The use of “Pliable Media” in Promoting Symbolization in the Psychoanalytical Psychotherapy of Psychosis

Abstract

Introduction

In psychosis, the capacity of symbolization is lost to different extents and patients live in a concrete world of objects. Moreover, the lack of boundaries between self/other, inside/outside severely impairs the capacity of these patients to understand and recognize reality from the delusional dimension.

Objectives

Working through psychotic concreteness and accessing a first subjectivation of this experience, that leads to the development of a first symbolization.

Aims

Achieving the possibility to access a first symbolization and begin a delicate process of appropriation of the emotional experience with the establishment of the boundaries between inside/outside.

Methods

The use of “pliable media”, such as drawing, as therapeutic mediation allows a partial defraction of the violent transferential dynamics from the therapist and let unsymbolized material to emerge less destructively in the treatment fostering a first figurability.

Results

The Squiggle game as “pliable medium” facilitates a first encounter in the therapeutic relationship and represents a primal transitional area that allows a gradual working through process to take place where the establishment of the boundaries between inside/outside could begin.

Conclusions

We suggest that the use of “pliable media” in the early stages of the psychotherapy of psychotics can significantly favor a first encounter between patient and therapist and, at the same time, provides the first experience of a transitional space where a working through process leading to first representations can take place.

Disclosure of interest

The authors have not supplied their declaration of competing interest.