On the determination of autistoid organizations in non-autistic adults

Psychogenic autistic phenomena occurring in non-autistic adults are being increasingly discussed in the psychoanalytical literature. The author endeavours to determine autistoid organizations, which are understood to be a particular form of pathological retreat. Together with the use of autistic objects, two-dimensional levelling out, the failure of unconscious communication, and of projective identification, a characteristic of these retreats is that they are meant to afford protection against paranoid-schizoid fears of the external and unintegrated states of the internal world. The formation of such autistic reactions should be sought not only in traumatic separations and the inadequate containment of primary objects, but also in constitutional weakening. Intolerance accompanying projective identification and damage to primal fantasies/preconceptions are discussed. In conclusion, a clinical illustration with autistoid and hypochondriacal retreats clarifies some of the aspects discussed.