ABSTRACT
In recent years there has been an increasing awareness amongst analysts that behind the neurotic aspects of the patient's personality there lies hidden a psychotic problem which needs to be dealt with to ensure real stability. This was particularly highlighted by Bion (1957) in his seminal paper on the differentiation of the psychotic from the non-psychotic part of the personality. However, sooner or later they reveal phenomena which are strikingly similar to those observed in so-called autistic children. These autistic phenomena are characterized by an almost impenetrable encapsulation of part of the personality, mute and implacable resistance to change, and a lack of real emotional contact either with themselves or the analyst. Progress of the analysis reveals an underlying intense fear of pain, and of death, disintegration or breakdown. These anxieties occur as a reaction to real or feared separation, especially when commitment to analysis deepens.
