Evolution Psychiatrique最新文献_第10页

Les pavés du dire, ou quand la rue se fait réseau soignant Les pavés du dire，或当街道成为护理网络时

IF 0.6 4区医学 Q4 PSYCHIATRY

Evolution Psychiatrique

Pub Date : 2024-12-01 Epub Date: 2024-06-12 DOI: 10.1016/j.evopsy.2024.05.004

Camille Veit (Psychologue clinicienne, Docteure en psychologie, Maîtresse de conférences en psychopathologie clinique)

Goals

“I am a housed homeless person”. This statement says something about the experience of constructing an address – a term whose polysemy is immediately obvious in the context of therapeutic practices with people who frequent or have frequented the street. Under certain conditions, how can the street become a constellation of care?

Method

The street is considered here from the perspective of institutional psychotherapy, Lacanian psychoanalysis, and phenomenology. I take a retrospective look at a clinical case, providing insights into, on the one hand, the creation of “spaces of habitability” (de Certeau) and, on the other, the “shared caregiving function” (Tosquelles). I discuss the clinical implications of these findings, as well as their impact on support and accommodation services for the unhoused.

Results

The street doesn’t exist: this is a prerequisite for any possible practice with whoever stays, lives, or makes use of the street. Thus, there is no “street” that can be essentialized: it is constantly made and unmade by those who cross it and inhabit it. The uses of the street – the ways in which it is inhabited – are considered on a case-by-case basis. A distinction between circulation, homelessness, and wandering is then sketched out, based on the concept of “pedestrian enunciation” (Michel de Certeau).

Discussion

Dwelling is always an attempt at dealing with dreams, ideals, and the impossible. Inhabitable spaces are created between shelters, homes, displacements, and circulations. From a clinical perspective, taking these singular ways of living into account is a prerequisite for any possible encounter. Sometimes, this encounter has therapeutic or even psychotherapeutic effects.

Conclusion

In light of the above, clinicians should be mindful of adopting a unanimously militant stance, a theoretical withdrawal, charitable kindness, or a desire to rehabilitate at all costs. These slippages are inevitably revealed as such in the interstices of a practice that should be polyphonic.

目标 "我是一个有住房的无家可归者"。这句话道出了构建一个地址的经验--在对经常或曾经经常在街头出现的人进行治疗的过程中，这个术语的多义性是显而易见的。在某些条件下，街道如何才能成为一种关怀的集合体？方法这里从机构心理治疗、拉康精神分析和现象学的角度来探讨街道。我对一个临床病例进行了回顾性研究，一方面对 "可居住性空间"（德-塞尔托）的创造，另一方面对 "共同的护理功能"（托斯克勒斯）进行了深入探讨。我将讨论这些发现的临床意义，以及它们对为无家可归者提供的支持和住宿服务的影响。结果街道并不存在：这是与任何逗留、居住或使用街道的人开展任何可能的实践的先决条件。因此，不存在可以被本质化的 "街道"：街道是由那些穿过街道和居住在街道上的人不断创造和不创造的。街道的用途--街道的居住方式--要根据具体情况来考虑。然后，根据 "行人表达"（Michel de Certeau）的概念，勾勒出流通、无家可归和游荡之间的区别。可居住的空间是在庇护所、家园、流离和循环之间创造出来的。从临床角度来看，考虑到这些独特的生活方式是任何可能的相遇的前提。结语综上所述，临床医生应注意不要采取一贯的激进立场、理论上的退缩、慈善的仁慈或不惜一切代价进行康复的愿望。在本应是多声部的实践中，不可避免地会出现这样那样的偏差。

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引用次数: 0

Deleuze and Guattari as readers of Freud 作为弗洛伊德读者的德勒兹和瓜塔里

IF 0.6 4区医学 Q4 PSYCHIATRY

Evolution Psychiatrique

Pub Date : 2024-12-01 Epub Date: 2024-11-06 DOI: 10.1016/j.evopsy.2024.10.001

Loreline Courret (Docteure en philosophie)

Objectives

The aim of this article is to show that the critique of the place and function of the Oedipus complex in Freudian psychoanalysis implies a critique of Freudian aesthetics.

Method

We will first propose a reconstruction of what Deleuze and Guattari take from Freudian aesthetics, namely an aesthetics of form, centered on the theater, and starting from Freud's experience as a spectator of Sophocles’ Oedipus Rex. In a second movement, we will try to identify what Deleuze and Guattari intend to propose to replace this aesthetic of form, and which they name “schizophrenic literature,” situate in the short story rather than in the theater, and explicitly referring to delirium.

Results

This strategic reconstruction allows us to formulate a hypothesis: that Freud would have implicitly made the theater the matrix of subjectivity, first in its aesthetics, but also in his individual aesthetic experiences and his preferences for a certain type of literary work.

Discussion

This systematic reading of Freudian “creative writing” theory challenges the concept of sublimation as the point of doctrine that rests on the selection of an “Oedipal” corpus and type of art. If the aesthetics of the form can be located in Freud's biography as a “literary effect” whose aesthetic pleasure is found in the economy of the spectator's projections onto the objects on stage, the aesthetics of the formless that is expressed by “schizophrenic literature” mobilizes a violence proper to the sublime: it is not definitively formalizable, and calls for very different feelings that transfigure the coordinates of an aesthetic experience.

Conclusion

This schizophrenic tendency of literature leads to an ecological approach to the psychic, attentive to a context where the distinction between nature and culture is never clear.

本文旨在说明，对俄狄浦斯情结在弗洛伊德精神分析学中的地位和功能的批判意味着对弗洛伊德美学的批判。方法我们将首先提出对德勒兹和瓜塔里从弗洛伊德美学中获取的东西的重建，即以戏剧为中心的形式美学，并以弗洛伊德作为索福克勒斯的《俄狄浦斯王》的观众的经验为出发点。在第二步中，我们将尝试确定德勒兹和瓜塔里打算提出什么来取代这种形式美学，他们将其命名为 "精神分裂文学"，以短篇小说而非戏剧为中心，并明确提及谵妄。结果这种策略性的重构让我们提出了一个假设：弗洛伊德首先在其美学中，而且在其个人审美经验和对某类文学作品的偏好中，隐含地将戏剧作为主体性的母体。讨论这种对弗洛伊德 "创意写作 "理论的系统性解读，挑战了将升华概念作为学说要点的观点，这种学说的基础是对 "俄狄浦斯 "语料和艺术类型的选择。如果说形式美学在弗洛伊德的传记中被定位为一种 "文学效果"，其审美愉悦在于观众对舞台对象的经济投射，那么 "精神分裂文学 "所表达的无形式美学则调动了一种崇高所特有的暴力：它并不能被明确地形式化，它需要非常不同的感受来改变审美体验的坐标。结论：文学的这种精神分裂倾向导致了一种心理生态学方法，它关注的是一种自然与文化之间从未明确区分的环境。

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引用次数: 0

Index des mots-cles 关键词索引

IF 0.6 4区医学 Q4 PSYCHIATRY

Evolution Psychiatrique

Pub Date : 2024-12-01 Epub Date: 2024-11-23 DOI: 10.1016/S0014-3855(24)00123-3

引用次数: 0

CV2 - editorial board CV2 - 编辑委员会

IF 0.6 4区医学 Q4 PSYCHIATRY

Evolution Psychiatrique

Pub Date : 2024-12-01 Epub Date: 2024-11-23 DOI: 10.1016/S0014-3855(24)00107-5

引用次数: 0

« La semaine prochaine, je serai sorti ». La psychothérapie à l’épreuve du temps en milieu carcéral "下周，我将出狱"。监狱中久经考验的心理疗法

IF 0.6 4区医学 Q4 PSYCHIATRY

Evolution Psychiatrique

Pub Date : 2024-12-01 Epub Date: 2024-06-06 DOI: 10.1016/j.evopsy.2024.05.003

Elise Pelladeau (Maître de conférences HDR en psychologie clinique et psychopathologie)

Objective

The aim of this article is to describe the way in which the announced release from prison precipitates the work of linking in the final stages of psychotherapeutic work, and to illustrate the transferential modalities involved. More specifically, we examine the fates and functions of what we propose to call a “hallucinatory temporality” in psychotherapy, at the dawn of the announcement of release from prison.

Method

To illustrate our ideas, we will use the case of Joël, who has been detained in custody for armed robbery, and is in a state of legal recidivism. This patient was receiving weekly psychotherapy in prison and had been seen in a care unit in the few months prior to his release.

Results

In this article, we wanted to illustrate the way in which release from prison, as a negative of the shock of imprisonment, can affect the subject's fantasy life, between anticipation and impulse realization.

Discussion

The defenses mobilized by Joël during the interview seemed to us to be particularly relevant in the way in which they pressed on the drive in the service of the rise in tension, thus producing an effect of reversal from the passive pole to the active pole, even in the time of the session. This temporality, over-invested in its risk thresholds between getting out and staying in, seemed to us to draw artificial contours like so many fantasmatic stopping points to force the representational system in favor of a hallucinatory circulation with masturbatory functions.

Conclusion

If, from the perspective of Roussillon's work cited above, we conceive of symbolization as an experience of subjectivation through domination, it is easy here to see how the ramparts of the therapeutic setting can act as a hallucinatory crossroads, at the tempting moment of dreaming, or at least trying to “hallucinate” the way out. The support of this hallucinatory space – from temporal circularity to fantasmatic temporality – seems to us to benefit from the inter-holding put to work and described by Ciavaldini, even in its transferential manifestations in the session. Beyond the session, as “beyond the wall”, would thus put to the test the solidity of the psychic rampart fashioned by a path other than that of domination.

本文旨在描述在心理治疗工作的最后阶段，宣布出狱是如何促成链接工作的，并说明其中涉及的转移模式。更具体地说，我们要研究的是，在宣布出狱之初，心理治疗中的 "幻觉时间性 "的命运和功能。结果在这篇文章中，我们想说明的是，作为对监禁打击的一种否定，刑满释放会在预期和冲动实现之间影响受试者的幻想生活。讨论在我们看来，若埃尔在访谈过程中调动的防御似乎与我们特别相关，因为它们压迫驱动力的方式是为张力的上升服务的，从而产生了一种从被动极到主动极的逆转效果，甚至在访谈的时间里也是如此。在我们看来，这种时间性过度依赖于 "出去 "和 "待在 "之间的风险阈值，似乎是在人为地划定轮廓，就像许多幻想中的停止点一样，迫使表象系统倾向于具有手淫功能的幻觉循环。结论如果我们从鲁西永（Roussillon）上述著作的角度出发，将象征化视为一种通过支配而实现主体化的体验，那么我们就不难看出，在梦境的诱惑时刻，或至少在试图 "幻化 "出路的时刻，治疗环境的斜坡是如何充当幻觉十字路口的。这种幻觉空间的支持--从时间的循环性到幻想的时间性--在我们看来，似乎得益于奇亚瓦蒂尼（Ciavaldini）所描述的相互牵制，甚至在治疗过程中的转移表现也是如此。因此，作为 "墙外 "的 "会话之外"，将考验由统治之外的路径所打造的精神堡垒的坚固性。

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引用次数: 0

L’inquiétante étrangeté du handicap mental 精神残疾令人不安的陌生感

IF 0.6 4区医学 Q4 PSYCHIATRY

Evolution Psychiatrique

Pub Date : 2024-09-01 Epub Date: 2024-04-16 DOI: 10.1016/j.evopsy.2024.03.002

<div><h3>Objectives</h3><p>This article aims to bypass the epistemological impasses produced by the contemporary development of the concept of disability – a concept formed in close relation with the societal context and with questions of human rights, more than with a nosographic and clinical problematic - and more precisely with regard to mental disability, a clinical entity whose classification history is particularly difficult, and yet at the heart of the edification of psychiatry since the 19th century. In studying this trajectory, we aim to demonstrate the interest of psychoanalysis's theoretical-clinical approach.</p></div><div><h3>Method</h3><p>We analyze the evolution of psychiatric and psychoanalytical conceptions of mental disability. We discuss them and identify avenues of reflection for the psychoanalytically oriented clinical and therapeutic work we do with young disabled patients and their parents.</p></div><div><h3>Results</h3><p>Mental disability is placed in the historical dynamic of the attempts to classify it: idiotism, idiocy, mental debility, mental or intellectual disability, etc. Its proven or strongly assumed organic etiology originally marginalized, and continues to marginalize, certain modes of clinical thinking and psychic treatments, of which the psychoanalytical approach is one.</p></div><div><h3>Discussion</h3><p>We discuss and differentiate between the concepts of “mental” and “psychic” and the ambiguity of their meanings. The “mentally handicapped” subject, when reduced to their neuronal aetiology, is considered from a deficit perspective, which relegates the investigation of psychic life to the background or even renders it superfluous. Following in the footsteps of D. Widlöcher, we point out that Kraepelin's thinking, which made the therapeutic indication dependent on the supposed aetiology, is now outdated. We therefore emphasize the individual differences in the relationship that develops between the young disabled person and his or her family, and in the interaction between their psyches. The effects of the birth of a disabled child on the construction of the feeling of parenthood, the bond of filiation, and parental narcissism are thus understood within the dynamics of interactions, both real and <em>fantasized</em>, which necessarily differ according to the subjects, parents and children. More specifically, we consider J. Laplanche's “fundamental anthropological situation” as a heuristic model for thinking about the psychic life of the child with a disability and the infantile sexuality that constitutes it, in adult-child interaction, as in everyone else. We hypothesize that the parental encounter with a child presenting a handicapping pathology is likely to send some parents back to their own “uncanniness,” that is to say, to the disturbing return of a repressed or primitive way of thinking abandoned a long time ago, coming from their own “internal foreign land.” This internal irruption is likely to lead t

本文旨在绕开当代残疾概念的发展所造成的认识论上的障碍--残疾概念的形成与社会环境和人权问题密切相关，而不是与分类学和临床问题有关--更确切地说，是与精神残疾有关，精神残疾是一个临床实体，其分类历史特别困难，但自19世纪以来一直是精神病学的核心。通过对这一轨迹的研究，我们旨在展示精神分析的理论-临床方法的趣味性。方法我们分析了精神病学和精神分析对精神残疾概念的演变。我们对这些概念进行了讨论，并为我们为残疾青少年患者及其父母所做的以精神分析为导向的临床和治疗工作确定了反思的途径。结果精神残疾被置于试图对其进行分类的历史动态中：白痴、白痴、精神衰弱、精神或智力残疾等。讨论我们讨论并区分了 "精神 "和 "心理 "这两个概念及其含义的模糊性。如果将 "弱智 "主体归结为神经元病因，那么就是从缺陷的角度来考虑的，这就将对精神生活的研究置于次要地位，甚至是多余的。追随维德洛赫（D. Widlöcher）的脚步，我们指出，克拉佩林将治疗指征依赖于假定病因的思想现已过时。因此，我们强调残疾青年与其家人之间的关系以及他们的心理互动中存在的个体差异。因此，残疾儿童的出生对父母身份感的构建、亲子关系的纽带以及父母的自恋的影响，都是在现实和幻想的互动动态中理解的。更具体地说，我们将 J. Laplanche 的 "基本人类学情境 "视为一个启发式模型，用于思考残疾儿童的心理生活，以及在成人与儿童的互动中，与其他人一样，构成残疾儿童心理生活的幼稚性。我们假设，父母与出现残疾病理的儿童相遇时，很可能会让一些父母回到他们自己的 "不可思议 "中，也就是说，回到一种来自他们自己的 "内部异域"、很久以前就被遗弃的压抑或原始思维方式的令人不安的回归中。这种内在干扰很可能会导致父母幻想的重新演绎，重新激发儿童的动力。在其他临床情况下，它可能会促使父母采取激烈的防御措施，旨在冻结自己和孩子的驱动力，从而阻碍孩子翻译神秘信息的努力和他们的理解欲望，并抑制基于自我情欲动力的心理生活的创造力。结论：精神分析对弱智患者的理解、倾听和临床治疗是建立在对婴儿期，即无意识、无意识的婴儿期性行为的基本认识基础之上的；精神分析方法允许在某些可能冻结、抑制或压抑儿童心理生活的配置中重新激活驱动力。

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引用次数: 0

Parler de sexualité dans une institution totale : une ethnographie clinique 在全机构中谈论性：临床人种学

IF 0.6 4区医学 Q4 PSYCHIATRY

Evolution Psychiatrique

Pub Date : 2024-09-01 Epub Date: 2023-07-19 DOI: 10.1016/j.evopsy.2023.05.003

Objectives

Talking about sexuality in a health care institution is not an easy task insofar as it contributes to the disclosing of the subjective and cultural postures of professionals, in contexts still marked by the absence or lack of professional training on this subject. Talking about sexuality can also endanger or challenge the institution.

Method

This paper presents a secondary analysis of what is presented as a form of “clinical ethnography.” The materials used in this study were collected in 1996-1997, in the context of a crisis situation caused by the revelation of illicit sexual relations between a head special educator and a young woman labelled as mentally handicapped, in a care institution. In the course of a psychosociological intervention carried out in response to a request from the management of the institution, professionals from different categories were able to express themselves on these “events” and to address, more generally, issues related to sexuality in the institution. The sessions, moderated by the author of the study and a psychoanalytic research assistant, were recorded and transcribed for subsequent feedback to participants.

Results

The thematic content analysis of the transcripts of the sessions allowed for a better understanding of the psychosocial obstacles to communication about sexuality, the subjective difficulties related to speaking out, the phenomena of denial of sexuality, as well as the representations of sexuality in institutional situations.

Discussion

The documents discussed here invite reflection on the complexity of collecting information and stories about sexuality in institutional settings. They explore communication processes and, in particular, the difficulties of communicating about sexuality and sexual abuse in institutions in the health and social sector.

Conclusion

This study suggests ways in which clinical support can be provided to teams affected by and confronted with traumatic events and the personal and professional difficulties that may arise from such situations.

目的在医疗机构中谈论性问题并不是一件容易的事，因为这有助于揭示专业人员的主观和文化态度，而在医疗机构中，这方面的专业培训仍然缺失或不足。本文对 "临床人种学 "进行了二次分析。本研究使用的材料是在 1996-1997 年收集的，当时的情况是，一名特殊教育机构的负责人和一名被贴上智障标签的年轻女性之间的不正当性关系被揭露，从而引发了一场危机。在应机构管理层的要求进行社会心理学干预的过程中，不同类别的专业人员就这些 "事件 "发表了自己的看法，并更广泛地讨论了机构中与性有关的问题。会议由本研究的作者和一名心理分析研究助理主持，并进行了记录和誊写，以便随后反馈给参加者。结果对会议誊本进行的主题内容分析使我们能够更好地理解有关性交流的社会心理障碍、与直言不讳有关的主观困难、否认性行为的现象以及机构中的性行为表征。这些文件探讨了沟通过程，尤其是在卫生和社会部门的机构中就性行为和性虐待进行沟通的困难。结论本研究提出了一些方法，可以为受到创伤事件影响和面临创伤事件的团队提供临床支持，并解决可能由此产生的个人和职业困难。

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引用次数: 0

Dysphorie épistémologique et trans-psychiatrie 认识论障碍和跨精神病学

IF 0.6 4区医学 Q4 PSYCHIATRY

Evolution Psychiatrique

Pub Date : 2024-09-01 Epub Date: 2024-07-31 DOI: 10.1016/j.evopsy.2024.07.004

Bernard Andrieu (Professeur) , Renaud Evrard (Pyschologue, Maître de conférences HDR)

引用次数: 0

L’expansion de la « dysphorie de genre » : un phénomène social ou psychologique ? 性别焦虑症 "的传播：是社会现象还是心理现象？

IF 0.6 4区医学 Q4 PSYCHIATRY

Evolution Psychiatrique

Pub Date : 2024-09-01 Epub Date: 2023-04-18 DOI: 10.1016/j.evopsy.2023.02.004

<div><h3>Objectives</h3><p>Any clinician cannot fail to wonder about the notion of “gender dysphoria” as a disease or as a disorder. The review of the few international epidemiological studies on gender transition requests leads to an attempt to “decipher” the reasons for the exponential growth of this new clinical category. Is it a psychopathological or a social phenomenon, or both? We will examine separately the cases of children and adolescents. Children experiencing hesitations about their sexual identity tend to give up requests for transitions; as for teenagers (12 girls for every boy), they seem to be largely influenced by social networks. We will position ourselves strictly on the clinical and deontological level, to defend medical ethics, at a distance from the ideological considerations disseminated by the media. Starting from the recognition of the very strong increase in France of requests to “change sex/gender” in children and adolescents in recent years, we will note that this claim of “gender dysphoria” is presented differently by children before and after puberty. From a clinical point of view, it is necessary to understand that gender dysphoria would be the result of different identification processes for children and adolescents; it also presents as a gendered behavior like other known behavioral disorders in adolescence. The objective of this article is therefore to decipher this pandemic phenomenon and to question it as a social rather than a medical phenomenon. We must then recommend great caution in medical procedures, sometimes irreversible, on these children.</p></div><div><h3>Method</h3><p>Based on an analysis of the international literature, we focused on international epidemiological studies and on the scarce data available to us in France. We compare these data with those from testimonies of adolescents in the process of “identity transition” or “detransition” in France and in other countries, because the complaints and claims are identical. These data were collected and studied until the end of 2021. These data and testimonies will be confronted with our knowledge in the domain of child and adolescent psychiatry and psychoanalysis, the latter being a theoretical construction of childhood sexuality.</p></div><div><h3>Results</h3><p>The results drawn from the analysis of these testimonies and from existing epidemiological studies show, firstly, that a fundamental distinction must be made between the phenomenon of “gender dysphoria” in children and in adolescents. The evolution of the demands is drastically different in terms of volume and environmental causality. Secondly, in adolescence, this demand for a change of identity indisputably concerns a very large majority of girls. Finally, this demand, therefore sexualized, can be seen as a fragile identity, added to other pathologies. It should also be considered with demands regarding identity and the impact of propaganda on social networks towards youth.</p></div><div><

目的：任何临床医生都会对 "性别焦虑症 "作为一种疾病或障碍的概念感到疑惑。通过对国际上为数不多的有关性别转换请求的流行病学研究进行回顾，我们试图 "破解 "这一新的临床类别呈指数增长的原因。这是一种心理病理现象还是一种社会现象，抑或两者兼而有之？我们将分别研究儿童和青少年的案例。对自己的性身份犹豫不决的儿童往往会放弃转变身份的要求；至于青少年（12 个女孩对 1 个男孩），他们似乎在很大程度上受到了社会网络的影响。我们将严格从临床和道义的角度出发，捍卫医学伦理，远离媒体传播的意识形态因素。近年来，法国儿童和青少年要求 "变性/变性 "的案例急剧增加，从这一认识出发，我们将注意到，在青春期之前和之后，儿童提出 "性别焦虑症 "的方式是不同的。从临床角度来看，我们有必要了解性别焦虑症是儿童和青少年不同识别过程的结果；它也像其他已知的青春期行为障碍一样，表现为一种性别行为。因此，本文的目的在于解读这一普遍现象，并将其作为一种社会现象而非医学现象加以质疑。在分析国际文献的基础上，我们重点研究了国际流行病学研究和法国现有的稀缺数据。我们将这些数据与法国和其他国家处于 "身份转换 "或 "脱离 "过程中的青少年的证词进行了比较，因为他们的抱怨和诉求是相同的。这些数据的收集和研究工作一直持续到 2021 年底。这些数据和证词将与我们在儿童和青少年精神病学以及精神分析领域的知识进行对比，后者是对儿童性行为的一种理论建构。结果对这些证词和现有流行病学研究进行分析后得出的结果表明，首先，必须对儿童和青少年的 "性别焦虑症 "现象进行根本区分。就数量和环境因果关系而言，需求的演变是截然不同的。其次，在青春期，这种改变身份的要求无可争议地涉及到绝大多数女孩。最后，这种性化的要求可以被看作是一种脆弱的身份认同，与其他病症相辅相成。我们在此讨论的重点是一些临床和流行病学方面的因素，这些因素使我们能够将这些要求承认青少年 "性别焦虑症 "的新需求视为一种 "社会流行病 "现象。我们将讨论儿童和青少年的性别和身份认同概念，以及经常出现的、令人担忧的 "相关疾病"。对身体这一特殊问题的反思将引导我们质疑 21 世纪对女性的拒绝。我们还将考虑所选择的治疗方法和所提供的支持的影响，最后对少女的要求进行反思。我们建议在这些人生阶段采取必要的谨慎和道德行动，并捍卫所有儿童在其所选择的身份认同的正常演变过程中发展的必要性。对 "性别焦虑症 "的诊断不应被理解为将儿童或青少年束缚在某种性别中的诊断（无论其是否愿意，转换疗法目前在法国是被禁止的），相反，它应使儿童或青少年在这些性别定型观念面前获得解放，因为他们往往被这些定型观念所束缚，甚至被绑架。因为身体没有病，所以有必要保护它，使其免受任何有害转变的影响。但最重要的是，通过避免任何身份污名化，我们可以让儿童和青少年重新拥有自己的身体形象，从而实现心理和解剖学上的统一。这样，他/她就可以在日后必须面对的多种成人性取向中保持选择的自由。

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引用次数: 0

Talking about sexuality in a total institution: A clinical ethnography 在一个完全的机构中谈论性：临床人种学

IF 0.6 4区医学 Q4 PSYCHIATRY

Evolution Psychiatrique

Pub Date : 2024-09-01 Epub Date: 2023-08-08 DOI: 10.1016/j.evopsy.2023.07.001

Objectives

Talking about sexuality in a health care total institution is not an easy task insofar as it contributes to the disclosing of the subjective and cultural postures of professionals, in contexts still marked by the absence or lack of professional training on this subject. Talking about sexuality can also endanger or challenge the institution.

Method

This paper presents a secondary analysis of what is presented as a form of “clinical ethnography”. The materials used in this study were collected in 1996–1997, in the context of a crisis situation caused by the revelation of illicit sexual relations between a head special educator and a young woman labelled as mentally handicapped, in a care institution. In the course of a psychosociological intervention carried out in response to a request from the management of the institution, professionals from different categories were able to express themselves on these “events” and to address, more generally, issues related to sexuality in the institution. The sessions, moderated by the author of the study and a psychoanalytic research assistant, were recorded and transcribed for subsequent feedback to participants.

Results

The thematic content analysis of the transcripts of the sessions allowed for a better understanding of the psychosocial obstacles to communication about sexuality, the subjective difficulties related to speaking out, the phenomena of denial of sexuality, as well as the representations of sexuality in institutional situations.

Discussion

The documents discussed here invite reflection on the complexity of collecting information and stories about sexuality in institutional settings. They explore communication processes and, in particular, the difficulties of communicating about sexuality and sexual abuse in institutions in the health and social sector.

Conclusion

This study suggests ways in which clinical support can be provided to teams affected by and confronted with traumatic events and the personal and professional difficulties that may arise from such situations.

目的在医疗保健机构中谈论性问题并非易事，因为这有助于揭示专业人员的主观和文化态度，而在医疗保健机构中，这方面的专业培训仍然缺失或不足。本文对 "临床人种学 "进行了二次分析。本研究使用的材料是 1996-1997 年收集的，当时的危机状况是，一名特殊教育主任和一名被贴上弱智标签的年轻女性在一家护理机构发生了不正当的性关系。在应机构管理层的要求进行社会心理学干预的过程中，不同类别的专业人员就这些 "事件 "发表了自己的看法，并更广泛地讨论了机构中与性有关的问题。会议由本研究的作者和一名心理分析研究助理主持，并进行了记录和誊写，以便随后反馈给参加者。结果对会议誊本进行的主题内容分析使我们能够更好地理解有关性交流的社会心理障碍、与直言不讳有关的主观困难、否认性行为的现象以及机构中的性行为表征。这些文件探讨了沟通过程，尤其是在卫生和社会部门的机构中就性行为和性虐待进行沟通的困难。结论本研究提出了一些方法，可以为受到创伤事件影响和面临创伤事件的团队提供临床支持，并解决可能由此产生的个人和职业困难。

{"title":"Talking about sexuality in a total institution: A clinical ethnography","authors":"","doi":"10.1016/j.evopsy.2023.07.001","DOIUrl":"10.1016/j.evopsy.2023.07.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Talking about sexuality in a health care total institution is not an easy task insofar as it contributes to the disclosing of the subjective and cultural postures of professionals, in contexts still marked by the absence or lack of professional training on this subject. Talking about sexuality can also endanger or challenge the institution.</p></div><div><h3>Method</h3><p>This paper presents a secondary analysis of what is presented as a form of “clinical ethnography”. The materials used in this study were collected in 1996–1997, in the context of a crisis situation caused by the revelation of illicit sexual relations between a head special educator and a young woman labelled as mentally handicapped, in a care institution. In the course of a psychosociological intervention carried out in response to a request from the management of the institution, professionals from different categories were able to express themselves on these “events” and to address, more generally, issues related to sexuality in the institution. The sessions, moderated by the author of the study and a psychoanalytic research assistant, were recorded and transcribed for subsequent feedback to participants.</p></div><div><h3>Results</h3><p>The thematic content analysis of the transcripts of the sessions allowed for a better understanding of the psychosocial obstacles to communication about sexuality, the subjective difficulties related to speaking out, the phenomena of denial of sexuality, as well as the representations of sexuality in institutional situations.</p></div><div><h3>Discussion</h3><p>The documents discussed here invite reflection on the complexity of collecting information and stories about sexuality in institutional settings. They explore communication processes and, in particular, the difficulties of communicating about sexuality and sexual abuse in institutions in the health and social sector.</p></div><div><h3>Conclusion</h3><p><span>This study suggests ways in which clinical support can be provided to teams affected by and confronted with </span>traumatic events and the personal and professional difficulties that may arise from such situations.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 3","pages":"Pages e33-e48"},"PeriodicalIF":0.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133719385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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