Drawing from clinical work with adolescents in a home for troubled children (MECS), which confronts us with the absence of a treatment demand as well as with the kind of bonding that is prone to narcissistic seduction, incestuality, and omnipotence, we investigate the kinds of framework that could enable us to engage a therapeutic process. To this end, we present a definition of the “triple echo” setting and illustrate its potential effects and tools by means of the situation of a fifteen-year-old adolescent boy
The use of the sensorial is twofold, involving binding and unbinding effects. The idea of trans-figuration lends itself to the representation of a play of figurations in which the other is a necessary partner. The insistent way the body intervenes in adolescence cannot be interpreted entirely as a glitch; it can just as well be seen as a lead-in and may appear as an operator within the very process of subjectivation.
In this article new forms of contradiction-conflict resulting from changes in the perception of limits that psychoanalysts encounter in their practice today are conceived from the perspective of the notions of work of the negative and of subjectivation
Mr V. was hospitalized in a psychiatric ward and we met him in the context of an open consultation in the department which receives patients with corporal complaints, whatever the diagnosis. The overwhelming event in Mr V’s life ( his first name means life in FRENCH), stems from a dentist’s root canal operation on his healthy teeth. In the aftermath of this shattering event, an encounter with a man during the same year that Mr V became the father of a son, his words led us in the direction of what could have engendered the psychic conflict and caused the failure of his repression of a homosexuality that the subject could neither represent or integrate. His homosexual passion, unknown and repressed, had led him to a physical and psychic decline as well as to catastrophic complaints contributing to an impasse in a life, up to that moment, without problems. In the staging of his words, the events of the encounter took on a sense, informing him about the homosexuality evoked by paternal words and the failure of his repression.
The register of the moment directly poses the question of désirance and its influence in the process of subjectivation. Starting with the problem of the encounter in the libertine, the author offers an exposé of relational issues at the onset of the genital phase. The register of consensual defeat instigates the creation of an amorous, masochistic self on which the subjectal evolution will in part depend. The moment – through the effect of divestment it introduces into the encounter, but also through the effect of putting into perspective it gives rise to – gives potential to this operation which determines the genital subject.
The author envisages the figure of the friend in its attracting role with regard to the register of depression in adolescence. At once caught up in a loss of objects and in the loss of a condition, which he must now subjectivate, the adolescent would find in the person of the friend that actor – facilitating agent, subject of experience and a support to projection and/or identification – able to sustain him effectively in this work which involves, in an essential way, the register of the encounter.
The author highlights the original axes of Kari Hauge’s clinical presentation: which combines an accommodation of the regression of the adolescent girl as in the treatment of a child with an encountering technique based on the specificity of the adolescent dimension – the formulation of interpretations both of unconscious content and of the actual relation between the patient and the analyst. This practice allows for an elaboration of infantile Oedipus complexes re-actualized by adolescence while facilitating a resumption of the process of subjectivation, once the needs of dependence have been acknowledged.
The « Maisons des Adolescents » treatment centers of two districts around Paris are built on a network of pluri-professional workers dealing with adolescents. They provide access to low threshold primary and secondary care services, as well as organizing referrals to other services. They also provide support and training to professionals and help them share some difficulties. They enhance the links between professionals, provide training and exchange groups. But they also have some paradoxes, like adults’ ambivalent opinion of adolescence. The fact that psychiatrists are actively involved in settings that sustain « mental health » is also questioned. When clinical referral is needed, the authors underline the effects of their active implication in the local network, in terms of symbolic effects and dynamic effects in the clinical encounter with the adolescent. The most important thing is to make the encounter real and supportive for the identification and identity processes of adolescence.
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