Spécificités du transfert dans l’autisme. Du cas Dick à la psychanalyse contemporaine avec les autistes

Objectives

The aim of this work is to examine the specific features of transference in autism and define the aim of analytic treatments with autistic patients.

Method

Based on a literature review of the pioneers of psychoanalysis with autistic children, their conceptions of autism, the richness of their clinical teachings, and the analytic treatments they proposed, we formulate the hypothesis of a specific type of transference in clinical work with autistic children and propose a treatment orientation based on the fact that the analyst centers their intervention on the child's spontaneous solution.

Results

We demonstrate that transference in autism is mediated by the autistic double. Through the double, the subject avoids exchange, protects himself/herself from the encounter with the Other, and constructs his/her autistic dynamic. From the clinician's point of view, agreeing to bear the image of a double favors the construction or deployment of a solution specific to the subject, enabling them to inscribe themselves in the world. From then on, the subject can establish his or her construction with the help of a partner. Witnessing and guaranteeing the autistic person's suppletive construction seems to be the major transferential function, while at the same time opposing any outbursts of the drives.

Discussion

Our re-reading of the Dick case shows that the particular status of the object for the autistic person is a reference point from which the treatment can be oriented. This case, like other clinical studies, highlights the specific functioning of autistic thought, its subjective dynamics and particular skills, an originality that requires specific treatment directions.

Conclusion

Analytical practice with autistic patients, as we see it, is based on the functions of the autistic edge: protection, equipping jouissance, opening up to knowledge. When it's not there from the outset, opposing the outbursts of jouissance seems one of the best ways to provoke its election. Tempering the child's jouissance is also the best way to encourage the unfolding of his or her subjective construction. For analysts who work with autistic people, we recommend allowing oneself to bear the image of a double in order to instill change in the immutable, and a gentle forcing towards a beyond of the double.