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James, M. (1982). Autistic States in Children: By Frances Tustin. London: Routledge & Kegan Paul. 1981. Pp. 376.. Int. J. Psycho-Anal., 63:504-514.

(1982). International Journal of Psycho-Analysis, 63:504-514

Autistic States in Children: By Frances Tustin. London: Routledge & Kegan Paul. 1981. Pp. 376.

Review by:
Martin James

This book is issued by a general publishing house. It is for analysts but may nevertheless prove more quickly acceptable to certain general readers whom it will not threaten. Read in a general context, Autistic States in Children can be compared with Ladurie's Montaillou, also a work of scholarship enjoyed by the non-expert.

Here in this place, a first notice for analysts, our task for Tustin's book is to summarize its argument and impact and that done, to let the material speak for itself.

First then, the argument. In a phrase, Tustin brings us a new dimension in our theory: Primary autism, she says, is a normal state in the foetus and a degree of autism normal in the baby after it has been born; Tustin, in effect, equates primary autism with the responses of physiology. She sees pathological autism as the persistence of this normal foetal style of response beyond its due time. For then it is a reminiscence from the past and hinders better adaptations that would be possible.

Autism was previously hard to place in our theory, Tustin now puts it in line with psychoanalytic thinking: The physiological processes that once served adaptive and defensive purposes become an obstruction, a nuisance to further development, so in considering autism we are seeing normal physiology prolonged beyond its time.

But what are the reactions of physiology upon which later psychological developments are built? In utero the foetus maintains its equilibrium, its homeostasis, by animal responses which are appropriate in utero but gradually get beyond their time. These foetal responses at their most complex are conditioned reflexes learned by the foetus. They affect heart-rate, movement, time awareness and so on. More simply there are basic automatic responses made by the primordial foetus; the muscle and cell irritability that starts even in the zygote, morula and blastula. The zygote is of course the first combined cell formed by union of the gametes: the sperm and the ovum. These go on to form the new-born baby.

An essential part of Tustin's argument is that this new-born has to change from intra-uterine responses to those more adequate for life outside the womb but she points out that for a few months the new baby normally tends to use the old responses and has to be helped to accept the new ones.

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