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D'alberton, F. (2017). Psychoanalysis in Hospital: Early Adolescence and Somatic Functional Disturbances. Ital. Psychoanal. Annu., 11:121-135.

(2017). The Italian Psychoanalytic Annual, 11:121-135

Child and Adolescent Psychoanalysis

Psychoanalysis in Hospital: Early Adolescence and Somatic Functional Disturbances Language Translation

Franco D'alberton

Somatic functional disturbances, or somatoform disturbances, constitute a heterogeneous group of somatic conditions which cannot be explained from a medical standpoint, but which are quite frequently encountered by the general practitioner or in hospital wards (Luyten, Van Houdenhove, Lemma, Target, Fonagy, 2012).

In the paediatric field these express themselves in serious forms of asthenia which stop children being able to stand and give rise to fears of serious neuro-degenerative pathologies, with recurring abdominal pains, respiratory disturbances or episodes of persistent and paroxysmal coughing which are completely incapacitating by day but disappear mysteriously at night (Schulte, 2011; Campo, 2001).

Over time, my paediatrician colleagues have refined a special sensitivity which leads them to question the possible emotional causes, or joint causes, of this symptomatological picture, instead of setting off down the route of medicalisation, which often leads to a worsening of the situation.

Presented with clinical pictures which at first sight would seem to be playing out exclusively on the somatic level, we do not now tend to underestimate the symptomatological variety with which pre-adolescents and adolescents use their bodies as «tensional outlets to express their feeling of unwellness and their internal conflicts, in situations where the psychic apparatus is unable to cope with the increased instinctual pressure» (Blos, 1962, 60).

These conditions are often brought to hospital departments where, through cooperation between paediatricians and psychologists we have learned to understand how a disequilibrium between the quality and intensity of the new impulses and the capacities for keeping them integrated in a coherent system of mental functioning, may produce physical symptoms (Gutton, 1991; Birraux, 1990; Cahn, 1998).

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