Frances Tustin PDF
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Frances Tustin This is the first book to describe the life and work of Frances Tustin, a brilliant clinician whose understanding of autistic and psychotic children has illuminated the relationship between autism and psychosis for others in the field. Sheila Spensley defines Tustin’s position in traditional and contemporary psychoanalytic theory and explains how it is related to work in infant psychiatry and developmental psychology. She clarifies key terms and concepts of her work, showing how they are linked with the work of Bion, and with that of Grotstein and Ogden. Evaluating autism from an evolutionary point of view, she also considers the possibility of autism as a ‘missing link’ in the developmental chain of psychic growth. Frances Tustin makes Tustin’s seminal work accessible to the non- specialist reader and shows how relevant her thinking is to work in other areas such as learning disability and work with adult patients. Sheila Spensley is Consultant Clinical Psychologist and Psychoanalytic Psychotherapist at the Willesden Centre for Psychological Treatment, Willesden Community Hospital. Sheila Spensley’s Frances Tustin is a remarkable work: the author deftly interweaves a sensitively constructed personal account of the life of Frances Tustin with a detailed discussion of Tustin’s major clinical and theoretical contributions to the psychoanalytic understanding and treatment of autistic patients. Mrs Tustin’s ideas and clinical approach are subtle and complex (often deceptively so). I have been richly rewarded by careful study of her work over the past fifteen years, but nonetheless came away from each chapter of Spensley’s book feeling that I had learned something new and important about Tustin’s thinking. Spensley, with clarity and unpretentious erudition, discusses such topics as Tustin’s concepts of the sensation- dominated nature of autistic experience, the biological and interpersonal origins of autistic psychopathology, the unique quality of autistic anxiety, the differences between encapsulated and entangled forms of autism, the nature of ‘relatedness’ to autistic shapes and autistic objects. In each instance Spensley provides a rich commentary on the theoretical context for the idea under discussion as well as vivid clinical examples of the concept as Spensley has applied it in her own work. Frances Tustin will be highly valued reading by all mental health practitioners and teachers (of every level of experience) who are attempting the difficult task of deepening their understanding of autistic patients as well as the autistic component of healthier patients. Thomas H.Ogden, MD, Co-Director, Center for the Advanced Study of the Psychoses, San Francisco; Supervising and Training Analyst, Psychoanalytic Institute of Northern California; author of The Primitive Edge of Experience. The Makers of Modern Psychotherapy Series editor: Laurence Spurling This series of introductory, critical texts looks at the work and thought of key contributors to the development of psychodynamic psychotherapy. Each book shows how the theories examined affect clinical practice, and includes biographical material as well as a comprehensive bibliography ofthe contributor’s work. The field of psychodynamic psychotherapy is today more fertile but also more diverse than ever before. Competing schools have been set up, rival theories and clinical ideas circulate. These different and sometimes competing strains are held together by a canon of fundamental concepts, guiding assumptions and principles of practice. This canon has a history, and the way we now understand and use the ideas that frame our thinking and practice is palpably marked by how they came down to us, by the temperament and experiences of their authors, the particular puzzles they wanted to solve and the contexts in which they worked. These are the makers of modern psychotherapy. Yet despite their influence, the work and life of some of these eminent figures is not well known. Others are more familiar, but their particular contribution is open to reassessment. In studying these figures and their work, this series will articulate those ideas and ways of thinking that practitioners and thinkers within the psychodynamic tradition continue to find persuasive. Laurence Spurling Frances Tustin Sheila Spensley London and New York First published 1995 by Routledge 11 New Fetter Lane, London EC4P 4EE This edition published in the Taylor & Francis e-Library, 2005. “To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.” Simultaneously published in the USA and Canada by Routledge 29 West 35th Street, New York, NY 10001 © 1995 Sheila Spensley All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalogue record for this book has been requested ISBN 0-203-97635-5 Master e-book ISBN ISBN 0-415-09262-0 (hbk) ISBN 0-415-09263-9 (pbk) To Philip Much analytic theory is not only compatible with, but derives some antecedent probability from, our beliefs about biology. Money-Kyrle (1978) I am convinced of the strength of the scientific position of psychoanalytic practice. Bion (1962b) Contents Acknowledgements ix Introduction 1 1 Growing up in the bosom of the church 6 2 Professional development 11 3 The discovery of autism and the search to 19 understand it 4 Unnatural children 27 5 Encapsulation and entanglement 33 6 Mental cataclysm and black holes 43 7 The frontiers of consciousness 52 8 Of objects: concrete, sensory and transitional 60 9 The keeper of the keys 69 10 Mental handicap and mental illness 83 11 Psychoanalytic perspectives on learning impairment 96 12 The restoration of god 110 Glossary 121 Chronology 126 Publications by Frances Tustin 128 Bibliography 131 Index 139 Acknowledgements The suggestion that I might write this book originated in conversations between Frances Tustin and Laurence Spurling, the editor of this series. It was a pleasure for me to accept the task of writing about an area of psychoanalytic investigation which has long been a particular interest and about a writer whose work has contributed substantially to my own understanding. Personal friendship with the subject of biographical work can present problems but in this case I think the strength of shared interests and priorities has fortified rather than interfered with objectivity and critical freedom. I am grateful to Frances Tustin for her generosity in making available to me as much as she could recover of her history and of her memories and for providing me with the manuscripts of some of her clinical work. The research for the writing of the book has also brought unexpected pleasures in becoming an opportunity to renew old acquaintances and friendships and to make new ones. Pleasurable memories remain with me of a beautiful day at the New Forest home of Mrs Shirley Hoxter, retired Head of the Child and Family Department of the Tavistock Clinic, who gave her time to a careful reading of the first typescript and made a number of corrections and helpful suggestions. I am grateful to Fiona Spensley Barton and to Melinda Schneider who read the chapters as they emerged, hot from the PC, and made constructive criticisms. Thanks are due to Michael Sinason, former consultant psychotherapist at the Willesden Centre for Psychological Treatment, for first introducing me to computer technology. He was responsible forteaching me to become, much to my surprise, computer literate. Colin Spensley introduced the wonders of Windows and I am grateful also for his technological help and supervision which retrieved the book from many a threatened ‘black hole’. It would not have been possible to write this book at all without a substantial experience of working with deeply disturbed patients and it was my work with psychotic and borderline adult patients which interested me in the disturbances of childhood. I am ever grateful for the rare opportunity of having worked in one of the few NHS in-patient
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