The author proposes that the term “ pre-puberty ” be replaced by that of “ Almost-pubertaire ”, referring to the work of both Gutton and Jankélévitch. Indeed this formulation seems more appropriate to bearing witness to the particular dynamic that is in play during this time of life. No longer really a child, not yet adolescent, the subject of this in-between is more than ever confronted with the question of being, whose fundamental expression remains the inability to know what is to come.
The article deals with the way in which the eruption of the species during puberty is echoed in the individual subjectivity of the adolescent. After observing the upheavals Freud caused in the Darwinian conception of species, we explore the dialectic between individual and species through the case of Victor, an adolescent in therapy. We analyze transgenerational and group bonds which, because of their collective character, may be considered as psychical equivalents of species for the individual. The flame of existence nonetheless is eternalized in the form of fantasies of transmission and of generation, when in addition to the difference of generations, the difference between the sexes and finiteness of the individuals can be accepted.
As a jurist, the author investigates the notion of parenting with regard to that of parenthood. The bond of parenthood, whether through blood or adoption, allows a person to be attached to his family, to be named with reference to this family, and to situate himself within it. It carries out the subject’s genealogical inscription. Parenting takes into account parental competence and tends to combine parenthood and parental authority. It cannot be analyzed as a component of a legal bond. But when jurists use this notion to satisfy the expectations of those who want to play a recognized role of father and mother with regard to the child, or to call into question defective parents, the concept of parenting leads to the weakening of parenthood. The jurist can only deplore this decline in rights.
It is standard to say that the psychical work an adolescent must accomplish is a work of separation, in particular with the objects of childhood. In fact it seems more accurate to speak of an adjustment of bonds between parents and adolescent. The former must be neither too lax (otherwise the adolescent may feel abandoned) nor too clinging (otherwise the individual may be kept from constructing a psychical space of his own). An institutional phase in which each, adolescent and parent, will be able to find his place can help in finding the right distance. Participation in a parents’ group at the time of an adolescent’s institutionalization allows for work on the adjustment of bonds.
Adolescence is a crisis of the bond which makes it necessary for the adolescent to elaborate new connections with his environment. When a consultation is sought for different disorders, these should be studied at the same time within the logic of meaning characteristic of the subject and within the logic of the functioning characteristic of a dysfunctional family. A clinical observation illustrates the different therapies that are used in several directions.
While powerful pressure groups are militating in favor of the legalization of cannabis, the debate among adults is skewed because its development is centered on the question : is cannabis neuro-toxic or not ? Now, today’s adolescents do not use cannabis so much to “ get high ” as to “ go to sleep ”, including during the day, at school or in the workplace. Most cannabis use is no longer recreational and is no longer associated with partying or with transgression. This new kind of use, whose effect is cannabis intoxication and whose goal is to make commonplace intoxication in the activities of daily life, is coming ineluctably closer to the other well known form of intoxication, alcoholic intoxication. This is a very good reason to worry about the present and future of these adolescents.
The very large number of adolescents who smoke cannabis in a festive – or recreational – way do not, of course, have an addictive relationship with “ joints ”. But it is interesting to note that the use of this product is never far from various aspects of the conflict that constitutes adolescent crisis : in addition to providing an alternative – or a complement – to alcohol-induced intoxication, it is a matter of modifying in a limited way what is thought and felt, so as to improve relations with other adolescents, familiarize oneself with desire and first sexual experiences, facilitate manifestations of humor and, sometimes, manage excessive sensitivity and disturbing sexual and aggressive fantasies. Psycho-educational interviews permit these adolescents to question more generally the malaise peculiar to their age, its relational consequences and the manner in which they try to remedy it. In this, the family may usefully be associated with the treatment.
Through a large number of psychiatric emergencies (540 under age 18 in 2001), we explore the relation between the passage to the act and the emergency situation in adolescence: doesn’t modern psychiatry tend to define a psychiatry of the act ? The latter depends on internal causes at adolescence, but also on the environment. The work with these situations is then defined both by the constitution of an emergency service as an interior setting and by the development of an exterior network. The evolution of a ward for dealing with psychiatric emergencies in adolescence can thus be described.
The word “ contract ” in the title gives one to understand that there is a clear prior agreement, or at least a mutually accepted restriction; in other words, it suggests something definitive and under control. Attaching the qualifier “ treatment ” to it opens the way to the notion of therapeutic process with all that it connotes of psychical movement towards a future subject to ambivalence, to the pairing of idealization and de-idealization, to the contingent. The working process that has been engaged offers a therapeutic setting at once spatial and temporal which creates the conditions for the emergence of a transitional space. There is a fool’s bargain when the immediate normative aim takes precedence : – treatment by medicine alone- imposture of effective symptomatic treatment without any work of elaboration (which can lead to relapses and defensive psychical readjustments that allow the problem to evolve quietly with increasing risk) ; verification ; openness in information.
In France, The hospitalization of minors is governed by several legislative and statutory texts which emphasize that decisions about hospitalization and care belong to the holder of parental authority. However, they also assert the principle, in keeping with the international agreement concerning the rights of the child, of the necessity of the minor’s assent to care and the preservation, in specific cases, of medical confidentiality.
Adolescence, septembre 2002, 20, 3, 574-554
Revue semestrielle de psychanalyse, psychopathologie et sciences humaines, indexée AERES au listing PsycINFO publiée avec le concours du Centre National du Livre et de l’Université de Paris Diderot Paris 7