L'esperienza di cui voglio riferire è iniziata più di dieci anni fa, nell'autunno del '91: è utile che dica due parole per inquadrarne lo sviluppo storico, giacché essa è fatta di diverse contingenze e si è trasformata progressivamente fino ad assumere la propria figura attuale.
All'inizio mi era sta chiesta una consulenza limitatamente a due bambini autistici inseriti nella scuola con i quali, come si può immaginare, gli insegnanti si trovavano nella più grande difficoltà. Non voglio soffermarmi su questi casi, di cui ho già parlato in altre occasioni, e per i quali ci si può riportare ai testi pubblicati.
Devo solo dire come la matrice della modalità d'intervento che nel seguito mi si è imposta, e che articola contesto famigliare e contesto scolastico, sia nata nel tentativo di far fronte alle difficoltà di gestione degli autistici in un ambiente, come quello scolastico, originariamente predisposto ad altri fini che non il trattamento delle psicosi infantili o dei diversi comportamenti sintomatici che i bambini possono manifestare. In un certo senso, in fondo, l'essenziale dell'intervento che cerco oggi di organizzare consiste in un uso improprio della scuola realizzato attraverso l'orientamento del discorso psicoanalitico.
Una cosa è infatti vedere bambini autistici in un'istituzione ad hoc, pensata in base ai concetti della psicoanalisi, altra cosa è vedere bambini autistici in un'istituzione che ha come finalità primaria l'apprendimento e dove gli autistici funzionano come il granello di sabbia nell'ingranaggio. Quel che succede di norma, non sempre ma il più delle volte, è che i genitori vengano a lamentare che i figli non imparano al passo con gli altri bambini. Abitualmente, infatti, i genitori dei bambini che ho visto attuano una radicale scotomizzazione della condizione dei figli. I genitori delle classi culturalmente più povere, in spite of the diagnostic records provided by the ASL, which spread before my eyes when the talks, consider the children as little more than the stubborn, unwilling to understand what I explain to them often to the sound of blows. But it is the less serious cases. I found it more difficult with the parents of the middle class, who consider their children as misunderstood and look with distrust the school and its representatives, considered inadequate for the quality of the child. Now is not easy to teach reading and arithmetic to children with autism, as well as qualified personnel available to us, support teachers who have attended specialist courses, can not work miracles. We currently charge
un bambino autistico di cui ho da poco visto la madre, che è medico: impossibile accennare a qualsivoglia idea di difficoltà del figlio. Il bambino, dice, è intelligente, solo un po' lento, ma grazie al suo insegnamento si metterà presto in pari. Lei infatti a casa integra il lavoro delle maestre con lezioni che il figlio deve sorbire praticamente a tempo pieno. Se fanno una gita al lago è l'occasione per spiegare la differenza tra l'acqua dolce dei laghi e quella salata del mare. Mentre le maestre stanno introducendo la classe ai primi rudimenti di biologia lei arriva annunciando che ha già spiegato al figlio la struttura della cellula e che lui ha capito benissimo, anche se non riesce a ripeterla per la sua flemma di linguaggio. Quando ho avuto il colloquio con lei mi ha raccontato che per sciogliere quel lieve torpore del figlio era stata indirizzata da uno psicoanalista. Dopo averlo incontrato e avergli parlato si è però resa conto che quel tipo d'intervento non faceva per lui, perché pretendeva di sanare traumi di cui non c'era traccia in suo figlio, e nessuno meglio di lei lo può sapere, perché, mi dice: "Sono medico, e sono io il miglior terapeuta di mio figlio".
Non voglio, come dicevo, soffermarmi in particolare sul problema dell'autismo, che solo in una prima fase è stato il punto focale del lavoro. Porto l'esempio solo perché mi sembra emblematico del tipo di bricolage che impone il lavoro su patologie gravi in situazioni in cui non sono riconosciute tali e in un'istituzione che non ha come finalità l'obiettivo di un trattamento.
L'esperienza con l'autismo mi ha suggerito però il modo di usare la scuola per supplire alle carenze che presenta il contesto famigliare. In un certo senso questa è anche una china naturale della scuola. Il passaggio dalla scuola materna a quella elementare costituisce un salto significativo per il bambino perché lo mette di fronte a esigenze e responsabilità nuove in un ambiente nuovo, ed è un fattore scatenante di tutte le problematiche latenti: l'ansia, le crisi di panico, le fobie, oltre alle classiche difficoltà di apprendimento, trovano terreno d'insorgenza nelle prime classi elementari. L'ambiente scolastico si trova così a funzionare come via di risoluzione compensativa, oppure come ulteriore blocco in cui si consolidano i sintomi.
Stefano per esempio è un bambino piccolo di fisico e di età, è il più piccolo della classe e compirà i sei anni a dicembre. Ma è piccolo anche rispetto alla sua età, perché nei primi disegni che mi mostrano le maestre la figura umana è ancora rappresentata come cefalopode. Poche settimane dopo le cose sono già cambiate: disegna se stesso disteso sul letto nella sua cameretta in posizione un po' rigida, come sono i suoi movimenti, e circondato da oggetti tutti smisuratamente più grandi di lui. La figura non è più quella del cefalopode, ma quella di un bambino in un mondo un po' troppo grande per lui, that is beginning to wonder how to deal with. The simple immersion in the school environment, contact with their new friends, the more challenging situation gave him a boost of maturity before he missed. Sonia is a child instead of normal intelligence, with three older brothers who all had problems of school failure. The teachers are asking me to see her because she can not start with reading and writing. If not start once there is a risk that the initial refusal leads to an accumulation of delay engaging a downward spiral. The situation will not unlock until you speak with her mother, a woman who had once had ambitions to study without having the possibility of poverty family. E 'enough to bring out the crippling expectations that had projected on her daughter, considered the last resort after the failure of the largest, to produce an outcome reflecting the unblocking child. For Sonia, the school had had the opposite effect to that Stefano had worked as an engine for him, for she had worked as a catalyst of the present troubles in the relationship with the mother.
After initial request for advice focused on autism, was the event that led me to extend the intervention on a wider circle of increasing problems. The psychologist previously in service, in fact, left the office and I was asked to take the whole area of \u200b\u200bdisadvantage. I accepted, not without some hesitation, since this was also intervene on a range of diseases such as Down syndrome, about which I could not see how to plug through the analytical concepts. But the school learned to use me and I learned to use the school beyond the service requests.
The work is structured as follows: I normally do at the beginning of observation in all first class. This happens in mid-October, when teachers already have some idea of \u200b\u200bchildren. This allows them to report cases that present some difficulties in their eyes. It was originally followed in a little 'stiff bureaucratic practice: I had to take care of children "documented", that is those that are already reported to the nursery and sent at the UONPIA (Division of Neuro-Psychiatry, Child and Adolescents) where they are taken into treatment and provided clinical documentation. As the demands of the teachers have become more and more different: there is a child who is not reported but they seem particularly depressed, or agitated, or aggressive, or weird, there's another one that crosses a time of crisis contingencies family, a child is suspected to be abused, it seems another victim of abuse, one had a normal learning and suddenly stops, another can not longer hold in the classroom. Not that I have done nothing to solicit, unless try to come as close as possible to the requested, the area of \u200b\u200bintervention has gradually enlarged, and I also happened to be named because an entire class no longer responded to the conduct of teachers and showed the attitude of open rebellion: time would be considered a disciplinary problem and would have appealed to the headmaster, with his usual tools of repression, ranging from reference, to preach to the suspension, and today is usually asked the psychologist and, on occasion, as they are available, I applied the analyst, who must enter into a land where it is not immediately think that the concepts may be driving the unconscious, repetition, translation, the drive, but where just meet the intricacies and the harshness of the place, we realize that our extraordinary compass offers panoply theoretical.
consider only a symptom of the rage as Attention Deficit Disorder with Hyperactivity (ADHD). These fake labels have such a capacity to create imaginary entities that one day some teachers have called me to show me wonder a child was indeed a bit 'absent-minded, but oddly did not show any excess kinetic. The ADHD is the most obvious example of the medicalization process the discipline: it is happening a reification of that which belongs to the realm of subjective responsibility. In other words: i bambini che una volta venivano messi dietro la lavagna vengono oggi classificati DDAI e mandati dallo psichiatra. Lo psichiatra ha a disposizione uno strumento più potente della bacchetta sulle dita, perché ha il Ritalin con cui calmare le intemperanze dei più inquieti. La polemica sul Ritalin, che ha infiammato gli Stati Uniti e che si è accesa anche da noi, ci mostra le linee lungo le quali la psicoanalisi applicata, oltre alla propria peculiarità terapeutica, assume una valenza prettamente politica. La questione di fondo è: bisogna considerare l'individuo come entità a sé che può essere difettosa e sulla quale occorre intervenire correttivamente, con la farmacologia o con le tecniche di apprendimento, o bisogna considerare the subject in its relation with the Other, that is the child in the multiple plots in which it is involved in school and family? This problem, in my opinion is not only theoretical but necessitates a clear political decision which has consequences that can not be underestimated. In the school
the political component of applied psychoanalysis takes special emphasis when compared with all the learning technologies that come with the aura of pragmatism and speed by offering solutions in a predefined number of steps, facts which, if the child, as often happens, has not moved from his condition is considered affected by a form of the disease resistant to treatment. E 'impressive la violenza di certi interventi che mimando le hard sciences puntano a un preciso obiettivo e si fondano su un progetto apparentemente chiaro, quando la mettiamo a confronto con il paziente bricolage della psicoanalisi applicata, che segue piuttosto la propensione delle cose.
Ho visto un bambino psicotico di otto anni, con una famiglia di condizione medio-alta dove entrambi i genitori erano docenti universitari. Fin dall'inizio della scuola, poiché i genitori erano persone di cultura e tenevano particolarmente alla sua formazione intellettuale, il bambino era stato seguito con tecniche di apprendimento basate su cubetti, figurine, reticoli di lettere e di cifre. Era un bambino con comportamenti fortemente aggressivi e con una certa apparentemente inconsapevole capacity of irony: he could thwart attempts to approach the teacher support by force or evasion. I wonder what else could be done: the school was basically the only place where it was sheltered from the bombing notionistic organized by the parents. To which no criticism can not be moved, they were extremely anxious and in turn people in need. The critical objective here is the policy adopted by the child's cognitive and promoted by experts who have followed his "training". Of course, after years of relentless insistence, at least some basic cognitive skills had gained: I wonder if I write a few words and make some uncertain mechanical account the priorities were to choose for a child living in a desert of communication. When it was up to me, not only for children with autism, but also for those with severe retardation linked to complicated family situations, I prefer to distort the essence and purpose of favoring the inspiration to make school a place where they could find a response different from that given by the Other family. I tried to follow the idea of \u200b\u200bmaking the school a place of temporary, stand as one where the child can find the emotional and symbolic resources that could have had in the family.
The starting point is the concept, familiar to us, to substitute the name of the father, and more generally of temporary absence of sexual intercourse. In school, however, takes this notion of replacement extension inevitably increased, although it is still treating the school as a symptom. For children with autism how to build them a crutch is made, in most cases, relationships with teachers more sensitive. It 's a crutch that supports them until the transition to middle school and, unfortunately, can not bring with it, because there is no internalization process: the construction of only external support remains, an official from the environment. With autistic children it is difficult to build the dialectic between More and more family-school that allows the problems identified and addressed in the school context to be understood and elaborated consequently also within families. It 's a strategy that I found rather effective in many other cases.
extraordinarily instructive in this regard was for me the case of Stephen. In the first year of her I had not been reported any problems. At the end of the year the mother was asked to speak to expose a difficulty created by a moment of closure that the girl was crossing: it appeared frightened and clung to her morbidly. He attributed this situation to various health discomforts that were harassing, rhinitis, throat plates, varicella, hospitalization, and that in his opinion the girl struggled to overcome. The father in his speech, he looked weak, blurred away, apprehensive. Since now the last days of everything was sent back to school next season. The following year, the teachers ask me to comment on individual Stefania. They found her in what they call a serious regression: the child no longer speaks to adults and very little with his companions, has an almost total closure of the communication. Act only if requested insistently and persuasively, and when he is convinced collects the applause of encouragement of his companions. Learning, until then normal, it is suffering and threatens to crash. Stephanie has a sister two or three years is apparently the opposite of her lively and outgoing. A school has a special relationship with a companion, which appears particularly protective and maternal with her. If teachers have to say something to the whispers in the ear of this company because she relates: it is short, his spokesman. He's afraid of open spaces and falls in agony when the class is brought into the courtyard. One day we organize a trip outside the school: she does not want to go there, plan on a whim with the mother who gives up and keep it at home. The girl followed the UONPIA. I ask the teachers if they have talked to the therapists who see it and told me that yes, they have met but do not have any clear: they seemed rather confused and disoriented and have made some mention of a possible diagnosis of autism. I put these estimates on account of the often fractious relations that exist between the teachers and staff of health facilities and ask to see the baby.
Stephanie looks like a frightened little girl and totally inaccessible. It has all the things I ask you to do, draw, take the games, follow me, but does not say a word and does not answer any questions. Behind the air appear frightened but inhabited by an iron will. Usually I naturally, even with children more difficult to create a certain current of sympathy, and there is always a time when you unlock and I can make them laugh, to engage in a game or let them tell some stories. Stefania is an impenetrable sphinx, which keeps me head for over an hour with his eyes wide open without even tilt a corner of the lips. It is not autistic, nor is it braking inhibition: just do not want to talk about and no one can force her to do so. The following week, ask an interview with the mother and, as a watermark that only appears in looking at the light, I see emerging, in the image of the girl frightened me again, the figure of a child is completely different, which is able to bring exasperated mother, who is always agitated, running back and forth to the house without a moment's pause, that when he wants something from her mother always manages to get it. One day he missed all the morning on a network creaking of the bed up to break through and get hurt. "Why did not he stop?" I ask. "I told her to stop-responding - I have daughters cried all morning." "And Stephanie did not stop?". "No". "So what has she done?". "What could I do? I left her jump." I realize that Stephen then has full control of the family situation. There are no signs of his father's presence, the mother is unable to give the child the rules and runs at will, and also the expression of his fear becomes a way to control the mother. Accustomed to this total control of the situation, the domain that serves to contain the anxiety and to meet the rules and limits that no one gives it, the school must have seemed a more difficult to Stephanie, who could not circumscribe le stesse strategie adottate in famiglia. Ha capito però il punto vulnerabile della scuola, e quel che all'inizio è stata una ritirata difensiva è diventato il suo modo di dominare la nuova situazione. Se non vuole parlare nessuno può costringerla a farlo, e il suo silenzio mette in agitazione tutti, in modo che le redini ritornano in mano a lei. Cerco allora, in alcuni colloqui con la madre, di suggerirle dei modi per dare delle regole in casa a Stefania, mentre alle maestre suggerisco di non accettare più che Stefania comunichi attraverso la sua portavoce, e di non inquietarsi troppo se per il momento resta in silenzio, perché quando avrà qualcosa da chiedere lo chiederà. L'obiettivo è di rendere inutile il sintomo prima che to crystallize, while seeking to induce the relationship with the mother as an appropriate way to contain anxiety. For a period I have followed closely the teachers and have talks with his mother, but within a couple of months Stefania again a bit 'at a time to talk and resumed the normal pace of learning.
We see here a symptom that comes on school grounds, but that could not be addressed solely within the school. The approach of academic psychology in a school problem instead focuses on the educational framework and is generally based on perceptual or psychomotor re-education: it is to exercise the skills visuospatial deficits. The new alliance between cognitive psychology and neuroscience poi vede quasi sempre a monte un danno neurologico. Il difetto è nel bambino, o nelle sue complessità neuronali, quindi bisogna insegnargli a riconoscere le situazioni in cui incontra la sua specifica difficoltà. Poi bisogna abituarlo a servirsi agilmente di sussidi che gli semplificano il compito e indirizzarlo a strategie diverse per affrontarlo. Infine occorre mostrargli come aggirare il problema e come far leva sui propri punti di forza. Immaginiamo per esempio Stefania immessa in un algoritmo simile: non parla quindi bisogna darle dei sussidi. Ma se li era trovati da sé i sussidi, eleggendo una portavoce. Le strategie diverse per lei erano di non rivolgersi più direttamente agli adulti. Quanto ai punti di forza aveva ben trovato modo di farli valere con il silenzio. Vediamo bene il grandangolo che ci apre la psicoanalisi rispetto a questo programma angusto. Tutta la differenza sta nel considerare il bambino e il suo problema, come fa il cognitivismo, e il bambino nella sua soggettività in relazione con l'Altro, come facciamo noi dal punto di vista della psicoanalisi.
Naturalmente l'Altro è inconsistente, è una pasta sfoglia fatta di mille strati. Se si riesce però ad articolare un minimo di dialettica tra l'Altro famigliare e l'Altro scolastico, se si riescono a gestire ragionevolmente i conflitti maggiori presenti in ciascun contesto si vedono subito le cose andare meglio.
La classe in aperta rivolta, per esempio, che menzionavo sopra, non rispondeva più alla guida delle maestre simply because the two teachers were in conflict with each other. Added to this was that the conflict that divided them was sent to parents, in turn, divided into rival factions. It thus produces a climate of mutual disqualification that discredit hours on one now on the other hand, now on a teacher now on the other, with embarrassing squabbles that took place before the eyes of children. You can not find better way to remove a semblance of institutional authority, which put children in a conflict of loyalty where they do not know who to believe. No disciplinary action could restore order if I had not made sgarbugliare this complex knot of children and adults infantilization. Here too can appreciate the safety guide that applied psychoanalysis can offer, for example, simply with the concept of imaginary confrontation, which has no equivalent in the concepts of management of the groups proposed by systems theorists.
Let me conclude by saying at the bottom of a theory as complex as the analytical one, due to which, in particular Lacanian us, we were often accused of over-intellectualization and impractical, offers a box of tools handy and very rich in resources. You only knowing how to serve in a non-dogmatic. In this sense we have of the great advantages with respect to a certain rigidity that I could see application in other frameworks. The debate on standards in our field, belongs to the fifties, which means a remote past. Today, not only in the Freudian Field, but also the most advanced in North American psychoanalysis, for example, as are trends intersubjectivity of postkohutismo, applies the watchword of sdogmatizzazione, with the aim to free themselves from machinery rigid rules, or setting , technology. Even there, the United States that both were suspected to Freud, it is looking to build on principles. Principles are a bit 'different from ours, but where you can talk, and I think this is a sign of the vitality of psychoanalysis in relation to all other trends are born with the vocation to update it.
Marco Focchi
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