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I would like to thank Mrs. Alvarez for her very interesting paper which brings together in a lively, descriptive way some of the central developments in this treatment, which must have often felt long and laborious, despite considerable progress. She has given us a most valuable description of Bobbie's method of psychic survival through sticking to his object, and of the analytic struggle toward recognising the separateness and aliveness of himself and his object.
Of the many aspects of this case which might be discussed, I would like to focus on an impression I had of the insistent way in which Bobbie created and lived in an exclusive, two-object world. Certainly, he tried to overcome the separateness implicit in even the two-person relationship, but from his first session he knew that what he was needing was a bridge. What particularly struck me was the relative absence of direct material concerning jealousy and rivalry, especially as compared with material from other autistic children who often seem preoccupied with these problems at however primitive a level. It seemed to me that Bobbie was involved in an evasion of the third object in his relation to his internal mother, along with the attendant pain and anxiety which are so much a part of establishing any separate identity and allowing one's object and one's internal world to come to life. This third object to be avoided would be felt at different developmental levels as the intruding hardness of the nipple in the child's relation to the soft breast, as the father, or as the other babies felt to be coming between him and the mother.
The intensity and exclusiveness of Bobbie's relationship to his therapist which came across to me as part of the ambience of his analysis is probably connected to the urgency of attention Mrs. Alvarez felt Bobbie to evoke from her, as well as his mode of sticking himself to his object. His collapses and his enormous difficulty in internalising an object with any firmness, grasp or ca