Crossover approaches between neurosciences and psychoanalysis are receiving more and more methodological support. For this issue of the revue Adolescence, Rémy Potier interviews Roland Gori on the heuristics of this new research. Conceptual rigor often seems lacking in these approaches, which do not pay sufficient attention to the polysemy of concepts or to socio-historical issues.
Adolescence, 2011, T. 29 n° 3, pp. 531-544.
The author stresses four points mentioned by J. Dayan and B. Guillery-Girard. The first has to do with the reversal of conceptions of adolescence into a teleological model. The second offers a new reading of the clinical signs : a conception of the act not as a symptom, but rather as a structuring process. The third concerns the way in which we can conceive of the articulation between neurosciences and psychoanalysis. The last discusses the edification of a new framework for psychopathology. From the place of the « all-neuroscience » in the psychology of common sense, to the opening of a fruitful theorization, these interactions continue to raise questions for us.
Adolescence, 2011, T. 29 n° 3, pp. 517-526.
Case Reports, anecdotal evidence, descriptive epidemiologic studies, psychoanalytic and neuroscientific studies converge to conclude that impulsivity, sensation seeking and risky behaviours are common during adolescence. Epidemiological studies put forward that not only adolescents (fifteen-eighteen years old) but also young adults (eighteen/fifty five years old) are at increased risks of dangerous behaviours. Structural and functional neuro-imaging studies have shown that neural circuitry undergoes major reorganization during adolescence and young adulthood, particularly in those regions of the brain relating to executive functions, the self and social cognition. Decreases in gray matter volume during adolescence mainly reflect a massive reduction in the number of synapses ; meanwhile, increases in white matter volume reflect improvement of connectivity between distant regions of the brain, studies showing that the brain undergoes major microstructural changes during adolescence, and indeed beyond. Two different approaches to the « tendency to act » during adolescence are expressed in both neurosciences and psychoanalysis. One of the most widespread conceptions hypothesizes that this tendency results from some deficiencies, namely a lack of mentalization, for psychoanalysts, or an inability of the prefrontal cortex to exert a mature control over the emotional brain – the limbic system – for neuroscientists. Hence adolescents could be dominated by their drive or their emotions. The other conception, that we follow and we develop, is that the relative unbalance between emotion and cognition during that period, if any, allows a fine tuning of the brain structure through adjustment of connectivity and functionality of the prefrontal regions. From an evolutionary perspective, the last brain regions to mature in a given adolescent are also the last brain regions to develop phylogenetically. Taking into account gregariousness and social conformism of adolescents, the « tendency to act », often described in pejorative terms referring to their consequences as « risky behaviors », helps to edify a social brain adapted to the adulthood of a new generation.
Adolescence, 2011, T. 29 n° 3, pp. 479-515.
The author considers the concept of neuro-psychoanalysis in relation to adolescent ways of functioning. He briefly reviews the historical development and returns to three paradigms from the fiftieth Congrès des Psychanalystes de Langue Française des Pays Romans (1990) : the theory of catastrophes, the theory of chaos, and the concept of auto-organization.
Adolescence, 2011, T. 29 n° 3, pp. 467-477.
This article discusses processes involved in articulating and evaluating a model of time-limited psychodynamic psychotherapy for young people (TPP-A). Through the therapeutic focus on a significant area of developmental difficulty and/or disturbance, within a time-limited period, TPP-A aims to enable the young person to recover the capacity to meet developmental challenges and/or have this capacity strengthened. The article elaborates key aspects of the model and discusses an illustrative case.
Adolescence, 2011, T. 29 n°2, pp. 415-434.
The authors present their experiences with adolescents in borderline states, a particular form of adolescent suffering. Work with adolescents in borderline states using as a reference principle analytical concepts of groups helps – according to the authors – to activate the capacity for making representations and binding them to each other, by restoring to the subjects the dignity of persons who think and dream.
The authors present two clinical situations describing environmental groups – family-type communities and the « Centri di Aggregazione Giovanile » [socio-educational centers specialized in the care of pre-adolescents, adolescents and young adults] – in which they had a chance to share a method of psychoanalytical intervention oriented towards groups, which enabled them to engage with and treat adolescents in borderline states, for whom any classic psychoanalytical psychotherapeutic intervention would have been inapplicable or would result in failure.
The presence of an extended group situation allows borderline adolescents to experience the mental contention of anxieties. By moving in an interpsychical dimension, the psychodynamically oriented group creates the transitional space where difficult adolescents can cover and assimilate the distance between them and the milieu, between psychical space and the wider psychical space of the group.
Adolescence, 2011, T. 29 n°2, pp. 397-410.
Due to changes clinically observed in psychopathologies, care models have been evolving. This article focuses on what kind of possible work need to be made with adolescents facing to frequently psychosocial difficulties. In order to meet specific needs varying from one clinical situation to another, the author shows how important it is to create original models of care, wich remain open for change over time. A clinical vignette highlights which features are used to guide for setting up a framework of psychoanalytic therapy. Both the monitoring of verbal and nonverbal expressions from the patients and their transference on to therapists or stakeholders provide essential benchmarks for therapeutic choices.
Adolescence, 2011, T. 29 n°2, pp. 385-395.
Andreas is an adolescent who has broken with school. Welded to his mother with whom he forms a bubble with paranoid features, he has very few relationships based on otherness. His time in the Out-Patient Therapeutic Center, an almost unique psychotherapeutic perspective to our mind, will help to recreate thought about himself and develop his abilities to think about his own and others’ thoughts. Thus the institution offers an opportunity to triangulate Andreas’ psychical functioning, as it can for many patients in whom the « third party » is lacking as a psychical function, or is fragile to a harmful degree, and who are inscribed in perpetual movements of « leaving-being invaded) with the object.
Adolescence, 2011 T. 29 n°2, pp. 355-383.
During a session of psychotherapy, Benoît, 15 year-old, asks if he can make a painting of his blood – painting which he realizes then, at home, and describes in the following session : the eyes of Horus, which he found on internet. He presents a severe depression and projects of suicide, he cuts himself, the narcissistic fragility is massive and the identical problem in the foreground. Benoît claims his depression, says his fascination for its scars, he assimilates his need to see pouring his blood as a dependence with a drug. He wants to cut himself, he needs it, he feels existing. The blood relationships unite him strictly to her twin sister. He says that he does not suffer when he cuts himself, He undergoes in adversity, he feels and paradoxically hardens… The pain strengthens him and there even strengthens the limits of the ego. He so treats his excess big sensibility, signs for him of weakness and passivity which we set against the violence, the power and the strength which he feels in his auto-aggressive behavior.
Glances : his on his blood and painting. The place of the glance, the glances, the eyes of Horus, internal glance of Benoît on his blood which pours, his scars, trying to appropriate a body and a psyche which change and threaten it. Glance of his parents who suffer, he knows that, bewildered, they panic at the beginning, but their glances evolve. Glance of the therapist on his painting, as « adolescent » creation, and resumption of the myth in the therapy. The therapist, the psychotherapy of the attacks of the body, restore a relationship associating creation and representation, opening in the sense.
Adolescence, 2011, T. 29 n°2, pp. 355-383.
Young school shooters are far from fitting a common psychological style: some are described as sociable, others as loners. Some live in intact families, others in divorced or separated families. A set of sociological features unites them : the fulfillment of a virility rite when nothing else gives them a sense of self-worth, the impossibility of identifying with others, the wild hatred which in them takes the place of membership the world.
Adolescence, 2011, T. 29 n°2, pp. 325-337.