The dead part: An overfulness of emptiness—Some reflections on psychotherapy with young psychotic patients

Abstract

ABSTRACTDrawing on his experience of psychotherapy with psychotic children and adolescents, the author puts forward and discusses the idea that a psychically “dead part,” “an overfulness of emptiness,” lies at the core of the psychotic self. Through the presentation of his clinical work with Aldo, a psychotic adolescent, the author shows the deep sensorial, perceptive, presymbolic, and consequently preverbal nature of these originary psychic nuclei, together with the hard work that allows them to emerge during treatment. Moreover, the article focuses on regression-to-dependence phenomena and analysis of the primitive bodily features of countertransferential dynamics in work with these patients, which may be linked to the emergence of the “dead part” in the analytic relationship. The analyst’s psychosomatic experience that characterizes the encounter with these intense anxieties, together with the complex work of figurability that the analyst has to perform, is examined and discussed.