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With contributions from Anne Alvarez, Joshua Durban, Jeffrey L. Eaton, Bernard Golse, Didier Houzel, Howard B. Levine, Suzanne Maiello, Sylvain Missonnier, Bernd Nissen, Marganit Ofer, and Jani Santamaria.

The capacity to create psychic representations is now understood to be a developmental achievement. Without it, meaning cannot be ascertained and this can lead to "psychic voids" and "unrepresented states", which can contribute to the development of autism and autistic spectrum disorders (ASD). Unrepresented states are also implicated and encountered in other, non-autistic, non-neurotic conditions, such as psychosomatic disorders, addictions, perversions, and primitive character disorders. The affects that unrepresented states produce or are associated with are often those of terror, emptiness, annihilation and despair.

The organisation of the psyche consists of psychotic - i.e. unstructured - as well as neurotic parts of the mind; unintegrated as well as integrated areas; and unrepresented areas with little meaning as well as represented states consisting of specific ideas imbued with affect. Given this organisation, we should expect to find both an unstructured and a dynamic unconscious in all patients. This implies that, to some degree, unrepresented and unintegrated states are universal and will exist and be encountered in all of us. Consequently, the opportunities and challenges presented by the understanding and treatment of autism and ASD, where the unrepresented and its consequences (e.g. defensive organisations employed to protect against annihilation anxiety and catastrophic dread) can be encountered may offer us metaphors and clues relevant to aspects of the treatment of all patients, no matter what their dominant diagnoses may be.

Packed with theory and helpful case studies, this carefully edited collection from an international array of experts in the field is essential reading for all practising clinicians.

Contents:

About the editors and contributors

Foreword

CHAPTER ONE: Making the unthinkable thinkable: vitalisation, reclamation, containment, and representation

Howard B. Levine

CHAPTER TWO: Finding the wavelength: tools in communication with children with autism

Anne Alvarez

CHAPTER THREE: From chaos to Caravaggio: technical considerations in the psychoanalysis of autisto-psychotic states in relation to sensory-perceptual fragmentation

Joshua Durban

CHAPTER FOUR: The birth of emotional experience under the sea: a clinical case

Jani Santamaria

CHAPTER FIVE: The third topography: a topography of the bond, a perinatal topography

Sylvain Missonnier and Bernard Golse

CHAPTER SIX: Infantile autism: A pathology of otherness

Didier Houzel

CHAPTER SEVEN: Multi-two-dimensional: on autistic thinking

Marganit Ofer

CHAPTER EIGHT: From screaming to dreaming: notes on anxiety and its transformation

Jeffrey L. Eaton

CHAPTER NINE: A "felt-self": aspects of symbolising through psychotherapy

Jeffrey L. Eaton

CHAPTER TEN: The mute voice: autistic enclaves and transgenerational transmission

Suzanne Maiello

CHAPTER ELEVEN: From nothing to being? Technical considerations for dealing with unrepresented states

Bernd Nissen

Index