Psychoanalytic Work with Autistic Features in Adults: Clinical Intervention Methods and Technique

183 Pages·2018·2.07 MB·English

by  Laura Tremelloni

Psychoanalytic Work with Autistic
Features in Adults
Psychoanalytic Work with Autistic Features in Adults deals with the diagnostic
and therapeutic difficulties of working with patients with autistic residuals,
formed in early life experiences that have remained dormant in the unconscious
mind. Laura Tremelloni traces the process of identifying them in adult patients,
and stresses the need to develop a treatment plan suitable for this kind of
pathology.
This book uses clinical cases to examine the difficulties of work with hard to
reach adults with ‘gaps’ in their sense of Self and symptoms related to primitive
experiences of ‘non- being’. Tremelloni presents new, adaptive therapeutic inter-
vention methods for overcoming such obstacles and identifies the personification
and permanence of undeveloped parts of the Self, in hard to reach adults who
have otherwise developed satisfactorily and would not be diagnosed as autistic.
In such cases, the author suggests the need for clinicians to adapt classic psycho-
analytic approaches to the alternating levels of development of the separate parts
which the Self has broken into.
Psychoanalytic Work with Autistic Features in Adults will help clinicians in
psychoanalysis and psychoanalytic psychotherapy to more effectively reach such
patients, whilst attempting to address the problematic limitations of therapeutic
techniques in very difficult clinical cases.
Laura Tremelloni is a psychoanalytic psychotherapist in private practice in
Milan, Italy, working particularly with autistic children and adults as well as
psychotic patients. Her psychoanalytic training took place with analysts includ-
ing Benedetti, Cremerius and McDougall, and then with Resnik, Tustin and
Alvarez. She is a founding member of the Centro Internazionale Studi Psicodi-
namici della Personalità (CISPP), Venice, with Salomon Resnik and other col-
leagues, where lessons, seminars and meetings are held regularly, especially on
infantile autism and psychosis.

Psychoanalytic Work with
Autistic Features in Adults
Clinical Intervention Methods
and Technique
Laura Tremelloni
First published 2018
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2018 Laura Tremelloni
The right of Laura Tremelloni to be identified as author of this
work has been asserted by her in accordance with sections 77
and 78 of the Copyright, Designs and Patents Act 1988.
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.
Translated into English by Giuliana Di Gregorio and Camilla Gamba
Trademark notice: Product or corporate names may be trademarks
or registered trademarks, and are used only for identification and
explanation without intent to infringe.
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
Names: Tremelloni, Laura, author.
Title: Psychoanalytic work with autistic features in adults: clinical
intervention methods and technique / Laura Tremelloni.
Description: Abingdon, Oxon; New York, NY: Routledge, 2018. |
Includes bibliographical references and index.
Identifiers: LCCN 2017060117 (print) | LCCN 2017060652
(ebook) | ISBN 9781351014595 (Master) | ISBN 9781351014588
(Web PDF) | ISBN 9781351014571 (ePub) | ISBN 9781351014564
(Mobipocket/Kindle) | ISBN 9781138497788 (hbk: alk. paper) |
ISBN 9781138497801 (pbk : alk. paper) | ISBN 9781351014595
(ebk)
Subjects: | MESH: Autistic Disorder–therapy | Adult | Autistic
Disorder–psychology | Psychoanalytic Therapy–methods
Classification: LCC RC553.A88 (ebook) | LCC RC553.A88 (print)
| NLM WM 203.5 | DDC 616.85/882–dc23
LC record available at https://lccn.loc.gov/2017060117
ISBN: 978-1-138-49778-8 (hbk)
ISBN: 978-1-138-49780-1 (pbk)
ISBN: 978-1-351-01459-5 (ebk)
Typeset in Times New Roman
by Wearset Ltd, Boldon, Tyne and Wear
In memory of Salomon Resnik,
Whose human warmth and richness of thought inspired to
continue my search for new meanings.
To him, a fond memory and my complete gratitude for the
generosity with which he shared his experience as a brave
and original psychoanalyst.
I dedicate this book to my sons, Francesco and Fabio,
and to my grandchildren, Tommaso, Fiammetta, Samuele
and Olivia, with love.
Contents
Preface: explorations in terra incognita ix
Acknowledgements xiii
Introduction 1
PART I 5
1 About autism 7
2 About skin: the skin as a surface of the body 26
3 About sight and beauty 38
PART II 49
4 Clinical examples 51
5 Sara: living on the surface 55
6 Irene: from robot-l ike to person 94
7 Beatriz: backwards love 102
8 Monica: the psychic retreat 109
PART III 115
9 First encounters: adventures into the unknown 117
10 Transference and countertransference 121
11 The challenges of working with autistic traits 132
viii Contents
12 Suggestions for therapeutic interventions 138
Conclusions 154
Index 156
Preface
Explorations in terra incognita
The aim of this book is to bring together analytic work that has been carried out
over many years in order to show the importance of our thoughts and observa-
tions regarding our patients’ problems, as well as our own, with the intention of
mitigating their existential difficulties and symptoms.
The result of analytic work can be astonishing and even comforting, as we are
able to lead our patients to imagine new possibilities for fulfilment. On the other
hand, if the relationship is interrupted before our work comes to an end – indi-
cating that the relationship has broken down – we have to reflect upon what, how
and why we failed to understand.
We may wonder why psychoanalysts write so much about their clinical cases.
The simplest answer is that these written cases reflect their desire to share their
experience of analytic psychotherapy with their colleagues, or to add to a theor-
etical discussion.
As a matter of fact, when put to paper, analytic work becomes imperfect and
artificial: the totality of thoughts, associations, feelings and details is left out.
Although all these things cannot be retrieved and described, they exist as a
whole in our mind. This totality follows the changes within the patient, within
our relationship and even within ourselves.
How can one convey that a single word pronounced by the patient might
evoke in the therapist an emotion or a memory, which in turn connects with the
intention of the patient and thus leads to an interpretation?
In testifying to the value of psychoanalytic work, the written word as a ‘set of
signs’ is not a mere vehicle of information regarding the analytic journey. The
word must also transmit the emotions felt by both participants as well as the way
they interconnect. What happens in the analyst’s consulting room involves a par-
ticular encounter between two people that leads to a new, unexpected relation-
ship. This marks the beginning of a third new situation.
When we speak of the vicissitudes of the transference and highlight our
encounter with the primitive and unconscious parts of ourselves, something
inevitably emerges through spoken word and body language. Therefore, in
writing about psychoanalytic work, the analyst can neither avoid self-r eference
nor keep from displaying unconscious signs of personal enigmas.