Tustin, Francis (1986).  Autistic Barriers in Neurotic Patients (click preceding link) for information on purchasing from Amazon).  New Haven, Conn.:  Yale Univ. Press

Excerpts are below. Additional excerpts are here.

3--Autism is a state in which auto-sensuousness holds sway, attention being focused almost exclusively on bodily rhythms & sensations.  Objects in the outside world may be attended to, but on close observation it becomes clear that these are experienced as being part of the body or very closely akin to it.  People & things outside are scarcely used or seen as having a separate existence.  They are experienced as an extension of bodily activity & in terms of the sensuous experience of them, particularly the sensuous experience of touch.

6-7--The first four months of the infant's life should be considered as an extra-uterine pregnancy.  In my view, this shelters the infant from realizations which are more than his elementary neuro-mental apparatus can deal with. The newborn infant makes little or no adaptation to the mother's body as being separate and different from his own rhythms and sensations.  As far as he is concerned, the sensations in his mouth are the breast, his own bodily rhythms create an auto-sensual construct of 'mother'.

9--Awareness of bodily separateness from the mother means that he encounters the 'not-self' mother (that is, a mother who is not part of his body) whilst he is in a hypersensitized and over-reactive state in which everything is magnified.  This makes the experience intolerable.  Massive automatic reactions are set in train to block out awareness of the 'not-self' mother.  Auto-sensual activities are intensified to preserve the illusion of (a) fusion or (b) confusion with the mother.

29--Since his first traumatic experience of bodily separateness, the child has had virtually no sense of bodily separateness.  It is only as treatment helps him to bear the fact of his bodily separateness from that outside world that he also shows that he feels he is separated from it by a barrier and indicates that he feels enclosed in a shell. 

For most of the time the child behaves as if fused with the outside world, and outside objects are experienced as a prolongation of his bodily sensations or movements.  In his state of imitative fusion, everything is experienced as 'me', although, paradoxically, he has no sense of 'me' and 'not-me' except in fleeting moments of awareness as he begins to respond to treatment.  when these moments occur, the 'not-me' is quickly made into 'me', by feeling that it is part of his body and under his control.

39--Both types of child use the image of a 'hole' to express traumatic awareness of the bodily separateness which has precipitated their psychosis.  But the Confusional children are teetering on the verge of becoming aware that they are flesh & blood, and they occasionally experience and express this experience as a 'wound. 'Encapsulated children make no differentiation between animate & inanimate. 

For them, objects and people are all 'things'. 'Things' have 'holes', not 'wounds'.  It is only flesh and blood which is capable of having a 'wound'...As the morbid pathology increases, the hole becomes a black hole', and the 'wound' becomes a festering sore.  Autistic Objects are felt to block the 'hole' the soft objects of the Confusionals are felt to staunch the bleeding and mop up the pus.  When they become aware of bodily separateness, both types of child live in an extreme world of 'haves' and 'have-nots', which the child experiences as 'fullness' and 'emptiness'.

51—Awareness of bodily separateness on these basic levels is experienced as a loss of part of the body, which leaves a ‘hole’ or a ‘wound.’

56—The ‘not-me’ is felt to be inimical because it brings unbearably painful awareness of bodily separateness which is experienced as an amputation.

87—Autistic reactions are akin to auto-immune reactions to avoid and reject inimical alien substances. It seems that in an elemental sort of way, the mother comes to be such an alien substance to the autistic child.

100--The main purpose of Autistic Objects (that is, objects used as part of the body to give reassuring and diverting sensations) is to shut out menaces which threaten bodily attack & ultimate annihilation.  Hardness helps the soft & vulnerable child to feel safe in a world which seems fraught with unspeakable dangers, and about which he feels unutterable terror.  These objects help to prevent the realization of bodily separateness and to promote the delusion that impingements from the outside world are obstructed.

108—The infant’s primary illusion is that he and the mother are a continuum of bodily stuff. This negation of the outside world seems to be a persisting umbrage arising from intense aversion to the ‘not-me’ which has been catastrophically upsetting.

177--Another way in which such a child avoids being aware of his bodily separateness is by experiencing everything as if it is part of, and not separate from, his body. 

Thus, alongside his blurring of awareness of the features which the people around him are consciously attending to, he has an ultra-sharp awareness of cues which are normally picked up unconsciously, if at all, such as the muscle 'sets' of people, their tones of voice, their tiny gestures and the like.  Those psychotic children who avoid looking directly at a person have a fringe awareness of much that is not normally attended to. 

These 'fringe cues' constitute their world and, through them, they avoid the need for normal channels of symbolic communication which are dependent on awareness of separateness.  Thus, the psychotic child does not pay attention to the things we ask him to attend to but, without seeming to do so, is aware of much of which we are unconscious.  In this way, they feel part of the outside world and feel it is part of them without feeling separate from it.