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CV2 - editorial board CV2 - 编辑委员会
IF 0.6 4区 医学 Q2 Arts and Humanities Pub Date : 2024-05-25 DOI: 10.1016/S0014-3855(24)00038-0
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引用次数: 0
Élever la bizarrerie à la dignité du style. Pour une éthique de l’accompagnement des patients autistes 将怪异提升为风格的尊严。为自闭症患者提供支持的伦理道德
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-05-23 DOI: 10.1016/j.evopsy.2024.04.003
Isabelle Orrado (Psychanalyste, Post-doctorante en psychologie, Université de Brasilia, Brésil) , Jean-Michel Vives (Psychanalyste, Professeur de psychologie clinique et pathologique, Université Côte d’Azur, France)

Objectives

This article aims to identify how the analytical framework can lead an autistic subject to create an artisanal solution that allows him to enter the world.

Method

The Lacanian theoretical conceptualization is based on clinical observations collected during the treatment of a young autistic boy.

Results

We argue that engaging in therapeutic work with an autistic patient can offer him a potential environment – which we distinguish from potential space – in which his particular quirks can be elevated to the dignity of a style that the autistic child will himself shape and that will allow him a certain social bond.

Discussion

We qualify the therapeutic space offered by the analytical framework as a potential environment, which we define as the coordinates of the encounter set up by the clinician bringing into existence a Stimmung from which the child can experience his or her instinctual movements. Stimmung is to be understood as the phenomenological quality of the potential environment, simultaneously including tuning, invocative address, disposition, and atmosphere, i.e. a possible relationship with the Other. Clinical intervention would allow the child not to represent himself in this potential environment – which is the nature of potential space –, but to present himself to the world. It is the clinician's responsibility to bring into existence an Other who can isolate and put into circulation the subject's oddity – which could be considered a failure – bringing forth a singularizing sign and elevating it to the dignity of style that the autistic child will shape.

Conclusion

The style, thus obtained, corresponds to the possibility of a singular enunciative position – inscribing a presence in the world by tempering the weight of the subject –, which, in autism, always requires a certain amount of tinkering in order to arrive at a solution.
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引用次数: 0
Les vases communicants de la honte chez les auteurs de violences sexuelles 性暴力实施者之间羞耻感的传播媒介
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-05-23 DOI: 10.1016/j.evopsy.2024.05.002

Objective

Forensic clinical investigation frequently reveals the absence of shame in perpetrators of sexual violence while simultaneously victims seem overwhelmed by shame. We sought to understand this paradox by analyzing the dynamics of the introjection of shame in victims’ identification with the aggressor and of the injection of shame in the aggressor's projective identification with his victim.

Method

We focused on the case of Louis, a dismissed priest, sentenced for pedocriminal behavior. This case is part of a qualitative research project conducted on a population of 14 inmates of a Parisian prison and based on interviews structured around the individual's life story and analyzed with the Interpretative Phenomenological Analysis (IPA) methodology.

Results

We observe that behind Louis's apparent absence of shame, as with many of our research subjects guilty of sexual violence, there is, in fact, a great deal of unconscious shame, first introjected by the victim in the abuse suffered, and later injected in the victim in the abuse committed as a means to unload an unbearable shame.

Discussion

The introjection of the shame of the aggressor by his victim in the dynamic of Ferenczi's identification with the aggressor appears as a complement to the injection of shame by the aggressor into his victim through the dynamic of projective identification: both an ordinary projective identification in the form of a projective reversal of shame, and an operative projective identification in the form of perverse behaviors.

Conclusion

The communicating vessels of shame among perpetrators and victims of sexual violence, between injection and introjection, help us better understand the contagious characteristics of shame in the etiology of sexual violence.

目的法医临床调查经常发现性暴力施暴者没有羞耻感,而受害者却似乎被羞耻感淹没。我们试图通过分析受害者对施暴者的认同中羞耻感的注入以及施暴者对受害者的投射性认同中羞耻感的注入的动态来理解这一悖论。该案例是定性研究项目的一部分,研究对象是巴黎一所监狱的 14 名囚犯,研究以围绕个人生活故事的访谈为基础,并采用解释性现象学分析(IPA)方法进行分析。结果我们注意到,在路易斯表面上没有羞耻感的背后,实际上存在着大量无意识的羞耻感,这些羞耻感最初是由受害者在遭受虐待时注入的,后来又注入到受害者的虐待行为中,作为一种卸下难以承受的羞耻感的手段。讨论在费伦兹对施暴者的认同动态中,施暴者的羞耻感被受害者注入,这与施暴者通过投射性认同动态将羞耻感注入受害者的行为相辅相成:既有以羞耻感的投射性逆转为形式的普通投射性认同,也有以反常行为为形式的有效投射性认同。结论 性暴力施暴者和受害者之间羞耻感的交流媒介,即注入和内射,有助于我们更好地理解羞耻感在性暴力病因学中的传染性特征。
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引用次数: 0
Psychothérapie institutionnelle : ambiances de transferts 机构心理治疗:转移环境
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-05-17 DOI: 10.1016/j.evopsy.2024.04.004
Matthieu Braun (psychiatre, chef de clinique des universités, assistant des hôpitaux de région) , Christophe Chaperot (psychiatre, chef de pôle)

Objective

Public hospitals are necessary for patients with the most severe psychological suffering. Within an institution, the symptoms of some have an impact on the way the group functions, with counter-attitudes, scissionary projections, and so on. Ever since Jean-Étienne Esquirol, we have known that hospitals can be healing in themselves, if they are staffed by “skilled” caregivers. At a time when public hospitals are being restructured, can tools from the field of institutional psychotherapy help to “heal the hospital so that it can heal”, in Hermann Simon's aphorism? We articulate psychopathological knowledge with institutional concepts, in order to reflect on how to care for singularities through collective work.

Method

We present a theoretical-clinical elaboration based on clinical vignettes that attempt to capture the day-to-day practice of a public psychiatric department oriented towards institutional psychotherapy, and the psychotherapeutic care possible, in an institution, for psychotic subjects.

Results

Concepts derived from institutional psychotherapy are based on psychoanalytical and phenomenological psychopathologies that are tested in clinical practice: in particular, questions of space, atmosphere, and transference, at the heart of psychopathology. These concepts can be discussed and refined in the light of current research and practice, and support creative care approaches based on the logic of geographical sectors.

Discussion

Institutional tools seem to support caregiving teams in their response to psychological suffering. If they are not the subject of dogmatic positioning, they encourage a therapeutic alliance that is as close as possible to the subjectivity of the players involved, and enable a performative theorization of daily practice.

Conclusion

Joint attention to psychopathology and institutional clinical practice helps to provide individualized care and support for the singularity and subjectivity of the most fragile patients and the teams who work with them.
目的:对于心理痛苦最严重的病人来说,公立医院是必要的。在一个机构中,一些人的症状会影响到整个群体的运作方式,如反面态度、任务投射等。自让-艾蒂安-埃斯基罗尔(Jean-Étienne Esquirol)以来,我们就知道,如果医院配备了 "熟练 "的护理人员,那么医院本身就能起到治疗作用。在公立医院进行重组之际,机构心理治疗领域的工具是否可以帮助赫尔曼-西蒙(Hermann Simon)所说的 "治愈医院,使其能够治愈"?我们将精神病理学知识与机构概念相结合,以反思如何通过集体工作来照顾特殊性。方法我们以临床案例为基础,进行了理论-临床阐述,试图捕捉以机构心理治疗为导向的公立精神科的日常实践,以及在机构中对精神病患者可能提供的心理治疗护理。结果从机构心理治疗中得出的概念是基于精神分析和现象学的精神病理学,并在临床实践中得到检验:特别是空间、氛围和移情问题,这些都是精神病理学的核心。这些概念可以根据当前的研究和实践进行讨论和完善,并支持基于地理区域逻辑的创造性护理方法。如果这些工具不是教条式定位的主题,那么它们就会鼓励治疗联盟尽可能地贴近相关参与者的主观性,并使日常实践的表演理论化成为可能。结论对心理病理学和机构临床实践的联合关注有助于提供个性化护理,并为最脆弱的病人和与他们合作的团队的独特性和主观性提供支持。
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引用次数: 0
Prix de l’Évolution psychiatrique Jean Garrabé 2024 让-加拉贝 2024 年精神进化奖
IF 0.6 4区 医学 Q2 Arts and Humanities Pub Date : 2024-05-17 DOI: 10.1016/j.evopsy.2024.05.001
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引用次数: 0
Le « Soi territorial » et le suicide des agriculteurs : la solitude en un lieu inhabitable 领土自我 "与农民自杀:不适宜居住之地的孤独感
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-05-17 DOI: 10.1016/j.evopsy.2024.04.005

Objective

This study presents a reflection on the inhabitation of a place and the constitution of a territorial Self,’ in the context of ‘country’ life and work. The hypothesis is then put forward of a possible ‘psychopathology of (de-)territorialization,’ according to which a ‘non-place,’ generator of meaninglessness, may be involved in a suicidal dynamics specifically linked to the territorial dimension of the Self and the impossible inhabitation of a place.

Method

The clinical and psychopathological aspects are examined from the perspective of the link between certain ‘traditional farmers’ and the place where they live, with regard to the reciprocal imprint between psyche and territory.

Results

This exploratory study will provide guidance for clinical research into the suffering of farmers who fall outside the scope of commonly identified ‘psycho-social disorders.’

Discussion

The limitations and impasses induced by dissociative or melancholic processes are related either to a failure of Presence, compromising the construction of a habitable world, i.e. one that can be territorialized, or to the hostility of a world that is resistant to the dynamics of a territorialization process, and therefore unfit to allow us to dwell in it.

Conclusion

These considerations open up an original perspective for qualitative research aimed at understanding the relationships between alteration of the territorial foundations of the Self and suicidal intentionality.

本研究以 "乡村 "生活和工作为背景,对 "居住地 "和 "地域自我 "的构成进行了反思。然后提出一种可能的"(去)地域化精神病理学 "假设,根据这种假设,"非地域",即无意义的产生者,可能会卷入与自我的地域维度和不可能的地域居住有关的自杀动态中。方法从某些 "传统农民 "与其居住地之间的联系的角度,研究心理与地域之间相互印记的临床和心理病理学方面。结果这项探索性研究将为临床研究农民的痛苦提供指导,这些农民的痛苦不属于通常认定的 "社会心理失调 "的范围。讨论解离过程或忧郁过程所引起的限制和障碍,要么与 "存在 "的失败有关,它损害了可居住世界(即可以领土化的世界)的构建;要么与世界的敌意有关,它抵制领土化过程的动力,因此不适合我们居住其中。
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引用次数: 0
La psychothérapie institutionnelle à l’épreuve des crises. Une réflexion clinique au cœur d’un service de psychiatrie publique au décours de la crise sanitaire liée à la COVID-19 机构心理疗法在危机中经受考验。COVID-19 健康危机后公共精神科服务核心的临床反思。
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-05-07 DOI: 10.1016/j.evopsy.2024.04.001
Matthieu Braun (Psychiatre, Chef de clinique des universités, Assistant des hôpitaux de région) , Christophe Chaperot (Psychiatre, Chef de pôle)

Objective

Patients suffering from complex psychiatric pathologies require multi-disciplinary care and, in the event of decompensation, may need to be hospitalized. Institutional psychotherapy approaches psychotic, existential, and institutional crises as opportunities for clinical elaboration and the deployment of creativity. The public health crisis linked to the COVID-19 pandemic has prompted us to rethink its effectiveness and its place within pluralistic contemporary practices. It also offered the opportunity for an unprecedented anthropological reading. In this context, is institutional psychotherapy still a machine for producing “innovation”, for creating, or at least revealing, crises in order to overcome them?

Method

Key concepts from the field of institutional psychotherapy can be reexamined in the wake of the public health crisis. In the aftermath of the pandemic, we propose an elaboration of what the pandemic has taught us about day-to-day practice, in a public psychiatric department oriented towards institutional psychotherapy. We will draw on a re-reading of clinical vignettes, interviews with caregivers and patients, and notes taken at department meetings during the pandemic.

Results

The major concepts of institutional psychotherapy may have some limitations, but they can be reinvented by the caregiver–client collective. During a crisis, collective failings and individual symptoms seem to reveal each other. The therapeutic club represents a stage on which to unfold and elaborate both group and individual issues.

Discussion

In this context, the symbolic framework, collectively instituted, and the culture of a department can present operative points of support for continuing care. They “put in crisis” the prejudices and implicit theories of the actors, and support new narratives and new ways of making sense.

Conclusion

In the aftermath of a crisis, the therapeutic club remains a space of conflict and intrigue, at the crossroads of collective and individual health crises.
目的患有复杂精神疾病的患者需要多学科护理,如果病情加重,可能需要住院治疗。机构心理疗法将精神病、生存危机和机构危机作为临床阐述和发挥创造力的机会。与 COVID-19 大流行相关的公共卫生危机促使我们重新思考其有效性及其在当代多元化实践中的地位。这也为我们提供了前所未有的人类学解读机会。在这种情况下,机构心理治疗是否仍然是制造 "创新"、创造或至少揭示危机以克服危机的机器?在大流行病之后,我们建议详细阐述大流行病给我们带来的启示,即在以机构心理治疗为导向的公共精神科中的日常实践。我们将借鉴对临床小故事的重读、对护理人员和患者的访谈,以及大流行期间在科室会议上所做的记录。结果机构心理治疗的主要概念可能有一些局限性,但它们可以被护理人员-患者集体重新创造。在危机期间,集体的失败和个人的症状似乎会相互显现。在这种情况下,集体制定的象征性框架和科室文化可以为持续护理提供有效的支持点。它们将参与者的偏见和隐含理论 "置于危机之中",并支持新的叙述和新的理解方式。
{"title":"La psychothérapie institutionnelle à l’épreuve des crises. Une réflexion clinique au cœur d’un service de psychiatrie publique au décours de la crise sanitaire liée à la COVID-19","authors":"Matthieu Braun (Psychiatre, Chef de clinique des universités, Assistant des hôpitaux de région) ,&nbsp;Christophe Chaperot (Psychiatre, Chef de pôle)","doi":"10.1016/j.evopsy.2024.04.001","DOIUrl":"10.1016/j.evopsy.2024.04.001","url":null,"abstract":"<div><h3>Objective</h3><div>Patients suffering from complex psychiatric pathologies require multi-disciplinary care and, in the event of decompensation, may need to be hospitalized. Institutional psychotherapy approaches psychotic, existential, and institutional crises as opportunities for clinical elaboration and the deployment of creativity. The public health crisis linked to the COVID-19 pandemic has prompted us to rethink its effectiveness and its place within pluralistic contemporary practices. It also offered the opportunity for an unprecedented anthropological reading. In this context, is institutional psychotherapy still a machine for producing “innovation”, for creating, or at least revealing, crises in order to overcome them?</div></div><div><h3>Method</h3><div>Key concepts from the field of institutional psychotherapy can be reexamined in the wake of the public health crisis. In the aftermath of the pandemic, we propose an elaboration of what the pandemic has taught us about day-to-day practice, in a public psychiatric department oriented towards institutional psychotherapy. We will draw on a re-reading of clinical vignettes, interviews with caregivers and patients, and notes taken at department meetings during the pandemic.</div></div><div><h3>Results</h3><div>The major concepts of institutional psychotherapy may have some limitations, but they can be reinvented by the caregiver–client collective. During a crisis, collective failings and individual symptoms seem to reveal each other. The therapeutic club represents a stage on which to unfold and elaborate both group and individual issues.</div></div><div><h3>Discussion</h3><div>In this context, the symbolic framework, collectively instituted, and the culture of a department can present operative points of support for continuing care. They “put in crisis” the prejudices and implicit theories of the actors, and support new narratives and new ways of making sense.</div></div><div><h3>Conclusion</h3><div>In the aftermath of a crisis, the therapeutic club remains a space of conflict and intrigue, at the crossroads of collective and individual health crises.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 4","pages":"Pages 611-624"},"PeriodicalIF":0.6,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141043753","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}
引用次数: 0
Jürg Zünd : voir/faire voir l’espace
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-04-30 DOI: 10.1016/j.evopsy.2024.03.005
Philippe Veysset (Professeur agrégé de philosophie)
<div><h3>Goals</h3><div>By extending the analysis of a case identified by Ludwig Binswanger, the Jürg Zünd case, using a philosophical reading inspired by phenomenology, we strive to show that the patient – this is what gives meaning to his disorder – attempts to display the relevance (failure of reason) as well as the limits (reason remains operative) of a doctrine that was made familiar to him by his psychiatrist: existential analysis, notably its representation of space and language. This aims to illustrate the dangers posed by too insistent a dialogue between patient and caregiver when this patient is associated with diagnosis and therapy. Finally, it is a question of better marking the remaining gap between the practical field and the experiential field. The patient has renounced the rationality of her actions but continues to subscribe to that of her experience, the only means of “proof” remaining to her.</div></div><div><h3>Method</h3><div>Extend the psychiatrist's analysis by establishing a correspondence between the symptoms of the illness and the validations/refutations of this same analysis. The main danger of the analysis carried out here is a hyper-rationalization of mental disorder, but if, in the mental disorder, no element of reason remains, no psychiatry can see the light of day either. It is, however, clear that the simple failure of reason cannot be enough to put the scientific exploitation of mental disorder into perspective. We can therefore only follow the author in his frequent references to the fundamental texts of phenomenology. We could say that our analysis is experimental in nature.</div></div><div><h3>Results</h3><div>An in-depth analysis of the case shows that there is indeed a link between the patient's system of attitude and behavior and a desire to test the relevance of the phenomenological analysis applied by the caregiver to the patient.</div></div><div><h3>Discussion</h3><div>In the third <em>Critique</em>, known as <em>the Faculty of Judgment</em>, Kant strives to restore to a reason invalidated in its pure use a path, a field of sensitive expression that, spanning understanding and language, allows this reason to “say itself”, but this behavior is in turn struck by impotence, due to its antinomic structure. Only the body, left out of Kantian analysis, allows reason to find its balance because it is already in itself penetrated, corseted, steeped in reason, but also, by the same token, crushed by this reason, a reason which, by overwhelming the only means of expression that remains to it, overinvests this body and makes itself inaudible again. It will therefore be necessary to return the body to itself, free it from the influence of reason, reify it and, at the same time, allow to reappear what, perhaps, remains in the man of reason: madness, weak reason inhabiting a weakened body. To contradict reason is to speak it out loud, in the experience of its almost although never quite definitive loss, suspended as i
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引用次数: 0
Tristesse et mélancolie comme conséquence de la culpabilité : le Schuldigsein entre phénoménologie et psychanalyse 作为内疚后果的悲伤和忧郁:现象学与精神分析之间的舒尔迪辛
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-04-25 DOI: 10.1016/j.evopsy.2024.03.004
Dario Alparone PhD et Doctor Europaeus (Maître de conférences associé en psychologie clinique et psychopathologie à l’Université de Bretagne Occidentale, UFR Lettres et Sciences Humaines, Département de Psychologie. Doctor en criminologie psychanalytique, psychologue clinicien.) , Giorgia Tiscini (Psychologue, psychanalyste, Professeur en psychologie clinique et psychopathologie à l’Université de Rennes 2, France, Vice-Directeur du laboratoire Recherches en psychopathologie et psychanalyse (RPpsy))

Objective

This article aims to demonstrate the relevance of the concept of guilt in understanding the depressive syndrome, particularly in melancholic psychosis, in the phenomenological and psychoanalytic approaches to psychopathology. It does so by comparing Lacan's and Heidegger's approaches to subjectivity and existence.

Method

Through a bibliographic and conceptual analysis of the notions of guilt and melancholy in the phenomenological and psychoanalytic traditions, and using two clinical vignettes from the scientific literature, we highlight the significance of the concept of guilt in understanding melancholic psychosis.

Result

There is a possible parallel between Lacanian psychoanalysis and Heidegger's Daseinanalysis on the concept of guilt. It can be interpreted as the expression of the rejection of the unconscious but also as an expression of authentic existential projectuality of Dasein. This opens up several conceptual and methodological questions at the theoretical and clinical levels.

Discussion

Guilt could then be a clinical indicator of the subject's rejection of the unconscious, which in melancholic psychosis manifests as a totalizing identification with the waste-object, without other existential possibilities, without “lack.” From the perspective of existential analysis, the abnormal guilt of the melancholic could thus be understood as a form of foreclosure of Being.

Conclusion

Guilt in psychopathology can vary depending on the specific subjective conditions observed in clinical settings. In the case of melancholy, guilt is an indicator of the stagnation of the subject in relation to their existential possibilities. The existential inertia of the melancholic can be interpreted as a very current ontology of waste.
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引用次数: 0
L’inquiétante étrangeté du handicap mental 精神残疾令人不安的陌生感
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-04-16 DOI: 10.1016/j.evopsy.2024.03.002

Objectives

This article aims to bypass the epistemological impasses produced by the contemporary development of the concept of disability – a concept formed in close relation with the societal context and with questions of human rights, more than with a nosographic and clinical problematic - and more precisely with regard to mental disability, a clinical entity whose classification history is particularly difficult, and yet at the heart of the edification of psychiatry since the 19th century. In studying this trajectory, we aim to demonstrate the interest of psychoanalysis's theoretical-clinical approach.

Method

We analyze the evolution of psychiatric and psychoanalytical conceptions of mental disability. We discuss them and identify avenues of reflection for the psychoanalytically oriented clinical and therapeutic work we do with young disabled patients and their parents.

Results

Mental disability is placed in the historical dynamic of the attempts to classify it: idiotism, idiocy, mental debility, mental or intellectual disability, etc. Its proven or strongly assumed organic etiology originally marginalized, and continues to marginalize, certain modes of clinical thinking and psychic treatments, of which the psychoanalytical approach is one.

Discussion

We discuss and differentiate between the concepts of “mental” and “psychic” and the ambiguity of their meanings. The “mentally handicapped” subject, when reduced to their neuronal aetiology, is considered from a deficit perspective, which relegates the investigation of psychic life to the background or even renders it superfluous. Following in the footsteps of D. Widlöcher, we point out that Kraepelin's thinking, which made the therapeutic indication dependent on the supposed aetiology, is now outdated. We therefore emphasize the individual differences in the relationship that develops between the young disabled person and his or her family, and in the interaction between their psyches. The effects of the birth of a disabled child on the construction of the feeling of parenthood, the bond of filiation, and parental narcissism are thus understood within the dynamics of interactions, both real and fantasized, which necessarily differ according to the subjects, parents and children. More specifically, we consider J. Laplanche's “fundamental anthropological situation” as a heuristic model for thinking about the psychic life of the child with a disability and the infantile sexuality that constitutes it, in adult-child interaction, as in everyone else. We hypothesize that the parental encounter with a child presenting a handicapping pathology is likely to send some parents back to their own “uncanniness,” that is to say, to the disturbing return of a repressed or primitive way of thinking abandoned a long time ago, coming from their own “internal foreign land.” This internal irruption is likely to lead t

本文旨在绕开当代残疾概念的发展所造成的认识论上的障碍--残疾概念的形成与社会环境和人权问题密切相关,而不是与分类学和临床问题有关--更确切地说,是与精神残疾有关,精神残疾是一个临床实体,其分类历史特别困难,但自19世纪以来一直是精神病学的核心。通过对这一轨迹的研究,我们旨在展示精神分析的理论-临床方法的趣味性。方法我们分析了精神病学和精神分析对精神残疾概念的演变。我们对这些概念进行了讨论,并为我们为残疾青少年患者及其父母所做的以精神分析为导向的临床和治疗工作确定了反思的途径。结果精神残疾被置于试图对其进行分类的历史动态中:白痴、白痴、精神衰弱、精神或智力残疾等。讨论我们讨论并区分了 "精神 "和 "心理 "这两个概念及其含义的模糊性。如果将 "弱智 "主体归结为神经元病因,那么就是从缺陷的角度来考虑的,这就将对精神生活的研究置于次要地位,甚至是多余的。追随维德洛赫(D. Widlöcher)的脚步,我们指出,克拉佩林将治疗指征依赖于假定病因的思想现已过时。因此,我们强调残疾青年与其家人之间的关系以及他们的心理互动中存在的个体差异。因此,残疾儿童的出生对父母身份感的构建、亲子关系的纽带以及父母的自恋的影响,都是在现实和幻想的互动动态中理解的。更具体地说,我们将 J. Laplanche 的 "基本人类学情境 "视为一个启发式模型,用于思考残疾儿童的心理生活,以及在成人与儿童的互动中,与其他人一样,构成残疾儿童心理生活的幼稚性。我们假设,父母与出现残疾病理的儿童相遇时,很可能会让一些父母回到他们自己的 "不可思议 "中,也就是说,回到一种来自他们自己的 "内部异域"、很久以前就被遗弃的压抑或原始思维方式的令人不安的回归中。这种内在干扰很可能会导致父母幻想的重新演绎,重新激发儿童的动力。在其他临床情况下,它可能会促使父母采取激烈的防御措施,旨在冻结自己和孩子的驱动力,从而阻碍孩子翻译神秘信息的努力和他们的理解欲望,并抑制基于自我情欲动力的心理生活的创造力。结论:精神分析对弱智患者的理解、倾听和临床治疗是建立在对婴儿期,即无意识、无意识的婴儿期性行为的基本认识基础之上的;精神分析方法允许在某些可能冻结、抑制或压抑儿童心理生活的配置中重新激活驱动力。
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引用次数: 0
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Evolution Psychiatrique
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