Psychoanalysis

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I would like to state that I fully support the view that psychoanalysis can cure, solve conflicts and symptoms, and reduce fear and suffering. In many of the situations experienced by children , psychoanalysis helps them face thing that happen to them in a different way.

The subject we are discussing here today is very broad in its scope. I will attempt to offer a few answers about it focusing on the analysis of children and adolescents.

I would like to state that I fully support the view that psychoanalysis can cure, solve conflicts and symptoms, and reduce fear and suffering. In many of the situations experienced by children, psychoanalysis helps them face the things that happen to them in a different way.

Any analysis, at any age, is a historification process. It develops a narrative about our patients´ lives that is constantly being rewritten.

The child and the parents bring us a story, a history, and even a prehistory of their lives and situations; they often also bring us the symptom that led them to seek our assistance.

The therapist´s task is to listen to that story and rewrite it as part of the listening process, enabling the patient to build up a different position to face what is happening (or happened).

Needless to say, any psychoanalyst who works with children starts off with a series of theoretical concepts about the structuring of those children, in order to be attuned to the failures that may appear in their development and propose one specific approach or another. My point is that, very often, when we assess the possibility of treating a child by holding a series of diagnostic interviews, we discover that those who need treatment are not the child, but the parents; they may need counseling or it may be appropriate to treat the family as a whole.

Play is essential in childhood. To quote Freud, “every child at play behaves like a creative writer, in that he creates a world of his own, or rather, rearranges the things of his world in a new way which pleases him? It would be wrong to think he does not take that world seriously; on the contrary, he takes his play very seriously and he expends large amounts of emotion on it. The opposite of play is not what is serious but what is real.” (Creative Writers and Daydreaming).

Whenever the possibility of play gets trapped, halted, or stagnated, it is the child psychoanalyst´s task to start up the analytical device, so that what became trapped in the child´s growth and in his or her ability to play and be creative, and therefore to learn, can be listened to, processed, and metabolized.

What is specific to analysis with children is that the listening process is diversified; the discourse is broader because it is not only associated with oral language, with words. Children speak to us through their games, their drawings, their gestures, and even their silences. Child psychoanalysts have to be capable of “listening” to that rich range of discourses, and that listening process, that special encounter between the therapist and the patient, can be achieved as long as the conditions of the potential space are able to reappear.

Therefore, in Winnocott´s words, “psychotherapy has to do with two people playing together. The corollary of this is that where playing is not possible then work done by the therapist is directed towards bringing the patient from a state of not being able to play into a state of being able to play.”

Today, we encounter severe pathologies in children and adolescents. Most of them involve cases where listening or trying to recreate a history reveals a huge void, a veritable collapse: a moment when the possibility of integration is altered, primitive fears come to the surface, and the feeling, the threat of annihilation is such that the individual is suspended.

Having hopes for the future, seeing a possible future where others see nothing at all, is essential in these cases. As analysts, stirring up the past, do we attempt to leave that past in its annihilating function as an acknowledgment of what cannot be changed, or can we run the risk of stirring up that past, which is often empty, in order to shape a possible future?

The analyst´s position changes radically, as he or she abandons the role of a mere listener following the rule of abstinence to move into a place that encourages regression and aims to sustain the patient.

From the moment an analyst agrees to take on a case, he or she is clearly aiming for a possible future in which therapy can take place and the traumatic areas that threaten to repeat themselves can be worked through. The first goal is to not leave the subject stuck in an unmovable place. This first motion can lead to establishing a genuine therapeutic relationship.

Suggesting to children that they play with animal figures and dolls, and drawing without thinking about it, both contribute to creating the necessary transitional space so that thoughts have a place to be thought, memories have a place to be remembered, and affects have a place to be sustained.

This enables the child to bring out his or her fears through play, and the analyst to influence those fears in a different way.

In treatment, the ones rushing the process are often the parents. “This is going so slowly!” is a complaint we hear often in our immediate gratification society in the course of treatments with children. Pediatricians and neurologists sometimes claim that they would achieve the same results with medication: therefore, we have to work with the parents to help them understand what process, project, and waiting mean. In Spanish, the verb esperar, to wait, has the same root as esperanza, hope–in other words, the possibility of believing in the future, trusting others, and finding a space for oneself depends on how much we succeed in broadening our ability to wait.