Links between Henri Rey's Thinking and Psychoanalytic Work with Autistic Children

Reading the newly-published collection of Henri Rey's papers (Rey 1994) has been an extremely stimulating experience. Previously I had been familiar only with the paper included in Melanie Klein Today ‘Schizoid phenomena in the borderline’ (Rey 1979). Members of the Borderline Workshop at the Tavistock Clinic have heard about Rey's ideas through John Steiner, who has also discussed them in his recent book, Psychic Retreats (Steiner 1993). We now have the opportunity of reading the clinical detail on which these ideas are based.

The patients Rey describes are borderline adults, who, as he says, are able to make use of the verbal capacities of that part of their personality that has developed a higher level of symbolic functioning in order to convey the elemental terrors that besiege another part of them. These terrors are identical to those that child psychotherapists encounter in autistic children, and that have been described particularly by Tustin (1972, 1981, 1986, 1990) and by Meltzer and his co-workers (Meltzer 1975). These are the fear of falling through endless distances, of having their limbs or bits of their skin torn off, of their heads coming off their shoulders, of losing everything from inside their bodies. Just as we find that we can learn more about these states from those autistic children who have recovered sufficiently to be able to put them into words, so does the experience of adult borderline patients provide an invaluable additional perspective, at the same time as raising important issues of development and classification. For instance, one might wonder about differences between the adult neurotic patients with encapsulated autistic pockets, as described by Sydney Klein (Klein 1980), and Rey's patients who experience themselves as literally in a borderline no-man's land — neither adult nor child, neither male nor female, neither homosexual nor heterosexual — nowhere.

I should like to begin by quoting brief vignettes of some of these patients, si