Pub Date : 2023-12-20DOI: 10.1016/j.evopsy.2023.11.003
Francesca Melas (Médecin, Assistante en psychiatrie à l’Université Catholique de Louvain) , Sylvain Dal (Médecin psychiatre)
Objective
The notions of psychosis, neurosis, and perversion structured clinical thought during the golden age of psychoanalysis. But, even if psychosis and neurosis are still an integral part of our medical vocabulary, perversion, on the other hand, has become a forgotten or even obsolete concept. However, some mechanisms of interaction between patients and more precisely some suicide attempts seem to be significantly related to it. In this article, we offer the reader a second look at this clinical perversion.
Methodology
This article aims to study some perverse mechanisms that are present in clinical work with suicidal patients and to establish a current, historical, and non-exhaustive definition that will answer the following question: “can a suicide attempt be thought of as a perverse act in its address to the therapist?” The theoretical input will be supported by a preliminary clinical illustration about the hospital and ambulatory monitoring of a young patient.
Results
When suicidal acting out takes on a special meaning addressed to the therapist and allows the patient to seize power in the therapeutic relationship, we can clearly see the characteristics of perversion.
Discussion
A cautious approach should be adopted about this proposition: not all suicidal acts are to be associated without nuance with perversion. Similarly, it is up to the therapist to understand the mechanisms developed by the patient in the therapeutic relationship and to make them the object of shared therapeutic work.
Conclusion
This article offers the reader a theoretical and clinical approach to the suicidal act in patients whose psychic structure can be considered perverse. It allows us to: differentiate between addressed and un-addressed suicidal acts, acknowledge the resulting clinical difficulties, and explore avenues about the monitoring of patients after a suicide attempt.
{"title":"Le passage à l’acte suicidaire dans sa dimension perverse, analyse d’un cas clinique","authors":"Francesca Melas (Médecin, Assistante en psychiatrie à l’Université Catholique de Louvain) , Sylvain Dal (Médecin psychiatre)","doi":"10.1016/j.evopsy.2023.11.003","DOIUrl":"10.1016/j.evopsy.2023.11.003","url":null,"abstract":"<div><h3>Objective</h3><p>The notions of psychosis, neurosis, and perversion structured clinical thought during the golden age of psychoanalysis. But, even if psychosis and neurosis are still an integral part of our medical vocabulary, perversion, on the other hand, has become a forgotten or even obsolete concept. However, some mechanisms of interaction between patients and more precisely some suicide attempts seem to be significantly related to it. In this article, we offer the reader a second look at this clinical perversion.</p></div><div><h3>Methodology</h3><p>This article aims to study some perverse mechanisms that are present in clinical work with suicidal patients and to establish a current, historical, and non-exhaustive definition that will answer the following question: “can a suicide attempt be thought of as a perverse act in its address to the therapist?” The theoretical input will be supported by a preliminary clinical illustration about the hospital and ambulatory monitoring of a young patient.</p></div><div><h3>Results</h3><p>When suicidal acting out takes on a special meaning addressed to the therapist and allows the patient to seize power in the therapeutic relationship, we can clearly see the characteristics of perversion.</p></div><div><h3>Discussion</h3><p>A cautious approach should be adopted about this proposition: not all suicidal acts are to be associated without nuance with perversion. Similarly, it is up to the therapist to understand the mechanisms developed by the patient in the therapeutic relationship and to make them the object of shared therapeutic work.</p></div><div><h3>Conclusion</h3><p>This article offers the reader a theoretical and clinical approach to the suicidal act in patients whose psychic structure can be considered perverse. It allows us to: differentiate between addressed and un-addressed suicidal acts, acknowledge the resulting clinical difficulties, and explore avenues about the monitoring of patients after a suicide attempt.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139018920","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 : 2023-12-13DOI: 10.1016/j.evopsy.2023.05.001
Manuella De Luca (Professeur, Responsable du pôle de psychiatrie et de psychopathologie de l’adolescent et du jeune adulte)
{"title":"Pouvoir ou ne pas pouvoir être jaloux. À propos de … « Les bienfaits de la jalousie » sous la direction de Catherine Chabert et Estelle Louët","authors":"Manuella De Luca (Professeur, Responsable du pôle de psychiatrie et de psychopathologie de l’adolescent et du jeune adulte)","doi":"10.1016/j.evopsy.2023.05.001","DOIUrl":"10.1016/j.evopsy.2023.05.001","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139024354","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 : 2023-12-09DOI: 10.1016/j.evopsy.2023.11.001
Professor Jean Decety
Objectives
This theoretical essay attempts to explain, from an interdisciplinary naturalistic perspective that integrates the biological and social sciences, why and how beliefs associated with moral values can lead to dogmatism, intolerant opinions and attitudes, and can motivate violent collective actions.
Method
The article relies on an integrative analysis of the empirical literature, drawing on 138 articles (78% published in the last eight years) in anthropology, neuroscience, psychology, political science, and sociology to explain why and how moralization strongly increases the strength of beliefs and attitudes – in certainty and importance – which, in turn, motivates social engagement and induces attitudinal extremism regardless of ideological or political affiliation.
Results
Moral convictions are perceived as objective, absolute, necessary, universal, and infallible truths with strong links to emotions, the reward circuit, and the value system in the brain that motivates and controls behavior. Moral values are generally shared with other members of one's community and, therefore, linked to social identity. Perceived social consensus is an important input to objectivity. Objectively grounded moral principles generate an expectation of consensus, which can lead to intolerance and hostility regarding anyone who disagrees. Moral convictions motivate participation in collective action and inspire the courage to oppose perceived injustices, real or imagined, despite a personal cost. Cognitive rigidity is often a characteristic of moral convictions. Once an issue is moralized and considered objective, whether in the social, economic, or political domains, it is more likely to be perceived as an absolute belief, held with high confidence, and immune to corrective information. People who are highly confident in their beliefs are more prone to confirmation bias, making them dogmatic with a sense of moral superiority and less willing to seek or consider corrective information regardless of the accuracy of their beliefs. Specific neural signatures and low-level cognitive dispositions are reliably associated with personality orientations prone to political and social dogmatic attitudes.
Discussion
Opinions and attitudes, when moralized, can easily make people dogmatic and intolerant. Moral convictions can serve as mandates that facilitate political activism with extreme and often negative views. The conjunction of moral conviction and identity-based ideology is largely responsible for driving the contemporary hostile affective polarization of opinions. The lack of cognitive flexibility explains the failure to update, calibrate, and discard previous beliefs. This metacognitive overconfidence contributes to a dispositional tendency toward dogmatic intolerance. This makes it easier for people who are extreme in their political attitudes, regardle
{"title":"Pourquoi les convictions morales facilitent le dogmatisme, l’intolérance et la violence","authors":"Professor Jean Decety","doi":"10.1016/j.evopsy.2023.11.001","DOIUrl":"10.1016/j.evopsy.2023.11.001","url":null,"abstract":"<div><h3>Objectives</h3><p>This theoretical essay attempts to explain, from an interdisciplinary naturalistic perspective that integrates the biological and social sciences, why and how beliefs associated with moral values can lead to dogmatism, intolerant opinions and attitudes, and can motivate violent collective actions.</p></div><div><h3>Method</h3><p>The article relies on an integrative analysis of the empirical literature, drawing on 138 articles (78% published in the last eight years) in anthropology, neuroscience, psychology, political science, and sociology to explain <em>why</em> and <em>how</em> moralization strongly increases the strength of beliefs and attitudes – in certainty and importance – which, in turn, motivates social engagement and induces attitudinal extremism regardless of ideological or political affiliation.</p></div><div><h3>Results</h3><p>Moral convictions are perceived as objective, absolute, necessary, universal, and infallible truths with strong links to emotions, the reward circuit, and the value system in the brain that motivates and controls behavior. Moral values are generally shared with other members of one's community and, therefore, linked to social identity. Perceived social consensus is an important input to objectivity. Objectively grounded moral principles generate an expectation of consensus, which can lead to intolerance and hostility regarding anyone who disagrees. Moral convictions motivate participation in collective action and inspire the courage to oppose perceived injustices, real or imagined, despite a personal cost. Cognitive rigidity is often a characteristic of moral convictions. Once an issue is moralized and considered objective, whether in the social, economic, or political domains, it is more likely to be perceived as an absolute belief, held with high confidence, and immune to corrective information. People who are highly confident in their beliefs are more prone to confirmation bias, making them dogmatic with a sense of moral superiority and less willing to seek or consider corrective information regardless of the accuracy of their beliefs. Specific neural signatures and low-level cognitive dispositions are reliably associated with personality orientations prone to political and social dogmatic attitudes.</p></div><div><h3>Discussion</h3><p>Opinions and attitudes, when moralized, can easily make people dogmatic and intolerant. Moral convictions can serve as mandates that facilitate political activism with extreme and often negative views. The conjunction of moral conviction and identity-based ideology is largely responsible for driving the contemporary hostile affective polarization of opinions. The lack of cognitive flexibility explains the failure to update, calibrate, and discard previous beliefs. This metacognitive overconfidence contributes to a dispositional tendency toward dogmatic intolerance. This makes it easier for people who are extreme in their political attitudes, regardle","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138616764","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 : 2023-12-06DOI: 10.1016/j.evopsy.2023.10.006
Yann Craus (pédopsychiatre) , Carole Blanc (psychologue clinicienne) , Patricia Luthin (psychologue clinicienne) , Yann Diener (psychologue clinicien) , Hélène Gombeaud (orthophoniste) , Estela Roitman (psychomotricienne) , Eddy Raynal (psychomotricien) , Véronique Durousseau (orthophoniste) , Sandrine Deloche (pédopsychiatre) , Aude Béliard (maîtresse de conférences en sociologie) , Jean-Sébastien Eideliman (maître de conférences en sociologie) , Thibaud Pombet (maître de conférences en sociologie) , Livia Velpry (maîtresse de conférences en sociologie)
Objectives
In this article, we present the results of a research project conducted jointly by professionals from a child and adolescent mental health center (CMP) and sociologists. We explore how the first confinement (in the spring of 2020) affected the situation of the child patients at the CMP and their families, as well as the care practices of the professionals.
Methods
The study was implemented in May 2020. Nine mental health professionals (psychologists, child psychiatrists, speech therapists, psychomotor therapists, social worker) were invited either to write a text reflecting on their experience, or to participate in an interview with one of the four sociologists. In both cases, the suggestion was to describe clinical situations, focusing both on social and psychological aspects, and to formulate ideas on the effects of confinement based on these clinical examples, while preserving the anonymity of the patients. Following this phase, the mental health team and the sociologists met several times to collectively discuss the content of these texts and to elaborate a reflection at a more general level that resulted in this article.
Results
This research illustrates some effects of the Covid-19 crisis on children and families, notably the reinforcement of social inequalities, as witnessed by mental health care professionals. It also documents the adaptations of care practices (e.g. remote consultations) during this period, as well as the multiple questions that professionals had to address.
Discussion
Regarding the situations of the children and their families, the data collected reveal that social inequalities have been exacerbated by the context of the pandemic, but it also underscores how certain factors (type of housing, family configurations, individuals’ relationships with academic and public health norms) may have contributed to differences between families from similar socio-professional categories. Regarding mental health care, it appears that guaranteeing the continuity of the relationship with the child and/or the family was a crucial concern for the professionals. As face-to-face appointments were limited, practices arose that were not seen as options in the usual work environment and habits, such as phone consultations. Professionals questioned the effects and stakes of these remote encounters and were forced to reposition themselves clinically and therapeutically.
Conclusion
This research experience encourages us to renew this type of study, because of the richness of the results produced by an analysis associating professionals and sociologists, but also because of its contribution to the mental health team's capacity to reflect critically on its own practices.
{"title":"Crise sanitaire et soins psychiques pour les enfants. Une étude psycho-sociologique au CMP","authors":"Yann Craus (pédopsychiatre) , Carole Blanc (psychologue clinicienne) , Patricia Luthin (psychologue clinicienne) , Yann Diener (psychologue clinicien) , Hélène Gombeaud (orthophoniste) , Estela Roitman (psychomotricienne) , Eddy Raynal (psychomotricien) , Véronique Durousseau (orthophoniste) , Sandrine Deloche (pédopsychiatre) , Aude Béliard (maîtresse de conférences en sociologie) , Jean-Sébastien Eideliman (maître de conférences en sociologie) , Thibaud Pombet (maître de conférences en sociologie) , Livia Velpry (maîtresse de conférences en sociologie)","doi":"10.1016/j.evopsy.2023.10.006","DOIUrl":"10.1016/j.evopsy.2023.10.006","url":null,"abstract":"<div><h3>Objectives</h3><p>In this article, we present the results of a research project conducted jointly by professionals from a child and adolescent mental health center (CMP) and sociologists. We explore how the first confinement (in the spring of 2020) affected the situation of the child patients at the CMP and their families, as well as the care practices of the professionals.</p></div><div><h3>Methods</h3><p>The study was implemented in May 2020. Nine mental health professionals (psychologists, child psychiatrists, speech therapists, psychomotor therapists, social worker) were invited either to write a text reflecting on their experience, or to participate in an interview with one of the four sociologists. In both cases, the suggestion was to describe clinical situations, focusing both on social and psychological aspects, and to formulate ideas on the effects of confinement based on these clinical examples, while preserving the anonymity of the patients. Following this phase, the mental health team and the sociologists met several times to collectively discuss the content of these texts and to elaborate a reflection at a more general level that resulted in this article.</p></div><div><h3>Results</h3><p>This research illustrates some effects of the Covid-19 crisis on children and families, notably the reinforcement of social inequalities, as witnessed by mental health care professionals. It also documents the adaptations of care practices (e.g. remote consultations) during this period, as well as the multiple questions that professionals had to address.</p></div><div><h3>Discussion</h3><p>Regarding the situations of the children and their families, the data collected reveal that social inequalities have been exacerbated by the context of the pandemic, but it also underscores how certain factors (type of housing, family configurations, individuals’ relationships with academic and public health norms) may have contributed to differences between families from similar socio-professional categories. Regarding mental health care, it appears that guaranteeing the continuity of the relationship with the child and/or the family was a crucial concern for the professionals. As face-to-face appointments were limited, practices arose that were not seen as options in the usual work environment and habits, such as phone consultations. Professionals questioned the effects and stakes of these remote encounters and were forced to reposition themselves clinically and therapeutically.</p></div><div><h3>Conclusion</h3><p>This research experience encourages us to renew this type of study, because of the richness of the results produced by an analysis associating professionals and sociologists, but also because of its contribution to the mental health team's capacity to reflect critically on its own practices.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138618973","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 : 2023-12-01DOI: 10.1016/j.evopsy.2023.06.004
Carole Pinel (Psychologue clinicienne, Docteur en psychologie, Enseignant-chercheur en psychologie clinique et psychopathologie)
Aims
This article proposes to question the dimension of “inventive craftwork” in clinical practice, and to open up the field of its complexity, by taking as a basis the singular elaborative work of several young people participating in workshops within a mental healthcare institution. If today the notions of the unconscious, subjectivity, the patients’ word, desire, enjoyment, and lust are reduced to the bare minimum, and if the neuroscientific approach might ultimately ignore the field of the unconscious as some debates suggest, we will expose other horizons : that of the value of the word, that of the “clinical at the bedside,” that of the function of the symptom, and that of inventive “craftwork” as a singular creation. We will insist on the following postulate : rather than considering a subject as deficient, we will, instead, consider them as a subject attempting to deal with their anxiety. Beyond the question of understanding, we will strive not to back down in the face of psychosis, thus following the recommendations of previous psychiatrists.
Method
First, we will move away from a deficitary approach, as it is commonly understood today, in order to restore to their rightful places the function of the symptom and the welcoming of a singular subjective “oddness.” We will rely on the words of the teenagers who participated in and with whom we worked in the offered creative workshops. This description will consist in highlighting the singular logic at work in each young person, and how each of them teaches us their own way of dealing with their symptom. We will propose to learn from the singular language of these subjects participating in the workshops to receive the inventive way in which they deal with the suffering they are facing. Then, we will revisit the questions of art, creation, and sublimation in the work of Sigmund Freud. If the inventor of psychoanalysis thinks of creation as illusory, as difficult to understand through analysis, as drawing on the child's play, or even as sublimation, by exploring these patients’ contributions, we will look at the works of several psychoanalysts who succeeded Freud, or who read him from different point of view. Donald Woods Winnicott worked extensively on the dimension of play and creativity in his clinical practice with children. He also looked at what he called the “creative lifestyle.” This author shifts from Freudian sublimation to opening the field of transitionality. In his Seminar on the Ethics of Psychoanalysis Jacques Lacan questioned the sublimation of and the destiny of the trieb by demonstrating how this destiny consists in elevating its primary goal to the rank of a shareable work. This literature review will allow us to question the dimension of creation within clinical practice. With the Freudian model alone not being able to account for the creative impulse, Jacques Lacan also proposed the concept of the sinthome, in the la
{"title":"Élever le bricolage à la dignité du savoir-y-faire avec le symptôme","authors":"Carole Pinel (Psychologue clinicienne, Docteur en psychologie, Enseignant-chercheur en psychologie clinique et psychopathologie)","doi":"10.1016/j.evopsy.2023.06.004","DOIUrl":"10.1016/j.evopsy.2023.06.004","url":null,"abstract":"<div><h3>Aims</h3><p>This article proposes to question the dimension of “inventive craftwork” in clinical practice, and to open up the field of its complexity, by taking as a basis the singular elaborative work of several young people participating in workshops within a mental healthcare institution. If today the notions of the unconscious, subjectivity, the patients’ word, desire, enjoyment, and lust are reduced to the bare minimum, and if the neuroscientific approach might ultimately ignore the field of the unconscious as some debates suggest, we will expose other horizons : that of the value of the word, that of the “clinical at the bedside,” that of the function of the symptom, and that of inventive “craftwork” as a singular creation. We will insist on the following postulate : rather than considering a subject as deficient, we will, instead, consider them as a subject attempting to deal with their anxiety. Beyond the question of understanding, we will strive not to back down in the face of psychosis, thus following the recommendations of previous psychiatrists.</p></div><div><h3>Method</h3><p>First, we will move away from a deficitary approach, as it is commonly understood today, in order to restore to their rightful places the function of the symptom and the welcoming of a singular subjective “oddness.” We will rely on the words of the teenagers who participated in and with whom we worked in the offered creative workshops. This description will consist in highlighting the singular logic at work in each young person, and how each of them teaches us their own way of dealing with their symptom. We will propose to learn from the singular language of these subjects participating in the workshops to receive the inventive way in which they deal with the suffering they are facing. Then, we will revisit the questions of art, creation, and sublimation in the work of Sigmund Freud. If the inventor of psychoanalysis thinks of creation as illusory, as difficult to understand through analysis, as drawing on the child's play, or even as sublimation, by exploring these patients’ contributions, we will look at the works of several psychoanalysts who succeeded Freud, or who read him from different point of view. Donald Woods Winnicott worked extensively on the dimension of play and creativity in his clinical practice with children. He also looked at what he called the “creative lifestyle.” This author shifts from Freudian sublimation to opening the field of transitionality. In his Seminar on <em>the Ethics of Psychoanalysis</em> Jacques Lacan questioned the sublimation of and the destiny of the <em>trieb</em> by demonstrating how this destiny consists in elevating its primary goal to the rank of a shareable work. This literature review will allow us to question the dimension of creation within clinical practice. With the Freudian model alone not being able to account for the creative impulse, Jacques Lacan also proposed the concept of the sinthome, in the la","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117337986","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 : 2023-12-01DOI: 10.1016/j.evopsy.2023.09.001
Renaud Evrard (psychologue, maître de conférences – HDR en psychologie) , Marianne Dollander (psychologue, maître de conférences en psychologie) , Evelyn Elsaesser (Independent researcher) , Callum Cooper (Senior lecturer) , David Lorimer (Programme director) , Chris Roe (Professor)
{"title":"Erratum à « Expériences exceptionnelles nécrophaniques et deuil paradoxal: études de la phénoménologie et des répercussions des vécus effrayants de contact avec les défunts » [Evol. Psychiatr. 86 (2021) 799–824]","authors":"Renaud Evrard (psychologue, maître de conférences – HDR en psychologie) , Marianne Dollander (psychologue, maître de conférences en psychologie) , Evelyn Elsaesser (Independent researcher) , Callum Cooper (Senior lecturer) , David Lorimer (Programme director) , Chris Roe (Professor)","doi":"10.1016/j.evopsy.2023.09.001","DOIUrl":"https://doi.org/10.1016/j.evopsy.2023.09.001","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0014385523001159/pdfft?md5=8e10810d49f84188ca4d3777b614278c&pid=1-s2.0-S0014385523001159-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138484258","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 : 2023-12-01DOI: 10.1016/j.evopsy.2023.04.002
Jean Naudin (Psychiatre, Docteur en philosophie, Expert auprès des tribunaux, Chef de service à Marseille)
Objectives
This article aims to show how the forensic psychiatric examination reconstructs, by progressing gently from the facts and the intimate history of a life, a clinical practice which is specific to it.
Method
We set aside the theories that prevail in the medical and judicial domains in order to make the clinical phenomena appear as they occur in the subject's natural experience of the world. We practice this form of reduction beginning with the encounter with the patient, and relate it in this article by choosing a literary style (37 numbered paragraphs made up of a number of equal words), that is faithful to its subjective progression, made of gentleness, formalizations, and cuts showing the objective points of attachment to the solidity of the clinical.
Results
The clinical facts occur in the patient's lived world and in the common world, each one thought of as a reality of daily life and a reality of work, and which are co-constructed by institutions and culture. Our results are presented as clinical variations on the theme of the forensic psychiatric examination, highlighting the importance of the subject's inner history as well as the importance of his or her culture.
Discussion
This work shows how, by passing from the oral to the written form and then returning to the oral form at the time of the hearing, the expert witness does not so much describe the facts as he produces them, by placing them in direct relation with subjective experience: that of the perpetrator, that of the victim, and that of the expert himself. As a collection of stories, no fact, clinical or judicial, has any meaning in isolation. It only becomes worthwhile through the relationship that it makes present from various angles and points of view, characteristic of the plural realities that make up the co-construction of the expertise. The phenomenological method, by progressing gently, allows the facts to appear as they can make sense to each of the protagonists. A common horizon of values can then emerge from the discussion and the successive passages from oral to written form, which sheds light on the possibilities of discernment, choice, and responsibility that structure the missions entrusted to the expert witness.
Conclusion
Phenomenology brings to forensic psychiatry a rigorous method of progression on the philosophical level as well as on the clinical level. It can thus contributes to the progression of the judicial truth without draping the reality of the clinical facts with any cerebral mythology or any preconceived theory applied from the outside to the facts, to the subject's own experience, and to what links them.
{"title":"Phénoménologie, expertise, méthode : comment les pratiquer avec douceur","authors":"Jean Naudin (Psychiatre, Docteur en philosophie, Expert auprès des tribunaux, Chef de service à Marseille)","doi":"10.1016/j.evopsy.2023.04.002","DOIUrl":"10.1016/j.evopsy.2023.04.002","url":null,"abstract":"<div><h3>Objectives</h3><p>This article aims to show how the forensic psychiatric examination reconstructs, by progressing gently from the facts and the intimate history of a life, a clinical practice which is specific to it.</p></div><div><h3>Method</h3><p>We set aside the theories that prevail in the medical and judicial domains in order to make the clinical phenomena appear as they occur in the subject's natural experience of the world. We practice this form of reduction beginning with the encounter with the patient, and relate it in this article by choosing a literary style (37 numbered paragraphs made up of a number of equal words), that is faithful to its subjective progression, made of gentleness, formalizations, and cuts showing the objective points of attachment to the solidity of the clinical.</p></div><div><h3>Results</h3><p>The clinical facts occur in the patient's lived world and in the common world, each one thought of as a reality of daily life and a reality of work, and which are co-constructed by institutions and culture. Our results are presented as clinical variations on the theme of the forensic psychiatric examination, highlighting the importance of the subject's inner history as well as the importance of his or her culture.</p></div><div><h3>Discussion</h3><p>This work shows how, by passing from the oral to the written form and then returning to the oral form at the time of the hearing, the expert witness does not so much describe the facts as he produces them, by placing them in direct relation with subjective experience: that of the perpetrator, that of the victim, and that of the expert himself. As a collection of stories, no fact, clinical or judicial, has any meaning in isolation. It only becomes worthwhile through the relationship that it makes present from various angles and points of view, characteristic of the plural realities that make up the co-construction of the expertise. The phenomenological method, by progressing gently, allows the facts to appear as they can make sense to each of the protagonists. A common horizon of values can then emerge from the discussion and the successive passages from oral to written form, which sheds light on the possibilities of discernment, choice, and responsibility that structure the missions entrusted to the expert witness.</p></div><div><h3>Conclusion</h3><p>Phenomenology brings to forensic psychiatry a rigorous method of progression on the philosophical level as well as on the clinical level. It can thus contributes to the progression of the judicial truth without draping the reality of the clinical facts with any cerebral mythology or any preconceived theory applied from the outside to the facts, to the subject's own experience, and to what links them.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121764485","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 : 2023-12-01DOI: 10.1016/j.evopsy.2023.04.003
Pascal Le Maléfan
{"title":"Janet ultime. À propos de … « Les formes de la croyance » de Pierre Janet","authors":"Pascal Le Maléfan","doi":"10.1016/j.evopsy.2023.04.003","DOIUrl":"10.1016/j.evopsy.2023.04.003","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124658446","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 : 2023-12-01DOI: 10.1016/j.evopsy.2022.11.001
Houari Maïdi (Professeur de psychologie clinique et psychopathologie)
{"title":"Des structures cliniques selon Lacan. À propos de … « Les structures cliniques–Fondement et perspectives d’une doctrine lacanienne » de Miguel Sierra Rubio","authors":"Houari Maïdi (Professeur de psychologie clinique et psychopathologie)","doi":"10.1016/j.evopsy.2022.11.001","DOIUrl":"10.1016/j.evopsy.2022.11.001","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126425607","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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