Psychotic functioning in adolescence: The perverse solution to survive

Abstract

A psychotic breakdown in adolescence marks the emergence of a manifest aspect of a more complex process that has its origins in the patient's family pre‐history and in the patient's childhood story. This period of life is characterized by a sensorial explosion and adolescents will react differently according to the different resources they have at their disposal. Adolescents will attempt to create defensive solutions in order to face this decompensation on their own. In particular, polymorphously perverse behaviours can be utilized because of their specific characteristics in order to create a potent defence used to arrest a still more severe regression and at the same time providing the time necessary to safely navigate through a difficult and dangerous developmental phase. These solutions can be transitory or transform themselves into lasting defensive adaptations. These defensive modalities are very complex and articulated and can become fossilized in time, as, for example, in the case of a use of perverse defences against a breakdown. An analyst finding him/herself in these situations will find it difficult to differentiate in the diagnosis between a condition that is due to a perverse functioning used as a defence against decompensation, and a truly perverse structure that is beginning to emerge after puberty.