ABSTRACT
Psychoanalysis was originally based on the study of patients who had developed the basic possibilities for human relationships. Thus, in the early stages, our work with non-relationship autistic states will have certain differences from that with the more usual relationship-oriented ones. Patients in autistic states are trapped in an unshareable world of self-generated tactile sensations. Only things which can be touched and manipulated seem real. Because they cannot be seen, touched or handled, psychic experiences are outside the scope of these children. Patients in autistic states live mostly in terms of peripheral awareness, listening to tones of voice, for example, rather than to what are being said to them. In adult neurotic patients this autistic part reacts in a devious way and avoids straightforward, direct contacts with people. The therapist has to be firm in encouraging such patients to find the courage to 'stomach' the hard 'not-me' bit.
