This is a clinical reflection about the formation of a personality at risk for psycho-somatization in adolescence. The reappearance of childhood soma at puberty is indicative of early distortions in the mother-baby relation and of the failure of the early Oedipal phase, which fosters somatization and the allergic object-relation in the transference. The genital body then becomes the sick body.
The psychotherapy carried out in the post-puberty period enables these to be articulated with the history of the subject and with the adolescent process which is under way.
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Brigitte Wedling : an adolescent’s journey from psoriasis to conduct disorders
Through one adolescent’s journey, this work will explore the meanderings of his psychical functioning and the diversity of his psoriasis expressions, conduct disorders, drug addiction – all of which are desperate attempts to check drive invasion and assure his psychical survival. The links between psoriasis and the protective shield on the one hand, and conduct disorders and destructiveness on the other, are investigated in order to understand the evolution of the psychotherapy and the psychical elaboration which underlies it.
Irina Adomnicai : a work suspended
The psychoanalytical treatment of a boy, suffering Basedow’s disease at this period of life, offer the author an opportunity to discuss psychical modifications and their possible somatic involvement in the patient’s development. The difference between auto-soothing processes and masochism is considered in this clinical approach.
Jean-Claude Elbez : the psychosomatic and processes of adolescence
Adolescence, with its pubertaire and subjectivation processes, is an especially delicate moment when primary traumas are revisited as deferred action. In cases where these conflicts have remained on the margins of representation and have generated psychical defenses along the lines of splitting, the processes of puberty will lead to a return of what has been split off ; where repression has occurred, they will lead to a return of what has been repressed. In both cases, the risk is that what returns will be an unbound destructiveness, paving the way for drive disintrication, or even the “ de-driving ” of the drive, so that it turns into instinct, with the risk of somatic disorganization.
Stéphane Bourcet, Camille Rossi : the hypochondriac complaint in adolescence
Hypochondriac complaints, frequent during adolescence, are a request directed at another and address an object of love and/or hatred. The adolescent is complaining about the traumatic breaking-in of puberty and seeking the witness of others. Hypochondriac complaints are carriers of a massive narcissistic investment. The organ about which the adolescent complains condenses the whole of the traumatized body through genitalization. The body, centered by its multiple complaints, is a place of projection, crystallizing in the body mass all thought, which then becomes meaningless. The hypochondriac adolescent, prompted by a very active underground fantasy of immortality, seems to substitute the time-space dimension of disease for the time and space of human existence ending in death.
Valérie Boucherat-Hue : about the adolescence-crisis and “ versatile ” allergic attacks
The view, commonly held by psycho-somaticians, that adolescence with its body-changes is one of the phases least exposed to somatic disorders in the development of the individual, is far from being shared by psychoanalysts.
It is based on an economically unequal relationship between psychological problems and somatic disorders and will be submitted to clinical investigation conducted on allergy-prone asthmatic young adults and older adolescents.
Asthma attacks experienced during adolescence should not only to be considered in relation to the psychosomatic and structural nature of the individual, which conditions the ways in which they appear, but also, as can be seen in this study, in relation to a psychodynamic form of interpretation, for in many clinical cases they seem to constitute an incentive rather than an obstacle to maturation.
One can thus distinguish the “ regressive ” allergic attack aimed at avoiding an incoming puberty conflict situation; the “ constructive ” allergic attack caused by the build-up of fantasy activity that, once released, produces a strongly symbolically-marked stimulus; and the “ disruptive ” allergic attack that results from a psychosomatic disorder-like impulse-discharge.
The object of this paper is to show that whatever the age at which illness strikes, the extent of the initial disorder, or the worsening of the condition brought about by an asthma attack in the adolescence, none of these factors necessarily determine the adult’s somatic and psychological future life.
Philippe Gutton : outline of a theory of genitality
This text is comprised of three parts. The concept of the genital archaic is re-examined and established as the prime mover of the pubertaire. Subjectivation or adolescens has its origin in the earliest mechanisms for managing the original trials : cathexis, withdrawal of cathexis and counter-cathexis. The concepts of original repression and suppression are particularly studied in the avatars of the construction of the pubertaire scene. The so-called clinic of the breakdown is theorized in a new way. A study of dream functioning at puberty revisits the processes in play by way of clinical work.
Philippe Gutton : spelunker by vocation
The theme of the pubertaire includes the revelation of the third dimension of the female body : the evolution at puberty of the maternal feminine. The author examines what he would call the maternal genital metaphor. Ordinarily, the erotic play of young adolescents is a symbolization of the masks of the maternal depths. In pathology there is a disavowal of the metaphor, defended by the practices of incorporation, aspects of the fetishizing of the adolescent’s body. Surface sexuality is commonplace at the beginning of adolescence. It can be perpetuated – the example of André Gide is investigated.
Dominique Agostini : an adolescent in the great war : bion
Using the « War Journal » (June 1917-January 1919) of Bion and the « Commentaries » he wrote 50 years later, the author establishes links between the war experience of the adolescent Bion and certain concepts created by the analyst Bion. Most notably, those of « catastrophic change », « nameless terror », « psychotic personality », and « group mentality ».
Antoine Masson : turning back to the rupture in order to be « oneself », carried away
Through a clinical sequence held in the transference with Jeremy, who has been lost in a nasty feeling of tedium for four years, the author tries to exemplify the work of the « clinic of the event », at the level of the diagnostic mode, involving both the paradoxical situation and the subject’s attempt to recognize himself in it ; at the level of the course of the work, which consists of turning back to the breaking point of existence while sustaining oneself on various forms of the « two » brought back in the transference ; and at the level of the crossing operation which conjugates the arrival at a finishing line and the transmutation of the return in forward-moving force. The poet’s experience is used to pinpoint what is at stake in such a clinical course, which opens up the possible from a point that looks impossible.