This article will describe a long-term psychoanalysis using a self-psychology approach with a child who was diagnosed with ASD (age 4 at the beginning of the analysis). The analytic process, accompanied by deep empathy for the child’s enclosed and different world, relies and builds on the child’s own inner resources. Together the therapist and patient creatively learn about each other so that the analyst can join the child’s world in his own unique way. The analysis raises questions about the potential of psychoanalysis and the psychoanalyst’s role for the autistic patient, who has his own vision of the outside world from within his particular inner world. Can we take his suffering and difference upon ourselves and let him experience belonging and inclusion, thus aiding his developmental process of integrating the fragments of his existence into a living, adaptive, creative person thriving within relationships?