I was curious last class about the difference between primary and secondary autism and I think that there are probably many factors going on. However, I think that judging from the Ellen Stockdale report that what she is experiencing could be better related to schizoid phenomena then autism. Firstly, Tustin is clear that there is a very early etiology for the ‘shapes’ and interaction she is talking about:
In this paper, the author presents a revision of these views, in that she now reserves the term autism to refer solely to pathological conditions. Her present view is that autism is a system of protective, but alienating auto-sensual aberrations which have developed to deal with an infantile trauma of seeming to be wrenched away from a motheringperson's body. She suggests that in an unduly fused nursing situation, mother and child had felt undifferentiated from each other. Thus, the infant had taken it for granted that the mother's body was a permanent part of 'its' body. It was an unbearable shock when this was found to be not so. The author suggests that autistic reactions to this shock are the source of the autistic child's many deficits (Tustin, Revised Understandings of Psychogenic Autism, p. 589-9)
Secondly, Tustin is familiar with Asperger’s and clearly says it is different
I have come to view autistic processes as being reactions that are specific to traumas. In the Kanner-type syndrome, the traumas occurred in the suckling situation of infancy when both mother and baby were assaulted by sudden and unexpected awareness of their separatedness from each other after an abnormally close association of ‘at-oneness’ with each other. The Asperger-type children seem to have encountered traumatic situations later in life, not necessarily at the suckling stage, and to have used autistic manoeuvres to protect themselves against these seemingly life-threatening disasters. The insulating manoeuvres of the Kanner-type children throw light on the Asperger disorder, just as the speaking Asperger children help us to understand the non-speaking Kanner-type children more fully (Tustin, Autistic Children Who Are Assessed as Not Brain-Damaged, p. 113-4).
For Ellen Stockdale to be “painfully shy, and lacking in self-confidence” and unable to look others in the eye requires much more development of ego then the child can have at the early suckling stage which Tustin and Segal and others point to as earlier than Klein’s paranoid-schizoid phase.
Painful self-conscious shyness is often related to the increase of ego that goes along with the anal stage. Wilhelm Reich, for example, talks about ‘anal shyness’ in Character Analysis.
I think that the most useful way to consider asperger’s or secondary autism would be based upon the model of narcissism that functions within mental bisexuality. Freud writes:
This is the place for two remarks. First, how do we differentiate between the concepts of narcissism and egoism? Well, narcissism, I believe, is the libidinal complement to egoism. When we speak of egoism, we have in view only the individual's advantage; when we talk of narcissism we are also taking his libidinal satisfaction into account. As practical motives the two can be traced separately for quite a distance. It is possible to be absolutely egoistic and yet maintain powerful object-cathexes, in so far as libidinal satisfaction in relation to the object forms part of the ego's needs. In that case, egoism will see to it that striving for the object involves no damage to the ego. It is possible to be egoistic and at the same time to be excessively narcissistic—that is to say, to have very little need for an object, whether, once more, for the purpose of direct sexual satisfaction, or in connection with the higher aspirations, derived from sexual need, which we are occasionally in the habit of contrasting with ‘sensuality’ under the name of ‘love’. In all these connections egoism is what is self-evident and constant, while narcissism is the variable element. The opposite to egoism, altruism, does not, as a concept, coincide with libidinal object-cathexis, but is distinguished from it by the absence of longings for sexual satisfaction. When someone is completely in love, however, altruism converges with libidinal object-cathexis. As a rule the sexual object attracts a portion of the ego's narcissism to itself, and this becomes noticeable as what is known as the ‘sexual overvaluation’ of the object. If in addition there is an altruistic transposition of egoism on to the sexual object, the object becomes supremely powerful; it has, as it were, absorbed the ego. (Introductory Lectures, p.417-8).
At the phallic level in which love for the other is recalled- ‘phallic narcissism’ means that a man can date women and have sex with them but not really be attached or care for them in any way. However, if we entertain this idea at the earlier anal level then we have a notion that “very little need for an object” becomes a full out incomprehension of the object. At the same time, instead of the ‘cockiness’ of the phallic-narcissist we’d have what Freud in other places has called the ‘omnipotence of thought’ in which the anal narcissist believes he is God-like in his thought and overvalues thinking like the narcissist over-values his ‘image’ or the impression he makes on others.
Freud, in this bisexual structure, shows that the altruist (the passive or feminine side) can relinquish her egoism and make the object powerful. At the anal stage we can say that the child’s interaction with the mother stands for ‘all people’ with transference to god-like people while the later phallic interaction stands for the good class with transference to heroes, while at the later genital stage (after Oedipus) the authority stands for bosses and teachers, and more mundane authorities. Ellen Stockdale’s problem then might be more easily understood as ‘echoism’ at the anal stage in which she makes all individuals supremely powerful in analogy to a woman at the phallic stage waiting for a prince to find her and not seeking to develop her own skills to work and establish her own independence that way. Going along with this we would point to the anal echoist as truly ‘repeating’ what other people say (as an echo) rather than finding a pleasure in intellectual understanding. This needn’t mean that the person will flunk school. There are other factors like gaining the approval of the parents, etc. which will drive the child. Instead the issue is one of pleasure in the intellect. Another person may find it fun to learn another language the anal echoist would not find it fun. Also the “love” at the anal stage isn’t the same as it is at the phallic stage but is better characterized as a symbiosis of losing one’s own identity. In the Ellen Stockdale report she writes:
She was most afraid of eye contact with those people she felt closest to, of anyone with whom she was romantically involved, because eye contact with them meant a loss of sense of self—of self-identity, or ego structure. “Red” experienced this loss as either “dying” or losing all her feelings, her reality, or as being changed into her nonfeeling self, Ellen. Red felt that people close to her could see inside her, see her feelings, read her mind (p. 14)
In addition Freud writes of such early object cathexes and their resulting identifications once they are ‘abandoned’ potentially leading to MPD:
Although it is a digression from our aim, we cannot avoid giving our attention for a moment longer to the ego's object-identifications. If they obtain the upper hand and become too numerous, unduly powerful and incompatible with one another, a pathological outcome will not be far off. It may come to a disruption of the ego in consequence of the different identifications becoming cut off from one another by resistances; perhaps the secret of the cases of what is described as ‘multiple personality’ is that the different identifications seize hold of consciousness in turn. Even when things do not go so far as this, there remains the question of conflicts between the various identifications into which the ego comes apart, conflicts which cannot after all be described as entirely pathological (The Ego and The Id, p. 30-1)
Also in the Report we are given another way to capture the equivalency of these two states:
When not using Ellen's cover of learned social behavior, “Red” was unable to greet people comfortably as they entered a room; she simply stared vacantly. She once made her therapist refrain from looking at her for an entire session because she felt that her feeling self would “die” if he looked at her. Then she would switch into superficial Ellen, who could not describe the feelings “Red” had experienced. At times when she wanted to preserve her feelings, she would ask people she was close to (and who she felt would understand) not to talk to her or look at her lest she “die.” (p. 14-5)
The feeling of psychic death, which Freud goes to pains to remind us can’t be something that is experienced can be set up as a negation. The not-finite can mean perfection but the not-finite can also mean death (i.e. what is not finite and living = the dead). In Beyond the Pleasure Principle Freud writes:
It may be difficult, too, for many of us, to abandon the belief that there is an instinct towards perfection at work in human beings, which has brought them to their present high level of intellectual achievement and ethical sublimation and which may be expected to watch over their development into supermen. I have no faith, however, in the existence of any such internal instinct and I cannot see how this benevolent illusion is to be preserved. The present development of human beings requires, as it seems to me, no different explanation from that of animals. What appears in a minority of human individuals as an untiring impulsion towards further perfection can easily be understood as a result of the instinctual repression upon which is based all that is most precious in human civilization. The repressed instinct never ceases to strive for complete satisfaction, which would consist in the repetition of a primary experience of satisfaction. No substitutive or reactive formations and no sublimations will suffice to remove the repressed instinct's persisting tension; and it is the difference in amount between the pleasure of satisfaction which is demanded and that which is actually achieved that provides the driving factor which will permit of no halting at any position attained, but, in the poet's words, [‘Presses ever forward unsubdued.’]
The backward path that leads to complete satisfaction is as a rule obstructed by the resistances which maintain the repressions. So there is no alternative but to advance in the direction in which growth is still free—though with no prospect of bringing the process to a conclusion or of being able to reach the goal. The processes involved in the formation of a neurotic phobia, which is nothing else than an attempt at flight from the satisfaction of an instinct, present us with a model of the manner of origin of this supposititious ‘instinct towards perfection’—an instinct which cannot possibly be attributed to every human being. The dynamic conditions for its development are, indeed, universally present; but it is only in rare cases that the economic situation appears to favour the production of the phenomenon (BPP, p. 42).
Another clue is in Ellen’s feelings of shame attached to the body:
As she learned to feel in a consistent way (sexual feelings, hunger, pain, and others needs), she began to become aware of her body. She had always before been repelled by it, feeling herself to be ugly and smelly—she hated the idea of smells coming out of her body. Sometimes she felt that she could smell in herself the food she had eaten, and she feared that others could smell it too. This became an excuse not to get physically close to others. Whether these feelings were legitimate or were an excuse for her fear of physical closeness to others is unclear—possibly a combination of the two. (p. 21)
The anal stage quality of having shameful feces inside of one which emit odours just as dead or putrid flesh does could probably be derived from this. In a similar way the perfection at the anal stage is represented by an ‘anal phallus’ that is seen as a reaction formation to feces:
The anal phallus is uncastratable because it is renewable; it is by definition the only indestructible penis, at once dead and eternal (castration and life are inseparable as are death and anality in the unconscious). Like the phoenix, he is reborn out of his ashes or recreates himself through auto-fertilization. Like the phoenix, he is dressed in dazzling colours that 'make him more beautiful than the most splendid of peacocks' (Grimal, 1958). Thus the myth of the phoenix seems to me to represent the fantasy of the uncastratable phallus (it is reborn out of its ashes), acquired without being connected to the progenitor (it fertilizes itself); its character, necessarily anal on the one hand and idealized on the other, is represented by the ashes and the brilliance of its colours. If in the course of development the anal phallus precedes the genital penis, it becomes after the fact, imitation (prostheses, orthopaedic instruments, likely to replace a member or to aid a deficient function, are identified in the unconscious with the anal phallus and are frequently chosen as fetishes). Through idealization the anal phallus presents itself as a genital penis; masking its essentially excremental characteristics, it preserves the invulnerability proper to itself and plays, so to speak, on two planes.
(Chasseguet-Smirgel, Perversion, Idealization and Sublimation, p.356)
To be uncastratable and self-fertilizing and invulnerable seem to be the hallmark of perfection to me. Other analysts also talk about the fantasy of a single phallus for all people:
In a number of cases I have found the fantasy that only one grandiose phallus exists in the whole world. When the patient is in possession of it or is identified with it, everyone else is deprived of it and thus totally destroyed. In the negative phase, the tables are turned: the grandiose phallus belongs to somebody else— perhaps to its rightful, original owner— who, full of contempt, now destroys the patient. Either way, the acquisition of this glorified organ is accomplished through violent aggression… the still completely sexualized and glorified object is set up as a primitive ego ideal, as something he longs to be… reverting to magical identification, the patient who has regressed to this infantile level may feel as though he were the magnificent phallus-father, as though he were his own ego ideal. Repair is achieved once more via magic fusion. But after a short time, as we have seen, this wishful identification turns into the opposite; it is doomed to break down, as the uncontrollably mounting aggression destroys the glorified object. To relieve the ensuing intolerable feelings of annihilation, the aggression must be counteracted by a renewed elevation of the object; hence the grandiose phallus is restored to it and the entire process starts all over again (Reich, Pathologic Forms of Self-Esteem Regulation, p.225-6)
We can compare this to Lord of the Rings and the one ring that controls other rings or ‘the Emperor’ in Star Wars that represents the person in control of the galaxy. In other words, the anal phallus of perfection is a very common and powerful motif in culture and in the pursuits of anal obsessionals. I think that the work of Alfred Adler on this front becomes more understandable. Adler shows the regressive nature of the phallic ego ideal to reach back into god-likeness:
This goal introduces into our life a hostile and fighting tendency, robs us of the simplicity of our feeling and is always the cause of an estrangement from reality since it puts near to our hearts the idea of attempting to over-power reality. Whoever takes this goal of godlikeness seriously or literally, will soon be compelled to flee from real life and compromise, by seeking a life within life; if fortunate in art, but more generally in pietism, neurosis, or crime (Individual Psychology. p.8).
 Echoism would refer to the nymph Echo who fell in love with Narcissus. She would be the example of “transposition of ego” onto the love object (the opposite of narcissism):
The story is told in Book III of the Metamorphoses, and tells the story of a "talkative nymph" who "yet a chatterbox, had no other use of speech than she has now, that she could repeat only the last words out of many." She falls in love with Narcissus, whom she catches sight of when he is "chasing frightened deer into his nets." Eventually, after "burning with a closer flame," Echo's presence is revealed to Narcissus, who, after a comic, yet tragic scene, rejects her love. Echo wastes away, until she "remains a voice" and "is heard by all."
 I’m not the only one who has made the connection between anality and death:
Karl Abraham (1) supplied evidence to illustrate the connection between the mental representation of feces and the dead body. The relationship is also underscored by Bertram Lewin (19). It is most poetically expressed by Shakespeare in Hamlet's thoughts on Yorick's remains. Hamlet: Why not imagination trace the noble dust of Alexander till he find it stopping a bunghole? … Alexander died, Alexander was buried, Alexander returneth into dust; the dust is earth; of earth we make loam; and why of that loam (whereto he was converted) might they not stop a beer barrel? The equation of death, corpses, and feces is the central theme of Fenichel's paper on “Respiratory Introjection” (5). In his paper on the Rat Man (7), Freud discussed the interest of obsessionals in death and in life after death. Freud stated that his patient earned the nickname of "carrion-crow" because he religiously attended funerals. In view of the marked anality of obsessionals, one could anticipate their preoccupation with death (Brodsky, The Self-Representation, Anality, and the Fear of Dying, p. 105-6)