The clinical account is an indirect approach whose only function is to help one get one’s bearings. Through, or more exactly, in the throughways of a trajectory wherein a young man in the care of Aide Sociale à l’Enfance, in a context of complete failure to achieve social or professional integration, I will try to show how a process of subjectivation was elaborated, allowing this youth to reconstruct his present by the yardstick of his past, to symbolize and to appropriate what had until then only been felt. This text is written as a triptych. The three parts can be read independently of one another, but it is nevertheless in the link between them that the specific nature of the argument I wish to put forth in this article will be developed. Each part refers to a reading, a phase of elaboration. It opens with a clinical vignette, a preamble to the reflection which follows. I could have connected the vignettes in a single sequence and developed my elaboration point by point afterwards. I have preferred this (dis)articulation which, in my opinion, better serves to dramatize the case in question.
The instinct peculiar to puberty acts in the therapy, in a brutal, harsh and unsymbolized way. The acting out is generated by the emergence of new instinctual feelings, still not elaborated nor integrated to the Self. The creative ability of the adolescent, carried on by the clinician, enables to sublimate the puberty violence and find a way of clearing other than instinctual or sexual. Here, it is the « Mystical Animal » which will come and symbolize the entrance to puberty and its investments.
There is a tendency in the systemic psychiatry of mental states to consider periods of sadness or persistent discouragement in the adolescent, or even just morose states, as signs of pathology. Following the theories of D. W. Winnicott, E. Gut, P. Fédida and Ph. Gutton, we develop the dynamic viewpoint according to which the depressive movement that is inherent to mental life plays a part in the regulation of psychical life. Set in motion by loss or abandonment, it fosters the redistribution of investments, a veritable « re-affectation ». The depressed adolescent subject needs to be accompanied, not immediately treated. Although the outcome of adolescent depressiveness is usually favorable, we will examine some possible harmful outcomes, calling depression in such cases « unproductive », « death depression » or « depression of unbinding ». Two emblematic pathological figures, mental anorexia in the young girl and addictive conducts, are seen as resistances to depressiveness, which is nonetheless a key part of a process of integration. These illustrate, following the example of the dismantling of thought in psychotic depressions – desperately expressed in artistic productions – the essential role that the body plays as a constituent and a means of psychical life.
revue Adolescence, 2011, T. 29 n°4, pp. 737-745.
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