The Contribution of Projective Clinical Work to the Understanding of Repeated Suicide Attempts: The Case of Margaux

The repeated suicide attempts (phlebotomies and hanging attempts) made by Margaux can be seen within the framework of a borderline personality disorder. We attempt to demonstrate the value of a projective clinical approach which, combined with a straightforward clinical approach without additional instruments, makes it possible to understand mental functioning in situations where the presence of a psychosis was initially suspected. This clinical case suggests that self-aggression serves as a way of modulating intense negative affects and that failure in the task of separation-individuation, mobilized by puberty, violently intensifies the archaic defence mechanisms, in this case splitting, coupled with massive projection. In other words, the highly stimulating mental events associated with unconscious sexuality reduce the effort to make contact with the mind and favour recourse to the body in an attempt to expel all mental conflict.