THE WINGS OF ICARUS RISK AND ACCIDENTS IN ADOLESCENCE.
by Paola Carbone


The epidemiological approach in suicidology is confronted with numerous methodological and conceptual limitations that influence underestimation of deliberate self-harm. So-called masked suicidal behaviour is of great interest in this respect.

While Ms. Carbone does not consider accidents in adolescence from a solely suicidological perspective, she provides an interesting psychodynamic interpretation of them through close examination of the related literature. What emerges is a correlation with guilt feelings, the tendency to act out, narcissistic fragility and omnipotence. In this sense, accidents share an area of action which is close to, but does not fully coincide with, attempted suicide: inwardly and outwardly aggressive fantasies are materialized in accidents, but via a short circuit that excludes awareness and intentionality. The Russian roulette metaphor - of inspiration to many authors in the field - likens accidents in adolescence to masked suicide, or to the expression of an unmentalized conflict between living and dying. Hence, as the author stresses, the sole difference between an accident and attempted suicide appears to be the conceivability of the self-destructive plan.

Ms Carbone maintains that the considered literature covers such general questions, commonly present in adolescents, that it cannot be deemed specific to adolescents who have accidents. The psychodynamic model of the accident closely explores puberty (the bodily experience, the Oedipus complex) in addition to correlations with depression, the grieving process, acting out and other aspects variously linked to many adolescent accidents, such as circumstance, hurry, speed, etc..

The experimented research-intervention model is also very interesting and provides a design for secondary accident prevention in adolescence.

We must agree with the theory, reiterated throughout the work, that… the efficacy of (accident, in the same way as suicide) prevention is linked to the duration of the experience and the possibility of making the "object" an active part of the decision-making process.