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Robin Holloway’s recent book, Asperger’s Children, contributes substantially to the discourse on the psychoanalytic understanding and treatment of children with ASD.† Holloway’s discussions of splitting and projective identification of bully and victim aspects of the patient, together with his consideration of primitive anxieties and defenses characteristic of children with Asperger’s, are both insightful and clinically useful. In addition, Holloway calls attention to pressing issues within the field. At the forefront is the need to build bridges between psychoanalysis and practitioners in disciplines with differing points of view, who also work in the field of autism and whose knowledge and experience can enrich psychoanalytic work. Collaborative approaches—Gilbert Kliman’s Reflective Network Therapy in which psychoanalytic clinicians work with ASD children in educational settings comes to mind—offer a way that analytic understanding of ASD can contribute to effective treatment for millions of children and adults who suffer from autism.† Second, since ASD is clearly a neurobiological disorder with neurological deficits, as well as psychological conflicts, can psychodynamic therapy make a significant contribution to treatment? Also, can a therapist convey realistic optimism about an ASD patient’s ability to change and have a fulfilling life? After providing a brief overview of Holloway’s comprehensive volume, I will attempt to contribute to the discussion regarding conflicts and deficits.
In chapters two through eight, Holloway presents “clinical dialogues” with patients, ranging in age from nine to thirty-one. Each “dialogue” presents
case material replete with verbatim interchanges that convey the quality of the therapist-patient relationship. These “dialogues” provide the clinical basis for the remainder of Part One and demonstrate Holloway’s sensitivity and attunement to his patients, as well as his own emotio