Psychosis Psychosis in Children This work is the outcome of the course taught this year by the analyst Cecilia Collazo on "Psychosis in children. In it was developed an approach to clinical psychosis in children, through the recognition of theoretical and practical issues that cross, according to the Freudian-Lacanian psychoanalytic theory. It also enabled an approach to the diagnosis of a psychologist in the treatment of children through various accounts of clinical materials.
This study aims to stop at some theoretical and practical issues relating to autism. It begins with the conceptualization of Leo Kanner, the first to talk about autism, to continue with some of the latest theoretical developments. Among them will be considered cognitive-behavioral theories and psychoanalysis to be totally opposite what they raised in relation to the etiology and treatment of this condition, making a comparative analysis between what they propose each of these theoretical positions. Since "Witnessing psychosis is a second choice, but the primary and fundamental here is to choose to embody the role of the analyst and not back in that exact space. Place where the subject is betting its inception, space we can appoint a neologism that is not psychotic, by the way and we respect deeply, who deigned Lacan called, simply, llanguage [1]
autism
Any exposure should From the observations of Leo Kanner, who, in 1943, identified a syndrome that had eleven children. Succinctly explained a number of behavioral traits allowing to describe: the inability to establish relationships with people, delayed speech acquisition, use non-speech communication once acquired, delayed echolalia, pronoun reversal, play activities and stereotyped repetitive, obsessive insistence on the preservation of identity , lack of imagination, good rote memory and normal appearance. Thus this syndrome nominated "autistic disturbances of affective contact."
abnormalities were already apparent in early childhood, which set him apart from schizophrenia or childhood psychosis, as described above. However, many of these children had been considered mentally retarded or schizophrenic. Thus, one issue that has generated several discussions was the choice of name (autism) and leading to confusion with the meaning given by Bleu at the same word to indicate the active withdrawal into the realm of fantasy that had the schizophrenic patients. Kanner however clarified that in these children was not a change after this initial relationship, not a withdrawal of an interest that befell previously, like schizophrenic patients, but was from the beginning of life extreme autistic loneliness that neglected, silenced, ignored, whatever child reaches the outside.
What about the etiology? Kanner said: "We must assume that these children have been born with an innate inability to achieve the usual biologically provided affective contact with people, as other children come into the world with innate physical or intellectual handicaps" [2] Thirteen years
then in 1956, Kanner with Eisenberg, kept track of these eleven children and found that the syndrome could occur after apparently normal development during the first year of life or the first two years, and reduced to two pathognomonic symptoms of the table: extreme autistic loneliness and longing preserve the identity. Thus decided to change the name of this syndrome and call it "early infantile autism" and they changed the etiological hypothesis: "It's a total psycho-biological disorder will require a comprehensive study of dysfunction in each level of integration: biological, psychological and social ... Current knowledge leads to the inference that both innate and experiential factors combine to produce the clinical picture. "[3]
In summary, early infantile autism has been established as a clinical syndrome. It is characterized by extreme loneliness and a concern for the preservation of equality the environment (sameness) and manifests itself in the first two years of life. History, early and distinguish the clinical course of childhood schizophrenia. [4]
From the description of this syndrome early infantile autism began to make several inquiries from different schools of thought. This paper briefly resume the ideas behind autism, two of the major trends in today's boom: the cognitive-behavioral theories and psychoanalysis.
To begin we will refer to cognitive-behavioral treatments that are held in the premise "do not try to enter the world of child crazy, we must bring to our world "[5].
One representative of this approach, Simon Baron-Cohen hypothesized etiology of cognitive deficits present in autism, in reality it is a specific deficiency: "impaired ability to attribute mental states (such as beliefs, knowledge states, etc..) themselves and others "[6]. Thus called by the name of "mental blindness" to the deficit.
Another representative of this approach suggests that Angel Rivière is autistic this person an accident of nature (genetic or metabolic, infectious, etc.). intersubjective refused access to the inner world of others. One for which the others and probably himself are closed [7].
treatment is an attempt to develop in the child these altered functions, and reduce emotional and behavioral abnormalities that may accompany the disorder, through explicit teaching processes. The core of treatment is always learning, requires a careful control of environmental conditions and the provision of teaching and learning patterns. Under some conditions and cases it may be necessary to employ systems of intervention in the internal environment (drugs) to facilitate the occurrence and make the experience positive.
This use of drugs is integral with the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), closely linked to the discourse of "science" and thus to the "medicalization" of mental illness. This manual is standardization, which does not stop in the etiology of mental illness, but produced a comprehensive catalog of signs and different sets meet increasingly specific. Within this catalog autism is considered a Pervasive Developmental Disorder (autistic-like). There is indicated a number of criteria must be met to diagnose someone with this disorder. Therefore, the cause is a series of failures, damage or lack of development, including social interaction, communication and the presence of behaviors, stereotyped interests and activities, with an age of onset before three years .
Here the treatment is the same for all subjects, and no distinction is the subject of individual consciousness and its operations, the mainstay of treatment.
But what about the subject? Where is the uniqueness of each treatment for each particular subject? These cognitive-behavioral treatments, there is a blurring of subjectivity that goes away to "erase the subject of enunciation and failing to recognize the differences between subjects, considering only the traits that make them identical "[8]. So there is nothing unexpected, since the subjective particularities disappear.
So what psychoanalysis from that deal? Guidance from Lacanian psychoanalysis starting point is to articulate in these children the presence of a subject in the most problematic: the choice, and the effects it produces on the correlation between the subject and the enjoyment. This requires taking into account the importance of the concept of trauma, and that leads to an emphasis on the impact that language has on being speaker. "In autism have a kind of rejection to the involvement of trauma. Unfathomable decision not to be affected by the mark of the llanguage that pierces the body. Decision of being, not a subject that enacts the spring of an election. Found in these conditions, a failure in the operation of embodiment, in terms of refusal to register the trauma. There is an unconscious rejection of the registration area. Therefore the subject has not consented to the failure to be involved language, is responsible for its position not to enter the discourse, if not parasitazo by language. In these imaginary children is disrupted, and the symbolic, given the radical rejection that takes place around it, does not affect the body trim and drain. There is a disturbance of the body that does not sign, that is not embodied. This lack of consent, manifested in the attempt to disengage from the traumatic consequences of the llanguage, leave these subjects out of all social ties, ie outside of discourse "[9].
Here we see that this characterization is done from the autistic child psychoanalysis differ materially from those developed in the DSM-IV. Where there is disturbance, disability, absence, lack (of reciprocity, games, etc.), The position of psychoanalysis aims to recognize what yes there is in these children:
1) Another effort to keep the outside: there is a clear decision of these children do not consent to involvement.
2) is not indifferent to the presence of the other, but their behaviors differ according to the notice or appear to openly or discreetly.
3) is housed in the language, understand our code, even when they are ready to do theirs.
4) Not willing to be required, if you insist or force, is isolated or triggers attacks of violence and mortification towards you or others.
5) worked aggressively to achieve escape the encounter with the Other, is calculated and advance in their responses that enable him to avoid being confronted with the involvement and articulates it maneuvers that disorient and divide us. Therefore
treatment here does not consist of the altered learning behavior, but from what Lacan suggests in "logical time and the assertion of anticipated certainty. A new sophistry "are geared to a particular search, which allows to find the particular form (your calculation) that the subject found to have its decision, in turn prevent an encounter involving him in a relationship to another.
Following the ideas proposed in assertive logic, the invention is possible of a device. The device support: device approach in Place Making Foundation whose director is the analyst Marita Manzotti. The same is a therapeutic device that is held in a space that is neither public nor private, where there is more than one therapist working with each child and all equally participate in the contextualization of subjective location of each child, in a space within Device: hipotetómetro. Therefore, this device offers every child the approach to a framework that introduces the subject as such (in its indeterminacy), singling out what the particular child (detail) makes knotting, linking or substitution between real and significant through maneuvers, calculations and anticipations that allow us to direct the work. [10]
1) A first move will occur in the so-called moment of seeing: when the eyes of therapists, ranging modulating a proposition of order "known to be" unknown subject. Following instinctual transformation targets in hand and back on itself, the maneuvers are performed in the first half, unfold from investments (asset-liability), mimicry, changes in shape and distance, changes in the intensity of demonstrations. Therefore the moment of seeing is a non-scheduled time, which may be approaching the formulation logic of "we know that" producing a confidence from the similarity condition, which makes it possible at a later time to articulate an expected early surprise the person in question.
2) Time to understand: the moment of seeing reaches its conclusion with the location of the detail. This is where the "Hipotetómetro" where from five articulators: the voice, eyes, body, treatment with the objects and bodies is to hypothesize the cue point advance, while waiting place which the subject does not calculate the match. The detail, the residue of observation, we can form the hypothesis of the presence of a subject in its calculation. This detail is displayed without the subject is recognized there, but characteristically are executed repeatedly. Textualize details that allow a hypothesis that guides us in advance of an expected meeting with this guy. This hypothesis will confirm its authenticity if you can move the child's response to avoid getting involved in their own decision to jilt the Other.
3) Time to complete: it is such the key to a strategy based on the anticipated certainty provided by the hypothesis. Having verified the hypotheses in this awakening that occurs as a result of the surprise, again establishing the moment of seeing to try to sustain their new production.
Finally and in conclusion we see that from clinical psychoanalysis works differently with each child, expected it to be displayed, to do with the uniqueness of it and not otherwise. That its detail is what appears to be so analytical work case by case basis. There is no "Autistic" or children with "TGD" if there is an autistic boy who has characteristics that particularize and make it different from another autistic child. Therefore in "the direction of treatment will be important to apply as the particular case, the detail that makes each child, respecting the materials chosen for their work, tastes and preferences, those who serve or collaborate to provide the assistance necessary for the assembly of what has happened as an obstacle, or failed to effectuate "[11].
Maria Laura Castignani
Baron-Cohen "Autism: a specific cognitive disorder of blindness of the mind."
Collazo, C. What do you hear an analyst? . Ed Grama. 2007
DSM-IV-TR Diagnostic and Statistical Manual of Mental Disorders. Ed Masson.
Fernández, E. Ed diagnose psychosis Letra Viva.
Kanner, L. Eisenberg L "early infantile autism" Leo Kanner in Childhood psychosis: initials studies news and insights. " 1973.
Kanner, L. "Autistic Disturbances of Affective Contact," Nervous Child at No. 3, Vol 2 1943.
Lacan, J. "The logical time and the assertion of anticipated certainty. A new sophism "In Writings 1. Twenty-first Century Ed. 1989.
Manzotti, M. Clinical autism. The device support. Ed Grama. Team
Publication 111. Day Centre, therapeutic and educational. Encounter: A clinical institution "Baio et al. Team
Publication 111. Day Centre, therapeutic and educational. "About psychosis in the child "Marcela Errecondo.
Riviere, A. "Disorders of development and special educational needs" Cap 1. Open University of Catalunya, 1996.
[1] Collazo, C What do you hear an analyst? . P. 100. Ed Grama. (2007)
[2] Kanner, L "Autistic Disturbances of Affective Contact," Nervous Child at No. 3, Vol 2 1943.
[3] Kanner L, Eisenberg L "early infantile autism" in Leo Kanner Childhood psychosis: initials studies news and insights. 1973.
[4] op.cit. P. 5.
[5] Manzotti M Clinic autism. The device support. P. 13. Ed Grama. 2005
[6] Baron-Cohen "Autism: a specific cognitive disorder of blindness of the mind."
[7] Riviere, A "developmental disorders or special educational needs" Cap 1. Open University of Catalunya, 1996.
[8] Manzotti M op.cit. P. 14. Ed Grama.
[9] Op Cit pp. 30 - 31.
[10] In "A Sinthome" Partnership for Care, Research and Education of Autism and Psychosis in Children "which works in the town of City Bell (La Plata), whose director is the analyst Cecilia Collazo, is from this device also works stand.
[11] Collazo, C What listening to an analyst? . Ed Grama. 2007
Source: This work has been published on the website of the Sigma ( www.elsigma.com ), in paragraph Psychoanalysis and Education.
