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Holloway, R. (2021). Some psychodynamics in Asperger's -- A case report. IJP Open, 8:3.

(2021). IJP Open, 8:3

Some psychodynamics in Asperger's -- A case report

Robin Holloway

This paper is an attempt to capture some of the central psychodynamics present in Asperger’s Disorder. This task is undertaken by analyzing a number of dialogues selected from 7 years of once weekly psychoanalytic psychotherapy with my patient, Jack. A countertransference dream featuring Jack is also described and analyzed. I focus on the analytic field which developed between Jack and me. I attempt to disentangle some of the inextricably intertwined threads of the transference/countertransference dialectic that evolved between us. I sketch in some of Jack’s defenses, which include autistic types of defense. These defenses involve walls, barriers, fortifications, castles and other psychic retreats. I suggest how it was possible to hook up with some of his defences to advance the treatment. I go on to outline some aspects of his inner world, and his object relations (both internal and external). I try to capture aspects of how Jack saw himself, and how this interacted with my way of seeing him. Contrary to DSM-5, I submit that the clinical evidence, described in detail, supports retaining the diagnosis of Asperger’s Disorder as a highly useful diagnostic entity with specific underlying psychodynamics. In addition, I make the claim that there are three different types of Asperger’s Disorder and that Jack’s psychodynamics represent one of these types – what I call the “uninhibited/aggressive type.”

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