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Exploration de la projection vers l’avenir de jumeaux ayant vécu la maladie et le deuil de leur double à l’aide du dessin d’une personne cueillant une pomme sur un arbre 通过画一个人从树上摘苹果,探索在双胞胎生病和悲伤中幸存下来的双胞胎的未来前景
Q4 Medicine Pub Date : 2025-01-31 DOI: 10.1016/j.neurenf.2025.01.004
B. Plouvier, E. Bouteyre-Verdier

Objective

Few studies have been carried out in the field of pediatric palliative care concerning the experience of siblings, especially of twins. While some research has highlighted the impact of a child's disease and bereavement on his or her siblings, to our knowledge, no study became interested in the projection into the future of children and teenagers who have experienced the disease and bereavement of a twin.

Methods

Using the Person Picking an Apple from a Tree drawing (Gantt and Tabone, 1998) and a semi-directive interview, this study examined the way in which two teenagers aged twelve and seventeen who have experienced their twin's disease and lost, project themselves into the future.

Results

These teenagers’ projection into the future is marked by the experience of their double's disease and bereavement. Strong fears of disease transmission and death were identified, making them worried of their future and of becoming parents. The identity upheaval and the need to learn to live without the other were particularly noticed.

Discussion

Questioning the way in which bereavement is experienced before reaching adulthood, the collected data raise the question of how to support these bereaved twins (and, more broadly, siblings) in the face of growing questions about death.

Conclusions

This study confirms the need to give voice to these bereaved siblings and offer them appropriate therapeutic support.
目的在小儿姑息治疗领域,关于兄弟姐妹尤其是双胞胎的经验研究很少。虽然一些研究强调了儿童的疾病和丧亲之痛对他或她的兄弟姐妹的影响,但据我们所知,没有研究对经历过疾病和丧亲之痛的儿童和青少年对未来的预测感兴趣。方法采用《从树上摘苹果的人》(Gantt and Tabone, 1998)和半指导性访谈,本研究考察了两个分别为12岁和17岁的青少年,他们经历了双胞胎的疾病,并失去了他们,他们对未来的规划。结果这些青少年对未来的预测以双亲的疾病和丧亲经历为特征。对疾病传播和死亡的强烈恐惧使他们对自己的未来和成为父母感到担忧。身份的剧变和学会在没有他人的情况下生活的需要尤其引人注目。讨论:收集到的数据质疑了人们在成年前经历丧亲之痛的方式,并提出了一个问题:在面对越来越多的关于死亡的问题时,如何支持这些丧亲的双胞胎(以及更广泛地说,兄弟姐妹)。结论本研究证实了我们有必要为这些失去亲人的兄弟姐妹发声,并为他们提供适当的治疗支持。
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引用次数: 0
Inceste au sein d’une fratrie : spécificités cliniques, modèles explicatifs, qualification juridique et principes de la prise en charge 兄弟姐妹中的乱伦:临床特征、解释模型、法律资格和照顾原则
Q4 Medicine Pub Date : 2025-01-17 DOI: 10.1016/j.neurenf.2025.01.001
H. Albadine , L. Mesquida , A. Revet
Sibling sexual abuse is the most widespread form of incest and is often perceived as being normal, consensual sexual exploration. As little is revealed by the victims and little is reported by healthcare professionals, this can have serious physical and psychological consequences for the victims. This article develops, in the field of child and adolescent psychiatry, the perspectives opened by the law of 21 April 2021 aimed at protecting minors from sexual offences and incest and by the report of the “Commission indépendante sur l’inceste et les violences sexuelles faites aux enfants” (CIIVISE ; Independent Commission on Incest and Sexual Violence against Children) published in November 2023. The aim of this study is to help healthcare professionals gain a better knowledge and understanding of this complex phenomenon, to appreciate its scale, to have access to theoretical models to guide their understanding, to be aware of recent legal developments and their resulting medico-legal obligations, and to provide them with practical guidelines for caring for patients and their families. Disclosure of incest usually leads to a major family crisis requiring multidisciplinary care for the victim, the perpetrator and the family as a whole, through individual and group interventions. Professional secrecy can be broken when it comes to reporting abuse of minors, and prevention is crucial. Thus the question of incest should be raised more systematically during interviews. Finally, this article highlights the need for future work aimed at establishing precise protocols and recommendations for professionals.
兄弟姐妹性虐待是最普遍的乱伦形式,通常被认为是正常的,双方同意的性探索。由于受害者透露的情况很少,卫生保健专业人员报告的情况也很少,这可能对受害者造成严重的身心后果。在儿童和青少年精神病学领域,本文发展了2021年4月21日旨在保护未成年人免遭性犯罪和乱伦侵害的法律以及“防止乱伦和未成年人性暴力侵害委员会”的报告所开辟的视角(文明社会;《乱伦和性暴力侵害儿童问题独立委员会》于2023年11月出版。本研究的目的是帮助医疗保健专业人员更好地了解和理解这一复杂现象,了解其规模,获得理论模型来指导他们的理解,了解最近的法律发展及其产生的医疗法律义务,并为他们提供照顾患者及其家属的实用指导方针。揭露乱伦通常会导致重大的家庭危机,需要通过个人和团体干预,对受害者、肇事者和整个家庭进行多学科的照顾。当涉及到报告虐待未成年人时,职业保密可以被打破,预防是至关重要的。因此,在采访中应该更系统地提出乱伦问题。最后,本文强调了未来工作的需要,旨在为专业人员建立精确的协议和建议。
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引用次数: 0
Santé mentale des jeunes durant la crise Covid-19 : une revue systématique de l’enfance au début de l’âge adulte 2019冠状病毒病危机中的青少年心理健康:从童年到成年早期的系统回顾
Q4 Medicine Pub Date : 2025-01-15 DOI: 10.1016/j.neurenf.2024.12.002
A. Mauroy , M. Rossignol , C. Dieu , F. Laforgue , S. Lahrour , A. Sibeni , J. Gaugue
To better understand the effects of a crisis on youth mental health, a systematic review was conducted on the impact of Covid-19 on the mental health of young people aged 0 to 25. We carried out a systematic search for scientific articles in five online databases. Only peer-reviewed articles investigating the effects of Covid-19 on youth mental health and published prior to November 2021 were included. Articles have been coded by several researchers to ensure reliability. After sorting, the search identified 212 references included in this review. Results are presented by age (infancy, childhood, adolescence, early adulthood) and by Covid-related themes (mental health before/during crisis, social restrictions, Covid-19 information, environmental conditions, Covid-19 infection, daily activities, school/work). Results highlight a deterioration in mental health at the third onset of the Covid-19 crisis, regardless of age. However, the symptomatic expression of the difficulties experienced differed according to age. Among the factors aggravating mental health difficulties, history of mental health problems and familial consequences of Covid-19 are discussed. In addition, protective factors are also highlighted, such as social support and maintaining routines.
为了更好地了解危机对青少年心理健康的影响,我们对Covid-19对0至25岁年轻人心理健康的影响进行了系统回顾。我们对5个在线数据库中的科学文章进行了系统的检索。只纳入了同行评议的研究Covid-19对青少年心理健康影响的文章,并在2021年11月之前发表。文章已由几位研究人员编码,以确保可靠性。整理后,检索到纳入本综述的212篇文献。结果按年龄(婴儿期、童年期、青春期、成年早期)和与Covid-19相关的主题(危机前/危机期间的心理健康、社会限制、Covid-19信息、环境条件、Covid-19感染、日常活动、学校/工作)分列。结果显示,在Covid-19危机第三次爆发时,无论年龄大小,心理健康状况都在恶化。然而,所经历的困难的症状表现因年龄而异。在加重精神健康困难的因素中,讨论了精神健康问题史和Covid-19的家庭后果。此外,还强调了保护因素,如社会支持和维持常规。
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引用次数: 0
La prescription de médicaments psychotropes chez l’enfant et l’adolescent en France : caractéristiques et évolution entre 2010 et 2023 法国儿童和青少年精神药物处方:2010年至2023年的特点与演变
Q4 Medicine Pub Date : 2025-01-07 DOI: 10.1016/j.neurenf.2024.12.001
S. Ponnou , X. Briffault , V. Aragno , B. Thomé , F. Gonon
<div><h3>Context</h3><div>Questions related to the consumption of psychotropic medications among children and adolescents have garnered sustained interest in scientific literature and public debates at the international level. In France, prevalence data have not been updated since 2010. The aim of this article is to analyze the French National Health Data System Sample (ESND) to describe the trends in psychotropic medication use in the pediatric population between 2010 and 2023, as well as the various clinical, demographic, and social variables that may contribute to prescribing practices.</div></div><div><h3>Methods</h3><div>We conducted a systematic analysis of psychotropic medication consumption among individuals aged 0–17 in the ESND (2% of the French population) between 2010 and 2023, focusing particularly on the following drug classes: N05A antipsychotics, N05B anxiolytics, N05C hypnotics and sedatives, N06A antidepressants, N06B psychostimulants, N03 antiepileptics, and N04 antiparkinsonians.</div></div><div><h3>Results</h3><div>The incidence of psychotropic medication use among children and adolescents declined from 2.30% in 2011 to 2.14% in 2023. The prevalence of psychotropic medication use among those aged 3–17 rose from 3.25% in 2011 to 3.94% in 2023. More specifically, this prevalence increased from 2.32% in 2011 to 3.22% in 2023 among children aged 6–11. Among adolescents aged 12–17, it rose from 4.96% in 2011 to 5.49% in 2023. Between 2010 and 2023 the number of prescriptions per year per patient increased for most therapeutic classes, particularly for hypnotics (+137%), antidepressants (+88%), antiepileptics (+62%), antipsychotics (+50%), and psychostimulants (+40%). The duration of treatment varied significantly between therapeutic classes, being limited to one month for anxiolytics and antidepressants. Median treatment durations for other ATC classes were particularly long. The number of months of use increased by +76% between 2010 and 2023, rising from 80 months per 1000 individuals in 2010 to 138 months per 1000 individuals in 2023, with an acceleration in the period from 2021 to 2023. Poly-prescriptions were common and involved all medication classes. In 2022, 72% of psychotropic medications for children were prescribed by general practitioners, 7% by pediatricians, and 9% by psychiatrists and child psychiatrists. In 2022, 30% of children receiving at least one psychotropic prescription lived in socially disadvantaged conditions – a rate which was 50% for antipsychotics. Psychotropic medication use in children and adolescents increased during the COVID crisis and continued to rise until 2023.</div></div><div><h3>Discussion and conclusion</h3><div>The analysis of the ESND confirms a general increase in the prevalence of psychotropic medication use in the pediatric population, marked by a rise in the number of boxes per year per patient and a lengthening of treatment durations for many drug classes. Incidence remained stable an
与儿童和青少年使用精神药物有关的问题在国际一级的科学文献和公开辩论中引起了持续的兴趣。在法国,患病率数据自2010年以来没有更新过。本文的目的是分析法国国家卫生数据系统样本(ESND),以描述2010年至2023年间儿科人群中精神药物使用的趋势,以及可能影响处方实践的各种临床、人口统计学和社会变量。方法系统分析2010年至2023年ESND(占法国人口的2%)0-17岁人群的精神药物使用情况,重点关注以下药物类别:N05A抗精神病药、N05B抗焦虑药、N05C催眠药和镇静剂、N06A抗抑郁药、N06B精神兴奋剂、N03抗癫痫药和N04抗帕金森药。结果儿童青少年精神药物使用率由2011年的2.30%下降到2023年的2.14%。3-17岁青少年精神药物使用率由2011年的3.25%上升至2023年的3.94%。更具体地说,6-11岁儿童的患病率从2011年的2.32%上升到2023年的3.22%。在12-17岁的青少年中,这一比例从2011年的4.96%上升到2023年的5.49%。在2010年至2023年期间,大多数治疗类药物每年每位患者的处方数量都有所增加,特别是催眠药(+137%)、抗抑郁药(+88%)、抗癫痫药(+62%)、抗精神病药(+50%)和精神兴奋剂(+40%)。治疗持续时间在不同治疗类别之间差异显著,抗焦虑药和抗抑郁药限制在一个月。其他ATC类的中位治疗持续时间特别长。从2010年到2023年,使用手机的月数增加了76%,从2010年的每1000人80个月增加到2023年的每1000人138个月,并在2021年到2023年期间加速增长。多重处方很常见,涉及所有药物类别。2022年,72%的儿童精神药物由全科医生开具,7%由儿科医生开具,9%由精神科医生和儿童精神科医生开具。2022年,在接受至少一种精神药物处方的儿童中,有30%生活在社会弱势环境中,而服用抗精神病药物的儿童中这一比例为50%。在COVID危机期间,儿童和青少年使用精神药物的情况有所增加,并持续上升至2023年。讨论和结论ESND的分析证实了儿科人群中精神药物使用的普遍增加,其特征是每位患者每年的药箱数量增加,许多药物类别的治疗持续时间延长。发病率保持稳定,并在此期间略有下降,这表明处方做法发生了变化。自COVID期间以来抗抑郁药和抗焦虑药处方的增加与国际数据一致,而精神兴奋剂使用的持续增加可能代表了法国特有的趋势。
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引用次数: 0
Développement de la compréhension du lexique mathématique de la MSM au CM2 à partir de quatre épreuves d’évaluation orthophonique 从MSM到CM2数学词汇理解的发展,基于四项语言评估测试
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.1016/j.neurenf.2024.11.006
A. Lafay , M.C. Helloin
Mathematical vocabulary predicts the development of mathematical skills. The aims were to evaluate the construct validity of four subtests assessing children's understanding of mathematical vocabulary and to provide developmental benchmarks of word acquisition. A group of 535 French children from preschool (4–5 years old) to the fifth grade completed from one to four tests of mathematical vocabulary comprehension from the Examath 5-8, Examath 8-15, and Exalang 8-11 tests. The results showed that preschoolers understood fewer mathematical words or expression than kindergarteners, who understood fewer mathematical words than first graders, and so on. Moreover, some words were already understood by the preschoolers (e.g.: first, add), while others were still being acquired by fifth graders (e.g.: as many) or not yet acquired (e.g.: dividend, product). These benchmarks on the acquisition of mathematical vocabulary in French-speaking schoolers, available for practitioners, will provide useful support for mathematical assessment and intervention in typically developing children and those at risk for difficulties.
数学词汇预示着数学技能的发展。目的是评估评估儿童数学词汇理解的四个子测试的构念效度,并提供词汇习得的发展基准。535名从学龄前(4-5岁)到五年级的法国儿童完成了从Examath 5-8、Examath 8-15和Exalang 8-11测试的一到四项数学词汇理解测试。结果显示,学龄前儿童对数学词汇或表达的理解比幼儿园儿童少,幼儿园儿童对数学词汇的理解比一年级儿童少,等等。此外,有些单词学龄前儿童已经理解了(如:first, add),而其他单词仍在五年级学习(如:as many)或尚未掌握(如:dividend, product)。这些关于法语学生数学词汇习得的基准可供从业人员使用,将为正常发展儿童和有困难风险的儿童的数学评估和干预提供有用的支持。
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引用次数: 0
Étude qualitative du vécu du harcèlement par les adolescents victimes 对青少年性骚扰受害者经历的定性研究
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.1016/j.neurenf.2024.11.005
M. Roques , D. Laimou , M. El Husseini , D. Drieu , A.-V. Mazoyer , S. Spiers , P.-J. Egler , E. Baranger
This research proposes to understand the experiences of 21 teenage victims of harassment with a preventative and therapeutic aim. After the persons involved in the research arrived at a consensus around the definition of harassment, we re-examined the psychological impact and harmful consequences of such violence. Using interpretive phenomenological analysis (IPA) as the approach to the qualitative analysis of the discourse that the research team used to understand the lived experience of harassment, we identified four sub-themes: - internalized violence; - harassment and the questioning of identity; - lack of support; - harassment as enabling possible changes. With these sub-themes in mind, the research group discussed harassment as exposing issues linked to adolescence, which also can be understood as including the inability to contemplate such issues (such as bodily transformations, puberty, relationships with others, etc.). At the end of our discussions we reflected and proposed various tools and approaches that could be used to “mobilize” (maybe stimulate?) symbolization capacity such as the theater of the oppressed or even of family groups.
本研究旨在了解21名青少年性骚扰受害者的经历,以预防和治疗为目的。在参与研究的人就骚扰的定义达成共识后,我们重新审视了这种暴力的心理影响和有害后果。使用解释现象学分析(IPA)作为研究团队用来理解骚扰生活经验的话语的定性分析方法,我们确定了四个子主题:-内化暴力;-骚扰和对身份的质疑;-缺乏支持;-骚扰,使可能的变化。考虑到这些次要主题,研究小组将骚扰视为与青春期相关的暴露问题,也可以理解为包括无法思考这些问题(如身体变化,青春期,与他人的关系等)。在讨论结束时,我们反思并提出了各种可以用来“动员”(也许是刺激?)符号化能力的工具和方法,例如被压迫者甚至家庭群体的戏剧。
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引用次数: 0
Risk factors for sex trafficking of domestic minors: An umbrella review of recent international literature 国内未成年人性交易的危险因素:近期国际文献综述
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.1016/j.neurenf.2024.10.003
N. Proia-Lelouey , G. Desquesnes

Purpose

The sex trafficking of domestic minors remains a major problem despite the many laws designed to protect them. This risk has expanded to an unprecedented scale through the Internet and social networks. However, there are no reliable data on prevalence.

Methods

The authors carried out an umbrella review of the literature on the risk of sexual exploitation among young people by conducting a narrative analysis of the six most recent literature reviews.

Results

A strong congruence among sociodemographic, economic, and family factors was identified. The review was useful in highlighting the complexity of the process of recruitment and retention in prostitution, and in reflecting on protection strategies for young people.

Discussion

There is a debate about whether girls are at greater risk than boys, but all authors agree that the age group most at risk is young people aged 12 to 14. However, no author links this to their adolescence, or considers the impact of this phase of development on the potential risk behaviors of these young people. The main finding of contemporary studies is the negative involvement of intermediary institutions such as schools and welfare services. However, these authors did not use these data in their recommendations. This should be a priority in future prevention programs.
目的尽管有许多旨在保护国内未成年人的法律,但对他们进行性交易仍然是一个主要问题。这种风险已经通过互联网和社交网络扩大到前所未有的规模。然而,没有关于患病率的可靠数据。方法:作者通过对最近的六篇文献综述进行叙事分析,对有关年轻人性剥削风险的文献进行了总括性综述。结果社会人口、经济和家庭因素具有较强的一致性。这项审查有助于突出招募和保留卖淫人员过程的复杂性,并有助于反思保护青年人的战略。讨论关于女孩是否比男孩更容易患自闭症存在争议,但所有作者都同意,风险最大的年龄组是12至14岁的年轻人。然而,没有作者将这与他们的青春期联系起来,或者考虑到这一发展阶段对这些年轻人潜在风险行为的影响。当代研究的主要发现是学校和福利服务等中介机构的消极参与。然而,这些作者并没有在他们的建议中使用这些数据。这应该是未来预防项目的重点。
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引用次数: 0
Agenda Neuado – 2025 新议程- 2025
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.1016/j.neurenf.2025.01.002
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引用次数: 0
Les fonctions exécutives et leur influence sur les performances académiques chez les enfants d’âge scolaire en Tunisie 行政职能及其对突尼斯学龄儿童学习成绩的影响
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.1016/j.neurenf.2024.11.008
S.-E. Saadi

Objectives

Executive functions are essential cognitive abilities that help children adapt to the school environment, thus facilitating their academic success. This study used a correlational approach to examine the relationship between executive functions and academic performance in school-aged children in Tunisia. The focus was on understanding how different components of executive functions, such as working memory (WM), mental flexibility, and inhibition, relate to achievement in core subjects including language-related subjects, mathematics, and sciences.

Patients and methods

A sample of 180 children, aged 7 to 12 years old, was assessed using the Behavioral Rating Inventory of Executive Function (BRIEF) which was filled out by both parents and teachers. The BRIEF is a well-established tool for evaluating executive functions in children and provides a comprehensive view of their behavior in different settings.

Results

The analysis showed strong correlations between working memory (WM) and performance in language arts and mathematics, as reported by teachers. Correlations were weaker for mental flexibility and inhibition in language arts and moderate for mathematics. Parent evaluations revealed generally weaker correlations in language arts, though moderate correlations were found for mathematics. No significant correlation was identified for science across all executive functions assessed in both types of evaluations. Additionally, other executive functions, such as planning/organization, showed strong correlations with language arts and mathematics in teacher evaluations and moderate correlations in parent evaluations. Inhibitory control displayed strong correlations with language arts and mathematics according to teachers but more moderate correlations in parent evaluations.

Discussion

The results revealed notable variability between teacher and parent assessments. Teachers reported stronger correlations between executive functions and academic performance. The lack of significant correlations for science in both evaluations contrasts with conclusions typically reported in the literature. These discrepancies may be explained by the use of different assessment tools in various studies, cultural factors, or specific characteristics of science instruction in Tunisia within the context of this sample.

Conclusion

Executive functions play a key role in primary school students’ academic success. Understanding their link to academic performance would help identify students in need of additional support and facilitate the implementation of targeted remediation programs. Future research should consider factors that influence the assessment of these functions. Furthermore, exploring the relationship between executive functions and academic achievement through predictive models would represent a promising avenue to analyz
目的执行功能是帮助儿童适应学校环境的基本认知能力,从而促进他们的学业成功。本研究采用相关方法来研究突尼斯学龄儿童的执行功能与学业表现之间的关系。研究的重点是了解执行功能的不同组成部分,如工作记忆(WM)、心理灵活性和抑制力,与核心科目(包括语言相关科目、数学和科学)的成绩之间的关系。采用由家长和老师共同填写的执行功能行为评定量表(BRIEF)对180名7 ~ 12岁儿童进行评估。简要报告是一种完善的评估儿童执行功能的工具,并提供了他们在不同环境下的行为的全面视图。结果分析显示,工作记忆(WM)与教师报告的语言艺术和数学成绩之间存在很强的相关性。语言艺术方面的心理灵活性和抑制力的相关性较弱,数学方面的相关性中等。父母的评价显示,在语言艺术方面的相关性普遍较弱,尽管在数学方面发现了中度相关性。在两种类型的评估中,没有发现科学与所有执行功能之间的显著相关性。此外,其他执行功能,如计划/组织,在教师评价中与语言艺术和数学表现出很强的相关性,在家长评价中表现出适度的相关性。抑制控制在教师评价中与语言艺术和数学表现出较强的相关性,而在家长评价中表现出较弱的相关性。讨论结果揭示了教师和家长评估之间的显著差异。教师报告说,执行功能和学习成绩之间存在更强的相关性。在这两项评估中,科学方面缺乏显著的相关性,这与文献中通常报道的结论形成了对比。这些差异可能是由于在不同的研究中使用不同的评估工具、文化因素或本样本背景下突尼斯科学教学的具体特征所造成的。结论执行功能在小学生学业成功中起关键作用。了解他们与学习成绩的联系将有助于确定需要额外支持的学生,并促进有针对性的补救计划的实施。未来的研究应考虑影响这些功能评估的因素。此外,通过预测模型探索执行功能与学业成绩之间的关系,将为分析其预测中期学业成绩的潜力提供一条有希望的途径。
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引用次数: 0
Construire, déconstruire, reconstruire les souvenirs : l’inlassable tâche du patient en psychothérapie, l’indéfectible engagement du thérapeute ? À propos de quelques particularités dans l’accompagnement psychothérapique des enfants et des adolescents 构建、解构、重建记忆:患者在心理治疗中孜孜不倦的任务,还是治疗师孜孜不倦的承诺?关于儿童和青少年心理治疗支持的一些特点
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.1016/j.neurenf.2024.10.002
C. Mille, M. Braun, O. Yendjadj
Remembering, again and again, to solve the enigma of a symptomatic expression related to a burrowed suffering, such is the response of a more or less zealous neurotic patient to his or her psychoanalyst's implicit expectations. The stream of screen memories is churned out in a transference field of attraction and renders the suitable material to develop successive drafts of a “explanatory biography”. Traumatic memories which are the most present in the patient's memory often get their affective and emotional charge from an afterwardsness effect and invite one to pursue research in other regredient ways towards an older past. It is evident though that the therapist is not able to reach “pure memories”, and that in the course of time only “pivotal” memories show up around which fantasies spin and strengthen. Yet we know about Freud's persistence, even after he gave up on his “Neurotica” in “searching for the source of the Nile”, that is to say having access to the oldest memories, and how he hung onto his first conception according to which fantasies would only emerge from a previous experience. The constructions from the psychoanalyst, put together based on his theoretical bedrock, have thus the function of filling in the gaps of memory and in favourable cases allow the patient's associations to be revitalised and help the emergence of even more concealed memories. They are also supposed to be plausible hypotheses for the reconstruction of traces from a non-memorable past. Memories also contribute to forge a sense of identity and come within the scope of everyone's “identificatory compromise”. Consequently, the therapist's role could consist of supporting the work of the “I, historian” his patient is trying to make, taking into account the narratives from his kin, the noteworthy moments in the course of his life, and the way he cares about his self-image. It comes down to the therapist to help the patient with splitting off from the official versions which summon him to an incontestable place in the generations succession or in the family dynamics. In this perspective, the psychotherapeutic work aims to give value to the memories that might lead to new prospects but may encounter difficult obstacles to overcome. A child in psychotherapy is barely preoccupied by remembering the past, which does not prevent him from being sensitive to the fact that his therapist might make references to material from former sessions or remind him what was going on at the moment they met. A teenager's position is fundamentally different: he might not tolerate being relegated to the persistent role of the infantile when he is trying to be acknowledged in his teenage identity. He can, however, rediscover the pleasure of telling, portraying himself as the therapist suggests wordings and rewordings. Naturally, each case appears to be different from one teenager to another, depending on the underlying psychopathological organisation of their personality. Some of
一次又一次地记住,要解开与埋藏的痛苦有关的症状表达之谜,这就是一个或多或少热心的神经病患者对他或她的精神分析学家的隐性期望的反应。屏幕上的记忆流在吸引的移情场中被炮制出来,并为一部“解释性传记”的连续草稿提供了合适的材料。创伤性记忆是患者记忆中最重要的部分,它们的情感和情绪往往来自事后效应,并促使患者以其他悔恨的方式对过去进行研究。很明显,治疗师无法达到“纯粹的记忆”,随着时间的推移,只有“关键的”记忆出现,幻想围绕着这些记忆旋转和加强。然而,我们知道弗洛伊德的坚持,即使在他放弃了他的“神经学”,“寻找尼罗河的源头”之后,也就是说,他可以接触到最古老的记忆,以及他如何坚持他的第一个概念,根据这个概念,幻想只会从以前的经历中出现。精神分析学家在其理论基础上构建的结构具有填补记忆空白的功能,在有利的情况下,可以使患者的联想重新焕发活力,并帮助出现更多隐藏的记忆。它们也被认为是一种貌似合理的假设,可以用来重建一个不值得记忆的过去的痕迹。记忆也有助于形成一种认同感,并在每个人的“身份妥协”范围内。因此,治疗师的角色可能包括支持“我,历史学家”的工作,考虑到他的亲属的叙述,他生命过程中值得注意的时刻,以及他关心自己的自我形象的方式。这归结为治疗师帮助病人从官方版本中分离出来,这些版本召唤他在世代继承或家庭动态中处于无可争议的位置。从这个角度来看,心理治疗工作的目的是赋予记忆的价值,这些记忆可能会带来新的前景,但可能会遇到难以克服的障碍。一个接受心理治疗的孩子几乎不会被过去的记忆所占据,这并不妨碍他对这样一个事实保持敏感:他的治疗师可能会参考以前治疗的材料,或者提醒他在他们见面的那一刻发生了什么。而青少年的处境则完全不同:当他试图承认自己的青少年身份时,他可能无法忍受被贬为一个持续的婴儿角色。然而,他可以重新发现讲述的乐趣,按照治疗师建议的措辞和措辞来描绘自己。当然,每个青少年的情况似乎都是不同的,这取决于他们性格中潜在的精神病理组织。他们中的一些人似乎没有记忆,或者已经把过去抹去了,而另一些人似乎被理想化的童年束缚着怀旧之情,或者被痛苦的过去所吸引,永远无法摆脱。因此,视情况而定,治疗师将不得不扮演探矿者、档案保管员、重新解释者、历史学家,甚至是参与生活史过程的人。
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Neuropsychiatrie de l''Enfance et de l''Adolescence
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