The paper discusses a new approach to the psychotherapy of the child with autism: the developmentally informed use of the psychotherapist's counter-transference to repair the deficits in a particular subgroup of severely autistic children marked more by indifference than by avoidance. The deficits concern social, communicative, play and self-regulation functions. Infant development research has illuminated certain precursors of social/cognitive development, and it is important that therapists tune responses to the appropriate, possibly very early, developmental level at which the child is functioning. Technical problems involved in dealing with the addictive elements in autistic repetitive behaviours are also discussed. Modem developments in psychoanalytic technique have helped, but even these may need supplementing in the treatment of severely impaired children.
Alvarez, A.
(1992). Live company: Psychoanalytic psychotherapy with autistic, borderline, deprived and abused children. London: Routledge.
2.
Baron-Cohen, S.
(1988). Social and pragmatic deficits in autism: Cognitive or affective? Journal of Autism and Developmental Disorders, 18(3).
3.
Bion, W.R.
(1962). Learning from experience. London: Heinemann.
4.
Bowlby, J.
(1988). A secure base: Clinical applications of attachment theory. London: Routledge.
5.
Braten, S.
(1987). Dialogic mind: The infant and the adult in proto-conversation. In M. Carvallo (Ed.), Nature, cognition and systems. Dordrecht/Boston: D. Reidel.
6.
Brazelton, T.B.
, Koslowski, B., & Main, M. (1974). The origins of reciprocity: The early mother-infant interaction. In M. Lewis & L.A. Rosenblum (Eds.), The effect of the infant on its caregivers. London: Wiley Interscience.
7.
Dawson, G.
, & Lewy, A. (1989). Arousal, attention, and the socioemotional impairments of individuals with autism. In G. Dawson (Ed.), Autism, nature, diagnosis, and treatment. New York: Guilford.
8.
Di Cagno, L.
, Lazzarini, A., Rissone, A., & Randaccio, S. (1984). Il neonato e il suo mondo relazionale. Rome: Borla.
9.
Frith, U.
(1989). Autism: Explaining the enigma. Oxford: Blackwell.
10.
Hobson, P.
(1993). Autism and the development of mind. Hove: Erlbaum.
11.
Joseph, B.
(1989). Addiction to near death. In M. Feldman & E. Spillius (Eds.), Psychic equilibrium and psychic change. London: Tavistock/Routledge.
12.
Kanner, L.
(1944). Early infantile autism. Journal of Pediatrics, 25, 3.
Klein, M.
(1959). Our adult world and its roots in infancy. In The writings of Melanie Klein (vol. 3). London: Hogarth.
15.
Luria, A.R.
(1987). Foreword. The mind of a mnemonist. Cambridge, MA: Harvard University Press.
16.
Macfarlane, A.
(1977). The psychology of childbirth. London: Fontana/Open Books.
17.
Meltzer, D.
(1973). The origins of the fetishistic plaything of sexual perversions. In Sexual states of mind. Strath Tay: Clunie Press.
18.
Meltzer, D.
(1975). Explorations in autism: A psycho-analytical study. Strath Tay: Clunie Press.
19.
Miller, L.
, Rustin, M.E., Rustin, M.J., & Shuttleworth, J. (1989). Closely observed infants. London: Duckworth.
20.
Murray, L.
(1991). Intersubjectivity, object relations theory and empirical evidence from mother-infant interactions. Infant Mental Health Journal, 12.
21.
Newson, J.
(1977). An intersubjective approach to the systematic description of mother-infant interaction. In H.R. Schaffer (Ed.), Studies in mother-infant interaction. London: Academic.
22.
Reid, S. (1988). Personal communication.
23.
Rutter, M.
(1983). Cognitive deficits in the pathogenesis of autism. Journal of Child Psychology and Psychiatry, p. 24,
24.
Sandler, A.M.
, & Sandler, J. (1958). Psychoses, borderline states and mental deficiency in childhood. Bulletin of the British Psychological Society, p. 35.
25.
Steiner, R.
(1987). Some thoughts on `La Vive Voix' by Ivan Fonagy. International Review of Psycho-Analysis, 14.
26.
Stem, D.
(1985). The interpersonal world of the infant. New York: Basic Books.
27.
Trevarthen, C.
(1978). Modes of perceiving and codes of acting. In H.J. Pick (Ed.), Psychological modes of perceiving and processing information. Hillsdale, NJ: Erlbaum.
28.
Trevarthen, C.
, & Marwick, H. (1986). Signs of motivation for speech in infants, and the nature of a mother's support for development of language. In B. Lindblom & R. Zetterstrom (Eds.), Precursors of early speech. Basingstoke: Macmillan.
29.
Tustin, F.
(1981). Autistic states in children. London: Routledge.
30.
Wing, L.
, & Attwood, A. (1987). Syndromes of autism and atypical development. In D. Cohen & A. Donnellan (Eds.), Handbook of autism and pervasive developmental disorders. New York: Wiley.
31.
Wing, L.
, & Gould, J. (1979). Severe impairments of social interaction and associated abnormalities in children: Epidemiology and classification. Journal of Autism and Developmental Disorders, 9, 11-29.
32.
Winnicott, D.
(1965). The theory of the parent-infant relationship. In The maturational processes and the facilitating environment. London: Hogarth.
