The physician working in a care centre for torture victims cannot practice medicine in the same way as he/she would do elsewhere. He/she must listen to the ravages that are the result of the torture and try to understand the biological mechanisms that operate in the traumatic memory. Displaying an intelligent visual and manual listening of the body enables the treatment of the suffering implied in past and actual experiences of the patient. A multidisciplinary approach is indispensable in order to cope with fragmentation and to restore thought circulation.
In clinical experience with trauma as a result of political violence, shame reveals both the intimate and social intrusion of the individual subjected to the omnipotence of another and the attempt to fend off this intrusion. In this way, between veiling and unveiling, shame questions the psychoanalyst in the form of a silent cry, as a complaint without words. Interweaving clinical fragments and references to the work of cinematographers, this text explores the complexity of the affect of shame in the cure with adult and adolescent survivors of war massacres as well as the effects of political violence at the level of transference. Writing appears as the locus of transmission of the impossible and opens up the way to the field of speech.
Proposing body-transitions in an analytic relationship with borderline patients as a first step, then letting it happen, seems transgressive at first but is ultimately very creative and efficient. The bodies of the patient and analyst are engaged in a “feeling-with” via touch, knowledge-held-in-the-gesture, via trances. Ferenczi had already experienced these forms of clinical work with some success. We refer here to this new form of analytic psychotherapy. Thus, the body-subjects become capable of floating. The very contemporary art-works made by Ulrike Bolenz opens up even more the creative dimension of the body-transitions. The idea is that the desire of borderline subjects will be such that the inter-personal meeting is not avoided, even considering the risk to the person of the analyst. Nowadays Ferenczi would say that there are no other means to complete a treatment than open his inner world to the patient, and that this absolutely does not lead to an identification with the analyst.
The originality of the setting in which therapeutic mediation techniques, for example, painting, pottery, modelling, are employed in child psychosis rests in the fact that the child can thus engage with an attempt at representation based on sensory modalities. These include the child’s own sensorimotor aspects and the sensorial qualities of the “malleable medium”. The manner in which he or she makes use of this is part of the transference dynamics. The clinician must therefore extend his or her capacity for attentiveness in order to take into account these various forms of sensorimotor expression. In child psychosis and autism, it is essential to focus on the kind of associativity that is an integral feature of body language and behaviour. In this paper, the author describes the specific nature of symbolization processes and of transference dynamics in mediation-based therapies, with particular emphasis on the importance of the transference onto the malleable medium and of the transference that makes use of sensory diffraction.