The psychodynamic treatment of a disturbed adolescent: a Vygotskian perspective

From the vantage point of the interplay between action and language, the author traces the mental transformation of a disturbed adolescent during the course of treatment. Conceptually, this account superimposes the work of Vygotsky on a psychoanalytic understanding of the clinical process. Through systematic observations of the patient's behavior and speech, as well as of interventions aimed primarily at fostering the reemergence of intense affects, the author describes four cycles of communicative complexity. The beginning of self-reflection in a withdrawn, impulsive, hostile teenager, within the arena of an intensive psychodynamic treatment, reinforces Vygotsky's position that crucial changes in the relationship between speech and action can occur in a short period of time.