Chapter III: Autism Proper - Timmy

This sturdy and handsome boy came to treatment at the age of six years and nine months, and was seen five times per week for approximately four years with significant, but on the whole disappointing results. However, the process of the analysis as seen at the time and as comprehended in retrospect through comparison with other cases, has come to form the foundation of our conception of the Autistic State Proper. The difficulty of exposition is very great indeed and we therefore wish to outline the plan in advance so that it may be followed more easily.

We will present first a history composed of selected facts from his development, that is, facts selected because of their special relevance to the treatment experience. Then we will record one of the early sessions with Timmy, chosen because of its completeness in sampling the phenomena that he presented in the playroom. Upon this background of history and clinical description we will then describe in a more general way the transactions of the first three years of the treatment in order to demonstrate how the mind and body of the therapist came gradually into possession of a consortium of qualities and functions that could pull together the child's scattered mentality. Only then could a process recognizable as infantile transference evolve. Finally we will describe the transference events and their outward manifestations during a period in the fourth year centering on a most interesting lapse in Timmy's previously well-established faecal continence.

Timmy was the third of four children of a united couple and the only manifestly disturbed child. The parents were intelligent and well-educated upper-middle-class people, and the father's high position in an international firm required that they live abroad. The two exceptions to this were a period of prolonged convalescence for the mother when Timmy was five months old, and the first three years of his psychotherapy.

The first five months of his life wer