From Ashes to Ashes: The Heroic Struggle of an Autistic Boy Trying to be Born and Stay Alive

This paper investigates the concept of psychogenic autism that has been proposed by Frances Tustin. Her work centers on the dynamics of this serious illness with an emphasis on the infant’s experiences in the earliest connection with the mother. Tustin writes that the sudden and violent disruption of the skin-to-skin maternal/infant contact gives rise to pathological attempts to heal this separation; namely, through the infant’s shutting out contact with the external emotional world. An extensive clinical vignette is offered to illustrate how these dynamics are manifest clinically and the author’s efforts to establish a meaningful connection with a young patient. Transference and countertransference reactions are discussed in detail.