Pub Date : 2024-10-10DOI: 10.1016/j.evopsy.2024.09.001
Cécile Gorin (Médecin en Chef, Psychiatre), Célia Breton (Psychologue de Classe normale, Psychologue), Carole Milan (Médecin en Chef, Psychiatre), Charles Gheorghiev (Médecin en Chef, Chef du service de Psychiatrie de l’HIA Sainte Anne)
<div><h3>Objectives</h3><div>Early medical and psychological intervention models are currently dominated by debriefing in conditions of exceptional stress such as armed conflict. Intervention must be rapid and coordinated in order to meet the needs of the victims, by encouraging the verbalization of emotions and the restoration of social links. The historical origins and evolution of debriefing, from past wars to its contemporary application, underline a different, preventive, role in a psychiatry.</div></div><div><h3>Method</h3><div>The effects of psychological trauma on the individual and the group involve deleterious dissociation phenomena requiring the restoration of a reassuring framework. The role of debriefing in reintegrating the experience through the development of a shared narrative encourages a process of reconnection, which contributes to this reassuring effect. However, the principle of immediately encouraging traumatized individuals to express themselves verbally calls into question debriefing's conformity with usual psychotherapy practices. Teaching it, which is not in itself an act of care, is nevertheless an opportunity to approach its effects, through the same dynamic of identification in the trainees. The development of new teaching methods, such as simulation, is particularly relevant here, as it emphasizes the acquisition of know-how rather than the transmission of theoretical knowledge. The teaching is based on a behavioral approach, the aim being to encourage trainees to perfect their skills by repeating role-playing exercises, thereby facilitating the transmission of interpersonal and communication skills.</div></div><div><h3>Results</h3><div>The training of military health professionals, particularly in psychiatry, is vital if they are to cope with the specific constraints of military operations. The aim of this training is to prepare healthcare professionals to intervene in isolated situations and to manage crisis scenarios. A specific educational initiative has been set up at the military hospital Sainte-Anne in Toulon, based on simulation to teach medical-psychological debriefing for the benefit of medical staff who are deployed on missions. The teaching team uses role-playing to simulate operational crisis situations involving traumatic exposure, offering trainees a realistic and interactive approach. This simulation-based approach enables trainees to confront unforeseen situations specific to the military context, while developing the practical and emotional skills that are essential in the management of psychological disorders. In addition, this teaching method encourages reflective practice and promotes an empathetic approach to patients, differentiating the teacher's posture in this context from that which is usually adopted in medicine. In this way, simulation serves as a catalyst for initiating authentic exchanges between trainees and trainers, over and above the effects of subjective experiences specific to ea
{"title":"L’enseignement du débriefing médico-psychologique par la simulation : quand le transfert se loge au cœur des effets de transmission d’un savoir","authors":"Cécile Gorin (Médecin en Chef, Psychiatre), Célia Breton (Psychologue de Classe normale, Psychologue), Carole Milan (Médecin en Chef, Psychiatre), Charles Gheorghiev (Médecin en Chef, Chef du service de Psychiatrie de l’HIA Sainte Anne)","doi":"10.1016/j.evopsy.2024.09.001","DOIUrl":"10.1016/j.evopsy.2024.09.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Early medical and psychological intervention models are currently dominated by debriefing in conditions of exceptional stress such as armed conflict. Intervention must be rapid and coordinated in order to meet the needs of the victims, by encouraging the verbalization of emotions and the restoration of social links. The historical origins and evolution of debriefing, from past wars to its contemporary application, underline a different, preventive, role in a psychiatry.</div></div><div><h3>Method</h3><div>The effects of psychological trauma on the individual and the group involve deleterious dissociation phenomena requiring the restoration of a reassuring framework. The role of debriefing in reintegrating the experience through the development of a shared narrative encourages a process of reconnection, which contributes to this reassuring effect. However, the principle of immediately encouraging traumatized individuals to express themselves verbally calls into question debriefing's conformity with usual psychotherapy practices. Teaching it, which is not in itself an act of care, is nevertheless an opportunity to approach its effects, through the same dynamic of identification in the trainees. The development of new teaching methods, such as simulation, is particularly relevant here, as it emphasizes the acquisition of know-how rather than the transmission of theoretical knowledge. The teaching is based on a behavioral approach, the aim being to encourage trainees to perfect their skills by repeating role-playing exercises, thereby facilitating the transmission of interpersonal and communication skills.</div></div><div><h3>Results</h3><div>The training of military health professionals, particularly in psychiatry, is vital if they are to cope with the specific constraints of military operations. The aim of this training is to prepare healthcare professionals to intervene in isolated situations and to manage crisis scenarios. A specific educational initiative has been set up at the military hospital Sainte-Anne in Toulon, based on simulation to teach medical-psychological debriefing for the benefit of medical staff who are deployed on missions. The teaching team uses role-playing to simulate operational crisis situations involving traumatic exposure, offering trainees a realistic and interactive approach. This simulation-based approach enables trainees to confront unforeseen situations specific to the military context, while developing the practical and emotional skills that are essential in the management of psychological disorders. In addition, this teaching method encourages reflective practice and promotes an empathetic approach to patients, differentiating the teacher's posture in this context from that which is usually adopted in medicine. In this way, simulation serves as a catalyst for initiating authentic exchanges between trainees and trainers, over and above the effects of subjective experiences specific to ea","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 4","pages":"Pages 695-711"},"PeriodicalIF":0.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722000","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}
Pub Date : 2024-07-23DOI: 10.1016/j.evopsy.2024.07.003
Romuald Jean-Dit-Pannel (Psychologue clinicien-psychothérapeute, Professeur des universités)
Goals
I develop my hypothesis of a two different corsets, the second skin and the ego-skin corset, which respectively prevent or deploy according to the psychic reappropriations of the subjects, specially transgender subjects.
Method
My practice as a clinical psychologist-psychotherapist and my research with transgender subjects led me to wonder about a metapsychology of the corset. I expose here two clinical cases.
Results
Two cases in particular led me to think about an authentic depressive capacity that I call here sadness-fluid or fluidity of sadness by analogy to gender-fluid, the fluidity of gender.
Discussion
Also, I reflect on the operative armature that can impose itself throughout the transition process, by the diversity of experiences, stories, and resources found in the subject's different environments.
Conclusion
The therapeutic needs of trans subjects in their journeys and their reflections lead us to consider the needs to loosen, to untie certain ties. This uncorsetting favors a reflexive fluidity, so that the subject can evolve in an authentic ego-skin corset where it belongs to itself.
目标我提出了两种不同紧身胸衣的假设，即第二层皮肤紧身胸衣和自我皮肤紧身胸衣，它们分别根据受试者（尤其是变性受试者）的心理再利用情况进行阻止或部署。方法我作为临床心理学家-心理治疗师的实践以及对变性受试者的研究让我对紧身胸衣的元心理学产生了好奇。我在这里揭示了两个临床案例。结果有两个案例特别让我想到了一种真实的抑郁能力，我在这里将其称为 "悲伤的流动性"（sadness-fluid）或 "悲伤的流动性"（fluidity of sadness），与 "性别的流动性"（gender-fluid，即性别的流动性）相类比。讨论此外，我还思考了在整个变性过程中，变性人在不同环境中的经历、故事和资源的多样性可能会给自己带来的影响。结论变性人在其变性过程中的治疗需求以及他们的反思让我们考虑到放松和解开某些束缚的需求。这种解开束缚的方式有利于反思的流动性，这样主体就能在属于自己的真实自我束缚中发展。
{"title":"Armature-opératoire et tristesse fluide chez des sujets transgenres : d’une seconde peau à un Moi-peau corsets","authors":"Romuald Jean-Dit-Pannel (Psychologue clinicien-psychothérapeute, Professeur des universités)","doi":"10.1016/j.evopsy.2024.07.003","DOIUrl":"10.1016/j.evopsy.2024.07.003","url":null,"abstract":"<div><h3>Goals</h3><p>I develop my hypothesis of a two different corsets, the second skin and the ego-skin corset, which respectively prevent or deploy according to the psychic reappropriations of the subjects, specially transgender subjects.</p></div><div><h3>Method</h3><p>My practice as a clinical psychologist-psychotherapist and my research with transgender subjects led me to wonder about a metapsychology of the corset. I expose here two clinical cases.</p></div><div><h3>Results</h3><p>Two cases in particular led me to think about an authentic depressive capacity that I call here sadness-fluid or fluidity of sadness by analogy to gender-fluid, the fluidity of gender.</p></div><div><h3>Discussion</h3><p>Also, I reflect on the operative armature that can impose itself throughout the transition process, by the diversity of experiences, stories, and resources found in the subject's different environments.</p></div><div><h3>Conclusion</h3><p>The therapeutic needs of trans subjects in their journeys and their reflections lead us to consider the needs to loosen, to untie certain ties. This uncorsetting favors a reflexive fluidity, so that the subject can evolve in an authentic ego-skin corset where it belongs to itself.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 3","pages":"Pages 497-507"},"PeriodicalIF":0.6,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839190","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}
Pub Date : 2024-07-17DOI: 10.1016/j.evopsy.2024.07.002
Matthieu Braun (psychiatrist, head of a university clinic - regional hospital assistant) , Christophe Chaperot (psychiatrist, head of department)
Objective
Patients suffering from complex psychiatric pathologies require multi-disciplinary care and, in the event of decompensation, may need to be hospitalized. Institutional psychotherapy approaches psychotic, existential and institutional crises as opportunities for clinical elaboration and the deployment of creativity. The health crisis linked to the Covid-19 pandemic has prompted us to rethink its effectiveness and its place within plural contemporary practices. It also offered the opportunity for an unprecedented anthropological reading. In this context, is institutional psychotherapy still a machine for producing “innovation”, for creating, or at least revealing, crises in order to overcome them?
Method
Key concepts from the field of institutional psychotherapy can be reexamined in the wake of the health crisis. In the aftermath of the pandemic, we propose an elaboration of what the pandemic has taught us about day-to-day practice, in a public psychiatric department oriented towards institutional psychotherapy. We will draw on a re-reading of clinical vignettes, interviews with caregivers and patients, and notes taken at department meetings during the pandemic.
Results
The major concepts of institutional psychotherapy may have some limitations, but they can be reinvented by the caregiver-client collective. During a crisis, collective failings and individual symptoms seem to reveal each other. The therapeutic club represents a stage on which to unfold and elaborate both group and individual issues.
Discussion
In this context, the symbolic framework, collectively instituted, and the culture of a service can present operative points of support for continuing care. They “put in crisis” the prejudices and implicit theories of the actors, and support new narratives and new ways of making sense.
Conclusion
In the aftermath of a crisis, the therapeutic club remains a space of conflict and intrigue, at the crossroads of collective and individual health crises.
{"title":"Institutional psychotherapy put to the test by the health crisis. Clinical reflection at the heart of a public psychiatric service","authors":"Matthieu Braun (psychiatrist, head of a university clinic - regional hospital assistant) , Christophe Chaperot (psychiatrist, head of department)","doi":"10.1016/j.evopsy.2024.07.002","DOIUrl":"10.1016/j.evopsy.2024.07.002","url":null,"abstract":"<div><h3>Objective</h3><p>Patients suffering from complex psychiatric pathologies require multi-disciplinary care and, in the event of decompensation, may need to be hospitalized. Institutional psychotherapy approaches psychotic, existential and institutional crises as opportunities for clinical elaboration and the deployment of creativity. The health crisis linked to the Covid-19 pandemic has prompted us to rethink its effectiveness and its place within plural contemporary practices. It also offered the opportunity for an unprecedented anthropological reading. In this context, is institutional psychotherapy still a machine for producing “innovation”, for creating, or at least revealing, crises in order to overcome them?</p></div><div><h3>Method</h3><p>Key concepts from the field of institutional psychotherapy can be reexamined in the wake of the health crisis. In the aftermath of the pandemic, we propose an elaboration of what the pandemic has taught us about day-to-day practice, in a public psychiatric department oriented towards institutional psychotherapy. We will draw on a re-reading of clinical vignettes, interviews with caregivers and patients, and notes taken at department meetings during the pandemic.</p></div><div><h3>Results</h3><p>The major concepts of institutional psychotherapy may have some limitations, but they can be reinvented by the caregiver-client collective. During a crisis, collective failings and individual symptoms seem to reveal each other. The therapeutic club represents a stage on which to unfold and elaborate both group and individual issues.</p></div><div><h3>Discussion</h3><p>In this context, the symbolic framework, collectively instituted, and the culture of a service can present operative points of support for continuing care. They “put in crisis” the prejudices and implicit theories of the actors, and support new narratives and new ways of making sense.</p></div><div><h3>Conclusion</h3><p>In the aftermath of a crisis, the therapeutic club remains a space of conflict and intrigue, at the crossroads of collective and individual health crises.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 3","pages":"Pages e49-e60"},"PeriodicalIF":0.6,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852274","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}
Pub Date : 2024-06-25DOI: 10.1016/j.evopsy.2024.05.005
Gabriela Patiño-Lakatos (Psychologue clinicienne, post-doctorante (2019–2023) pour le projet de recherche ANR Staccato 2019, membre associé UTRPP, psychologue au CMP, la source) , Cristina Lindenmeyer (Psychanalyste, professeur de psychopathologie, membre titulaire UTRPP) , Sophie Bergheimer (Psychologue clinicienne, chercheure contractuelle (2019–2023) pour le projet de recherche ANR Staccato 2019, ATER (2023–2024))
<div><h3>Objectives</h3><div>This article examines the use of clay modeling as an instrument for clinical analysis of the relation to one's own body and to the object. While modeling is a widely-used medium in therapeutic work, we present here the use of the modeled self-portrait as a projective method in a research situation involving sensorial mediation using touch. The aim is to understand how the subject invests and engages a relation with this object, based on the way s/he invests and represents her/his body and sensations.</div></div><div><h3>Method</h3><div>The modeling situation was proposed individually to 19 participants at the first of six meetings. The choice of the modeled self-portrait in this research project is inspired by a psychoanalytical epistemology that enables us to understand the unconscious psychic dimensions of body image and the relation to the object, as well as the concepts of mediation, the projective situation, and transference. In the absence of a pre-existing reference to a systematized methodology for analyzing the self-portrait with modeling clay, we referred to psychoanalytic work on projective tests to construct a qualitative analysis grid based on the material collected.</div></div><div><h3>Results</h3><div>The modeled self-portrait enabled us to take into consideration, from an economic, dynamic, and topical point of view, on the one hand, the content that emerged in the modeling and in the verbalizations that accompanied it, and, on the other hand, the characteristics of the modeling process itself. The modeling situation gave rise to regressive and projective movements, leading the participants to express key elements of their personal history, their sensory situation, and the areas of the body invested or disinvested, as well as their psychic behaviors in relation to the object in the present of this research encounter. We identified four ways in which participants related to modeling, depending on their subjectivity and their position in the research process. The form given to the modeling, its structure, and the parts represented or not provided us with indications of certain features of the participants’ body image and the way in which they were able to express it in the space-time of this encounter. We hypothesize that through its connections with the subject's body image, the three-dimensional self-portrait expresses the way in which participants invest their bodies, and sometimes body zones linked to the senses, such as touch, through the modeling activity itself, but also other senses through the elements represented or not, verbalized or not, about the created-modeled object.</div></div><div><h3>Discussion</h3><div>We present some considerations on the complex connections between the relationship to modeling, to the object of sensory mediation through touch, and to autobiographical speech in the interview situation, considering the participants’ verbal and non-verbal productions during the process
{"title":"La situation projective du modelage comme instrument clinique dans une recherche sur un dispositif de médiation sensorielle","authors":"Gabriela Patiño-Lakatos (Psychologue clinicienne, post-doctorante (2019–2023) pour le projet de recherche ANR Staccato 2019, membre associé UTRPP, psychologue au CMP, la source) , Cristina Lindenmeyer (Psychanalyste, professeur de psychopathologie, membre titulaire UTRPP) , Sophie Bergheimer (Psychologue clinicienne, chercheure contractuelle (2019–2023) pour le projet de recherche ANR Staccato 2019, ATER (2023–2024))","doi":"10.1016/j.evopsy.2024.05.005","DOIUrl":"10.1016/j.evopsy.2024.05.005","url":null,"abstract":"<div><h3>Objectives</h3><div>This article examines the use of clay modeling as an instrument for clinical analysis of the relation to one's own body and to the object. While modeling is a widely-used medium in therapeutic work, we present here the use of the modeled self-portrait as a projective method in a research situation involving sensorial mediation using touch. The aim is to understand how the subject invests and engages a relation with this object, based on the way s/he invests and represents her/his body and sensations.</div></div><div><h3>Method</h3><div>The modeling situation was proposed individually to 19 participants at the first of six meetings. The choice of the modeled self-portrait in this research project is inspired by a psychoanalytical epistemology that enables us to understand the unconscious psychic dimensions of body image and the relation to the object, as well as the concepts of mediation, the projective situation, and transference. In the absence of a pre-existing reference to a systematized methodology for analyzing the self-portrait with modeling clay, we referred to psychoanalytic work on projective tests to construct a qualitative analysis grid based on the material collected.</div></div><div><h3>Results</h3><div>The modeled self-portrait enabled us to take into consideration, from an economic, dynamic, and topical point of view, on the one hand, the content that emerged in the modeling and in the verbalizations that accompanied it, and, on the other hand, the characteristics of the modeling process itself. The modeling situation gave rise to regressive and projective movements, leading the participants to express key elements of their personal history, their sensory situation, and the areas of the body invested or disinvested, as well as their psychic behaviors in relation to the object in the present of this research encounter. We identified four ways in which participants related to modeling, depending on their subjectivity and their position in the research process. The form given to the modeling, its structure, and the parts represented or not provided us with indications of certain features of the participants’ body image and the way in which they were able to express it in the space-time of this encounter. We hypothesize that through its connections with the subject's body image, the three-dimensional self-portrait expresses the way in which participants invest their bodies, and sometimes body zones linked to the senses, such as touch, through the modeling activity itself, but also other senses through the elements represented or not, verbalized or not, about the created-modeled object.</div></div><div><h3>Discussion</h3><div>We present some considerations on the complex connections between the relationship to modeling, to the object of sensory mediation through touch, and to autobiographical speech in the interview situation, considering the participants’ verbal and non-verbal productions during the process","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 4","pages":"Pages 829-848"},"PeriodicalIF":0.6,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-19DOI: 10.1016/j.evopsy.2024.06.001
Sebur Kapu (Doctorant)
{"title":"Repenser la génétique de la schizophrénie à l’ère de la crise de la reproduction. À propos de… « Schizophrenia and Genetics: The End of An Illusion » de Jay Joseph","authors":"Sebur Kapu (Doctorant)","doi":"10.1016/j.evopsy.2024.06.001","DOIUrl":"10.1016/j.evopsy.2024.06.001","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 3","pages":"Pages 583-591"},"PeriodicalIF":0.6,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047791","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}
Pub Date : 2024-06-12DOI: 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。
{"title":"Les pavés du dire, ou quand la rue se fait réseau soignant","authors":"Camille Veit (Psychologue clinicienne, Docteure en psychologie, Maîtresse de conférences en psychopathologie clinique)","doi":"10.1016/j.evopsy.2024.05.004","DOIUrl":"10.1016/j.evopsy.2024.05.004","url":null,"abstract":"<div><h3>Goals</h3><div>“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?</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div><em>The</em> 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).</div></div><div><h3>Discussion</h3><div>Dwelling is always an attempt at dealing with dreams, ideals, and the impossible. <em>Inhabitable spaces</em> 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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 4","pages":"Pages 639-650"},"PeriodicalIF":0.6,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402708","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}
Pub Date : 2024-06-06DOI: 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.
{"title":"« La semaine prochaine, je serai sorti ». La psychothérapie à l’épreuve du temps en milieu carcéral","authors":"Elise Pelladeau (Maître de conférences HDR en psychologie clinique et psychopathologie)","doi":"10.1016/j.evopsy.2024.05.003","DOIUrl":"10.1016/j.evopsy.2024.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Discussion</h3><div>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 <em>functions.</em></div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 4","pages":"Pages 651-660"},"PeriodicalIF":0.6,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141391722","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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