“Making a person”: Clinical considerations regarding the interpretation of anxieties in the analyses of children on the autisto-psychotic spectrum

Abstract

ABSTRACTIn the course of psychoanalysis, some children who are initially diagnosed as suffering from Autistic Spectrum Disorder (ASD) turn out to move back and forth along an autisto-psychotic spectrum. This subgroup, or spectrum, is characterized by a mixture of paranoid-schizoid anxieties and less differentiated autistic anxieties-of-being. Thus, these children could be described as borderline autistic. The interpretation of unconscious anxiety proves to be a crucial factor in the analyses of these children. They are characterized by an overwhelming influx of intermingled anxieties. Thus, it is the analyst’s difficult task to try and trace the dominant, urgent anxiety and interpret it in its own “language.” It is helpful to interpret and show the child how autistic withdrawal serves against further fragmentation, and the way fragmentation prevents an influx of paralysing anxieties-of-being. Furthermore, different anxiety states require different technical considerations and means. This is especially so when the type of anxiety is related to disintegrated or unintegrated states of the body. Clinical material taken from a five-sessions-per-week analysis of a boy, initially diagnosed as ASD and later on as suffering from childhood schizophrenia, will attempt to demonstrate the internal dynamics and the technical challenges involved when working with the autisto-psychotic spectrum.