Thoughts on Autism with Special Reference to a Paper by Melanie Klein

In her paper “The Importance of Symbol Formation in the Development of the Ego”,⁶ Melanie Klein describes her analysis of a four-year-old boy whom she calls Dick and whom we would now recognise to be an autistic child. I seek to discuss Mrs Klein's paper from the point of view of autistic pathology.

Mrs Klein wrote her paper in 1930. At that time, Leo Kanner's classic paper⁵ in which he differentiated the syndrome he called. “Early Infantile Autism” from mental deficiency had not been written. We had to wait until 1943 for his findings to be available to us. It is a mark of Melanie Klein's originality and perspicacity that in her paper she anticipated many of Kanner's findings. For example, of Dick's case she wrote “many cases of this sort are classified as mental deficiency”. (p. 230) The following description Klein gave of Dick shows that he was a classic example of Kanner's type of autism.

She writes:

This child, Dick, was largely devoid of affects, and he was indifferent to the presence or absence of his mother or nurse. From the beginning he had only rarely displayed anxiety, and that in an abnormally small degree. He had almost no interests, did not play, and had no contact with his environment. For the most part he simply strung sounds together in a meaningless way, and constantly repeated certain noises. When he did speak he generally used his meagre vocabulary incorrectly. But it was not only that he was unable to make himself intelligible; he had no wish to do so. More than that, Dick's mother could at times clearly sense in the boy a strong negative attitude which expressed itself in the fact that he often did the very opposite of what was expected of him When he was hurt, he displayed very considerable insensitivity to pain, and felt nothing of the desire, so universal with little children, to be comforted and petted he also ran round me, just as if I were a piece of furniture. (p. 221 & 222)

As an infant, Dick had had great difficu