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Since the discovery of infantile autism by Kanner, a number of distinguished psychoanalysts have made steady advances in understanding this strangely aberrant condition. Margaret Mahler brought autism within the orbit of normal infant development while Meltzer and his co-workers have offered psychodynamic models. Now Frances Tustin brings a new dimension to our understanding by linking autism and its phenomena to our ontological development and inheritance.
In this, her third book she develops further her view, first adumbrated in Autistic States (1981) that disturbances at an autistic level are yet to be found at the core of many common adult psychopathological disorders. Her formulations are original and far-reaching and the integration of her thinking into Kleinian theory may have implications for clinical practice and even for some fundamental conceptions about infant development itself. These questions are developed by Grotstein in his forward to the Yale University Press edition. It is unfortunate that this was not available for Karnac's publication. It is a serious loss, for Grotstein addresses clinical and theoretical implications which help the reader to orient Tustin's highly original contribution within the mainstream of the development of psychoanalytic thinking.
Frances Tustin's work has been translated into a number of languages and, in many respects, receives more active attention in Europe than in England where the field of autism and mental retardation has been dominated by behavioural and cognitive psychology. That her discoveries reach far beyond the confines of that area expediently termed “mental handicap” is clear; paradoxically, there is danger of their relevance being lost to the very field in which the discoveries were made. Mrs. Tustin has devoted many years to the treatment of that group of mentally handicapped children whom Leo Kanner first identified and differentiated from the organically impaired in 1943. These children seem to have suff