Evolution Psychiatrique最新文献

{"title":"CV2 - editorial board","authors":"","doi":"10.1016/S0014-3855(25)00006-4","DOIUrl":"10.1016/S0014-3855(25)00006-4","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Page CO2"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158966","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}

{"title":"La psychiatrie est-elle prédisposée au scientisme ?","authors":"Philippe Amarilli (psychiatre des hôpitaux, ex-chef de clinique, ex-maître de conférences associé à l’ULP Strasbourg)","doi":"10.1016/j.evopsy.2024.10.007","DOIUrl":"10.1016/j.evopsy.2024.10.007","url":null,"abstract":"<div><h3>Objective</h3><div>The author explores the risk of essentializing pathological entities, over time and in particular nowadays, and reflects on psychiatry's potential predisposition to scientism.</div></div><div><h3>Method</h3><div>The author revisits the foundations of psychiatry through the study of several major authors who have had an epistemological reflection on the order of psychiatric discourse (Foucault, Lacan, Swain, Lantéri-Laura, Dowbiggin, etc.).</div></div><div><h3>Results</h3><div>Psychiatric logic is characterized by the emergence of a subjective position of exteriority to insanity on the one hand, and, on the other hand, the postulate of an organicity of the morbid process inherent to medical logic, even before any psychiatric knowledge is constituted.</div></div><div><h3>Discussion</h3><div>The author emphasizes the uniqueness of psychiatry within the medical field, in that it has undergone considerable institutional and social development, even though the promise of future knowledge that would fully establish its legitimacy did not materialize during that time.</div></div><div><h3>Conclusion</h3><div>The author sees a predisposition to scientism in this assumption of taking a medical approach to mental suffering, combined with a quest for legitimacy within that same field. He concludes that the psychiatric entities that are developing deserve to be questioned in light of the specificities of psychiatric discourse.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Pages 161-168"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143159055","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}

{"title":"Récupération des fonctions mnésiques et exécutives après un burnout : suivi à un an de patients en arrêt de travail pour épuisement professionnel","authors":"Charlie Renaud (Maître de conférences) ,&nbsp;Agnès Lacroix (Professeure des universités)","doi":"10.1016/j.evopsy.2024.08.003","DOIUrl":"10.1016/j.evopsy.2024.08.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;Numerous studies have demonstrated an association between burnout and cognitive difficulties, yet there is a paucity of longitudinal research on the subject. This study aims to conduct a one-year follow-up on patients who have experienced clinical burnout. Additionally, the literature suggests that variables such as depression, anxiety, neuroticism, emotional regulation strategies, and return to employment may influence cognitive recovery and the patient's perception thereof. Therefore, this study also seeks to delineate the potential roles of these variables in patients’ cognitive recovery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;We conducted two assessments with 22 patients (19 women and 3 men), with an average time lapse of 386.10&lt;!--&gt; &lt;!--&gt;days (SD&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;20.71) between evaluations. Cognitive functions were assessed using neuropsychological tests. Initially, the MEM-III and GREFEX were employed, while the MEM-IV (the only test altered between the initial encounter and follow-up) was used to assess memory in the second evaluation. The BRIEF-A questionnaire was utilized to evaluate executive functions. Additionally, the French Big Five Inventory, HADS, and the emotion regulation scale were employed to delve into the participants’ psychological profiles.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Significant improvements were observed in all memory domains evaluated, encompassing auditory, immediate visual, and delayed visual memory. Regarding executive functions assessed through tests, only four out of sixteen analyses demonstrated significant improvement. These analyses pertained to errors in the interference condition of the Stroop test, categories in the MCST, time for TMT B, and the number of words generated in literal fluency tasks. Self-assessments from the BRIEF-A indicated improvement in the overall executive index and metacognition index. Anxiety and depression levels did not significantly differ one year after the initial assessment. Only burnout and neuroticism levels showed a significant decrease. Furthermore, no differences were observed between patients who had resumed employment and those still seeking employment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Memory impairments appear to be temporary and reversible, while executive function data reveal a more nuanced outcome, with a substantial difference between test-assessed recovery and patient self-evaluation. Test results indicate some improvements, particularly in tests assessing inhibition and mental flexibility. However, these improvements may be attributed to increased cognitive endurance, as these tests were administered last in the battery. Patient self-evaluations of executive functions may suggest increased confidence in their cognitive abilities. Exploring the role of self-esteem in the self-assessment of cognitive functions after burnout would be an intriguing avenue for further research. Finally, among all tested co-variables, only neur","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Pages 121-133"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143159022","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}

{"title":"Le livret militaire, le dossier étudiant et la carrière médicale de Lacan","authors":"David Monnier (Enseignant-chercheur)","doi":"10.1016/j.evopsy.2024.05.007","DOIUrl":"10.1016/j.evopsy.2024.05.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;After having studied the conditions of Lacan's doctoral dissertation in a previous article, I turn to uncovering his academic studies and his medical career to place it in its context.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;Search for references to the thesis of Lacan, confrontation of historical data, textual analysis and commentary. I first reread Lacan to pick out biographical references that might be judicious in the context of this study. I then carried out a literature review. This is not enough to establish a detailed chronology of the facts. After that, I visited a number of libraries and other archive sites. I collected material data: Lacan's unpublished student file; his unpublished administrative service records; the military recruitment register where he appears; his military record, some rare, unused, or unpublished photos of Lacan as a student; various little-known elements about his various lodgings during this period. I examined these different documents and compared them with other sources and various information in order to clarify his professional career in medicine.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;I found several medical internships Lacan completed before psychiatry. From March 1921 to February 1922, he did a one-year internship in Paul Hallopeau's surgical department at Trousseau hospital. From March 1922 to October 1922, he did a seven-month internship in the dermatology department of Edouard Jeanselme at Saint-Louis hospital. From October 1922 to February 1923, he did a five-month internship in the childhood illnesses department of Edmond Lesné at Trousseau hospital. From March 1923 to February 29, 1924, he did a one-year internship in Paul Ribierre's cardiology department at Necker hospital. From June 1924 to February 1925, he did a nine-month internship under Marie-Paul Claisse's supervision at Laënnec hospital. From March 1925 to October 1925, he did an internship of approximately seven and a half months in the Lenormand department at Saint-Louis hospital. From October 1925 to February 1926, he did an internship of approximately four and a half months in the neurology department of Georges Guillain at Salpêtrière hospital. From March 1926 to January 1927, he did an internship of approximately ten and a half months in Octave Crouzon's neurology department of the Salpêtrière. This journey highlights an aspect of Lacan that is not ignored, unrecognized, or underestimated but on the contrary appears with the clarity of evidence as soon as it is said: a portrait of Lacan as a worker with children. Indeed, his first job, from November 1932 until October 1933, was in a child neuropsychiatry clinic. It is enough to briefly recall some milestones of his later work to see that this area of childhood is significant and that Lacan's contribution is substantial. And although Lacan certainly did not have a university hospital career in the strict sense, since he left the hospital environme","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Pages 135-144"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848736","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}

{"title":"Jürg Zünd : voir/faire voir l’espace","authors":"Philippe Veysset (Professeur agrégé de philosophie)","doi":"10.1016/j.evopsy.2024.03.005","DOIUrl":"10.1016/j.evopsy.2024.03.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Goals&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;In the third &lt;em&gt;Critique&lt;/em&gt;, known as &lt;em&gt;the Faculty of Judgment&lt;/em&gt;, 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","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Pages 97-120"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160436","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}

{"title":"Le rôle des angoisses de perte dans la récidive suicidaire","authors":"Laura Pralus (étudiante en Master de Psychopathologie Clinique Psychanalytique, Université Lumière Lyon 2) ,&nbsp;François-David Camps (professeur de Psychopathologie et de Psychologie Clinique, Centre de Recherche en Psychopathologie et Psychologie Clinique (CRPPC), Université Lumière Lyon 2)","doi":"10.1016/j.evopsy.2024.08.001","DOIUrl":"10.1016/j.evopsy.2024.08.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Repeated suicide attempts are a particularly difficult clinical problem. Multiple suicide attempts in the same patient often leave caregivers with a feeling of incomprehension and therapeutic powerlessness. Far from being a “raptus,” the act of suicidal recividism is underpinned by complex psychic processes. In particular, we look at the role of the object and the loss of perception of the object in the dynamics of repeated suicidal acts.</div></div><div><h3>Method</h3><div>We conducted research with three women hospitalized in a psychiatric unit. We offered them a semi-directive interview, followed by the Rorschach and the T.A.T., and finally an open interview. Part of the research process was designed to give the participants the opportunity to express themselves freely, leaving room for imaginative reverie based on the rule of free association. Our methodology is based on an individual case study.</div></div><div><h3>Results</h3><div>Frédérique, Nora, and Olga all took the projective tests. However, the T.A.T. showed some difficulty in processing the instructions. The protocols as a whole showed little investment of thought, a form of passivity in the face of the material, with a predominance of avoidant maneuvers. Using our data, we will question the quality and capacity of our subjects to summon a sufficiently solid internal object. We will also analyze our patients’ narratives, which are more invested in an anaclitic mode, where relationships, and particularly specular relationships, are at the forefront. The narratives are thus mainly mobilized around the treatment of loss through the excitement it can arouse in our subjects.</div></div><div><h3>Discussion</h3><div>Object support is particularly invested in a negative function. We thus studied the relational modalities of our subjects with regard to object dependence, the question of loss and the anxiety it can engender, as well as its associated manifestations.</div></div><div><h3>Conclusion</h3><div>By exploring the unconscious dynamics underlying suicidal acts, and in particular recidivism, we are led to believe that this type of act contains an address to the object, an address that remains unknown to the subject itself and that requires a response from the object for which it is intended. The absence of a response from the object would give rise to an unbearable excitation, for which the subject can imagine no other solution than resorting to a suicidal act. The inevitable return of these unworkable situations would explain suicidal recidivism.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Pages 1-11"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158967","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}

{"title":"Zoe Chalaux, Multitudes, 2023","authors":"Norbert Godon (Artiste, conférencier)","doi":"10.1016/j.evopsy.2025.01.002","DOIUrl":"10.1016/j.evopsy.2025.01.002","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Pages 176-180"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143159020","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}

{"title":"Hospitalisations sans consentement : repères historiques et contemporains de l’intervention judiciaire dans le contrôle des mesures","authors":"Alice Viterbo (Praticien hospitalier contractuel)","doi":"10.1016/j.evopsy.2024.02.004","DOIUrl":"10.1016/j.evopsy.2024.02.004","url":null,"abstract":"<div><h3>Objectives</h3><div>The question of judicial control emerged with the debates surrounding the law of 30 June 1838 instituting psychiatric hospitalization. However, it was systematically rejected until the law of 5 July 2011. This article examines the conditions under which such control was introduced.</div></div><div><h3>Method</h3><div>The aim is to analyze the debates surrounding the protection of the rights of mental patients hospitalized under judicial control during the proposed reforms to compulsory hospitalization. The reasons for the exclusion of judicial control from the 1838 and 1990 legislation will first be examined, before looking at the conditions leading to judicial review in 2011.</div></div><div><h3>Results</h3><div>The introduction of systematic judicial control appears to be the result of the mobilization of patients’ associations, who brought the Question Prioritaire de Constitutionnalité (QPC) before the courts. This ability to use the law reflects a more developed legal knowledge, due to the legal route taken to assert their claims. This method of imposing reform bypasses the usual channels for reform.</div></div><div><h3>Discussion</h3><div>The reform has therefore led to the decision to unify litigation and to a systematic hearing by the <em>juge des libertés et de la détention</em> (JLD) for any patient hospitalized without consent.</div></div><div><h3>Conclusion</h3><div>The use of the QPC as a strategy for imposing reforms in psychiatry has flourished in the years since the reform, in particular to question the legality of other psychiatric practices. However, the ability of the law to prevent these decisions from being arbitrary needs to be questioned.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Pages 145-160"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792362","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}

{"title":"Élever la bizarrerie à la dignité du style. Pour une éthique de l’accompagnement des patients autistes","authors":"Isabelle Orrado (Psychanalyste, Post-doctorante en psychologie, Université de Brasilia, Brésil) ,&nbsp;Jean-Michel Vives (Psychanalyste, Professeur de psychologie clinique et pathologique, Université Côte d’Azur, France)","doi":"10.1016/j.evopsy.2024.04.003","DOIUrl":"10.1016/j.evopsy.2024.04.003","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Method</h3><div>The Lacanian theoretical conceptualization is based on clinical observations collected during the treatment of a young autistic boy.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Discussion</h3><div>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 <em>Stimmung</em> from which the child can experience his or her instinctual movements. <em>Stimmung</em> 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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Pages 59-69"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141142888","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}

{"title":"Violences sexuelles, traumatismes et mentalisation : étude de la dynamique psychique à partir du cas Hélène","authors":"Crystal Tomaszewski (Doctorante) ,&nbsp;Dr Aziz Essadek Mcf en psychologie clinique et psychopathologie (Psychologue clinicien) ,&nbsp;Héloïse Onumba-Bessonnet (Directrice générale) ,&nbsp;Dr Christophe Clesse MSc, MRes, BSc, CPsychol (Lecturer in psychology, Psychologue clinicien) ,&nbsp;Dr Rose-Angélique Belot (Professeure de psychologie clinique et psychopathologie, Psychologue clinicienne)","doi":"10.1016/j.evopsy.2024.06.002","DOIUrl":"10.1016/j.evopsy.2024.06.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Experiences of sexual violence lead to a wide range of psychopathologies, often associated with post-traumatic stress disorder. Mentalization abilities, developed in relation to attachment figures, play a significant role in the development of psychological trauma. We explore the notion that low mentalization capacities, coupled with fearful attachment, hinder the psychological processing of trauma. This article aims to identify the psychological mechanisms at play in our participant and to clinically refine the exploration of our hypothesis, while isolating the relevant role of clinical tools (AAI, RSQ, RFQ, and Rorschach) in shaping the management of patients who have experienced sexual violence.</div></div><div><h3>Method</h3><div>Theoretical-clinical links are proposed to align the use of these tools with the psychological issues faced by the participant.</div></div><div><h3>Results</h3><div>The participant exhibits psychological trauma following childhood experiences of sexual violence, a disorganized attachment profile, and a failure in mentalization with a stiffening of mentalization processes.</div></div><div><h3>Discussion</h3><div>Impairment in mentalization abilities is evident in the Rorschach test, characterized by rigid thinking, difficulties in symbolization, intrusive early childhood experiences, and significant relational avoidance. Due to the risk posed by establishing a new relationship, establishing the therapeutic relationship should be the focus of initial psychotherapeutic work. Subsequently, the work can address experiences of violence and trauma.</div></div><div><h3>Conclusion</h3><div>This case sheds light on trauma management through the reactivation of mentalization and symbolization processes in an individual with an insecure/fearful attachment profile. In the psychotherapeutic treatment of patients with similar metapsychological characteristics, these elements can inform the development of an appropriate care pathway.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Pages 13-28"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158968","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}