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DOI 10.1711/2130.23090 Scarica il PDF (68,1 kb)
Rich&Piggle 2015;23(4):463-465



Contents & abstracts



Theory and Technique
S. Andreassi and A. De Coro. Phantasy and Delusion in Seriously III Patients: Conjugating.
Time. Richard e Piggle, 23, 4, 2015, 349-360.

The article revolves around the part played by phantasies that take the form of day-dreaming. On the basis of certain theoretical considerations founded on the classical psychoanalytical literature but also supported by research both on the function of the imagination and on its relations with memory, the authors hypothesize that the relationship between phantasies and thinking’s temporal dimension (such as imagining future actions) is a useful indicator of the gravity of an instance of psychopathology, when understood in the sense of arrested development. Patients’ phantasies can offer an analyst precious information about the presence of different levels of psychopathological organization in their mental functioning. They can also suggest to analysts the most viable path to attuning themselves to their patients’ difficulty in symbolizing emotional meanings. The authors cite some clinical examples that illustrate the theoretical perspective presented.

Focus
The Sick Body: Psychotherapy with Children and Adolescents

D. Petrelli. Introduction. Richard & Piggle, 23, 4, 2015, 361-369.

A. Scanu. Autistic Defences in a Little Boy with Congenital Squinting. Psychoanalytic Therapy as a Means of Promoting Body-Mind Integration and Building up the Self. Richard & Piggle, 23, 4, 2015, 370-381.

This work presents the case of Roberto, a little four-year-old boy with a history of autism and severe congenital squinting. The latter was treated for several years by way of occlusion therapy and then reduced surgically. Intensive psychotherapy made it possible to pinpoint the connections between the organic disorder and the structuring of distinctive autistic defences and to experience how resistant and consolidated such defences were. At the same time, however, it revealed how it was possible, through the therapeutic relationship, to modify them by seeking a way of promoting body-mind integration that interacted with and supported the changes introduced at an organic level by the surgical operation.
A. Vantaggio. A Child’s Experience of Analysis and of His Own Darkness. Richard & Piggle, 23, 4, 2015, 382-395.

This work describes the psychoanalytic therapy undergone by a seven-year-old boy suffering from a rare form of congenital optic atrophy. The article highlights how the disease itself brought about the analytical encounter with the patient by triggering the structuring of defensive forms of behaviour that reflected the way in which the disease had been experienced and worked through by the child within his relationship with his parents. During the course of the therapy, the patient gradually let go of his pathological defences, whilst becoming interested in examining the reality of his loss and developing a more authentic inner world. That permitted him to repair his poor self-image by interiorizing an inner containing object that was to allow him to work through his suffering.


F. Gigli. “The Great Whiteness”: Notes on Psychotherapeutic Work with Adolescents Suffering from Haematological and Oncological Diseases. Richard & Piggle, 23, 4, 2015, 396-403.

The area of haematological and oncological disease is particularly complex and delicate. An illness of the blood evokes an idea of genetic transmission, heredity and family “tainting” and, in comparison with other forms of disease, transmits a strong sense of inevitability and elusiveness., The issue seems even more complex during adolescence and direct engagement with a systemic illness that spreads everywhere without the possibility of establishing boundaries re-awakens powerful fears, thereby threatening the foundations of an identity that is still a work-in-progress. The fact of being in grave danger exposes a person to the un-representable idea of a “life with a short expiry date”: it unexpectedly renders finite a time that had just begun to reveal itself as available, explorable and long, indeed, infinite. Naturally, psychotherapeutic intervention with adolescents who pit themselves against these kinds of illnesses – and in a hospital context – is obliged to modify the setting and rapidly redesign itself. It is inevitably necessary to engage directly in a project in which there might not be time, in which the waiting needed for working-through takes uncustomary forms and could rapidly be compressed, thereby exposing the therapist him/herself to abrupt inner oscillations.


C. Armenti, O.S. Trabucco and E. Tulimieri. The Experience of Illness: A Thinking-Space in a Paediatric Oncology and Haematology Day Hospital. Richard & Piggle, 23, 4, 2015, 404-420.

The work presents a series of reflections developed in the context of a project conducted at a paediatric Oncology and Haematology Day Hospital where, for several years, the authors have been providing a service offering psychological support to sick children and adolescents and their families. The various activities offered are described through significant examples and comprise Reception, Mediation between the doctors and nursing staff, the patient and his/her family, a Play Space and a Psychological Outpatient Clinic. The latter offers a space for listening that, although not always structured, allows people to voice emotional aspects that are often neglected, since the attention would, otherwise, be focussed solely on the patient’s sick body to be cured.


C. Armenti. Carlo: An Example of Psychotherapy in Hospital. Richard & Piggle, 23, 4, 2015, 421-431.

This work describes the clinical case of an eight-year-old boy suffering from thrombocytopenia who was treated for a year by way of once-weekly psychotherapy at the paediatric oncology and haematology Day Hospital at the Hospital of Salerno. The author offers an in-depth reflection on the difficulty of approaching both the child’s and his parents’ experiences and fears relating to the illness and the limitations that such an illness imposes. The account of the case also permits reflection on the distinctive features of a psychotherapeutic journey inside a hospital institution, by highlighting its limitations and possibilities.

Clinical Reflections
P. Masoni and A. Rossi. From “the Non-existent Object” to “the Absent Object”: the Forming
of a Container during the First Month of Group Psychotherapy with Autistic Children. Richard & Piggle, 23, 4, 2015, 432-439.

The authors offer reflections on the first month of group psychotherapy with four children, aged between four and six, who were imprisoned in an autistic withdrawal. The experience demonstrates interesting possibilities of making progress along the path of development and can constitute a model for psychoanalytical clinical research into the group mind in autism. The group acts as a multiplier: each child expresses differentiated physical and proto-mental appeals that can also reach the others, thereby creating strong possibilities for development if such appeals are adequately welcomed and worked through. Starting with the “indigestible” material in circulation, the therapist suffers the children’s fears in his/her own body, sharing strong sensorial experiences with them. A little girl seems to represent the most archaic level. Enveloped by crying, mucus secretions and tears, she carries everyone’s primitive need to have a proper space inside one’s mother: captured by a pregnancy phantasy, she finds the therapist’s body, plants herself inside it and will not let herself be torn away. During subsequent sessions, the theme of “container” presented by the other children develops into forms of graphic representation and play, constituting a drive towards thought.

The Enchanting Screen
S. Oliva. Larse and the Real Girl. Richard & Piggle, 23, 4, 2015, 440-442.


C. Mezzalama. A Simple Life. Richard & Piggle, 23, 4, 2015, 443-445.

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