You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The psychoanalytic concept of acting out has been largely reduced in the field of mental health to a byword for behaviors of which providers disapprove. This article seeks to revitalize the psychoanalytic concept of acting out by exploring its significance in work with adolescents in inpatient psychiatric settings who do not respond to behavioral health therapies. Utilizing a Freudian-Lacanian lens, this article examines the ways in which acting out is a response by the adolescent to an elimination of desire found within family systems as well as in psychiatric systems. The elimination of desire leads to the collapse of the fantasy that guarantees desire. Acting out, in the Freudian-Lacanian sense, is a method of reproducing that fantasy in action. By providing an interpretation or construction that touches upon the fantasy and the role of desire, such adolescents are able to reestablish the fantasy at the symbolic level and to cease their pattern of circulation through psychiatric systems. Two clinical vignettes provide examples of what such interpretations and constructions may look like in acute inpatient psychiatric settings. Clinical implications of this theoretical development will then be explored.