The escalation of self-destructive acting out in adolescence is viewed as a compulsive repetition of traumatic or repeated microtraumatic events. These traumatic events, which occurred during early childhood, are or were linked to the absence of the object and the subsequent sense of emptiness that was experienced. The different functions of compulsive repetition are then discussed in the context of identity search and borderline pathology during adolescence. Finally, the author discusses the mental work required of the therapist when working with adolescents presenting these types of issues, particularly when speech cannot be used for intersubjective communication.
Such a title, which is enigmatic to say the least, requires us to resort to a dictionary in order to draw out some possible meanings. On the basis of the different definitions suggested, some lines of reflection open up for therapists trying, sometimes in vain, to attract adolescents to their « merchandise » and make them loyal customers. There is a clinical expression, « the adolescent not for consumption », or who is at least viewed as such by those close to him, and who removes himself from all forms of psychotherapeutic appetence addressed to him. The fantasy of consumable subject/object which underlies this strategy of avoidance warrants investigation. In the most worrisome situations, this fantasy will betray an adolescent who is not fit for consumption on account of his refusal of the sexually differentiated body or of becoming an adult. The ultimate question is that of what therapeutic setting can be tolerated by an adolescent in this register.
The psychotherapy of a teenager who practices body attacks sheds light on archaic processes at work in terms of bodily resistance to the investment of the object and the refusal of otherness. The dual situation reactualizes an internal otherness blocked by adhesive, anti-drive alienation from tyrannical, undifferentiated objects. Vigilance against visible « sensory-motor » objects as an effect of the Other, and against the counter-transference, works, with the aid of a psychodramatic style, to re-establish the transitionality which was blocked in this narcissistic teenager.
Through a combined reading of the works of Ph. Gutton and V. Bonamino, the author examines three interconnected aspects of analytic work with adolescent patients : the styles, the tools, and the moving forces at work in the analytic treatment. This gives an idea of the particular position of the analyst working with adolescents, who must be ready to be transformed into a mediating object in order to re-start a capacity for thought and to enable the patient’s intimate relationship with himself to be restored.
The analyst who accompanies the adolescent on his way to adulthood is identified in the transference with a sort of « Hector » and experiences his patient’s analytical process as a transfiguration of his being « Achilles » into his becoming Aeneas, the only hero who manages to make it to a satisfactory adulthood. Classical texts and mythological figures do provide supports and representations that are useful in working with adolescents, especially in helping the transference and counter-transference to develop. Adolescence, 2013, T. 31, n°2, pp. 345-366.
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