Summary:

This work focuses on the dilemmatic psychotherapeutic proposal of an 11–year-old girl, developed after arriving at a diagnosis "affective insensitivity", also referred to as severe disturbances in the empathy processes. The analysis and questions raised about the diagnostic and psychotherapeutic process is carried out with the substrate of a relational psychoanalytic approach that maintains that in a strict sense there is no isolated mind, both development and trauma become the contextual and historically situated intersubjective relational dimension. Human becoming is configured in the complex correlations between multiple combinations –conscious and unconscious– of genetic and congenital properties and lived experiences, within the framework of the fans of identifying influences, located in relational matrices, which operate as a substrate of the configurations of empathy.

The psychotherapeutic proposal focused only on a part of Juliet’s manifest behavior and on her manifest need for flattery that –when they are put at risk, a collapse occurs that favors the acting out of extreme violence–, leaves out: –the configuration paths of the problem and its meanings, intra and intersubjective; –conscientious and unconscious intra and intergenerational pacts; –function of defenses and manifest behaviors in intra and intersubjective balance; –risk of invoking unconscious fears at the invitation to be moved by the suffering of others. Likewise, it should be noted that the abused child is left out of the picture and is put at risk of being re-victimized, a ethical failure.

Key words: Psychotherapy | empathy | relational psychoanalysis