ABSTRACT
In this chapter, I will attempt to convey aspects of my thinking about the way I work both with patients who are living in the solipsistic world of pathological autism and with patients who are experiencing the world in terms of normal early infantile experience of a sensation-based sort. The earliest sensation-based experience of the infant—and possibly of the foetus—can devolve into pathological autism as a consequence of a combination of constitutional and environmental problems. The constitutional hypersensitivity to stimuli (i.e. an inadequate capacity for filtering and ordering stimuli) may in some cases be so severe that even good mothering is not sufficient to supplement the infant’s capacity to filter and organise his experience. The infant is so “raw” (metaphorically skinless) psychically that he cannot tolerate the unexpected. Consequently, human interaction, with all of its inherent unpredictability, is unbearably painful and leads the infant or child to withdraw into an inner, lifeless, mechanical world governed by autistic defences (forms of psychic self-protection that I will be describing in the course of this chapter).
