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This book is a collection of sixteen papers, some already published and some delivered to various psychotherapeutically interested audiences which show the development of the author's ideas on the nature of autistic symptomatology and its defensive role. It is in two parts, the first of which deals with her experiences in the treatment of autistic children and the second with the more transient autistic phenomena emerging in the therapy of adolescent and adult neurotic patients. In addition to the vivid account of the first group of patients most analysts should find her conclusions in the second group directly relevant to their own work with adults, especially those who seem encapsulated at times in a state of mind which prevents further progress.
The main thrust of her argument is that psychogenic autism arises as a consequence of a traumatic arrest of normal development in the infant which leads to a domination by what she terms autosensuousness, an inability to function on a thinking, imaginative and conceptual level and to have meaningful object relations. Her thesis is that the autistic state is a reaction to the traumatic awareness of separation from the child's mother, a trauma which occurs before the core of the self has been established sufficiently to be able to cope with it. This may happen in some infants who have been separated too soon or in those where the association went on too long or was too close. Instead of a psychic core they have an unmourned sense of loss, described by one child as a black hole with a nasty prick in it. Even those children who have been reported as autistic from birth may have chanced upon 'autistic objects' very early in life and turned away from the suckling mother who because of depression or lack of confidence is unable to muster enough firmness and resilience to attract the infant away from the illusory delight of these sensation objects to a real enjoyment of her breast which he can then learn to use as separate f