Autism definition: causes and diagnosis

The psychodynamic approach, specifically contemporary psychoanalytic psychopathology in which we participate, defines a specific functioning of the autistic mind. Firstly, it identifies a deficit in initial symbolic functioning, meaning a difficulty in resorting to language1. For individuals with autism, this involves difficulties in understanding and using symbolic references that language typically helps to frame; notably space, the body, and time. They are, therefore, dealing with a world without boundaries where everything blends together (inside, outside, front, back). If they cannot establish a limit, they find themselves invaded in their own body, in the form of intrusive gazes and excessive demands (both gaze and voice being perceived as overwhelming), without the possibility of locating them. It is this invasion that can lead certain individuals to adopt self-mutilating or even hetero-aggressive behaviors, aiming to establish this distance when it is not symbolizable.

In order to protect themselves from this invasion, they may adopt a certain drive economy, including the retention of drive objects (vocal, oral, anal, scopic), a tendency towards immutability, avoidance of others, and a withdrawal into oneself, which may lead them into profound solitude. Léo Kanner, a pioneering psychiatrist in establishing definitions of the autistic syndrome, already stated in 1943 that “all of the children’s activities and utterances are governed rigidly and consistently by the powerful desire for aloneness and sameness. […] There is from the start an extreme autistic aloneness that, whenever possible, disregards, ignores, shuts out anything that comes to the child from the outside. Direct physical contact or such motion or noise as threatens to disrupt the aloneness is either treated “as if it weren’t there” or, if this is no longer sufficient, resented painfully as distressing interference.”2

Based on this initial identification, the contemporary psychoanalytic approach situates the autistic subject’s compensatory capacities in the selection of an affinity, a specific interest, or a particular object, emphasizing the strengths or talents of autistic individuals. Through this choice, the subject constructs a tailor-made ‘border,’ capable of serving a delimiting function between themselves and the world. This externalized object, or « affinity, » locates the invasive « jouissance » outside the body, introducing a gap between the subject and others, enabling the subject’s access to language, and fostering the emergence of a ‘I.’ In other words, the affinity serves as a reference point for the subject, a tool for conversion and translation that they deploy and articulate to compensate for the impossibility of resorting to language. “whether it’s the wires the child carries around with him, or the various constructions produced by autistic children, everywhere it’s an additional organ that the child is attempting, at the cost of his life if necessary, to introduce as the organ that would suit language in his body”3

This ‘border’ is characterized by three interconnected elements: « the autistic object, the island of competences, and the double.4» We find affinity in its capacity to facilitate the development of knowledge around a specific object and all its intricacies. Additionally, the double comes into play when the subject incorporates the dynamics of an object or a living being to compensate for their own. As this border unfolds and becomes more complex, it enables the emergence of an enunciative position, the delimitation of a body schema, the establishment of a pacified connection to others, and the development of a knowledge foundation about the world. This ultimately leads to the creation of a « multidimensional space5» through which the subject can move and interact.

1 Cherel, M. “The creative perspective of autism: The extraordinary case of the autistic painter Iris Grace”. L’Évolution Psychiatrique, 9 September 2023

2 Kanner L, Rosenberg, M. (1990). Autistic disturbances of affective contact. Neuropsychiatrie De L’enfance Et De L’adolescence, 38, 65‑84.

3Laurent É. Thoughts on autism. Bulletin Groupe Petite Enfance, 10. Paris: Nouveau réseau Cereda; 1997. p. 40–5.

4 Maleval, J-C. The autist and his voice. Seuil, 2009

5 Op.cit. Cherel, M. The creative perspective of autism: The extraordinary case of the autistic painter Iris Grace.

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