Frances Tustin
DESCRIPTION: Frances Tustin described states of encapsulated withdrawal in adult patients who were by no means autistic. Her theory of autism is now outdated, but her clinical descriptions continue to be studied.
The ‘autistic armour’ in adults without autism
In 1986, Frances Tustin published *Autistic Barriers in Neurotic Patients*. The book does not deal with autistic adults, but with patients without a diagnosis of autism. Tustin describes distinct spheres of experience and functioning in these patients that remain largely inaccessible in the psychoanalytic process: they speak, interpret, and understand without certain psychological domains being affected.
Her theory on the aetiology of childhood autism is now outdated. She herself later retracted key assumptions. Her clinical descriptions of withdrawal, sensory self-stabilisation and psychological isolation, however, continue to be valued. The two must be distinguished: an incorrect attribution of the causes of autism on the one hand, and a historical clinical terminology for phenomena of withdrawal in non-autistic adults on the other.
Frances Tustin
Frances Tustin was born in Darlington in 1913 and died on 11 November 1994. She initially worked as a teacher. She came to psychoanalysis in 1943 through a course taught by Susan Isaacs. From 1950 to 1953, she trained as a child psychotherapist at the Tavistock Clinic. Her training analysis with Wilfred Bion lasted sixteen years. Her supervisors included Esther Bick, Herbert Rosenfeld and Donald Meltzer. In 1984, she became an Honorary Affiliate of the British Psychoanalytical Society.
Her most important books include *Autism and Childhood Psychosis* (1972), *Autistic States in Children* (1981), *Autistic Barriers in Neurotic Patients* (1986) and *The Protective Shell in Children and Adults* (1990).
This sequence marks a shift in her focus: from the autistic child to isolated psychological states in children and adults without a diagnosis of autism.
Objects and Forms
Tustin distinguished between two phenomena, which she regarded as forms of elementary self-soothing.
Autistic objects are hard and provide sensory stimuli. A set of keys, a piece of metal or a toy car is clutched in the hand, not because of its function or symbolic meaning, but because of the pressure it exerts on the skin. What matters is the sensation of firmness, boundary, and resistance. In this context, the individual object is interchangeable. Its material properties matter more than its personal significance.
Autistic forms, by contrast, are soft and less concrete. Tustin understood these to be vague, body-oriented sensory constructs intended to bundle together and soothe disordered sensory impressions. She identified them, for example, in the handling of saliva, food in the mouth or other soft bodily materials. According to her description, these forms create a feeling of warmth and envelopment that is available at all times.
For Tustin, both phenomena are characterised by the fact that they require no counterpart. The object does not respond. The form does not demand a relationship. Here lies their stabilising function, but also their limitation: they reduce dependence and protect against being overwhelmed, while keeping relationships and emotional processing at a distance.
Encapsulation
From such observations, Tustin developed the concept of autistic encapsulation or the autistic armour. She used this to describe a physical and psychological protective process that precedes the psychological defence mechanism: an early, reified precursor to repression, denial, or forgetting.
This refers to a psychological realm in which primal fears are not symbolically processed but remain sealed off. Tustin included among these fears of dissolving, falling, disappearing, nothingness or physically experienced mutilation. The affected area is not processed or integrated. It is sealed off.
As early as 1972, Tustin noted that such encapsulations could also be found in the character organisation of comparatively unremarkable individuals. She cited rigid splits, superficial identifications and a pronounced need for control as indicators. She linked this organisation, amongst other things, to phobias, sleep disorders, anorexia nervosa, elective mutism, psychosomatic complaints and learning difficulties.
She reasoned that a loosening of this ‘armour’ could unleash considerable affective instability. In this context, Tustin mentioned manic-depressive fluctuations. Encapsulation therefore appears to her not only as a restriction, but also as a stopgap measure: it holds together something that would otherwise be experienced as unmanageable.
The ‘black hole’
Tustin’s description of the ‘black hole’ became particularly well known. It stems from a boy she called John. He experienced the nipple as a part of his own mouth that had been torn off and was missing. In this fantasy, the mouth became a black hole with a painful or threatening spike.
Tustin interpreted this image as an expression of an experience in which separation from another’s body is experienced not as a mere absence, but as a physical severance. Herein lies the untenable leap in her theory: from the clinical description of a single child to a general theory of the development and aetiology of autism.
Tustin later admitted that her Kleinian training shaped her conceptual framework. The categories through which she initially interpreted her observations could not have adequately captured what she had found.
The 1991 revision
In 1991, Tustin published the essay ‘Revised Understandings of Psychogenic Autism’ in the International Journal of Psycho-Analysis. In it, she explicitly retracted the assumption of a normal primary autistic phase.
According to Tustin, the findings from infant observations refuted the postulate of an initial autistic phase of development. Consequently, autism could not be understood as a fixation on such a phase or as a return to it. From then on, she reserved the term ‘autism’ for ‘pathological conditions’.
This revision had a long history. As early as 1986, she replaced the term ‘psychogenic autism’ with ‘psychobiological autism’. In 1992, she stated that no form of childhood autism could be attributed exclusively to psychogenic causes. Her last published essay, from 1994, is entitled ‘The Perpetuation of an Error’.
It is rare in the history of psychoanalytic thought for an author to publicly retract central elements of her own work. However, Tustin’s later position is frequently overlooked. To this day, her name is often associated with a view that she herself had rejected.
Why her theory of autism is outdated
Autism is now classified as a ‘neurodevelopmental disorder’ in the ICD-11 and DSM-5-TR. Research findings point to a complex interplay of genetic and neurobiological causes. Simple psychogenic explanations are considered untenable.
The large Swedish family and twin study by Sandin and colleagues, published in 2017, analysed 37,570 pairs of twins and 2,642,064 pairs of siblings, including 14,516 diagnoses of autism. It estimated heritability at around 83 per cent. Environmental factors that differed between siblings accounted for around 17 per cent of the variance. Shared environmental factors had virtually no significant effect.
This effectively undermines virtually the entire family of psychogenic autism theories, particularly the notion that autism stems from emotional coldness, a lack of attachment or a damaging parent-child relationship. The figure of the ‘refrigerator mother’, which dates back to early misinterpretations by Kanner and was popularised by Bruno Bettelheim, has been scientifically and ethically discredited.
Dianna Kenny subjected Tustin to a fundamental critique in SAGE Open in 2019. She interprets Tustin’s work as an example of psychoanalytic theory-building that has failed to incorporate findings from infant and autism research adequately. Her criticism also targets the institutional and theoretical groupthink within the circles of Klein, Bick, and Tustin.
Tustin and the question of blame
Tustin espoused a flawed theory of the aetiology of autism, but did not blame parents in the way that was later occasionally attributed to her.
She described Kanner's and Bettelheim’s ideas as cruel and erroneous. She expressly stated that autism was nobody’s fault. According to Tustin, most autistic children had experienced neither emotional coldness nor neglect or violence at the hands of their parents.
This does not exonerate her theory, but it does distinguish it from a direct pathologisation or moral condemnation of parents. Her position was incorrect, but it was not based on the claim that parents were to blame for autism.
Theoretical context
Tustin’s concepts sit within a psychoanalytic framework concerned with the formation of psychological boundaries: how the internal and the external, the self and the object, and the body and relationships are organised before linguistic symbolisation.
Author | Concept | Central idea |
|---|---|---|
Esther Bick | Second skin | The skin acts as the primary psychological container. Where a supportive counterpart is lacking, muscle tension, constant movement or incessant talking can form a substitute shell. |
Donald Meltzer | Adhesive Identification | The subject clings to the surface of the other without forming a psychological space in between. |
Thomas H. Ogden | Autistic-contiguous position | A mode of experience in which touch, surface, rhythm and sensory proximity organise the experience. |
Didier Anzieu | Skin-ego | The skin is understood as a model of a psychological shell and boundary. |
Wilfred Bion | Container-Contained | Indigestible experience can become psychologically conceivable through the receptive and processing function of another person. |
These concepts are historically and theoretically linked, but they are not identical. They should neither be merged into a single theory of autism nor used as diagnostic categories.
Adult patients without autism
The more specific clinical context of Tustin’s book is Sydney Klein’s 1980 essay ‘Autistic Phenomena in Neurotic Patients’. Klein described patients whose analysis may appear outwardly organised and productive, whilst their experience remains thin, formulaic or untouched in crucial areas. It is reflected upon, understood and interpreted. Yet something essential remains unchanged.
In 1992, Judith Mitrani described the survival function of ‘autistic manoeuvres’ in adult patients. These refer to behaviours that may initially appear to be resistance but actually serve a stabilising function: a rigid ritual to begin the session, a consistent manner of speaking, an object held in the hand, a monotonous tone of voice or a recurring physical action.
Such practices need not be understood as deliberate avoidance. They can support a fragile psychological organisation by preventing unregulated emotions, separation anxiety or experiences of disintegration from becoming overwhelming. From this perspective, the question is not only how a behaviour can be changed therapeutically, but also what function it has fulfilled up to now.
In this context, the Frances Tustin Memorial Trust refers to ‘autistic enclaves’ in children and adults. ‘Enclave’ is a more precise metaphor than ‘encapsulation’: it refers to a demarcated area with its own logic within an otherwise differently organised personality.
No statement about autism
The problematic impact of this tradition of terminology begins where its language is misunderstood in a diagnostic context. What Tustin, Klein and Mitrani described in adult neurotic patients is not autism, not ‘mild autism’ and not a hidden autism spectrum.
These are psychoanalytic descriptions of withdrawal, self-stabilisation and areas of psychological functioning that are difficult to access in people with other clinical presentations. The use of the word ‘autistic’ is historically conditioned and, from today’s perspective, misleading. It stems from an era in which autism was, to some extent, understood as an acquired condition.
Anyone who today speaks of ‘autistic encapsulation’ in a non-autistic adult should therefore clarify that what is meant is a specific clinical description, not an autism statement. Conversely, Tustin’s concepts are not a suitable tool for interpreting autistic people. Stimming, withdrawal, repetitive behaviours and sensory self-regulation in autistic people should not automatically be interpreted as ‘encapsulation’, ‘defence’ or ‘avoidance of relationships’. They are linked to a specific way of processing stimuli and can have regulatory, communicative or functional significance.
What remains of Tustin’s work
Three aspects of her work remain worth reading, even if her aetiology of autism is clearly rejected.
· The description of the sensory function of hard objects. An object clenched in the fist, pressure on the skin or a particular surface can act as a concrete form of self-stabilisation, without this necessarily having to be interpreted in symbolic or biographical terms.
· The observation that therapy can proceed correctly, calmly and in a way that focuses on understanding, without addressing specific psychological areas. A low-conflict process is not necessarily productive. Smoothness can also indicate isolation.
· Public self-correction. Tustin revised key assumptions when empirical findings contradicted them. Her final essay on the persistence of an error is therefore also a rare example of intellectual integrity within the psychoanalytic tradition.
Key points
• Frances Tustin described encapsulating withdrawal and self-preservation functions in non-autistic children and adults, particularly in *Autistic Barriers in Neurotic Patients* (1986) and *The Protective Shell in Children and Adults* (1990).
• Her concepts include hard ‘autistic objects’, soft ‘autistic forms’ and encapsulation as a physical and psychological protective process.
• Tustin did not regard such demarcated areas simply as defences, but as a fundamental mechanism for organising oneself against psychological overload and disintegration.
• Her theory of psychogenically caused autism has been refuted. From 1986 onwards, Tustin revised key aspects of her own assumptions and, in 1991, explicitly withdrew the hypothesis of a normal primary autistic phase.
• Autism is a neurodevelopmental condition with a complex aetiology that is predominantly determined by genetic and neurobiological factors. Psychogenic explanations and theories attributing blame to parents are scientifically untenable.
• Tustin firmly rejected attributing blame to parents and described such theories as cruel and erroneous.
• The withdrawal phenomena described in non-autistic adults must not be confused with autism. They are neither a diagnostic indicator of autism spectrum disorder nor a model for explaining the autistic experience.
Sources
· Melanie Klein Trust, entry ‘Frances Tustin’ (Maria Rhode, 2017): https://melanie-klein-trust.org.uk/writers/frances-tustin/
· Frances Tustin Memorial Trust, About Frances Tustin: https://www.frances-tustin-autism.org/about-frances-tustin/
· Tustin, F.: *Autism and Childhood Psychosis*, Hogarth Press 1972; *Autistic States in Children*, Routledge & Kegan Paul 1981; *Autistic Barriers in Neurotic Patients*, Karnac 1986; *The Protective Shell in Children and Adults*, Karnac 1990
· Tustin, F.: Revised understandings of psychogenic autism, International Journal of Psycho-Analysis 72 (1991), 585–591: https://pubmed.ncbi.nlm.nih.gov/1797714/
· Taipale, J.: Caught on the surface. Tustin on autistic experience, Frontiers in Psychology 14 (2023), 1243310: https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1243310
· Haag, G.: Autistic Capsule/Nucleus, in: International Dictionary of Psychoanalysis: https://www.encyclopedia.com/psychology/dictionaries-thesauruses-pictures-and-press-releases/autistic-capsulenucleus
· Kenny, D. T.: Faulty Theory, Failed Therapy. Frances Tustin, Infant and Child Psychoanalysis, and the Treatment of Autism Spectrum Disorders, SAGE Open 9 (2019): https://journals.sagepub.com/doi/10.1177/2158244019832686
· Sandin, S., Lichtenstein, P., Kuja-Halkola, R., Hultman, C., Larsson, H., Reichenberg, A.: The Heritability of Autism Spectrum Disorder, JAMA 318 (2017), 1182–1184: https://pubmed.ncbi.nlm.nih.gov/28973605/
· Bick, E.: The Experience of the Skin in Early Object-Relations, International Journal of Psycho-Analysis 49 (1968), 484–486
· Meltzer, D., Bremner, J., Hoxter, S., Weddell, D., Wittenberg, I.: Explorations in Autism. A Psycho-Analytical Study, Clunie Press 1975
· Ogden, T. H.: On the Concept of an Autistic-Contiguous Position, International Journal of Psycho-Analysis 70 (1989), 127–140; The Primitive Edge of Experience, Jason Aronson 1989
· Anzieu, D.: *Le Moi-peau*, Dunod 1985; German edition: *Das Haut-Ich*, Suhrkamp: https://www.suhrkamp.de/buch/didier-anzieu-das-haut-ich-t-9783518288559
· Bion, W. R.: Learning from Experience, Heinemann 1962
· Klein, S.: Autistic Phenomena in Neurotic Patients, International Journal of Psycho-Analysis 61 (1980), 395–401
· Mitrani, J. L.: On the survival function of autistic manoeuvres in adult patients, International Journal of Psycho-Analysis 73 (1992), 549–559: https://bgsp.edu/app/uploads/2014/12/Mitrani-J-On-the-Survival-Function-of-Autistic-Manoeuvres-in-Adult-Patients.pdf
· Mitrani, J. L., Mitrani, T. (eds.): Frances Tustin Today, Routledge, 2015
Related
DESCRIPTION: Frances Tustin described states of encapsulated withdrawal in adult patients who were by no means autistic. Her theory of autism is now outdated, but her clinical descriptions continue to be studied.
The ‘autistic armour’ in adults without autism
In 1986, Frances Tustin published *Autistic Barriers in Neurotic Patients*. The book does not deal with autistic adults, but with patients without a diagnosis of autism. Tustin describes distinct spheres of experience and functioning in these patients that remain largely inaccessible in the psychoanalytic process: they speak, interpret, and understand without certain psychological domains being affected.
Her theory on the aetiology of childhood autism is now outdated. She herself later retracted key assumptions. Her clinical descriptions of withdrawal, sensory self-stabilisation and psychological isolation, however, continue to be valued. The two must be distinguished: an incorrect attribution of the causes of autism on the one hand, and a historical clinical terminology for phenomena of withdrawal in non-autistic adults on the other.
Frances Tustin
Frances Tustin was born in Darlington in 1913 and died on 11 November 1994. She initially worked as a teacher. She came to psychoanalysis in 1943 through a course taught by Susan Isaacs. From 1950 to 1953, she trained as a child psychotherapist at the Tavistock Clinic. Her training analysis with Wilfred Bion lasted sixteen years. Her supervisors included Esther Bick, Herbert Rosenfeld and Donald Meltzer. In 1984, she became an Honorary Affiliate of the British Psychoanalytical Society.
Her most important books include *Autism and Childhood Psychosis* (1972), *Autistic States in Children* (1981), *Autistic Barriers in Neurotic Patients* (1986) and *The Protective Shell in Children and Adults* (1990).
This sequence marks a shift in her focus: from the autistic child to isolated psychological states in children and adults without a diagnosis of autism.
Objects and Forms
Tustin distinguished between two phenomena, which she regarded as forms of elementary self-soothing.
Autistic objects are hard and provide sensory stimuli. A set of keys, a piece of metal or a toy car is clutched in the hand, not because of its function or symbolic meaning, but because of the pressure it exerts on the skin. What matters is the sensation of firmness, boundary, and resistance. In this context, the individual object is interchangeable. Its material properties matter more than its personal significance.
Autistic forms, by contrast, are soft and less concrete. Tustin understood these to be vague, body-oriented sensory constructs intended to bundle together and soothe disordered sensory impressions. She identified them, for example, in the handling of saliva, food in the mouth or other soft bodily materials. According to her description, these forms create a feeling of warmth and envelopment that is available at all times.
For Tustin, both phenomena are characterised by the fact that they require no counterpart. The object does not respond. The form does not demand a relationship. Here lies their stabilising function, but also their limitation: they reduce dependence and protect against being overwhelmed, while keeping relationships and emotional processing at a distance.
Encapsulation
From such observations, Tustin developed the concept of autistic encapsulation or the autistic armour. She used this to describe a physical and psychological protective process that precedes the psychological defence mechanism: an early, reified precursor to repression, denial, or forgetting.
This refers to a psychological realm in which primal fears are not symbolically processed but remain sealed off. Tustin included among these fears of dissolving, falling, disappearing, nothingness or physically experienced mutilation. The affected area is not processed or integrated. It is sealed off.
As early as 1972, Tustin noted that such encapsulations could also be found in the character organisation of comparatively unremarkable individuals. She cited rigid splits, superficial identifications and a pronounced need for control as indicators. She linked this organisation, amongst other things, to phobias, sleep disorders, anorexia nervosa, elective mutism, psychosomatic complaints and learning difficulties.
She reasoned that a loosening of this ‘armour’ could unleash considerable affective instability. In this context, Tustin mentioned manic-depressive fluctuations. Encapsulation therefore appears to her not only as a restriction, but also as a stopgap measure: it holds together something that would otherwise be experienced as unmanageable.
The ‘black hole’
Tustin’s description of the ‘black hole’ became particularly well known. It stems from a boy she called John. He experienced the nipple as a part of his own mouth that had been torn off and was missing. In this fantasy, the mouth became a black hole with a painful or threatening spike.
Tustin interpreted this image as an expression of an experience in which separation from another’s body is experienced not as a mere absence, but as a physical severance. Herein lies the untenable leap in her theory: from the clinical description of a single child to a general theory of the development and aetiology of autism.
Tustin later admitted that her Kleinian training shaped her conceptual framework. The categories through which she initially interpreted her observations could not have adequately captured what she had found.
The 1991 revision
In 1991, Tustin published the essay ‘Revised Understandings of Psychogenic Autism’ in the International Journal of Psycho-Analysis. In it, she explicitly retracted the assumption of a normal primary autistic phase.
According to Tustin, the findings from infant observations refuted the postulate of an initial autistic phase of development. Consequently, autism could not be understood as a fixation on such a phase or as a return to it. From then on, she reserved the term ‘autism’ for ‘pathological conditions’.
This revision had a long history. As early as 1986, she replaced the term ‘psychogenic autism’ with ‘psychobiological autism’. In 1992, she stated that no form of childhood autism could be attributed exclusively to psychogenic causes. Her last published essay, from 1994, is entitled ‘The Perpetuation of an Error’.
It is rare in the history of psychoanalytic thought for an author to publicly retract central elements of her own work. However, Tustin’s later position is frequently overlooked. To this day, her name is often associated with a view that she herself had rejected.
Why her theory of autism is outdated
Autism is now classified as a ‘neurodevelopmental disorder’ in the ICD-11 and DSM-5-TR. Research findings point to a complex interplay of genetic and neurobiological causes. Simple psychogenic explanations are considered untenable.
The large Swedish family and twin study by Sandin and colleagues, published in 2017, analysed 37,570 pairs of twins and 2,642,064 pairs of siblings, including 14,516 diagnoses of autism. It estimated heritability at around 83 per cent. Environmental factors that differed between siblings accounted for around 17 per cent of the variance. Shared environmental factors had virtually no significant effect.
This effectively undermines virtually the entire family of psychogenic autism theories, particularly the notion that autism stems from emotional coldness, a lack of attachment or a damaging parent-child relationship. The figure of the ‘refrigerator mother’, which dates back to early misinterpretations by Kanner and was popularised by Bruno Bettelheim, has been scientifically and ethically discredited.
Dianna Kenny subjected Tustin to a fundamental critique in SAGE Open in 2019. She interprets Tustin’s work as an example of psychoanalytic theory-building that has failed to incorporate findings from infant and autism research adequately. Her criticism also targets the institutional and theoretical groupthink within the circles of Klein, Bick, and Tustin.
Tustin and the question of blame
Tustin espoused a flawed theory of the aetiology of autism, but did not blame parents in the way that was later occasionally attributed to her.
She described Kanner's and Bettelheim’s ideas as cruel and erroneous. She expressly stated that autism was nobody’s fault. According to Tustin, most autistic children had experienced neither emotional coldness nor neglect or violence at the hands of their parents.
This does not exonerate her theory, but it does distinguish it from a direct pathologisation or moral condemnation of parents. Her position was incorrect, but it was not based on the claim that parents were to blame for autism.
Theoretical context
Tustin’s concepts sit within a psychoanalytic framework concerned with the formation of psychological boundaries: how the internal and the external, the self and the object, and the body and relationships are organised before linguistic symbolisation.
Author | Concept | Central idea |
|---|---|---|
Esther Bick | Second skin | The skin acts as the primary psychological container. Where a supportive counterpart is lacking, muscle tension, constant movement or incessant talking can form a substitute shell. |
Donald Meltzer | Adhesive Identification | The subject clings to the surface of the other without forming a psychological space in between. |
Thomas H. Ogden | Autistic-contiguous position | A mode of experience in which touch, surface, rhythm and sensory proximity organise the experience. |
Didier Anzieu | Skin-ego | The skin is understood as a model of a psychological shell and boundary. |
Wilfred Bion | Container-Contained | Indigestible experience can become psychologically conceivable through the receptive and processing function of another person. |
These concepts are historically and theoretically linked, but they are not identical. They should neither be merged into a single theory of autism nor used as diagnostic categories.
Adult patients without autism
The more specific clinical context of Tustin’s book is Sydney Klein’s 1980 essay ‘Autistic Phenomena in Neurotic Patients’. Klein described patients whose analysis may appear outwardly organised and productive, whilst their experience remains thin, formulaic or untouched in crucial areas. It is reflected upon, understood and interpreted. Yet something essential remains unchanged.
In 1992, Judith Mitrani described the survival function of ‘autistic manoeuvres’ in adult patients. These refer to behaviours that may initially appear to be resistance but actually serve a stabilising function: a rigid ritual to begin the session, a consistent manner of speaking, an object held in the hand, a monotonous tone of voice or a recurring physical action.
Such practices need not be understood as deliberate avoidance. They can support a fragile psychological organisation by preventing unregulated emotions, separation anxiety or experiences of disintegration from becoming overwhelming. From this perspective, the question is not only how a behaviour can be changed therapeutically, but also what function it has fulfilled up to now.
In this context, the Frances Tustin Memorial Trust refers to ‘autistic enclaves’ in children and adults. ‘Enclave’ is a more precise metaphor than ‘encapsulation’: it refers to a demarcated area with its own logic within an otherwise differently organised personality.
No statement about autism
The problematic impact of this tradition of terminology begins where its language is misunderstood in a diagnostic context. What Tustin, Klein and Mitrani described in adult neurotic patients is not autism, not ‘mild autism’ and not a hidden autism spectrum.
These are psychoanalytic descriptions of withdrawal, self-stabilisation and areas of psychological functioning that are difficult to access in people with other clinical presentations. The use of the word ‘autistic’ is historically conditioned and, from today’s perspective, misleading. It stems from an era in which autism was, to some extent, understood as an acquired condition.
Anyone who today speaks of ‘autistic encapsulation’ in a non-autistic adult should therefore clarify that what is meant is a specific clinical description, not an autism statement. Conversely, Tustin’s concepts are not a suitable tool for interpreting autistic people. Stimming, withdrawal, repetitive behaviours and sensory self-regulation in autistic people should not automatically be interpreted as ‘encapsulation’, ‘defence’ or ‘avoidance of relationships’. They are linked to a specific way of processing stimuli and can have regulatory, communicative or functional significance.
What remains of Tustin’s work
Three aspects of her work remain worth reading, even if her aetiology of autism is clearly rejected.
· The description of the sensory function of hard objects. An object clenched in the fist, pressure on the skin or a particular surface can act as a concrete form of self-stabilisation, without this necessarily having to be interpreted in symbolic or biographical terms.
· The observation that therapy can proceed correctly, calmly and in a way that focuses on understanding, without addressing specific psychological areas. A low-conflict process is not necessarily productive. Smoothness can also indicate isolation.
· Public self-correction. Tustin revised key assumptions when empirical findings contradicted them. Her final essay on the persistence of an error is therefore also a rare example of intellectual integrity within the psychoanalytic tradition.
Key points
• Frances Tustin described encapsulating withdrawal and self-preservation functions in non-autistic children and adults, particularly in *Autistic Barriers in Neurotic Patients* (1986) and *The Protective Shell in Children and Adults* (1990).
• Her concepts include hard ‘autistic objects’, soft ‘autistic forms’ and encapsulation as a physical and psychological protective process.
• Tustin did not regard such demarcated areas simply as defences, but as a fundamental mechanism for organising oneself against psychological overload and disintegration.
• Her theory of psychogenically caused autism has been refuted. From 1986 onwards, Tustin revised key aspects of her own assumptions and, in 1991, explicitly withdrew the hypothesis of a normal primary autistic phase.
• Autism is a neurodevelopmental condition with a complex aetiology that is predominantly determined by genetic and neurobiological factors. Psychogenic explanations and theories attributing blame to parents are scientifically untenable.
• Tustin firmly rejected attributing blame to parents and described such theories as cruel and erroneous.
• The withdrawal phenomena described in non-autistic adults must not be confused with autism. They are neither a diagnostic indicator of autism spectrum disorder nor a model for explaining the autistic experience.
Sources
· Melanie Klein Trust, entry ‘Frances Tustin’ (Maria Rhode, 2017): https://melanie-klein-trust.org.uk/writers/frances-tustin/
· Frances Tustin Memorial Trust, About Frances Tustin: https://www.frances-tustin-autism.org/about-frances-tustin/
· Tustin, F.: *Autism and Childhood Psychosis*, Hogarth Press 1972; *Autistic States in Children*, Routledge & Kegan Paul 1981; *Autistic Barriers in Neurotic Patients*, Karnac 1986; *The Protective Shell in Children and Adults*, Karnac 1990
· Tustin, F.: Revised understandings of psychogenic autism, International Journal of Psycho-Analysis 72 (1991), 585–591: https://pubmed.ncbi.nlm.nih.gov/1797714/
· Taipale, J.: Caught on the surface. Tustin on autistic experience, Frontiers in Psychology 14 (2023), 1243310: https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1243310
· Haag, G.: Autistic Capsule/Nucleus, in: International Dictionary of Psychoanalysis: https://www.encyclopedia.com/psychology/dictionaries-thesauruses-pictures-and-press-releases/autistic-capsulenucleus
· Kenny, D. T.: Faulty Theory, Failed Therapy. Frances Tustin, Infant and Child Psychoanalysis, and the Treatment of Autism Spectrum Disorders, SAGE Open 9 (2019): https://journals.sagepub.com/doi/10.1177/2158244019832686
· Sandin, S., Lichtenstein, P., Kuja-Halkola, R., Hultman, C., Larsson, H., Reichenberg, A.: The Heritability of Autism Spectrum Disorder, JAMA 318 (2017), 1182–1184: https://pubmed.ncbi.nlm.nih.gov/28973605/
· Bick, E.: The Experience of the Skin in Early Object-Relations, International Journal of Psycho-Analysis 49 (1968), 484–486
· Meltzer, D., Bremner, J., Hoxter, S., Weddell, D., Wittenberg, I.: Explorations in Autism. A Psycho-Analytical Study, Clunie Press 1975
· Ogden, T. H.: On the Concept of an Autistic-Contiguous Position, International Journal of Psycho-Analysis 70 (1989), 127–140; The Primitive Edge of Experience, Jason Aronson 1989
· Anzieu, D.: *Le Moi-peau*, Dunod 1985; German edition: *Das Haut-Ich*, Suhrkamp: https://www.suhrkamp.de/buch/didier-anzieu-das-haut-ich-t-9783518288559
· Bion, W. R.: Learning from Experience, Heinemann 1962
· Klein, S.: Autistic Phenomena in Neurotic Patients, International Journal of Psycho-Analysis 61 (1980), 395–401
· Mitrani, J. L.: On the survival function of autistic manoeuvres in adult patients, International Journal of Psycho-Analysis 73 (1992), 549–559: https://bgsp.edu/app/uploads/2014/12/Mitrani-J-On-the-Survival-Function-of-Autistic-Manoeuvres-in-Adult-Patients.pdf
· Mitrani, J. L., Mitrani, T. (eds.): Frances Tustin Today, Routledge, 2015
Related
Newsletter
Möchten Sie informiert werden, wenn ich einen neuen Blogbeitrag veröffentliche? Tragen Sie sich gern hier ein.
Klicken Sie auf „Kostenlos abonnieren“, wenn Sie meine Datenschutzerklärung gelesen und akzeptiert haben. Ihre Einwilligung können Sie jederzeit widerrufen.
Newsletter
Möchten Sie informiert werden, wenn ich einen neuen Blogbeitrag veröffentliche? Tragen Sie sich gern hier ein.
Klicken Sie auf „Kostenlos abonnieren“, wenn Sie meine Datenschutzerklärung gelesen und akzeptiert haben. Ihre Einwilligung können Sie jederzeit widerrufen.