Subversion et humour dans le traitement analytique d'un patient schizophrène

The psychoanalytical therapy of schizophrenic patients is traditionally based on the development of a positive transference and on an interpreting, holding analytic work. In this paper, we present the case-study of a patient for whom all “making-sense” work became persecuting. We will name this very ambivalent person an “alterno-valent” patient. Within this conflicting transference, only a humoristic approach allowed us to develop a trustful relationship with the patient. We describe the subversive nature of this relationship-humour, which is to take a completely opposite position to the analytical position, but to remain nevertheless attentive and empathic. We show further how this humoristic play serves us to interpret the transference. The humour-concept is assimilated to the Freud's “Witz”. We refer further to the literature in order to describe the psychotic transference as an oscillating movement between “transference-erotomania” and the “let-down-position”, both also deleterious. We propose the idea that the therapist's effort to make sense could induce in psychotic patient a psychic disorder who acts first as a defence (against the confusing pointing of the Big Other), second as a guarantee for the permanency of the relationship (the subject's disorder engage the Big Other in an organizing work). We also use “the concept of “projective identification””-concept, which is considered not only as the projection against bad objects, and also as a mechanism that allows the projection of the working-out abilities.