Vista's Autism Center


Dr. Anne Alvarez, PhD, MACP, Consultant Child and Adolescent PsychotherapistMy name is Dr. Anne Alvarez, and I am a Child and Adolescent Psychotherapist. I am the past Co-Convener of the Autism Service, Child and Family Department at Tavistock Clinic, London, and I teach at the University of Essex. I published over 50 articles and I am an author, most recently of “The Thinking Heart: Three Levels of Psychoanalytic Therapy with Disturbed Children”. A book was published in my honor, entitled “Being Alive: Building on the Work of Anne Alvarez”, published in 2002. Previously I was a Visiting Professor at the San Francisco Psychoanalytic Society and I am an Honorary Member of the Psychoanalytic Centre of California. With several decades of experience, I am an established specialist in Psychotherapy for Autistic, Borderline, Deprived and Abused Children. This makes me feel qualified to attest to the accomplishments of Dr. Joshua Durban in the field of Psychoanalysis. I am truly thrilled that he may now be able to spread his clinical expertise and teaching to America.

Mr. Durban is a well-known expert in the field of Psychoanalysis, known for his work with child and adolescent patients manifesting autistic and psychotic pathology. His therapeutic work and extensive research have aided the treatment of countless individuals worldwide. His resume reflects his caliber: his position on the Faculty of The Sackler School of Medicine at Tel Aviv University, his critical work for Tel HaShomer Hospital, his founding of The Israeli Psychoanalytic Inter-Disciplinary Forum for the Study of Autistic Spectrum Disorder, his position on the Editorial Board of the International Journal of Psychoanalysis, his renowned private practice, and his countless publications, all indicate his high standing in the field.

As one of the first to introduce psychoanalytic treatment to Autism Spectrum Disorder (“ASD”) children in Israel. Mr. Durban has been crucial to the further development of the field of Psychoanalysis in general, not only in Israel but beyond. He has spearheaded the institution of seminars on the subject in universities, the founding of The Israeli Psychoanalytic Inter-Disciplinary Forum for the Study of Autistic Spectrum Disorder, and has published innovative research which had an extensive ripple effect globally. On a smaller but therefore not less significant level, Mr. Durban has had a remarkable impact on the lives of many ASD patients and their families. His findings about the interpretation of the autisto-psychotic level of primitive anxieties have been crucial in the understanding and analysis of children on the spectrum. He is one of the few psychoanalysts who can truly immerse in the world of ASD children, understand their language, and interpret them to their families and teachers.

For years, whenever I have supervised Israeli Child Therapists or Child Analysts I have been astonished by the previous developments in their patients with autism. I will hear a history of a child or toddler in an almost vegetative state, terribly stunted in his development of language and mind, and then hear about what is now a high functioning and academically successful teenager with an active social life and many competencies, and maybe some anxieties. This is not easy to achieve, and, as I said, it is delightful news that this outstanding level of expertise may be about to spread to America.

Maria Rhode, Emeritus Professor of Child Psychotherapy at the Tavistock ClinicMy name is Maria Rhode. I am an Emeritus Professor of Child Psychotherapy at the Tavistock Clinic in London, where I formerly co-convened the Autism Clinical Workshop; member of the Association of Child Psychotherapists; and Child Analyst of the British Psychoanalytical Society. I trained at the Tavistock Clinic, where I was supervised by Martha Harris, Donald Meltzer and Frances Tustin; I have a particular interest in childhood autism and psychosis, language development and infant observation, and have written and lectured widely on these subjects. Most recently, I have published an audited case series of an early intervention for toddlers at high risk of autism and their families. I received the Frances Tustin Memorial Prize in 1999.

Joshua Durban’s many publications have made him internationally pre-eminent among psychoanalysts working with children and young people on the autism spectrum, as well as with adults who experience some of the same anxieties. Like other contemporary psychoanalytic clinicians, he is not concerned with aetiology, but focuses instead on the client’s emotional experience, informed by the conviction that neurodivergent people, like anyone else, benefit by having attention paid to their emotional life. He offers them help with managing the emotional consequences of neurodivergence, and also acts as a sensitive translator who can help the team to understand what the child is thinking, feeling and doing. Reducing the child’s burden of stress and anxiety makes it more possible for them to take advantage of the opportunities available and to achieve their full potential.

Joshua Durban has been at the forefront of developing approaches and treatments that have improved the quality of life for many children and adults on the spectrum. He has been paving the way in the development and acceptance of psychoanalytic treatments and has performed crucial research on the central role of anxiety in the formation and symptomatology of autistic states. He was one of the very first clinicians in Israel to psychoanalyze children on the autism spectrum, and joined the Faculty of the Sackler School of Medicine at Tel Aviv University, where he co-founded the Post-Graduate Kleinian Studies Program. In addition, his teaching led to a major increase in the number of Israeli analysts undertaking the training in work with children, and he has made a central contribution to the practice and research at Israeli psychoanalytically-informed multidisciplinary kindergartens for children on the spectrum. His numerous publications have appeared in major journals and he is a much-requested public speaker internationally. He is a member of various international research groups on children with autism; a co-opted member of the Committee on Child Abuse of the International Psychoanalytical Association; and a member of the Editorial Board of the International Journal of Psychoanalysis, which is the premier journal in the field. I feel certain he will inspire important innovation in the field of autism within the therapeutic environment offered by Vista Del Mar Child Services.

“I’m Not Alone Anymore”

The fall I turned 15, the world was breaking down. The same thought was running through my head in a loop, endlessly, never letting me go: I don’t know enough. In my head, I made lists of all that I know in the world, but, with each listing, it seemed I knew less. I was anxious, and in pain, and felt broken. My parents, distraught, looked for a therapist who could ease their child’s burden. They found one, and my life changed.

These days, expressions such as “I feel seen” and “I see you” have become overused far past the point of cliché. Yet when I say that, when I started analysis, I “felt seen” for the first time in my life, I mean it in the full and true sense of the phrase: until that fall, no one—not my parents, or siblings, or what “friends” I had—knew how scared, and alone, and alien, and empty I felt; they knew nothing of the terrors that filled my inner world, they had no clue of its horror and desolation; and they did not know that what was so easy for them—just living day-to-day, having friends—felt impossible to me. I was an alien living among earthlings, I was in hostile and incomprehensible territory. I did not imagine for a moment that I could be understood or helped. But I was happily, wonderfully wrong.

When starting my analysis—which was conducted in Israel according to the Durban Method—I did not know that I was on the spectrum. No one had ever mentioned the possibility, and it had never occurred to me. I was diagnosed, yet that was, and can only be, just the beginning. It is impossible to summarize more than a decade of analysis in a few paragraphs. All that I have space to say is it was not easy, but that session by session, month by month, year by year, I, together with my therapist, built a life, and a world; I have learned to know myself, and to know others; and I was not alone.

Years passed. I finished high-school, then a BA. I applied to a graduate program, at an Ivy League university, in a field that fascinates me more than anything else in the world. I got in. In my studies, my autistic features, far from hindering me, have proved my greatest assets. So many need Adderall to study, but the potency of amphetamines cannot compare with the sheer power of autistic hyper-fixation; when harnessed, this energy source sustains research and writing like nothing else. Likewise, hyper-sensitivity can make the mundane unbearable and the day-to-day nightmarish, but it enables me to observe more deeply, and experience beauty more profoundly, than I would have otherwise. That I am on the spectrum may help explain why, after years of grad school, I’m still having the time of my life. For me, it’s a no-brainer: I’m doing the things I love most in the world—thinking, and teaching, and writing—and I’m being paid for it. Truly, I’m living the dream.

However, I do not want to give a falsely simplistic impression of my life, and of my psychic state. My tendency to obsess, to ruminate, to go through the same loop of thoughts again, and again, and again—these mental patterns are etched into my very brain, and continue to cause me great suffering. My sensitivity, that at times makes me feel overwhelmed, and flooded, and burdened beyond all endurance, has not dimmed—I still cover my ears every time an ambulance goes by. And while I am welcomed in the society of the earthlings, and enjoy their company greatly, I still feel, from time to time, as though I come from a different planet. Analysis is no miracle cure. Yet I am stronger now, and more aware, than I have ever been; I am, if I may say so myself, kicking ass in my academic and professional life; I’m a published poet; and I have true friends. Put differently, I am able to feel and to think, to love and to work. And I’m not alone anymore.

The fall I turned 15, the world was breaking down. This fall my birthday has come again, and the world—both inner and outer—is a place I cannot merely survive in, or just “function” in, but flourish, and play, and delight in. This transformation would not have been possible without psychoanalytic therapy; yet this chance to see and be seen, to be understood and respected, is available to far too few autistic people, both in the States and around the world. I think it is past time that we changed that.

Back to Top