A complete description of adolescence may be made using a conceptual model that connects two kinds of system, open and closed. Far from representing diagnostic categories, these systems are constructions illustrating different adaptive choices available to adolescents at a critical time in their development. Open systems indicate the effort to transform the self, while closed systems indicate a need to control, force and change other people. Reference to both these systems has profound implications for practice and theory, not least because they provide a different way of looking at adolescence, the goal no longer being separation, but rather transformation.
The Emergency Room is the healthcare service most used by youths. Two principle phenomena bring them in: accidents and somatic manifestations. These have one factor in common : a body that is both agent and victim of adolescent disorders and acts. Using research conducted in five hospitals in Rome between 2000 and 2002, most notably at San Eugenio Emergency Services, we offer some thoughts on the clinical value and the evolving function of the onetime clinical encounter (meeting « just once »). Taking into account the different time schemes at play in this sort of meeting space – like crisis situations or the element of surprise – we will see how the Emergency Room interview can provide an opportunity for « creative risk » for a time, a long time within an instant, but also for a new perspective on the event the adolescent has experienced, if we can be receptive to his paralyzed time scheme and allow him to appropriate our own life history.
The possible paths that the affects of one’s love life may take, starting with the moment when the object is born, then as an investment of oneself and the other, and finally in so-call mature love, are blended together in numerous forms and in the intensity of transference love. Starting with the dynamic between transference and counter-transference at work in the analysis of Antonella, we will see how clinical work sheds light on the many vicissitudes adolescents go through, their infinite symptomatic solutions, the countless pains of their love life, which are linked to their fidelity to the primary identification, to the strength of this loved and hated bond, but also, at the same time, to the reactivation of the process of subjectalization and subjectivation.
This article offers a reading of pairs of pupils’ outbursts/teachers’ responses, as seen from the conceptual field of psychoanalysis, and considers these events as drive creations, the subjective finds of desiring subjects. This postulate is based on the conceptual and practical elaborations of Freud and J. Lacan, which account for events, similar to pupils’ outbursts and teachers’ responses, that arise between patient and therapist in the practice of analytic treatment. This kind of heuristic position allows us to hypothesize that some pupils resort to acting out during class and that the responses elicited from the teacher have to do with « knowing how to handle them ». From this perspective, adolescent inventions and their adult echoes bear witness to a new academic reality that allows adolescents and teachers to build together. These conducts are brought into focus through interpretive analysis of the discourse of the subjects of the lesson as they talk about what they are experiencing.
This text emerged from discussions and reflections that occurred between my work as a psychoanalyst and my work as a supervisor. I wrote it after a discussion with an assistant I’m supervising. She was telling me of her concerns about encounters with very young adolescent boys who are very inhibited and silent in the session with her. This recurring difficulty had led her to ask me if it would not be wiser to refer them to male therapists? This led me to reflect upon ways of getting out of the impasse she found herself in with these patients.
We explore both practice and the relation between theory and clinical work in a mediation workshop in a day-center. Using the case of Maud, we present collaborative work between the artist and the various practitioners carrying out psychoanalytic work with several difficult patients. The procedural aspect of mediation work complements the verbal approach when dealing with these patients who lack a capacity for symbolization.
Faced with issues of changes associated with adolescence, the adolescent subject is in the throes of what, in the object-relation, comes from a necessary loss. When separation as a process is not dialectizable, it keeps the subject in a position of submission, locking him within an enclosure. To open up a space for creativity where such lock-down has occurred is the aim of workshops conducted by artists in a day-hospital. Supports ensured by the artist carry out a « portage », understood as holding and handling, in the sense that the artist establishes an encounter using subject matter that he carries psychically and is receptive to the lines and sketches of the adolescent’s formations.
We have developed a psycho-sensorial therapy that we call Multisensorial mediation treatment (SMMS). When dealing with severe forms of anorexia, in which patients seriously abuse their body, we had the idea of offering a particular psychotherapeutic space, in surroundings that are pleasing to the senses, allowing the patient to assume a regressive position that fosters access to childhood memories and archaic psycho-affective impressions. This therapeutic space uses olfactory stimulation by scents chosen during an aromatherapy workshop, combining them with warm enveloping of the body, relaxing music and a dimly lit room. The object of this treatment is help the anorexic patient revisit childhood memories, both pleasant and traumatic, and build a sense of psycho-corporal security which has been lacking until now, within a containing setting.
Psychoanalytical psychopathology sheds light on the technique of packing. But recent neurophysiological, developmental, psychopathological and institutional studies have come together to enable this treatment practice to construct a psychotherapeutic setting for autistic and psychotic children and adolescents, as long as this is part of a complex institutional structure that takes into account all aspects necessary to the care of the patient in question. The vehement attacks of its detractors are put into perspective by the good clinical results it produces, about which a program of clinical research will issue a report in the coming months.
A commentary on the current debate about packing, this introductory article explores the archaic fantasies which corporal therapy stirs up in public opinion.