Alexithymie et subjectivation

Abstract

IntroductionRegarding the different aspects of alexithymia, this text presents the observation of a ten years old child showing the signs of a serious difficulty to access subjectivisation. A massive inhibition was observed anytime the child was confronted to a question about his feelings. After a few months of treatment, we could note that no evolution was to be seen, despite what looked like an invested and pleasant relationship for the child. On the contrary, this relationship looked cold, empty and non-sensed for his therapist. These observations helped us identifying an unusual disorder in the psycho-affective development: alexithymia. In this context, experimenting an atypical transfer relationship with this patient, the therapist decided to propose a device based on sessions with the patient and his mother, using the mother's disposition to interpret her son feelings. MethodThe therapist proposed sessions divided in two parts. The therapist would see the child alone in the first place, then his mother would join them to discuss the last weeks and the incidents she observed. These regular discussions proposed in what we propose to call a “circular way” seem to have made real what was there from the beginning: a very intimate, dyadic and almost internal way to communicate feelings between mother and child. We used psychoanalytic references (Winnicott, Green, Richard…) to develop our way of being with the patient as well as to describe our intellectual path throughout the work. ResultsDuring the first year of treatment, it has been possible to observe some specific aspects of the family system and to open a way to a better subjectivisation for the patient. The psychotherapy keeps going, we can observe that the child resistances have begun to decrease and complete motherless sessions with the patient have now started, at his request. ConclusionWith this text, the authors intend to present the application of a main subject in the field of children psychiatry: the necessity to keep being creative, open-minded and prepared to adapt the therapeutic device to every patient with specific needs.