Ignacio Melo : the work of composition in consultations with adolescents

In this article I describe my way of practicing therapeutic consultations with adolescents, explicating it through four excerpts from interviews, in light of the reflection of some others who have helping my thinking. I speak of the conditions which have presided over the communication with my patient, particularly narcissistic identification. The central point of my technique is what I call the work of composition, which is defined as follows : the work of composition is a narration of diverse, elements sometimes unconscious, more often preconscious and manifest. It also establishes links between different regimes of functioning. A creation of the session, its components come indistinctly from the patient’s presentation or from the analyst’s thinking. The latter treats the narration in a propositional mode, tells the suffering in another way than in terms of symptoms, and does not aim to arrive at a profound truth. Concretely, this means that he must be ready to give up the narration if the patient judges it to be displaced or not useful. Its explicative character carries meaning, but this is not necessarily a causal hypothesis, and may take the form of enacting a conflict, or the formulation of a paradox. The composition is a narrative that can be infinitely rewritten, if necessary. If is also a proposition of a mode of functioning : various experiences, sources of pain or joy, sometimes contradictory or even paradoxical, can be recounted in a narration. And the analyst invites the patient to himself become a composer and, in so doing, to feel relief, or even to take pleasure in this. In this sense, composition is an instrument of transformation. I conclude by specifying that this work must lead to a deconstruction of bothersome functions, which are a source of suffering and hinder psychical development.

Adolescence, 2011, T. 29 n°1, pp. 9-62.