The time of remission as a possible re-appropriation of the self

Abstract

IntroductionCancer in adolescents is often described as a “double penalty” imposed on the subject. The therapists of these young patients often refer to a clinical pathology of loss of self, intrusion, and strangeness. We will focus on this specific clinical pathology of adolescents with cancer, and the psychic work noticeable at the time of remission.AimWe aim at illustrating how, for adolescents, the time of remission can be an important time to start a psychical work on the illness. In order to help the subject to integrate this experience at this precise time of his/her construction, the therapist favors its “tracking”, that is, putting signifiers back in a temporality in order to restore a continuous feeling of existence. It is therefore more about getting back on the track, or better said enabling to get back on the track of psychic dynamics. Thus, in a therapeutic space, the adolescent can face threats of psychic breakdown and identity loss, though without falling into depression.MethodWe will use clinical stories to illustrate the importance of respecting the temporality with these young patients, as well as the possible work of “tracking” based on means like writing.ResultsThe clinical work enables to precise the specifics of the therapeutic approach according to the phases of illness and to treatments: if treatment time is hardly ever propitious for a psychic elaboration, the time of remission is more so. When referring to cancer patients, many authors evoke the loss of “a part of oneself,” an identity, by analogy with the pubertal process. The knowledge on illness and death creates a new relation between psychic and somatic. At some points, the adolescent feels like he/she is living a defenseless life: like puberty, illness creates a break, a rift, by establishing a before and an after in the life of the subject.ConclusionWhat these adolescents come and ask to the therapist, once their treatments are over, is a question related to links: link with the treatment location, link with a roundtrip between before and after the illness, in order to build or rebuild continuity in their history. During the therapeutic sessions, the re-appropriation of the self can be facilitated by means like writing.