Déficience sensorielle, utilisation de l’espace et constitution de l’espace psychique. Psychothérapie d’un enfant aveugle

Abstract: Based on material from psychotherapy with sensory deficient patients (blind or deaf children and adults) this paper analyses subjects’ use of physical space in transference as well as in the elaboration of psychical spaces. Through the psychotherapy of Tom, a blind child, drawing upon Winnicott''s work, we will show how this space, which is at first unapproachable, is progressively assimilated into a shared reality. This space is first experienced as suffering, before being ultimately used creatively and playfully as transitional space. This transformation occurs through the integration of aggressiveness induced by the occupation of this space. Any discontinuity is experienced by the patient as a rupture of the relationship. Furthermore, discontinuity is associated with the elaboration of separations and an increase in the patient''s capacity to distinguish the self from the object. We thus hypothesize that differentiation from the object may pose a particular challenge for sensory deficient patients. The absence of the visual or vocal bond accentuates adhesive identifications (Bick, 1986 ). These pathological identifications can be repeated in transference, where they take the form of the patient''s excessive need for continuous vocal tactile or visual contact. Supported by the therapist, these adhesive identifications can be overcome, and the patient''s access to a three-dimensional world can be facilitated. [Copyright &y& Elsevier]