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This is a treatise on psychotherapy with autistic children written by a sensitive, articulate, experienced therapist who can convey the psychotic process and the relevant phases of therapy. Francis Tustin was analyzed by W. R. Bion. She works at the Child Guidance Training Center in London, which is affiliated with a day unit and a hospital for psychotic children, and she supervises child therapists at the Tavistock Clinic. The definition and description of the child's problems, and the theory behind the technique of the therapy follow the Kleinian approach.
Tustin begins by suggesting changes in Kanner's concept of autism by stating that it “misses the point that pathological autism seems to be an arrest at, or regression to, an early developmental situation which has become intensified in a rigid form.”
Tustin takes the position that “normal primary autistic processes are of the nature of sensations arising from inbuilt dispositions” and are not cause for alarm unless the child is incapable of sufficient uses of nurture and “remains in, or regresses to, a sensations-dominated state.” The cognitive and emotional developments then stop or deteriorate and “in this state of inanition primary autistic processes perseverate or are reinstated.” This is pathological autism. Later she distinguishes abnormal primary autism, encapsulated secondary autism and regressive secondary autism. She keeps these distinctions throughout the book in terms of theory, clinical examples, and therapeutic recommendations. She has ten pages of charts on these distinctions. There are also three pages of charts in which she distinguishes infantile autism from childhood schizophrenia.
While this book was obviously written for the child therapist, there