitive" (i.e., less evolved, less civilized, certainly incapable of governing themselves without white people running the show for them!) by white people.

While I'm not really worried about autistic people oppressing neurotypicals --- we don't have the numbers or the political power or social privilege to do so systematically, although individual autistic chauvinists can, and do, loudly proclaim their neurological superiority on the Internet --- this kind of "Aspie-supremacist" rhetoric valorizing the Vulcan-like, superintelligent-but-socially-naive autistic person can further marginalize autistic people who don't fit that mold. If the autistic-rights movement embraces the "Aspie" to the exclusion of other autistic points of view, then other types of autistics will be right where they were before neurodiversity: voiceless and unnoticed.

Friday, September 4, 2009

The Slow Erosion of Hard-Won Freedoms

Via Pandagon, I found this jaw-dropping article in The Nation about crisis pregnancy centers, those innocuous-seeming places offering "alternatives to abortion."

Apparently, rather than give women the help they need to make their own choices, crisis pregnancy centers often coerce women into 1) having the baby, and then 2) giving the baby up for adoption.

This coercion might take the form of misinformation and scaremongering about abortion and single motherhood, of isolating her from her family and friends and hammering her with messages about her unfitness to be a mother, or even of denying a woman money she needs (like, say, reimbursing her for hospital bills she incurred during pregnancy and delivery) unless she agrees to give up her child:
When Jordan arrived [at Bethany Christian Services crisis pregnancy center in Greenville, South Carolina], a counselor began asking whether she'd considered adoption and talking about the poverty rates of single mothers. Over five counseling sessions, she convinced Jordan that adoption was a win-win situation: Jordan wouldn't "have death on her hands," her bills would be paid and the baby would go to a family of her choosing in an open adoption. She suggested Jordan move into one of Bethany's "shepherding family" homes, away from the influence of family and friends.
...
Bethany guided Jordan through the Medicaid application process and in April [of 1999] moved her in with home-schooling parents outside Myrtle Beach. There, according to Jordan, the family referred to her as one of the agency's "birth mothers" - a term adoption agencies use for relinquishing mothers that many adoption reform advocates reject - although she hadn't yet agreed to adoption. "I felt like a walking uterus for the agency," says Jordan.

Jordan was isolated in the shepherding family's house; her only social contact was with the agency, which called her a "saint" for continuing her pregnancy but asked her to consider "what's best for the baby." "They come on really prolife: look at the baby, look at its heartbeat, don't kill it. Then, once you say you won't kill it, they ask, What can you give it? You have nothing to offer, but here's a family that goes on a cruise every year."
...
Jordan selected a couple, and when she went into labor, they attended the birth, along with her counselor and shepherding mother. The next day, the counselor said that fully open adoptions weren't legal in South Carolina, so Jordan couldn't receive identifying information on the adoptive parents. Jordan cried all day and didn't think she could relinquish the baby. She called her shepherding parents and asked if she could bring the baby home. They refused, chastising Jordan sharply. The counselor told the people Jordan was having second thoughts and brought them, sobbing, into her recovery room. The counselor warned Jordan that if she persisted, she'd end up homeless and lose the baby anyway.

"My options were to leave the hospital walking, with no money," says Jordan. "Or here's a couple with Pottery Barn furniture. You sacrifice yourself, not knowing it will leave an impact on you and your child for life."

The next morning, as Jordan was rushed through signing relinquishment papers by a busy, on-duty nurse serving as notary public. As soon as she'd signed, the couple left with the baby, and Jordan was taken home without being discharged. The shepherding family was celebrating and asked why Jordan wouldn't stop crying. Five days later, she used her last $50 to buy a Greyhound ticket to Greenville, where she struggled for weeks to reach a Bethany post-adoption counselor as her milk came in and she rapidly lost more than fifty pounds in her grief.

When Jordan called Bethany's statewide headquarters one night, her shepherding mother answered, responding coldly to Jordan's lament. "You're the one who spread your legs and got pregnant out of wedlock," she told Jordan. "You have no right to grieve for this baby."
This story is almost an exact duplicate of the stories collected in Ann Fessler's The Girls Who Went Away: The Hidden History of Women Who Surrendered Children for Adoption in the Decades Before Roe v. Wade --- the helplessness, the loneliness and desperation Jordan felt going in; the "choices" she made because her alternative was homelessness; the utter refusal of the people at the adoption agency to treat her like a person, with interests and feelings of her own. Instead, they alternately praised her or demonized her: when she decided she would go ahead and keep the baby (after five sessions' worth of strongly pro-life, pro-adoption "counseling"), she was "a saint," but if she ever entertained other ideas, she became a selfish monster, either a murderer or a weak, childish woman who couldn't see past her own fleeting emotions to make The Right Choice.

The strength of these terms of praise or blame --- seesawing wildly between angelic and demonic --- is itself a pretty powerful persuasive tactic. First, remember that Jordan was living in a strange city in the home of the couple that was "shepherding" the adoption; most people want to be well-liked by the people they see every day, especially if those are one's only social contacts, as those people were hers. It would take an unusual degree of independence, emotional self-sufficiency and self-esteem to make a choice that everyone around you was telling you was a catastrophically bad idea: irresponsible, financially ruinous, destructive of the would-be parents' hopes and the child's future, and just plain selfish. Second, those extreme categories --- saint or monster --- and the nanofiber-fine line that seems to separate them serve, along with the dislocation and the isolation among near-strangers, to disorient Jordan and break down her will. Not being able to predict how an authority figure will react to what you say or do, especially when their reaction might be an angry one, makes most people especially anxious to stay on that authority figure's good side.

For comparison's sake, here are some descriptions of what giving a baby up was like from The Girls Who Went Away:
Any of my conversations I had with the social worker before giving birth were all basically trying to help me understand why I couldn't keep my son. Afterward, I had to go to the district court in Augusta and sign the papers. The judge was not friendly; he was being very businesslike. He put the papers in front of me to sign and I just kind of stood there. Finally I said, "What happens if I don't sign?" He got very angry and said that I'd already cost the poor, hardworking taxpayers enough time and trouble and if I didn't sign the papers he'd declare me incompetent, and how would I like my son to know that about me?

One of the questions that come up when you go to court and relinquish is they ask you if you have been coerced in any way, and I thought it was the height of hypocrisy. Of course, you're coerced. You're coerced by your parents, who said "Don't come home again if you plan to keep that child. We're not going to help you." You're coerced by everyone around you because of the shame and lack of acceptance by society and your community. You're not acknowledged as a fit mother because you had sex before marriage.

The judge congratulated me on how courageous I was. I was furious that he would tell me about courage. It was about defeat. It was totally about shame and defeat.

I stayed in the hospital about two days afterward and then it was this very strange Twilight Zone sort of time. I had to go back to the maternity home to collect my things, knowing what I knew. I couldn't say anything. They're all happy, happy, happy, chatter, chatter, chatter, and I've just experienced this loss. How could you tell people that? So I just became voiceless. I couldn't speak it. I really just kind of shut down.

I went back to Penn State. I started school again in four days. I finished school and then I was on to happily ever after. But I wasn't happy anymore. I mean, I realized there was something really wrong.
Now, these women gave up their babies as young, unwed women in their teens and early twenties in the 1950s and '60s, before legal abortion, contraception and the second wave of feminism. Few of them had any idea, before all this happened to them, exactly how sex and pregnancy even worked; they were not things that respectable people talked about.

For almost two decades now, conservative policymakers have been trying their hardest to bring back this set of circumstances. If overturning Roe itself isn't feasible, they've still managed to put as many barriers as humanly possible between women and abortion: mandatory waiting periods and counseling, parental notification laws, mandatory ultrasounds, etc. That's been going on since at least the 1990s, when the Hyde Amendment banned the use of government funds (i.e., Medicaid) to pay for abortions. A newer development is the attempt, through misinformation (abstinence-only and abstinence-plus sex education, which dwell on inflated failure rates of various contraceptive methods and urge students to stay celibate until they marry), to recreate the cultural climate of silence, shame and ignorance that kept unwed mothers so powerless in the first place.