Pub 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":"2024-11-28","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 : 2024-11-06DOI: 10.1016/j.evopsy.2024.10.001
Loreline Courret (Docteure en philosophie)
Objectives
The aim of this article is to show that the critique of the place and function of the Oedipus complex in Freudian psychoanalysis implies a critique of Freudian aesthetics.
Method
We will first propose a reconstruction of what Deleuze and Guattari take from Freudian aesthetics, namely an aesthetics of form, centered on the theater, and starting from Freud's experience as a spectator of Sophocles’ Oedipus Rex. In a second movement, we will try to identify what Deleuze and Guattari intend to propose to replace this aesthetic of form, and which they name “schizophrenic literature,” situate in the short story rather than in the theater, and explicitly referring to delirium.
Results
This strategic reconstruction allows us to formulate a hypothesis: that Freud would have implicitly made the theater the matrix of subjectivity, first in its aesthetics, but also in his individual aesthetic experiences and his preferences for a certain type of literary work.
Discussion
This systematic reading of Freudian “creative writing” theory challenges the concept of sublimation as the point of doctrine that rests on the selection of an “Oedipal” corpus and type of art. If the aesthetics of the form can be located in Freud's biography as a “literary effect” whose aesthetic pleasure is found in the economy of the spectator's projections onto the objects on stage, the aesthetics of the formless that is expressed by “schizophrenic literature” mobilizes a violence proper to the sublime: it is not definitively formalizable, and calls for very different feelings that transfigure the coordinates of an aesthetic experience.
Conclusion
This schizophrenic tendency of literature leads to an ecological approach to the psychic, attentive to a context where the distinction between nature and culture is never clear.
{"title":"Deleuze and Guattari as readers of Freud","authors":"Loreline Courret (Docteure en philosophie)","doi":"10.1016/j.evopsy.2024.10.001","DOIUrl":"10.1016/j.evopsy.2024.10.001","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this article is to show that the critique of the place and function of the Oedipus complex in Freudian psychoanalysis implies a critique of Freudian aesthetics.</div></div><div><h3>Method</h3><div>We will first propose a reconstruction of what Deleuze and Guattari take from Freudian aesthetics, namely an aesthetics of form, centered on the theater, and starting from Freud's experience as a spectator of Sophocles’ <em>Oedipus Rex</em>. In a second movement, we will try to identify what Deleuze and Guattari intend to propose to replace this aesthetic of form, and which they name “schizophrenic literature,” situate in the short story rather than in the theater, and explicitly referring to delirium.</div></div><div><h3>Results</h3><div>This strategic reconstruction allows us to formulate a hypothesis: that Freud would have implicitly made the theater the matrix of subjectivity, first in its aesthetics, but also in his individual aesthetic experiences and his preferences for a certain type of literary work.</div></div><div><h3>Discussion</h3><div>This systematic reading of Freudian “creative writing” theory challenges the concept of sublimation as the point of doctrine that rests on the selection of an “Oedipal” corpus and type of art. If the aesthetics of the form can be located in Freud's biography as a “literary effect” whose aesthetic pleasure is found in the economy of the spectator's projections onto the objects on stage, the aesthetics of the formless that is expressed by “schizophrenic literature” mobilizes a violence proper to the sublime: it is not definitively formalizable, and calls for very different feelings that transfigure the coordinates of an aesthetic experience.</div></div><div><h3>Conclusion</h3><div>This schizophrenic tendency of literature leads to an ecological approach to the psychic, attentive to a context where the distinction between nature and culture is never clear.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 4","pages":"Pages e61-e72"},"PeriodicalIF":0.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721926","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 : 2024-10-28DOI: 10.1016/j.evopsy.2024.09.003
Yann Auxéméry
<div><h3>Objective</h3><div>One hundred and fifty years after the word first appeared in the English lexicon, how can we still talk about “psychotherapy” today? While the original aims and methods of the concept of “psychotherapy” appeared simple and generic, namely “to heal through the mind,” our contemporary psychiatry and psychology have developed a multitude of “psychotherapies”, which generally present themselves as distinct. This makes it difficult for patients and their families to find their way around, difficult for our psychiatric interns and psychology master's students to orient themselves, and difficult for our administrative authorities to get involved.</div></div><div><h3>Method</h3><div>As they appear to us to be fundamental to the very essence and future of the notion of “psychotherapy,” in order to approach its definition, we call upon the language sciences: (i) lexico-bibliographical, by analyzing the scientific literature in international databases and, more generally, specialized psychological and psychiatric language; (ii) psycholinguistics, with reference to the clinical sciences of language; (iii) computerized linguistics, as the recent deployment of artificial intelligence in the field of mental health invites us to do, at both diagnostic and therapeutic levels, with the emergence of psybots. Our final objective will be to propose a synthesis and redefinition of the notion of psychotherapy for contemporary psychiatry and clinical psychology.</div></div><div><h3>Results</h3><div>The majority of sources indicate that psychotherapy is widely used to treat psychiatric illnesses, psychological and psychosomatic disorders, and existential suffering. The notions of the unconscious and awareness, the place of verbal and non-verbal languages, and the importance of the patient–practitioner relationship are the most widely accepted. The somatic approach and group psychotherapy are mentioned less frequently. The organization of sessions is rarely mentioned, as is the status of the therapist or the idea that the therapist's uniqueness is a central element of the treatment. The need for specific training for the practitioner was mentioned more often, as was the possibility of combining psychotherapy with pharmacological or environmental therapies. With regard to the evaluation of treatment, the notion of defining an objective (global or focal) is mentioned only incidentally, as is the importance of scientific validity, in particular taking into account the risk of undesirable effects.</div></div><div><h3>Discussion</h3><div>The dynamic notion of therapeutic processes or mechanisms is rarely mentioned, yet the study of change processes could help to define psychotherapies. The evaluation of psychotherapeutic practices would be capable of federating “psychotherapy” on the basis of a common foundation and, building on this, opening up to the possible specificities of “psychotherapies” according to their indications and/or methods. Althoug
{"title":"Qu’est-ce qu’une psychothérapie aujourd’hui ? Du psychothérapeute au « psybot » : vers une nouvelle définition","authors":"Yann Auxéméry","doi":"10.1016/j.evopsy.2024.09.003","DOIUrl":"10.1016/j.evopsy.2024.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>One hundred and fifty years after the word first appeared in the English lexicon, how can we still talk about “psychotherapy” today? While the original aims and methods of the concept of “psychotherapy” appeared simple and generic, namely “to heal through the mind,” our contemporary psychiatry and psychology have developed a multitude of “psychotherapies”, which generally present themselves as distinct. This makes it difficult for patients and their families to find their way around, difficult for our psychiatric interns and psychology master's students to orient themselves, and difficult for our administrative authorities to get involved.</div></div><div><h3>Method</h3><div>As they appear to us to be fundamental to the very essence and future of the notion of “psychotherapy,” in order to approach its definition, we call upon the language sciences: (i) lexico-bibliographical, by analyzing the scientific literature in international databases and, more generally, specialized psychological and psychiatric language; (ii) psycholinguistics, with reference to the clinical sciences of language; (iii) computerized linguistics, as the recent deployment of artificial intelligence in the field of mental health invites us to do, at both diagnostic and therapeutic levels, with the emergence of psybots. Our final objective will be to propose a synthesis and redefinition of the notion of psychotherapy for contemporary psychiatry and clinical psychology.</div></div><div><h3>Results</h3><div>The majority of sources indicate that psychotherapy is widely used to treat psychiatric illnesses, psychological and psychosomatic disorders, and existential suffering. The notions of the unconscious and awareness, the place of verbal and non-verbal languages, and the importance of the patient–practitioner relationship are the most widely accepted. The somatic approach and group psychotherapy are mentioned less frequently. The organization of sessions is rarely mentioned, as is the status of the therapist or the idea that the therapist's uniqueness is a central element of the treatment. The need for specific training for the practitioner was mentioned more often, as was the possibility of combining psychotherapy with pharmacological or environmental therapies. With regard to the evaluation of treatment, the notion of defining an objective (global or focal) is mentioned only incidentally, as is the importance of scientific validity, in particular taking into account the risk of undesirable effects.</div></div><div><h3>Discussion</h3><div>The dynamic notion of therapeutic processes or mechanisms is rarely mentioned, yet the study of change processes could help to define psychotherapies. The evaluation of psychotherapeutic practices would be capable of federating “psychotherapy” on the basis of a common foundation and, building on this, opening up to the possible specificities of “psychotherapies” according to their indications and/or methods. Althoug","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 4","pages":"Pages 749-792"},"PeriodicalIF":0.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721924","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 : 2024-10-26DOI: 10.1016/j.evopsy.2024.08.003
Charlie Renaud (Maître de conférences) , Agnès Lacroix (Professeure des universités)
<div><h3>Objectives</h3><div>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.</div></div><div><h3>Method</h3><div>We conducted two assessments with 22 patients (19 women and 3 men), with an average time lapse of 386.10<!--> <!-->days (SD<!--> <!-->=<!--> <!-->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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Discussion</h3><div>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
许多研究已经证明了倦怠和认知困难之间的联系，但缺乏对这一主题的纵向研究。本研究旨在对临床倦怠患者进行为期一年的随访。此外，文献表明，抑郁、焦虑、神经质、情绪调节策略和重返就业等变量可能影响认知恢复和患者对认知恢复的感知。因此，本研究也试图描述这些变量在患者认知恢复中的潜在作用。方法对22例患者（女性19例，男性3例）进行2次评估，平均间隔时间为386.10 d （SD = 20.71）。使用神经心理学测试评估认知功能。最初，使用memi - iii和GREFEX，而在第二次评估中使用memi - iv（在初次接触和随访之间唯一改变的测试）来评估记忆。使用BRIEF-A问卷评估执行功能。此外，采用法国大五量表、HADS和情绪调节量表对参与者的心理特征进行了深入研究。结果在所有被评估的记忆领域中，包括听觉、即时视觉和延迟视觉记忆，都观察到显著的改善。关于通过测试评估的执行功能，16项分析中只有4项显示出显著改善。这些分析涉及Stroop测试干扰条件的错误、MCST的类别、TMT B的时间和字面流畅性任务产生的单词数量。BRIEF-A的自我评估表明，总体执行指数和元认知指数有所改善。初步评估一年后，焦虑和抑郁水平没有显著差异。只有倦怠和神经质水平有显著下降。此外，在恢复工作的患者和仍在寻找工作的患者之间没有观察到差异。记忆障碍似乎是暂时的和可逆的，而执行功能数据揭示了一个更微妙的结果，在测试评估的恢复和患者自我评估之间存在实质性差异。测试结果显示出一些改善，特别是在评估抑制和心理灵活性的测试中。然而，这些改善可能归因于认知耐力的提高，因为这些测试是在电池中最后进行的。患者对执行功能的自我评估可能表明他们对认知能力的信心有所增强。探讨自尊在职业倦怠后认知功能自我评价中的作用将是一个值得进一步研究的方向。最后，在所有测试的协变量中，只有神经质似乎与患者的认知恢复有关。抑郁和焦虑并不总是对倦怠和认知功能之间的联系产生主要影响。结论本研究有助于对职业倦怠后认知恢复的细致理解。执行和记忆功能似乎不是以同样的方式进化的。此外，该研究强调了患者对自己认知能力的看法的重要性。这些发现强调了深入研究指导临床干预和该领域未来调查的必要性。
{"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) , Agnès Lacroix (Professeure des universités)","doi":"10.1016/j.evopsy.2024.08.003","DOIUrl":"10.1016/j.evopsy.2024.08.003","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Method</h3><div>We conducted two assessments with 22 patients (19 women and 3 men), with an average time lapse of 386.10<!--> <!-->days (SD<!--> <!-->=<!--> <!-->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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Discussion</h3><div>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":"2024-10-26","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}
Pub Date : 2024-10-24DOI: 10.1016/j.evopsy.2024.10.002
Madeleine Azubuike (Psychologue clinicienne et doctorante) , Fanny Marteau-Chasserieau (Maître de conférences en psychologie) , Nathalie Duriez (Professeur des universités)
Objective
Psychotherapy is an immensely diverse field of practice, in which multiple models and protocols coexist. This diversity can be an asset but can sometimes hinder the path toward a common understanding of what works in psychotherapy. The aim of this article is to show that the therapeutic alliance construct can provide an integrative frame of reference when it comes to understanding the psychotherapeutic process.
Method
This narrative review of the therapeutic alliance concept embraces the diversity of theories and practices in psychotherapy. We draw on the contextual model (Wampold, 2001) and the therapeutic alliance model (Bordin, 1979).
Results
The reviewed studies mainly focus on individual psychotherapy for adult patients and are drawn from the international literature over the past fifty years.
Discussion
We explore the epistemological and practical implications of these studies. One part of the research explores the links between alliance and psychotherapy outcomes, while another explores alliance as a therapeutic process.
Conclusions
The contextual approach and the alliance model can be used to provide a definition of psychotherapy that is common to different schools of thought. These concepts offer a framework for quality psychological care.
{"title":"L’alliance thérapeutique : un paradigme trans-théorique pour les psychothérapies","authors":"Madeleine Azubuike (Psychologue clinicienne et doctorante) , Fanny Marteau-Chasserieau (Maître de conférences en psychologie) , Nathalie Duriez (Professeur des universités)","doi":"10.1016/j.evopsy.2024.10.002","DOIUrl":"10.1016/j.evopsy.2024.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>Psychotherapy is an immensely diverse field of practice, in which multiple models and protocols coexist. This diversity can be an asset but can sometimes hinder the path toward a common understanding of what works in psychotherapy. The aim of this article is to show that the therapeutic alliance construct can provide an integrative frame of reference when it comes to understanding the psychotherapeutic process.</div></div><div><h3>Method</h3><div>This narrative review of the therapeutic alliance concept embraces the diversity of theories and practices in psychotherapy. We draw on the contextual model (Wampold, 2001) and the therapeutic alliance model (Bordin, 1979).</div></div><div><h3>Results</h3><div>The reviewed studies mainly focus on individual psychotherapy for adult patients and are drawn from the international literature over the past fifty years.</div></div><div><h3>Discussion</h3><div>We explore the epistemological and practical implications of these studies. One part of the research explores the links between alliance and psychotherapy outcomes, while another explores alliance as a therapeutic process.</div></div><div><h3>Conclusions</h3><div>The contextual approach and the alliance model can be used to provide a definition of psychotherapy that is common to different schools of thought. These concepts offer a framework for quality psychological care.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 4","pages":"Pages 793-810"},"PeriodicalIF":0.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721925","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 : 2024-10-24DOI: 10.1016/j.evopsy.2024.09.002
Sophie Gallet (Psychiatre)
<div><h3>Objectives</h3><div>Patients who are victims of incest frequently have body image disorders. My own experience as a dancer led me to formulate a hypothesis: ballroom dance could be useful for this population of patients to allow them to reclaim their bodies, to learn that their bodies are not their enemies, and that the body of others is not perceived as a danger. To do this, I wanted to trace the history of dance therapy and review the literature on dance therapy as a therapeutic intervention for victims of incest.</div></div><div><h3>Methods</h3><div>The confluence of dance and psychoanalysis will allow the emergence of dance therapy with three major figures in particular. First of all, Marian Chace and Dance Movement Therapy. She was a modern dancer who came to realize that her students come to her for much more than dance lessons. So, she began volunteering in a psychiatric hospital, where she ultimately became a paid staff member. She created a working group that was so successful that the patients themselves wanted to put on a show within the hospital. It was in 1940. She will officially become the first dancer-therapist in 1946. Next comes Trudi Schoop, who met Bleuler and worked mainly with schizophrenic patients. She used dance to harmonize body image and develop body awareness. Finally, Rose Gaetner, a French woman, trained as a psychomotor therapist, whose work focused primarily on classical dance with children and adolescents. The structuring side, mirror work, and the quest for beauty are for her a means of narcissistic restoration. It also introduces a very interesting concept: tonic dialogue.</div></div><div><h3>Results</h3><div>Today, dance therapy remains little known, especially in France, and its indications remain to be precisely defined, although studies have shown its effectiveness with both somatic and psychological pathologies. More specifically regarding dance therapy as a therapy for patients who are victims of incest, a review of the literature unfortunately brought up only eight studies on the subject. The protocols are very diverse and somewhat lacking in solidity. However, all these studies tend to show the effectiveness of dance therapy with this specific population.</div></div><div><h3>Discussion</h3><div>It is very interesting to note that dance has always been part of humanity. From the Paleolithic, we find traces of it with “the dancing sorcerer,” and it is very possible that it was used for therapeutic purposes. These were most likely trance dances, but these dances have persisted until today, whether it is the Neapolitan Tarantella, Breton dances, or even voodoo. We also find the same characteristics in rave parties. These dances often have an aspect of treatment, particularly for psychological disorders. We can then wonder if rave parties do not also respond to a need in the face of societal unhappiness. Dance therapy was born during the first part of the 20th century, during the era of asylum psychi
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