This article presents a clinical treatment that develops from childhood, through adolescence, to young adulthood, from three different perspectives: diagnosis, psychoanalytical psychotherapy and supervision. Are we dealing with a family traumatic pathology, childhood psychosis evolving into an adolescent borderline state, a problem of subjectivation? Interpretive technique will be studied in detail in relation to transference modes.
Adolescence, 2015, 33, 4, 823-835.
The metapsychological status of adolescence as a psychoanalytic concept becomes meaningful with the definition of adolescence as already described by the author in his previous works.
Hence, the clinical approach evidences the insufficiency, on the one hand of the traditional conceptions according to which the use of the concept of symptom aims at multiplying personality profiles in the new psychopathological group of borderline states and, on the other hand, of the approach as described within the structure of the borromean knot as suggested by lacan.Resting on his latest works on the borderline state conceived as a « state » rather than as a « structure », hence being liable to be present in any structure, and which rests on the concept of « limit », the author insists on the distinction between behaviours and symptoms at adolescence and suggests that adolescence should be considered as a logical time of construction for the sinthôme and borderline states as provisional or fixed states that are specifically unstable of such a sinthôme. He here closes his paper with a few notes on the study of the qualities of such a sinthôme.
Adolescence puts the course of early development back into play and works towards the expansion of the psychical apparatus. At puberty, the adolescent is called to provided himself and others with a stable narration (though it may be reworked) of his history and his childhood. The elaboration of puberty entails complex and difficult psychical work, and exposes one to the organization of a psychopathology.
In the borderline adolescent especially, the needs of evolution activate anxiety and conflict in a significant way. The conflict is born of traumatic cores from the past which, on the one hand, generate the fear of re-living fragmentation and, on the other hand, the expectation of the inevitable and continual actualization of the traumatic experience.
The analyst then is responding to the adolescent’s difficult process of becoming aware of himself (his difficulty in making his affective states legible for himself and others) as well as to his perception of not having enough « auto » psychical processus (empty and chaotic feeling of self) through a lengthy self-analytical work. This is the start of knowing and transforming the therapeutic relation which is continually at risk of shutting itself up in confused unity and an endless mirroring function.