Delusional development in child autism at the onset of puberty: vicissitudes of psychic dimensionality between disintegration and development

Although the psychogenetic hypotheses on child autism have been superseded, psychoanalysis can still reflect on the relational exchange and its sensory aspects in concomitance with the mental development of these patients. Without making generalizations as regards the pathogenesis, but considering the specific features of each autistic child, it may be possible to achieve an integration of those islands of competence that make up these patients' limited personal heritage. Such integration may be reached through the analysis of representational, emotional and relational transformations. The first part of this article describes the case of an autistic child in treatment from the age of four on a four-times-weekly basis who, during puberty, developed severe formal thought disorders together with delusional and hallucinatory formations. The second part develops some post-Jungian theoretical contributions, such as the concept of self as nothingness and the idea of the unsaturated archetype, so as to evaluate the function of some a-priori concepts in support of the analyst's position. These concepts are considered in relation to Bion's model of transformation, and to the formulations on dimensional awareness, especially on the shift from a two-dimensionality to three-dimensionality view, as well as to the rhythm of the object's presence and absence.