In the aftermath of a seventeen year war covering the south aestern part of south Africa, Mozambique’s civil war victims count up to about one million of the fifteen million whole population ; a third of the inhabitants have suffered displacement. The madness of war includes that of thousands of children and youths drafted as servants and soldiers either willingly or forced to. They have been beaten to be forced to fight, being treatened of death, they have either been tortured or have themselves tortured others. Most of them have been drafted during their childhood, so they have become adults or adolescents during the war period.
Understanding this spécific population’s psyche implies using complexe compréhensive méthods ; the character features of général and psychodynamic range are related to child-victim clinical practice, as well as that of authors of extreme violence ; the ethno-psychiatric dimension being the model of other more specific issues related to local particularities. Cultur and the fundamental pact which links men between themselves are both, through these situations, rudely attecked, and this is prejudicial for the future.
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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.
Bernard Doray:concepcion of gaza : very young soldiers
This paper begins with two figures from the clinical study of the extermination and forced self-extermination of the Mayan Indians of Guatamala. This approach, situated between individual treatment and social history, is contrasted with the case of Birahima, a child soldier from Liberia and Sierra Leone, which belongs to the ideological literature and history of the present day.
These are two ways of approaching a process that will swell in rhythm with the tide of impoverishment and de-symbolization now sweeping the planet. International agencies set up juridical safeguards, but the psychological accompaniment of former child and adult soldiers still benefits from little genuine clinical competence.
Raymond Cahn, Nicole Taieb-Flicstein: the outcome of psychoanalytic treatments at adolescence
From the personal experience of the author, the several outcomes of psychoanalytic treatments at adolescence (from the breakdown to the working-through of their termination) are here examined with reference to the specificity of their criteria and modalities according to that age.
Rather than authentic ends of treatments, what is to be elaborated is the liability of giving the experience of treatment the quality of a good-enough experience within a difference accepted by both partners. Thus the possibility of a return, however uncertain it may be, towards a time and place which the youth will have made his.
Catherine Chabert: why use psychodrama at adolescence?
The specificity of psychodrama as compared to other kinds of treatment is here questioned and mainly with regards to difficult adolescents. The author shows how the method being original in terms of setting, intervention technique and interpretation and their effects on transference has a major impact and therapeutic efficiency on those adolescents who wouldnÕt use the traditional approach. On top of that, psychodrama appears to be a very useful clinical and metapsychological tool.
Harold Berh: group analytic psychotherapy at adolescence
The author suggests a detailed analysis of how to set up a true group analytic psychotherapy setting both as far as the preparation and selection of its members, its composition and its first session. Numerous examples are here called forth to illustrate the internal dynamics of the group and the impact of exterior influences.
Anna Maria Nicol Corigliano: psychoanalytic family therapy at adolescence
After having described the specific evolution gone through by both the adolescent and his family, the author presents the choice of the setting for the family therapy. The original approach of an ÇÊintegrated therapyÊÈ is here offered to adolescents with very serious clinical disturbances, associating both individual treatment and family- or couple-treatment.
Enrico de Vito: individual psychoanalytic psychotherapy at adolescence
Resting on the uniqueness of the psychoanalytic process, the author presents the multifold modalities of cure liable to be used with the psychotherapy of adolescents. He analyzes the several implications towards a therapeutic action of the new discoveries on the development of the new born, and on attachment, as well as in the field of neurosciences.
Besides, the author insists on the assessment phase and the best adaptated indications as well as the goals mainly centered on the rehandling of self-reorganization processes through a research on the psychological representations.
Moses Laufer, Egle Laufer: psychoanalysis at adolescence
The authors claim that psychoanalysis is the best treatment for severely ill adolescents. Their approach is centered on the developmental breakdown having taken place after puberty transformations leading to a pathological state. Such a breakdown prevents the adolescent from integrating gradually the sexually mature body in his psychological reality, thus conditioning a breakdown in his relationship to reality. These adolescents behave in a defensive psychotic behaviour without its being a true and definite psychosis. The developmental breakdown were to be re-lived along the analysis in the form of a ÇÊtransference breakdownÊÈ offered to severely ill adolescents.