¿Cómo es que una problemática depresiva puede fijarse en una depresión la cual si no es tratada puede a su turno convertirse en una patología más grave? Un tratamiento antidepresivo es justificado, pero si este no está asociado a una cura relacional conduce al adolescente, bien tratado, pero mediocremente curado, a una problemática de aspecto paranoico. Dos otros casos que fueron relatados en la prensa, ponen en evidencia ese riesgo evolutivo existente en el marco de un contexto social, en el cual no se deja de poner en relieve el ¡malestar adolescente!
How can a depressive problem become fixed in a depression that, with neglect, can itself be frozen into a more serious pathology? A treatment with anti-depressives, which was justified but not associated with a relational therapy, leads an adolescent who was well treated but received mediocre care into a problematic that appeared paranoiac. Two other cases recently reported in the press provide more evidence of this evolving risk within a social context where “adolescent malaise” is constantly evoked.
Comment une problématique dépressive peut se figer en une dépression qui, négligée, peut elle-même se fixer en une pathologie plus sérieuse ? Un traitement antidépresseur, justifié mais sans être véritablement associé à un soin relationnel, conduit un adolescent, bien traité mais médiocrement soigné dans une problématique d’allure paranoïaque. Deux autres cas, relatés dans la presse viennent souligner ce risque évolutif dans un contexte social où l’on ne cesse de souligner le « malaise adolescent » !
Un tal titulo por lo menos enigmático impone el recurso a un diccionario para al menos entender algunas significaciones potenciales. Apoyándose sobre las diferentes definiciones propuestas, algunos polos de reflexión emergen para los clínicos que a veces intentan en vano de atraer y fidelizar los adolescentes en sus « fondos de comercio » Existe una expresión clínica de « el adolescente in consumible » al menos juzgado como tal por sus prójimos y que por lo menos se sustrae de la misma manera a toda forma de apetencia psicoterapéutica hacia el. La fantasmatica del sujeto/objeto consumible que representa esta estrategia de evitamiento merita de ser explorada. En las situaciones las más preocupantes. Ello viene a significar una adolescencia in consumible como rechazo de un cuerpo sexuado o del devenir adulto. La pregunta última reside en cual dispositivo psicoterapéutico tolerable para un adolescente sobre ese registro.
Existe una especificidad en el trabajo con adolescentes lo cual implica trasformaciones del dispositivo psicoanalítico clásico. A partir de estudios de casos de adolescentes difíciles en situación de « breakdown » y en ruptura de desarrollo, el autor desarrolla e ilustra esta noción de transformación del marco de la cura. Ella interroga la plaza de la interpretación, su especificidad en el trabajo con adolescentes y el interés de aparear el trabajo interpretativo con otros útiles afín de ayudar al sujeto a acceder a su historizacion y sus vivencias traumáticas.
La héroizacion de la adolescencia podría comprender dos procesos. Uno de ellos es del orden de la creación de la intersubjetalizacion construyendo así los ideales de la adolescencia ; el otro da lugar a aquella construcción constituida del intercambio de miradas del mundo infantil y adulto institucionalizado en un superego societal.
El héroe, seria aquel que resiste a sucumbirá pesar del discurso del maestro que lo repudia en un breakdown lauferien y se dice a favor de la causa adolescente.
This article recounts individual psychotherapeutic work undertaken with a deaf adolescent, in the specialized institution where he was received, and shows to what extent adolescence can be a violently disorganizing crisis, but also a time when new resources can be mobilized. Separated from his family since the age of four years and ten months on account of his handicap, his entry into puberty brings the issue of this estrangement to the forefront. At this moment, Amadou evokes different versions of the separation, genuine « scènes pubertaires (pubertary scenes) » (Gutton, 1991) in which the childhood event is made present, the violence of this event linking it to the violence of puberty. The crisis he goes through is an opportunity to elaborate the childhood trauma, to find and investigate supports offered by his environment – psychotherapy, the institution, and the family. This case study helps us to reflect more generally upon the Oedipal issues of separation, the visit from his parents at the acme of his crisis having enabled him to get more involved in an adolescens process (Gutton, 1996). This work also provides an opportunity to study the work of anthropologists and psychoanalysts (Emy, 1972, 1988 ; Ortigues, 1966) whose work sheds precious light on the child’s separation from the mother and the family, and on the specific characteristics of the organization of the Oedipus complex in an African milieu.
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.
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.
The case of the « Wolf Man », a young man who presented grave problems in adolescence, is revisited here in light of the concept of the pubertaire scene. Indeed, when we look closely at it, this primal scene exhumed by Freud is in fact a pubertaire scene co-constructed by Freud and his patient. Starting with this hypothesis, it is possible to explain the failure of the psychoanalytical treatment which will leave the Wolf Man facing a breakdown he could not surmount. This analysis seeks to show the possible effects of the analyst’s unanalyzed pubertaire on his patient.
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