ABSTRACT
This chapter addresses the autistic phenomena encountered in the defensive organisation of "as-if", to illuminate both the pressures on the analyst from within and without to remove herself from the encounter, and the understanding that may help the analyst stay in contact with her patient. In the "as-if" world, opposites smoothly coexist without contradiction, but this shapeless quality is paired with a constriction that pinches awareness of internal and external reality. The analyst in close contact with a patient, who treats reality as fantasy, feels in a sensory deprivation chamber, as there is no ordinary sensory or human feedback that one has any trust in. Esther Bick initially focused on the sensory experience produced in the skin by tactile pressure, but later developments have emphasised aspects of rhythm, patterning that is visual or auditory, familiar scents, accustomed moods, that also serve the function of creating a bounded sensory floor.
