«Entry» into Autism

The ways into autism and psychosis are a matter of enormous interest, and there is currently a significant body of research about it, and not only within psychoanalysis; research which it is right that psychoanalysis should address, so as to understand what role it can play both with respect to understanding the nosodromic processes and in terms of treatment.

Dario De Martis, quoting a famous assertion by Henry Ey, liked to remember that «schizophrenia comes not at the beginning of development, but at the end» (Ey, 1954, my translation).1 By which he meant that, whatever the nature of the terrain of vulnerability in which it originates, the nosodromic course of psychosis is often long, complex, and anything but linear, both before and after its onset. Sometimes it is punctuated or noisily signalled by those «catastrophic-matricidal» moments which Jaspers had wonderfully illustrated in his descriptions of Wahnstimmung and primary delusional experience (although Freud had also dealt with this phenomenology himself two years before in the Schreber Case). Nevertheless, before and around these critical moments, there is often a long pre-history and a long pre-clinical and sub-clinical history: it is a story of transformations which are, at the same time, transformations of mental stances, of the experience of the Self, experience of the world, and the concomitant neurobiological stances. Moreover, multiple facts can intervene in the evolution and directions which this long-buried history can take.

In recent decades, beginning with the work of Gerard Huber's great Bonn school, and of his pupil Joakim Klosterkötter (Gross et al., 1998; Huber et al., 1992; Klosterkötter et al., 2001), but also that of other important research groups, we have been given minute descriptions of the transformative sequences which can lead from «base phenomena» (direct indicators of the underlying vulnerability) to preclinical phenomena, and from these to prodromic phenomena and then to manifest p