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This is an updated edition of Francis Tustin's 1981 book of the same title. The earlier book received great acclaim, not only from those professionals working in the field of child autism but from a wider audience of those concerned with the whole variety of mental health work from a psychoanalytic viewpoint. The author offered a theory of autistic functioning and its development which was convincing, extremely well described, and above all stemming from her humane wish to reach these extremely cut-off children.
In the present volume Tustin adds an introductory chapter, in which the clinical presentation of the autistic child is described. The other major change is a theoretical one. Tustin no longer believes that the origins of autism lie in a normal stage of development and stem from a regression to, or sticking in, that stage. She now regards that the autistic infant's failure to cathect the external world in preference for ‘swaddling’ itself in ‘swathes’ of auto-generated sensation to be pathological from the beginning. (I quote these words to give a flavour of Tustin's ability to convey the autistic child's experience with a poetic evocation.)