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WHEN DESCRIBING THE fundamental characteristics of schizophrenia Bleuler (1911), (1912) included what he called autism, which implies: detachment and withdrawal from reality; absolute or relative predominance of internal life; a loss of the sense of reality; and autistic (or dereistic) thinking.
Since Bleuler, two ways of thinking about autism have developed: On the one hand the concept of autism was limited to the idea of withdrawal and detachment, with the building of a "wall" which divided the person from the external world. This probably occurred in psychiatric thinking due to the widespread influence of Kanner's (1966) description of early infantile autism. On the other hand, and paradoxically, the concept was reduced to "a loss of the sense of reality." Autism proved to be, in this second interpretation, not simply a withdrawal but also an expansion, and, furthermore, an activity of which the fundamental characteristic was the predominance of internal life without withdrawal: dereistic thinking. Rapaport (1959), commenting upon Bleuler's paper of 1912, says that according to Bleuler, autism includes withdrawal as well as autistic thinking, and that the sole existence of autistic thinking is not autism.
According to Bleuler, realistic thinking and autism (or dereistic thinking) can exist together. He admits cases in which autism may be partial. Autism essentially includes a predominance of internal life which implicitly implies a loss of the sense of reality and dereistic thinking, but does not necessarily imply detachment or