Self-Calming Strategies

This patient is 14 years old, and suffers from migraines and abdominal pains. When he was three years old, he lost his sister, who was two years older than him, in a car accident. He is haunted by a repetitive image: the precise moment when he was thrown out of the car door during the crash. This scene had survived the period of latency without being subjected to sufficient repression. He spent his whole childhood playing indefinitely at provoking an accident between two small cars. This game did not become richer over the course of time and was more the expression of a traumatic neurosis than a real game. The exchanges at the beginning of the psychotherapy were extremely impoverished and trivial. The patient spoke only in response to questions. He had no perceivable affects or fantasies. There was no question of imagining anything. If the analyst tried to draw him away a bit from the factual and descriptive level, he replied: “The imaginary world is useless.” He was stuck to reality, that's all.

The sessions were distressing. Finally, he livened up a little when speaking about a neighbour who played the drums. He said he listened to him playing for hours, without it being clear what sorts of thoughts went through his mind while he was doing this. In the end, he signed up for drum lessons. Practising playing the drums (in French this is called répétition) then took the place of the accidents

he brought about with his little cars. He practised for hours and lived with constant noise. He played a sort of hard rock called The Dead. It is a violent, deafening, repetitive form in which the music is reduced to the minimum, in favour of speed. Pushed by this force, the death drive, he transformed his arms into a rhythmic, automated machine. By producing these sounds, he brought the accident back, as it were, while at the same time keeping it out of his mind.

This behavioural regression, which contrasts with a regression that gives rise to thinking, constitutes what we cal