ABSTRACT
Social withdrawal in adolescence is becoming a widespread manifestation of distress in Western post-modern societies. It is a growing and varied phenomenon, which can manifest itself along a gradient of severity. It can be a natural aspect of an evolutionary phase through adolescence, or it can be the most overt symptom of a complex and insidious distress, which manifests itself with different shades, toward more severe psychic conditions. In these latter cases, the withdrawal may become deeply entrenched, extend to all life domains and bind to manifestations of the schizotypal spectrum. These may fester subthreshold and lead up to frankly psychopathological situations, where a rigid withdrawal from any social context is structured and intertwined with positive and negative psychotic symptoms. In the first part of this chapter, we will briefly describe the phenomenon, going beyond the symptomatic manifestations to reflect on the underlying intra- and interpsychic dynamics. Starting from clinical material, we will then reflect on possible clinical strategies. We will propose that a multi-professional team intervention, with psychoanalysts, neuropsychiatrists, and educators, with a psychoanalytic coordination, is essential. We will reflect how the psychoanalytic role can take place at two levels. At the first, as separate therapeutic spaces for the adolescent and the parents who, as is often the case, are the only possible initial points of contact with these situations. At the second level, the psychoanalytic coordination has a developmental containment function for the environment around the adolescent and for the clinical equipe as well. In this role as a second level container, the analytic intervention allows for the grasp of splits and projections of anguish between the adolescent, the parents and the environment, thus helping to contain and transform them. Furthermore, it allows for a calibration and synchronization of each therapeutic step by the different clinicians by the recognition of the psychic dynamics which underlie the symptoms and on the actual developmental possibilities of the adolescent.
