Making the Thought Thinkable: On Introjection and Projection

Ellen Stockdale's paper offers a moving account of the torments and burdens of the perceptual/emotional world of an autistic person. I was particularly fascinated by her description of the relentless echo effect of other people's voices and was led to wonder how this might link with the repetitive phrases and echolalia in autism. I am certain it has implications for therapeutic technique: how would such a person hear interpretations, and how might he or she be helped to reduce the echo effect? It would seem that something is wrong with the medium/space in which the sounds are traveling. Is it too vast, too empty?

It has been well documented that autistic people have difficulty in filtering and regulating their sensory and emotional experience (Tustin, 1981; Dawson and Lewy, 1989). It is either too close, or, as in the case of a very ill passive autistic patient of mine, Robbie, too remote and faint. Robbie's inner world was perpetually empty, and when an object appeared it seemed to have little to offer; he later called it a “net with a hole in it.” As he gradually came more to life and more into contact, one particular fantasy was central. He saw himself as down a deep pit but was able to come dramatically to life when someone threw him a very very long rope to pull him out. This lifeline image seemed linked with the technical problem with which I was constantly faced: namely, how