Archives de catégorie : ENG – Psychothérapie IV – 2009 T.27 n°1

Bernard Brusset: from the maturation of the instinct according to Pierre Male to the pubertary according to Philippe Gutton

From Pierre Male to Philippe Gutton, the specific nature of the work of adolescence has been affirmed, producing great developments in contemporary perspectives of psychoanalysis, not without some effect on the latter. Metapsychological renewals have been set up to give an account of the diversity of the clinical treatment of adolescence. This is always primarily a matter of the young adolescent’s confrontation with the pubertary genital. The traumatic effect of this emergence, in an initial break with the latency period and with the phallic narcissistic infantile genital organization, determines modes of defense which may be of an archaic type in relation with primary flaws in the psychical organization. The impact of puberty reveals these by re-actualizing them, and adolescence as a psychical work determines their outcome. The psychotherapy of adolescence retains the essential part of the psychoanalytical method, association of ideas, but this is fed by the therapist in order to foster a putting into representation and into words. The analyst’s psychical availability and plasticity of identification helps him to find, in his own style, the right tone and the proper distance.

Adolescence, 2009, T. 27, n°1, pp. 217-234.

François Ladame : an adolescent psychoanalysis

The psychoanalysis of a severely ill 17 year-old adolescent boy illustrates some characteristics of the treatment after a developmental breakdown. I insist on the necessary (re)construction of the fantasies that were « blanked » by the traumatic enactments, as well as on the unavoidable psychotic transference.

Adolescence, 2009, T. 27, n°1, pp. 199-216.

Philippe Givre : adolescent dreams and transformational

activity. the conceptual path of françois ladame
The conceptual approach proposed by François Ladame highlights the original notion of a « protective shield for the inside » whose internalization, during the second phase of separation-individuation, is one of the major issues of the adolescent phase. We must therefore show how the roles and functions of the Subconscious, the dream-work and the « protective shields for the inside »intermingle in order to achieve the development of the sexually differentiated body. All these interrelations and interweavings also rehabilitate the role of the Ego which must find compromises capable of integrating the new reality principle tied to the emergence of genitality and tolerating the presence of incestuous and parricidal fantasies that have been kept alive, bearing in mind that incest is at the heart of adolescence. For F. Ladame, this leads to the central idea that the true innovation, or even revolution, in adolescence, rests in the possibility of tolerating the exclusion of the primal scene, while keeping alive the representation of the relationship between the parental couple.

Adolescence, 2009, T. 27, n°1, pp. 177-198.

Séverine Rézette : the autist’s humor

Both « creativity » and « inventiveness » are linked to newness, originality; however, one difference remains which is linked to the motivation and the pattern(s) that allows them to arise. The psychotic patient and the autistic patient may have an access to one or another, but not as a result of achieved sublimation. Sublimation – as a « specific aim » – is a quest for « a happy capacity of satisfaction of drive » or « a satisfaction of a drive in the change of its object, without repression », as J. Lacan expresses it in Ethics of Psychoanalysis – concerns pathologies in which the Other is considered as an object. In the expression « satisfaction of the drive » the whole sex drive theory is concerned. This will invite us to examine the moment when some autistic patients may be involved in the field of inventiveness but without any access to sublimation. The discussion will be open as far as the autistic patient’s capacity for representation is concerned.

Adolescence, 2009, T. 27, n°1, pp. 167-175.

Fanny Dargent : red, narcissisus. recourse to the body and refusal of otherness

The psychotherapy of a teenager who practices body attacks sheds light on archaic processes at work in terms of bodily resistance to the investment of the object and the refusal of otherness. The dual situation reactualizes an internal otherness blocked by adhesive, anti-drive alienation from tyrannical, undifferentiated objects. Vigilance against visible « sensory-motor » objects as an effect of the Other, and against the counter-transference, works, with the aid of a psychodramatic style, to re-establish the transitionality which was blocked in this narcissistic teenager.

Adolescence, 2009, T. 27, n°1, pp. 157-165.

Tatiana Pellion : « head in the clouds », or some questions raised by the treatment of an adolescent suffering from migraines

The question of the migraine as a body event in an adolescent is treated with reference to its articulation with the drive. We thus explore the shared elements of both pain and drive, with respect to their connection to the body. Furthermore, we discuss one of the analyst’s interventions during a session, as well as its clinical consequences on the subject’s relationship with the invocatory drive and with its object, the voice. The function of the voice and of its drive shaping as mediation between primitive parental authority and the constitution of the subject’s superego is also developed here. We mostly insist on the function of extraction of the voice object from the body, and we therefore refer to the Freudian concept of « the thing », as well as to the Lacanian object a, in its primary dimension concerning the drive. We thus emphasize the relationship between the drive and the little object a during adolescence.

Adolescence, 2009, T. 27, n°1, pp. 143-155.

Jacques Clauvel : the killing brother

Psychical incest on two levels, mother-father, mother-son, may be a risk factor for fraternal violence, as may be seen in the treatment of a boy in late adolescence presented by the author. In cases where there is a parental configuration of an incestuous type and a traumatic brother, we observe a complex internal object, the killing brother, who constantly destroys within the psyche. To limit, or even eliminate, the damaging action of this internal object, it is useful for the analyst to be able to represent, from the position of the counter-transference, both the parent and the brother, ceaselessly moving between one and the other. The killing brother object is rendered harmless by being removed from his false place as nuclear object and place back into his place as an orbital object. The interpretation, in the founding myth, of Eteocles and Polynices, the warring brothers, enables us to deepen our knowledge of different aspects of this psychical reality.

Adolescence, 2009, T. 27, n°1, pp. 133-142.

Gianluigi Monniello : the young adult and his analysis

The condition of young adulthood appears to be a structural necessity in the human being’s process of becoming. This time of life is distinct from both adolescence and so-called adult maturity. The author explores the factors that differentiate the specific nature of the intrapsychic, interpersonal and psychical economy of the young adult.
The second problematic consists of finding out if there is enough containing function to make possible the working-through of primitive sufferings that have not yet been elaborated and open the way to decisive introjections.
The third concerns the assimilation of identifications to identifying models, now de-sexualized enough (apprentice identification), an assimilation which can take place « without too much thought », and which helps reinforce the subconscious.
The fourth and last problematic, the relation with the body of the parents, can be clearly recognized, in view of the reduction of incestuous anxieties, and the intracorporal identifications can thus be revealed and elaborated.
The clinical material shows that these patients are more disposed to analysis on the couch but less sensitive to the subjectalizing holding function than adolescents.

Adolescence, 2009, T. 27, n°1, pp. 117-132.

Rita Sferrazza : the individual psychodrama, lever of therapy and resource for the analyst

The individual psychodrama, in its various configurations, offers a range of therapeutic possibilities. This article gives an account of some of them. But our attention will be focused particularly on the interest of a selective use of psychodrama at a specific moment when a teenager’s therapy was winding down. The interest for the young person and especially the interest for the therapist, whose capacities for elaboration were paralyzed, will be underscored, as well as the determining factors which push a therapist to resort to the form of psychodrama known as « of release ». Lastly, a clinical vignette will make it possible to measure the entire range of such recourse on the continuation of an analytical process.

Adolescence, 2009, T. 27, n°1, pp. 107-116.

Régine Gossart : which framework for the act?

More and more often, we meet patients whose psychical operating process presents difficulties in the process of symbolization and split-off zones where early experiments are embedded, their traces still registered in their first form, which is essentially a corporal one. These traces then return in acted or somatized form. There are therapeutic settings which allow for an encounter, in tune with the patient and the therapist, and help to contain these acted manifestations which consequently are no longer regarded as « passages to the act » by as « passages through the act » in order to be included in the psychical process of transformation.

Adolescence, 2009, T. 27, n°1, pp. 99-106.