Pub Date : 2025-06-23DOI: 10.1016/j.evopsy.2025.06.001
Benoît Verdon (Psychologue clinicien, psychanalyste, professeur de psychologie clinique)
<div><h3>Objectives</h3><div>Understanding the psychic distress associated with the body's vagaries necessitates an exploration of the body's investment in fantasy. The body's robustness or fragility, its active and passive potentialities, its openness and closedness, penetrability and impenetrability, uprightness and sagging are all sources of representations and affects that transcend the objectivation of actual symptoms, illnesses, accidents, and disabilities. Moreover, the fear of being vulnerable, deficient, or ill is often heightened by the experience of aging, agedness, and the apprehension around cerebral decline, of particular concern among those who are growing older. Our aim was to focus on distinguishing the psychic representations of the body that are challenged by the widely shared experience of memory impairments that have not been confirmed as pathological by medical and neuropsychological assessments. This approach allowed us to understand how the psychic functioning of patients who worry about presenting prodromes or symptoms of cerebral pathologies mobilizes representations of bodily afflictions, revealing signs of narcissistic sensitivity and fragility as well as of fantastical conflicts.</div></div><div><h3>Methods</h3><div>The Rorschach test has generated substantial research results on the psychic processes involved in representing the body and the dynamic interplay between narcissistic and objectal investments in various types of psychopathological organization and clinical contexts. In this study, the test was administered to women and men who spontaneously sought consultation for memory issues, after having been informed that neither neuropsychological nor medical tests had confirmed any identifiable cerebral etiology able to explain their daily memory impairments. By focusing our study on representations of the body and its afflictions, we could identify both the vulnerabilities and strengths of different forms of primary identification that potentially shape identity stability and unity; the establishment of solid yet flexible internal and external boundaries; and the sensitivity to containment or fragmentation. Additionally, we observed the vulnerabilities and strengths of different forms of secondary identification, where body representations are more organized around bisexuality and sexual differences, reflecting sensitivity to notions of lack, size, and the body's function as active or passive, robust or powerless.</div></div><div><h3>Results</h3><div>For some patients, the issue of envelope porosity emerged as a salient and central concern. Their narcissistic vulnerabilities make them particularly sensitive to memory lapses, analogous to breaches in the bodily envelope through which contents might escape, thus compromising identity integrity, the solidity of differentiation, as well as the stability of self-esteem and of the investment therein. For other patients, representations of bodily afflictions were more cl
{"title":"Représentations psychiques des atteintes du corps en contexte de vieillissement. Apports du test de Rorschach à la compréhension psychodynamique de la plainte cognitive","authors":"Benoît Verdon (Psychologue clinicien, psychanalyste, professeur de psychologie clinique)","doi":"10.1016/j.evopsy.2025.06.001","DOIUrl":"10.1016/j.evopsy.2025.06.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Understanding the psychic distress associated with the body's vagaries necessitates an exploration of the body's investment in fantasy. The body's robustness or fragility, its active and passive potentialities, its openness and closedness, penetrability and impenetrability, uprightness and sagging are all sources of representations and affects that transcend the objectivation of actual symptoms, illnesses, accidents, and disabilities. Moreover, the fear of being vulnerable, deficient, or ill is often heightened by the experience of aging, agedness, and the apprehension around cerebral decline, of particular concern among those who are growing older. Our aim was to focus on distinguishing the psychic representations of the body that are challenged by the widely shared experience of memory impairments that have not been confirmed as pathological by medical and neuropsychological assessments. This approach allowed us to understand how the psychic functioning of patients who worry about presenting prodromes or symptoms of cerebral pathologies mobilizes representations of bodily afflictions, revealing signs of narcissistic sensitivity and fragility as well as of fantastical conflicts.</div></div><div><h3>Methods</h3><div>The Rorschach test has generated substantial research results on the psychic processes involved in representing the body and the dynamic interplay between narcissistic and objectal investments in various types of psychopathological organization and clinical contexts. In this study, the test was administered to women and men who spontaneously sought consultation for memory issues, after having been informed that neither neuropsychological nor medical tests had confirmed any identifiable cerebral etiology able to explain their daily memory impairments. By focusing our study on representations of the body and its afflictions, we could identify both the vulnerabilities and strengths of different forms of primary identification that potentially shape identity stability and unity; the establishment of solid yet flexible internal and external boundaries; and the sensitivity to containment or fragmentation. Additionally, we observed the vulnerabilities and strengths of different forms of secondary identification, where body representations are more organized around bisexuality and sexual differences, reflecting sensitivity to notions of lack, size, and the body's function as active or passive, robust or powerless.</div></div><div><h3>Results</h3><div>For some patients, the issue of envelope porosity emerged as a salient and central concern. Their narcissistic vulnerabilities make them particularly sensitive to memory lapses, analogous to breaches in the bodily envelope through which contents might escape, thus compromising identity integrity, the solidity of differentiation, as well as the stability of self-esteem and of the investment therein. For other patients, representations of bodily afflictions were more cl","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 4","pages":"Pages 567-579"},"PeriodicalIF":0.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610482","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 : 2025-06-19DOI: 10.1016/j.evopsy.2025.05.001
Alexiane Cocqueret (Doctorante (ED566)) , Elisa Eugene (Master Sport et Expertise de la Performance de Haut Niveau) , Alexandre Legendre (Maître de Conférence) , Bernard Andrieu (Professeur des universités)
<div><h3>Objectives</h3><div>In the scientific literature, injury is most often understood as no more than a physical functional limitation and, therefore, as strictly negative. However, as we discuss here, there is also an effect on psychological integrity. The entire body appears to be impacted, both physically and psychologically, as an injury can simultaneously influence self-esteem, body image, and confidence in one's body schema. We first interviewed circus artists during an exploratory study, and we then interviewed elite athletes (EAs) for a case study. The goal was to characterize their respective experiences of injury to analyze the various effects of injury from the prism of bodies facing the extreme.</div></div><div><h3>Methodology</h3><div>We conducted semi-structured interviews with four EAs in combat sports (two female judokas, one male judoka, and one female fencer, with a mean age of 26 years [standard deviation<!--> <!-->=<!--> <!-->1 year]). These interviews were recorded, transcribed, and anonymized. As a first step, participants produced an awareness drawing, where they could visually represent the state of their bodies and its association with their injury history. The instructions for creating this drawing were minimally restrictive so as to encourage the most spontaneous representations possible.</div></div><div><h3>Results</h3><div>The results of the exploratory study highlighted certain positive aspects of injury, such as the opportunity to slow down a rhythm of life that is extremely intense, exhausting, or even detrimental given the demands of performance as well as the opportunity to foster self-learning during and after recovery. In the case study, the EAs represented their various, often numerous injuries through awareness drawing, which, in tandem with the subsequent explanatory interview, spurred greater bodily and mental awareness. Experiences of shared injury were frequently associated with the normalization of pain, reinforced by the fact that rest periods were kept minimal because of internal and external pressures. In this context, the first injury stood out due to its emotional impact and implications, as it often marked a significant turning point in the athlete's life. It had the possibility to become an opportunity for personal development through the specific skills it fostered, such as the development of an “injury radar”, or the specific skills it helped enhance, like resilience.</div></div><div><h3>Discussion</h3><div>The results of these two studies highlight that injuries can have certain benefits for EAs, despite injuries being typically regarded as functional limitations. Looking beyond the difficulties extensively documented in the literature, injury can prompt self-reflection and an assessment of one's practices, which can prove beneficial. Some EAs used this moment to reconsider their sporting career and objectives, while others perceived their practices as evolving through successive injuries.
{"title":"Dessiner ses blessures sportives : une reconfiguration psychologique et affective de son corps émersif","authors":"Alexiane Cocqueret (Doctorante (ED566)) , Elisa Eugene (Master Sport et Expertise de la Performance de Haut Niveau) , Alexandre Legendre (Maître de Conférence) , Bernard Andrieu (Professeur des universités)","doi":"10.1016/j.evopsy.2025.05.001","DOIUrl":"10.1016/j.evopsy.2025.05.001","url":null,"abstract":"<div><h3>Objectives</h3><div>In the scientific literature, injury is most often understood as no more than a physical functional limitation and, therefore, as strictly negative. However, as we discuss here, there is also an effect on psychological integrity. The entire body appears to be impacted, both physically and psychologically, as an injury can simultaneously influence self-esteem, body image, and confidence in one's body schema. We first interviewed circus artists during an exploratory study, and we then interviewed elite athletes (EAs) for a case study. The goal was to characterize their respective experiences of injury to analyze the various effects of injury from the prism of bodies facing the extreme.</div></div><div><h3>Methodology</h3><div>We conducted semi-structured interviews with four EAs in combat sports (two female judokas, one male judoka, and one female fencer, with a mean age of 26 years [standard deviation<!--> <!-->=<!--> <!-->1 year]). These interviews were recorded, transcribed, and anonymized. As a first step, participants produced an awareness drawing, where they could visually represent the state of their bodies and its association with their injury history. The instructions for creating this drawing were minimally restrictive so as to encourage the most spontaneous representations possible.</div></div><div><h3>Results</h3><div>The results of the exploratory study highlighted certain positive aspects of injury, such as the opportunity to slow down a rhythm of life that is extremely intense, exhausting, or even detrimental given the demands of performance as well as the opportunity to foster self-learning during and after recovery. In the case study, the EAs represented their various, often numerous injuries through awareness drawing, which, in tandem with the subsequent explanatory interview, spurred greater bodily and mental awareness. Experiences of shared injury were frequently associated with the normalization of pain, reinforced by the fact that rest periods were kept minimal because of internal and external pressures. In this context, the first injury stood out due to its emotional impact and implications, as it often marked a significant turning point in the athlete's life. It had the possibility to become an opportunity for personal development through the specific skills it fostered, such as the development of an “injury radar”, or the specific skills it helped enhance, like resilience.</div></div><div><h3>Discussion</h3><div>The results of these two studies highlight that injuries can have certain benefits for EAs, despite injuries being typically regarded as functional limitations. Looking beyond the difficulties extensively documented in the literature, injury can prompt self-reflection and an assessment of one's practices, which can prove beneficial. Some EAs used this moment to reconsider their sporting career and objectives, while others perceived their practices as evolving through successive injuries.","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 4","pages":"Pages 581-600"},"PeriodicalIF":0.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610483","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 : 2025-06-09DOI: 10.1016/j.evopsy.2025.04.007
Mathias Winter
<div><h3>Objectives</h3><div>This article explores the history of medical and psychological expertise on sex/gender identity by studying the presentation of a case of “hermaphroditism” given by the psychiatrist Valentin Magnan and the surgeon Samuel Pozzi in 1911. It examines how these authors dealt with the discrepancy between the organic and psychosocial dimensions of sex, and it highlights the epistemological and ontological problems that emerge. The article also discusses the continuing echoes in current controversies in gender medicine.</div></div><div><h3>Methods</h3><div>Our study consists of an in-depth analysis of a presentation given to the French Academy of Medicine regarding a case of <em>“inversion du sens génital chez un pseudo-hermaphrodite féminin</em> [sexual inversion in a female pseudo-hermaphrodite]”. We conducted a detailed analysis of the minutes of the presentation, with the aim of revealing the internal logic, theoretical presuppositions, and metaphysical implications of the clinical judgements made by Magnan and Pozzi. Our primary sources include other texts by Magnan and his contemporaries on homosexuality and “sexual perversion”. Historical and epistemological studies of sex, sexuality, and hermaphroditism are used as secondary sources. Our theoretical framework draws mainly on the epistemological concepts of Kuhn and Bachelard.</div></div><div><h3>Results</h3><div>The clinical observations presented by Magnan opposed the patient's organic sex, which was, despite the presence of ambiguous genitalia, unambiguously female given the histology of the patient's gonads (ovaries), and the patient's psychological sex, which was defined as male based on both the patient's sexual attraction to women and the patient's psychological and moral characteristics. The psychiatrist's discourse suggested both symmetry and ontological equivalence between these two dimensions of sex. Overlooking the potential role of early gender assignment, education, and social environment on the patient's self-identification as male, Magnan proposed a naturalistic interpretation of the case, summed up by the expression “a male brain in a female body”. In his earlier writings on “sexual inversion”, Magnan frequently uses the above phrase and the reciprocal “female brain in a male body”, directly echoing Ulrichs’ famous “female soul in a male body”. However, in the context of the 1911 presentation, the use of this phrase appears to reflect an epistemological impasse, which results from the conjunction of the paradigms “hermaphroditism” and “sexual perversion”. In contrast, Pozzi avoided this impasse by proposing a theory that highlights the role of the patient's social environment and beliefs in the development of their sexual instinct and the formation of their identity. This theory draws on the psychological mechanism of suggestion as well as on Darwin's reflections on the domestication of animals. This perspective introduces an ontological hierarchy bet
{"title":"« Un cerveau d’homme dans un corps de femme » : le problème du sexe « psychique » chez Valentin Magnan et Samuel Pozzi (1911)","authors":"Mathias Winter","doi":"10.1016/j.evopsy.2025.04.007","DOIUrl":"10.1016/j.evopsy.2025.04.007","url":null,"abstract":"<div><h3>Objectives</h3><div>This article explores the history of medical and psychological expertise on sex/gender identity by studying the presentation of a case of “hermaphroditism” given by the psychiatrist Valentin Magnan and the surgeon Samuel Pozzi in 1911. It examines how these authors dealt with the discrepancy between the organic and psychosocial dimensions of sex, and it highlights the epistemological and ontological problems that emerge. The article also discusses the continuing echoes in current controversies in gender medicine.</div></div><div><h3>Methods</h3><div>Our study consists of an in-depth analysis of a presentation given to the French Academy of Medicine regarding a case of <em>“inversion du sens génital chez un pseudo-hermaphrodite féminin</em> [sexual inversion in a female pseudo-hermaphrodite]”. We conducted a detailed analysis of the minutes of the presentation, with the aim of revealing the internal logic, theoretical presuppositions, and metaphysical implications of the clinical judgements made by Magnan and Pozzi. Our primary sources include other texts by Magnan and his contemporaries on homosexuality and “sexual perversion”. Historical and epistemological studies of sex, sexuality, and hermaphroditism are used as secondary sources. Our theoretical framework draws mainly on the epistemological concepts of Kuhn and Bachelard.</div></div><div><h3>Results</h3><div>The clinical observations presented by Magnan opposed the patient's organic sex, which was, despite the presence of ambiguous genitalia, unambiguously female given the histology of the patient's gonads (ovaries), and the patient's psychological sex, which was defined as male based on both the patient's sexual attraction to women and the patient's psychological and moral characteristics. The psychiatrist's discourse suggested both symmetry and ontological equivalence between these two dimensions of sex. Overlooking the potential role of early gender assignment, education, and social environment on the patient's self-identification as male, Magnan proposed a naturalistic interpretation of the case, summed up by the expression “a male brain in a female body”. In his earlier writings on “sexual inversion”, Magnan frequently uses the above phrase and the reciprocal “female brain in a male body”, directly echoing Ulrichs’ famous “female soul in a male body”. However, in the context of the 1911 presentation, the use of this phrase appears to reflect an epistemological impasse, which results from the conjunction of the paradigms “hermaphroditism” and “sexual perversion”. In contrast, Pozzi avoided this impasse by proposing a theory that highlights the role of the patient's social environment and beliefs in the development of their sexual instinct and the formation of their identity. This theory draws on the psychological mechanism of suggestion as well as on Darwin's reflections on the domestication of animals. This perspective introduces an ontological hierarchy bet","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 3","pages":"Pages 518-535"},"PeriodicalIF":0.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779278","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 : 2025-05-14DOI: 10.1016/j.evopsy.2025.04.005
Florestan Delcourt (Psychologue, Doctorant en Psychologie) , Jacques Auxenfants (Traducteur) , Caroline Gros (Psychanalyste, Docteure en Philosophie)
Objectives
Psychiatric phenomenology is a twentieth-century movement that, after a quiet period, is experiencing a major resurgence in both research and clinical spheres. While people often erroneously cite Karl Jaspers, in 1912, as the source of the movement, initially Husserlian in origin, others, such as Pierre Bovet and Josef Parnas, date its appearance to 1922, at the 63rd Meeting of the Swiss Psychiatric Society. Given that the meeting's minutes did not exist in French, we undertook a translation.
Methods
After retrieving the text from the Swiss Archives of Neurology and Psychiatry, we translated it into French.
Results
Our translation of this meeting's minutes shows the contributions made by Ludwig Binswanger and Eugène Minkowski to the emergence of the as-yet unpublished movement. Furthermore, we can note that several historical figures in the field of psychiatry, such as Eugen Bleuler, not only attended the event, but also took part in it.
Discussion
In addition to the translation of the two psychiatrists’ presentations, the translation of the subsequent exchanges highlights the interest and suspicion that this philosophical movement elicited from the audience of psychiatrists. Some notions, such as intuition and experience, were discussed, and questions were raised regarding the links between this approach and other disciplines, such as psychiatry itself, aesthetics, and psychoanalysis.
Conclusion
Our translation provides insight into the founding of this movement, as well as into the challenges that, based on the meeting's minutes, seem to have provoked debate from the outset.
{"title":"L’Acte de naissance de la phénoménologie psychiatrique – la traduction du Procès-verbal de la 63e assemblée de l’Association Suisse de psychiatrie","authors":"Florestan Delcourt (Psychologue, Doctorant en Psychologie) , Jacques Auxenfants (Traducteur) , Caroline Gros (Psychanalyste, Docteure en Philosophie)","doi":"10.1016/j.evopsy.2025.04.005","DOIUrl":"10.1016/j.evopsy.2025.04.005","url":null,"abstract":"<div><h3>Objectives</h3><div>Psychiatric phenomenology is a twentieth-century movement that, after a quiet period, is experiencing a major resurgence in both research and clinical spheres. While people often erroneously cite Karl Jaspers, in 1912, as the source of the movement, initially Husserlian in origin, others, such as Pierre Bovet and Josef Parnas, date its appearance to 1922, at the 63rd Meeting of the <em>Swiss Psychiatric Society</em>. Given that the meeting's minutes did not exist in French, we undertook a translation.</div></div><div><h3>Methods</h3><div>After retrieving the text from the <em>Swiss Archives of Neurology and Psychiatry</em>, we translated it into French.</div></div><div><h3>Results</h3><div>Our translation of this meeting's minutes shows the contributions made by Ludwig Binswanger and Eugène Minkowski to the emergence of the as-yet unpublished movement. Furthermore, we can note that several historical figures in the field of psychiatry, such as Eugen Bleuler, not only attended the event, but also took part in it.</div></div><div><h3>Discussion</h3><div>In addition to the translation of the two psychiatrists’ presentations, the translation of the subsequent exchanges highlights the interest and suspicion that this philosophical movement elicited from the audience of psychiatrists. Some notions, such as intuition and experience, were discussed, and questions were raised regarding the links between this approach and other disciplines, such as psychiatry itself, aesthetics, and psychoanalysis.</div></div><div><h3>Conclusion</h3><div>Our translation provides insight into the founding of this movement, as well as into the challenges that, based on the meeting's minutes, seem to have provoked debate from the outset.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 3","pages":"Pages 500-517"},"PeriodicalIF":0.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779277","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}
This study addresses the relational adjustments of individuals who have lost a loved one due to femicide. It explores how co-victims perceive the impact of femicide on their interpersonal relationships, by examining the social support provided by their close circle and various aid services.
Method
Semi-structured interviews were conducted to explore the psychological consequences and relational challenges faced by bereaved families. A thematic content analysis was carried out, allowing for an in-depth examination of the interview transcripts through the identification of key themes.
Results
The results highlight the relational challenges and psychological consequences experienced by families grieving after a femicide. The subjective nature of emotional bonds is emphasized, particularly through the testimony of participants. The findings reveal that co-victims of femicide experience significant relational changes after the tragedy, both within their social circle and with support services.
Discussion
This study enhances the understanding of family and interpersonal relationships in the context of femicide. The results emphasize the importance of social support in the grieving and rebuilding process, highlighting the essential role of close relations and professionals during these critical periods.
Conclusion
This article contributes to advancing discussions on the support of bereaved individuals after a violent death, while also addressing avenues for future research.
{"title":"Réaménagements relationnels des co-victimes d’un féminicide","authors":"Soline Guyomar CandidatePhD, Suzanne Léveillée (Professeure)","doi":"10.1016/j.evopsy.2025.03.013","DOIUrl":"10.1016/j.evopsy.2025.03.013","url":null,"abstract":"<div><h3>Objectives</h3><div>This study addresses the relational adjustments of individuals who have lost a loved one due to femicide. It explores how co-victims perceive the impact of femicide on their interpersonal relationships, by examining the social support provided by their close circle and various aid services.</div></div><div><h3>Method</h3><div>Semi-structured interviews were conducted to explore the psychological consequences and relational challenges faced by bereaved families. A thematic content analysis was carried out, allowing for an in-depth examination of the interview transcripts through the identification of key themes.</div></div><div><h3>Results</h3><div>The results highlight the relational challenges and psychological consequences experienced by families grieving after a femicide. The subjective nature of emotional bonds is emphasized, particularly through the testimony of participants. The findings reveal that co-victims of femicide experience significant relational changes after the tragedy, both within their social circle and with support services.</div></div><div><h3>Discussion</h3><div>This study enhances the understanding of family and interpersonal relationships in the context of femicide. The results emphasize the importance of social support in the grieving and rebuilding process, highlighting the essential role of close relations and professionals during these critical periods.</div></div><div><h3>Conclusion</h3><div>This article contributes to advancing discussions on the support of bereaved individuals after a violent death, while also addressing avenues for future research.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 3","pages":"Pages 415-429"},"PeriodicalIF":0.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779372","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 : 2025-04-28DOI: 10.1016/j.evopsy.2025.01.003
Pierre Delion (Professeur émérite de pédopsychiatrie, praticien hospitalier honoraire, psychanalyste)
{"title":"Enfin un discours scientifique sur les neurosciences ! À propos de… « Neurosciences, un discours néolibéral. Psychiatrie, éducation, inégalités » de François Gonon","authors":"Pierre Delion (Professeur émérite de pédopsychiatrie, praticien hospitalier honoraire, psychanalyste)","doi":"10.1016/j.evopsy.2025.01.003","DOIUrl":"10.1016/j.evopsy.2025.01.003","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 368-371"},"PeriodicalIF":0.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090535","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 : 2025-04-25DOI: 10.1016/j.evopsy.2025.01.001
Christophe Chaperot (Psychiatre, Chef de pôle)
Objective
The psychotherapy of psychotic patients is the subject of much debate and discussion, with two underlying factors: firstly, the fear of doing worse than better, and secondly, the need to flush out the underlying ideologies likely to aggravate the implicit discrimination of patients under the mask of benevolence, which in reality is rejectionist. To put it bluntly, there are three main approaches: containment of enjoyment, which allows the patient to elaborate at the same time (with the risk of psychic sclerosis), cognitive remediation, with the risk of ideological normalisation, and finally immersion in the psychotic world (with the risk of supporting delirium and its suffering). In this paper, we will discuss this third possibility, drawing on the thinking of Gaetano Benedetti, and consequently on a psychoanalytical basis. It is neither a question of proselytising Benedetti's thought, nor of ostracising other approaches.
Method
The main principles of Benedetti's thinking will be taken up again, at the same time as we propose clinical illustrations from our own practice. A brief reminder of the difference between psychoanalysis and psychotherapy and psychoanalysis will be offered, as well as the impossibility of psychoanalysis with a psychotic patient, which is why our title indicates ‘psychoanalytic psychotherapy’.
Result
It appears that Benedetti's theses, and the praxis that follows from them, do not concern all psychotic patients or all psychoanalysts; they require a kind of special nature that Freud was already talking about in his day. The crucial point is, on the one hand, ‘positivisation’ (considering that the delusional patient is telling the truth because it is his reality). The other aspect concerns an attitude of ‘partial identification’, i.e. identifying with the patient in his psychosis and working in solidarity with him on the basis of his truth.
Discussion
Psychoanalytic psychotherapy of psychotic patients using (partial) identification can be an interesting way of gaining access to the patient's most intimate psychopathological mechanisms, in order to offer help in the same way as an architect rather than an archaeologist (in Freud's sense of the typical cure).
Conclusion
Benedetti has devised a way of approaching psychosis that may prove useful in a number of cases, while putting the possibility of success into perspective. Success results in the construction of an undecidable structure combining unconscious elements of the patient and others of the analyst as a result of identification effects causing a form of unconscious hybridisation.
{"title":"Gaetano Benedetti's psychoanalytical psychotherapy of psychoses: Illustrations from a number of clinical situations","authors":"Christophe Chaperot (Psychiatre, Chef de pôle)","doi":"10.1016/j.evopsy.2025.01.001","DOIUrl":"10.1016/j.evopsy.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>The psychotherapy of psychotic patients is the subject of much debate and discussion, with two underlying factors: firstly, the fear of doing worse than better, and secondly, the need to flush out the underlying ideologies likely to aggravate the implicit discrimination of patients under the mask of benevolence, which in reality is rejectionist. To put it bluntly, there are three main approaches: containment of enjoyment, which allows the patient to elaborate at the same time (with the risk of psychic sclerosis), cognitive remediation, with the risk of ideological normalisation, and finally immersion in the psychotic world (with the risk of supporting delirium and its suffering). In this paper, we will discuss this third possibility, drawing on the thinking of Gaetano Benedetti, and consequently on a psychoanalytical basis. It is neither a question of proselytising Benedetti's thought, nor of ostracising other approaches.</div></div><div><h3>Method</h3><div>The main principles of Benedetti's thinking will be taken up again, at the same time as we propose clinical illustrations from our own practice. A brief reminder of the difference between psychoanalysis and psychotherapy and psychoanalysis will be offered, as well as the impossibility of psychoanalysis with a psychotic patient, which is why our title indicates ‘psychoanalytic psychotherapy’.</div></div><div><h3>Result</h3><div>It appears that Benedetti's theses, and the praxis that follows from them, do not concern all psychotic patients or all psychoanalysts; they require a kind of special nature that Freud was already talking about in his day. The crucial point is, on the one hand, ‘positivisation’ (considering that the delusional patient is telling the truth because it is his reality). The other aspect concerns an attitude of ‘partial identification’, i.e. identifying with the patient in his psychosis and working in solidarity with him on the basis of his truth.</div></div><div><h3>Discussion</h3><div>Psychoanalytic psychotherapy of psychotic patients using (partial) identification can be an interesting way of gaining access to the patient's most intimate psychopathological mechanisms, in order to offer help in the same way as an architect rather than an archaeologist (in Freud's sense of the typical cure).</div></div><div><h3>Conclusion</h3><div>Benedetti has devised a way of approaching psychosis that may prove useful in a number of cases, while putting the possibility of success into perspective. Success results in the construction of an undecidable structure combining unconscious elements of the patient and others of the analyst as a result of identification effects causing a form of unconscious hybridisation.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 197-206"},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090538","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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