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My subject is a seventeen-year-old autistic boy whom I have been treating by the psycho-analytical method over a period of ten years. I will outline certain developments which have taken place in him during this period, but I should say from the start that these developments are limited. They are limited both by the nature of his illness, which seems designed to prevent innovation and change, and also by the considerable interruptions to which his treatment was exposed in his first six years at the Clinic.
I hope to show how he began his treatment with an effort at making contact with me as a way of overcoming intolerable anxieties about separation and separateness; how, to a large extent, he lost this link during the early interrupted years, and how he gradually came to find it again. I would also like to say something about two very different methods he now employs for achieving this contact. One of these seems to promote change and growth and life in him, while the other is death to development.
Bobbie was referred to a consultant in 1963 at age four with a note from his G.P. that he was backward in speech and behaviour, and at times very withdrawn. He was psychologically tested then and several times since, and is estimated to be of at least average intelligence. Five times weekly treatment was recommended, but the parents could not manage it, and Bobbie started at the Clinic twice weekly with his first therapist late in 1963. His mother was seen by a case worker, and they met most of the time in a foursome.
Bobbie spoke little, used to walk into ponds, run into the road, and would try desperately to stick fallen leaves back on to trees. He never used the word “I” and once in nursery school said that a jigsaw was a “broken mummy”. I used to see him on the stairs of the Clinic and he was an appealing, delicate looking child with a lost, floppy, rag-doll look about him.
Bobbie's parents, together with the maternal grandparents, came here fro