Función del diccionario computarizado del ADL en el estudio del cambio clínico en prepúberes

Abstract

Este trabajo forma parte de una investigación de caso único acerca de cambio clínico en niños y pre púberes. El foco de nuestro estudio es el vínculo en sesión. El diccionario del ADL desde el punto de vista clínico sirve para detectar con fineza los cambios en una sesión o varias de ellas. Puede servir para contrastar sus resultados con el análisis de los relatos o el de las frases y generar rectificaciones. También sirve para detectar problemas de figurabilidad de algún erotismo, lo que nos permite anticipar ciertas escenas relatadas o desplegadas en sesión. En esta ocasión intentaré exponer los resultados de la combinación de dos herramientas del ADL, el análisis de las frases y el de las palabras. La aplicación del diccionario del ADL al material clínico de un paciente que transcurre entre la prepubertad y el despuntar de la adolescencia temprana, me suscitó las siguientes preguntas: ¿Contribuye a describir metapsicológicamente el cambio clínico? ¿Aporta a detectar el proceso de la figurabilidad psíquica de la pulsión en sesión? ¿Sirve a los fines de plantear preguntas respecto de las defensas? El paciente es Juan a quien atendí entre los 8 y los 12 años. Sus padres adoptivos consultaron por problemas en el ámbito escolar: la dificultad para concentrarse y aprender. Asimismo, dentro o fuera del colegio, ante las frustraciones, tendía a desbordarse y estallaba en gritos o golpes. El primer fragmento ocurrió a cinco meses de iniciado el trabajo, sesión previa a la vacación invernal. El segundo y el tercero corresponden al último año de tratamiento. El segundo, al comienzo de ese ciclo y el tercero a poco tiempo del cierre.

This study is part of a single case study regarding clinical change in adolescent and pre-adolescent children. The focus of the study is the in-session relationship. The instrument is the DLA which is devised to study discourse from a Freudian psychoanalytical perspective. It detects drives and defenses. It contains an inventory of seven drives and five structuring defenses (plus other complementary ones). The instruments to detect the drives are based on the assumption that the latter are expressed in scenes that can be narrated or deployed when speaking, in a relationship with the analyst. The narrations (extra-transferential scenes) are investigated with the narration grid. For the deployed scenes in session, an act of speech grid, a para-verbal grid and a motor act grid allow to explore analytical exchange. The DLA dictionary is a psychoanalytic semantic categorization of words. Freud taught how to detect the erogenous value of words (e.g.: “fire”, “bite”, “thrash” have precise erogenous significance). It consists of seven files, one per drive. Many words may integrate more than one file. Each term may be included in up to three files. Narrative sequences are the basis for the creation of the dictionary, which means that the construction mode is deductive. For example: Intrasomatic drive language emphasizes inherent economic toll or organic intrusion scenes. Consequently references to accounts or references to body states contribute to the location of words such as “gain” “revenue”, “cough”, “guts” in the corresponding file. The number of words in each file is not consistent; this was resolved applying differential values. Values inversely proportional to the amount of terms for each file. From the clinical point of view the dictionary is useful to detect, in a refined way, changes during a session or in many of them. It can be useful to contrast its results with those of the analysis of the narrations or speech acts and generate rectifications. Also it allows to detect figurability problems regarding a drive, which allow to anticipate certain scenes, narrated or deployed in session. These instruments can be applied both to the patient and to the analyst, making it possible to study clinical change on the level of the relationship. On this occasion the results of the combination of two tools the DLA, analysis of acts of speech and words will be presented. The DLA dictionary application to the clinical material of a patient, whose age ranges from pre-pubescence to early adolescence, raised the following questions: Does it contribute to describe clinical change metapsychologically? Does it contribute to detect psychic figurability of drives in the session process? Is it useful to raise questions regarding the defenses? The patient is Juan whom I assisted when he was 8 up to when he was 12 years old. His adoptive parents consulted because of problems at school: difficulty to concentrate and learn. Also, inside or outside school when confronted with frustrations, he tended to overreact screaming and hitting.