Multiple Suicide-Attempts in Adolescence: Psychodynamic Understandings on the Process of Integration of Hallucinated Bodily Experiences

Abstract

Introduction.

Suicidal adolescents have a severely damaged body/mind relationship where issues pertaining to adolescence and psychache are tightly intertwined causing dissociation, hallucinations and concreteness. In this conundrum, the suffering mind swings from being identified and split from the body favouring self-harm and bodily together with visual hallucinations.

Objectives.

Investigating and working through suicidal concreteness together with the role and meaning of hallucinations in adolescents with a story of multiple suicide attempts.

Aims.

Achieving a first integration and appropriation of the emotional experience with the establishment of the boundaries between mind/body, inside/outside giving up hallucinations.

Methods.

Prolonged intensive psychodynamic work focusing on self-representation, the working through of persecutory internal objects causing rage, hostility and attacks on the affective links with the environment allowed a gradual process of integration of the self with the decrease of suicidiality.

Results.

The working through and containment of persecutory internal objects led to the possibility to unconsciously give up hallucinations and integrate the emotional experience in the mind together with the development of first effective boundaries between inside/outside.

Conclusions.

An intense work of containment and working through of persecution and rage in the early stages of the psychotherapeutic treatment of adolescent multiple attempters can significantly favour the relinquishment of hallucinatory mechanisms and self-harm as a way to cope with intolerable anguish and psychache. This favours the process of in dwelling of the psyche in the soma as described by Winnicott.

Disclosure of interest

The authors have not supplied their declaration of competing interest.