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Psychoanalyst and teacher, Joshua Durban, explores the perplexing terrain between hope and despair in working with children with autistic spectrum
disorder (ASD). The therapeutic relationship generates particular qualities of transference, countertransference, and their unique emergence in somatic reactions, affective experience and enactments. Reading Durban's article, we might recognize an all-too-familiar mood of despair that work with children ‘on the spectrum’ can bring. How often does a feeling of futility in the face of autistic encapsulation require that we proceed in our work only with a sense of faith? Through this article we come to recognize the significance of the swing from despair to hope. We also might be struck by Durban's quiet references to faith, which perhaps reflect what Jungians might call a symbolic attitude in encountering seemingly lifeless chaos - an attitude that makes way for the transcendent function.
Durban reveals how feelings of hope and despair in the analyst, ‘are linked with and influenced by the child's primitive unconscious phantasies regarding the destruction and possible reparation of the primary object’ (p. 187). He offers a well-articulated description of countertransference experiences and transference dynamics in the psychoanalysis of children, adolescents and adults with ASD. Reflecting on his own psychoanalytic experience, theoretical contributions of others and two case descriptions, he emphasizes that it is a capacity in the analyst to fluidly move between the jarring poles of despair and an elusive hope that helps to make room to apprehend the child's primitive and fragmented communications of chaotic states.
The author reviews how pioneering psychoanalytic work with ASDs, including that of Alvarez (1992, 2012), Alvarez and Reid (1999) and Tustin (1981, 1990), as well as his own more recent observations (Durban 2011 and 2012), have revealed some typical countertransference and transference patterns. For example, we ha