Psychoanalysis on the Spectrum: Encounters with Primitive Mental States
A one-day conference for those working psychoanalytically with children and adults

Saturday 7th March 2026, 9.30 am – 4.45 pm (GMT)
Hybrid – Online or In Person at 10 Union Street, London Bridge, London SE1 1SZ

*In Person – Standard £100
*In Person/Concession £80
*Lunch included

Online – Standard £80/Online – Concession £65

(Concessions are for candidates/students. Please email lukeperry@psychoanalysis-bpa.org for a code)

Book your ticket here

A recording will be available for 14 days after the event.

Programme

Since 1978/1980, it has been recognised that the primitive mental states and existential bodily terrors that Frances Tustin described in children on the spectrum are also encountered in children and adults who do not meet the criteria for an autism diagnosis. This extends to those who suffer from difficulties including psychosomatic symptoms, eating disorders, school refusal, dyspraxia, and being 'difficult to reach'.

Following a brief theoretical introduction concerning some of the key psychoanalytic findings from work with children on the autism spectrum, the conference goes on to show, first, how an awareness of these features can add to the understanding of adult patients who are not 'normal neurotic'. This is followed by a presentation of work with a child, in order to show what the actual syndrome looks like and how it can be approached psychoanalytically. The parent/infant relationship is then explored by two analysts who were involved in an early intervention project. This revealed the importance of the interaction between parents and their at-risk toddlers in influencing whether a toddler receives a diagnosis. The day will close with a plenary discussion.

Introduction
Maria Rhode will present a brief theoretical introduction concerning some of the key psychoanalytic findings from work with children on the autism spectrum.

Trying to Enter the Long Black Branches: Some technical extensions of the work of Frances Tustin for the analysis of autistic states in adults
Dr Judith Mitrani suggests a number of technical extensions/clinical applications of Frances Tustin’s work with autistic children, which are applicable to the psychoanalysis of neurotic, borderline and psychotic adults. These are especially relevant to those individuals in whom early uncontained happenings (Bion) have been silently encapsulated through the use of secretive autosensual manoeuvres related to autistic objects and shapes. Although such encapsulations may constitute obstacles to emotional and intellectual development, are consequential in both the relational and vocational spheres for many analysands, and present unending challenges for their analysts, the author demonstrates ways in which it may be possible to detect and to modify these in a transference-centered analysis. A detailed process of differential diagnosis between autistic states and neurotic/narcissistic (object-related) states in adults is outlined, along with several clinical demonstrations of the handling of a variety of elemental terrors, including the ‘dread of dissolution’. The idiosyncratic and perverse use of the analytic setting and of the analyst and issues of the analysand’s motivations are considered and illustrated. A new model related to ‘objects in the periphery’ is introduced as an alternative to the more classical Kleinian models regarding certain responses and/or non-responses to transference interpretation. Issues a propos the countertransference are also taken up throughout.

Working on Doubt in Psychoanalytic Psychotherapy with an Autistic Child: an exploration of being together
Masaaki Nishimura
I describe a psychoanalytic psychotherapy with a child with ASD and our struggle to be together emotionally. Throughout the psychotherapy process, it was vital that I worked on countertransference, particularly my own doubts. I often found myself exposed to very strong existential doubt, ranging from questions about my capacity to be with the child to doubts about psychoanalytic psychotherapy with children with ASD itself. Working through these doubts enabled me to sustain our exploration of being together in the psychoanalytic space, despite many disruptions—sometimes taking the form of enactments on my part. It also helped us develop a potential space and time to be together emotionally, without rigidifying our attitudes towards the two different human beings together in the same space. I experienced many instances where my rigidifying attitude, particularly towards psychoanalysis, led to the impossibility of working psychoanalytically with the child. Through these struggles, we managed to gradually develop a unique internal and external space and object, which generated new meanings of being together in psychotherapy. This process appeared to change not only the boy’s attitude towards being with me but also my attitude towards him. I believe this psychotherapy demonstrated that psychoanalysis can offer a very unique experience—not only for children with ASD but also for us, psychoanalytic clinicians—to internalise or develop a shared space and object. I believe this can further contribute to our exploration of relational life.

Early Intervention for Toddlers at Risk of Autism: Before and after observations and an audited case series
Maria Rhode and Becky Hall: Both psychoanalytic and non-psychoanalytic clinicians are increasingly intervening early with at-risk very young children and their parents. Maria Rhode will outline an audited case series of at-risk toddlers that showed a significantly lower rate of diagnosis in children who were offered a psychoanalytically and observationally informed intervention, and Becky Hall will describe what it felt like to visit one such family as a research assistant beforehand and afterwards, with observations of the mother and toddler together.

Biographies

Becky Hall qualified as a Child and Adolescent Psychotherapist from the Tavistock clinic in 2009 and subsequently trained as a Psychoanalyst with the British Psychoanalytic Association (BPA). She has worked extensively in Child and Adolescent Mental Health Services (CAMHS) and has developed a particular interest in fostering, adoption and parental mental health. Alongside her NHS work in a specialist team for Looked After Children and Care Leavers, she has a private clinical practice, supervises, writes, and teaches Infant Observation at the BPA. She is an ACP registered Training Analyst and a Trustee of the Stuart Hall Foundation through which she co-ordinates and provides support for under-represented and disadvantaged students in receipt of bursaries on the Tavistock pre-clinical course (M7) and Child Psychotherapy training (M80).

Judith L. Mitrani, PhD, is an Emeritus Training and Supervising Analyst at the Psychoanalytic Center of California and a Fellow of the IPA. She has contributed enormously to building a bridge between Kleinian/Bionian thought and some essential aspects of American Intersubjectivity, considering the analytic process as a two-person psychology concerned with the enduring effects of early pre- and post-natal experience upon the emotional, mental, and relational development of the individual. Her original concepts and her explication of Bion’s work have been instrumental in refining the understanding of our therapeutic work with patients who are ‘difficult to reach’. She has taught, supervised, and presented papers in a number of countries and has authored A Framework for the Imaginary: Clinical Explorations in Primitive States of Being (1997/2008), Ordinary People and Extraordinary Protections: A Post Kleinian Approach To The Treatment of Primitive Mental States (2001), and  Psychoanalytic Technique and Theory: Taking the Transference (2015). With her husband, Dr. Theodore Mitrani, she organized, edited, and translated both Encounters with Autistic States: A Memorial Tribute To Frances Tustin (1996) and Frances Tustin Today (2015). Shortly after the death of Frances Tustin in 1994, Dr. Mitrani founded the International Frances Tustin Memorial Trust and went on to establish an Annual Frances Tustin Memorial Prize and Lectureship.

Maria Rhode is Professor Emeritus of Child Psychotherapy at the Tavistock Clinic and University of East London, member of the Association of Child Psychotherapists and Child Analyst of the British Psychoanalytical Society. Her main interests are childhood autism and psychosis, language development and infant observation, and she has contributed papers, book chapters, and co-edited books on these subjects. She is an Editorial Board member of the International Journal of Psychoanalysis and a recipient of the Frances Tustin Memorial Prize.

Masaaki Nishimura was originally trained as a clinical psychologist in Japan, primarily working at a children’s home with very deprived children, some of whom had developmental conditions such as Autistic Spectrum Disorder (ASD). During this time, he encountered the Tavistock model of working with autistic children. He then moved to London in order to train as a child and adolescent psychotherapist at the Tavistock Clinic. Later, he pursued training to become a psychoanalyst at the Institute of Psychoanalysis. He currently works with children, adolescents, and adults at his private practice, Camden Psychotherapy Unit, and an independent medical centre in London.

REFUNDS: Tickets are fully refundable until 14 days before the lecture, after which time no refunds will be issued.

Image: I want! I want! (1793) by William Blake, The Fitzwilliam Museum, Cambridge