The autistic pseudosignifier: Imaginary dialectization of signs in the clinic of autism

Language specificities in autism

Specificities in language and speech development are a defining feature characterizing individuals who are diagnosed today on the autism spectrum (ASD) as well as one of the major determinants in their prognosis (Mawhood et al., 2000). It is estimated that about 40% of the individuals diagnosed according to this scale do not use spoken words to communicate (Centers for Disease Control and Prevention, 2018). Those who do develop language proficiency commonly use language in a literal or concrete way that is lacking in generativity and limited in flexibility (Hobson, 2012). This affects their ability to comprehend, engage with, and adjust to the perspective of other people and limits their ability to construct stable conceptual frameworks that transcend the immediate context of experience (Erard, 1985, p. 112). When it comes to the understanding of symbolism, these difficulties give rise to marked disadvantages that are especially noticeable in symbolic play (Herrera et al., 2006; Hobson et al., 2009), particularly when attempting to encode general concepts (e.g., “flock”), ambiguities (e.g., “it”) and abstractions (e.g., “time”) into their vocabulary (de Marchena et al., 2015; Grandin, 2006; Plaisted, 2001).

A variety of alternative and augmentative language and communication aid systems for autistic people have been developed in the past; among them, the Picture Exchange Communication System (PECS) has been the most notable. PECS is part of the Applied Behavior Analysis (ABA) framework and is based on predetermined conditioning schemes that attach signs to referents using various reward systems. It aims to teach autistic children that iconic signs can be used for communication, such as in articulating responses to requests or for commenting on the environment; that signs can also be discriminated from one another according to their desirability and then used to form requests such as “I want the ball” (Ganz et al., 2012).

PECS, however, does not provide autistic subjects with the capacity to encode abstract, ambiguous, or general concepts. Rather, it focuses on the acquiring of rigid relationships between iconic signs and referents: it teaches the child a predetermined objective knowledge and, in this sense, disregards the unique ways autistic children think as well as the unique solutions they find for their own problems. Most importantly, it does not concern itself with the subjective effects that are a major goal of psychoanalysis: those effects, beyond pedagogy, that are at the level of one’s body, identity, and situatedness in the humanized world.

This article investigates unique modes of encoding that do grant autistic subjects access to this level of conceptual complexity. Toward that end, an etiological description of the role that language plays in autism is presented in the context of Jacques Lacan’s psychoanalytic teaching. On the basis of clinical evidence, a theory of the dialectization of iconic signs is developed that is premised on the synthesis of nonconcrete, idiosyncratic images and that, ultimately, can provide a method of tackling the symbolization difficulties reported by autistic subjects. This theory is then associated with a unique psychoanalytic position in regard to the treatment of autism that aims to enrich one’s vocabulary and have an effect on one’s subjective position.

Pseudo-Concepts in autism

Many autistic subjects and case studies of autistic clients attest to the fact that the conceptual poverty that characterizes autistic sign language is not ineluctable. These demonstrate that, by using their memorizing skills and the manipulation of signs, autistic subjects are able to encode and understand complex concepts. This section will focus on the case of Temple Grandin, whose extraordinary memorizing skills and particular talent in manipulating mental imagery enable her to encode general, ambiguous, and abstract concepts into her vocabulary using iconic signs. It is on the basis of Grandin’s (2006) detailed description of this process that a psychoanalytic theory of the dialectization of signs will be developed and provided with clinical support.

According to Maleval (2012), “the autistic child particularly appreciates icons . . . which schematically represent the entity, person, event or attribute” (p. 40). This appreciation is widely elaborated in Temple Grandin’s (2006) book Thinking in Pictures, in a section where she describes how she enjoys studying images in a photographic way (p. 13). Using her remarkable memorizing skills, she can “photocopy” a written page or a piece of art and later take the images she memorized and rearrange them in her mind to create new images. She says that this works like a computer graphic editor, placing the images she remembers on a computer screen, superimposing them, rotating them in three-dimensional space, redrawing them, and even playing and replaying them like a movie (pp. 12, 15). Grandin adds that her capacity to “think in pictures” is like an internet image search engine such as Google images. The more pictures she collects into her database, the more complex her imaginary constructions become and, at a certain point, like a jigsaw puzzle, they assemble into “picture categories” that are akin to “word categories” that form concepts (pp. 31–32).

This is how Grandin (2006) describes her capacity to encode general concepts into her vocabulary like the word “dogs”:

My concept of dogs is inextricably linked to every dog I’ve ever known. It’s as if I have a card catalogue of dogs I have seen, complete with pictures, which continually grows as I add more examples to my video library. If I think about Great Danes, the first memory that pops into my head is Dansk, the Great Dane owned by the headmaster at my high school. The next Great Dane I visualize is Helga, who was Dansk’s replacement. The next is my aunt’s dog in Arizona, and my final image comes from an advertisement for Fitwell seat covers that featured that kind of dog. My memories usually appear in my imagination in strict chronological order, and the images I visualize are always specific. There is no generic, generalized Great Dane. (p. 12)

Grandin emphasizes that, in comparison to nonautistic subjects, who are able to conceive of vague generalized pictures or semispecific pictures in their minds when they think about the word “dog,” in her case, she conceives of a set of the specific pictures of all the dogs she has ever seen.

Most children who enter language by using signifiers overgeneralize at lexical, morphological, and syntaxial levels (Ambridge et al., 2013). Their acquisition of concepts is characterized by a movement from the general to the particular. Accordingly, for example, a nonautistic child would begin by identifying all birds as “chicken,” only later learning to distinguish between a “chicken” and a “duck.” On the contrary, many studies suggest that autistic children have difficulties generalizing (de Marchena et al., 2015; Plaisted, 2001). Correspondingly, the process Grandin (2006) implements to enter language starts with the specific and works toward generalization: “My thinking pattern always starts with specifics and works toward generalization in an associational and consequential way” (p. 16). As the aforementioned example of the word “dogs” illustrates, Grandin constructs a visual configuration composed of a catalogue of associated particular images; this configuration functions as a general concept that she can then use in order to understand the world and interact with others. In this case, the common name designating the species “dog” is encoded into Grandin’s vocabulary by opposing a multiplicity of pictorial proper names, each referring to an image of a particular dog.

In a most compelling paragraph, Grandin explains how she is able to encode abstract concepts:

I visualized concepts such as peace or honesty with symbolic images. I thought of peace as a dove, an Indian peace pipe, or TV or newsreel footage of the signing of a peace agreement. Honesty was represented by an image of placing one’s hand on the Bible in court. A news report describing a person returning a wallet with all the money in it provided a picture of honest behavior. (p. 17)

In the same way she encodes even more complex idioms, by breaking them down into a specific configuration of images. For instance, the “power of glory” is constructed by interposing the image of a semicircular rainbow and an electrical tower.

Grandin (2006) adds that the encoding of complex concepts into her language not only gives rise to a quantitative effect of an accumulation of signs but also has a qualitative effect that is meaningful, all-encompassing, and affects her subjective position. Particularly, she says that whenever she revises a concept in such a way, it is like “getting a new version of software for the computer” (p. 11). These “software updates” also characterize moments of subjective transition and major change in her life, like graduating from high school and enrolling in a college. She can encode these moments of personal growth and change in her life by associating them with an image of herself going through a particular door. “Each door or gate enabled me to move on to the next level,” she says, testifying to the transformative power of her linguistic-imaginary inventions (p. 18). The next section will delve further into the nature of these subjective effects in psychoanalytic terms.

The inventive supplementary constructions mentioned above are referred to by Maleval (2009) as “pseudo-concepts” (pp. 210–211). “Pseudo” literally means: supposed or purporting to be but not really so; false; not genuine; or resembling or imitating. Correspondingly, Grandin (2006) admits that the power of her pseudoconcepts is limited. For instance, when a text has no concrete meaning, like the text in philosophy books, Grandin is unable to convert it into pictures and it remains incomprehensible for her (p. 15). She adds that there are many other concepts that she has not been able to encode using visual corollaries, particularly notions pertaining to “getting along with people” (p. 20).

Grandin’s (2006) method for encoding pseudoconcepts is distinct from the linguistic skills acquired through other facilitative methods such as PECS. First, encoding pseudoconcepts does not have anything to do with attaching a sign to a referent. On the contrary, it is a sophisticated process in which a sign that lacks a referent is encoded into one’s vocabulary. Second, Grandin’s method itself is idiosyncratic in the sense that the encoding of pseudoconcepts is done by interposing iconic signs that she relates to specific events in her life, which have a particular meaning for her. Accordingly, a system based on Grandin’s method cannot offer predetermined schemes for encoding pseudoconcepts and, correspondingly, cannot predict in advance what signs would be useful for each and every subject. This necessitates adopting a case-by-case framework.

Third, the method does not rely on semantics—what Lacan would refer to as the “signified”—but instead imitates the way signifiers function in the process of signification. Grandin concerns herself neither with matching dictionary definitions nor with the symbolic form of the icons she chooses; she fabricates oppositional formations of signs that are not necessarily semantically related to one another. Moreover, one of the most remarkable features of Grandin’s (2006) method is its capacity to affect her position as a subject. These are therapeutic effects beyond the level of pedagogy and are disregarded by language and communication aid systems that rely on the applied behavior analysis (ABA) model.

Finally, Grandin’s (2006) account focuses on the construction of pseudoconcepts using iconic signs. This method of encoding is common to autistic subjects who are considered to be “visual thinkers,” that is, individuals who think in photographically specific imagery. However, Grandin emphasizes that there are different types of specialized thinking that can be said to characterize autistic subjects. Other than visual thinkers, there are also “music and math thinkers” who think in patterns, identifying repetitions and relationships between sounds and numbers instead of photographic images. There are also “verbal logic thinkers” who think in word details. These are autistic subjects who are word specialists, excelling in studying languages, statistics, and other forms of organized knowledge (pp. 28–29). Therefore, we see that while autism is considered as a single clinical structure, it has many shades which depend on the particular use of signs and implemented by each subject. Accordingly, it is hypothesized that each of these types of autistic thinkers could develop different methods capable of constructing pseudoconcepts in a way homologous to the one presented by Grandin (2006).

Lacanian perspective: Imaginary dialectization of signs

This section will develop Grandin’s (2006) particular method for encoding complex concepts using iconic signs into a psychoanalytic theory of autism. It will focus on the way that signs can be manipulated in the creation of pseudoconcepts using Lacan’s theory of the master signifier and its “dialectization” during an analysis. ⁷ By doing so, the following section will offer a theory of the “imaginary dialectization of signs” as a possible course of treatment for autism.

One of the prototypical forms of intervention in a Lacanian analysis concerns what Lacan calls “master signifiers.” As noted earlier, Lacan (1955–1956/1997) relies on the linguistic theory of signifiers to expound on various functions of the psyche (p. 167). In the late 1960s and 1970s, he added that among these signifiers, there are some qualitative distinctions; one of them being the distinction between what he calls a “master signifier,” which he denoted as S1, and the rest of the signifying chain, which he calls “binary signifiers” and denotes as S2. Binary signifiers are just “regular” signifiers that take part in the process of signification through their relationships with other signifiers. Master signifiers are privileged signifiers that are disproportionately important in relation to binary signifiers. They are usually signifiers that have the utmost value for the subject and their validity is commonly accepted without debate (Bracher, 1994, p. 112). Master signifiers receive their privileged position in the discourse of the subject because they come as an answer to those aspects of discourse where libidinal elements cause a fundamental distortion, that is, the places where discourse is unable to “say it all.” This is why master signifiers have an important role in the distribution and arrangement of affects in the libidinal economy of the subject (Hook & Vanheule, 2016, p. 6).

According to Fink (1997), master signifiers are often recognized in analysis by the fact that the client repeatedly comes back to them (p. 77). They could be terms like “death,” “embarrassment,” “narcissism,” or any other term that always seems to halt the subject’s speech: to close down meaning-making and stop the chain of association, instead of opening things up (p. 135).

According to Bailly (2009), one of the main features of an analysis is to bring to light the master signifiers in the unconscious (p. 64). Fink (1997) articulates this in a more nuanced way when he argues that one goal of analysis is to “dialectize” master signifiers (p. 77). In this process, the analyst’s interventions aim to “clear the blockage” imposed by the master signifier in the client’s discourse (Hook & Vanheule, 2016, p. 7). The term “dialectization” is used by Lacan to refer to the way in which the symbolic opposition of two terms can affirm a third term (Miller, 1996, p. 245). In this sense, dialectization is to be understood as a symbolic effect that goes beyond the constancy and fixation of one master signifier producing a movement in the signifying chain (Fink, 1999, p. 43). ⁸

Fink (1997) adds that this is achieved by bringing master signifiers into relation with other binary signifiers. In other words, by insisting that the patient might elaborate more around the dead ends and introducing possible alternate avenues for elaboration, to turn these dead ends into pathways (p. 78). This can be represented by the famous Lacanian formula S1—>S2. This formula states that, on the one hand, S1 is positioned at the beginning of a signifying chain, giving rise to the articulation of S2. However, on the other hand, in terms of the signifying process, S2 retroactively determines S1 and, more particularly, the position of the subject in relation to S1 (Hook & Vanheule, 2016, p. 6).

Lacan (1966/2006) argues that “the signifier represents the subject to another signifier” (p. 694). In this sense, when the master signifier is linked with a new set of signifiers, a shift in the subject’s position in relation to this signifier can happen as well. Hook and Vanheule (2016) call this a “movement from the subjugation [to the S1] to subjectivization [of the S1]” (p. 8). In other words, when a master-signifier is dialectized, the subject assumes a new position in relation to its discourse. Instead of repetitively circling the total opacity of the master signifier, the client articulates something of the inane hold that the signifying process has on their own subjective co-ordinates. This kind of articulation has a subjective effect and its cultivation is part and parcel of the treatment of neurosis. ⁹

Grandin’s (2006) construction of pseudoconcepts can be said to be structurally homologous to the dialectization of master signifiers described by Fink (1999). However, it is not reducible to the clinic of neurosis—because instead of dialectizing a master signifier, Grandin (2006) dialectizes a multiplicity of iconic signs. As stated earlier, the sign is a linguistic unit that embodies a rigid biunivocal relationship between a sensory form and a referent. When one encounters a sign that lacks a referent it becomes very difficult to encode it into one’s vocabulary. This is the problem autistic subjects face when attempting to encode general, ambiguous, and abstract concepts. Grandin’s solution to this problem is to establish a relationship between a multiplicity of iconic signs in order to produce an iconic category that functions as the referent for the original sensory form. This iconic category produces an effect in which the meaning of the whole matrix of interposed signs exceeds the particular meanings of its parts. Or, in other words, it produces a new concept that is more than the qualitative accumulation of the signs that compose it.

Grandin (2006) could be said to interpret a set of images as a metaphor rather than a sequence of literal representations (Arendell, 2015, p. 73). In compliance with Evans and Dubowski (2001), we might argue that in doing so she develops a level of “representational insight” that leads to a sensitivity to symbolization (p. 59). Therefore, I suggest referring to it as the imaginary dialectization of signs. Compared to the symbolic dialectization of the master signifier, this unique form of linguistic manipulation is imaginary, first, because it is achieved through the use of iconic signs and, second, because it imitates the functioning of signifiers in the process of signification: imitation being an imaginary compensatory strategy implemented in psychotic stabilization (Lacan, 1955–1956/1997, p. 251).

The effects of the imaginary dialectization of signs correspond with what Maleval (2021) describes as the “thawing of the master signifier” in autism (p. 176). Recall that master signifiers have an important role in organizing the libidinal economy of the subject. Accordingly, Maleval (2021) argues that a “retained” alienation in autism blocks the operationality of the master signifier and thus freezes the subject’s affective life (p. 78). In comparison, I argue that, rather than “thawing” and reinstating the master signifier, the dialectization of signs offers a substitute for its libidinal function. In this sense, it gives rise to particular alterations on the level of drive functioning, where the “aimless” movement of the drive circuit is circumvented by a “rim” that locally organizes its trajectory (Brenner, 2020, 2022). In doing so, the imaginary dialectization of signs can be said to treat the disjunction between affect and language in autism (Maleval, 2009, p. 216), providing the subject with an opportunity to expand their affective vocabulary in a safe and nonthreatening way. One could argue that it demonstrates the way art can sometimes dialectize what cannot be encoded in symbolic representation and, in this sense, could also be referred to as a unique form of sublimation (Freud, 1910, pp. 15, 29). ¹⁰

The clinic of the pseudosignifier

Fink (1997) explicitly addresses the dialectization of master signifiers in autism when he comments that “autism might be seen as a case in which there is one or only a very few master signifiers that are virtually impossible to dialectize” (p. 78). In contrast, we see now that it is not the scarcity of master signifiers that characterizes autism but rather the autistic subject’s sole recourse to the sign. What we discover in Grandin’s (2006) account is that through the imaginary dialectization of signs, autistic subjects can in fact encode general, ambiguous, and abstract pseudoconcepts into their vocabulary, giving rise to a substantial effect on their subjective position that is commonly associated with the function of the master signifier.

Clearly, the autistic pseudoconcept fulfills some of the functions of the Lacanian signifier. However, can we say that the autistic subject, by dialectizing the sign, is able to gain access to the level of the signifier? There is an ongoing debate regarding the autistic disposition towards the use of signs instead of signifiers. Inherent to this debate is a question: Do we see in autism the “primacy of the sign” or do autistic subjects demonstrate a “sole recourse to the sign”? In recent years, Maleval has softened his approach regarding the autistic sole recourse to the sign. For instance, Maleval (2018) argues that autistic subjects do have a passive and reduced mode of access to the domain of signifiers in addition to their recourse to the sign. He adds that some autistic subjects develop an expressive language that can progressively “mobilize the signifier” (Maleval, 2021, p. 182). The autistic dialectized sign might indeed personify a mode of reduced access to the functions of the signifier. However, as I have stressed in the past, even if the sign incorporates some of these functions, this does not necessarily make it one (Brenner, 2020, p. 222). Recall that a signifying chain is composed of phonological elements that by themselves signify nothing, while the autistic pseudoconcept is a construct made of a multiplicity of signs, each referring to a particular image. In this sense, instead of determining the pseudoconcept as a fully fledged signifier, I suggest referring to it as a pseudosignifier: a unique construction, reserved to the work of autistic subjects with signs. For autistic subjects who reject the Other as the locus of signifiers, it becomes a supplementary construction that marks out a space for an ancillary “synthetic Other” composed of signs and pseudosignifiers (Maleval, 2009).

From a Lacanian perspective, even though the prefix “pseudo” might literally mean “fiction,” it does not lose its relation to truth. For Lacan (1959–1960/1992), “‘fictitious’ does not mean illusory or deceptive as such.” On the contrary, according to Lacan, “every truth has the structure of fiction” (p. 12). Correspondingly, in terms of the pseudosignifier, it is not so much its falsity that is at stake, but rather its meaningful effects and the dramatic change it introduces into one’s life.

So far, we have attributed the meaningful effects of the pseudosignifier to the construction of concepts. However, one must note that the dialectization of the sign does not only provide an intellectual gain. As noted earlier, akin to the dialectization of the master signifier, the dialectization of the sign also affects one’s subjective position. In the more psychodynamic clinical setting, this type of dialectization will commonly take the form of artistic creation in the context of art therapy.

For instance, in their work with autistic subjects, art therapists Evans and Dubowski (2001) argue that visual art can facilitate the creation of a sign system that can form the basis of further language development. They add that, through their engagement with images, autistic children can form a language and develop the vocabulary of that language (p. 36). In their model of interactive art therapy, Evans and Dubowski use art as a means of linguistic expression that gives a particular form to that which is being experienced, expressed, and communicated in the therapy room. They state that “like language, art has its own structures and mechanisms for creating, shaping and concretizing ‘meaning’” (p. 58). In practice, Evans and Dubowski encourage playful drawing experiments that help establish mechanisms for encoding complex representations, which are in turn necessary for the development of symbolic systems that enable the expression of more complex abstract concepts. Evans and Dubowski focus on the maintenance of the transference ¹¹ and the introduction of materials and activities that enable the development of the dynamics that condition the capacity for symbolization (p. 101).

Martin (2009) proposes a practical framework of art therapy for autistic subjects that allows for the development of flexible thinking and the ability to encode abstract concepts into their vocabulary. He states that “art is both literally and figuratively a useful ‘drawing board’ for the mind’s pictures” (p. 67). He provides a clear schematic for the creative process in a clinical setting and elaborates its steps (p. 68). Martin adds that abstract representation can be developed through artistic projects that aim to create personal symbols that represent the child’s interests or feelings. When facilitating the development of these complex artistic representations, Martin notes the child’s favorite themes and materials as well as the length of their playtime; he then rates their activity along a continuum from least independent to most independent (p. 69). By supporting the child’s independent inventions in the transference, a nonfigurative or abstract representation can sometimes be created using elements of art such as color, composition, scale, placement, and so forth. Martin then compels the child to assign associations with the abstract elements (e.g., blue is cold, jagged line is frustrated, etc.) until a title is attached to the piece. Correspondingly, in his work with a 3-year-old autistic child, the child molded several figures out of clay, each referring to an object recalled from memory. When asked to name these objects, the child calls them: cup, cupcake with candle, cake with candles, ice cream cone (see Figure 1, left to right). As Evans (1998) suggests, in naming a scribble as something, children open up both a possibility for the interpretation of other new things and the ability to see relationships between them. She adds that this can compel them to create symbols that form the scaffolding for the future development of their linguistic skills (p. 21). Thus, in a case presented by Martin (2009), after naming some clay figures, a child goes on to compile them into a montage that he names “birthday party.” By doing so, he encodes the concept into his vocabulary and consolidates the anxiety that arose when recalling the memory of his birthday party (p. 70).

OPEN IN VIEWER

Figure 1.

“Birthday party” composed of a cup, a cupcake with a candle, a cake with candles, and an ice cream cone. From Art as an early intervention tool for children with autism (p. 70), by N. Martin, 2009, Copyright 2009 by Jessica Kingsley Publishers. Reprinted with permission.

In a similar vein, Emery (2004) describes how, in the context of art therapy, a 6-year-old autistic child first draws a picture of his favorite restaurant—a McDonald’s sign with big arches. Then the child draws a picture of the exterior of the restaurant including its playhouse. Following the second drawing, the therapist asks the child how he gets there, and the child responds that his mother drives him. The therapist then asks the child to draw this picture. After some struggles the child draws a picture of a car and a picture of his mother and himself. He goes on to put the three pictures side by side and draws a ground line across the bottom of all three pages. At this moment, the child is able to contextualize several images for the first time. In reviewing this case, Gazeas (2012) suggests that this signifies significant growth in his therapy, which finally leads him, in the end of his therapy, to gift his therapist with a booklet including drawings of his favorite restaurants.

Commonly, when asked to draw a picture of a tree, an autistic child will draw a particular tree that they encountered in the past. These cases exemplify the use of art materials in a concrete rather than a symbolic way (Segal, 1957). Similarly, in a case study presented by Rees (1995), a 30-year-old autistic adult draws a collection of elements but is unable to come up with a single title to describe them. Thus, a single drawing that includes the figures of Santa Claus and a dog is called “Santa Claus and dog.” When the opposition of two terms does not affirm a third term—as seen in this case—we cannot say that this artistic creation involves dialectization.

In terms of working with autistic adults in the context of art therapy, Elkis-Abuhoff (2008) presents a case of an 18-year-old person named Emma diagnosed with Asperger syndrome who comes to therapy complaining of difficulty in school and socializing with her peers. Elkis-Abuhoff describes how, through her work with collages, progress in Emma’s therapy could be noted. He describes how Emma was initially only able to draw collages that included nonhuman elements that did not touch each other. As the therapy progressed, Emma was able to add new elements into the collages, particularly human elements, and that helped her express her feelings and to connect with other people. Elkis-Abuhoff describes a dramatic change in Emma’s position in society and a drastic increase in her involvement with her peers at school. Finally, he remarks that, through her work with the collages, Emma could open a “new channel of communication that had been previously unavailable and unknown to [her]” (p. 269). He adds that the exploration of the notions raised through her work with images and their elaboration in her therapy enabled Emma to “incorporate the exercise outcomes into her identity, changing her perceptions and behaviors” (p. 269).

When addressed through the psychoanalytic framework developed in this article, the aforementioned clinical case studies can be described as exemplifying the imaginary dialectization of signs using figurative iconic representations. By attaching a common name to constructs composed of a multiplicity of pictorial proper names, the clients presented in these case studies experience the creation of pseudosignifiers. In doing so, they encode complex concepts into their vocabulary but also address affective factors in their therapy, bringing forth important changes in their position as subjects in the world. In other words, they supplement their initial refusal of the alienation in language. This enables them to safely deposit intimate aspects from their affective life in a semantic domain that can be shared with others.

In previous publications, I have identified several modalities of the implementation of the sign in the clinic of autism for its protective, dynamic, and social gains (Brenner, 2020, pp. 259–261; 2021, 2022). If it is indeed the case that the dialectization of signs has substantial clinical effects, the work with iconic signs in the context of art therapy can be added to the list of the different modalities of the implementation of the sign in the clinic of autism. This modality necessitates a distinct psychoanalytic position in the treatment of autism. By adopting this position, the analyst facilitates the production of pseudosignifiers by identifying points of stoppage in the subject’s conceptual encoding and assists in the dialectization of signs. As is seen in the examples provided by Elkis-Abuhoff (2008), Emery (2004), Evans (1998), Evans and Dubowski (2001), Martin (2009), and Rees (1995), this approach, when implemented in the context of art therapy, can address communication difficulties and assist in developing symbolic systems that provide the means for encoding complex concepts into one’s vocabulary. It is by developing a mastery in the dialectization of signs that art therapy can provide autistic subjects with the conceptual complexity that enables a sense of autonomy that can provide a link to the outer world, leading to other substantial subjective effects and impacting their lives (Martin, 2009). It is not the acquisition of relationships between signs and referent, but rather the mastery of the dialectization of signs and the synthesis of pseudosignifiers that is the aim of this psychoanalytic orientation. In this, it differentiates itself from other more pedagogical approaches, such as PECS, that aim to teach language to autistic children. However, most of all, it is unique in claiming that this mastery can be gained only through the particular inventions brought about and cultivated in the transference on a case-by-case basis.