The author presents the concept of fear of breakdown (Winnicott, 1963) to think about situations of vulnerability and experiences due to living conditions, social, political, economic and family environment. Fear of breakdown shows that the environment influences the human psyche. Links this concept with maletrê, (Kaës, 2012) or uneasiness, insubstantiality or the evil of being. In the clinic with children, she verifies the presence of early experiences of helplessness due to territorial migrations, unemployed parents, violent or immersed in the use or trafficking of drugs and/or the lack of real conditions of human living. Clinical vignettes show that both concepts are articulated and bring elements to understand the suffering experienced at an early age. It considers the need to reflect on how the psychoanalyst can contribute to listen, feel, think and act together with this population.

And this brings us to the deeper meaning of the term, since we have to use the word “breakdown” to describe the unthinkable state of affairs that underlies the defense organization. (Winnicott, 1974, p.1).

The fear of breakdown, conceptualized by Winnicott in 1963, seems to be a useful concept to think about the situations of vulnerability and experiences that many children experience early due to living conditions and the social, political, economic and family environment. The fear of collapse or breakdown, understood from Winnicottian work as a failure in the organization of defenses, present in psychotic phenomena, shows that the environment has a fundamental influence on the structuring of the human being's psyche.

In this concept we find the germ of what Kaës develops in 2012 with the neologism malêtre of our time, translated by Segoviano (2014) as “uneasiness”, insubstantiality or the evil of being, a pain, a helplessness, an evil in the being of humanity. The failures of the environment experienced early are like a “collapse” in the essence of being. Malêtre or uneasiness introduces the experience of feeling of “not being” that calls into question the ability to exist. The dilemmas typical of the era, which question whether to agree or disagree with oneself, with others and face the vicissitudes of the world around us.

We present some clinical vignettes that show how both concepts are useful, intricate, and provide us with elements to understand the intense suffering of children and adolescents.

The clinic on the borders
We observe in our clinic an increase in pathologies originating from early experiences of collapse, mothers unable to care or "insufficiently good", sometimes, because they themselves have not been cared for. With environmental failures of various origins: unemployed parents, violent and/or immersed in drug use or trafficking, various migrations territorial, social helplessness, lack of conditions to live humanely. Children and adolescents who experience and feel cruelty and hostility that cannot be metabolized, barely expressed in disruptive, criminal behavior or in acts committed against one's own body.

We see a social reality that fractures human beings, difficult living conditions that prevent many of those assigned to care from getting sick. These are families and/or health or education professionals who become mentally ill, without the possibility of acting in a transformative sense of the reality experienced by children and adolescents. Either because they feel powerless in the face of such fractures, or because they try to act and care with the desire to become “savior heroes” from cruel reality. Finally, we need to reflect on how the psychoanalyst can contribute to listening, feeling, thinking and acting with this population.

El malêtre – uneasiness
Kaës (2014), when working on malêtre, or contemporary unease, brings us closer to the feeling of a “loss of psychic place” and the need to find in culture, a place to place what we find. The author quotes Winnicott (1967).

He saw there an extension of the notion of phenomena, objects and transitional spaces: «When using the word culture, I think of the tradition that we inherit. I think of something that is the common heritage of humanity, to which individuals and groups can contribute, and from which each of us will be able to extract something, if we have a place to put what we find. I think it is possible to characterize contemporary unease by the difficulty in constituting that “place to put what we find” Kaës, R. 2014, p. 214.

That place can be given by a group that gives the feeling of belonging to the world, a place where desire circulates, the possibility of creating and feeling valued. The efforts to provide children and adolescents with community spaces, places for meeting, creation, music, and group sports such as volleyball, soccer, dance, music, offered in spaces such as coexistence centers. Psychoanalysts should be in this type of space, contribute and sustain. The listening groups with therapeutic mediators offered to children, adolescents, their parents, those in vulnerable situations, and immigrants are a type of space that we offer “where to put what we find.” In these listening spaces they can place experienced feelings such as violence, rejection, exclusion, homophobia, racism, among others.

The clinic with children and adolescents in vulnerable situations.
In the clinic with children and adolescents we hear stories that move because it is very difficult to conceive that, at an early age, children are subjected to a naturalization of violence, risks that place them between life and death. It is shocking to hear that little Juan, the brother of two imprisoned traffickers, who is less than 10 years old, mentions not being afraid of death when asked about the risks of a police officer or person from the opposite side, to the drug trafficker for whom he works, which mate and responds: "what's the problem, anyway we're all going to die someday."

Or The Story of Tadeo, a story by Bernardo Kucinski² who runs away from home in order to survive maternal violence. He leaves aimlessly, to meet an uncertain destiny, but one that he imagines is safer than receiving the beatings that his mother gave him, when he did not receive his father's pension or for having received a reprimand from the teacher. It is very difficult to hear the mother of an 11-year-old child, cared for in a Psychosocial Care Center (CAPSIJ), say how much it bothers her and she does not want to take care of her son because he is “this child who is not even fit for a small plane.”³

Experiences that could be multiplied and that question the peculiar way of being in the world of some children and adolescents, who apparently go out into the world, without fear, or without caring about their own life or with no other desire than to survive. Survive, to perhaps give life some possibility of being lived, be it, over domination or slavery, subjected to the power of the one who early leads him to crime, for just a piece of bread. Other kids seem to look for a way to heroically immortalize themselves, as if life, being, and “being in the world” were not worth living. At this point, two experiences seem to converge: on the one hand, the feeling of emptiness, typical of the experience described by Winnicott as a breakdown or collapse, and on the other hand, the feeling of the uneasiness of a life that does not seem to be found in the social field. community, family, a network of protection, care.

From the children's clinic in the field of public health, we highlight an increase in cases “diagnosed” as “autistic” or “autistic spectrum”. Many of them, immigrant children, children of parents, fleeing from dictatorial regimes that have little interest in the value of the human being, or from places where having the bare minimum to live with dignity seems impossible due to the living and working conditions. offered to their parents. Thus, feelings of uncertainty, experiences of discontinuity (Puget, 2015) seem to be installed early, imposing links of little support.

These are children who, when they arrive with their parents to the city or country that welcomes them, lose their language, their history, their ancestors, their rituals, myths and customs that would initiate them as beings inserted into a community of belonging. Uprooted, helpless, both they and their parents seeking to survive, adapt to the demands of the country that welcomes them, without being able to adapt, many times, to cultural differences, language, socialization patterns, behavior, schooling. Required, in most cases, to speak the language of the country that hosts them, prohibited from speaking their native language, with a view to “facilitating the learning of the new language” and culture.

The reality of public services that serve populations of children and adolescents, in the social, educational and social fields, is increasingly frequented by children and adolescents with various symptoms, which are no less important than the failures experienced in their family environments. , community, social of origin. Children and adolescents with experiences of little or no support that cause various disruptive symptoms that exclude them from daily coexistence with peers or adults. In general, they live in situations of vulnerability and psychosocial risk, with unemployed parents, underemployed, victims of situations of violence in their environment, their city-country of origin.

We thus verify the presence of a social reality that is close to what Käes (2012) describes as restlessness, the evil-being of our time or, as Puget (2015) postulates, uncertainty and discontinuity, disconcerting ruptures. Regarding the uncertainty linked to contemporary transformations, he reflects.

“The exhaustion of some hypotheses, new problems, natural social and cultural modifications, political conditions and the flow of life disconcert, worry, stimulate, create ruptures” (Puget, 2015, p, 63).

Uncertainty has taken over our daily lives, as reflected in the feeling of diffuse discomfort present in various areas. Regarding political discourse, Puget (2015) comments that the complaints are not only about the crimes committed, as the climate of insecurity creates the elements that justify violence, the exercise of repression by those who should take care of citizens. The general climate is one of hopelessness, it seems that we can do nothing, this also paralyzes us. In Brazil, it is very clear how repression and violence go hand in hand, with the young, the black, and the poor being the most affected.  The so-called principle of uncertainty, according to the author, “connects with the perception of the fragility of belongings, ties and certainties” (Puget, 2015, p.65).

The clinic with children and adolescents is increasingly characterized by the presence of experiences described by Winnicott as the “breakdown” or “fear of collapse” and a feeling of emptiness, accompanied by environments with little or no support. The increase in children and adolescents with autism spectrum diagnoses, attention and concentration disorders, lack of limits, increasingly early pregnancies, suicide attempts, attacks on one's own body - ingesting chemical substances or cutting oneself - requires attention and care that includes the creation of containment spaces and repair of environmental failure. Winnicott was betting that some of the children he cared for could thrive, thanks to the provision of a supportive environment.

Reestablishing a trustworthy environment requires not only caring for the child and adolescent but also caring for their family, school and institutional environment. It is essential to provide a supportive environment, capable of restoring what failed and allowing the necessary passage from non-integration to integration. Working on the environment can mean approaching the school, the shelter and, fundamentally, those who take care of the child and who, at many times, also feel neglected. Another alternative is to approach children and adolescents in listening groups, offering groups with therapeutic mediations, such as theater, painting, drawing, and stories. We are thinking of children and adolescents, for whom poetry, the journey of creative living, seems aborted before becoming subjects.

The fear of collapse - Breakdown
In 1963, Winnicott described the breakdown or fear of collapse as a situation experienced early on of environmental failure, of deprivation when the self-had not yet been integrated, thus describing a defensive organization against what was experienced, unthinkable, since it has no possible record or representation, for having happened before the integration of the self. In psychoneuroses, Freud describes castration anxiety as a defense, and in psychotic states what is prioritized is a failure in the integration of the ego. It is not a traumatic situation capable of being remembered, even if it takes a while, with some difficulty or ease. What Winnicott is going to describe is the existence, I would say, of “non-experiences”, since there is no “memory” of some event, it is something that is much more difficult, it is “nothing having happened when something useful could have happened, establishing itself.” thus the sensation of emptiness” (Winnicott, 1963/1994, p.75).

The fear of collapse is not something that can be verbalized as when one says “I am afraid of dogs” or “fear of facing life”, it is a sensation, a defense that is articulated in the face of the imminence of falling, detaching oneself from any moment, without being supported by a gaze – sustaining – typical of the maternal function. The collapse, Winnicott claims, would have occurred and been stored without registration, without representation, just as an unnameable anguish. Anguish that could arise in moments where similar failures occur in a subject's life. We particularly think that experiences such as exile, immigration or migration, the absence of maternal care, massive living with children, without a caring gaze can favor the emergence of these experiences.

We assisted a young adult who, at the time of immigrating to a first world country, with the expectation of improving his working condition in a first world country, was unable to live and adapt to the demands that the new reality imposed on him. He experienced various breakdowns throughout some years of immigration: not being able to continue the work he was doing in his country of origin, having to perform tasks for which he did not feel prepared, separating from his partner. The feeling of anguish was constant, he lived with various bodily symptoms, depressions from which he could not get out. Sometimes he attributed it to the medication, other times to the lack of listening and understanding of the concerns that tormented him, which he said did not give him value, due to the cultural difference, the lack of empathy from the doctors, other times, to the feeling of loss and impossibility of return to their country of origin.

At various times during his stay in that country he felt broken and prevented from living, loving and working. It was not very easy to rescue or connect in the way that, as a baby, he had lived with a depressed mother, who could not support him with a loving gaze, absorbed in her own sad memories, of uprooting, of losing her origins. She seemed to barely live to please a husband, as if the child (newborn or grown) had no existence, as if nothing happened “when something good could have happened” (Winnicott, 1963/2000, p.118). Her mother had also left her country of origin, and seemed to have never integrated into the country that welcomed her, going into exile due to a military dictatorship that prevented her from continuing to live in her own country. Both mother and son seemed incapable of being able to live, assimilate the changes, the new experiences, and integrate into the country that welcomed them or that they had chosen to live in.

El Malêtre – or unease, bad being, restlessness
Kaës (2012) considers that the cultural malaise described by Freud (1929) does not consider the characteristics of what is currently experienced, such as failures in the way of making links, in the ineffectiveness of social metaframework guarantors. Failures at this level affect the “metapsychic guarantors of psychic life.” The contracts, the alliances, the pacts would articulate the individual psyche with the social, the subject becomes I, from the functioning of these contracts, but if from the social this base is broken, in what way can the subject be sustained. The author creates the neologism “Malêtre” to describe the feeling of dissatisfaction, discontent characterized by psychic life being “shaken” due to this weakening that calls into question the ability to exist.

The question at hand, writes Rene Kaës, “is that of the greatest obstacles that hinder the process of subjectivation, the becoming of the self, the very capacity to exist, to establish ties and to form a society.”

I form the neologism “Malêtre”, without a hyphen, as we say abuse or malformation or “deser” (désêtre), because it is about pain, helplessness and evil in the very being of humanity. Without a doubt great words, but also great evils that force clinical analysis, metapsychological construction and ontological interrogation to coexist (Kaës, 2012, p.4, italics added)

What has changed, since Freud's writing between two wars, Unrest in Culture, are the socio-historical conditions that we could call the world before and after Auschwitz, following countless thinkers. According to the author, “the intersubjective and intergenerational contract” that could function as a guarantor or meta social framework, the feeling of belonging to a group, a collective, is weakened, “in pieces” (Kaës, 2014, p. 209). The social spaces, the contracts, the organizing stories (myths, beliefs) that could serve as protection are broken.

The protection of the closest environment (family, school) in cases like Tadeu does not seem to work, the school is not sensitive to the body marks with which Tadeu arrives at school, or, for example, the lack of a lunch in the school. recreation. On the other hand, when we hear some Bolivian immigrants, who leave their places of origin called to work in “offices”⁴ in Brazil and expect that the “countryman” could be considered as someone who would protect them in a foreign country and not support them in slave conditions⁵. One of the stories of a family care shows the story of the brother and sister-in-law having brought them to work in San Pablo, and when she becomes pregnant, the sister-in-law tells her that “she brought them to work and not to have a baby.” This couple, like many Bolivian immigrants, will be kept in the condition of “slaves” since they will not be able to have their documents until they have paid the ticket and expenses with maintenance. Many of them spend years in this condition.

The link – Vincular - Clinic
It is within the framework of our work with immigrants as my postdoctoral research, with emphasis on the use of the therapeutic mediator called group pictogram and its use in therapeutic consultations with families, couples and groups that we confirm the close relationship between the concepts of breakdown or collapse and malêtre. And, it is precisely this clinic that leaves the private sphere, of classical psychoanalysis, of the couch, that goes to meet the social field, that brings questions, new paradigms and revision of concepts.

We agree with Kaës' statement that work with other devices such as groups, families, institutions have allowed the emergence and expansion of some concepts, highlighting the recognition of the simultaneous presence of three psychic spaces, articulated with each other, marked with particular unconscious productions. , typical of the encounter and interference of the three spaces: the singular or intrapsychic subject constituted as the subject of a link, the intersubjective space and the group space. Each of these spaces is defined by specific properties, but also by the conscious and unconscious relationships that exist between them. And, it is certainly Winnicott, the precursor, or thinker who opens the possibility of psychoanalysis to think beyond the intrapsychic, the place of maternal presence, with its functions of containing, caressing, naming the world and thus considering the founding value of the environment. He is a psychoanalyst, a thinker who finds the relationship between the intrapsychic and the social fundamental.