[Place of psychoanalysis in a day hospital for psychotic little children]

The authors try to draw conclusions from Winnicot's articles on the discontinous nature of emotional development. They try to understand how autism may originate in disruptions of self-non-self" attachments. However, they admit that the child's personality may develop even within such disruptions. In an experiment of intensive care in a day-hospital for autistic or psychotic children they have tried to restore these attachments in the hospital itself, through continuous care by each member of the staff, regardless of qualification or training. This continuity provides a basis for relationships which may be voiced and interpreted during the children's therapy as they share this reference experience. Its continuity makes life in the institution therapeutic in itself, even without psychoanalytic interpretations. The lack of spoken language gives rise to communication difficulties and use of an educated self is a current project. Two clinical observations exemplify the parallel work of parents and children and their reciprocal interactions. As the origin and future of these psychoses are still open questions, the possible responsibility of predisposing or initial fragilizing factors which facilitate this lasting personality organization is to be considered.