Delusional development in child autism at the onset of puberty: vicissitudes of psychic dimensionality between disintegration and development

Abstract

Although the psychogenetic hypotheses on child autism have been superseded, psychoanalysis can still reflect on the relational exchange and its sensory aspects in concomitance with the mental development of these patients. Without making generalizations as regards the pathogenesis, but considering the specific features of each autistic child, it may be possible to achieve an integration of those islands of competence that make up these patients' limited personal heritage. Such integration may be reached through the analysis of representational, emotional and relational transformations. The first part of this article describes the case of an autistic child in treatment from the age of four on a four-times-weekly basis who, during puberty, developed severe formal thought disorders together with delusional and hallucinatory formations. The second part develops some post-Jungian theoretical contributions, such as the concept of self as nothingness and the idea of the unsaturated archetype, so as to evaluate the function of some a-priori concepts in support of the analyst's position. These concepts are considered in relation to Bion's model of transformation, and to the formulations on dimensional awareness, especially on the shift from a two-dimensionality to three-dimensionality view, as well as to the rhythm of the object's presence and absence.

Recognizing Psychosis in Autism Spectrum Disorder

“…Along this line of research, a central question is whether ASD children are able to distinguish between their subjective perceptions and reality. If we assume that the autistic condition implies an intrinsic difficulty in distinguishing between fantasy and reality, the recognition of a delusion in these patients becomes a very complex psychopathological task ( 36 ).…”

“…In several cases, it is reported how much may be difficult for these patients to describe their delusions and for the clinicians to identify and classify them ( 30 ). For this reason, some authors have hypothesized to investigate the presence of delusional ideas also through drawings ( 36 ).…”

Contacting a 19 month‐old mute autistic girl: A clinical narrative

“…One might expect that four decades after Tustin's (1972) seminal book, Autism and Childhood Psychoses, publications of successful resolution into the health of early treatments of child cases in the autistic spectrum would, in the frame of the current epidemic of autism, have become commonplace, but this is far from being so. Child cases depicting evolving therapeutic processes were published among others by Alvarez (1992Alvarez ( , 2010Alvarez ( , 2012, Bisagni (2012), Cecchi (1990), Dale (1997), Haag (1993Haag ( , 1997, Houzel (1999Houzel ( , 2004, Korbivscher (2013), Lechevalier (1997), Maiello (1997), Rhode (1997Rhode ( , 2004Rhode ( , 2005Rhode ( , 2008Rhode ( , 2012 and Rodrigu e (1955). However, most clinical narratives did not proceed to termination, nor was the end result clearly stated.…”

On the impact of words: interpretation, empathy and affect regulation

“…Parallel to this, rather than emphasizing the attachment model and its developments, my analytic spinal cord is built upon the Bionian notion of container/contained (with all its correlates in terms of the development of the capacity for thinking) and upon the Winnicottian notion of holding (as contributing to a sense of ‘going‐on‐being’). I add to these the post‐Jungian notions of the archetype awaiting realization (i.e, as being primarily devoid of complex representational contents) and of the primary Self as an unsaturated potential for becoming a subject in relationship (Bisagni ).…”