Osmotic Anxieties and Autistic Defensive Organizations


Frances Tustin explored a range of early autistic anxieties of being, most of them concrete and bodily in nature. These anxieties are characterized by a catastrophic terror of change related to a pre-mature awareness of separateness and the ensuing threat of dissolution or ‘non-being’. Tustin discovered and deepened our understanding of the way these overwhelming early anxieties might trigger various autistic defensive organizations. In this presentation I’ll describe a special kind of osmotic anxieties, first described by Herbert Rosenfeld, which characterizes extreme forms of hyper-permeability and lack of self-object differentiation in the infant. These osmotic or diffuse anxieties , which are not located in either self or object but rather being everywhere and nowhere at the same time, often repeat and enact intra-uterine catastrophes, real or phantasized. I will bring clinical material from the analyses of an ASD child and of an adult patient and show the various defensive organizations deployed as a way of warding-off these anxieties. I will also discuss questions of technique while confronting these anxieties.

Joshua (Shuki) Durban

is a training and supervising child and adult psychoanalyst at the Israel Psychoanalytic Society and Institute where he also teaches. He is on the faculty of the Sackler Faculty of Medicine, Tel-Aviv University, The Psychotherapy Program, Primitive Mental States track and the Post-Graduate Kleinian Studies track. He is the scientific co-editor (with Dr. Meirav Roth) of the Hebrew edition of the collected works of Melanie Klein. He is a member of the IPA inter-committee for the prevention of child abuse. He serves as an advisor and supervisor for national and international projects on the subject. He works in private practice in Tel-Aviv with children, adolescents and adults and specializes in the psychoanalysis of ASD and psychotic children and adults. His papers were printed in journals such as: IJPA, Psyche, The Journal of Child Psychotherapy, Free Associations, Ethos and The American Journal of Psychotherapy. His work was translated into French, German, Spanish and Portuguese. He has also contributed chapters to several books on mourning, on trauma, on evil, on ghosts in the consulting room, on the role and training of physicians, on refugees and on autism.