A small percentage of mentally handicapped or 'autistic' children are in the habit of looking at their hands, a behaviour which I will call hand regarding behaviour or h.r.b. Cases showing this behaviour were studied and the following tentative conclusions emerged:
a. The behaviour is symbolic, and it is symbolic of an emotional encounter with a parent, (or parent figure).
b.These encounters are of two opposite emotional types, with the child expressing affection, or aggression.
c. These reactions are triggered by current and corresponding actions by a parent figure, where the adult either shows affection to the child, or satisfies the child's needs in some other way, or reprimands the child, or frustrates one of his needs in some other way.
This behaviour, h.r.b., is related to more extreme symbolic responses to the child's own hands, and indeed to other parts of his body, and also to reactions to inanimate objects. In related actions on the child's hands we may see more extreme and physical responses such as kissing the hands, or biting them. These reactions might be called hand directed behaviour, or h.d.b. These conclusions are, of course, also hypotheses to be tested in future research.

INTRODUCTION

OBSERVATIONS - CASES.

INTERPRETATION

In these cases the hand in the flat, spread fingers or claw shape seems to represent a person, the palm and fingers symbolising the face and hair respectively. More specifically the representation seems to be of a parent or parental figure. Symbolic interactions between these children and other people, especially adults, as represented by their hands, are of two diametrically opposed types. TYPE I Anger, hatred and aggression. TYPE II Love and affection. What prompts or triggers each symbolic interaction is likely to be a real situation with a real person, the parent figure. There is a logical match between the sort of incident/situation occurring with the parent figure and the type of symbolic interaction which follows. A real situation of discord between the parent figure and child will evoke an interaction of type I, whereas a real situation where the child is receiving affection from a parent figure will prompt an interaction of type II. A person's hand or palm may be regarded as a sort of unstructured stimulus complex, an objectively vague and indistinct form like clouds, the surface of the moon, Rorschach ink blots and so on. In contrast to highly structured stimuli such forms can suggest very different things to different people, and just what is seen is dependent upon subjective factors such as a person's needs, mood, habits of thought, preoccupations etc. In the class of structured stimuli would be placed photographs, which should mean almost the same thing to all observers, while in the class of unstructured stimuli would be placed the palm of a person's hand, in which one could see virtually anything one wanted to see. This discussion of course is related to the psychological phenomenon of 'projection'. The fact that the palm is a roundish shape with lines (fingers) projecting from it, which could suggest hair, would make it more likely that what is seen would be a face, the uncertainty would lie in just whose face is seen. The fact that people probably have a predilection to see faces in unstructured stimuli, such a tendency being hard wired into the nervous system, again makes it likely that a face will be seen, e.g. the man in the Moon. We might remark here on the fact that I do not recall seeing a child hold his hand to his face in a position such that the fingers are orientated in a left-right direction, with respect to the child's view. Clear similarities in appearance and mode of construction may be seen between children's drawings of themselves and their parents, on the one hand, and on the other, of the sun. An initial circle serves for face or Sun disc and around this are placed radiating lines which serve for hair or rays, and not uncommonly they draw faces on their sun. In their thinking , as revealed by our prompted tree drawing story method, it is clear that the sun is a parent symbol, sometimes kind, loving and benevolent (warm), and sometimes angry and punishing (hot). Such very basic, primitive ideas and equivalences are also seen in the mythologies of earlier peoples. The Egyptian sun god, to take an example, is more or less a father figure. He can be a source of love but also oftentimes of anger, of benevolence but also of authority and power. It is observed that many s.l.d. children exhibiting behavioural difficulties show bad scarring , often on the backs of their hands, due to years of biting themselves. This indicates displaced aggression onto something and someone 'near to hand '. Aggression would be caused by someone frustrating one of the child's need drives. Aggression cannot be aimed directly at the frustrator because there is conflict with other drives, e.g. fear and, or love of the person etc. There is also an element of emotional suppression in this behaviour, of controlling oneself, of hiding one's true feelings. This self-mutilation is compatible with our hypothesis that the child's hand symbolises the parent figure. The aggression, properly directed at the adult, since it is the adult who angered the child, is displaced onto the child's hand. This self -

mutilation is probably most common where a rejecting , turning away of the parent figure would, in the child's mind, merit a more severe retaliatory aggressive act than would an angry rebuke, possibly precipitating a physical attack in reality, or a symbolic one in fantasy, i.e. biting the back of the hand. We note that the physical aggression involved, either directed at objects in themselves or to objects symbolic of other objects, is predominantly biting , (oral aggression), while the affectionate interaction is often kissing, mouthing or sucking , (oral receptive). Psychoanalysts tell us that this oral phase, both in its receptive and aggressive aspects, is the earliest psychosexual stage of development of the normal child as it suckles at its mother's breast, and so would be expected of any individual functioning at this level, whatever his chronological age might be. In certain circumstances, e.g. a craving for attention, a child may regress to this oral phase. At such a stage one would expect the child to soil and wet itself, and further, that its feeding habits would be primitive and messy. In addition the tendency to discard either food or clothing may be exhibited, representing a rejection of the mother as both food (breast), and clothing (love and protection). Body parts as symbolic objects can provide a vehicle for fantasy in children who can not so easily manipulate internal symbols or representations via normal mental processes and have the advantage of convenience, being necessarily always present to hand. The hand in this role is perhaps an intermediate stage in the process of internalisation of an object, e.g. the mother or father parental figure. In case A, this behaviour is clearly a symbolic re-enactment of a typical angry confrontation between mother and daughter. These are both very strong-willed females in dispute over who (if either) should control the other, who should have power and authority in the home environment and over the objects in it, including the primary object of sexual desire, the father. J. plays the part of herself, while her comfort cloth, hair and left hand play the part of the mother, the latter symbolic object representing more specifically the mother's glaring face. As playwright, scriptwriter, director and actress J. has total control over what occurs in fantasy after S. orders her to sit up, total real control over her left hand and so total symbolic control over the parent figure it represents in the drama. J. relieves her feelings symbolically and so fairly safely, she symbolically attacks the mother with a hand (tugs on her own hair), and with her teeth (chews her comfort cloth) while glaring at her angrily (stares at the palm of her left hand). In similar fashion the child bullied at school later achieves partial satisfaction in fantasies of successful revenge on the bully. We note that it is J.'s left hand which represents the mother, while the other plays itself. This right hand is tugging on J.'s hair, a symbolic attack on the mother. We thus have the mother represented by J.'s left, weaker, non-preferred, bad hand. The raised left hand was trembling with tension in a sort of minor tonic-clonic spasm. One could imagine the right side of J.'s brain as being both a) the mother, sending motor messages to, and receiving proprioceptive sensory messages from, the mother/ hand/face to attack her ( J.) and b) J. herself, counteracting the above motor impulses more or less peripherally in the same organ, which also represents itself, J.'s hand. Here the hand could be seen as grasping the mother's face or head, granting J. even more power over the parental figure. Not only is it J's left and weaker hand which symbolises the mother, it is still J.'s hand and she has control over it, both as a real and as a symbolic object. J. relieves her feelings in fantasy: this is a private matter, there is an element of disguise and the 'message' is not communicated clearly to others, (or to herself ? ), and so

she need fear no retaliation. Perhaps if one could show that one understands the 'message' then this may be regarded as a true, intentional , deliberate and conscious communication between two people. In the fantasised continuation of the beginning, which is a typical interaction between mother figure and daughter in reality, a different conclusion can be arrived at; reality is modified to be nearer to J.'s heart's desire. Rather than comply with the authority figure's order , (as J. actually does), she will get her own way, she will gain the upper hand over the parental figure, she will outface her and be triumphant. J.'s behaviour can be compared with someone imagining a specific disliked person as the punch-bag they are hitting, so relieving their aggressive feelings towards this person in a partially symbolic fashion. Such behaviour is less internal and symbolic than the fantasy situation we have described for J., something is really assaulted, but not the thing the aggressor really wishes to attack. It is a real external (though symbolic) object which cannot retaliate and is safe to attack. J. is genuinely angry and directs real aggression towards the symbolic objects. Perhaps she is not quite as angry as she would be towards the object of her ire and therefore not as aggressive to its symbols, nonetheless the reality of the emotion and aggression is undisputed. A glove puppeteer may adopt the roles of two people or creatures simultaneously, using his two hands to represent two distinct entities; this seems similar to J.'s fantasy behaviour. In contrast to her behaviour we can consider theatre or film where the distance from reality is greater. Here the emotions are assumed and counterfeit; the actors pretending to be angry, afraid, in love and generally to be people other than themselves, in situations possibly alien to their experience. J. often covers various of her bodily orifices with her comfort cloth or dress, e.g. her mouth, nostrils and genitals, this may involve a slight degree of insertion. With her hair the action is more clearly an intrusion (in to her nostril). J.'s gentler use of cloth and hair represents J.'s desire for decide for herself whether the mother blocks (protects from invasion) or intrudes into any of her orifices. It could also represent a gentle contact of the lips or mouth with the mother, e.g. a kiss or a mouthing or sucking of the mother - breast (an oral receptive response). J.'s aggressive response to S was caused by her desire to slouch into a lying position with her comfort cloth in her mouth, being frustrated. She wants to remain a baby with no responsibilities, obligations or demands on her, she wishes to be cared for completely, given what she wants, allowed to do what she wants, immediately, without having to make contact with other people or express her needs. In case B, K.W. shows similar symbolic behaviour when his over-activity is frustrated, to some degree, by an authority figure, (especially a man). He additionally strikes the symbolically engaged left hand with his right, shouting and staring wide-eyed at it. Here we see rather more enhanced aggressive behaviour directed at the symbolic authority figure in the actual physical striking of the symbol. K.W. attacks himself as well as others and, as would be expected, the observations of 11.12.98 show him engaging in both affectionate and aggressive symbolic hand use. In case C, B. S. illustrates type II symbolic interactive behaviour s where affectionate exchanges are portrayed; 'mummy' is bestowing love and attention on him. (The symbolic object is not always his own hand, but may sometimes be one of his "precious objects", (comb, keys, TV remote control). B.S. utters an expression of sympathy and concern into his hand. Is he enacting a scene where 'mummy', (an echo), is expressing sympathy and concern for him? Case D also illustrates type II behaviour in affectionate interaction with parental authority figures. G.H. represents both mother and father with her hands and goes as far as kissing her palms in turn where, symbolically, a person's lips would be and giggling as she does so.

DISCUSSION

J. and G.H. illustrate quite clearly the two distinct varieties of this behaviour, J. exhibits type I and G.H. type II. A number of questions logically arise: (i) What are the characteristics of children who engage in this type of behaviour, children of what intellectual level and stage and type of communication, what personality type, and what family situation? (ii) Do some children engage predominantly in type I behaviour, while some engage more in type II ? (iii) Do children who engage more in one type have other common features, while children who engage more in the other type have different common features? Some provisional answers present themselves. (i) Children of a high enough level, but in the s.l.d. range, who are apart from their family and who may have family difficulties, (e.g. J. and G.H.). (ii) and (iii) Children who are extra-punitive, directing their anger outwards, may engage more in type I behaviour (e.g. J.), while children who are intro-punitive, directing their anger against themselves, engaging in self - injurious behaviour, (s.i.b.), may engage more in type II behaviour, (e.g. G.H.) Note J. also tugs at her hair. I believe the hair here is a symbol of the mother. Her behaviour could be seen as verging on s.i.b. but I believe it is more properly understood as an outwardly directed attack. J. also sees and treats inanimate objects as symbolic objects, as when she smashes her mother's plant pots.

This symbolises an aggressive attack on her mother, especially on her child-bearing abilities. In this case meaning is even clearer because these plant and flower pots contain earth in which living things develop and grow. There is over-generalisation in this symbolic behaviour due to the strength of the sex and maternal drive and the degree of its frustration. The behaviour is not so clearly or consciously a communication, but rather the enactment of fantasy. J. engages in this sort of s.o. use but doesn't show ordinary s.o. use, probably due to the perception of objects as symbols of sex or reproduction overpowering more normal and specific perceptions, such that for her a cigar could not "just" be a cigar, or more relevantly to her case, a plant pot could not "just " be a plant pot. Note that J. has the condition of precocious puberty, no doubt exacerbating the problem of over- generalisation of sexual symbolism. Note that this type of object symbolism is of a different type from that seen in t.r.a. (token real action). In the former Freudian type, the object is a symbol of some other object by virtue of similarity of form or function, the similarity been possibly quite remote and abstract and the class or category very wide (over-inclusion and over-generalisation). In the type of symbolism seen in t.r.a. the object remains itself (or rather the specific type of object remains itself) and the symbolism or conceptualisation is function. So a young normal, preverbal child or older mentally handicapped one may give his mother his coat, engaging in real actions with real objects, though symbolising a desire for his mother to dress him and then take him out to the park or shops etc.

With a drive that is strong , though not necessarily unusually so, plus a lack of inhibitory controls and selectivity over the expression of the drive, (factors with social and aesthetic determinants), we expect attempts to satisfy desires in socially unacceptable situations with very inappropriate objects. Pica and public masturbation are indeed witnessed, the drives here being obviously hunger and sex respectively. A number of factors could be responsible for these drives, e.g.:- a) physiological reasons, e.g. high b.m.r. related to hyperactivity etc. b) normal drive not being satisfied, e.g. actual hunger. c) drive is not merely physiological but psychological e.g. emotional hunger expressed as a desire for food. G.H. is indeed emotionally deprived, she has a strong and frustrated drive for parental affection, and this hunger for love and affection is manifested in her hunger and craving for food c), and the associated regressive behaviours of fingering and daubing it on her chest. In learning theory models of behaviours such as s.i.b., attention and affection are seen as rewarding and reinforcing the behaviour, thus making it more probable. On the other hand, this model emphasises the child's negative attitude towards itself, which generates s.i.b., under certain circumstances. We must therefore endeavour to make children such as G.H. more positive about themselves and, or less unrealistically positive about their parents. This will hopefully reduce the degree of intro-punitive behaviour displayed, allowing the child to re-direct aggression outwards to a greater extent, which should be considered as being psychologically healthier.

Further discussion.

The development of nervous control in an infant's body is cephalo-caudal and proximo-distal, i.e. 1st  head, eyes, mouth, tongue, lips. 2nd  trunk. 3rd  arms and legs. 4th  hands and feet. 5th  fingers and toes. In the initial phase the infant's sense of self, its ego is nebulous and poorly delineated, although roughly focused at the temple, behind and between the eyes. This fledgling identity is causally related to the increasing conscious control of the organs of the head , those functioning in perception and the expression of needs. It is interesting to note here that this locus of I-feeling persists throughout life undiminished. Initially the child's needs are uncomplicated, it requires sustenance and expresses this simply by crying , consequently gratification (via the mother) is swift and sure. This instant gratification runs counter to the development of the self/not-self discrimination, which therefore remains non-conceptualised at this stage. All things within the infant's perceptual fields are of a unity, an amorphous ego with no distinctions. As the infant develops, its desires proliferate and thus the gratification of these is increasingly delayed by parental uncertainty. The infant's idea of what is under its sway and therefore what constitutes itself contracts from everything it perceives to those parts of its anatomy that he can consciously control. XThis burgeoning control over increasingly more distal portions of its body (obviously due to the maturation pattern of the nervous system), correlates and is in step with, the re-expansion of the ego, ultimately to the physical limits of the body. The normal separation of self and not-self is therefore progressively conceptualised and ultimately established by both increasingly delayed desire gratification and growing conscious control of the body. The preceding is in way of establishing a psycho-neurological basis for the higher-level s.l.d. child's symbolic use of its hands.

The child is in this manner facilitated in its semi-disassociation of these distal organs and their consequent symbolic application, due to that diminished sense of I-ness associated with more distal portions of its anatomy, that we have previously alluded to as being most symptomatic of this functional level. During certain interactions with others, the child thus temporarily reverts to an earlier conception of this extremity, wherein the sense of self is, to a greater or lesser extent, disconnected from this organ, allowing it to represent the parental figure. It is commonly observed that children such as G.H. strike their heads (especially their foreheads) either with their hands or against hard surfaces. This is tantamount to an attack against their basic, essential, core self. 'N' is the initial letter of various English words. Similarly, in b.s.l., in finger-spelling, the hand shape 'n' is the initial of a variety of finger-spelt words. The hand shape 'n', short for 'name', can invoke or call-up a whole range of names, it is the symbol of a large class of specific names, animate or inanimate; in the former group being members such as 'John', 'Peter' and so on. In the b.s.l. sign for name the hand-shape 'n' is initially brought to the body of a specific person, specifically the forehead of the signer. This is the seat of their identity, their self and so this drastically limits the meaning to 'Peter' or 'John' etc. (One's name is a symbol of one's individual self, and in primitive and, or pathological states or stages of development, of mind, one's name is thought of as almost identical with, or a real part of, one's actual self. Similarly this is the case with inanimate objects). Note that the second movement of the 'n' (name) hand-shape is from the signer's forehead or temple, the seat of Peter-ness or John-ness etc., outwards. The person's name, or a copy, is, as it were, taken from the person, from their basic self, and presented for social communicative use.

Note some other signs connected with this part of the body (head): i.e. think, know, believe, clever, silly, mad, forget and remember etc. We have thus far concentrated on the hands as symbolic objects and in this context note that the voluntary control of these organs allows of their 'directorial' manipulation by the child in its fantasy enactment. The hair also has a symbolic significance for the child, although of a different and more limited kind. Hair can be assigned a role, but obviously, unlike the hands, cannot be directed as it is not under neural control. Females tend to generally have long hair and this comes to symbolise femininity, (particularly the mother) for both boys and girls. In the case of girls this connection is further reinforced by their mothers' ministrations during childhood: brushing, combing, and styling of the hair. These attentions may not always be pleasant and may indeed involve a degree of discomfort if the hair is knotted or tangled. The girl's hair comes to represent the mother in both her good and bad and angry aspects. We may note here the habit of girls or women to free their hair from tight styles, bands, clips etc., letting it loose, literally 'letting their hair down', when relaxing , at play or engaging in sexual activity. A similar attitude is observed regarding restrictive clothing, this being shed in favour of looser-fitting garments under similar circumstances. These observations can be interpreted as the girl or woman casting off the restrictive, inhibitory influence of the mother and the associated perception of her interference in the girl's or woman's sexual interaction with a male (conceivable on some level as a father figure). Pulling hair is one of the forms of aggression more commonly encountered in females and could be seen in connection with the previous points regarding the symbolism of hair. Even the pulling of one's own hair, which normally would be considered as self-abusive, can be reinterpreted in light of these facts, such that the hair is not perceived by the child as an intrinsic part of its basic core self and can therefore easily assume the role of another in fantasy.

Additional.

More recently G.H., during affectionate interactions, has involved the hands of the affection-giver, grasping them and smiling at their palms. This seems to represent a healthier state of mind, as does the externalisation of some of her aggression. These factors indicate a less self-absorbed, more socially aware state and a less self-negative intro-punitive attitude respectively. The involvement of the affection-giver's hands might represent a transitional stage in the child's acceptance of the adult as a parent figure.

In the years I have known these children, none of them seems to have changed noticeably their type of behaviour towards their symbolic hand object(s). However, with some of them, the direction of their aggression has become less polarised. For example G.H. originally demonstrated purely self-directed aggression, but has now begun to show aggression to others . All the children seem to be at a stage of expressive communication where they are able to use photographs, pictures and symbols to express a variety of desires.

B.S.'s head slapping is rather 'superficial' and motivated by a desire for attention, sympathy and concern. In the absence of an audience it quickly stops. With G.H. her self-aggression seems much more the result of a real desire to injure herself. The parallel is with the distinction between a suicidal gesture and a genuine suicide attempt., although the distinction is rather artificial, these two representing the poles of a behavioural continuum. There is indeed a continuous variation in the degree of the gamble one takes and the chances one allows others, or 'fate' etc. to intervene to save one.

G.H.

A. actual attitude and responses to self and others.	a. later, began to hit others. b.1 previously used to hit herself, only or mainly.
B. hand symbol behaviour.	a. 0 b. 1 gazes fondly at her hand.

B.S.

A. actual attitude and response to self and others.	a. attacks others, pulls their hair, (not their core self). b. 1 hits self on head.
B. hand symbol behaviour	a. 0 b. 1 gazes fondly at his hand.

 

J.W.

A. actual attitude and responses to self and others.	a. 1 used to hit other people, (on head). b. 0 never hit her real, basic self but pulled her hair = the other.
B. hand symbol behaviour	a. 1 stares crossly at her hand(s). b. 0 doesn't smile or look fondly at her hand(s).

K.W.

A. actual attitude and responses to self and others.	a. 1 hits others, (and his hand = the other). b. 1 hits his chin, with his hand.
B. hand symbol behaviour.	a. 1 stares crossly at hand. b. 1 looks fondly on it.

0 = not observed

1 = observed

Appendix II

Individual A		Individual B
Inner Core Self, e.g. face, temple, forehead and chin.	Outer Self, e.g. hair and head.	Outer self, e.g. hair and hand.	Inner Core Self, e.g. face, temple, forehead and chin.

The above diagram expresses a view of the situation that may cover all the observed facts. We may see the outer parts of persons as closer together, literally and figuratively, (i.e. more similar) and the behaviour of a person directed to these, their own outer parts or the outer parts of another, as more similar than one might imagine. Aggression by individual A on A, on his core self, may be seen as much more removed and much more dissimilar to aggression by A on B's core self.