The Onset of Schizophrenia in Adolescence: Developments from a Structural and Clinical Point of View (original) (raw)
Related papers
CONCEPTUALIZING AND TREATING PSYCHOSIS: A LACANIAN PERSPECTIVE STIJN VANHEULE
Starting from the hypothesis that psychosis makes up a structure with a precise status for the unconscious, the author explores how, from a Lacanian point of view, the treatment of psychosis is organized. Special attention is paid to the specificity of the psychotic symptom and the way transference characteristically takes shape. It is indicated that the occurrence of psychotic symptoms bears witness to a subjective crisis, in which no signifiers provide support when, at the level of the unconscious, the subject is dealing with fundamental self-directed epistemic questions (‘who am I?’) and questions concerning the intentionality of the other (‘what do you want?’). Characteristically, such questions are organized around intimate topics like dealing with parenthood and authority; life in the light of death; sexuality in relation to love and procreation; and sexual identity. Psychotic crises are triggered upon confrontations with such issues in daily life, while no support by means of a master signifier or Name-of-the-Father can be found. Crucial to the Lacanian approach to treatment is that the psychoanalyst aims at restoring a place for the subject in relation to the Other, which is threatened in episodes of acute psychosis. Clinical material from Lacanian work with a female patient suffering from manic-depressive psychosis is discussed.
The Phenomenology of Schizophrenia Occurring in Childhood
Journal of the American Academy of Child and Adolescent Psychiatry, 1989
Thirty-five children, aged 4 to 13 (X = 9.54), meeting strict DS/'.f-1l1 criteria for schizophrenia. are described. The subjects were diagnosed using a newsemistructured interview. All were in the normal rangeof intelligence (mean IQ = 94) and free of neurological disorders. Characteristic auditory hallucinations werepresent in 80% and delusions in 63% of the sample. The mean age of onset of psychotic symptoms was 6.9 years. Premorbid histories of attention deficit, conduct disturbanceand/or developmental abnormalitieswerecommon. The nature and content of psychotic symptoms varied with developmental stage. The phenomenological presentation of the sample wassimilar to previous studiesof youngschizophrenic children.
Transference and a New Relation in Psychosis
2005
The author considers that the main problem in the comprehension of psychosis is the difficulty to reach the split unconscious. In the analytical treatment of psychotic patients he emphasizes the recommencement of suspended development in the new relatioship promoted by the dynamic process. The author also refers the breakdown of the feeling of power and the prevalence of "imagoico-imagetic" identification in this pathology, An extract of a patient's analysis with psychic encalves documents the exposed theory.
Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 2002
In this article I use Lacan's early theory of schizophrenia as corrected by the School of Leuven. Early in his career Lacan argued that schizophrenic people have a defective relation to language. Vergote and several of his students-all from Leuvenpoint out that schizophrenics also have a defective relation to their bodies. Lacan calls the defective relation to language a defect in the symbolic and he calls defective relations to the body a defect in the imaginary. Repairing defects in the symbolic requires introducing in the emotional life of the patient the paternal function of the law. Repairing the imaginary requires the more maternal help of mirroring, affirming, and holding. I underline that the two forms of healing that need to occur in the treatment of schizophrenics seem contradictory. I then proceed to demonstrate that two therapists, Bertram Karon-a non-Lacanian-and Palle Villemoes-a Lacanian-artfully combine the two contradictory strategies which are theoretically required. The remainder of the article is then devoted to a summary and a discussion of the different methods developed by these two therapists. I demonstrate that both do healing work at the imaginary level and the symbolic level. Sometimes these two therapists explicitly point out that they make a shift in their healing work with the patient; sometimes they do not alert the reader that they do so. I claim that in the work of both therapists it is the contradictory work at the level of the imaginary and of the symbolic that is healing, not the therapeutic intervention at the imaginary alone or at the symbolic alone.
La tentation psychotique [The Psychotic Temptation]
The International Journal of Psychoanalysis, 2010
which are briefly mentioned and discussed in the book, involve the understanding of the functioning of the mental apparatus. Thus, in addition to reparation, the creation of a symbolic psychic functioning or its opposite, the denudation of the psyche of its functions, are important factors in the development of creativity. This is also true with regards to the evolution from psychosis to sanity and the capacity to dream. The book may have gained, in my view, with the inclusion of additional discussions with contemporary Kleinian authors to expand on these subjects and thus enrich the elaboration of the essential premises put forward by both the themes and interviews in the book. Although not qualifying as a textbook, this original compilation offers a textual type of seminar. In that sense it is unique and would interest all those who appreciate the evolution of psychoanalytic thought as it helps put the history of psychoanalysis in perspective. It is a living historical account of one of the most influential psychoanalysts of our time; and, because it touches on so many aspects of both individual and social issues, it will be appreciated by psychoanalysts of all persuasions as well as by artists, therapists, philosophers and others. A valuable addition to our psychoanalytic library.
TREATING PSYCHOSIS TODAY: A LACANIAN TAKE
Journal of the American Psychoanalytic Association, 2023
This paper examines the principal ideas from Jacques Lacan's psychoanalytic theory of psychosis. According to Lacan's theory in the 1950s, the central organizing element of symbolically organized mental life, the Name-of-the-Father, is missing in psychosis. That theory changes with later conceptual developments in Lacan's work that focus on the incompleteness of symbolic functioning. This connects with how, in his works from the late 1960s and the 1970s, Lacan embraces the idea of a fundamental non-rapport and symbolic non-existence at the basis of mental life. In a second step, the paper explores what the Lacanian model of psychosis implies with regard to ethical positioning, addressing the unconscious, handling transference, and crisis and stability in psychosis. A clinical case discussion focuses on a yearlong therapeutic trajectory with a young man with Down's syndrome who suffered from psychotic experiences.
Conceptualizing and Treating Psychosis: A Lacanian Perspective
British Journal of Psychotherapy, 2017
Starting from the hypothesis that psychosis makes up a structure with a precise status for the unconscious, the author explores how, from a Lacanian point of view, the treatment of psychosis is organized. Special attention is paid to the specificity of the psychotic symptom and the way transference characteristically takes shape. It is indicated that the occurrence of psychotic symptoms bears witness to a subjective crisis, in which no signifiers provide support when, at the level of the unconscious, the subject is dealing with fundamental self-directed epistemic questions ('who am I?') and questions concerning the intentionality of the other ('what do you want?'). Characteristically, such questions are organized around intimate topics like dealing with parenthood and authority; life in the light of death; sexuality in relation to love and procreation; and sexual identity. Psychotic crises are triggered upon confrontations with such issues in daily life, while no support by means of a master signifier or Name-of-the-Father can be found. Crucial to the Lacanian approach to treatment is that the psychoanalyst aims at restoring a place for the subject in relation to the Other, which is threatened in episodes of acute psychosis. Clinical material from Lacanian work with a female patient suffering from manic-depressive psychosis is discussed.
The Question of the Father and Sexual Disturbances in Psychosis
British Journal of Psychotherapy, 2005
The first half of this paper attempts to track and to elaborate Freud's thesis on the mechanism proper to psychosis with particular attention paid to the case of Schreber. It is written emphasizing that Freud was only at the initial stages of his work on the function of the father and that this led to the stumbling blocks he encountered and left him dissatisfied with his work. The second half of the paper looks at the way in which Jacques Lacan took up Freud's work. It looks at how he used it to understand the structure of psychosis in a new way, giving the specific problems that arise in psychosis a central place in the practice of psychoanalysis. How is that one day life is orderly and you are content, a little cynical perhaps, but on the whole just so, and then without warning you find the solid floor is a trapdoor and you are now in another place whose geography is uncertain and whose customs are strange?. .. We who were fluent find life is a foreign language. (Jeanette Winterson 1987, back cover)