Why we consider an institutional approach fundamental for working with autism


TORREON. A Welcome and Treatment Space for Children and their Families.

Gracia Viscasillas. Clinical coordinator.


We are, in this age, a few, those striving to attack things, to create within ourselves spaces for life, spaces that didn’t exist, or seem to have to find a place in space.

Antonin Artaud

Written on the wall in Torreón


It seems to us that an institution oriented by psychoanalysis is a privileged place for the putting into place of the welcoming of and offer to the subject. A welcoming of its modes of treatment, defence, confronted by the invasion of jouissance it suffers. An offer, constructed through a plurality – of spaces, of participants – in order to construct a “space”, an “atmosphere”, that constitutes a place of response beyond the effects of signification. It is starting from this work that we can speak of the civilising effects of jouissance.


To inhabit this place of response passes through putting the accent on the welcoming of the subject, in the particularity it brings with it to put to work. For years, we have wagered in our institutions on the orientation given to us by the ‘plural practice’, which implies that we make the “treatment” emphasise the Other with which the subject has to do – the participants, the institution itself – and the effects of this that can be glimpsed in the subject. In order to do this, it is important to capture the conditions of the Other that permit, for each subject, the facilitation of an encounter.


The French language has one word, “être”, where we have two: ‘ser’ and ‘estar’. Sometimes it seems as if we live in a society in which the demand in relation to these children is that they “are” (estén) well, in the sense that it is not noticed that they are “different”, that is, that they become “normalised”. This vision that puts the accent on “apparent being” (estar aparente), leaves aside the fact that each one of them “is” (es), no longer in their difference, but instead in their singularity. In Torreón, we wager on the creation of places in which each of them can “be as they are” (estar como es), and what we find is that in making this wager they can precisely “be well” (estar bien). Be well, not in the still-frame of their supposed “normalisation”, but instead in “their” normality, that of each of them.


With this aim, in Torreón, we have articulated an institution in which we unfold different proposals: specific workshops, Torreón mornings or afternoons (when the children participate in small groups in different workshops: library and computers, art, psychomotor skills, music, theatre, cooking…), school support classes in the centre or at home, individual treatments; and now we are trying out home therapeutic accompaniment. With the adolescent group, in addition to the workshop spaces, we organise trips to different places of leisure in the city (cinema, bowling alley, swimming pool, museums, shopping…).

We attend to 70 children and young people between 3 and 21 years of age. Many of them are also in individual treatments in other institutions or with other colleagues.


In the workshops, the proposal we carry out with the children is ludic, rejecting the “X-therapy” that imprisons them under the considerations of deficit and re-education.


This doesn’t mean that Torreón is a playschool. On the contrary, the participants responsible for each workshop put to work, each one in their own style, a mode of accompaniment that looks for the encounter, pacification, the putting to work of the circulation of speech, work with the body, the possibility of being together with others, and very fundamentally the creation of a place for each subject and its productions.


Torreón is not a centre specifically for autistic children. We work with them amongst others, together with children that present other kinds of difficulties. This implies a complexity in the work, which is – of course – the responsibility of the team of participants.


Usually, at least two participants are responsible for the workshops: in order to accompany children to another space if they need to leave and come back, in order to accompany different games or uses of materials, in order to facilitate conversation and plural interventions and, very fundamentally, in order to promote the diffraction of transference.


We have established that in each space a work proposal is set out – which can come from the educators or be suggested by the children at the beginning of or during the workshop, or from one day to the next.

However, this proposal is never an imposition or demand. Rather, we think of the proposal made in each workshop as an organising element, because it is when confronted by this proposal that each subject is summoned to a choice; and it might be that the choice of one is taken as a good idea by the rest and that the general proposal is modified, or that there are different children working with different materials or different games. To work and give value to the choice is also a clinical wager, because in addition to pointing to the subject, it confronts the limits of choice – “one can’t do everything” – making this impossibility fall in the first place on the side of the institution and/or the participants, in a reference that on the one hand makes holes in the Other and on the other approaches that apparatus of jouissance constituted by language.


In order for all this to take place, the different dispositifs of the team’s work are fundamental:


-The meetings that we have at the end of every day with the different teams that make up the workshops that the children attend. These meetings, with the clinical coordinators, are very important in order to ensure that the participants don’t remain trapped in their own jouissance, which many situations confront them with, or in the anxiety that is often provoked.

We know that working “plurally” is not the same as working in a “team”. The different workshops are not fixed compartments. Something that happens in one space can give rise to a response in another, and we must be aware of this. Working ‘plurally’ also implies safeguarding ourselves from the narcissism of small differences, and the positive contribution of observations, responses and effects, in a wager on collective reading that cannot be produced without the one by one.


-Case meetings, which we periodically have in order to elaborate work on a case that integrates the work done in the different workshops with a wider temporal perspective.


-Case supervision and training meetings, which we have once a month and in which the whole team participates.




For Lucas (a fictitious name), aggressive tension and a trait of voracity stand out in many situations in each space. Every day, in every workshop, we had to be very attentive, intervene plurally, not enter into the aggressiveness that he summoned as a response, protect the other children in a firm way but at the same time be receptive to the subject, surround him with words picked up on the wind, invert proposals and situations in order to reduce the jouissance that pushed him. A “no” to the jouissance that invaded him at the same time as a “yes” to the subject have been for us a fundamental orientation that all of us try to carry out. But it is in the symptom itself that we find a mortifying aspect and an aspect that provides a solution. Now, in the kitchen, he makes, and worries about making, meals “that everybody likes”.





Toño (a fictitious name) is a very silent boy. At the beginning, his impulse was to go and bite the children if they touched the toys that he was playing with or came very close.

For Toño, it is important that we make room for his choice of an object, allowing him to take it to the different workshops, and on many occasions to also take it home, something that also makes the journey home easier for his mother. It is an object with which he isolates himself in a repetitive game. But accepting his choice on our part also allows him to include us in his game and to accept in a pacified way the presence of other children who he now observes and follows in their games.


The importance of making room for this object was already discerned the first time he came to Torreón. He chose in the library the game “Hunt the Mouse”, and offering to help him take it to the psychomotor room allowed him to attend this workshop. There, after a solitary, calm period with this game, Marina decides to pick up the mouse and raise it onto the blocks, turn it on so that it runs, jumps… Toño observes. Later, he also plays in these parts of the room, with the mouse in his hand. Then Marina introduces the “catching” game: she picks up the mouse that Toño had and says to him “Bet you can’t catch me!” The boy smiles and accedes to the game. Later it will be him who provokes Marina, showing her the mouse and running away. This scene was the matrix for a lot of work with the boy, in which the field of his objects of interest has been widened, new words have emerged, and also moments of relating with other children.




The mother of an autistic boy, Luis (fictitious name), arrives overwhelmed by the difficulties her son presents in daily relations, and by the stigma attached to her in different places by people saying that the problem is that she has not educated him correctly. Already in the first interview, the mother is surprised when the boy speaks calmly with the director as he walks through the different spaces, having presented him as an autistic child who speaks very little.


In the workshops – which according to the mother he attended very happily – Luis was quiet in the beginning and very serious in all the tasks he carried out. Little by little, the educators introduce “banal” conversations while the children go about their business. On one occasion, I go into the Art workshop. On child is drawing dinosaurs, another making Angry Birds with different materials. Luis constructs a big figure that takes him many days to make. In the taller, I take an interest in what each of them does, and ask out loud whether there is not an Angry Birds film. Luis jumps up very enthusiastically to tell me yes, that he has seen it, and he recounts it in luxurious detail… a kind of detail that the other children also add.

In another session, we continue to speak about films, and one of the educators says that she likes to eat popcorn while she watches them. The conversation drifts, very animatedly, towards the idea of organising a party in Torreón to watch a film, and we all propose a lot of activities for the party… We even fix a date! I say that unfortunately I will be away. And it is Luis, with great tenderness, who says that we should postpone it so that I can be there too.


Starting from there, Luis becomes happy, creative, proposes a lot of activities and ideas.

The mother is motivated by this change in her son, which she also observes at home. Every day she brings us a little vignette that we listen to, and to which we gave all its value. There is a very important change in her concerning her way of understanding and relating with her son. And she brings a phrase of Luis’ that moves her: “Mum, now you love me more”.




These are always interventions that are supported on relationships, on transference, and it is always starting from this that we calculate the introduction of small variations that, taking into account the children’s objects, signifiers, particularities, open the field to new objects, new signifiers, new games and materials, and that also make possible the inclusion in their field of a more pacified relation with others.


To conclude, I want to say that Torreón doesn’t pretend to be a “total” institution, an institution closed in on itself, but instead that we constitute ourselves as the point of a network that in its framework sustains the subject in its productions, in the discovery of new resources that treat that which exceeds it.


Translation: Howard Rouse