Pub Date : 2025-04-17DOI: 10.1016/j.evopsy.2025.03.009
Franck Le Roux (Docteur en psychologie, Chercheur associé, Coresponsable du séminaire Histoire et épistémologie de la psychopathologie, Psychologue)
{"title":"Quelle épistémologie pour la psychanalyse aujourd’hui ? À propos de… « Penser et écrire par cas en psychanalyse. L’invention freudienne d’un style de raisonnement » de Guénaël Visentini","authors":"Franck Le Roux (Docteur en psychologie, Chercheur associé, Coresponsable du séminaire Histoire et épistémologie de la psychopathologie, Psychologue)","doi":"10.1016/j.evopsy.2025.03.009","DOIUrl":"10.1016/j.evopsy.2025.03.009","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 4","pages":"Pages 754-762"},"PeriodicalIF":0.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610516","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 : 2025-04-12DOI: 10.1016/j.evopsy.2025.03.012
Théodore Onguene Ndongo (Psychologue clinicien, Chercheur associé, Chargé de cours) , Daniel Derivois (Psychologue clinicien, Professeur des Universités en psychologie clinique et psychopathologie)
Objectives
This article focuses on the process of enlisting and transforming children into soldiers in Congo. It analyzes the psychological mechanisms at work in this dynamic.
Method
As part of a Unicef project (DDR-Demobilization, Disarmament, Reintegration), many children (9–17 years old) associated with armed forces and groups were met several times (five interviews per child) in Centers for Transit and Orientation (CTO) upon their return from combat zones. An interview grid was constructed which allows us to explore their family situation before enlistment, their motives, their account of their stint in the armed groups, and the reasons for remaining in the armed groups. This article focuses on six emblematic cases.
Results
The process of transforming children into soldiers is understood through what we propose to call the process of Janissarization. This process reflects the recuperation of the effects of societal catastrophes with the aim of actively transforming children/adolescents into soldiers by means of the subversion of the usual maturation processes of the psychic apparatus: psychic rearrangement in connection with puberty, choice of genital object, and redirection of the referential system (and of the ideal) in which these different mutations take place.
Discussion
The discussion focuses on the warlord's approach, which includes the reversal of the structuring symbols of the group-community, the development of a paradoxical bond of attachment to the warlord, the instrumentalization of the figure of the intruder, and finally the establishment of a monstrous victim-executioner scene. The figure of the child soldier is strongly based on the more common figure of the intrusive and unwanted child. The main differences between these two figures lie in the lifting of the ban on murder and in the establishment of an executioner-victim scenario.
Conclusion
Janissarization is thus an active process, which concerns the manipulation of the symbolic, and an active operation of creating and then hijacking a universe of meaning, codes, and ideology within the group. Whatever their modes of enlistment, the child/adolescent soldiers concerned by this process require sustained and adapted support that frees them from armed conflicts.
{"title":"Du processus psychique de transformation d’enfants en soldats : une clinique de la janissarisation","authors":"Théodore Onguene Ndongo (Psychologue clinicien, Chercheur associé, Chargé de cours) , Daniel Derivois (Psychologue clinicien, Professeur des Universités en psychologie clinique et psychopathologie)","doi":"10.1016/j.evopsy.2025.03.012","DOIUrl":"10.1016/j.evopsy.2025.03.012","url":null,"abstract":"<div><h3>Objectives</h3><div>This article focuses on the process of enlisting and transforming children into soldiers in Congo. It analyzes the psychological mechanisms at work in this dynamic.</div></div><div><h3>Method</h3><div>As part of a Unicef project (DDR-Demobilization, Disarmament, Reintegration), many children (9–17 years old) associated with armed forces and groups were met several times (five interviews per child) in Centers for Transit and Orientation (CTO) upon their return from combat zones. An interview grid was constructed which allows us to explore their family situation before enlistment, their motives, their account of their stint in the armed groups, and the reasons for remaining in the armed groups. This article focuses on six emblematic cases.</div></div><div><h3>Results</h3><div>The process of transforming children into soldiers is understood through what we propose to call the process of Janissarization. This process reflects the recuperation of the effects of societal catastrophes with the aim of actively transforming children/adolescents into soldiers by means of the subversion of the usual maturation processes of the psychic apparatus: psychic rearrangement in connection with puberty, choice of genital object, and redirection of the referential system (and of the ideal) in which these different mutations take place.</div></div><div><h3>Discussion</h3><div>The discussion focuses on the warlord's approach, which includes the reversal of the structuring symbols of the group-community, the development of a paradoxical bond of attachment to the warlord, the instrumentalization of the figure of the intruder, and finally the establishment of a monstrous victim-executioner scene. The figure of the child soldier is strongly based on the more common figure of the intrusive and unwanted child. The main differences between these two figures lie in the lifting of the ban on murder and in the establishment of an executioner-victim scenario.</div></div><div><h3>Conclusion</h3><div>Janissarization is thus an active process, which concerns the manipulation of the symbolic, and an active operation of creating and then hijacking a universe of meaning, codes, and ideology within the group. Whatever their modes of enlistment, the child/adolescent soldiers concerned by this process require sustained and adapted support that frees them from armed conflicts.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 3","pages":"Pages 373-384"},"PeriodicalIF":0.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779331","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 : 2025-04-11DOI: 10.1016/j.evopsy.2025.03.011
Ketty Steward (psychologue clinicienne, docteure en psychologie de l’université Paris 8) , Arnaud Plagnol (psychiatre, professeur de psychologie à l’université Paris 8) , Renald Asvazadourian (psychiatre, spécialiste de la psychiatrie du sujet âgé)
Aims
Based on Michel Foucault's notion of subjectivation through self-writing and Paul Ricœur's reworking of narrative identity, our aim is to clarify the clinical relevance of an autobiographical writing group for depressed seniors.
Method
After an analysis of Foucault's self-writing and its relationship to Ricœur's narrative identity, we illustrate its scope by studying the dynamics generated by the participation of an elderly depressive patient in an autobiographical writing group. The effects of the participation on depression were assessed using the Montgomery Asberg Depression Rating Scale, an observation grid of the group activity, a semi-directive interview held at the end of the program, and a series of remote clinical interviews.
Results
In addition to an improvement in mood, the way the person appropriated the writing process gives evidence of an experiential recovery, with a new meaning conferred to one's existence and an in-depth reconfiguration of the subjective universe.
Discussion
The concepts of self-writing and narrative identity are complementary in shedding light on the dynamics observed in the reported case. The data gathered from the person, who was not initially expected to embrace the invitation to write (lack of educational achievements, entrenched depression in a 70-year-old complicated by dependency), confirms the clinical potential of an approach based on self-writing within a group of elderly people.
Conclusion
The proposal of a structured writing activity, based on the conceptual contributions of Michel Foucault and Paul Ricœur, may prove fruitful in the recovery process for elderly people with depression, even if this can only be confirmed by the appropriation of the process within the person's lived experience.
{"title":"Écriture de soi et identité narrative : quel apport pour le rétablissement de la personne âgée dépressive ?","authors":"Ketty Steward (psychologue clinicienne, docteure en psychologie de l’université Paris 8) , Arnaud Plagnol (psychiatre, professeur de psychologie à l’université Paris 8) , Renald Asvazadourian (psychiatre, spécialiste de la psychiatrie du sujet âgé)","doi":"10.1016/j.evopsy.2025.03.011","DOIUrl":"10.1016/j.evopsy.2025.03.011","url":null,"abstract":"<div><h3>Aims</h3><div>Based on Michel Foucault's notion of subjectivation through self-writing and Paul Ricœur's reworking of narrative identity, our aim is to clarify the clinical relevance of an autobiographical writing group for depressed seniors.</div></div><div><h3>Method</h3><div>After an analysis of Foucault's self-writing and its relationship to Ricœur's narrative identity, we illustrate its scope by studying the dynamics generated by the participation of an elderly depressive patient in an autobiographical writing group. The effects of the participation on depression were assessed using the Montgomery Asberg Depression Rating Scale, an observation grid of the group activity, a semi-directive interview held at the end of the program, and a series of remote clinical interviews.</div></div><div><h3>Results</h3><div>In addition to an improvement in mood, the way the person appropriated the writing process gives evidence of an experiential recovery, with a new meaning conferred to one's existence and an in-depth reconfiguration of the subjective universe.</div></div><div><h3>Discussion</h3><div>The concepts of self-writing and narrative identity are complementary in shedding light on the dynamics observed in the reported case. The data gathered from the person, who was not initially expected to embrace the invitation to write (lack of educational achievements, entrenched depression in a 70-year-old complicated by dependency), confirms the clinical potential of an approach based on self-writing within a group of elderly people.</div></div><div><h3>Conclusion</h3><div>The proposal of a structured writing activity, based on the conceptual contributions of Michel Foucault and Paul Ricœur, may prove fruitful in the recovery process for elderly people with depression, even if this can only be confirmed by the appropriation of the process within the person's lived experience.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 3","pages":"Pages 385-398"},"PeriodicalIF":0.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779332","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 : 2025-04-09DOI: 10.1016/j.evopsy.2025.03.010
Elise Pelladeau
Objective
In this article, we will look at the object in psychoanalysis, and more specifically the object of excitation, as a drive coordinate between original monism and the primacy of the other. We will question the function of the object in the relationship to excitation, particularly in adolescence.
Methodology
To illustrate our remarks, we will use the weekly psychotherapy of an adolescent girl presenting an anorexia nervosa syndrome.
Results
The treatment also brought up to date the link to the drive object by accentuating a relationship to excitation locked in the pubertal process. Instead of emancipation, it would seem to be a form of reactionary over-investment of the biological body in its very constraints, in order to counterbalance them: it would be a question of drying up the drive body, by systematically going against the needs of the biological body, whatever the cost. The question of the object is thus very much embroiled in this biphasic sexuality in its adolescent version, but also in the negotiation of arousal under the primacy of the other, which is particularly precocious.
Discussion
If adolescence is not “a period of reliving this separation-individuation”, then how can we think about the instinctual impact on the negotiation of the bond with the other of an effective separation, whether total or partial? The question of the object caught in the net of libidinal subversion and its pitfalls would then open up avenues of release in therapy directly linked to the modalities of satisfaction in the transference.
Conclusion
The purpose of this article is not to make a generic decision in favor of one theoretical/clinical model that would supersede others in all circumstances, but our clinical practice clearly invites us to subscribe to the contributions of Laplanche, and also of Dejours, for whom the involvement of the body is at the forefront of libidinal subversion and its designs.
{"title":"Monisme primaire ou primat de l’autre. Considérations théoriques et implications cliniques à l’adolescence à partir d’un cas d’anorexie mentale","authors":"Elise Pelladeau","doi":"10.1016/j.evopsy.2025.03.010","DOIUrl":"10.1016/j.evopsy.2025.03.010","url":null,"abstract":"<div><h3>Objective</h3><div>In this article, we will look at the object in psychoanalysis, and more specifically the object of excitation, as a drive coordinate between original monism and the primacy of the other. We will question the function of the object in the relationship to excitation, particularly in adolescence.</div></div><div><h3>Methodology</h3><div>To illustrate our remarks, we will use the weekly psychotherapy of an adolescent girl presenting an anorexia nervosa syndrome.</div></div><div><h3>Results</h3><div>The treatment also brought up to date the link to the drive object by accentuating a relationship to excitation locked in the pubertal process. Instead of emancipation, it would seem to be a form of reactionary over-investment of the biological body in its very constraints, in order to counterbalance them: it would be a question of drying up the drive body, by systematically going against the needs of the biological body, whatever the cost. The question of the object is thus very much embroiled in this biphasic sexuality in its adolescent version, but also in the negotiation of arousal under the primacy of the other, which is particularly precocious.</div></div><div><h3>Discussion</h3><div>If adolescence is not “a period of reliving this separation-individuation”, then how can we think about the instinctual impact on the negotiation of the bond with the other of an effective separation, whether total or partial? The question of the object caught in the net of libidinal subversion and its pitfalls would then open up avenues of release in therapy directly linked to the modalities of satisfaction in the transference.</div></div><div><h3>Conclusion</h3><div>The purpose of this article is not to make a generic decision in favor of one theoretical/clinical model that would supersede others in all circumstances, but our clinical practice clearly invites us to subscribe to the contributions of Laplanche, and also of Dejours, for whom the involvement of the body is at the forefront of libidinal subversion and its designs.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 3","pages":"Pages 443-456"},"PeriodicalIF":0.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779374","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 : 2025-04-08DOI: 10.1016/j.evopsy.2025.03.004
Christophe Chaperot (Rédacteur en chef de L’Évolution psychiatrique, psychiatre, chef de service)
{"title":"Un certain personnage du psychiatre : « le psychiatre espiègle »","authors":"Christophe Chaperot (Rédacteur en chef de L’Évolution psychiatrique, psychiatre, chef de service)","doi":"10.1016/j.evopsy.2025.03.004","DOIUrl":"10.1016/j.evopsy.2025.03.004","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Page 351"},"PeriodicalIF":0.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090532","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 : 2025-04-03DOI: 10.1016/j.evopsy.2025.03.002
Eugénia Jeltikova doctorante en psychanalyse (Enseignante agrégée de lettres classiques)
Objectives
Considering the psychological rearrangements that accompany somatic pathology in terms of the hypochondriacal position sheds light on the subjective experience of illness and allows for a reconsideration of the care relationship in somatic medicine from a transferential perspective. This article aims to contribute to the dialogue between psychoanalysis and medicine, particularly through applying a psychoanalytic lens to autoimmune diseases, the increasing prevalence of which is a characteristic feature of contemporary societies.
Method
Based on an analysis of Freud's and Ferenczi's observations on hypochondria, the hypothesis of a broad spectrum of plural hypochondrias allows us to define the hypochondriacal position of the chronic somatic patient, by differentiating it from authentically psychopathological hypochondria by the presence of an underlying organic condition. Testimonials from patients suffering from autoimmune diseases provide insights into the dynamics of this hypochondriacal position, enabling the conceptualization of certain issues.
Results
The hypochondriacal position of the chronic somatic patient is a consequence of a verified organic impairment, distinguishing it from psychopathological hypochondria. Whether the underlying pathology is organ-specific or systemic, a symptomatology dominated by pain and fatigue leads to a blurring of the contours of the suffering body in the patient's self-image. Unlike psychopathological hypochondria, it is not a specific somatic site that serves as the fixation of libido, but the somatic body as a whole, experienced as a suffering corporeality. The chronicity of the condition solidifies the hypochondriacal position, given the repetition of medical experiences (auscultations, examinations, consultations, hospitalizations) and the self-monitoring advice received from doctors, along with the concern of loved ones, which engages the patient in a chronicized relationship of self-examination of their body.
Discussion
The role of others — whether medical professionals or close friends and family members — proves crucial in the establishment and persistence of the hypochondriacal position. Diagnostic wandering fosters the patient's hypochondriacal identification. The failures to articulate the reality of their somatic suffering lead them to adopt medical language, potentially alienating themselves by finding expression only in operational terms. The hypochondriacal position may serve as a retreat and refuge against the object loss and self-bereavement that chronic somatic pathology imposes on the patient.
Conclusion
The care relationship in somatic medicine is rarely discussed in terms of transference. The hypothesis of the hypochondriacal position of the chronic somatic patient allows us to approach the transferential investment placed by the patient on thei
{"title":"La position hypocondriaque du sujet souffrant d’une pathologie somatique chronique : un éclairage psychanalytique de la relation médecin–patient","authors":"Eugénia Jeltikova doctorante en psychanalyse (Enseignante agrégée de lettres classiques)","doi":"10.1016/j.evopsy.2025.03.002","DOIUrl":"10.1016/j.evopsy.2025.03.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Considering the psychological rearrangements that accompany somatic pathology in terms of the hypochondriacal position sheds light on the subjective experience of illness and allows for a reconsideration of the care relationship in somatic medicine from a transferential perspective. This article aims to contribute to the dialogue between psychoanalysis and medicine, particularly through applying a psychoanalytic lens to autoimmune diseases, the increasing prevalence of which is a characteristic feature of contemporary societies.</div></div><div><h3>Method</h3><div>Based on an analysis of Freud's and Ferenczi's observations on hypochondria, the hypothesis of a broad spectrum of plural hypochondrias allows us to define the hypochondriacal position of the chronic somatic patient, by differentiating it from authentically psychopathological hypochondria by the presence of an underlying organic condition. Testimonials from patients suffering from autoimmune diseases provide insights into the dynamics of this hypochondriacal position, enabling the conceptualization of certain issues.</div></div><div><h3>Results</h3><div>The hypochondriacal position of the chronic somatic patient is a consequence of a verified organic impairment, distinguishing it from psychopathological hypochondria. Whether the underlying pathology is organ-specific or systemic, a symptomatology dominated by pain and fatigue leads to a blurring of the contours of the suffering body in the patient's self-image. Unlike psychopathological hypochondria, it is not a specific somatic site that serves as the fixation of libido, but the somatic body as a whole, experienced as a suffering corporeality. The chronicity of the condition solidifies the hypochondriacal position, given the repetition of medical experiences (auscultations, examinations, consultations, hospitalizations) and the self-monitoring advice received from doctors, along with the concern of loved ones, which engages the patient in a chronicized relationship of self-examination of their body.</div></div><div><h3>Discussion</h3><div>The role of others — whether medical professionals or close friends and family members — proves crucial in the establishment and persistence of the hypochondriacal position. Diagnostic wandering fosters the patient's hypochondriacal identification. The failures to articulate the reality of their somatic suffering lead them to adopt medical language, potentially alienating themselves by finding expression only in operational terms. The hypochondriacal position may serve as a retreat and refuge against the object loss and self-bereavement that chronic somatic pathology imposes on the patient.</div></div><div><h3>Conclusion</h3><div>The care relationship in somatic medicine is rarely discussed in terms of transference. The hypothesis of the hypochondriacal position of the chronic somatic patient allows us to approach the transferential investment placed by the patient on thei","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 275-289"},"PeriodicalIF":0.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090550","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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