Fantasía y realidad

(Análisis de un núcleo autístico atípico)

Abstract

This is the case of a patient who confused phantasy and reality. The analysis of that confusion made it possible to reach an autistic nucleus and the treatment, which had come to a standstill at the time, could go on. Owing to the projection of the patient’s autism into space, the nucleus was constituted by the school he was teaching at. In that close redoubt the patient had created a series of characters: “the teacher”, “the headmaster”, “the Doctor”, “the General”, on the basis of pseudoidentifications. He could thus live a life of phantasy, foreign to the life of the self. These characters stood for the patient’s father and brothers. By means of the autistic nucleus he intented to keep his mother entirely for himself. He had failed partly in building up this nucleus, for he had had to introduce into it his own persecutors (father and brothers) as intermediaries in his attempts towards the total possession of his mother.
In dealing with the origin of this a-typical autistic nucleus, we had to consider the patient’s nurse who, like his own mother, had idealized and persecutory features at the same time. Mother and nurse constituted a confused binomial which did not make possible a successful dissociation. Delusion from both figures led to the formation of the nucleus and accounted for its a-typical character.
We give some examples of typical autistic nuclei and we compare them with our patient’s.
Side by side with a life of phantasy, this patient led an apparently adult life, fairly adapted to reality. This was reason why his world of fiction remained concealed during years of treatment. External circumstances led to the discovery of his autistic nucleus.