ABSTRACT
This chapter looks into the transferal and countertransferal dynamics in analytical work with adult patients with autistic residuals. Transference in autism does not initially happen in a symbolic way due to the level of disintegration of the Self. It may be expressed through the need for proximity, equality, or with a phantasy of physical fusion. Or, at times, the patient may project dissociated and confused parts of the Self, trying to transform the analyst into an autistic object that can reproduce his first object relationship. The alternating between his ‘being’ and ‘non-being’ in the sessions can confuse the analyst, continually modifying the countertransference. The analyst will have to work hard to withstand the desolation and emptiness and not give into the mortal death that is projected onto her; she should try to transmit presence, attention and vitality. Therapeutic ability rests on being able to acknowledge her own hatred and contain and process all these feelings, in order to come up with new thoughts. The analyst will need to offer the patient an open mental state that can hold on to open questions, along with another space in which meanings can be offered to the patient to choose from.
