AUTISM AND CHILDHOOD PSYCHOSIS Frances Tustin AUTISM AND CHILDHOOD PSYCHOSIS Frances Tustin Foreword by Victoria Hamilton London KARNAC BOOKS First published by The Hogartll Press Ltd, 1972 This edition reprinted in 1995 with their permission by H. Karnac (Books) Ltd. 58 Gloucester Rod London SW7 4QY Copyright 63 1972 by Frculces Tustin Foreword copyright O 1995 by Victoria Hamilton All rights resewed. No part of this publication may be reproduced. stored in a retrieval system, or transmitted in any form or by any means, electronic, mecha~ical,p hotocopying, recording, or otlier- wise, without the prior permission of the publisher. The rights of Frances Tustin to be identified as author of this work have been asserted in accordance with 99 77 and 78 of the Copyright Design and Patents Act 1988. Brltlsh Llbrary Cataloguing in Pubilcatlon Data A catalogue record for this book is available from the British Library. ISBN: 1-85575-1 10-0 Printed in Oreat Britain by BPC Whcatons Ltd. Exeter To the parents who have entrusted their children to my care ACKNOWLEDGEMENTS The responsibility for the views and insights described in this book is my own, but there are many people to whom I am indebted for inspiration and help. The deepest influence on my thinking has naturally been that of Dr. W. R. Bion with whom I had the privilege of many years of personal analysis followed by a short but helpful assimilative period with Dr. S. Leigh. I have also learned much from my husband, Professor Arnold Tustin, who from his background as a physical scientist. has made astringent comments on every chapter of this book. Supervisors, colleagues, friends, patients and their families have been a further source of stimulation and learning. Particular gratitude is felt towards the psycho-analysts who compose the Melanie Klein Trust who not only gave their time to reading this book, but generously encouraged and expedited its publication. Finally, I want to thank Dr. Mary Lindsay who made it possible for me to have the necessary time for revision of the manuscript for publication. vii CONTENTS ACKNOWLEDGEMENTS vii UST OF lLLUSTRATIONS AND CHARTS X FOREWORD by Victoria Hamilton xi One Autism Two Psychotic Depression Three Autistic Processes in Action Four 'Grit' and 'Second Skin' Phenomena Five Autistic Processes: Further Discussion Six Autistic Objects Seven Systems of Pathological Autism Eighl Classification as a Basis for Treatment Nine Early Infantile Autism and Childhood Schizophrenia as Specific Syndromes Ten A Clinical Description of Childhood Schizophrenia Eleven A Setting for Psychotherapy Twelve Phases in Psychotherapy Conclusion REFERENCES INDEX