Pub Date : 2025-06-01Epub 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":"2025-06-01","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 : 2025-06-01Epub Date: 2024-08-10DOI: 10.1016/j.evopsy.2024.06.003
Stéphane Muths (Psychologue clinicien, Docteur en Psychopathologie et chercheur associé au CRPMS URP 3522, Chargé d’enseignement à la Faculté de psychologie de l’Université de Strasbourg) , Renaud Evrard (Psychologue clinicien, Maître de conférences HDR en Psychologie)
Aims
We examine the alienating and structuring aspects of shame in a psychotherapeutic setting. The aim is to determine its place in the construction of identity from the latency phase through puberty where psychotic movements are present.
Method
We will base our study on the case of Augustin, a ten-year-old whose presentation suggested a form of psychosis, with social withdrawal, psychomotor agitation, social communication disorders, and behavioral problems. We were able to see him for three years in a medical and psychological center for children. We describe the development of symptoms, the family configuration, and the main stages of his treatment. We sketch out the main features of this case, interpreting the particularities of Augustin's contact and his destructive movements as relating to a struggle against psychic invasion by an alienating family logic.
Results
This clinical work led us to identify psychotic manifestations that surpass a simple and exclusive structural distinction. We were able to highlight the family component in the psychopathological expression of Augustin's case, based on the father's paranoid logic. The specific relationship with language is revealed as an instrument of the transferential logic that allows a form of subjectivation of the risk of psychic invasion by shame.
Discussion
The clinical picture required us to move away from the DSM's logic of piling up diagnoses in order to shed light on psychic functioning, revisiting the notion of psychotic disorders in children and adolescents so as not to confine Augustin's case to a single trajectory. It was necessary to avoid the temptation to read into the family configuration the ‘causes’ of the child's disorders, rather than some of their coordinates. By working on the child's experiences and the malleable medium, the individual therapeutic mediations we implemented enabled us to co-construct a therapeutic space that facilitated access to play by taking into account the development of the affect of shame in the transferential relationship.
Conclusion
The aim of the psychotherapeutic process was to create a space that could accommodate the destructive movements of the object and thus offer the possibility of symbolizing the destructive and invasive elements of the family scene, and the fragilities of the ego specific to the psychotic movements in place. On the basis of an analysis of these elements, the psychotherapeutic work enabled the sensations of contamination and invasion of the psyche to be recaptured in order to construct a form of psychic containment that prevented movements of confusion between the self and the other. Augustin's case illustrates the symptomatic modulations specific to psychotic elements, highlighting the fragility of contact in the psychic construction of children and adolescents.
{"title":"Actualisation de la notion de psychoses infantiles dans un dispositif psychothérapique : la place de la honte dans le transfert avec l’enfant aux portes de l’adolescence","authors":"Stéphane Muths (Psychologue clinicien, Docteur en Psychopathologie et chercheur associé au CRPMS URP 3522, Chargé d’enseignement à la Faculté de psychologie de l’Université de Strasbourg) , Renaud Evrard (Psychologue clinicien, Maître de conférences HDR en Psychologie)","doi":"10.1016/j.evopsy.2024.06.003","DOIUrl":"10.1016/j.evopsy.2024.06.003","url":null,"abstract":"<div><h3>Aims</h3><div>We examine the alienating and structuring aspects of shame in a psychotherapeutic setting. The aim is to determine its place in the construction of identity from the latency phase through puberty where psychotic movements are present.</div></div><div><h3>Method</h3><div>We will base our study on the case of Augustin, a ten-year-old whose presentation suggested a form of psychosis, with social withdrawal, psychomotor agitation, social communication disorders, and behavioral problems. We were able to see him for three years in a medical and psychological center for children. We describe the development of symptoms, the family configuration, and the main stages of his treatment. We sketch out the main features of this case, interpreting the particularities of Augustin's contact and his destructive movements as relating to a struggle against psychic invasion by an alienating family logic.</div></div><div><h3>Results</h3><div>This clinical work led us to identify psychotic manifestations that surpass a simple and exclusive structural distinction. We were able to highlight the family component in the psychopathological expression of Augustin's case, based on the father's paranoid logic. The specific relationship with language is revealed as an instrument of the transferential logic that allows a form of subjectivation of the risk of psychic invasion by shame.</div></div><div><h3>Discussion</h3><div>The clinical picture required us to move away from the DSM's logic of piling up diagnoses in order to shed light on psychic functioning, revisiting the notion of psychotic disorders in children and adolescents so as not to confine Augustin's case to a single trajectory. It was necessary to avoid the temptation to read into the family configuration the ‘causes’ of the child's disorders, rather than some of their coordinates. By working on the child's experiences and the malleable medium, the individual therapeutic mediations we implemented enabled us to co-construct a therapeutic space that facilitated access to play by taking into account the development of the affect of shame in the transferential relationship.</div></div><div><h3>Conclusion</h3><div>The aim of the psychotherapeutic process was to create a space that could accommodate the destructive movements of the object and thus offer the possibility of symbolizing the destructive and invasive elements of the family scene, and the fragilities of the ego specific to the psychotic movements in place. On the basis of an analysis of these elements, the psychotherapeutic work enabled the sensations of contamination and invasion of the psyche to be recaptured in order to construct a form of psychic containment that prevented movements of confusion between the self and the other. Augustin's case illustrates the symptomatic modulations specific to psychotic elements, highlighting the fragility of contact in the psychic construction of children and adolescents.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 247-259"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090548","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 : 2025-06-01Epub Date: 2025-04-03DOI: 10.1016/j.evopsy.2025.03.002
Eugénia Jeltikova doctorante en psychanalyse (Enseignante agrégée de lettres classiques)
<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
{"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":"2025-06-01","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}
Pub Date : 2025-06-01Epub Date: 2025-02-12DOI: 10.1016/j.evopsy.2025.01.009
Louis Sass (professeur) , Jérôme Englebert (professeur)
Objective
The aim of this paper is to present an interview with Louis Sass, Professor of Clinical Psychology at Rutgers University, USA. His work is recognized worldwide, and he has been a visiting professor at several institutions, notably in Paris in 2008–2009, and in Belgium in Ghent, Brussels, and Liège in 2023–2024 (as part of the Chaire Francqui program). The interview was conducted in French during Jérôme Englebert's academic stay in New York and at Rutgers University.
Method
The method consists of an interview with Louis Sass. The questions concern his main influences and the original readings he makes of authors essential to his work. The transdisciplinary dimension of his work is also highlighted and discussed.
Results
Louis Sass is one of the leading specialists in the phenomenological understanding of schizophrenia. He has published numerous articles and several books on psychopathology, the most famous of which is Madness and Modernism: Insanity in the Light of Modern Art, Literature, and Thought (Revised edition, Oxford University Press, 2017). This book is an attempt to understand the schizophrenic mind by exploring its parallels with the avant-garde art and thought of 20th century “modernism” and “postmodernism.” Madness and Modernism introduced the concept of hyper-reflexivity, which is today considered, in the field of phenomenological psychopathology, as a crucial element of schizophrenic experience and a characteristic sign of this existential condition. In addition to psychopathology, Professor Sass's contributions are also to be found in the fields of philosophy, psychoanalysis, art, anthropology, and ethnography. He is also interested in the Rorschach test, which he teaches to clinical psychology students at Rutgers University.
Discussion
One sentence in this interview neatly sums up Sass's interest in developing original ways of understanding complex phenomena such as psychopathological conditions, but also various forms of literary and artistic expression or, more recently, different ontologies encountered in ethnographic fieldwork: “What interests me is appreciating the sophistication of others who have been seen in an overly simplistic way.”
Conclusion
This interview provides an overview of the work of this important author of phenomenological psychopathology.
{"title":"Entretien avec Louis Sass par Jérôme Englebert. Réalisé à Rutgers University (New Jersey, USA) le 21 mars 2023","authors":"Louis Sass (professeur) , Jérôme Englebert (professeur)","doi":"10.1016/j.evopsy.2025.01.009","DOIUrl":"10.1016/j.evopsy.2025.01.009","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this paper is to present an interview with Louis Sass, Professor of Clinical Psychology at Rutgers University, USA. His work is recognized worldwide, and he has been a visiting professor at several institutions, notably in Paris in 2008–2009, and in Belgium in Ghent, Brussels, and Liège in 2023–2024 (as part of the Chaire Francqui program). The interview was conducted in French during Jérôme Englebert's academic stay in New York and at Rutgers University.</div></div><div><h3>Method</h3><div>The method consists of an interview with Louis Sass. The questions concern his main influences and the original readings he makes of authors essential to his work. The transdisciplinary dimension of his work is also highlighted and discussed.</div></div><div><h3>Results</h3><div>Louis Sass is one of the leading specialists in the phenomenological understanding of schizophrenia. He has published numerous articles and several books on psychopathology, the most famous of which is <em>Madness and Modernism: Insanity in the Light of Modern Art, Literature, and Thought</em> (Revised edition, Oxford University Press, 2017). This book is an attempt to understand the schizophrenic mind by exploring its parallels with the avant-garde art and thought of 20th century “modernism” and “postmodernism.” <em>Madness and Modernism</em> introduced the concept of hyper-reflexivity, which is today considered, in the field of phenomenological psychopathology, as a crucial element of schizophrenic experience and a characteristic sign of this existential condition. In addition to psychopathology, Professor Sass's contributions are also to be found in the fields of philosophy, psychoanalysis, art, anthropology, and ethnography. He is also interested in the Rorschach test, which he teaches to clinical psychology students at Rutgers University.</div></div><div><h3>Discussion</h3><div>One sentence in this interview neatly sums up Sass's interest in developing original ways of understanding complex phenomena such as psychopathological conditions, but also various forms of literary and artistic expression or, more recently, different ontologies encountered in ethnographic fieldwork: “What interests me is appreciating the sophistication of others who have been seen in an overly simplistic way.”</div></div><div><h3>Conclusion</h3><div>This interview provides an overview of the work of this important author of phenomenological psychopathology.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 332-345"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090437","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 : 2025-06-01Epub 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":"2025-06-01","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 : 2025-06-01Epub Date: 2024-11-28DOI: 10.1016/j.evopsy.2024.10.005
Christophe Chaperot (Psychiatre, Chef de service)
Objective
The psychotherapy of psychotic patients is the subject of much debate and discussion, with two underlying factors: firstly, the fear of making situations worse rather 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. Roughly speaking, there are three main approaches: containment of jouissance, which allows the patient to elaborate (with the risk of psychic sclerosis); cognitive remediation, with the risk of ideological normalization; and finally immersion in the psychotic world (with the risk of propping up delirium and the suffering it brings about). In this paper, I will discuss this third possibility, drawing on the thinking of Gaetano Benedetti, and consequently on a psychoanalytical basis. It is neither a question of proselytizing Benedetti's thought, nor of ostracizing other approaches.
Method
The main principles of Benedetti's thinking will be taken up again, at the same time as I propose clinical illustrations from my own practice. A brief reminder of the difference between psychoanalysis and psychotherapy will be offered, as well as the impossibility of psychoanalysis with a psychotic patient, which is why my title refers to “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, “positivization” (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 her psychosis and working in solidarity with her 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 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 hybridization.
{"title":"La psychothérapie psychanalytique des psychoses selon Gaetano Benedetti : illustrations au travers de quelques situations cliniques","authors":"Christophe Chaperot (Psychiatre, Chef de service)","doi":"10.1016/j.evopsy.2024.10.005","DOIUrl":"10.1016/j.evopsy.2024.10.005","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 making situations worse rather 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. Roughly speaking, there are three main approaches: containment of jouissance, which allows the patient to elaborate (with the risk of psychic sclerosis); cognitive remediation, with the risk of ideological normalization; and finally immersion in the psychotic world (with the risk of propping up delirium and the suffering it brings about). In this paper, I will discuss this third possibility, drawing on the thinking of Gaetano Benedetti, and consequently on a psychoanalytical basis. It is neither a question of proselytizing Benedetti's thought, nor of ostracizing 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 I propose clinical illustrations from my own practice. A brief reminder of the difference between psychoanalysis and psychotherapy will be offered, as well as the impossibility of psychoanalysis with a psychotic patient, which is why my title refers to “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, “positivization” (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 her psychosis and working in solidarity with her 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 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 hybridization.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 185-195"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090537","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 : 2025-06-01Epub Date: 2025-02-14DOI: 10.1016/j.evopsy.2025.01.010
Thomas Rabeyron (Professeur de psychologie clinique)
Aim
Transference is a fundamental concept in analytical practices and theories, whose modeling can be refined through insights from other disciplines such as cognitive neurosciences.
Method
We show how this concept can be connected to various findings from cognitive neurosciences, offering a fresh perspective on conceptualizing the dynamics of transference.
Results
Connections between transference and connectionist theories, distinctions between implicit and explicit memory, certain properties of self-organized networks such as pattern completion, studies in social cognition on experimental transference, and recent work on brain synchronization using hyperscanning techniques are presented and examined in dialogue with psychoanalytic metapsychology.
Discussion
Numerous points of convergence emerge between these disciplines, helping to build a model of the mind supported by elements from diverse but complementary methodological fields.
Conclusion
The elements presented in this work underscore the relevance of the psychoanalytic conceptual modeling of transference, emphasizing its essential importance in any psychotherapeutic work.
{"title":"Le transfert entre neurosciences et psychanalyse","authors":"Thomas Rabeyron (Professeur de psychologie clinique)","doi":"10.1016/j.evopsy.2025.01.010","DOIUrl":"10.1016/j.evopsy.2025.01.010","url":null,"abstract":"<div><h3>Aim</h3><div>Transference is a fundamental concept in analytical practices and theories, whose modeling can be refined through insights from other disciplines such as cognitive neurosciences.</div></div><div><h3>Method</h3><div>We show how this concept can be connected to various findings from cognitive neurosciences, offering a fresh perspective on conceptualizing the dynamics of transference.</div></div><div><h3>Results</h3><div>Connections between transference and connectionist theories, distinctions between implicit and explicit memory, certain properties of self-organized networks such as pattern completion, studies in social cognition on experimental transference, and recent work on brain synchronization using hyperscanning techniques are presented and examined in dialogue with psychoanalytic metapsychology.</div></div><div><h3>Discussion</h3><div>Numerous points of convergence emerge between these disciplines, helping to build a model of the mind supported by elements from diverse but complementary methodological fields.</div></div><div><h3>Conclusion</h3><div>The elements presented in this work underscore the relevance of the psychoanalytic conceptual modeling of transference, emphasizing its essential importance in any psychotherapeutic work.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 207-218"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090539","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 : 2025-06-01Epub Date: 2025-03-25DOI: 10.1016/j.evopsy.2025.03.001
Delphine Jacobs (Psychiatre infanto-juvénile, chef de clinique, professeur) , Jean Steyaert (Psychiatre infanto-juvénile, chef de clinique, professeur) , Kris Dierickx (Ethicien, professeur ordinaire) , Kristien Hens (Ethicien, professeur de recherche)
<div><h3>Goal</h3><div>After three quarters of a century of research and clinical experience, autism spectrum disorder (ASD) turns out to be surprisingly heterogeneous in its presentations, causes, and cognitive mechanisms. In light of the varied nature of this diagnosis, it is unclear how the array of (predominantly “basic”) research findings on ASD is translated into information that is meaningful and valuable to parents and clinicians. Few studies are dedicated to detecting the views and experiences of an ASD diagnosis of a child by parents and clinicians, nor to engaging an ethical reflection on their personal perspectives. An ethical reflection on the results of the empirical studies with parents and physicians leads to the formulation of clinical-ethical considerations towards both policy-makers and clinicians concerning the clinical care offered to young children with ASD.</div></div><div><h3>Method</h3><div>We conducted in-depth interviews on how parents and physicians view and experience a young child's ASD diagnosis. Parents were queried longitudinally: before the start of the diagnostic ASD assessment, right after the feedback session at the end of the assessment, and 12 months later. The interviews were analyzed in Nvivo 11 according to the guidelines of Interpretative Phenomenological Analysis.</div></div><div><h3>Results</h3><div>The interviewed parents and physicians addressed ‘psycho-relational’ implications of an ASD diagnosis as much as ‘treatment-oriented’ implications. The psycho-relational ‘exculpatory’ effect was particularly appreciated, which consists in both parents and child being able to exonerate themselves with regard to the child's unusual behavior towards both the parents and other adults. The interviewed parents and physicians often came to view the ASD diagnosis in a pragmatic way, in the light of its usefulness for child, parents, and to a lesser extent, professionals. Twelve months after their child received an ASD diagnosis, the interviewed parents mainly had come to value the ASD diagnosis for two reasons: the access to care it ensured, and the framework it provided allowing them to adapt their interactions with the child because of the ASD diagnosis. The interviewed physicians from their side needed an ASD diagnosis in order to be useful in their clinical practice, particularly in cases where they were able to describe the child toward parents and teachers using phrases such as “he wants to do what is expected from him but is not able to”, and in order to provide appropriate care. Clinicians expressed some doubts about the use of and need for a formal diagnosis. They preferred to establish a descriptive and treatment-oriented profile of the child, a profile of which an ASD diagnosis was sometimes considered to be just one useful part.</div></div><div><h3>Discussion</h3><div>Based on an ethical analysis and reflection, we formulate four clinico-ethical considerations in relations to policy, and four in relatio
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