Autism and Childhood Psychosis: By Frances Tustin. London: Hogarth Press; New York: Science House. 1972.

One of the charges of psychiatry against psychoanalysis used to be, before the war, that psychoanalysts, especially lay psychoanalysts, could not comprehend the nature of psychosis. This charge was especially applied in the case of the lay psychoanalyst but at that time, among psychiatrists themselves, the idea of childhood psychosis was not taken very seriously, and

before 1943 the word autism was of little clinical importance, while at this very time Mrs Klein and many other psychoanalysts (some of whom were also lay) were very much concerned with the problem of psychosis.

Nowadays, no doubt, the charge is still made, but because of psychoanalytic researches, also another charge is made and this new charge comes from a different direction. If the roles are now reversed it is due to an understanding, which is much greater now than thirty years ago, of the development of psychotic processes. Where, once then, it used to be the psychoanalysts who were accused of neglecting medical, and so psychiatric, facts, now it is the psychiatrists who are told that they are merely dealing with symptoms in offering drugs and electric shocks and neglecting development.

With the passage of time the detailed content of old controversy becomes empty, or even absurd, and no doubt this will happen to the question of relative contributions from genetics, environment and chemistry to the manifestations of psychosis. Once these factors are collated they will surely be reconciled together. Meanwhile the warfare of entrenched experts has been encroached upon by lay interest. This interest is stoked and encouraged by newspapers and broadcasting and no doubt the advance guard, of the lay intruders into the arcane mysteries, was provided by the psychoanalysts. Among these invaders, the medical psychoanalysts who were no longer working in mental hospitals were held to be just as irresponsible as the lay analysts whom they sponsored in concerning themselves with psychotic phenomena.

It may