The ‘black hole’: a significant element in autism*

First of all, I would like to clear away certain misunderstandings. For example, I have found that in certain circles to talk about the possible psychogenic origin of some types of autism, and to suggest that some autistic children can be helped by appropriate psychotherapy, is like showing a red rag to a bull. I understand why this should be so. In the early days after Leo Kanner differentiated the rare syndrome he called early infantile autism from congenital subnormality (1943), the psychoanalytic child therapists made unduly optimistic claims for alleviating this sad condition by the type of psychotherapy they employed. (This was usually a modification of a classical Freudian technique.) They raised hopes in parents which were unfulfilled. In addition, they blamed the mothers for their child's distressed condition in a simplistic and unsympathetic way. The autistic children were often depicted as innocent victims of an overly intellectual mother's cold, uncaring unresponsiveness.

In my writings I have tried to redress the balance by seeing the mother's point of view, as did Dr Tischler (1979). I have also tried to show the child's unwitting contribution to the autistic state. After all, we are all flawed creatures and apportioning blame is a sterile pastime. Understanding is what psychotherapy is about. A syndrome as rare as early infantile autism is likely to be the result of an unusual concurrence of both genetic and environmental factors, the balance of which may be different in each case.

In my own work, I have tried to become clear about the type of