Too much to swallow? Some reflections on adolescent overdose

Abstract

ABSTRACTOverdose, as a subcategory of self-harm, is under-represented in the psychoanalytic literature in terms of attempts to understand what may underpin it. Given the current prevalence of overdose amongst self-harming adolescents, it seems important to try to understand this from a psychoanalytic perspective. Drawing on clinical material from adolescent patients who overdosed, the author attempts to make sense of how overdose was used by these patients as a means of unconsciously communicating their difficulties. It is suggested that overdose might be understood in the following ways: as a physical enactment of the way in which the patient’s mind is overwhelmed by thoughts, feelings and experiences which it cannot digest or process; as a disguised wish beneath overt self-destructiveness to take in a ‘good feed’; as an enactment of past and present force-feeding, both literally and figuratively, by parents or carers; as an enactment of an internalised death wish from an object which has projected something poisonous into the patient.