Une expression particulière de PTSD à l’adolescence

Abstract

ObjectivesAdolescence is a developmental stage marked by the reactivation of œdipal issues and the emergence of sexual feelings, a period of separation and autonomy, overwhelming for many, traumatic for some. Adolescence is also a time for the expression of psychotic potentiality. An event on itself insignificant can have a high value and contribute to the traumatic collapse of the Self already weakened by the process of adolescence. In some circumstances, a PTSD appears which can take the shape of a psychotic decompensation. Patients/material and methodWithout being paradigmatic, the case report illustrates the appearance of this particular expression of PTSD in adolescence. Basing itself on a description of the individual and relational process, are examined the factors related to the young in question and the factors related to his social and family environment, taking part in the emergence of the psychic suffering. The paper also develops a reflection on the notion of trauma in adolescence. So some authors think that the crossing in adolescence constitutes a reality trauma so much the interior tumult hustles the references marks, certainly when the young evolves without parental support cordial and structuring. The quality of the bonds of attachment is thus of primary importance. In addition, we can wonder, in front of “delirious blaze”, about a possible beginning of schizophrenia. ResultsFrom the case report, beyond the process of adolescent transformation, it is interesting, without being exhaustive, to locate some factors supporting the particular expression of PTSD: A family operation established on a procedure defined by event-driven and the not very inclined one in the elaboration; a mother investing her parental function with pregnance, invading the interactive space intrapsychic of the child; a father, absent, distant, with the function not very operative symbolic system, not placing at the disposition of the young of the soothing answers and structuring; a quality of reception of the traumatized young marked by the indifference, the disqualification, the rejection. The psychic effraction is certainly corollary so much reactions of the entourage, the glance of the other, which it returns on the subject, influences the narcissico-object balance; a young mobilized psychic defensive mechanisms as projections and identifications. ConclusionIt proves to be important to consider some factors of the young and his environment who seems contribute to the expression of a psychotic symptomatology-like reactional method with a traumatic event. The trauma overflows the defensive mechanisms and involves a collapse of self whose symptomatic translation lets foresee a psychotic potentiality. The paper approaches some principles of the therapeutic accompaniment then: Intervene most prematurely possible by improving the axis of prevention and the recognition by the first-time professionally of the clinical signs of psychotic decompensation, by the facilitating the access to the specialized healthcare; respect the evolutionary criterion, by taking into account temporality of the psychic device, the connections between trauma and time; center on the clinical care by establishing a differential diagnosis, arresting the psychic functioning of the young, observing his state according to contact and links.