Self-sensuality in fantasy: reflections on early development based on a case history

On the basis of a detailed account of the analysis of a severely disturbed female patient with suicidal tendencies and pronounced mood swings, in whom sensory impressions were particularly important, the author investigates the phenomena of hypersensuality and self-sensuality. These are shown to be closely bound up with the patient's primitive erotisation of both the transference and her life outside the analysis, their function being one of self-feeding designed to blot out the awareness of separation and separateness. Depending on a given subject's personality development and the position from which mental events are experienced, the author notes that this self-sensuality may be external, acted out or largely confined to fantasy. The case history leads to some theoretical reflections, supported by the results of infant observation conducted by the author and his assistants, on the possible connection between erotised patterns of relating in such patients and the existence of autistic nuclei. In the final part of the paper, the author considers whether the two familiar Kleinian positions need to be supplemented by a third, 'autistic', position, discusses the relevant consequences and implications, and emphasises that the assumption of the existence of such a position carries the risk of its reification. He ends with a poetic example that sums up the isolation of the patients concerned.