Effective Treatment Strategies for Autism during the First Five Years of Development

There is a gap between, on the one hand, psychoanalytic theory regarding treatment for autism that recognizes both relational and body-based treatment and, on the other, conventional psychoanalytic treatment. Recent psychoanalytically based empirical research data indicate that treatment strategies exist to address the ineffective and pathological coping strategies present in infants and children with autism spectrum disorders (ASDs). This panel, chaired by Stephen Seligman, used videotape clips of therapy sessions over the course of a multi-year treatment of a child beginning at ten months, as well as verbal presentation of case material by the treating psychoanalyst, Molly Romer Witten. Gilbert Foley, a psychoanalyst, and Gerard Costa, a developmental psychologist and infant mental health specialist, were discussants; together they laid out the principles of the change process and illustrated the complex issues present early in life for children who present with behavior on the autism spectrum.

Seligman began by introducing the topic of the psychoanalytic theory of autism by reviewing past and current controversies. The problem with the “refrigerator mother” theory, which postulated that autism is an infant's defensive response to a cold, rejecting mother, was that it defined the problem unidimensionally. The pendulum has since swung in the other direction, and a new unimensional error is currently favored: the attribution of primary causal influence to neurobiological deficits in the infant. The truth, Seligman said, involves the interaction of endowment and environment. This transactional perspective is well described in the work of