ABSTRACT
Frances Tustin, investigating the most profound of all schizoid formations, that of autism, found that the autistic individual forms a rigid protective shell. This chapter demonstrates the differences between the four main personality types-narcissistic, borderline, hysteric, and schizoid-and the overlap between them due to their common root in the sensitivity to sameness and difference, when ego-functioning is disavowed, under-developed, or suspended. In the consulting room the schizoid patient finds the reality of analysis painful. They are "thick-skinned narcissists" who have grown a thick skin to protect them from the pain and power of the other. They do not rail against the analysis openly. Each particular personality type represents a different solution to the problems of the pain, fear, and loss involved in separation and the recognition of otherness, the sensitivity of the emotional core, and the establishing a response to the difficulty of developing flexible and integrative ego-functioning.
