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Notice — The original version of the Prologue by Katharine Gould has been removed, and a corrected version posted here.
“There is from the start an extreme autistic aloneness that whenever possible disregards, ignores, shuts out anything that comes to the child from outside.” (Kanner, 1943)
“I'm stuck in a dark cave, but in my hand I have a laser to cut my way outside” (from the dream of an 11-year-old boy with a diagnosis of Asperger's syndrome, 2010)
The purpose of the contributing authors in this issue is to demonstrate the various effective uses of psychoanalytically informed treatment with patients diagnosed with Asperger's syndrome. Collectively, they demonstrate some of the more inspired and nontraditional methods available. This is a timely issue because, in spite of the considerable progress in diagnosing and treating autistic spectrum disorders, there remains a pervasive and misinformed consensus that psychoanalytic therapy is largely ineffective with these patients.
The two opening quotes, which were expressed almost 70 years apart, encompass the largely unchanged understanding of autism and, most important, as will be illustrated by the articles in this issue, they indicate the recent psychoanalytically informed methods of treatment that have made it possible for some of these patients to experience being found and then to reverse the process by finding us. For the eleven year old dreamer quoted above, the outside world was hardly ignored or disregarded. The laser he used to cut himself free was a metaphor for the empathic understanding and desire for reciprocity that he had experienced and internalized in therapy.
Pertinent to the issue's topic is the recent recommendation by the American Psychiatric Association that Asperger's syndrome should no longer be a separate diagnosis, but instead be included under Autistic Syndrome Disorders in its new authoritative Diagnostic and Statistical Manual of Me