Presentation, Practicing mediations in therapeutic groups

The primary role of the image in the life of the mind is evident in an experience that we all have of ourselves, of our own selves.  It is one that is presented, to put it evocatively, like a kind of interior “film,” one that excites us, involves us, makes us rejoice and suffer and, through this, allows us to be living witnesses to the continuity of our existence. Psychoanalytic research, from its inception, has witnessed and investigated the role and importance of the image in the life of the mind, a “path” that began with Freud and has been trodden by many of his greatest followers, and one that still seems rich and fertile.  Perhaps it is because, among the countless other reasons, “images,” as Gribinski sustains, “have an acute intelligence of the world, of our separate relationship with the world,” and at the same time they have the magical power to render incomplete separations “happily imperfect.” Like a bridge that anchors us to the ground, images anchor us to the background of the affective continuity that gives sense to our existence.  I am reminded of my first meeting with Claudine Vacheret.  I was struck by her capacity to oscillate between directness and warmth in our communication, as well as the rigor and depth of her mind.  The image of this memory was the bridge that stood for my experience with the Photolangage method.  Using her clinical-psychoanalytical experience and her expertise in training and teaching methodology, Vacheret has given substance to this method in both theory and clinical practice.  In only a few years, it has spread on an international level. Acquisition of the method requires specific training designed and run by Vacheret herself, along with her collaborators. This approach, described and brought to life so well in the article by Vacheret in this issue from both the clinical and experiential points of view, is focussed, in particular, on facilitating an intervention in all the situations in which a difficulty of representation and integration exists, tied to the precarious stabilization of the transitional function. The work illustrates this technique in an organic way.  I would like to make reference here to some elements of the method that I believe are relevant at the clinical and theoretical levels.  In particular, I refer to the “integrating function of the image” that, in reference to the thought of Winnicott, could be thought of as a “play space” with multiple values concerning, on the one hand, the intrapsychic procedure, meaning the “internal” occurrences of the self and, on the other hand, the ties that organize the construction of the relational and intersubjective dimension.  In the play space, the basic factor is realized that, in my opinion, spans all of the works in this edition; in fact, through the sensory-perceptive use of the photograph that activates the potential internal images, the unspeakable is said and the unthinkable thought.  This occurs because of the bridge function that the image, dynamized in this way, constructs between affection – the body, and representation – the mind.  Again with reference to Winnicott, we can think of the necessity of a support in order for the transitional activity to be organized.  Constituting the image as a transitional object in this way allows for the clear expression of a sensory reverie of the maternal body. The various studies span the different phases of life (infancy, adolescence, infirm adulthood, old age) and the dimensions of the mind (primitive mind, mind in transformation, other mind, “holed” mind).  In the work of Pons, a group of workers, mute in the face of grief, find through Photolangage the words to express the impotence, pain, anger, and frustration experienced by those who work daily in paediatric and newborn intensive care wards.  We see in this case that, on the psychic level, the “mute” silence functions as a defensive block with respect to the perception of internal occurrences, taking on a sort of “anti-grief function.”  The word-image is born through the subject’s dream, in which she gives the warmth of her “body” in order to warm the cold and lifeless one of the baby-group.  Proceeding in the metaphor of spanning the life and the mind, we find the work of Schmitt that, facing a lack of representation due to mental retardation, uses the image to support a difficulty of differentiation that is found in adolescent patients with an insufficiently coherent self.  In this case, we see how the supportive element that realizes the integral presence of the maternal body is visible in the function of reparative mirroring in the gaze of the group, but above all, in the gaze of the subjects.  It is a factor that, by cementing the lacunae of cohesion, the internal void of the self, allows for a sustainable re-occurrence of the experience of existence, as separateness. That which is outlined in the aforementioned article finds explanation in the work of Calenzo, who analyzes the way in which the void carries out a central function of the psychic organizer of the “mind” of a group of women with psychic troubles.  His work shows how, through the mediation of the image, the transition from the ghosts of the individual void to the ghosts of the group void and the consequent birth of symbolization within the group can be realized. The institutional background, present in all these studies, assumes a central connotation in the article of Comin and De Maria.  The institutional void, and the resultant difficulty of therapeutic symbolization, is confronted as a transformable element, parallel to the necessary transformations that take place in the treatment of gravely ill patients.  The idea that treating what is lacking in the boundary of these patients’ selves is possible by softening the boundary between treated group and institutional group finds application through the use of Photolangage’s “democratic” technique.  In this way, through the mediation of the photograph, Photolangage allows for the creation of a “play space” which is shared, because of its placement, by an expressive and representative boundary.

Regarding the boundary of the facility of the treatment proposed by the Photolangage method, one finds the stimulating and generous work of C. Belakhovsky and C. Joubert, who treat patients suffering from Alzheimers and, after all, seem to be familiar with the sense of void, loss, and devitalisation that these people experience.  These holes are like “lacunae” that appear possible to fill metaphorically with the vital substance of the “maternal body” that, in the unravelling, filters images within the group. The patient’s occurrence that is captured by the photograph of the mother and child who gaze at one another, one in the arms of the other, constitutes the metaphor of the connecting tissue that I have tried to explain.  The infancy and maternity of M. is reflected in this photograph, both negated and lived in the separation.  The symbolic space that is drawn by the distance between these two figures who gaze at each other from inside an embrace becomes the icon of a sustainable void: the transformative factor of absence in shared emotions and thoughts.