Relational Therapy and an Incomplete Attachment: A New Look at the Etiology and Treatment of Autism Spectrum Disorders - Glossary of Terms

In introducing a new theory of autism, it is important that everyone have a glossary of terms that can be referred to that explains the terminology I use in my writings. This glossary is a ‘work in progress’ that will be tweaked as I receive feedback about how helpful it is.

1. Incomplete Attachment (also referred to as a lack of attachment) - the belief that children on the spectrum have not had the advantage of a completed attachment. Thus during the attachment period of life (birth – three years old) the child has not attached to the caregivers. There are probably many reasons why this has not occurred. It is not the fault of anyone. It is my belief that what one sees when observing children on the spectrum is a child who is waiting for the attachment process to be completed. The child is doing the best he/she can to cope with this predicament. All the behaviors such as flapping arms, nonverbal communication, echolalia, lack of responsiveness to others or inability to communicate one’s needs are coping mechanisms that can make sense when taken from this perspective.
2. Sense of Self-Agency – is the ability of the self to take initiative, to regulate oneself and to be the source of one’s behavior. A sense of self-agency is developed within a relationship with another person. The autistic person has an incomplete attachment thus does not have the advantage of self-agency. The functioning levels of those with ASD correspond with the degree of self-agency the individual has. The lower functioning individual has very little self-agency and thus is nonverbal or can only use echolalia. As the individual gains more self-agency we start to see the use of words such as “me” and “I” as well as more interactive behaviors. Then we start to call the person high functioning.
3. Dissociation – Parts of the self are not conscious to or available to the person to use in their communications with others. It is the state that the ASD individual lives. Bromberg (1994) believes all individuals begin life made up of multiple self-states. Our wholeness develops through a relationship with another person. * Because the autistic person lacks an attachment, he remains in a non-whole state. Thus the individual has different parts of himself that have not integrated. What does dissociation look like: 1) the person who is talking about one thing and then switches to another topic very dramatically, 2) the person who cannot talk about feelings, but can talk about an obscure topic, 3) the person who has a special ability such as remembering dates, but cannot attend to the topic at hand.

* For more information see: Bromberg, P. M. (1994), “Speak! That I May See You” Some Reflections on Dissociation, Reality, and Psychoanalytic Listening. Psychoanalytic Dialogues, 4 (4): 517-547.