Pre-Psychosis

This concept advanced by René Diatkine expresses the perplexity of the clinician when faced with a child for whom the threat of psychosis in adolescence or in adulthood cannot be excluded entirely. It does not indicate therefore a more or less vague resemblance with the register of psychosis, but rather a prognostic concern. It relates to questions about the evolution of the processes of the child's psychic equilibrium during his development and the way in which he will be able to deal on a lasting basis with the excitation by which he is besieged.

A young girl was in psychotherapy on a twice a week basis. Her massive inhibition in learning to read and a certain excitability were a source of concern for her parents. She presented herself as a little woman, a miniature woman, the miniature of her mother. What was suggestive of pre-psychosis was the constant excitation of her thought and the fact that her recourse to play and narrative gave her little relief.

She explained: “At school I sometimes feel I have all the dead animals in my feet. Once, I was going down the stairs, and it bothered me; I was afraid that they would make me fall because they were in my feet, I could feel them. In class too, I could feel them in my back, in the back of my chair, and I asked a friend if she could see them. It stops me from working to feel them like that.” While she was talking, she took a piece of pink modelling clay and rolled it. The phallic vermicelli, grew longer between her fingers, almost mechanically, then she took it in both hands and reduced it, then thickened it, shortened it, placed it vertically on the table, and crushed the base of it; the vermicelli had changed in appearance. Finally, she lifted it up with its base, turned it round and said: “It's a mushroom!” This manipulation made the analyst feel ill-at-ease. The pink vermicelli was not playing its usual role. In spite of its name “mushroom”, there had been no displacement. It was almost a penis that she was caress