Editorial
João Baptista N. F. França - 499

Borderline patients: sense of reality, reality test and reality processing
Luís Claudio Figueiredo - 503
Development of the concept enactment through the study of a borderline configuration
Roosevelt M. Smeke Cassorla - 521
Between neurosis and psichosis: a few considerations over the borderline cases on psychoanalysis clinic
Maria Vitoria Campos Mamede Maia - 541
Dreaming the feminine. A path througt somatization and hallucination
Cândida Sé Holovko - 557
Limit- cases in adolescence
Raquel Plut Ajzenberg - 581
Contemporaneous clinic: Some considerations
Altamirando Matos de Andrade Jr. - 593
Thoughts about the experience with patients described as borderline
Claudio Castelo Filho - 605
Clusters of meaning: live evidence within early intervention with children and their parents
Mariângela M. de Almeida, Magaly Miranda Marconato e Maria Cecília Pereira da Silva - 637
Psychoanalysis and drug dependents: where is the father?
Sérgio de Paula Ramos - 649
Autistic disorders and dialogic space: Conversation between dialogism and psychoanalysis.
Vera Regina J. R. Marcondes Fonseca, Vera Silvia Raad Bussab e Lívia Mathias Simão - 679
The psychoanalist, the clinics and the psychosomatic
Milton Della Nina - 693
On becoming a person: the importance of the analyst’s affetctive response to the dreams of an emotionally deprived schizoid patient
Franco Borgogno - 711
The psychoanalytic work with adolescents, today
Virginia Ungar - 735

Borderline patients: sense of reality, reality test and reality processing
Luís Claudio Figueiredo

A borderline patient is apt for reality testing but often goes through repetitive acts of testing his fantasies against objective reality unsuccessfully. The ground for these partial failures of reality testing is that he has not been able to build a solid sense of reality and found many difficulties processing reality demands. The present paper suggests some lines of thought about this question, such as the importance of working through the depressive position and the Oedipus complex in the process of building up a solid sense of reality. A sense of reality, in its own turn, will favour a continuous processing of reality demands. When reality processing becomes as continuous as life itself, the repetition of individual reality tests becomes less frequent and necessary and more satisfying. Directions for the psychoanalytic treatment of such patients are also presented.

Key words
Borderline, reality test, sense of reality, depressive position, Oedipus Complex.

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Development of the concept enactment through the study of a borderline configuration
Roosevelt M. Smeke Cassorla

The objective of the paper is to discuss some aspects related to the enactment s functions. After a review of the concept, a borderline patient, with whom the analytical process seemed to be developing productively, is described. Following a change in the setting, an acute enactment took place. Its understanding enabled the realization that the analytical couple were involved in an unconscious collusion, where a symbiotic relationship had been established among the patient, the analyst and his family. That relationship prevented the couple from touching highly destructive unconscious phantasies and archaic traumatic situations. The comprehension of the enactment enabled the dissolution of the collusion.
It is proposed that, besides the resistance aspect, the collusion may have been useful to strengthen the patient s mental mechanisms and the trust in the analytical work, which demanded certain time. The intense enactment arises, unveiling the collusion, when the patient and the analyst feel able to face the destructive aspects.
It is speculated that both enactments may occur in the analysis of this kind of patients (borderline), as part of the natural history of the analytical process, and their function is to re-live their archaic experiences in the analysis, also with the aim to elaborate them. Finally, the author proposes a classification of enactments: normal, pathological, acute and chronic enactments.

Key words
Enactment, borderline, analytical technique.

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Between neurosis and psichosis: a few considerations over the borderline cases on psychoanalysis clinic
Maria Vitoria Campos Mamede Maia

This article presents Winnicott s notion of antisocial tendency and false-self as an answer to contemporary fluidity in a contemporary cenary where the individual is born and live into. For study this cenary we have as reference Bauman, Julio de Mello, Da Poian, Rassial and Outeiral.

Key words
False-self, anti-social tendency, borderline cases.

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Dreaming the feminine. A path througt somatization and hallucination
Cândida Sé Holovko

The author intends to demonstrate how the transference situation created the necessary field for the emerging of fundamental aspects of femininity, in a patient with an intense dissociation of the feminine in her self.
Manifestations of this feminine universe are expressed in the psychosomatic symptom, in the hallucinatory symptom and in the oneiric narrative evidencing the path of the development of psychic representations. From new vertices, the author points that these symptoms were indicating a movement of assuming emotional experiences that had never taken place in the patient s psychic and somatic organization.
Based on clinical material, aims at a discrimination of the concepts Feminine and Femininity, as two different aspects on human s constitution.
In this paper, Winnicott s conceptions of pure feminine element and personalization were of considerable worth, as were Bion«s and Antonino Ferro s theories about the dream.

Key words
Feminine and masculine sexuality, pure feminine element, pure masculine element, somatization, corporeity, personalization, hallucination, dream, rêverie, alpha elements, balpha elements, subjective object, transitional space, self, self-false.

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Limit- cases in adolescence
Raquel Plut Ajzenberg

The main proposal of the project is about problem teenagers with a special focus on the chemical dependency to which some of them are submitted.
These patients are a part of the contemporary clinic in a broad sense. They are part of the group that the borderline concepts describe. The borderline concept is rather thought of as an irregular space, permeable and plastic with different elevations. These frontiers are not statistics they are unstable and oscillate from the internal to the external world, causing great instability and vulnerability of the psychic. Since the beginning of their lives these individuals are submitted to an external pathogenic condition loaded with affectionate laces in such a perverse manner that they impair the construction of a mental architecture that would give them sustenance during their development. These self-support columns become corroded and porous by small but constant tremors, which come from the hostile external world that crack the mental structure. In this project I will point out some types of functions of the psychic related to such patients considering that drugs have a different and specific function according to the kind of psychic organization. In the first part I will illustrate some peculiar forms of psychic organization to these teenagers. In the second part I will comment on observations made while treating young people particularly young girls, who use drugs significantly in their relation with the environment and prove some traumatic sources of the ego- object relationship.

Key words
Borderline -limit, extreme cases, trauma.

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Contemporaneous clinic: Some considerations
Altamirando Matos de Andrade Jr.

In this paper the author intends to show how he works with the patients that come to analysis without a clear complaint asking for few sessions and refusing what is so called, a classical setting. Some clinical vignettes will be discussed in order to show the work during the interviews before the beginning of the analytical process. The contemporary clinic will be considered to understand the meanings involved in the analytic millieu of our present time.

Key words
Contemporaneous clinic, demand for analysis, transference, countertransference, first interviews.

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Thoughts about the experience with patients described as borderline
Claudio Castelo Filho

The author narrates two clinical situations with patients that could be called borderline. In the first, an intelligent and clever woman though very precarious in her emotional development seems to be attached to a belief (without which she feels she would not be able to survive) that she is a non recognized genius because of the envy and jealousy of the ones around her and that all of them make the best they can to put her down. Every effort made by the analyst to introduce her to her difficulties and problems is felt as a violent and destructive attack. The analyst feels that there is hardly any breech in her state of mind so it is very difficult to establish a realistic conversation with her. Though she constantly complains of the treatment she receives from the analyst she never misses a session and states that she needs analysis and wants it very much. The analysis continues for more than a decade till the perception that the analyst was improving in his career triggers in the patient a wave of very disturbed behavior leading to a standpoint. In the second situation, a woman, although graduated in college, seems to be mentally retarded because of her almost complete absence of capacity for abstraction. The analysis goes through several years demanding a great effort and lots of patience from the analyst due to stale feelings and very reduced hope that the patient would find any meaning in whatever he says. Nevertheless, the patient, very eventually and surprisingly, has a deep insight, though ephemeral.

Key words
Borderline, survival.

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Clusters of meaning: live evidence within early intervention with children and their parents
Mariângela M. de Almeida, Magaly Miranda Marconato e Maria Cecília Pereira da Silva

Seeing parents and young children together offers a unique opportunity to listening to parental expressions of anxiety about their child, while lively observing the child playing and interacting with them. In this setting, we actually learn from experience about their initial modes of relationship as a family. Our interventions, enriched by our observations at the very here and now of the child s ways of being, help the parents to highlight perceptions about the actual child and gradually discriminate the actual experience with that particular child from what may have been many times perceived through projections and unconscious identifications or expectations.
Through clinical cases (including some video-recorded vignettes), this paper discusses moments in which this potentiality expresses itself very vividly, allowing significant realizations (clusters of meaning) to emerge. Based on theoretical references by W. Bion, D. Winnicott, and S. Lebovici, an attempt is made to detail and describe the nature and constitution of these clusters of meaning, as well as what seems to facilitate their emergence in the particular setting of psychoanalytic work with young children and their parents.

Key words
Clusters of meaning, early intervention, parent-infant relationship, transgenerational
phenomena, unconscious identifications.

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Psychoanalysis and drug dependents: where is the father?
Sérgio de Paula Ramos

Despite the common occurrence of drug abusers in the psychoanalytic clinic, contemporary literature on the subject, particularly among publications in the International Journal of Psychoanalysis, is sparse. This paper aims to review the most important psychoanalytic contributions on drug dependency in the last 100 years, then attempts to compare their postulations to the findings of pertinent prospective studies. In these patients we find a persistent symbiotic object relationship, which ties them to a narcissistic functioning where drug use is viewed under the light of both pleasure without object and omnipotently controlled need. I shall also discuss the possible contribution of the mother and father in the genesis of this condition, focusing on the compromise of the paternal function as the deciding factor.
In the second part, based on clinical material, the author discusses psychoanalytic views on chemical dependency, focusing on the importance of the compromise of the paternal function. Also considered are the indications and counter indications of psychoanalytic treatment for chemical dependents, as well as pertinent technical peculiarities. The conclusion reached is that psychoanalysis may be recommended for consistently abstinent chemical dependents, and in such cases, special attention should be focused on the process of rupture of symbiosis; process which is eased by the ressurgence of the paternal function.

Keys words
Psychoanalysis, prospective studies, drug dependence, alcoholism, paternal function, father.

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Autistic disorders and dialogic space: Conversation between dialogism and psychoanalysis.
Vera Regina J. R. Marcondes Fonseca, Vera Silvia Raad Bussab e Lívia Mathias Simão

The authors initial hypothesis is that early face-to-face interactions provide a dialogic space that will allow a sense of self and other to be acquired, since inside it self simultaneously defines and is defined by the other.
If, for several reasons, such early interactions are impaired, the dialogic space may be collapsed, making self and other to be in an existential conflict, what may result in some kinds of developmental disorders.
Using the verbatim transcriptions of one psychoanalytic session of an eleven-year-old boy diagnosed as having Pervasive Developmental Disorder, the authors aim to discuss the child s deficit in dialogic interaction, using the ideas from Dialogism as a background. During the session, it becomes clear how both partners have to tolerate a great amount of misunderstandings, not knowing, taking risks and still keep searching for a minimally shared path, in order not to break the dialogic link.
Since such children seem to lack such shared experiences, being in a dialogic interaction, despite all the errors from both sides, seems to provide a new kind of relationship, in which a more robust sense of self and other, as well as a sense of contingence, agency and synchrony is achieved.

Key words
Pervasive, developmental disorders, dialogism, child psychoanalysis.

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The psychoanalist, the clinics and the psychosomatic
Milton Della Nina

In this paper the author presents his cogitations about the role of the psychosomatic manifestations in the psychoanalytic clinics. The author starts from a conceptual and clinical substratum presented by Brazilian psychoanalytic authors and discriminates the approach of Psychosomatics from the psychosomatic vision that all the psychoanalysts should have of their patients, even if they do not have psychosomatic complaints. He intends to demonstrate how the psychoanalytical practice conception represents a differential factor in the importance attributed to the psychosomatic manifestations during the emotional experience shared in a psychoanalytical consultation. Then, highlighting the countertransference and the presimbolic communication as organizing factors of the observation, the author intends to approach a research proposition to what he calls the psychosomatic in the daily clinical practice. He tries with this paper to outline a conceptual position sustained by his clinical practice, showing how an empathic search in the psychoanalytic room can privilege not only the psychic but also the somatic roots of the emotional experience.

Key words
Emotional experience, empathy, countertransference, presimbolic communication, somatization, psychosomatics, psychoanalytical research, psychoanalytical clinics, analytical field, psychosomatic patient.

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On becoming a person: the importance of the analyst’s affetctive response to the dreams of an emotionally deprived schizoid patient
Franco Borgogno

What patients mainly want – as Ferenczi claimed as early as 1932 in the Clinical Diary and as Bion later expressed in his Cogitations (1992) – and what some patients need, is to experience how their analyst lives and processes in the transference and countertransference dynamics the interpersonal events that lie at the origin of their affective and mental suffering. This is especially true with schizoid patients who were profoundly emotionally deprived in childhood. In this paper I will investigate this crucial aspect of the intersubjective analytic relationship in the treatment and in some dreams of just such a patient, an extremely silent and inert young woman. Through a detailed examination of clinical material from various stages of her analysis, I will explore how the analyst’s unconscious emotional response serves both as a tool for comprehension and a key element of environmental facilitation – a new beginning, to use Balint’s (1968) phrase – that may help the patient attain a level of development and emancipation she has never experienced before.

Key words
Schizoid patient, dreams, affective response of the analyst, transference and countertransference, new beginning, identification with a deprivational object, spoilt children.

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The psychoanalytic work with adolescents, today
Virginia Ungar

The paper is centered in the psychoanalytic clinic whit adolescents patients at this time. A brief theoretical route is made in the first place on the authors who have made contributions fundamental on the problematic adolescent soon to focus problematic present of the adolescent along with the changes in relation to the previous generations. Finally the question of the “analizabilidad”of the adolescents is approached and also the most frequent reasons for consultation in that age in the present times. The presentation of a case of a patient is included who began his treatment since 15 years of age, being in his third year of analysis, to illustrate some aspects of the problematic adolescent and simultaneously certain technical aspects of the analytical work with patients in that stage of the life.

Keys Words
Adolescence • technique • work with adolescents, today.

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