A Difficult Beginning: Commencement and Birth in the Analysis of an Adolescent

The author distinguishes between two kinds of beginning, conceptually tied to two ways of approaching the psychoanalytic situation described as <i>epistemological</i> and <i>ontological</i>. Through a clinical case, the author shows how her work with a troubled adolescent had two beginnings that corresponded to these types. In this way, she tries to expand on the literature about the <i>ontological turn,</i> focusing on what <i>beginning</i> means in this context. For treatment to succeed, a <i>birth</i> must emerge, a transformative moment with the potential for significant change. The combined ability to transform the most primitive, somatopsychic pain can be more effective if shared by analysts and patients in a predominantly aesthetic form.