Autism

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Autism has had two meanings. The first, historically associated with schizophrenia, refers to the investment of a person's psychic energy in his or her own delusions, which prevents the person from investing in the outside world. The second refers to an absence of development of communication with others beginning in earliest infancy.

The word was introduced into the psychiatric vocabulary by Eugen Bleuler in 1911 in his description of schizophrenia. However, a hint of it could be detected as early as 1907 in the correspondence between Freud and Jung: "Bleuler still misses a clear definition of autoerotism and its specifically psychological effects. He has, however, accepted the concept for his Dem[entia] pr[aecox] contribution to Aschaffenburg's Handbook. He doesn't want to say autoerotism (for reasons we all know), but prefers 'autism' or 'ipsism"' (Freud and Jung, p. 44-45).

Bleuler, who very early on took an interest in Freud's work, did not accept his libido theory, and this was the reason for the amputation that produced the word autism from autoerotism: to distance it from the libidinal significations of the latter term, while keeping the former's Greek root, auto, meaning "self." For Bleuler, the autism of schizophrenia is a shutting-in of the subject in an impenetrable, incommunicable world, closed in on itself, made up of unorganized delusional elements to which all the subject's disposable mental energy is attached.

In 1943, Leo Kanner adopted the term to describe "early infantile autism," a syndrome associated with problems of communication and social behavior, as well as serious developmental disturbances of mental functioning, most notably of imagination

Psychoanalytic research bearing upon infantile autism led to significant advances in the understanding of the beginnings of psychic life. From the genetic point of view, for example, infantile autism corresponds to a stage of psychical development to which the child regresses or remains fixated. In research with normal infants after her initial studies of autistic children, Margaret Mahler placed autism on a developmental axis that progresses from birth to "separation-individuation." Donald Winnicott attributed the genesis of autism to maternal care, particularly the ability to protect the infant from inconceivable anxieties: a feeling of disintegration, being unable to stop falling, lacking relation to its own body, and having no orientation. Bruno Bettelheim defined the "extreme situation" that set the baby on the path to becoming autistic as a feeling that it could not act in a manner favorable to itself, but that every action on its own part could only be unfavorable because of a "mutuality" between the child and its mother.

From the structural point of view, autism is governed by a structure that establishes mental functioning. The students of Jacques Lacan developed the concept in this direction by relating it sometimes to the concept of "foreclosure" (Piera Aulagnier and Maud Mannoni), sometimes to "jouissance" (Éric Laurent), and sometimes to the "topology of the subject" (Rosine and Robert Lefort).

From a dynamic point of view, it was possible to explore infantile autism in terms of the transference and counter-transference. In 1975, Donald Meltzer proposed a model articulated around three concepts: "the dismantling of the ego," "the bidimensionality of the object relation," and "the adhesive identification." Dismantling is a splitting of the ego along the lines of articulation of the different sensorial modalities, so the autistic child never concentrates feelings on the same object, and stimuli received is never synthesized. The world, perceived in this way, is without depth or volume and is reduced to a juxtaposition of sensations. Bidimensionality is a mode of relation to a libidinal object, established in a world without depth. It is a relation of surface to surface, a binding with an object not experienced as having an interior. Adhesive identification is the result of bidimensionality: the self identifies itself with the object on the surface, owning to no more interior space than the object itself. This prevents mental communication necessary to the development of thought.

Later, Meltzer proposed a model based on the theory of "aesthetic conflict." He suggested that the fetus, at the end of pregnancy, is eager to exercise its senses but receives only the most filtered stimuli in utero. Birth would be experienced as liberation and as something marvelous because of the abundance of sensorial stimulation. The impact would be experienced as an intense aesthetic experience that would at the same time be a source of anxiety because of the vivid contrast between the infant's overabundant awareness of the qualities of the object's surface and complete misrecognition of the object's interior. Occasionally, the impact of the aesthetic object would be so intense as to force the infant to withdraw into infantile autism.

Frances Tustin has emphasized a fantasy of discontinuity, which the autistic infant experiences physically as the tearing away of a part of its own substance. So long as it lacks the experience that makes possible symbolization, an infant would seem to require the illusion of continuity between its body and the object upon which its drives are satisfied. The autistic infant imagines a catastrophic rupture in this continuity that takes the form of a fantasy of mouth-tongue-nipple-breast, experiencing a damaged breast and torn-off nipple that leaves the mouth a black hole inhabited by tormenting objects. To protect itself from the pain caused by this black hole, the autistic infant constructs the delusion of merging with the environment that abolishes any separation or space, any difference or alterity. To maintain these delusionary autistic objects, concrete objects are not manipulated for use value or symbolic value, but solely for the surface sensations that they offer, giving the illusion of continuity between body and environment. By means of his or her own secretions (tears, saliva, urine, feces) and autistic objects, the subject creates what Tustin called "autistic forms," which are cutaneous or mucous with nebulous, unstable contours. The autistic subject procures these as a salve to minimize pain and as protection from the exterior world. But these autistic forms cannot be shared with others or identified with objects in the external world. The autistic child uses sensitivity to stimuli to protect himself or herself from the external world; Frances Tustin calls this "perverse self-sensuality."

See Also

References

  1. Freud, Sigmund, and Jung, Carl G. (1974a [1906-13]). The Freud-Jung letters: the correspondence between Sigmund Freud and C. G. Jung (William McGuire, Ed.; Ralph Manheim and R. F. C. Hull, Trans.). Princeton: Princeton University Press Press.