ABSTRACT
The word “psychosis” was not applied to the child before the first half of the twentieth century. The psychopathology of childhood did not develop before this period. Psychoanalysis, stressing the crucial importance of early psychic development, has been responsible for a great deal of its deepening. The expression “childhood psychosis” appeared in the 1930s. Then several types of psychosis were described (autistic, symbiotic, deficit-based, psychotic dysharmony). In 1979 this endeavour to differentiate various types of childhood psychoses was called into question with the concept of “autistic spectrum disorders” which mixes again under the same heading all psychotic disorders of childhood thought of as being from an exclusive organic origin. The author points out this aetiological a priori. He points out also the danger of a psychogenetic a priori which has been put to the fore by some psychoanalysts accusing the parents of making their child psychotic. He pleads for a psychoanalysis looking for meaning and not for aetiologies. He hypothesises that autistic children are unable to transform their own experiences in representations. They can only enact their internal states. The analyst treating an autistic child plays a role similar to the role of a mother vis-à-vis her infant: receiving the infantile projections and transforming them into representations. This function requires the right balance between maternal and paternal qualities in the analyst’s mind, i.e. a psychic bisexuality regularly attacked by the autistic mechanisms and needing to be repaired in the analyst’s counter-transference. The author suggests the following stages in the progress of the transference of an autistic child in treatment: transference onto the container – infantile transference – transference neurosis – end of the treatment. He concludes with a clinical illustration of psychoanalytic work with an autistic child.
