The concept of autism as described by Bleuler and Minkowski constitutes a key element for diagnosis and understanding of schizophrenia. Bleuler in particular emphasized the possibility of non- productive yet symptomatic schizophrenia.

This argument seems to us very important because on the one hand the culture linked to DSM risks losing these historical knowledge and limits the diagnosis on productive or behavioral symptoms. Autism is an important clinical feature of schizophrenia and the related disorders of consciousness. Some features of autism are related to the symptom called ‘anhedonia’, considered by some authors and ranging from the ‘feeling of the loss of feelings’ typical of severe depression to schizophrenic abulia-apatia.

Our work focuses on the relation between these symptoms (which refer to the reality of consciousness) and an ‘instinctual’ reality that is actualized beyond the level of explicit consciousness.

Because these symptoms can roam around a common core, as part of affectivity, may be related to a psychopathological dimension of the second level, unconscious, in which the affective reality is primarily compromised. The annulment drive (Anulliertrieb, ‘pulsione di annullamento’), theorized by Fagioli (1971), as related to loss of vitality, can ‘cancel’ the psychic reality which lies at the foundation of affects and may explain both autism and anhedonia.

Fagioli’s theoretical formulations, in fact, include a basic human reality beyond consciousness (i.e. vitality), which gives origin to affective reality.