A Psychoanalytic Lens
When I work with people on the autism spectrum, I often use tools from modern medicine and brain science. But sometimes, I also turn to ideas from psychoanalysis—a way of thinking that focuses on feelings, relationships, and early experiences. One person whose work has influenced me is Frances Tustin, a British therapist and psychoanalyst who worked closely with autistic children.
Tustin had a different way of understanding autism. She didn’t see it only as a brain-based condition, but also as something that can be shaped by how a child experiences the world—especially if that world feels confusing, overwhelming, or scary.
Tustin believed that for some children, the outside world—especially the feeling of being separate from a parent or caregiver—can feel too hard to handle. She thought that certain autistic behaviors, like repeating movements or focusing on specific textures, might be ways to calm down or block out too much input. In her view, these behaviors weren’t random or “bad”—they were smart ways to feel safe.
Some ideas from her work that I find helpful include:
- Autistic sensations: Repetitive behaviors like rocking or rubbing might help a child feel secure, almost like a comfort object.
- Emotional protection: Some kids might build a “bubble” around themselves to protect against feelings that are too big or confusing.
- Blurry boundaries: Tustin noticed that some children seemed unsure where their bodies ended and the world began. This could make ordinary experiences feel overwhelming or even frightening.
I don’t believe that autism is caused by parenting or emotional trauma. The old idea that a “refrigerator mom” could cause autism was not only wrong—it’s been deeply harmful to families and to society. I follow the science that shows autism is based in brain development and genetics. But I also know that each person’s inner world—their thoughts, feelings, and early experiences—matters too. We’re all shaped by how we experience the world, and that includes people on the spectrum.
Tustin’s ideas remind me to slow down, listen carefully, and look for the emotional meaning behind a behavior. Sometimes, what looks like “shutting down” or “tuning out” is actually someone trying to protect themselves.
For some families or individuals, Tustin’s way of thinking helps make sense of things they’ve struggled to explain. For others, it might not fit—and that’s okay too. My job is to meet you where you are, offer ideas that feel useful, and stay curious and open.
References
- Tustin, F. (1981). Autistic States in Children. London: Routledge.
— In this foundational book, Frances Tustin shares her clinical observations and theories about how some children use sensory and behavioral patterns to protect themselves emotionally. - Tustin, F. (1990). The Protective Shell in Children and Adults. London: Karnac Books.
— Tustin expands on her earlier work by exploring how people may build psychological “shells” in response to overwhelming emotional experiences. - Alvarez, A., & Reid, S. (1999). Autism and Personality: Findings from the Tavistock Autism Workshop. London: Routledge.
— This book builds on Tustin’s psychoanalytic approach and includes thoughtful critiques and developments by other clinicians in the field. - Boston Change Process Study Group. (2010). Change in Psychotherapy: A Unifying Paradigm. W. W. Norton & Company.
— While not about autism specifically, this work highlights how deep emotional change happens in relationships—something that aligns with the spirit of Tustin’s thinking. - Cottis, T. (2009). “The relevance of psychoanalytic thinking in understanding autism.” Clinical Child Psychology and Psychiatry, 14(4), 537–550.
— A modern discussion of how psychoanalytic ideas can contribute to our understanding of autism today, while also acknowledging their limits and historical context.