The labyrinth: Searching for a way out through the defences

Area of Science:

• Psychoanalytic Psychology
• Child Psychiatry
• Clinical Psychology

Background:

• This case study examines a 12-year-old boy exhibiting projective-expulsive functioning through rude and vulgar language.
• The analysis utilizes the metaphor of the Cretan labyrinth to illustrate the patient's pathological organizational defenses and the therapeutic process.

Purpose of the Study:

• To analyze the projective-expulsive functioning of a pediatric patient within a psychoanalytic framework.
• To explore the evolution of transference and the therapeutic frame in a long-term analysis.
• To describe a clinical case conducted across different modalities (video and in-person).

Main Methods:

• A three-year psychoanalytic case study of a 12-year-old boy.
• Utilizing the labyrinth metaphor to conceptualize the patient's internal world and defenses.
• Conducting the analysis in two modalities: initial video sessions during the pandemic, transitioning to in-person sessions three times weekly.

Main Results:

• The patient's projective-expulsive functioning, characterized by intense and vulgar language, was analyzed.
• The therapeutic process involved confronting difficulties within a structure resembling a labyrinth.
• Introjection of insufficiently contained primitive parental objects and vehement projection were observed.
• Transference was marked by significant hatred and incontinence.
• The therapeutic frame gradually transformed from inhospitable to more accommodating.

Conclusions:

• The labyrinth metaphor effectively captures the intricate defenses and therapeutic journey in this case.
• The dual-modality approach (video and in-person) demonstrated adaptability in psychoanalytic treatment.
• The analysis highlights the dynamic interplay of introjection, projection, and transference in childhood psychopathology.