Description of set-up

During my work with mentally handicapped adolescents (mild and moderate) in a centre for special education, I quickly felt the need to offer a support to the clinical relationship. These adolescents suffering (for most of them) from both intellectual and language deficiencies, had no ressources to invest in a relationship of a clinical type where language is the only medium. Direct visual confrontation with the psychologist, as well as verbal sollicitations from him, constituted other unfavourable parameters, many of them suffering from psychopathological disorders causing troubles in interpersonnal relationship. When I introduced in the relationship a projective or cognitive test, or free drawing and painting, I noticed that these tools acted as catalysis, links and supports which allowed them to express their own way of being.

Some of them could then reveal theur strong investment in this moment of gathering, and their personnal qualities and character became perceptible (seriousness, tenacity, humour, creativity.). For others it was a means to express their daily psychological difficulties: latent depression, more or less intense and invalidating narcissical devalorisation, underlying anxiety manifestig itself by hyperactivity and unstability, no identity references and lack of structure in the personnality, massive anxiety, etc..

On the other hand, I noticed that the educational teams were very concerned by these adolescents, who were seen as unable to project themselves in the future, and as following their course day after day without investing themselves, and with more or less passivity.

How to make them aware of the active role they could play in relation to their own future ? How to mobilise them around a professional project ? How to prepare them to leave the centre at the end of their course ?

I felt that the peer group, who has a strong influence at that age, could constitute a priviledged tool to help mobilising these adolescents in a project for the future.

As a conclusion to this analysis, I decided to create this "Photolanguage group", as a psychic group aid for adolescents experiencing personnal difficulties. All the members of the staff have been very helpful and enabled the project to be executed in the best of conditions.

The Photolanguage Group is composed of adolescents (15 to 19 years old) engaged in professional training leading to professional recognition. Seven to eight places are available, this number being the maximum allowing personnal contact and attention. "Candidates" can be sent by any professional in the centre, this choice is confirmed by the psychiatrist and myself, taking into consideration the global equilibrium of the group (diversity in the individual problems).

Before they are formally accepted in the group, I meet individually each candidate, try to explain to him what it is all about, why I think this group can help him and invite him to participate to the first session before confirming his long-term engagement.

Each session lasts a school term; the group members are the first to be invited to the next session. In fact the participants normally come back, term after term, until the end of their course. I found it important to keep the same rhythm for the sessions and the school terms. It gives the opportunity to each member of the group to evaluate and reaffirm his implication in this psychotherapy, this timely rhythm serving as reference to him.

As all the members of the group have not reached the same level in their apprenticeship( 1 st , 2 nd or 3 rd year), the group allows "ins" and "outs", some of the members being at their very first session and others being on the point to leave the group. The position of the different members of the group in relation to each other, is thus different depending of the duration of their attendance to the group.

Each series of sessions normally begins by an inaugurative session, traditionally with open questions ("Choose the photograph which pleases you best") and ends with a conclusive session with a sort of evaluative question ("What did you find more difficult in the work with photolanguage? Tell it by the means of two photographs")

The medical nurse of the centre collaborates with me in this work. The team is thus composed of myself, psychologist, and a medical nurse. Each week we welcome this group of adolescents in the same place (a large hall) and at the same time. They leave their respective classes to come and join us for this Photolanguage Session which lasts approximately one and a half hour.

Before the session we prepare it: on which theme are we going to work ? How are we going to formulate it ? This is the elaboration of the "question". In the same time, we choose a series of photograph (around 30) which we will propose for this session and which illustrates well enough the fields of representations suggested by the question. This is the choice of the photographs.

Immediately after the session, we write notes, as exact as possible, on the proceeding of the session, the choice of photos, the verbal interventions and behaviours of each member of the group, our reactions and impressions. This time is also for us a time of "perlaboration" of what the group has lived during the session, and helps us to elaborate the question for the next session.

We must indicate, at this point, that the rhythm of work in the centre does not allow us to report the session as precisely as we would wish. However, the global direction of the work, the choice of photographies and wordly expressions of each and every member of the group appears to me as very correctly described.

I will propose now the description of a session and then comment it.

Clinical Sequence

The Photolanguage Group functions here for the second consecutive year. Some of the members of last year's group have accepted to participate for one more year: three boys: Loïc, Claude and Matthias, and two girls: Ghislaine and Danielle. Rémi is a new member. At the beginning of the term, we write the question on the blackboard, after having formulated it orally, because we are aware of the difficulty of memorisation of some of the members. All of them being familiar with simple reading, they can refer to it during the working session.

I have chosen, for this presentation, a session from the first term, after one and a half months of work. Everybody is now familiar with the Photolanguage method and with the group. We can thus, in a climate of trust and confidence, suggest the following question:

"Sometimes, we do not agree with a person or a situation. When you do not agree, how do you express it? Tell it with one or two photographs."

After having written the question, the adolescents gather around the board and take some time to read. Claude asks if he must tell "how he feels when he does not agree". I formulate the question once more: "how we react".

Rémi, Ghislaine and Matthias find it difficult to choose. Standing next to the photographs, Rémi tells me: "I hesitate". During the previous session, he had chosen no photograph, but when he saw mine, he exclaimed:

"I nearly chose this one!" Today, I encourage him to take the photo he might hesitate to choose.which he does.

Ghislaine also tells me that she has chosen a photograph but that she is not sure that it is the good one.

Mattias does not choose at all "because of the question", he says. We suggest: "Try to remember some things you did not agree with". "It never happens", he answers.

Everybody has come back into the circle.

Rémi is the first to present his photograph: it represents five adolescent boys working under the supervision of an adult, each of them concentrating on a model, with a screw in their hand.

Rémi tells us: "He is the leader. he looks at the work of the boys.he does not agree with the work of one of them.He looks at him."

I ask Rémi how does the leader express that he does not agree. "Bad.severe."he answers.The photograph passes from hand to hand. When it arrives to Ghislaine, she says: "Oh yes, it may be a leader, or it may be one of the workers. May be he meaningfully does anything".

Matthias remembers that he had already chosen this photograph, during a session concerning work. My colleague confirms that, it was a question about appenticeship, and apprentices in a workshop.

The photo comes back to Rémi. Talking directly to Claude, who is part of the workshop, he says: "Electricity. It looks like the electricity workshop, doesn't it, Claude?" Claude very abruptly replies: "Not at all!"

In the group, the concensus tends to lead to the idea that the worker is being "slanged" . The nurse says: "May be he hasn't listened correctly, he wasn't attentive!" Ghislaine suggested that, may be, he has not understood what is expected of him.

I mention here that the two situations imaginated by the group are very different.: it is not the same thing to act wrongly "on purpose", and to do the wrong thing because you have not understood what is expected of you!

It is my turn. I present the photograph I have chosen: it represents fireworks. I compare the fireworks to the anger I feel inside myself in situations I really do not agree with. I explain that I tend to control the sparkles that the others would not understand. I also notice that the sparkles disappear quickly. When we succeed in making ourselves understood if we do not agree with somebody, the positive effects can last a long time.

The group keeps quiet, with no reaction. Then Ghislaine remembers the fireworks she saw on a 13 th of July. In the group she was, a small girl was afraid, and they had to go back home. "Another one wanted to stay, but my sister Aurore did not agree: she was too small to stay alone. She could be raped," explains Ghislaine. The group stands still. Not a word. Everybody was amazed by the statement. I then sugesst that, even when you are a child you must sometimes tell that you do not agree.

The nurse presents a photograph which shows three persons of different generations: old woman, man and child.

In relation with the previous photograph, she talks about the moments which follow the anger, when you can talk together calmly and come to an agreement. She thinks about her own adolescents who sometimes have such strange ideas.

In turn, I talk about this photo: the grand-mother talks to her son, to her grand-son. Adolescents can also think sometimes that adults have strange ideas.

Loïc then presents a photograph representing men practising a martial art, lined up one next to the other.

"Men doing judo. If I was their leader I would tell them that I agree and that I don't agree. We are going to learn judo but this does not mean that we quarrel in the streets." " Judo is not solely combats, it's fun."

I reformulate what Loïc has said, judo has its rules, it is practised, in specific places, at specific moments.

Ghislaine declares: "I have never practised judo. But a punch in the eye must be sore!" I comment that, in the photograph, there is nobody just in front of the fist of each judoka. The nurse then refers to extreme cases. "Some people express their disagreement by violence, by a punch in the face, for example."

Rémi asks if there are many violent people. What does he think? Does he notice a lot of them around him? "On the TV, in the news, he answers. "The man who killed the little girl!" Matthias then tells us that Van Damme wants to become president of the USA . "He is a champion of karate," comments Loïc. "So, he knows the rules and he applies them correctly," I added.

Now Claude wants to present his photograph. It shows people gesticulating, singing or shouting, with "posters" on which the written words cannot be understood. In the centre, a child, on the shoulders of a woman. "I have thought a lot. There are different situations, different people. I have chosen with the friends: when some of them get into my room and take my things, sometimes I say nothing, and sometimes I do this". He shows the photo. I ask him to be more precise. "I shout. I am a poster on which it is written: don't let them get you."

The group laughs, some smile, the atmosphere becomes lighter. Loïc, who was quite serious until now, relaxes. Matthias tells about his quarrels with his room-neighbours. The nurse then tells him that it can also happen to him not to agree with somebody. Matthias explains that he thought the question concerned only the photolanguage group. That's why he could not answer.

We began to discuss around the theme: if we all agreed about everything, how great it would be! It is the opinion of the young ones, the nurse and myself being more hesitant: would it not be monotonous? Ghislaine does not know what monotonous means. We explain. Rémi comments that "anyway, there are problems in life". Loïc agrees: "Yes, that's life!"

We continue with the two last photographs because there are only ten minutes left before the end of the session.

Danielle presents a group of young people sitting on the grass, some of them hold a piece of paper, they talk and look at each other.

"A group. to say that, if we have problems, we must talk about them to an adult or to other adolescents. we must not keep them for ourselves." I ask Danielle to link her answer with the question, and, to help her, I suggest that "not to agree" can be the problem. She agrees.

The last photo is that of Ghislaine and shows a young girl, sitting on her bed and looking at the floor. "She is sitting on her bed, may be she is sad, she looks down."

I suggest that, may be, when Ghislaine does not agree with something, she reacts like on the photo. "Yes, at home, when I do not agree, I go on my bed and I think." "May be you feel sad?" "Yes, I cry."

The session ends on these words.

Comments

At the beginning of the session, we notice the difficulty in the choice of the photos. Ghislaine is not sure, Rémi hesitates, Matthias cannot imagine a situation where he does not agree.

During the session we will understand that Matthias has interpreted the question as concerning only the Photolanguage Group. It was so for the previous session: we had worked on the way each of us lived the moments of silence within the group. ("During the sessions of Photolanguage, there are moments of silence. How do you experience these moments of silence within the group? Express it with the help of one or two photos.") Matthias has functionned on the same model. May be the question for today was not precise enough? However, even if Matthias has misunderstood the question for today, it remains true that it is often difficult for him to choose. He keeps close to one participant or another while we move around the photos, and often chooses the same photos as another member of the group. We have often suspected that he waits for people to take their photos before selecting one that another person has already chosen. We can thus notice that Matthias experiences, in the group, as in life in general, a difficulty to express his own personnality. From there, we can easily imagine that it is even more difficult for him to accept that he is in conflict with others, that he disagrees with them ("This never happens"). We will see later when this inhibition will disappear.

The first words were said by Rémi. They also suggest a difficulty to exist as such, in this case to face an adult, who is a mirror reflecting a worthless self image: the leader of the group does not agree with the worker, his look upon him is hard, severe.

This is probably why Rémi hesitated in his choice, dared not risk himself: what would we think about his photo? Would we be critical, unhappy? Would we judge his work, his choice, not sufficient, unsatisfactory?

Rémi's words arise an echo within the gorup, his photograph provokes associations between thoughts: the work of intersubjectivity begins, an associative link deploys between each other, the image suggested by Rémi is taken again, prolonged, transformed,.the workers (or the students) are doing wrongly on purpose, probably the leader shouts upon them.they are not attentive.may be they have not understood the instructions.

The question of today is thus perceived by the group as evoking an angry adult - teacher, manager, parent? The group follows Rémi. It seems to me that we can hear, through these comments, the feeling of school failure experienced by these adolescents, "not good enough" mentally and even physically sometimes.( Rémi has a small, but noticeable, physical handicap.) We can also evaluate the fundamental role played by the adult who is immediately present in the representations, acting as a gauge in reference to which the adolescent auto-evaluates himself.

When the photograph comes back to Rémi's hands, he seeks an individual contact, tries to establish a connivence with Claude, who refuses to identify himself with the workers: remember, he sais that they are doing nothing; he sees no link between them and his own workshop!

My photograph (fireworks) has no objective link with the previous one. I suggest the strength of the emotions and how anger can be retained, than controled until it can be expressed. Is it the power of the image ? or the fact that an adult has expressed himself to tell that it also happens to him not to agree? The presentation of this photo leads to particularly dense and violent images. The image of sexual violence expressed by Ghislaine seems to evoke two things: inter-personnal violence(somebody imposes himself, he denies the person facing him his right to be an actor by imposing on him his violence); and inter-generation violence( an adult imposes his adult sexuality to a child, denying the latter a place in the order of generations). As a symbol, it is two times murderous: it aims at the person's existence as a subject, and it aims at the existence af the child as such.

This is where my photograph leads! Fantasms of murder, fantasms of death. During the rest of the session, we will meet these themes again.

As an adult I am able to describe, through my photo, a situation where I disagree; I probably unwillingly reintroduce the image of the adult present at the beginning of the session, i.e. an adult with a hard look: the workers/pupils are probably shouted upon, the adult is very angry, will he get out of himself? Some adults cannot control themselves, and children can become victims. By my work, I probably wanted to evoke the interior emotion hidden by inhibition, the difficult road between feelings and words, thus identifying myself with the dificulties which these young people meet when it comes to verbal expression.

But the impact is different. The links it provokes help us to measure the intensity of the discomfort Ghislaine experiences when somebody "shouts"at her: the anxiety of being destroyed comes first, it is not the type of frustration which refers to the anxiety of castration, but it is more elementary, a feeling of total reject, relating to he very existence.

Another interpretation of this sequence would focus on the pulsionnary violence inherent to each human being, and evocated her by the image of fireworks. My words suggest an effort for self-control, for the control of our own emotions and internal reactions. Adolescents can feel "acted upon" by the pulsion catalysm related to the beginning of puberty, when they experience a loss of self-control, feeling powerless in front of the physical, hormonal, psychic and relational transformations occuring in them. May be the image of the child raper is to be understood as a pulsion miscontrol, breaking through the equilibrium set up by the latence ? The infantile sexuality is fading away, leaving place for a genital sexuality to develop. The adolescent experiences a big internal disequilibrium and might be overwhelmed by the power of what happens to him and upsets him.

Anyway, this sequence gives me the opportunity to affirm, in front of the group, that children also have something to express (that they do not agree), that they have a role to play in decisions for their own life, a right to fight against abuse. There are situations when opposition is legitimate even if it is a child opposing an adult.

The photograph proposed by the medical nurse calms down the group: it shows three generations co-existing in harmony. My colleague and myself are probably sensible to the "pre-conscious" and "unconscious" representations existing in the group in relation to the question of today: links between our ideas, mine then hers, suggest the misunderstanding between the generations(the strange ideas between adolescents/adults). Each generation is specific, has its own system of values, which is not understood by the others, only accepted but not shared, or, if so, only with great difficulty. Peaceful coexistence. but no sharing. What is transmitted, inherited from one generation to the other?

Loïc then presents the photograph with the judokas, a martial art evoking a combat. Moved by the power of the representations existing in the group, Loïc tries to "master" the relational and pulsional violence, loks for the regulators which wil be able to "contain" the possible overflows. Her, again, we can here the trial to master the violence on both intra-psychic and interpersonnal levels. Which defence mechaism the ego will it use to face the pulsions of the Id.In the field of relatioship also, Loïc seeks for the obstacles which will prevent the situations of opposition , of disagreement, from degenerating. There must be laws, there must be a leader to apply the laws, to establish clearly that everything is not allowed. Quarrels are not allowed "in the streets", they are meant to be "for pleasure", i.e. as a symbol within which the integrity of the opponent is not threatened. The rule of the game will indicate the winner an d the loser. In such cicumstances, everybody can face the other, in an erotising conflict. Agressivity can occur, there is no risk of terrorising retorsion. However, on Loïc's photo, nobody has an opponent, everybody is training individually, no fighting takes place.

What risks do we take when we accept to fight ? How to reconcile our need for dependance and our search for independence, for self-affirmation? Through Loïc's words, we can hear how fragile is the frontier between agressivity and violence, and the necessity of the presence of a leader to avoid excess.

The representation of unmetabolised violence comes back within the group; the martial art combat evokes a situation where the quarrel would be real, where somebody would take a punch in the eye. After the sexual violence, now it is the adult desire to kill he child which comes out directly (there are violent people, there are adults who kill children).

Just as Loïc has talked about the judoka master who would have the authority and restore order, and thus guarantee the safety of everyone, Matthias brings in the image of the president of the USA who is a karate champion.Of course he would put things back in order!

But how will these leaders react? Will they be reliable? Will they not use their art, their power to serve their own purpose, abusively? These questions are present, even if they are not clearly expressed, the reference to the authority is not completely reassuring.

Claude will bring down the tension with force, he affirms the right to self-defense, the necessity to become active and play a role in one's own destiny.

The relay is established between the generations; the images of self evolve, the adul-dependant child leaves place to an autonomous person, who helps himself, takes his own responsibility, and is ready to fight for his life and main interests.without too much guilt.

Loïc feels better, the group relaxes. Self-defense is in no way, abusive or sadistic: it can be necessary, we are first and foremosr responsible for our own life. but it is difficult to make an opinion as far as an adult authority is concerned, these adults we needed so much and from which we still expect so much support and recognition. To leave childhood and grow up , while breaking ree from adult dependency, may appear a real act of violence against us; it means putting an end to the situation as it existed before, "killing" parents symbolically. The adolescent will have to produce this necessary and fundamental violence to achieve psychic maturity; Claude, who had already manifested some determination in the group, (no! he had said to Rémi) leads the way by presenting his photograph. Just as the word "no" of the child constitutes a mutation, a turning-point in the construction of the self, and is a psychic organiser, says Spitz, the "no" of the adolescent will retake and prolong the work of individualisation of personnality.. or bring out its weaknesses. It is the adult role to evaluate and measure this break through, which can be so noisy sometimes, or so discreet, nearly silent at times.anyway so ambivalent!

The expression of personnal autonomy pre-supposes a fundamental violence which we must assume, and the work of the group around this theme will allow Matthias to present himself in a situation of opposition: now he can give us examples, there is no more inhibition in front of the look and of the judgement of the adult.

The scene has changed: it is no more question of children, killed or abused by adults acting with excessive power or pulsions, but of a world where people can meet each other, and negetiate the issues of the meeting, sympathy or antipathy, alliances or conflicts, pleasure to communicate or agressivity. The indication of an evolution towards a more autonomous, a more individuated self-representation, will be given by the nostalgia in the group: "if we all agreed, how nice it would be". No: Rémi and Loïc bring the group back to the principle of reality: "that's life, there are problems"; to live and assume our existence, we must renounce to the state of indifferentiation where the one and the other made one. We must assume the problems life bears if we want to exist.

Danielle then presents a photograph where adults and adolescents co-exist and talk to each other about the problems of life. may be about their disagreements, with no fear to be rejected. We can observe how we went from the photo showing disagreement between a leader and his workers, through an intermediate one showing two generations coexisting without real interaction, to a third one where people can talk to each other with no fear of being judged about their values. Self-image of the group, this image expresses Danielle's experience within this group: many times she said how she was touched that my colleague and myself also choose a photo, accept to expose ourself to the judgement of the youth, and be ready to play the game.allowing this young adolescent, deprived from her parents, to approach adults as, may be, never before, and using them as identification supports in her search for self-identity.

The session will end with the photo representing the painful reality of disagreement with family, evoking the difficulty of leaving the first objects of attachment.

As an echo to the nostalgia of the group in reference to a life without conflict, Ghislaine says how it is difficult to disagree with those of whom we have depended and we love.Does she also express, here, more personally, her incapacity to speak out her conflicts within her own family, which make her retire in a depressive condition impossible to elaborate?

The session ends on this image, expressing very adequately, on the group level, the psychic and affective cost inherent to the come back of the Oedipus complex during adolescence, this search of an issue to adulthood.

As a Conclusion.

The summing-up of the session will occur some weeks later. Claude told us that, what was more interesting in this work, was that he had been able to speak to the end of what he had to say. A nice way to express how the Photolanguage method has enabled the adolescents to feel listened to, to find their own words, their own way to tell and show what they had to say.

For others, more deprived, the representations of failure, of marasm, of danger, will dominate for a long time. "It is a broken bicycle and it is not repaired", we can hear during this summing-up. However, even in this situation, Photolanguage seems to be an adapted support to the recognition of the psychic life of these adolescents, a tool which allows them at least to express their profound hindrance to exist as such. In this case, to hold one's place in the group, to assume this place by elaborating one's own look on the photographs and trying to express it, is far from being a neglectable experience.

I hope to have expressed, through this clinical session, how the investment of these adolescents and ourselves offer a favourable set-up to inter subjective exchanges in a work oriented towards psychic autonomisation.

Nathalie SCHMITT

Rue du Lavoir

69620 FRONTENAS

FRANCE

Clinical Psychologist, participating to the seminar on Photolanguage, animated by Claudine Vacheret (prof) as a part of C.R.P.P.C. (Research Centre in psycopathology and clinical psychology), University Lumière Lyon 2, France.

English Translation :

Ronald B.D'SOUZA ( India ) -Marie Hélène D'ARIFFAT ( Mauritius ).

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