Psychiatry, psychoanalysis, Freud, Jung and autism

Historical reference points, paradigm shifts, controversies and critical reading

The guiding thread is simple: the word “autism” originated within the psychiatry of schizophrenia, was then taken up by child psychiatry, and was gradually transformed into a neurodevelopmental concept. In the meantime, psychoanalysis strongly influenced certain interpretations of autism, sometimes to the point of attributing its cause to early relationships or to parents. Contemporary history is largely the result of a gradual move away from these confusions.

The note also examines a more current question: in what ways can psychiatry be useful to an autistic person, and from what point does it become an inadequate conceptual framework if it treats autism itself as a mental illness to be eliminated?

Executive summary

The first difficulty is terminological. “Psychiatry”, “psychology”, “psychoanalysis”, “psychotherapy”, “neurology” and “analytical psychology” are not synonyms. Psychiatry is a medical specialty. Psychoanalysis is a theory and practice derived mainly from Freud. Jung initially participated in the psychoanalytic movement, then founded his own school, analytical psychology. Bleuler was a psychiatrist and director of the Burghölzli, where Jung worked. It was Bleuler who introduced the term Autismus in his theory of schizophrenia. [S1–S3]

The second essential point is historical: Bleuler’s “autism” in 1911 is not contemporary autism. It referred to a detachment from reality and a predominance of inner life in some people diagnosed with schizophrenia. The word had conceptual links with the auto-erotism discussed by Freud and with the “complexes” studied by Jung. Quoting today a sentence by Bleuler or Jung containing the word “autism” as though it directly described the present-day autism spectrum is therefore an anachronism. [S1–S3]

The third point is that the history of autism does not properly begin with Kanner. As early as 1925–1926, Grunya Sukhareva published descriptions of children that, retrospectively, strongly resemble what we now call autism. Kanner published the series that became canonical in 1943; Asperger published in 1944, after having already used the expression “autistic psychopaths” in 1938. Recent historical research also requires a critical examination of Asperger’s role under the Nazi regime. [S10–S13]

The fourth point concerns psychoanalysis. In the mid-twentieth century, particularly in certain countries and sectors of child psychiatry, autism was interpreted as childhood psychosis, defensive withdrawal, difficulty with separation, disturbance of the mother-child relationship, or a problem of access to the symbolic order. These theories are not all identical, and it would be wrong to place Klein, Mahler, Tustin, Lacan and Bettelheim in a single block. But to varying degrees they share the tendency to seek the cause or central mechanism of autism in psychic and relational organization rather than in atypical neurobiological development. [S14–S15]

The case of the “refrigerator mother” shows how far this framework could go. Kanner at times made remarks about the coldness of certain parents, even though in 1943 he had described autism as innate and later opposed blaming parents. Bruno Bettelheim much more forcefully spread a psychogenic theory of autism as a response to a rejecting parental environment. This view is now rejected: it is not supported by scientific evidence and imposed considerable guilt on families. [S11, S15]

From the 1960s to the 1980s, several changes converged: Bernard Rimland defended a biological conception; Michael Rutter and others showed that autism should be distinguished from childhood schizophrenia; the twin studies by Folstein and Rutter strongly reinforced the genetic hypothesis; epidemiological and developmental studies redefined the clinical picture; and the DSM-III of 1980 created a distinct category of “infantile autism”. This break was not simply a victory of biology: it also marked a move toward more observable criteria and a clearer separation between diagnosis and etiological theory. [S11, S16, S19]

Lorna Wing and Judith Gould then played a decisive role in the shift from a narrow category to a continuum or spectrum conception. DSM-IV and ICD-10 used several subcategories; DSM-5 and then ICD-11 brought them together under “autism spectrum disorder”. ICD-11 currently classifies autism among neurodevelopmental disorders and uses code 6A02 with specifiers concerning intellectual development and functional language. [S17–S20]

At the same time, another change was not only medical but also political and epistemological. From the 1990s onward, organized autistic people challenged the idea that the natural goal should be to eliminate autism or make the child “indistinguishable” from non-autistic people. Jim Sinclair, Autism Network International and the first online communities contributed to this break; the term “neurodiversity” then emerged through a collective process, often associated with Judy Singer and Harvey Blume. The question then became: should we only explain and treat the individual, or should we also transform the environment, power relations, barriers and expectations of normalization? [S24–S27]

The practical conclusion of this note is nuanced. Psychiatry is not “useless” for autistic people. An autistic person may experience depression, severe anxiety, bipolar disorder, psychosis, catatonia, suicidal ideation or other problems requiring psychiatric expertise. On the other hand, treating autism itself as a psychiatric illness to be treated is a category error. NICE guidance, for example, states that medication should not be used for the core features of autism and also asks clinicians to investigate physical, social and environmental factors. The French HAS, in its 2026 recommendations for children and adolescents, explicitly places psychoanalysis among interventions not recommended for ASD. [S21–S23]

The critical position proposed here is therefore to distinguish “psychiatry of autism” from “psychiatry for an autistic person when they need it”. In the first case, the risk is to pathologize a way of developing, perceiving, communicating and existing; in the second, psychiatry can be an occasional or specialized resource for a genuinely associated psychiatric problem. This distinction avoids both generalized psychiatrization and dogmatic rejection of all medicine.

How to read this note: three levels that must never be confused

1 — Documented historical facts. Dates, publications, professional roles, changes in classifications and positions explicitly attested by the sources.

2 — Interpretations and controversies. Debates about the scientific scope of a theory, the causes of a historical change, or the responsibility of particular authors. These points can be documented without constituting unique and definitive truths.

3 — Autistan reading. Normative conceptual analysis: critique of psychiatrization, assimilation and interpretive brutality; interest in accessibility, reciprocal adaptation and the distinction between autism and associated disorders. These propositions must be presented as an argued position, not as scientific consensus.

This separation is particularly important in this field because many conflicts arise from a silent slippage between observation, interpretation and causality. Saying that a person withdraws from an interaction is not the same as saying that they withdraw from reality; saying that psychotherapy gives meaning to an experience is not the same as demonstrating that it explains the origin of autism; observing a neurological difference does not automatically imply that it should be eliminated.

Minimal glossary to avoid confusing the disciplines

Term

Useful definition

Psychiatry

Medical specialty devoted to mental disorders and certain neurodevelopmental disorders. It has diagnostic, psychotherapeutic and pharmacological expertise, but its history and models have changed considerably.

Neurology

Medical specialty of the nervous system. Freud trained as a neurologist; Charcot was a major neurologist.

Psychology

A very broad scientific and professional discipline dealing with behavior and mental processes. It is reducible neither to Freud nor to psychoanalysis.

Psychoanalysis

A theoretical body, method of investigation and therapeutic practice derived mainly from Freud, centered on the unconscious, psychic conflicts, transference, defenses and childhood history.

Psychodynamic

A broader term than “psychoanalytic”. It refers to approaches concerned with conflicts, relationships, defenses and unconscious processes, sometimes quite distant from classical Freudianism.

Analytical psychology

The school founded by Jung after his break with Freud: collective unconscious, archetypes, individuation, psychological types and symbolism.

Psychosis

A term grouping states characterized, among other things, by a major alteration in the shared relationship to reality, for example certain delusions or hallucinations. Autism is not a psychosis, although an autistic person may also have a psychotic disorder.

Schizophrenia

A psychotic disorder distinct from autism. Historically, the two were long confused in child psychiatry.

Nosology

The art and science of classifying diseases and disorders. Kraepelin is a central figure in modern psychiatric nosology.

Neurodevelopmental

Concerning the way the nervous system and associated functions develop. The term alone does not determine whether a difference should be understood as pathology, disability, variation, or a combination of these dimensions.

Bleuler’s Autismus

A concept introduced within schizophrenia: detachment from reality with predominance of inner life. Not to be confused with contemporary autism.

Contemporary autism

A neurodevelopmental category currently defined by persistent differences in social communication/interaction and restricted, repetitive or inflexible patterns, with great heterogeneity.

Medical model

A framework that locates the problem primarily in the individual, their functioning or pathology, and seeks diagnosis, treatment, prevention or correction.

Social model of disability

A framework emphasizing the social, institutional, physical and attitudinal barriers that turn a difference or limitation into a situation of disability.

Neurodiversity

A concept according to which human neurological diversity is part of human variation; the associated movement challenges the automatic equation difference = defect to be eliminated, without necessarily denying disabilities or support needs.

1. Why this history produces so many misunderstandings

The history of autism crosses several disciplines that use neither the same methods nor the same words: neurology, psychiatry, psychology, psychoanalysis, special education, genetics, neuroscience, social sciences and, more recently, knowledge produced by autistic people themselves. The same term can therefore change radically in meaning depending on the period and the milieu in which it is used.

The most striking case is precisely the word “autism”. For Eugen Bleuler, at the beginning of the twentieth century, it referred to a phenomenon observed in schizophrenia and understood as a detachment from reality. In contemporary classifications, autism is placed among neurodevelopmental conditions or disorders. Between these two uses, the word changed its object as much as its definition. [S1, S2, S3, S20]

A second source of confusion is the prestige of names. Freud, Jung, Bleuler, Kanner or Asperger are sometimes cited as though they belonged to a continuous chain of discoveries all concerning the same thing. In reality, their objects, methods, concepts and historical contexts differ greatly.

A third confusion consists in believing that if an older school has been criticized, the school that succeeds it is automatically correct. The decline of psychoanalytic explanations of autism favored developmental, educational, behavioral, biological and genetic approaches. Some provided important knowledge; some also developed their own excesses, particularly when they made a non-autistic appearance the goal of success.

Finally, four questions that are often superimposed must be distinguished: what is autism? What are its causes? What problems does an autistic person encounter? And what should be done to help them? A theory may be relevant at one level and false or abusive at another.

Intellectual safety rule Whenever an older author uses the word “autism”, ask exactly what it referred to at that date. Whenever a theory offers “meaning”, ask whether it also claims to demonstrate a “cause”. Whenever a treatment produces a visible change, ask whether that change genuinely improves the person’s life or merely their conformity to other people’s expectations.

2. Before Freud: Charcot, Janet and Kraepelin

2.1 Jean-Martin Charcot: neurology, hysteria and clinical demonstration

Jean-Martin Charcot (1825–1893) was above all a major French neurologist associated with the Salpêtrière. His work on neurological diseases had a lasting influence on medicine. He also took an interest in hysteria and hypnosis, fields in which the boundary between neurology, psychology and clinical staging was then far less settled than it is today. [S4]

Freud stayed in Paris with Charcot in 1885–1886. This experience mattered in his gradual shift from strictly neurological medicine toward a psychological explanation of certain symptoms. Charcot should not, however, be turned into a “psychoanalyst before Freud”: Charcot remained a neurologist, and psychoanalysis did not yet exist as an established system.

2.2 Pierre Janet: dissociation, psychological automatism and the function of reality

Pierre Janet (1859–1947), a French physician, psychologist and philosopher, developed another tradition for studying hysteria, dissociation and subconscious phenomena. He described “fixed ideas” and dissociated psychological processes, with particular attention to psychological integration and what he called, among other things, the “function of reality”. [S5]

Janet is important for understanding that Freud was not the only thinker of the unconscious or non-conscious mental processes. Part of the popular history of psychology simplifies the landscape as if everything began with Freud, whereas a much broader body of work already existed.

2.3 Emil Kraepelin: classifying mental illnesses according to their course

Emil Kraepelin (1856–1926) represents another orientation: psychiatric nosology. He sought to distinguish mental illnesses by observing not only their symptoms but also their course over time and their prognosis. His category of “dementia praecox” grouped presentations that Bleuler would later reorganize under the name schizophrenia.

Kraepelin is not a direct ancestor of autism. His importance here lies in the fact that Bleuler built his own theory of schizophrenia in dialogue and disagreement with this nosological tradition. It was within this revision of schizophrenia that the word “Autismus” appeared. [S2, S3]

First paradigm shift By the end of the nineteenth century, psychiatry was already moving among several ways of understanding suffering: neurological lesion, clinical classification, psychological history, dissociation, suggestion and the unconscious. Psychoanalysis therefore did not arrive in a scientific desert; it was one response among several to a problem that was still very poorly understood.

3. Freud and psychoanalysis: contributions, ambitions and controversies

3.1 Freud: neurologist before becoming the founder of psychoanalysis

Sigmund Freud (1856–1939) trained as a physician and neurologist. He first worked in the neuroscience of his time, became interested in aphasia, hysteria and treatments by suggestion, and gradually developed a method and theory he would call psychoanalysis.

Freudian psychoanalysis is not a single hypothesis. It forms a very broad set: dynamic unconscious, repression, psychic conflict, transference, infantile sexuality, psychosexual development, dream interpretation, symptoms as compromise formations, and later the models of id, ego and superego. It is therefore intellectually weak to say globally that “Freud was right” or “Freud was wrong” without specifying the proposition being examined.

3.2 What Freud changed

Freud helped establish the idea that apparently absurd symptoms can have a history and meaning for the person; that the relationship with the therapist matters; that memories, conflicts, affects and childhood experiences are not incidental; and that consciousness does not summarize the whole of mental activity.

Some of these broad intuitions are compatible with modern knowledge—for example, the existence of non-conscious mental processes—but this does not automatically validate detailed Freudian metapsychology. The “unconscious” of modern cognitive science is not simply the Freudian unconscious under a new name.

3.3 Why psychoanalysis is scientifically controversial

A classic difficulty concerns the ability to test interpretations. Karl Popper made famous the idea that some psychoanalytic theories seem able to absorb almost any result: the patient’s agreement can be interpreted as confirmation, but disagreement as resistance. The philosophical discussion is more nuanced than the slogan “Freud is unfalsifiable”: Adolf Grünbaum, for example, argued that several Freudian claims are in principle testable, while strongly challenging the evidential value of certain clinical data produced within the analytic relationship itself. [S7]

A second difficulty is interpretive circularity: if the theoretical framework determines in advance the meaning of silence, refusal, a dream, a slip of the tongue or behavior, the system risks becoming closed to contradiction.

A third difficulty is generalization from a small number of heavily interpreted clinical cases. An individual history can be rich and true for one person without constituting a general law of human functioning.

A fourth difficulty is confusing therapeutic effectiveness with theoretical truth. Psychotherapy may help through the relationship, attention, verbalization, narrative reconstruction or other common factors without all the causal hypotheses of the therapeutic school being demonstrated.

3.4 The video of the elderly Freud: what it shows and what it does not show

There are indeed family films of Freud in London in 1938, including footage shot by Marie Bonaparte. He can be seen with his family, in the house or in the garden. The Freud in these images is 82 years old, has just fled Vienna after the Anschluss, and is in very fragile health. [S8, S9, S29]

Freud had suffered for years from cancer of the mouth and jaw, had undergone many operations and wore a prosthesis that made speech difficult, among other things. He would die on 23 September 1939. His diminished appearance or behavior in a late family sequence therefore provides no valid argument for or against psychoanalysis.

It is preferable to criticize Freud on the basis of his texts, reasoning, data, methods and the historical effects of certain ideas rather than on the visual impression produced by an elderly and seriously ill man.

Good response in discussion If someone invokes “Freud” as an authority or as a foil, ask: “Which specific proposition of Freud are we talking about? Is it an observation, a clinical interpretation, a general theory or a causal hypothesis? And what independent evidence supports it today?”

4. Bleuler, Jung and the birth of the word “autism”

4.1 Eugen Bleuler: the genuinely central figure for the word

Eugen Bleuler (1857–1939), a Swiss psychiatrist and director of the Burghölzli in Zurich, gradually replaced the expression “dementia praecox” with “schizophrenia”. In his major 1911 work, he also used the term “Autismus”. [S2, S3]

For Bleuler, “autism” was not a distinct neurodevelopmental condition. It was an aspect of schizophrenia: a detachment or withdrawal from external reality, with predominance of an inner world dominated by the patient’s own needs, affects, fantasies or logic.

The term partly comes from the conceptual environment of Freudian “auto-erotism”, from which Bleuler removed the explicitly sexual dimension. This lexical lineage explains why the history of the word autism touches psychoanalysis even though Freud never discovered contemporary autism. [S1, S3]

4.2 Jung: psychiatrist at the Burghölzli and interlocutor of Freud

Carl Gustav Jung (1875–1961) was indeed a physician and psychiatrist. Early in his career, he worked at the Burghölzli under Bleuler and studied, among other things, word associations and affective “complexes”. At the same time, he became close to Freud from 1906–1907 onward.

This position made Jung a pivotal figure: he participated in Bleuler’s clinical milieu while also being a major actor in the early psychoanalytic movement. Historians note that Jung’s work on complexes influenced the way Bleuler thought about certain schizophrenic phenomena. [S3]

But this does not mean that Jung developed a modern theory of autism. The word circulating at the time still referred primarily to schizophrenia.

4.3 Jung after Freud: analytical psychology, not simply a variant of Freudianism

The Freud–Jung relationship deteriorated and their break became explicit around 1913. Jung then developed his “analytical psychology”: collective unconscious, archetypes, individuation, shadow, anima and animus, psychological types, introversion and extraversion, and later synchronicity.

These concepts can be used as symbolic language, a tool for introspection or a psychological philosophy. Their subjective or cultural interest does not, however, automatically give them the status of demonstrated scientific mechanisms.

Above all, the conflation of Jungian “introversion” with autism should be avoided. An autistic person may be introverted, extraverted, or have characteristics that cannot be reduced to this axis.

The historical triangle to remember Freud provides part of the psychodynamic vocabulary; Jung works with Bleuler while in dialogue with Freud; Bleuler creates “Autismus” within his theory of schizophrenia. The Jung–autism link is therefore historically real, but indirect and prior to present-day neurodevelopmental autism.

5. From schizophrenic “Autismus” to childhood autism

5.1 Grunya Sukhareva: a long-neglected precursor

Grunya Efimovna Sukhareva, a Soviet child psychiatrist, published in Russian in 1925 and then in German in 1926 detailed descriptions of children with characteristics strongly resembling what would now be identified within the autism spectrum. She later also published on girls. [S10]

Her role reminds us that the history is not simply “Kanner, then Asperger”. Historical narratives themselves are influenced by languages, academic networks, translations and international visibility.

5.2 Leo Kanner in 1943: a distinct childhood condition

In 1943, Leo Kanner described eleven children in his paper on “autistic disturbances of affective contact”. He emphasized the very early and distinctive nature of the presentation and made a major contribution to the gradual separation of autism from classical schizophrenia. [S11]

Kanner nevertheless used the vocabulary of his time. Some of his formulations about parents and affective contact were later used or amplified in psychogenic theories. Kanner should not, however, be reduced to the simple inventor of the “refrigerator mother”: the history is more complex, and Kanner himself later explicitly opposed blaming parents.

5.3 Hans Asperger in 1944: similarities, differences and the Nazi context

Hans Asperger published his work on “autistic psychopathy” in 1944. He had already used this expression in a 1938 lecture. His descriptions mainly concerned boys with developed language but marked particularities in social relationships, interests and behavior. [S12]

Asperger is now surrounded by an important historical debate. Archival work by Herwig Czech documented significant accommodation with the Nazi regime, his use of “race hygiene” categories, and his cooperation with a pediatric system involved in the euthanasia of disabled children. He was not a member of the Nazi Party, but the older portrayal of Asperger as a resistant protector of children has become untenable in its simplified form. [S13]

This context does not by itself decide the validity of every clinical observation made by Asperger, but it requires us to distinguish scientific history, ethics and the later construction of a heroic figure.

5.4 The same label, several objects

1911 ≠ 1943 ≠ 2026 Bleuler uses “autism” within schizophrenia; Kanner and Asperger apply related terms to childhood developmental configurations; current classifications describe a neurodevelopmental spectrum. Reading these texts as though they all referred to exactly the same object produces major anachronisms.

6. The psychogenic and psychoanalytic period of autism

After Kanner, childhood autism remained for decades embedded in a vocabulary of “childhood psychosis”, “childhood schizophrenia”, affective withdrawal and early relationships. In a context where psychoanalysis held a very important place in some sectors of psychiatry—particularly in the United States in the mid-twentieth century and for much longer in France—it became tempting to explain autism as the result of psychic conflict or a pathological relationship. [S15, S28]

All psychoanalytic approaches should not be reduced to one formula: Melanie Klein, Margaret Mahler, Bruno Bettelheim, Frances Tustin and Lacanian schools do not say exactly the same thing. But they often share a decisive shift: the autistic phenomenon is interpreted through the construction of the self, object relations, separation, primitive anxiety, defenses or symbolic language rather than through different neurobiological development.

6.1 Melanie Klein: child psychoanalysis

Melanie Klein (1882–1960) developed a child psychoanalysis centered on early object relations, unconscious fantasies and primitive anxieties. Her famous case “Dick” is sometimes retrospectively read as possibly corresponding to an autistic child, but it would be anachronistic to say that Klein diagnosed autism in the contemporary sense.

Klein’s importance in this history lies mainly in the influence of her vocabulary on later theories of childhood psychosis and what would be interpreted as autistic defenses or withdrawals. [S3]

6.2 Margaret Mahler: “autistic” and “symbiotic” phases

Margaret Mahler (1897–1985) proposed a theory of early development in which she spoke, among other things, of a “normal autistic phase”, followed by a symbiotic phase before the process of separation-individuation. This notion of normal infant autism was later abandoned by developmental research.

This example shows a terminological danger: the word “autistic” can become a developmental metaphor and create the impression that clinical autism is the pathological fixation of a normal stage. Such continuity has not been established.

6.3 Frances Tustin: autism as psychic protection

Frances Tustin (1913–1994) is one of the psychoanalysts most closely associated with autism. She developed the idea of autistic formations or defenses protecting the child against primitive experiences of separation, rupture or psychic catastrophe.

Tustin revised some of her own positions and, in particular, abandoned the idea of a normal autistic phase in infancy. But her 1991 paper still speaks of a “psychogenic protective system” associated with a traumatic experience of separation. [S14]

The internal revision of a theory is intellectually important, but it does not turn a psychogenic hypothesis into demonstrated neurodevelopmental evidence.

6.4 Bruno Bettelheim and the “refrigerator mother”

Bruno Bettelheim (1903–1990) popularized to a very broad audience the idea that the autistic child withdrew into an “empty fortress” in reaction to an emotional environment experienced as destructive. The “refrigerator mother” theme linked autism to parental coldness or rejection.

This construction had particularly serious consequences: blaming mothers and families, potentially separating the child from their parents, interpreting parental objections as defenses, and diverting attention from concrete developmental and environmental needs.

Bettelheim does not summarize all of psychoanalysis, and the expression “refrigerator mother” has a more complex genealogy than his name alone. He nevertheless remains one of the main historical symbols of psychogenic explanations applied to autism.

6.5 Lacan and the French persistence

Jacques Lacan (1901–1981) profoundly reformulated French psychoanalysis around language, the symbolic, the imaginary and the real. He did not by himself build a complete and univocal doctrine of “Lacanian autism”. His students and different Lacanian schools also developed theories of childhood psychosis and autism.

France is a particular historical case: psychoanalysis, including Lacanian psychoanalysis, retained influence in some sectors of child psychiatry and institutions long after its decline in other countries. A 2021 analysis specifically describes France as a “cultural outlier” in this respect. [S15]

In 2026, the French Haute Autorité de Santé explicitly placed psychoanalysis among interventions not recommended for ASD in infants, children and adolescents, in light of the available evidence. [S23]

6.6 Why could these theories have seemed convincing?

They offered a coherent story at a time when biological and developmental mechanisms were very poorly known. They translated enigmatic behaviors into understandable human intentions, defenses and relationships. They also matched the prestige of psychoanalysis in certain medical and intellectual circles.

But an appealing explanation can become dangerous when it is practically impossible to contradict. If the child’s withdrawal is interpreted as defense, closeness as dependency, the mother’s protest as guilt, and her agreement as acknowledgment, the system manufactures its own confirmations.

Critical point The main problem is not that an autistic person might have a psychic life, conflicts, traumas or defense mechanisms—of course they can. The problem is turning these human dimensions into the general cause of their autism, and then reading every autistic manifestation through that presumed cause.

7. The turning point of the 1960s–1980s: development, biology, genetics and DSM-III

7.1 Bernard Rimland: challenging psychogenic explanations

In 1964, American psychologist Bernard Rimland, himself the father of an autistic child, published “Infantile Autism” and argued for a biological origin against psychogenic parental explanations. His historical role is important because he helped shift the discussion away from blaming families.

Rimland should not, however, be treated as an infallible authority: some of his later positions on controversial biomedical treatments were themselves criticized. History again shows that a corrective movement can provide a useful break without all of its proposals thereby becoming correct.

7.2 Michael Rutter and the separation from childhood schizophrenia

Michael Rutter and other researchers helped show that autism has a developmental profile, age of onset, course and characteristics that distinguish it from childhood schizophrenia. This separation became stronger during the 1960s and 1970s. [S11]

The conceptual change was immense: a child’s behavior was no longer necessarily read as the symbolic expression of a psychosis; greater attention was paid to the development of communication, interaction, language and learning, and to the stability of characteristics over time.

7.3 Genetics: the Folstein and Rutter twin study

The study by Susan Folstein and Michael Rutter published in 1977 on pairs of twins became a major milestone in establishing a genetic contribution to autism. It did not mean that a single “autism gene” had been discovered; rather, it helped make a general explanation based on parental attitude much less plausible. [S16]

Contemporary genetics confirms a complex architecture: multiple variants, heterogeneity, interactions with development, and no single cause for the whole spectrum. “Biological” therefore does not mean simple, deterministic or reducible to a single test.

7.4 DSM-III in 1980: an institutional boundary

DSM-II of 1968 could still classify childhood presentations under “childhood schizophrenia”. DSM-III of 1980 introduced “infantile autism” within pervasive developmental disorders and established a much clearer diagnostic separation from schizophrenia. [S11, S19]

DSM-III also marked a broader change in American psychiatry: after decades of strong psychoanalytic influence, classification sought more standardized descriptive criteria and aimed to be more “atheoretical” regarding causes. [S6, S28]

This standardization improved reproducibility, but it did not solve everything. Describing criteria still does not say why a phenomenon exists, how the person experiences it, or which dimensions arise from the individual and which from the environment.

Two different breaks 1) Autism separates from schizophrenia and childhood psychosis. 2) American diagnostic psychiatry partly separates from psychoanalytic vocabulary in favor of observable criteria. These two developments reinforce each other, but they are not exactly the same thing.

8. Leaving psychoanalysis is not enough: behaviorism, normalization and other risks

The decline of psychogenic explanations favored educational, developmental and behavioral approaches. This sometimes represented very concrete progress: observable goals, structured learning, assessment of outcomes, and attention to functional skills rather than presumed symbolic conflicts.

But behaviorism can produce another error: treating visible behavior as the primary object to be corrected, independently of why it exists and of the person’s experience. A reduction in visible autistic behavior is not necessarily a reduction in suffering.

Some histories of intensive behavioral intervention have valued goals such as becoming “indistinguishable from peers”. Such a criterion risks measuring success by resemblance to non-autistic people rather than by autonomy, understanding, well-being, communication, dignity or the possibility of living in accordance with one’s nature.

The dilemma is therefore not “psychoanalysis or ABA”. There are many other ways to provide support: augmentative communication, sensory adaptation, explicit teaching, cognitive aids, predictable environments, functional learning, relational support, support for families, attitudinal accessibility and the person’s own participation in decisions.

Succession error A theory can be false without its opponent automatically being right. The fact that psychoanalysis explained autism poorly does not prove that every behavioral intervention is desirable. The criterion must remain the person’s real life, not the victory of a school.

9. From syndrome to spectrum: Wing, Gould, DSM and ICD

9.1 Wing and Gould: broadening the view

Lorna Wing and Judith Gould published an epidemiological study in 1979 that helped show that social interaction difficulties and associated characteristics are distributed across a broader group than the classic Kanner cases. [S17]

In 1981, Wing popularized the expression “Asperger syndrome” in English-language literature and strongly contributed to the idea of an autistic continuum or spectrum. Her own experience as the mother of an autistic daughter and as a clinician also played a role in bringing families, clinical practice and research closer together. [S18]

9.2 DSM-IV, DSM-5 and ICD-11

DSM-IV of 1994 distinguished several categories within pervasive developmental disorders, including autistic disorder and Asperger syndrome. DSM-5 of 2013 grouped them under “autism spectrum disorder”, with specifiers. [S19]

The World Health Organization’s ICD-11 currently classifies autism spectrum disorder under code 6A02 within neurodevelopmental disorders and also uses specifiers, particularly concerning intellectual development and functional language. [S20]

The word “spectrum” does not mean a simple line from “slightly” to “very autistic”. Profiles are multidimensional: language, cognition, autonomy, sensory features, motor function, communication, regulation, health, support needs and environment can differ greatly from one person to another.

9.3 Classification is a tool, not the person

A diagnostic category can enable access to services, create a common language and support research. But it remains a clinical construction: it selects certain characteristics for a given purpose.

Diagnosis therefore summarizes neither the personality, values, abilities, concrete difficulties nor relationship to the world of an autistic person.

10. Antipsychiatry, institutions and criticism of medical power

In the 1960s and 1970s, several very different critiques were grouped under the label “antipsychiatry”. Thomas Szasz criticized the very notion of mental illness; R. D. Laing reinterpreted psychosis within its existential and family context; Erving Goffman analyzed “total institutions”; Michel Foucault historically examined the relationships among madness, knowledge and power.

These authors did not defend a common theory, and it would be misleading to present antipsychiatry as a homogeneous doctrine. Some of their contributions mainly concerned coercion, institutionalization, diagnostic authority and the capacity of a medical system to define a person without their agreement.

These critiques can illuminate the history of autism, particularly confinement, segregation and the confiscation of people’s own voice. But the neurodiversity movement is not simply a continuation of antipsychiatry. A person can recognize the existence of severe mental disorders and the usefulness of psychiatric care while contesting the psychiatrization of autism or certain coercive practices.

Useful distinction Criticizing psychiatric power does not mean denying all mental illness. Defending autism as neurodevelopmental variation does not mean denying that an autistic person may also experience depression, psychosis, bipolar disorder, catatonia or another problem requiring care.

11. Autistic self-representation and neurodiversity

11.1 A change of subject: from “speaking about” to “speaking with”

From the 1990s onward, organized autistic people began to intervene much more visibly in public discourse about them. Jim Sinclair and Autism Network International are among the important figures in this self-representation. The 1993 text “Don’t Mourn for Us” notably marked a break with narratives presenting autism only as a family catastrophe. [S24, S27]

This development changes the nature of relevant knowledge. Observations by professionals and relatives remain useful, but they can no longer be considered sufficient when an autistic person can describe for themselves what they perceive, understand, tolerate, fear or want.

11.2 Neurodiversity: a collective concept, not a denial of difficulties

The concept of neurodiversity developed collectively in autistic and online networks during the 1990s. Judy Singer is important for its academic formulation in the late 1990s, but recent historical work cautions against attributing to her alone the invention of a concept produced by a collective milieu that also included autistic people and writers such as Harvey Blume. [S24, S25]

Neurodiversity begins from the idea that neurological variations are part of human diversity. This does not imply that every difficulty is minor, that no one is disabled, that no care is needed, or that all forms of autism are alike.

The fundamental change is rather to reject the automatic equation: neurological difference = intrinsic defect to normalize. Difficulties may result from a combination of individual characteristics, environment, social expectations, lack of accessibility, health problems and support needs. [S26]

11.3 What this changes for research

A science of autism centered only on deficits observed by non-autistic people risks missing phenomena that autistic people consider essential: sensory overload, the effort of masking, bidirectional misunderstandings, the costs of adaptation, need for predictability, quality of life, accessibility and environmental effects.

Pellicano and den Houting therefore propose shifting part of autism research away from a model centered on individual deficits toward an approach that more seriously integrates neurodiversity, autistic priorities and context. [S26]

12. Is psychiatry appropriate for autism?

12.1 The short answer: not as an all-encompassing framework for autism

If the question is, “Is psychiatry the best framework for understanding what autism is as a whole?”, the answer of this note is no. Autism is now classified as neurodevelopmental, concerns the entire life course, and is reducible neither to an acute mental illness, nor to psychosis, nor to a state whose therapeutic objective would be disappearance. [S20]

An exclusively psychiatric approach risks prioritizing what resembles a symptom: unusual behavior, anxiety, agitation, withdrawal, rigidity or atypical speech. It may then underestimate communication, sensory experience, environment, learning, rights, autonomy, social relationships and accessibility.

The risk increases when a stable autistic difference is interpreted as a sign of decompensation, or when behavior caused by an unsuitable environment is treated pharmacologically without investigating its concrete cause.

12.2 But psychiatry can be useful to an autistic person

Saying that autism should not be psychiatrized does not mean that autistic people never need a psychiatrist. Like anyone else, they may experience depression, severe anxiety disorder, bipolar disorder, psychosis, sleep disorders, catatonia, suicidal ideation, adverse medication effects or other situations requiring psychiatric expertise.

The appropriate role then becomes: treat the autistic person’s psychiatric problem while taking their autism into account, rather than treat autism as though it were itself that psychiatric problem.

Formula to remember “Psychiatry for an autistic person when they need it” is not the same as “psychiatry of autism as a mental illness to be corrected”.

12.3 What contemporary guidelines say

For autistic adults, NICE says not to use antipsychotics, antidepressants or anticonvulsants to manage the core features of autism. The guideline also calls for investigation of physical, mental, environmental or relational factors when behavior becomes problematic. [S21]

A NICE quality statement puts the principle very clearly: autistic people should not receive medication for the purpose of treating the core features of autism. [S22]

This obviously does not prohibit medication indicated for a coexisting disorder or, in certain severe and carefully assessed situations, for behavior that places the person or others at risk. The distinction between a precise indication and treatment of “autism” is essential.

12.4 The risk of confusing behavior with a psychiatric symptom

A person who stops speaking may be overwhelmed, exhausted or in shutdown; a person who flees a place may be suffering from noise, pain or unpredictability; a person who insists on a rule may need coherence or may not understand an implicit exception. These possibilities do not exclude a psychiatric disorder, but they should be examined before automatically turning the behavior into a symptom.

This requirement is particularly important when the person communicates little or in an atypical way. The more difficulty they have explaining what they are experiencing, the greater the interpretive power of professionals becomes — and the more safeguards are needed against hasty interpretations.

12.5 A transdisciplinary approach is generally more appropriate

Understanding an autistic situation may require, depending on the problem: general medicine, neurology, psychiatry, psychology, speech and language therapy, occupational therapy, education, alternative communication, social work, sensory expertise, peer support, knowledge of rights and, above all, detailed knowledge of the person and their environment.

The psychiatrist can therefore be one useful professional among others. It becomes problematic when psychiatry is automatically placed at the top of an interpretive hierarchy simply because autism was historically attached to psychiatry.

13. Is psychoanalysis appropriate for autism?

13.1 As a general causal theory of autism: no

There is currently no solid scientific basis for explaining autism by an unconscious conflict, poor separation from the mother, symbolic failure, early relational trauma or a general psychogenic defensive withdrawal.

Contemporary knowledge places autism within neurodevelopment and shows, in particular, a strong genetic contribution while recognizing great heterogeneity. Historical psychogenic models do not provide a competing explanation with the same level of evidence. [S16, S20]

In 2026, the French National Authority for Health also classified psychoanalysis among interventions not recommended for ASD in children and adolescents. [S23]

13.2 As a space for talking chosen by an adult: a different question

An autistic adult may freely find value in psychoanalytic, Jungian, psychodynamic or another form of psychotherapy to discuss relationships, personal history, dreams, trauma, identity or conflicts.

This personal choice does not validate a psychoanalytic etiology of autism. A therapy may be useful to an autistic person without being a treatment for autism.

The same requirements then apply as for any psychotherapy: consent, no blame, understanding of autism, adapted communication, the possibility of challenging the therapist's interpretation, and assessment of actual benefits or harms.

13.3 The particular danger of interpretive authority

Psychoanalysis becomes particularly risky in autism when it gives the therapist systematic superiority over the meaning of what the person says. If an autistic objection is interpreted as “resistance”, if a request for precision becomes a “defense”, or if a need for coherence is read as a symbolic incapacity, the patient may lose the right to be treated as a credible witness to their own experience.

This risk connects with a more general difficulty of attitudinal accessibility: an unusual expression is quickly translated into the observer's framework instead of first being examined literally, placed in context and checked with the person.

Simple criterion A therapeutic interpretation must remain a revisable hypothesis, never a way of making the patient's words impossible to refute. If every objection confirms the theory, there is no longer genuine dialogue.

14. Autistan conceptual reading: reality, interpretation, adaptation and accessibility

Status of this section The elements that follow are an Autistan conceptual reading and working hypotheses. They are not presented as the current scientific consensus or as findings demonstrated by the history of psychiatry.

14.1 The strange legacy of “the autistic person cut off from reality”

The very word autism historically arose with Bleuler's idea of detachment from reality. For decades, this genealogy facilitated metaphors such as “locked in their own world”, “in a bubble”, “cut off from the world” or “empty fortress”.

Yet an autistic person who does not spontaneously follow a social convention is not necessarily less connected with reality. They may not understand an implicit meaning, may not share a convention, or may not assign the same importance to a social signal.

Autistan therefore proposes distinguishing at least two things: the relationship to reality itself and the relationship to conventional social interpretations of that reality.

14.2 The “natural frame of reference” hypothesis

In the working hypothesis known as the “natural frame of reference”, certain autistic characteristics could be understood not as withdrawal from reality but as reception that is less automatically transformed by social categories, implicit expectations, analogies or customary generalizations.

This hypothesis seeks in particular to account for the importance that coherence, truthfulness, precision, continuity of a rule, detection of contradiction or the natural character of an environment may have for some autistic people.

It should not be turned into the dogmatic inversion that “autistic people always see the truth and non-autistic people never do”. Rather, it is a line of inquiry for studying how different processing styles may generate reciprocal misunderstandings and how social conventions may sometimes be mistaken for reality itself.

14.3 From “social impairment” to bidirectional misunderstanding

Older theories almost always viewed the autistic person from the outside. The communication difficulty was located in the child or patient. A more interactional approach also asks: what does the non-autistic person understand about the autistic person? How cautiously do they interpret an unusual expression? Do they make their own implicit assumptions explicit?

Attitudinal accessibility consists precisely in suspending rapid accusatory interpretations, checking meaning, making rules explicit, allowing corrections, and not requiring the autistic person alone to anticipate the conventions of a world built mainly by non-autistic people.

14.4 Adaptation is not assimilation

An autistic person may need to learn about the non-autistic world, its conventions and its forms of communication. Autistan proposes thinking of this learning as learning a second language: learning to understand and communicate in another language does not require destroying one's mother tongue.

This distinction makes it possible to defend learning without normalization. The aim is not to keep the person ignorant of social codes; it is to enable them to understand and use those codes when useful, without making the erasure of their autistic nature the measure of success.

A visible “autistic accent” may even have a protective function: like a foreign accent, it signals to the other person that they should be cautious about implicit meanings, double meanings or spontaneous interpretations.

14.5 The environment also has an obligation to learn

Adaptation cannot be one-sided work. If the autistic person learns “non-autism”, the environment must learn to recognize autistic communication, sensory characteristics, needs for coherence and the risks of misinterpretation.

This reciprocity transforms the political problem: instead of asking only “how can we correct the autistic person?”, we ask “how can families, schools, administrations, services, public places and human relationships be made accessible to a person who functions differently?”

Useful conceptual reversal History moved from “the autistic person withdraws from reality” to a neurodevelopmental conception. Autistan proposes going further: examining whether some of the difficulties attributed to autism arise from a conflict between frames of reference, artificial or incoherent environments, and overly rapid non-autistic interpretation. This proposal remains to be documented empirically.

15. Frequent misunderstandings and short answers

“Jung discovered autism.”

No. Jung worked with Bleuler and stood at the historical Bleuler–Freud crossroads, but the “Autismus” of that period belonged to the theory of schizophrenia. Jung did not formulate today's neurodevelopmental conception.

“Freud invented autism.”

No. Bleuler created the term. There is, however, a lexical lineage from Freudian “auto-erotism”, which explains the historical link.

“Autism used to be schizophrenia.”

Bleuler's word referred to a schizophrenic phenomenon, and childhood autism was subsequently confused for a long time with childhood schizophrenia. But it would be misleading to say that contemporary autism is simply old schizophrenia under a new name.

“Autistic people are psychotic.”

No. Autism and psychotic disorders are distinct. An autistic person may also experience psychosis, just as they may have other health problems.

“Freud proved that symptoms come from childhood.”

He gave major importance to childhood history, but his detailed causal theories have not all been demonstrated. An influence of childhood does not automatically validate psychoanalytic theory.

“Popper demonstrated that all psychoanalysis is false.”

No. Popper criticized its difficulty in being falsified; the philosophical debate is more complex. Grünbaum, for example, challenged other aspects of psychoanalytic evidence. [S7]

“If psychoanalysis helps someone, Freud was right.”

No. Therapeutic improvement does not automatically demonstrate the theory that claims to explain the mechanism of that improvement.

“Mothers were blamed because of Kanner.”

Kanner used problematic formulations about some parents, but the psychogenic “refrigerator mother” theory was developed and popularized far beyond his observations, notably by Bettelheim.

“Psychoanalysis is still a standard recommendation for autism.”

No. For example, in 2026 the French National Authority for Health classified it among interventions not recommended for ASD in children and adolescents. [S23]

“Since autism is neurodevelopmental, everything is genetic.”

No. Neurodevelopmental is not synonymous with purely genetic, and the genetics of autism are complex and heterogeneous.

“Since autism is neurodevelopmental, the environment does not matter.”

False. The environment can greatly modify disability, stress, communication, learning and quality of life without being the cause of autism.

“Rejecting psychoanalysis means supporting ABA.”

No. These are two different debates. One can reject psychogenic theories and also criticize behavioral goals of normalization.

“Neurodiversity says autism is never disabling.”

No. Neurodiversity challenges the automatic equation of difference with a defect; it does not require denying disabilities, suffering or support needs.

“Psychiatry is therefore never useful for autistic people.”

No. It may be indispensable for certain coexisting disorders or crises. The criticism concerns the psychiatrization of autism itself and the inappropriate use of an all-encompassing psychiatric framework.

16. Timeline 1850–2026

This timeline does not claim to cover the entire history of psychiatry. It selects landmarks useful for understanding how autism moved from a term in schizophrenia to a neurodevelopmental category, and then to an object of debate about rights, accessibility and neurodiversity.

Date / period

Event

Why it matters

1856

Birth of Sigmund Freud and Emil Kraepelin.

Two contemporary but very different trajectories: psychoanalysis and psychiatric nosology.

1857

Birth of Eugen Bleuler.

He would introduce “schizophrenia” and “Autismus”.

1859

Birth of Pierre Janet.

Work on dissociation, psychological automatism and the function of reality.

1875

Birth of Carl Gustav Jung.

Psychiatrist at the Burghölzli, close to Freud before their break.

1885–1886

Freud stays in Paris with Charcot.

An important influence in his move from neurology toward a psychological understanding of certain symptoms.

1890s–1900s

Kraepelin develops his classifications, including dementia praecox.

The nosological basis that Bleuler would revise.

1900

Freud publishes The Interpretation of Dreams.

A symbolic landmark of psychoanalysis.

1906–1907

Beginning of the Freud–Jung rapprochement.

Jung also serves as a link with Bleuler's milieu.

1907

Bleuler's term that would become “Autismus” is already circulating in Jung–Freud correspondence.

Shows that the concept emerged within the field of schizophrenia and in contact with psychoanalytic vocabulary. [S1, S3]

1911

Bleuler publishes Dementia Praecox oder Gruppe der Schizophrenien.

Canonical use of “Autismus” within schizophrenia. [S2]

1913

Freud–Jung break.

Jung progressively develops analytical psychology.

1925–1926

Sukhareva publishes descriptions of children strongly resembling contemporary autistic profiles.

Work that remained little visible for a long time in the dominant Western narrative. [S10]

1938

Asperger uses “autistische Psychopathen” in a lecture; Freud flees Vienna for London.

Two contexts with no direct causal relationship, but historically contemporary.

1938–1939

Family films of Freud in London; health severely deteriorated.

Important for contextualizing late-life videos. [S8, S9, S29]

1939

Death of Freud.

End of life in London after exile.

1943

Kanner publishes his article on eleven children.

A major landmark in childhood autism. [S11]

1944

Asperger publishes on “autistic psychopathy”.

Viennese work in the Nazi context. [S12, S13]

1940s–1960s

Strong psychoanalytic influence in some sectors of psychiatry, especially in the United States and France.

Autism, childhood psychosis and early relationships often remain mixed together. [S15, S28]

1950s–1960s

Development and spread of psychogenic models, including the “refrigerator mother”.

Blaming families and interpreting autism as defensive withdrawal.

1964

Bernard Rimland publishes Infantile Autism.

An important biological challenge to psychogenic theories.

1960s–1970s

Rutter and others increasingly distinguish autism from childhood schizophrenia.

Developmental shift. [S11]

1977

Folstein and Rutter publish a twin study.

A landmark in demonstrating a strong genetic contribution. [S16]

1979

Wing and Gould publish their epidemiological study.

Broadening toward a dimensional conception. [S17]

1980

DSM-III: “infantile autism” within pervasive developmental disorders.

Clear diagnostic separation from schizophrenia. [S11, S19]

1981

Lorna Wing popularizes “Asperger syndrome” in English.

Contributes to the notion of a continuum/spectrum. [S18]

1990s

Development of organized autistic self-advocacy.

ANI, Jim Sinclair and the first online networks. [S24, S27]

1994

DSM-IV.

Multiplication of subcategories within pervasive developmental disorders. [S19]

1998

Judy Singer uses “neurodiversity” in her academic work; the concept develops collectively in the communities concerned.

Its origin should not be reduced to a single person. [S24, S25]

2013

DSM-5 combines several diagnoses into autism spectrum disorder.

Institutional shift toward a spectrum diagnosis. [S19]

2022

Publication of work calling for a paradigm shift toward autism science informed by neurodiversity.

Emphasis on autistic priorities, context and the limits of the deficit model. [S26]

2024

WHO publishes ICD-11 clinical descriptions including ASD 6A02 among neurodevelopmental disorders.

Current international framework. [S20]

2026

The French National Authority for Health publishes new child/adolescent recommendations and classifies psychoanalysis among interventions not recommended for ASD.

An important landmark in the French evolution. [S23]

17. Who is who?

Person

Position / profession

Idea or role

Link with autism

Jean-Martin Charcot

French neurologist

Hysteria, hypnosis, neurology; influence on Freud

Not an autism theorist

Pierre Janet

Physician, psychologist, philosopher

Dissociation, subconscious, function of reality

Intellectual context before/alongside Freud

Emil Kraepelin

German psychiatrist

Nosology; dementia praecox

Framework reorganized by Bleuler

Sigmund Freud

Neurologist by training, founder of psychoanalysis

Unconscious, repression, transference, infantile sexuality

Not the discoverer of autism; indirect lexical influence

Eugen Bleuler

Swiss psychiatrist

Schizophrenia; “Autismus”

Creator of the term in a schizophrenic sense

Carl Gustav Jung

Swiss psychiatrist, founder of analytical psychology

Complexes, archetypes, individuation, introversion/extraversion

Indirect historical link through Bleuler; no modern theory of autism

Grunya Sukhareva

Soviet child psychiatrist

Early descriptions of children

Forerunner long under-recognized

Leo Kanner

Psychiatrist

Childhood autism, 1943

Central landmark of the developmental conception

Hans Asperger

Austrian pediatrician

“Autistic psychopathy”, 1944

Historical landmark; Nazi context now documented

Melanie Klein

Psychoanalyst

Child psychoanalysis, object relations

Influence on psychodynamic models of childhood

Margaret Mahler

Psychoanalyst / child psychiatrist

Separation-individuation; “normal autistic phase”

Historical model now abandoned

Bruno Bettelheim

Author / psychologist with a complex professional background

“The Empty Fortress”, psychogenic theory

Symbol of parental blame

Frances Tustin

Psychoanalyst

Autistic defenses, psychogenic protective system

Internal revisions but retention of a psychogenic core

Jacques Lacan

Psychiatrist and psychoanalyst

Language, symbolic, imaginary, real

Strong influence on some French schools; no single autism doctrine

Bernard Rimland

Psychologist

Biological challenge to psychogenic theory in 1964

Useful rupture, despite later controversies

Michael Rutter

Child psychiatrist / researcher

Developmental autism, distinction from schizophrenia, genetics

Major figure in the scientific shift

Susan Folstein

Psychiatrist / geneticist

Twin study with Rutter

Landmark in autism genetics

Lorna Wing

Psychiatrist

Spectrum, Asperger syndrome, epidemiology

Central figure in the shift toward the spectrum

Judith Gould

Clinical psychologist / researcher

Camberwell study with Wing

Major contribution to the dimensional conception

Jim Sinclair

Autistic activist

Self-advocacy, ANI, “Don’t Mourn for Us”

Landmark in the shift toward autistic voices

Judy Singer

Sociologist

Early academic use of “neurodiversity”

Important but not unique figure in a collective origin

18. Practical principles for discussion

Ask for the exact meaning of the word as used at the time being cited.

Never treat “Freud”, “Jung”, “psychoanalysis” or “psychiatry” as homogeneous blocks.

Clarify whether a claim is descriptive, interpretive, causal or therapeutic.

Ask what could refute the hypothesis.

Assess separately the truth of a theory and the possible usefulness of a therapeutic relationship.

Do not confuse autism, schizophrenia and psychosis.

Do not infer from the failure of psychogenic theories that every biological or behavioral treatment is correct.

Do not confuse reduction of visible autistic behavior with improvement in quality of life.

First look for concrete causes of a difficulty: pain, overload, misunderstanding, change, environment, communication, sleep, coexisting disorder.

Treat the autistic person's testimony as data of primary importance, not as material to be automatically reinterpreted.

Preserve the possibility of psychiatric support for coexisting problems without making autism itself a psychiatric disease to be eradicated.

Prefer adaptation, accessibility, learning and autonomy to assimilation or normalization.

Summary sentence The history of autism is largely the history of a shift in perspective: from a supposed “withdrawal from reality” within schizophrenia to a neurodevelopmental difference, then to the broader question of how a society can understand and welcome different forms of perception, communication and relationship with the world.

19. Sources and references

The references [S1], [S2], etc. in the note correspond to the sources listed below. Links are provided to allow direct verification. Secondary historical sources are used for the genealogy of concepts; contemporary institutional recommendations are used for current public-health positions.

S1 — Evans, B. (2013), “How autism became autism: The radical transformation of a central concept of child development in Britain”, History of the Human Sciences. https://pmc.ncbi.nlm.nih.gov/articles/PMC3757918/ ↗

S2 — Kendler et al. / Bleuler centenary review (2011), “Eugen Bleuler: Centennial Anniversary of His 1911 Publication of Dementia Praecox or the Group of Schizophrenias”. https://pmc.ncbi.nlm.nih.gov/articles/PMC3196955/ ↗

S3 — “The Concept of Autism in Autism Spectrum Disorder and Schizophrenia Spectrum Disorder: Historical Divergence and Phenomenological Rapprochement” (2026). https://pmc.ncbi.nlm.nih.gov/articles/PMC13065430/ ↗

S4 — Charcot historical review, “Jean-Martin Charcot: Pioneer of Neurology”. https://pmc.ncbi.nlm.nih.gov/articles/11392517/ ↗

S5 — Historical review of hysteria, Janet and dissociation. https://pmc.ncbi.nlm.nih.gov/articles/PMC4695775/ ↗

S6 — Shorter, E. et al., “The history of nosology and the rise of the Diagnostic and Statistical Manual of Mental Disorders”. https://pmc.ncbi.nlm.nih.gov/articles/PMC4421901/ ↗

S7 — Stanford Encyclopedia of Philosophy, “Karl Popper” — discussion of Popper, Grünbaum and psychoanalysis. https://plato.stanford.edu/archives/fall2023/entries/popper/ ↗

S8 — Freud Museum London, “Freud in England, 1938–39”. https://www.freud.org.uk/exhibitions/freud-in-england/ ↗

S9 — Freud Museum London, “Cindy Sofer – Free Association” — home movies of Freud in 1938. https://www.freud.org.uk/exhibitions/cindy-sofer-free-association/ ↗

S10 — Sukhareva historical review (2025), “The Work of Grunya Efimovna Sukhareva in the Field of Autism Spectrum Disorder One Hundred Years After Her Original Description”. https://pmc.ncbi.nlm.nih.gov/articles/PMC12257787/ ↗

S11 — Volkmar et al. (2021), “The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond”. https://pmc.ncbi.nlm.nih.gov/articles/PMC8531066/ ↗

S12 — “A Concise History of Asperger Syndrome: The Short Reign of a Troublesome Diagnosis”. https://pmc.ncbi.nlm.nih.gov/articles/PMC4725185/ ↗

S13 — Czech, H. (2018), “Hans Asperger, National Socialism, and ‘race hygiene’ in Nazi-era Vienna”. https://molecularautism.biomedcentral.com/articles/10.1186/s13229-018-0208-6 ↗

S14 — Tustin, F. (1991), “Revised understandings of psychogenic autism”. https://pubmed.ncbi.nlm.nih.gov/1797714/ ↗

S15 — “Psychoanalysis in the treatment of autism: why is France a cultural outlier?” (2021). https://pmc.ncbi.nlm.nih.gov/articles/PMC8111966/ ↗

S16 — Folstein, S. & Rutter, M. (1977), “Infantile autism: a genetic study of 21 twin pairs”. https://pubmed.ncbi.nlm.nih.gov/562353/ ↗

S17 — Wing, L. & Gould, J. (1979), “Severe impairments of social interaction and associated abnormalities in children”. https://pubmed.ncbi.nlm.nih.gov/155684/ ↗

S18 — Lorna Wing historical/obituary review. https://pmc.ncbi.nlm.nih.gov/articles/PMC4495836/ ↗

S19 — Review comparing DSM/ICD autism classifications. https://pmc.ncbi.nlm.nih.gov/articles/PMC4111262/ ↗

S20 — WHO (2024), ICD-11 Clinical Descriptions and Diagnostic Requirements — Autism spectrum disorder 6A02. https://www.who.int/publications/i/item/9789240077263 ↗

S21 — NICE, Autism spectrum disorder in adults: diagnosis and management, recommendations. https://www.nice.org.uk/guidance/CG142/chapter/Recommendations ↗

S22 — NICE, Quality statement: autistic people are not prescribed medication to address core features of autism. https://www.nice.org.uk/guidance/qs51/chapter/quality-statement-6-treating-the-core-features-of-autism-medication ↗

S23 — Haute Autorité de Santé (2026), new ASD recommendations for infants, children and adolescents. https://www.has-sante.fr/jcms/p_3859897 ↗

S24 — Chapman et al. (2023), “Neurodiversity as Politics”. https://pmc.ncbi.nlm.nih.gov/articles/PMC9881465/ ↗

S25 — Botha et al. / annotated reading list (2024), collective history of the neurodiversity concept. https://pmc.ncbi.nlm.nih.gov/articles/PMC11616989/ ↗

S26 — Pellicano & den Houting (2022), “Shifting from ‘normal science’ to neurodiversity in autism science”. https://pmc.ncbi.nlm.nih.gov/articles/PMC9298391/ ↗

S27 — Leadbitter et al. (2021), autistic self-advocacy and neurodiversity movement. https://pmc.ncbi.nlm.nih.gov/articles/PMC8075160/ ↗

S28 — History of American psychiatric classification and psychoanalytic dominance. https://pmc.ncbi.nlm.nih.gov/articles/PMC4810039/ ↗

S29 — Freud Museum London, “Sigmund Freud’s Garden”. https://www.freud.org.uk/2021/07/13/sigmund-freuds-garden/ ↗

General conclusion

The relationship between Jung and autism is neither imaginary nor what a quick reading might suggest. Historically, Jung stands at the junction between Bleuler, who created the word “Autismus” within schizophrenia, and Freud, whose psychoanalytic vocabulary formed part of the intellectual environment in which that term arose. But Jung was not a founder of the modern conception of autism.

Psychoanalysis played a major role in the history of psychiatry and psychological understanding, but its causal application to autism produced psychogenic models that do not correspond to the current state of knowledge and that sometimes caused major harm, notably through blaming families and excessive interpretive authority.

Psychiatry, for its part, should not be rejected wholesale. Its history helped confine autism within categories of psychosis and pathology, but contemporary psychiatry can provide indispensable care for coexisting problems. The decisive question is what it is treating: a specific suffering or disorder, or autistic existence itself.

The most fruitful historical progress therefore consists less in seeking the school that has finally “got everything right” than in continually improving distinctions: autism and psychosis; difference and disease; characteristic and suffering; cause and consequence; individual and environment; adaptation and assimilation; help and normalization; interpretation and verification.

This methodological caution is particularly important for Autistan: it makes it possible to criticize historical errors without reproducing their central mechanism, which consisted precisely in imposing on the autistic person an external theory supposedly knowing better than the person what they were and what they should become.