Transformations in autism: working psychotherapeutically with autistic states

Abstract

ABSTRACTThis paper explores psychoanalytic ideas about autism, through vignettes from a long-term psychotherapy of an autistic adolescent who had developed an obsessive passion for photographing his world. The use of an autistic object will be explored here, as well as the change that occurred in the context of this therapy in the use of the object – from being a sensuous shelter and pseudo-protection from the world, to becoming a bridge to it, a vehicle for building a mind and a container for the patient’s experiences. The paper also examines the overall development of the patient, moving from a seemingly a-symbolic state of mind, to forming and using symbols that were in between symbolic equations and formal symbols. In this in-between mental state, ‘tangible-archetypal symbols’ existed, as defined by the author. Three characteristics of these symbols are defined, including their sensual nature, primary meaning and incoherent presentation to the world. These characteristics are illustrated in the context of the clinical material. Implications for clinical work with autistic states are discussed throughout the paper.