Jahrbuch der Psychoanalyse: Band 68: Autistische und autistoide Störungen – Erkennen und Behandeln

Themenschwerpunkt:

• Novina Göhlsdorf: Störung der Gemeinschaft, Grenzen der Erzählung. Die Figur des autistischen Kindes
  Abstract

  Leo Kanner’s and Hans Asperger’s first descriptions of autistic patients have shaped the conceptions of autism up to date. I demonstrate how the prototypical autistic child in Kanner’s and Asperger’s case histories is fundamentally constructed by strategies of narration. However, it is a symptomatic aporia that this figure resists narrative recording. The autistic figure, by definition, withdraws from any representation and, thus, remains an object of non-knowledge. Kanner and Asperger identify autism as a disorder of affective relations and of social communication. Thereby, they also outline the social as such. Given its radical strangeness, the figure of the autistic child constitutes a »key figure of modernity«. Its historical emergence can also be understood in terms of a wider contemporary discussion of the conditions and limits of modern society.
• Klaus Röckerath: Der Mechanismus von Antikythera. Versuch eines neuropsychoanalytischen Blicks auf den Autismus
  Abstract

  This essay tries to link the results of research on autism in the natural sciences with psychoanalytic conceptualizations. Genetic, epigenetic and fMRI studies (connectivism theory) are especially mentioned. It turns out that many bridges between the domains of natural science and psychoanalytic theories of autism (Tustin, Bick, Meltzer) can be built, although the latter encompass the autistic disorder in a far more complex way. The necessity of a thorough analytic training is emphasized, as the analyst depends on his counter-transference in psychoanalytic treatment of autistic personality disorders to a greater extent than usual.
• Bernd Nissen: Autistoide Organisationen
  Abstract

  The most important feature of autistoid organisations is the absence of projective identification as a result of the relinquishment of any hope of finding a containing object. Under epistemological points of view the paradoxical dynamic will be examined in which the pre-conception is not meeting with an adequate realization so that no conceptual transformation can occur, and -elements cannot be mentally qualified. So the rudimentary self feels permanently threatened by annihilation and dissolution. No mental thoughts can emerge. The not connectable fragments must be encapsulated, but remain threatening. A clinical example of an initial interview illustrates how such autistoid dynamics can unfold immediately and how the object is involved inductively. At the same time, objectal residues hoping for an understanding object become visible. Then, an analytical treatment will be possible.
• Celia Fix Korbivcher: Autistische Transformationen und das Verhältnis von Container und contained: Wie man mit psychotischen und autistischen Phänomenen in Kontakt kommt
  Abstract

  The author develops a concept of autistic transformations based on Bion’s theory of transformations and Tustin’s thoughts on autistic phenomena. For this purpose, the differences shown in projective transformations, transformations in hallucinosis and autistic transformations are unfolded, and the underlying psychotic and autistic phenomena. The author attempts to integrate the concept of autistic transformations in Bion’s theory. The impact of these phenomena on the analyst’s mind is examined. Two clinical vignettes illustrate the distinctive effect and are discussed. The specific quality of the analyst’s emotional experience contributes to the distinction of the part of the personality involved and allows the analyst to choose a differentiating approach in order to get in contact with the patient.
• Laura Viviana Strauss: Vom Pilotfisch zur Analytikerin... Das Auftrennen der Naht
  Abstract

  Two alternating bipolar rhythmical constellations act as a closed seam around the patient-hindering development in this psychoanalysis: On the one hand, the quick ephemeral use of projective and introjective mechanisms keeps the analyst outside, not allowing her to transform the projective identifications to which she is submitted. On the other hand, the maintenance of a symbiotic connection forces the analyst to share the medium in which the patient moves and to stay »inside«. Thus, the patient can control her and restrain her analytic function. Only by following this rhythm and by using a »forced« intervention at a certain moment, does it become possible to open the seam and stop the patient’s state of un-integration, allowing him to feel articulated and integrated.
• Maria Rhode: Psychoanalytische Behandlung von Kindern mit Störungen aus dem Autismusspektrum. Theoretische Implikationen
  Abstract

  In this paper the author reviews some of the findings that have emerged from the psychoanalytic treatment of children with autism, and discusses the contribution that such work can make to the understanding of three fundamental psychoanalytic concepts (primary identification, the Oedipus complex, and internalization). In line with the formulations of Klein, Tustin and Meltzer, the bodily level of experience and the child’s fear of his own destructiveness are seen to be central.
• Joshua Durban: Umhüllung und autistisch falsche Formen als schützende Schale gegen Formlosigkeit und Transformation
  Abstract

  This paper describes the process of ›mantling‹, which appears in the analyses of children with autism as they approach the possibility of catastrophic change. They cover themselves up and hide under the protection of an autistic ›second skin‹ based on false forms: an amalgam of the external traits of the analyst, the child and the care-taker. Meanwhile, they have been able to secretly withdraw and keep their autistic core intact. Mantling is mainly somatic, adhesive and obsessive in nature arising out of specific kinds of anxieties and unconscious phantasies. It may be regarded as a proto paranoid-schizoid fear of integration, masking a deep fear of a second breakdown, this time due to the possibility of change and the inevitable restructuring of the internal and external modes-ofbeing it entails. This process of mantling might lead to an autistic negative therapeutic reaction. However, if detected in time and interpreted, it might change into a necessary transitional organization leading to further growth and change, and to the development of more authentic forms. The role and function of mantling will be demonstrated with the help of clinical material taken from the five sessions-per-week analyses of a child and an adolescent.
• Luisa C. Busch de Ahumada und Jorge L. Ahumada: Formen autistischer und autistoider Dynamik: Das Zeitfenster für eine günstige Wendung [window of opportunity]
  Abstract

  After considering infantile autism from Kanner to Tustin, the paper describes the treatment of a nearly mute, hyperactive boy, starting at age two years nine months, shortly after symptoms emerged upon his mother’s pregnancy and subsequent depression while the family lived abroad. An initial period was denoted by lack of contact and hypermotility. A turning point then occurred in the fourth month of therapy on his becoming interested in a red marker, with which he drew some lines muttering a few syllables. Three or four sessions later, the analyst grasped that those syllables referred to a sizable red »rocket« he had once brought to a session. The clinical interactions that then opened up led to full recovery within the year: To start treatment soon after symptoms arise amounts to a veritable »window of opportunity«. The current autistoid turn in the context of a media society is reviewed, and the brief treatment of a nomadic post-adolescent girl is examined in terms of mimetic-autistic dynamics.

Karl-Abraham-Vorlesung:

• Joachim F. Danckwardt: Von ›Jenseits des Lustprinzips‹ zur ›Banalität des Bösen‹ – Weitere Bruchstücke zu Sigmund Freuds Lebens-Todestriebhypothese
  
  Abtract

  The author of the present paper takes up and reargues S. Freud’s original deathinstinct hypothesis from 1920 following H. Parens’ recent suggestion (2011) of reconsidering the death-instinct-based aggression theories, respectively developing new theories of aggression, in order to achieve an improved understanding of the varied manifestations of the aggressive-destructive behaviour as met in everyday life activity as well as in the clinical work with patients. In returning once again to Freud’s relevant works and seminal contributions published after 1920, the author of the present paper offers his own version of the further development of Freud’s theory of the death-instinct in addition to those proposed earlier by M. Klein, H. Segal and H. Rosenfeld. In order to achieve this, the author, by way of ›close reading‹, elaborates upon and makes explicit how Freud himself further developed his own original death-instinct hypothesis from 1920 in his writings over subsequent years. Furthermore, it is also discussed in detail how W. R. Bion, for the purpose of extended clinical applicability, while at the same time especially taking into account the early psychic development of the individual, further developed Freud’s various hypotheses concerning the innate human tendency towards aggressive-destructive behaviour. The theoretical and clinical usefulness of the different hypotheses is then illustrated by a ›close reading‹ of some decisive passages in Georg Büchner’s novella ›Lenz‹, which describes a by now famous episode of psychic breakdown in the life of the German poet Jakob Michael Reinhold Lenz (1751–1792); and, finally, by making extensive reference to Hannah Arendt’s attempt at understanding the supposed character deficit and thought disorder of Adolf Eichmann as discussed in her controversial report on the Eichmann trial, which she subtitled A Report on the Banality of Evil.