The author approaches the principle difficulty of adolescents in a refugee camp: their inability to project themselves into the future.
“ When we began to work with adolescents who have been through war, we observed that their “ past ” was limited to the period when they experienced the war. We also noted that their imaginings about the war were either absent or traumatizing. ”
Several clinical observations support this assessment and allow for three conclusions :
– one must not proceed too quickly with adolescents in modifying their image of the future
– one must not create images for them
– one must not fear their terrible images
Archives par mot-clé : Trauma
Naasson Munyandamusta : beyond the hills
The author studies the nature of the therapist’s engagement, more precisely his counter-transference when faced with the treatment of trauma. The example of Agathe is presented; her treatment takes place in the particularly tragic atmosphere of Rwanda.
Marie-Rose Moro, Christian Lachal, Thierry Baudet : extreme traumata and adolescence
The authors, all three of whom are involved in caring for adolescents in war zones as part of Doctors Without Borders, describe the traumatic semiology with reference to two parameters allowing for much variability: age and cultural context. They show the complexity of the semiology by means of a clinical history. Lastly, they analyze some parameters that must be established in order to recognize and treat the impact of trauma on these adolescents who are in pain, tragically hopeless and who sometimes conceal their suffering behind the mask of the hero, of violence and of transgression.
Michèle Bertrand : on war traumata
Trauma and traumatism should be considered from a dynamic perspective, that is to say as something which is ongoing and changes with time. Thus, the range of PTSD (Post-traumatic stress disorders) is limited, insofar as it is static, referring only to symptoms of a certain type. The recently promoted notion of resilience confirms this dynamic point of view. The adolescent may present disorders which do not belong to what is properly called “war neurosis”, but which seem more serious and troubling.
Olivier Douville : adolescent-fighters in « modern » wars
Using a clinical experience with adolescent survivors of civil wars in West Africa, the author introduces a series of clinical and anthropological analyses. Refusing any attempt to liken « modern » wars to ethnic wars, he returns to the particular status of the adolescent in the conflicts, and suggests guidelines for a rereading of the dimension of fraternal war and parricide, to show how the very question of identification (as result and as structure) is here made palpable. The adolescent scene summoned up by war is also destroyed in war. This raises the question of whether a youngster can accomplish the passage of adolescence as long as the trauma remains unelaborated.
Linda Slama : dangerous liaisons
Traumatic experience in childhood can result in the establishment by the psyche of primitive defensive strategies for confronting the dangerousness of the linking.
Through the story of « Diana », we will see how a paradoxical dynamic can be set up in adolescence between the search for erotic linkings and the attack on these linkings, the goal of which is to eliminate all need for these linkings.
The clinical treatment of « dangerous liaisons » consists in the adolescents’ search for partners whose distinguishing characteristic would be that they maintain and repeat the deficiencies and traumas linked to the earliest environment. Paradoxically, these liaisons perform the defensive function of protecting the adolescent against genuinely loving linkings, which are perceived as much more dangerous because of the underlying threat of dependence.
Mahommed Ham : from wandering to exile, or the paradigme for language
Through a clinical confrontation, the author shows how the listening is rough with the insistence of the purely descriptive account; and exactly when the dead end of the transference – counter transference is made of a sense of remorse. His analysis unfolds also a heuristics inspired by the language of their meeting and their primary language: Arabic. The latter by virtue of its specific structuration allows some words to assume the shape of metapsychological concepts, and at the same time to be a linguistic rest which open onto a lecture of trauma with an exit registred towards the working out of the letter.
Antoine Masson : From Blind Shock to Subjective View of and by Oneself
Through a clinical sequence involving an adolescent who presents himself as blind, the article shows the transmutation of an inability to constitute an horizon of the subjective world into a capacity, retrieved in the transference, for subjectivating (himself) from a traumatic point and for setting up the theater of an intimate world. The therapeutic progress begins from traces of the body’s being grasped, and sustains itself on the equivocal diagnosis attesting to both the blind alley and the attempt to exist. The question is then successively, to point out the blind alleys of the subjectivation of the adolescent passage, to provide living metaphors able to serve as primers for symbolization, to restore progressively the capacity to organize a view of the world and of oneself, to face what has happened, and finally to open a new subjective reality.
Bernard Duez: shutting-off and issues of undecidability
After a short ethnological and historical review, the author highlights the work of shutting-off (or retreating) by showing how this shutting-off requires a scene. Starting with a clinical example, emphasizing the scenic dimension and the notion of the internal groups, he shows how at the moment of shutting-off the adolescent falls into an unconscious contract between adolescents and the adult world. It appears that shutting-off refers primarily to problems of intrusion relating to the original insufficiency of the human subject. The work of the internal groups, oscillating between bonding with the other, appropriation of oneself and shutting-off, has the function of transforming the traumatic state, which the author defines as an ambiguous subjective state that confronts the subject with undecidability, with the impossibility of directing his drives. The invention of the bond of incompatibility is an attempt to emerge from this state and set in motion the work of the internal groups.
Jacques Hochmann : trend effects and psychotherapies
Psychical reality is outmoded. Hypnosis or learning theory-inspired therapies are now considered to be the only ones that work. Psychoanalysis should study their functioning in order to gain an understanding of their way of operating.