Open exchange: An Autistic Perspective on Live Company

It has come to our attention that views in Britain on the aetiology and treatment of autism are not homogeneous. While psychiatrists, researchers and other professionals involved in diagnosing, educating and providing other services for autistic people are generally up-to-date in their knowledge of the scientific evidence, there are still some psychoanalysts who believe that psychoanalysis is an appropriate treatment for autism. Both of us have been formally diagnosed with high-functioning autism or Asperger's syndrome. As such, we would like to claim the ‘right to reply’ to recent psychoanalytic writings about autism, of which we take Anne Alvarez's Live Company: Psychoanalytic Psychotherapy with Autistic, Borderline, Deprived and Abused Children (1992) to be representative. We feel that such writings not only ignore scientific research into autism, but also disregard and obscure the real experiences and feelings of people with autism.

Alvarez's book centres around the case of ‘Robbie’. This is typical of psychoanalytic writings on autism, which rely on case-histories, rather than scientific data to support their theories; the best-known example of this is Bruno Bettelheim's The Empty Fortress (1967), which is based entirely around case histories. This strategy could have two purposes: either to demonstrate the validity of the psychoanalytic method by showing its effectiveness in a given case or to persuade the reader of the accuracy of the psychoanalyst's understanding and interpretation of this particular patient's experiences.

The claim that a method is valid simply because an individual patient shows some progress after twenty-four years of treatment is obviously flawed, but typical of the psychoanalytic approach. In fact, the progress psychoanalysts describe in their case histories (Alvarez, 1992; Bettelheim, 1967), usually after many years of treatment (which necessarily also