ABSTRACT

This paper explores the emotional and mental barriers autistic children may face in the process of relating to other people as separate individuals. Clinical examples will illustrate these difficulties as they manifested in the therapeutic relationship and in the separation anxiety of two autistic patients. I will also explore the working through of the children’s separation difficulties in their relationship with the therapist. This work entailed both understanding the nature of the patients’ anxiety, as well as actively searching for a sliver of space for the therapist, which the children could tolerate. The work with one patient, who had more pronounced autistic symptoms and was non-verbal for many years, centred on forming bodily-physical separation. The work with the moderately symptomatic patient, who was verbally fluent, focused on tolerating ideational differentiation between him and the therapist. The children’s separation dread was understood by considering both psychoanalytic and neuro-cognitive models of autism. As these issues were worked through, the nature of the therapeutic relationship changed, from mainly consisting of an adhesive connection with the therapist, to more communicative, emotional and personal interactions. The discussion will address the way that the therapist’s use of her body and personality motivated the patients to relate with, rather than adhere to her.

摘要

本文探讨了自闭症儿童在与其他人作为独立个体建立联系的过程中可能面临的情感和心理障碍。临床实例将说明这些困难，因为它们表现在治疗关系和两名自闭症患者的分离焦虑中。我还将探讨如何解决孩子与治疗师的关系中的分离困难。这项工作既需要了解患者焦虑的本质，也需要积极为治疗师寻找儿童可以忍受的空间。对一名患有更明显的自闭症症状并且多年来不说话的患者的工作集中在形成身体和身体的分离上。与有中度症状的患者一起工作，他的语言流利，专注于容忍他和治疗师之间的观念差异。通过考虑自闭症的精神分析和神经认知模型，可以理解孩子们的分离恐惧。随着这些问题的解决，治疗关系的性质发生了变化，从主要由与治疗师的粘性联系组成，转变为更多的交流、情感和个人互动。讨论将讨论治疗师对她的身体和个性的使用如何促使患者与她建立联系，而不是依附于她。从主要包括与治疗师的紧密联系，到更多的交流、情感和个人互动。讨论将讨论治疗师对她的身体和个性的使用如何促使患者与她建立联系，而不是依附于她。从主要包括与治疗师的紧密联系，到更多的交流、情感和个人互动。讨论将讨论治疗师对她的身体和个性的使用如何促使患者与她建立联系，而不是依附于她。