Journal of ISSN: 2373-6445JPCPY

Psychology & Clinical Psychiatry
Conceptual Paper
Volume 2 Issue 2 - 2015
Autism: Lost in the Mirror?
Alison Barry*
Psychoanalytical Psychotherapist, Ireland
Received:August 11, 2014 | Published: January 28, 2015
*Corresponding author: Alison Barry, Psychoanalytical Psychotherapist, 12 Simmonstown Manor, Ireland, Tel: 0857565039; Email: @
Citation: Barry A (2015) Autism: Lost in the Mirror? J Psychol Clin Psychiatry 2(2): 00063. DOI:10.15406/jpcpy.2015.02.00063

Abstract

When I began my training as an analyst I took up a placement in an early intervention centre for autistic pre-scholars. The school was run on the psychological principles of ABA and children were tutored on a reward system promoting positive behaviors. Whilst working there I noticed that a number of children had a particular fascination for their mirrored image. This fascination was pervasive and many children would do their work primarily for the reward of the mirror. Through the lens of psychoanalysis I found this very interesting and Lacan’s Mirror Phase immediately came to mind and with this it bore the question as to whether or not there was something in the Mirror Phase of development that had an impact on what we see as symptoms of Autism.

Introduction

This article has been provoked as a consequence of the time I spent working in an early intervention centre for autistic pre-scholars. During my time in this centre I noted a particular fascination some of these children had with their mirrored image. This fascination appeared almost as fixation, accompanied with a mixture of both frustration and bliss, indicating perhaps a lack of mastery of the mirrored image and rather like the myth of narcissus, an entrapment in their own mirrored ideal ego. The question that springs forth from this observation, asks whether or not autism can be attributed to a failure at the level of the Mirror Stage? The Mirror Stage, as defined by both Lacan and Francoise Dolto, is one of the most important stages in the development of Subjectivity. It is at this stage that the child identifies with its own mirror image, a stage that is usually mastered from about six to eighteen months. For Lacan, this act marks the primordial recognition of one's self as "I" as an imagined whole being, separate from the mother, where the mother is the first mother. It is a necessary pre-curser for entry into the symbolic order and into ownership of language. Prior to this stage the child’s body is in an autistic state, it is a fragmented body with a primitive rudimentary ego where there is little delineation between self and mother. The purpose of the Mirror Stage is to reflect to the child an imagined whole self, outlined with a clear separateness from the mother allowing for the development of the ego and the sense ‘I’ or ‘me’. The DSM-IV [1] defines autism as consisting of delays in or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:

  1. Social interaction;
  2. Language as used in social communication;
  3. Symbolic or imaginative play.
The APA describes autism as being “neuro-developmental disorder and must be present from infancy or early childhood, but may not be detected until later because of minimal social demands and support from parents or care givers in early years” [1]. This is the psychiatric definition of autism and it is this definition that is most prevalent in common thinking. However, in keeping with Verhaeghe’s thinking as outlined in chapter 1 of On being Normal and Other Disorders, I feel that the thought process behind this type of codified nosological system lacks any theoretical underpinning and as a result has become more of a symptomological listing, “evoking the Biblical injunction to ‘go and name things”, rather than acting as a true diagnostic tool. Codified nosological systems such as the DSM fail to offer diagnostic criteria that allow effective treatment of the underlying aetiology of the disorder and accompanying symptoms and as such in conjunction with Verhaeghe, I feel that the DSM definition of autism is considerably lacking. As Verhaeghe suggests the theoretical framework offered by psychoanalysis and particularly by Lacan, provides the theoretical scaffolding that the current diagnostic criteria lack. Verhaeghe writes “both Freud and Lacan study the human being first and foremost as a being that manipulates symbols and undergoes their effects. This will be our own starting point” and mine also for the purpose of this article. The school that I worked in was specifically established to work with children who had been given the psychiatric diagnosis as being on the autistic spectrum. The overall aim of the school tutorship is to prepare the children to attend either a mainstream primary school or special needs primary school. The school is run under the guidelines of the principles of ABA and CBT and children are taught using the technique of positive reinforcement. Each day each child would have a set of tasks to complete, as defined by their teacher and psychologist and would carry out these tasks for a reward. Each child had a variety of different rewards that they would work for; for example; food stuffs, a particular toy, watching a DVD or for many of the children I observed, they would be fully satisfied with reward of their own mirrored image. On completion of a task they would be given a mirror and would take great delight in staring at their image but would be equally dismayed and upset when the mirror was taken away again. The children ranged in ages from between 2.5 years to 6 years and I worked one on one with each of these children, daily, for approximately 8 months. So to return to the question borne out of my observations whilst working in the school; can autism or autistic symptoms be seen to arise as a result of a particular failure at the level of the mirror stage and the particular ego instillation that occurs within this moment? In my attempts to seek an answer to this question I was struck by similarities between my questioning and Rosine Lefort’s case of ‘Nadia’ in her book “The Birth of the other” [2]. In her book Lefort carefully outlines the case of a very young girl ‘Nadia’ who initially presents with very autistic like symptoms. Through the sessions outlined in the book Lefort shows how Nadia journey’s beyond these symptoms and how she is able to move towards subjectivity. Using Francoise Dolto’s theories of Castration, Weaning, the Unconscious Image of the Body and the Mirror Stage, in conjunction with Lacan’s concept of Weaning and the Mirror Stage, my article looks to re-analyse Nadia’s case afresh through the lens of both these theorists in the hope of providing an answer as to whether or not a particular failure at the level of the Mirror Stage can give rise to autistic symptoms, thus accounting for the narcissistic entrapment of the autistic pre-scholars, with whom I worked so closely. I have chosen these key theoretical concepts in order to illustrate the importance of these moments for the development of the Ego, Ego Ideal and the relationship with the other, prior to entry into the symbolic. Please note that for the purpose of this piece I am focusing on the most important aspects of her treatment and her movement into subjectivity. There is much more to be said but that perhaps is for another piece of work. In the 1950s, Rosine Lefort worked in France at the Fondation Parent de Rosan. Lefort describes the Parent de Rosan as “an institution offering temporary asylum to children” [2] and it was her work with young analysands in this institute that began her training as a Lacanian analyst. Lefort kept meticulous notes on her sessions and has published two of her early cases in her book Birth of the other. Her analysis of these cases was carried out much later in the 1970’s where she presents a very detailed Lacanian analysis of these cases. The case of ‘Nadia’ concerns a very young pre-verbal orphan brought into the institute for care. Nadia was brought to the Parent de Rosan when she was thirteen months old. She had spent most of her existence up to this point in hospital having been separated from her mother at birth. Nadia had known no other kind of care other then institutional care. Physically she was in very poor health having suffered from recurrent rhino pharyngeal infections. She had had her adenoids removed when she was two months old and at five months had a double mastoiditis and then spent three months in hospital as a result of an abscess on her scar tissue. When she arrived into Lefort’s care “she looked utterly wretched.” “Nadia was very thin, with a yellowish complexion. Her face was emaciated; the striking feature was the big, dark-ringed eyes. The only lively thing about her was her look.” “Her growth was severely retarded: her weight was only eighteen pounds, and her length twenty-eight inches, In other words, she could have been taken for an eight month-old baby.” Lefort [2] describes Nadia as not living within her environment. Although she was over a year old, she made no attempt to move or to explore the world around her. She is described as sitting “immobile” in her cot for entire days. She was unable to relate to objects in the world around her, including people and food. If she was picked up or put on the floor with other children she would “not budge; her expression would go dead, and she would rock violently.” She made no attempt to pick up toys and play with them [2]. If she did take hold of an object she would let go of it as quickly as she touched it, as if she was incapable of bearing the presence of another object so close to herself. All of these symptoms could be described as having an autistic quality and Nadia at this point could be described as being autistic, however at the age of 13 months Nadia is too young to have been diagnosed as being autistic. Lefort, however, felt that there was something within Nadia, a desire, a desire that came across in her look and it was this that helped Lefort decide to work with Nadia psychoanalytically. Lefort witnesses this desire in Nadia’s reaction to watching the other children being fed. She describes it by nothing “Nadia hit the toy soldier and threw it down but without any visible sign of emotion”. Lefort interprets this as reaction as being Invidia, “which can only manifest itself in the scopic drive”. Where Invidia is a Lacanian concept conveying the devouring jealousy associated with the gaze [2]. The presence of Invidia for Lefort indicates the very real presence of Nadia’s desire. Lefort interprets Nadia’s Invidia as indicating that Nadia’s desire has a very specific relation to an object, this object being food, but this desire only being aroused when the object belonged to another child. So for Nadia the image of another child being fed was “the image of completeness closing in on itself”. As Nadia could take no pleasure in food or in being fed she only found desire in coveting the experience of another child being fed, from which she could gain no pleasure. Lefort remarks that “this object in relation to another, and which she had to keep at a distance, was none other than Lacan’s object a, the object cause of desire” [2]. I am going to reinterpret Lefort’s interpretation of Nadia’s Invidia, in order to add another layer to Lefort’s analysis of Nadia’s case.
I would argue that rather than witnessing Invidia what we see in Nadia’s gaze at the image of another child being fed, is in fact a confrontation with her own mirrored image. The image she is presented with is that of herself being fed by an adult, which is unbearable. As Lefort points out, there is no rivalry nor jealousy experienced by Nadia in this image, indicating that she has not accepted in full the existence of the object of the Other and as such what she sees in this image is an extension of herself and not one of rivalry in terms of the recognition of the child as the Other as is the case in Invidia. I would argue that this image of herself being fed is due to the lack of Dolto’s Umbilical and Oral castration that has failed to instill an Unconscious Image of her own body and as such she is unable to process this mirror image and so she is stuck, catatonic within the mirrored image she is presented with. As Lacan points out in Family Complexes and the Formation of the Individual, Lacan J [3] it is at Weaning and the Mirror Stage that the child is introduced to the other and in accepting the other as an object, the subject will begin to identify its subjectivity in relation to the other. As Dolto points out a subject can only navigate their way through the Mirror Stage if they have successfully moved through umbilical and oral castration and so I would argue that it is a failure at these moments that has resulted in Nadia being stuck, frozen in her mirrored image, being unable to identify with it, accept it or move through to the next stage of ego development. In other words she is unable to incorporate her own image and establish her own ego and so is unable to take on the “I” that is presented in the Mirror Stage and it is this that has led to a catatonic gaze and her autistic state. Nadia was separated from her mother at birth; her birth mother having suffered from tuberculosis. Dolto “understood autism as a response to a perceived or actual traumatic premature separation” Hall [4] and the separation of Nadia from her mother at birth is definitely a trauma in the real. Dolto makes reference to the importance of speaking about early traumas and that if they are not spoken about, if they are not symbolized through language, they will be carried internally and will be suffered in the real of the body and in the functional difficulties of the Unconscious Image of the Body. She says that autism is a result of “a very early rupture in the mother-infant relationship, before or after birth, a rupture that has never been spoken about and which has left the infant with no alternative but to relate a part of his own body in a masturbatory relationship,” which in Nadia’s case is manifest in her gaze [4]. She has been left to reside “in a state of fusional desire, unseparated from a ghost mother and menaced by death”, [4]. Therefore Nadia having suffered a trauma and lack of symboligenous castration at birth was forced into an autistic relationship with her body from her first moments of life. Symboligenous castration is “a word Dolto coined to describe the process enacted in a human being when another human being signifies to him, or her, that the realization of desire is prohibited by the law. This brings about, at first, a reaction of rebellion in the child, and then a depression which leads to inhibition, and finally a shift towards a register of shared pleasure” [5].
In Dolto’s terms castrations occur in the various trials that the child’s desire comes up against. For Dolto there are 6 key castrating moments, umbilical, oral, anal, the mirror stage, primary and oedipal. These castrations are necessary for the destiny of the unconscious image of the body and therefore in turn the unconscious. When Dolto speaks of the Unconscious Image of the Body she is referring to the entirety of the emotional, sensory and language experiences of early life. These experiences make up the unconscious that is then repressed after the Mirror Stage and Oedipal Complex [4]. The lack of symboligenous castration from her mother at birth made it impossible for Nadia to be weaned fruitfully. Dolto specifically describes the outcomes of castration as being the fruits of castration, in that castration whilst causing a loss of something also brings with it again. The fruits of weaning being the access to language. It is impossible to wean a subject from a ghost without offering symbolization through language. Nadia having never known a mother, only the institution of the other, was never able to form the necessary primitive, primal, safe maternal bond from which to separate and from which to form the necessary primal and primary signifiers. So therefore she became stuck at the age of 8months old, un-weaned and unable to face the Mirror. Having not moved through weaning she had not sublimated the Maternal Imago the result of which Lacan says is “death bearing” [3] and it is in this state of bearing death that Lefort finds Nadia. Dolto describes how the traumas “mobilize the death drives on to the body image” [4] and these are significantly at work within Nadia’s distorted Body Image. Lefort describes Nadia as evoking “something of death” [2]. She is overwhelmed with infection in “permanent otorrhea” and incapable of bearing life giving sustenance in food, habitually vomiting her food or in severe and repeated bouts of “diarrhoea.” She is therefore trapped, immobilized, catatonic, bearing death. The most important moment for both Nadia and Lefort occurs when instinctively Lefort realizes that she must not occupy a mothering position similar to the other care-givers, but similar to the position of the analyst must allow Nadia transfer mothering qualities on to her and therefore become placed by Nadia in the position of mother, as first other. She does this by refusing to treat Nadia like the other nurses and care-givers do. She does not engage in feeding rituals or clothing and bathing rituals. In doing so she becomes something different, something other than the caregivers with whom Nadia comes in contact and in this position as something other, Nadia is able to position Lefort as the mother that was taken from her at birth. In the same way that the analyst in the clinic does not take up a position but rather waits until the analysand through the transference puts the analyst into that position.
As a result the two are able to occupy the symbiotic infant-mother relationship vital in the first elements of life and it is then within this transferential position that Lefort is able to become her mother. I am very specific when I choose the word symbiotic. Lefort speaks of how the analysis with Nadia for a number of months replaced her own personal analysis as Lefort moved through some difficult moments in her own analytical journey. She writes that the treatment of Nadia “in some way performed the function, therefore, of a substitute in my own analytic process” [2] indicating that this relationship was as important to Lefort as it was to Nadia. This relationship became symbolized within the ‘you-me’ mouth marked out by Nadia very early in the transference, “that mouth she always returned to […] that was, as much [Lefort’s] as [Nadia’s]” [2]. Nadia uses Lefort’s mouth and her own mouth indiscriminately. Similar to the early mother infant bond where the child is unable to tell where the infant begins and the mother ends, Nadia uses this ‘you-me’ mouth to symbolize this. She moves between her own mouth and Lefort’s mouth as if she was unaware where her own mouth and Lefort’s mouth begins and ends. This relationship also becomes inscribed in Nadia’s refusal to take anything other than the bottle; that is her return to the breast, her return to the mother. Lefort writes that she heard that Nadia had “spontaneously refused to take anything but a bottle” thereby refusing all solid food, showing a regression to an early mother-infant feeding relationship. Castration is described by Dolto as occurring when “the child [has] experienced the satisfaction of a drive in a manner in which it is first sought, but at the same time the partial object, while providing bodily satisfaction, must be linked to a complete object, the person […] whom he loves, and who for her part acknowledged the pleasure he experiences from the satisfied drive” [6]. This is what happens for Nadia through her work with Lefort. She slowly becomes able to experience a satisfaction of the oral drive, that provides her with bodily satisfaction and this satisfaction is linked with an object, the bottle and a complete person, Lefort is able to acknowledge and symbolize this satisfaction through language. We see this at work throughout the sessions as outlined in chapter one, two and three in the Birth of the other [2]. Nadia goes through a vividly ambivalent relationship with Lefort and the bottle and the shared you-me mouth, both loving it and hating it, hitting it, biting it, kissing it and exploring it. Eventually reaching the point where she is able to tolerate satisfaction from the bottle as shown on the 3rd December when having displayed a great deal of aggression without anxiety towards the bottle and the ‘you-me’ mouth, she returns to her crib and utters a “sign of contentment and relief” [2], the sign of contentment here being seen as a hint to the possibility of language and the possibility of the entry into the symbolic. It is after this point that Nadia begins to move towards language in what Dolto describes as being the “fruits of castration” [4]. Whereby the fruit of oral castration and the movement away from the mother allows for access to language and to the symbolic. This is shown in Nadia’s first sounds, in her “ma, ma, ma”, indicating that in the speaking of “ma” Nadia is developing an unconscious image of her body. Dolto outlines the importance of the ‘ma’ in her concept of “image” or ‘I’, ‘ma’, ‘je’ in the development of the unconscious ‘image’ of the body. Where the “the first letter “I” is also the first letter of the word ‘identity’. The second syllable “ma” is the first syllable of “maman” or mother. The last syllable of “image” “ge” signifies earth, our base or our body” 1987 p12.
It is at this point that Nadia is ready to be castrated orally in Dolto’s terms or to be Weaned in Lacanian terms and this is a choice that Nadia makes herself. It is not something that is imposed on her by Lefort. Lefort allows Nadia the space to make this choice for herself, to let go of the ghost of her mother’s breast and to enter into language and with it to enter the realm of the other. Nadia embarks on her weaning/oral castration by flirting with the idea of eating crackers and tests them out on the ‘you-me’ mouth sharing them between Lefort and herself, allowing only Lefort at first to take bites, as shown throughout chapter 4. At the same time as flirting with eating crackers, Nadia also shows a slow disinterest in the bottle, which she drinks from and then plays with the nipple, pushing it in and out of her mouth playing with having it and then not having it, almost reminiscent of Freud’s “Fort … Da” [7] game which he analysis as the child’s pleasure/pain in the re-enactment of the comings and goings of the mother. Nadia is beginning to be able to symbolize oral castration and with it the loss of her mother. Nadia finally reaches the point of a full symboligenous oral castration when on the 21st January, Lefort is able to interpret Nadia’s actions verbally and puts into words the significance of her ‘fort … da’ game with crackers. Lefort tells her “that by eating she was learning to love, to be loved and to love life” [2]. Lefort beautifully signifies the movement from the bottle to solid food and the full symboligenous element to this; following from this point Nadia is able to move from the bottle to the cup and the dish and to eating solid food by herself and to be fed by Lefort. She has been weaned. Having had a symboligenous oral castration, having been weaned, Nadia is now equipped with the internal scaffolding or the primary signification in order to be able to face the Mirror Stage and she does this on the 22nd of January. While having her shoes put on she “shows a great deal of interest in her reflection and then in Lefort’s” and it was within this session that Lefort describes Nadia as if she has been “reborn”, “accepting without fear or anxiety” the mirrored image [2]. This shows that there has been a shift internally for Nadia. As if she has had a Lacanian ‘a-ha’ moment in the mirror where she has accepted the emergence of her own ‘I’ and in this is able to tolerate the idea that she exists as a separate entity from Lefort. This change in her seems to indicate Nadia’s acceptance of the castrations from her mother, the acceptance through the mirrored image that Lefort’s body and her body are not fused, that they are distinct and that the ‘you-me’ mouth is no longer shared. They are separate egos in separate bodies. This is further highlighted by Lefort saying to Nadia when she attempts to suck her nose that “she could not do this because her body and [Lefort’s] were two, not one” and it is at this point that she “took no more interest in [the bottle] at all” [2], choosing instead to eat cereal with a spoon from a bowl, showing in Lacanian terms, that she had successfully sublimated the Maternal Imago, allowing space for the recognition of the Other. It is also at this point that Nadia’s desire and demand begin to take shape with her emerging Ego. She makes verbal demands of “here” and “spoon”, indicating her access to language and with it the symbolic realm vital to the development of the subject. This language allows Lefort to understand her demands and with it the budding of Nadia’s desire brought about through the work. Up to this point Nadia had shown an interest in the mirror but until this moment she hadn’t as yet fully moved into the drama of the Mirror Stage. She has seen her reflection before now and has toyed with both it and with Lefort’s reflection but until this moment she had shown that she is not yet quite ready to fully incorporate her own ‘I” (in her desire to absorb Lefort) and it is not until she shows “no more interest” in the bottle that she shows that she is fully ready to manage the Mirror Stage which clearly outlines Dolto’s theory that it is not possible to move fully from one stage to the next without each stage having had a fruitful castration. The lack of interest in the bottle indicates that she been fully weaned, fully castrated orally and as such equipped with the tools to move into the Mirror Stage. Both Lacan and Dolto emphasize the importance of the Mirror Stage for ego development and instillation, however both theories claim differing affects on the subject. For Lacan it is a jubilant “a-ha” moment and for Dolto there is a trauma.
Prior to weaning, to her oral castration she was not in a position to negotiate the development of her own ego or of the internalization of her own ‘I’. The shoe scene with Lefort seems to show to us that Nadia understands and accepts the completeness of her own image allowing for a zipping up of her fragmented body image and a movement towards the Lacanian myth of being whole. On the 31st January Nadia seems to have a Doltoesque Mirror moment when “she stood up in front of the Mirror, smiling, and looked at [Lefort’s] reflection in it; the smile disappeared from her face” [2]. In the disappearance of the smile she seems to indicate that the trauma of the mirror, as Dolto sees it, has occurred. For Nadia at this point it is not the jubilant “a-ha” of Lacan’s Mirror Stage but the trauma of Dolto’s Mirror Stage. Here Nadia is for the first time really able to understand and accept her separateness from Lefort and from their ‘you-me’ mouth and so following on from the joyous Lacanian moment of the understanding of separateness comes the trauma of the realization of what that means, the letting go of the mother. For Nadia the joy of becoming a separate entity from the mother brings with it the understanding and the realization that the mother has to be let go of to achieve this and this is what Nadia seems to accept at this point in her Mirror Stage journey. It is from this moment that she is able to move towards fully understanding the image she is presented with in the actual mirror. On a number of separate occasions she stands in front of the Mirror with Lefort exploring the reflection and the boundaries of their bodies and it is through this exploration that she is able to have repeated ‘a-ha’ moments of Lacan’s Mirror Stage. We can see this in her exploration in the session on the 9th February when she blows herself a kiss, imitating a kiss that she has watched someone else blowing. In this reflected image of herself in the mirror blowing the kiss she is finding in her emerging ego and identity in the Ego Ideal as presented through the mirror. She no longer shows fear or anxiety in this mirror image and accepts the image of the other as depicted through the mirrored reflection of other nurses and children. It is through this that Nadia can begin to let go of Lefort and to accept the trauma as Dolto finds it of the realization of the Mirror Stage and it is this that allows Nadia to eventually choose to end her sessions with Lefort saying “Bye-Bye” [2] symbolizing to Lefort that she was ready to face the world on her own. In order for Nadia to move through the Mirror Stage successfully she must first have been castrated with “love” [3] from the trauma of her birth and from the ghost of her biological mother. Only having done this was she adequately equipped to journey through weaning and be achieve a fruitful castration at weaning, allowing the sublimation of the Maternal Imago, all of which created the platform which allowed the narcissism of the mirror stage to pass. It allowed her to achieve the ‘a-ha’ moment of ‘that is me’ in her reflected image that she so craved when Lefort first met her; thus creating the necessary myth of wholeness and with it the foundations of the ego and the ego ideal allowing her first steps into symbolic subjectivity with it the recognition of other as being apart from self and the ‘I’ as separate from the other. So as Lacan writes there is hope in psychoanalysis; the analyst in taking up the position of the Mirror, as Lefort so beautifully does for Nadia, is able to “accompany the patient to the ecstatic limit of ‘thou art that’ ” [8].

Conclusion

So to return to the original question posed by this article. Could autism be attributed to a failure at the level of the mirror? My re-interpretation of the case of Nadia seems to suggest that unsuccessful early infant castrations leading to a failure at the level of the Mirror Stage could lead to the entrapment of the ego at the level of the mirror and an entrapment in the autistic state that precedes mirror development. My thoughts return to those moments is at in the school working with the pre-scholars and what comes to mind is their fixation on their own mirrored image, similar to Nadia’s fixation when Lefort first encounters her on other children being fed. Held within this fixation for both Nadia and the pre-scholars, is the desire to engage with the mirrored image they encounter and a desire for an understanding as to who the image in the reflection is and ultimately a desire to be brought to the Lacanian point of the “thou art that”. Their inability to accept or incorporate the ‘that’ of the mirror seems to have left them stuck-frozen, similar in many ways to Nadia, in their own image. Unable to incorporate the ego that is mirrored back to them or to assimilate the ‘I’ that is presented to them, the overwhelming anxiety that they are left could account for the defenses of their autistic symptoms. Being caught in the moments prior to the acceptance of the mirror has left them with no choice but to foreclose their own ego, their ‘I’ and the other and so are left living in the autistic Lacanian fragmentation of the body. However, I will reiterate Lacan, there is hope in Psychoanalysis. As Lefort shows in her very careful notes it is possible, with early intervention, to help a child move past this state and into the world of the other, providing a sound argument for the use of psychoanalysis as part of the holistic approach in the modern treatment of autism in early intervention centres.

References

  1. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorder. DSM-IV-TR. (4th edn.), Text Revision, USA.
  2. Lefort R (1980) Birth of the Other. University of Illinois press, Paris, pp. 376.
  3. Lacan J (1938) Family Complexes in the Formation of the Individual.
  4. Hall G, Hivernel F, Morgan S, Mitchell J (2009) Theory and Practice in Child Psychoanalysis: An Introduction to the Work of Francoise Dolto, Karnac Books, London, UK, pp. 250.
  5. Dolto F (1984) L'Image consciente du corps. Editions du Seuil, Paris.
  6. Dolto F (1998) The Different Forms of Castration. Chapter Three, Seminars on Child Analysis, Irish Journal of Psychoanalytic Psychotherapy (6)1.
  7. Freud S (1920) Beyond the Pleasure Principle, Standard Edition of the Complete Works of Sigmund Freud. Vintage, London, UK, pp. 7-67.
  8. Lacan J (1949) The Mirror Stage as Formative of the I function as revealed in Psychoanalytic Experience. Ecrits, A Selection, Norton Press.
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