Lombardi Riccardo, Pola Marisa
Italian Psychoanalytical Society (IPA), Via Dei Fienaroli 36, 00153 Rome, Italy.
Int J Psychoanal. 2010 Dec;91(6):1419-44. doi: 10.1111/j.1745-8315.2010.00356.x.
This article explores aspects of the clinical development of a male 17 year-old patient who had four weekly sessions of psychoanalysis during an acute psychotic crisis. In the context of arrested adolescent development, a psychotic crisis can present an opportunity to set the process of maturation in motion again. Adolescent psychosis is examined in the light of Bion's theories of catastrophic change - in which the container/contained relationship becomes explosive and overwhelming - as well as of Ferrari's and Matte Blanco's hypotheses on the mind-body relationship. The authors emphasize the role of denial of the body and its changes in the genesis of adolescent psychotic conflict, and show how the analytic relationship can offer crucial reverie conditions for promoting recognition of the body, bodily sensations and affects, as a prerequisite for the activation of an autonomous mental system. This clinical approach entails recognizing the urgent need to make room for the elaboration of intrasubjective relationships and for mind-body dialogue, transference interpretations being postponed. Clinical material and fragments of analytic dialogue illustrate the authors' hypotheses and demonstrate the patient's development towards recognition of his body and an incipient capacity to think associated with the perception of the limits set by time and reality.
本文探讨了一名17岁男性患者在急性精神病性危机期间接受四周精神分析治疗的临床发展情况。在青春期发育停滞的背景下，精神病性危机可能为重新启动成熟过程提供契机。本文依据比昂的灾难性变化理论（即容器/被容纳物的关系变得具有爆炸性且无法承受）以及法拉利和马特·布兰科关于身心关系的假说，对青少年精神病进行了审视。作者强调了对身体及其变化的否认在青少年精神病性冲突发生过程中的作用，并展示了分析性治疗关系如何能够提供关键的幻想条件，以促进对身体、身体感觉和情感的认识，这是激活自主心理系统的前提条件。这种临床方法需要认识到迫切需要为主体内关系的阐述和身心对话留出空间，暂时推迟移情解释。临床资料和分析性对话片段阐释了作者的假说，并展示了患者在认识自己身体方面的发展以及与对时间和现实所设定限制的感知相关的初步思考能力。
