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.
Archives par mot-clé : Psychosis
Philippe Gutton : Solitude and Desolation
In this theoretical paper, solitude is defined as an affect which expresses the gap, or the boundary, between external objects and internal objects that is wide enough to enable a subject’s creative activity. This gap is just what is critical in adolescence. Desolation is the internal void of the psyche that finds no pointers for its creativity in its environment. Desolation seems to be the basis of depressive, hallucinatory, and paranoiac psychotic processes.
Delphine Scotto di Vettimo, Claude Miollan : Between Shame and Psychosis: A Reflection on Assumed Knowledge
Psychotherapeutic treatment of adolescents confronted with a psychotic experience reveals a characteristic feeling of shame. The first hypothesis formulated here addresses the existence of shame in such psychotic individuals based on archaic experience calling into question the Freudian, and classic, conceptual tool of post-Œdipal structural shame. The second hypothesis postulates that in clinical work the expression of shame as an ontological challenge against the Other represents an attempt by the subject to prove his or her existence. Our reflection focuses, through a clinical analysis, on the double occurrence of psychotic experience and a feeling of shame.
Stephan Wenger : Placing Psychotic Elements into the “World” of the Psychotic
Psychotic manifestations in adolescence can take on a defensive aspect when dealing with psychotic illness, a breakdown (Laufer, M. and M. E.). Fanny presented delusive and hallucinatory activity and her symptoms disappeared after two years of therapy. Psychotherapeutic technique must follow a common thread: the conviction that the delirious and the hallucinatory belong to the internal world of the patient and form part of her narrative about herself; the associative thread of the session makes it possible to suggest that the patient invite psychotic elements into her psychic space or world, thereby putting them into the “world,” which is an identity created by the psychotic person.
François Richard : The Work of Representation and the Psychotic Process
This paper supports the hypothesis that the process of subjectivation resorts to a firmness of personal or artistic style when the subject is threatened by psychotic attacks, especially during adolescence. Thought and representation are then seen to intensify in the subject, but it is difficult to distinguish between the excess of melancholic consciousness, psychotic anxiety, and a type of sublimation that is fascinated by drive chaos. The paper proposes a second hypothesis regarding, inversely, the usefulness of a kind of solitude and of masochistic compromise with object and reality. A moment of psychotic crisis in an adolescent girl with a neurotic problem is presented in terms of how the quest for the distinctiveness of style curbs her breakdown. The paper then analyzes the theatrical work of the playwright S. Kane in detail; indeed, here we find an example of the paradox of a suicide that follows successful representational mastery. Finally, we discuss Freud’s ideas about masochistic destructiveness and Winnicott’s ideas about the core of the true self as being non-communication.
Laurence Chekroun : The Evolution of a Psychotic Adolescent in Psychotherapy
Using E. and M. Laufer’s theories about adolescence and G. Haag’s theory about the normal development of babies, this article offers some reflections about the evolution of an adolescent girl in psychotherapy following a « development break » and the appearance of a delusion at the moment of puberty.
Caroline Lebrun : metaphorical and metonymical functions of clothing
After some considerations about the identity effects of clothing, the article shows how, in adolescence, clothing can serve a metaphorical and metonymical function, and how the therapist can make use of this, especially in cases of psychosis.
Geoffroy Willo, Sylvain Missonnier : cybernetic « emergence », an operator of the transference in psychosis
This article recalls the main steps of a « psychotherapy by virtual » of a young psychotic teenager. In this article, we will see how the use of a computer game proves to be a vector of a first transference address from the psychotic to the clinician.
Therefore, the virtual will be studied through the magnifying glass of the pathology, revealing a function of « emergence » specific to cybernetics.
This function is triple. Firstly, this contingency loads the emergence promises, allowing the user to expect from the machine anything but, and much more than, it is able to deliver. Secondly, this emergence gives the machine the appearance of autonomy, which helps the patient to delude himself into not considering himself as the origin of his representations. Lastly, this generator of representations enables the symptom by giving it a form, thus processing what Freud called a « force of healing drive » preparing the way for a transference relation
Adolescence, 2012, 30, 1, 179-189
Nathalie Guillier-Pasut, Daniel Derivois : the course of a clinical relation with a creative adolescent
The adolescent is extremely sensitive to his encounter with the other, both highly invested and greatly feared. Using an encounter with an adolescent boy treated in a child and adolescent psychiatric ward, and through a reflection on methodological issues of a therapeutic setting, this article follows, step by step, the course of the clinical relationship.
Adolescence, 2013, T. 31, n°2, pp. 439-458.