From chaos to Caravaggio: technical considerations in the psychoanalysis of autistopsychotic states in relation to sensory-perceptual fragmentation

In this article, I describe the psychoanalysis of a girl on the Autisto- Psychotic Spectrum and her struggle to emerge out of a severe autistic pathological organisation. At the beginning of her analysis, the girl was in a state of autistic confusion, which was manifested as a sensorial lack of colour differentiation. Following interpretative working-through of her deep anxieties-of-being, she established a sensorial-emotional ‘wall’, leading to a consolidation of a previously precarious primary splitting. This, in turn, led to a better capacity for emotional perception and differentiation. Further interpretation of her paranoid-schizoid anxieties enabled a gradual emergence of relatedness, communication, concern, and some integration and reparation. Moreover, as the girl’s linking functions, psychic space, object relations and integration improved, her sensory, perceptual and motor skills and integrative capacities improved as well. She eventually emerged into the emotional and sensorial ‘land of colours’. Thus, psychoanalytic psychotherapy, with its linking and mantling functions, proved to be indispensable for both her development, as well as for structural changes in her sensoryperceptual experience.