Having studied the cases of « Felix », « Ilse », and « Willy », which illustrate the concepts of internal objects, unconscious fantasies and the feminine phase common to both sexes, the author deals with the case of « Fabien Especel » (aged 18). This adolescent is the hero of If I Were You…, Julien Green’s fantastic novel (1947), whose internal world Klein explored in « On Identification » (1955), almost « as though he were a real patient ». The normal and pathological aspects of projective identification are developed and deepened in « On Identification », through the « analysis » of Fabien Especel.
The session and its continuum in everyday life must of course be considered as a third-party relation; in it, « two people looking at each other » are brought together and compromised under the same «other» gaze ; a group is formed, trust (and illusion) shared… The lighthouse, initially unknown (a stranger), inspires exchanges that are more and more familiar: talking replaces being looked at. Thanks to this third-party construction, the interactions that define the site can henceforth be interpreted or « reconstructed ».
In adolescence the body becomes a projection surface that one must control by adorning it, concealing it, abusing it, etc. Existence is a matter of skin, a question of the frontier between inside and outside. Cutting into the body brings suffering to the surface of oneself, where it becomes visible and controllable; it is much more an act of passage than a passage to the act
Because of the frequency and their contagiousness, self-inflicted wounds in adolescence have moved to the forefront, in both psychopathologic and social thinking. For some, the very frequency of this phenomenon makes it commonplace, and its function would seem essentially adaptive. For others, self-inflicted wounds are a kind of suicidal practice that doesn’t speak its name. Between these two extremes lie a multitude of possible significations and therapeutic responses. A survey of scientific literature on the psychopathological understanding of self-inflicted wounds in adolescence, this article raises some questions and shatters some certainties.
This article presents the case of Marie, an adolescent hospitalized in the Adolescent Crisis Ward in Geneva, for whom it was decided to introduce a treatment by packs. This technique is part of a therapeutic approach using corporal mediation. Initially intended for patients with psychotic disorders, its was gradually extended to include situations where there is an alteration of body image in association with various types of pathology.
For Marie, the treatment indication was based on an hypothesis of basic narcissistic fragility, linked with a primary lack of mothering and of protective shields.
We will offer some thoughts on the issue of the co-therapists’ bodies in individual psychoanalytic psychodrama for adolescents. We will try to show how the corporal experience of co-therapy gives birth to psychical representations that can be used in psychodramatic play. We will also investigate the difficulties of a treatment process that implies the engagement of the whole body. Lastly, we will discuss the therapeutic indications for such treatment and the pitfalls of seduction when dealing with adolescents who are often open to the danger of being overwhelmed by their drives.
The body participates intimately in psychical life, particularly during adolescence. Corporal references are upset and the psychical apparatus works at reformulating its representations of a body that has become pubescent.
In our practice of hospital treatment, we offer group therapy using corporal (or psycho-motor) mediation inscribed around corporal feelings, including the dimensions of sensations, emotions and fantasy. The set-up that we offer enables a therapeutic approach aimed at identifying sensations and putting them into words, then elaborating the perceptions associated with them, while maintaining a setting whose structure is supposed to offset the risk of narcissistic collapse associated with the lifting of certain kinds of splitting.
The theme of adolescence is approached in the light of classic psychosomatic theory, with some theoretical-clinical connections. Behavioral neuroses at this age seem to protect the soma, but paradoxically endanger the life of the subject, in symmetry with progressive diseases in the adult. Also, a deficiency in adolescent work has the potential to generate serious psychosomatic illnesses, either immediately or later on. The adolescent’s depression is the common denominator in most of these clinical situations; it entails a potential for object disinvestments and for the appearance of symptoms corresponding to essential depression as described by P. Marty. This paper questions the role of adolescence in the subject’s psychosomatic future.
In light of what is called the clinical treatment of borderline states, the author investigates some notions inscribed within the relations between body and psyche, such as perception, the sensory, sensuality, representation, emotion, affect and auto-eroticism.
Particular importance is given to the place occupied by infantile sensuality in connection with the establishment of auto-eroticism, insofar as sensuality is most often confused with the sensory. These notions still represent a large part of the difficulties psychoanalytical research encounters today. They maintain a narrow relation with the drives’ sphere of influence, but the opposition that has often been asserted to exist between the sensorial-perceptive and the intellectual can no longer be defended.
By underestimating the importance of the mother’s affective relation with the infant’s body in its ongoing development, psychoanalytical theories forget the major role of the body as a « vital dimension of human reality ». The author establishes a distinction between body-image as a structure founded on sensory experiences, and the body as internal object, which includes the erotic body and has the function of providing a solid basis for the development of the ego and its relation to reality. The parts of the body linked to experiences of pain, deprivation or the absence of contact cannot be introjected and remain split off from the body as internal object, causing developmental problems which may go so far as to constitute grave disturbances in the relation with reality.