When adolescent creativeness is unable to reconstruct the I-Ego taking into account the newness of puberty, the psychoanalyst must invent a specific practice : construction work with which the adolescent can identify. When adolescent creativeness is unshared and unable to be shared, the treatment should offer common ground where a two-person perlaboration can develop, in which the conditions (usually infantile) of the impasse (breakdown) will be imagined together. We will discuss : modes of intervention, particularly their flexibility and their limits ; the difference it makes whether the adolescent brings material to the session or not ; the process in play in the analyst’s constructions (in this case sublimation, which is opposed to the control exercised by the ideal) ; the implicit risk of deconstruction in any imaginary suggestion made by the analyst.
In this article, the author shows how the concept of subjectivation grew out of clinical work on psychotic states in adolescence. These are related to a melancholic core that is sometimes difficult to discern beneath the drive conflicts of puberty. Using a clinical case of adolescent-onset psychosis, the problem of the fundamental relation between psychosis, temporality and melancholy is restated in a way that can account for “ borderline ”-looking symptomotologies, within a post-Freudian theoretical framework and with reference to certain contributions of Green and Racamier.
Like other basic psychoanalytical constructions, the theory of therapeutic action is currently undergoing revision, and theorists of different persuasions are suggesting different mechanisms.
In the domain of clinical research, the author argues that psychoanalytical psychotherapy with adolescents enables us to describe both treatment goals, (that is, changes) and technique (that is, the strategies that can help to bring about these changes). Interventions that facilitate change can be placed in one of two categories : those which make use of several transformational aspects of the therapeutic relationship, and those which increase insight and reinforce identity.
In particular, the treatment of an adolescent suffering from personality disorder calls into question the identity of the analyst who is specifically engaged in the process of self-analyzing his own adolescence. The work of recognizing and elaborating this process can prove to be a fundamental therapeutic action.
The description of two clinical vignettes will illustrate the different therapeutic actions that are in play.