The polysemy of adolescent actings is rich and varied. To shed light on the unique clinical area of the adolescent act, I think it is useful to look at the contributions of the psychosomatic, particularly at the harmful effects of the loss of a rich inner dynamic in favor of or as a counterpoint to an explosion of externalized conducts. We will end by offering some ideas about the paradox of disruptiveness in the context of adolescent essential depression, where impulsiveness co-exists with wandering.
In an older adolescent with psychosomatic symptoms, the autosadistic symptom of trichotrillomania brings together deficiencies in the Body-ego and its attempts at autoerotic appropriation. These repeated traumatophiliac wounds are a survival method maintaining the excitation of a disavowed maternal absence whose memory traces infiltrate the memory of the sick body. What is at stake in the therapy is the revisiting, in the transference, of the homo- function and primitive auto-reflection.
This article is an invitation to read M. Benyamin’s book, Le travail du préconscient à l’épreuve de l’adolescence (Preconscious work challenged by adolescence). It will present the major axes of Benyamin’s thinking that give the clinician an original and captivating insight into the preconscious, as well as the psychosomatic and psychoanalysis of the adolescent.
The psychosomatic approach is something like the dancer’s split, stretching out to join, on the one hand, the medical approach, whose very foundation is the isolation and objectification of the symptom, and on the other hand, the subject, with his history, his fears and his sometimes complex demands. Using several clinical observations, we will try to show some particularities of this treatment in the adolescent.
I suggest the hypothesis of one instance, the body, which would be situated between the somatic and the psyche. It would be a place of representation as well as a borderline concept, like the drive which lies in it. I think of it mainly as an instrument for generating figurability. Thanks to its articulation with the subconscious, it would contribute the transforming potential of somatic excitation. This potential, created within the narcissistic relationship with the primal object, undergoes considerable readjustments with the arrival of puberty.
In the face-to-face encounter between a teenager and a psychoanalyst, the body is not only a part of speech but also a palpable and immediate element offered up to the other’s gaze, a fortiori when there are tattoos, piercing, or self-mutilation. In such circumstances, remaining a psychoanalyst-subject entails a response that cannot be dissociated from the construction of a theory about the Body.
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.
The authors study a case of male mental anorexia through psychosomatic clarification and the specificity of mentalization. They discuss the importance of modulating treatment approaches according to the attention given to psychical movements that can restart mental activity instead of and in place of self-destructive behaviors.
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