Différence entre autisme de kanner et 〈psychose infantile〉: Déficits d'unité vs d'identité de la situation?

Abstract

Although today it is nosographically invisible and diluted in the 〈autistic spectrum〉, the distinction between Kanner's autism and 〈infantile psychosis〉 (or pre-psychosis) is nonetheless clinically proven and regularly seen. Therefore, it seems necessary, irrespective of etiology, to understand the opposition between these two disorders and to indicate more precisely, their respective and specific manifestations. From the analogy with two separate kinds of agnosia, in this first step, we present the assumption that they consist of disorders respectively affecting unity and identity of the situation experienced (either bodily or environmentally). The deficit of unity in autism seems to impair the delimitation of unforeseen experiences and is displayed in the negative (or deficient) symptom of isolation. The preservation of identity displays itself through the positive (or compensatory) symptom of sameness, that is, of an excessive identity. The internal or external event is not apprehended in its complexity or in its cohesiveness, but only in its coherence. On the other hand, in infantile psychosis, the disorder impairs the discrimination of experiential variations and displays itself in the 〈negative〉 symptom of confusion. Preservation of unity displays itself, on the contrary, in a positive way, by invasion and fusion/fragmentation, that is, by an overly efficient or excessive unity. The situation is no longer considered to be homogenous or coherent, but only cohesive. The clinical and critical discussion of this hypothesis is supported by analogous propositions from authors of quite different theoretical schools, such as M. Mahler, F. Tustin, U. Frith and particularly, M. Lemay whose recent propositions about troubles of integration and of modulation seem to be similar to our own.