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Frances Tustin has had well over thirty years of clinical experience with autistic and psychotic children. In this her most recent publication, she has put together a number of papers which focus on the protective aspects of autism. This collection of papers, written since the publication of Austistic Barriers in Neurotic Patients , elaborates the concept of an encapsulated state of being which arises as a massive ‘flight’ reaction to protect against an untimely awareness of separateness.
The first part of the book deals with her own definition of autism and its origins. In particular, there is an emphasis on the need to find words and concepts with which to convey her understanding of these enigmatic, hard-to-reach children. Later she describes her thinking about psychotherapy with autistic patients, both children and adults who display what she calls ‘pockets’ of autistic functioning. Throughout the book she not only draws on her own vast experience, but illustrates her ideas with case material and correspondence she has gathered from colleagues and students also engaged in psychotherapeutic work with autistic patients.
In her thinking about the genesis of autism, Tustin hypothesizes that some infants are born with a hypersensitive and highly sensuous disposition. She goes on to state that this excessive vulnerability leaves these infants with inadequate capacities with which to adjust following the trauma of birth. The developing relationship with these susceptible infants and their mothers is also unduly fragile. Tustin rejects as misconception the idea that the mothers of autistic children are cold and aloof, but states that all the mothers of the children she has treated have reported being depressed following the birth of their baby, and that it is the mother's emotional unavailability that has not been able to meet the specific psychological demands of the infant. She believes that these fragile mothers and infants become ‘unduly equated with and undifferentia