Psychosis in autism

ABSTRACT This article discusses a unique form of withdrawal observed in children with ASD, using a detailed case study. This withdrawal can be understood as linked to a psychotic organisation, in addition to the autistic aspects and early developmental difficulties in the sense of self. A child on the spectrum with psychosis makes for a unique case, because the psychosis rests on an early developmental impairment. In such cases, a fragile self uses disintegration of the mind as a mechanism that enables blurring of the self. This defence mechanism is different from Tustin’s ideas about the autistic sensory blurring of the self through autistic objects and shapes. If this psychotic mechanism becomes fixed, it creates unique anxieties regarding the lack of self-nuclei. The constant projection of large parts of the self into outside figures creates a fear of rapid form transformation and poses unique challenges in analysis. A clinical example is given to illustrate these momentary states.