Object relations approaches to autism

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Notes

1 Asperger's syndrome no longer constitutes a separate diagnosis in DSM-5.

2 The last 25 years have seen the publication of a substantial number of edited collections and single-authored books. In English alone, these include Acquarone 2007, 2016; Ahumada and Busch de Ahumada 2017; Alvarez 1992, 2012; Alvarez and Reid 1999; Barrows 2008; Edwards 2001; Fix Korbivcher 2013; Holloway 2015; Levine & Power, 2017; Mitrani and Mitrani 1997, 2015; Rhode and Klauber 2004; Rustin et al. 1997; Sherkow and Harrison 2013; Tremelloni 2005, 2018. Many important recent contributions can unfortunately not be discussed for reasons of space.

3 This section is an extended version of Rhode (2015).

4 Some research studies have been published, though no controlled outcome studies. Alvarez and Lee (2004) have reported a single-case analysis of video-recordings that demonstrates an increase in dyadic interactions during the treatment of a severely autistic boy, though not of triadic interactions. Preliminary studies include Reid, Alvarez, and Lee 2001; Thurin et al. 2014; Rhode 2007).

5 Introjection may be problematic as well as projection (Alvarez 1999b; Rhode 2012a).

6 Since then, Holloway (2015) has described other adult patients with Asperger's syndrome.

7 The question of whether it is unconscious is a complicated one: many children on the spectrum behave as though the contact barrier (Bion) between conscious and unconscious were at best incompletely established (for example, Haag's patients seem to be in touch with bodily identifications that would not normally be consciously accessible).