Infantile Autism and the Inhibition of Fantasy*

When we confront the symptomatology of infantile autism, we are assailed by an even more bewildering picture than prevails in other forms of schizophrenia. Although a domination by fantasy may generally characterize that illness, infantile autism is marked not only by what seems to be a complete inhibition of fantasy and feeling, but by compulsions and rituals which seem incomprehensible only if we ignore what may be their function. In other instances where children resorted to rigid controls and did not allow themselves to fantasize, I have found that the objective of their defenses frequently appeared to be the management, not merely of violent feelings, but of violent impulses. Those children had not only been exposed to violence or overwhelmingly violent feelings, but had frequently been their target. In the case of Joey, whom I shall discuss here, I concluded from my observations of his stereotyped behavior that the symbolic violence which constantly engaged him represented a compromise between an overriding impulse to kill and an equally powerful need for restraint.

Although modern psychoanalytic techniques have demonstrated for some time that schizophrenia is not only reversible but curable, there is still considerable confusion regarding not only cure, but cause, and beyond that, diagnosis, particularly as it relates to