Pub Date : 2023-10-06DOI: 10.1016/j.evopsy.2023.09.003
Julie Chevalier (Psychologue clinicienne, docteure en psychologie clinique et psychopathologie)
Objectives
The environment is a concept that allows us to re-examine classical psychoanalytic psychopathology, starting with the nature of the symptom and the processes that structure it, then the notions of the normal and the pathological. This article thus proposes the main axes of a psychoanalytic psychopathology of the environment in an intersubjective dimension.
Method
We carry out a singular reading and analysis of Donald W. Winnicott's theories on the environment and the concepts related to it, in particular dependence, the self, aggressiveness, and repair. Then we describe their complementarities and their breaks with Anglo-Saxon theories, as developed by Sándor Ferenczi, Melanie Klein, and Michael Balint.
Results
There are different types of failures depending on whether the environment impinges affectively and bodily on the needs of the infant through seduction, torment, or disappearance. What matters is the moment of dependence during which they take place, generating either potentially a psychotic or manic-depressive organization at the moment of absolute dependence, or potentially an antisocial organization at the moment of relative dependence. The failures of the environment (Winnicott) can thus be considered complementary to the paranoid-schizoid and depressive positions (Klein), as well as to the concepts of ocnophilia and philobatism (Balint).
Discussion
The concept of environment also shows how motor skills constitute an important intersubjective experience in the construction of the self. In parents, this manifests itself above all in ordinary holding; in infants, in the aggressiveness at the origin of their spontaneous gestures, both destructive and creative, then becoming more broadly restorative in the family and social environments. Regression to dependence may become necessary for the exploration of primary experiences inherent to the individual-environment dyad, and may also have a function of intersubjective reintegration.
Conclusion
This sketch for a psychoanalytic psychopathology of the environment is therefore relevant for interpreting the sufferings of the self as intersubjective “disorders” and for analyzing clinical cases of regression to dependence in the analytic situation.
目标环境是一个可以让我们重新审视经典精神分析精神病理学的概念，首先是症状的性质和构成症状的过程，然后是正常和病态的概念。方法我们对唐纳德-温尼科特（Donald W. Winnicott）关于环境的理论以及与之相关的概念，尤其是依赖、自我、攻击性和修复等概念，进行了独特的解读和分析。结果根据环境是否通过诱惑、折磨或消失等方式对婴儿的需求造成情感和身体上的影响，会出现不同类型的失败。重要的是，这些失败发生在依赖的时刻，在绝对依赖的时刻可能产生精神病或躁狂抑郁组织，在相对依赖的时刻可能产生反社会组织。因此，环境的失败（温尼科特）可以被认为是对偏执狂-分裂样态和抑郁样态（克莱因），以及恋物癖和恋物癖概念（巴林特）的补充。在父母身上，这首先表现在普通的拥抱上；在婴儿身上，则表现在其自发手势的攻击性上，既有破坏性的，也有创造性的，然后在家庭和社会环境中变得更具有广泛的恢复性。因此，这一精神分析环境心理病理学的草图对于将自我的痛苦解释为主体间的 "失调"，以及在分析情境中分析向依赖性回归的临床病例具有重要意义。
{"title":"Esquisse pour une psychopathologie psychanalytique de l’environnement","authors":"Julie Chevalier (Psychologue clinicienne, docteure en psychologie clinique et psychopathologie)","doi":"10.1016/j.evopsy.2023.09.003","DOIUrl":"10.1016/j.evopsy.2023.09.003","url":null,"abstract":"<div><h3>Objectives</h3><p>The environment is a concept that allows us to re-examine classical psychoanalytic psychopathology, starting with the nature of the symptom and the processes that structure it, then the notions of the normal and the pathological. This article thus proposes the main axes of a psychoanalytic psychopathology of the environment in an intersubjective dimension.</p></div><div><h3>Method</h3><p>We carry out a singular reading and analysis of Donald W. Winnicott's theories on the environment and the concepts related to it, in particular dependence, the self, aggressiveness, and repair. Then we describe their complementarities and their breaks with Anglo-Saxon theories, as developed by Sándor Ferenczi, Melanie Klein, and Michael Balint.</p></div><div><h3>Results</h3><p>There are different types of failures depending on whether the environment impinges affectively and bodily on the needs of the infant through seduction, torment, or disappearance. What matters is the moment of dependence during which they take place, generating either potentially a psychotic or manic-depressive organization at the moment of absolute dependence, or potentially an antisocial organization at the moment of relative dependence. The failures of the environment (Winnicott) can thus be considered complementary to the paranoid-schizoid and depressive positions (Klein), as well as to the concepts of ocnophilia and philobatism (Balint).</p></div><div><h3>Discussion</h3><p>The concept of environment also shows how motor skills constitute an important intersubjective experience in the construction of the self. In parents, this manifests itself above all in ordinary holding; in infants, in the aggressiveness at the origin of their spontaneous gestures, both destructive and creative, then becoming more broadly restorative in the family and social environments. Regression to dependence may become necessary for the exploration of primary experiences inherent to the individual-environment dyad, and may also have a function of intersubjective reintegration.</p></div><div><h3>Conclusion</h3><p>This sketch for a psychoanalytic psychopathology of the environment is therefore relevant for interpreting the sufferings of the self as intersubjective “disorders” and for analyzing clinical cases of regression to dependence in the analytic situation.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135605963","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 : 2023-09-16DOI: 10.1016/j.evopsy.2023.08.003
Lucia Bley (Psychologue clinicienne, Docteure en Psychanalyse et Psychopathologie)
Objectifs
L’article propose de découvrir l’œuvre et le parcours clinique et politique de Fernando Ulloa, référence incontournable de l’analyse institutionnelle en Argentine, et ses échos avec le mouvement de la psychothérapie institutionnelle en France.
Méthode
Par une étude de ses œuvres et de ses interventions dans la sphère universitaire, psychanalytique et politique, nous montrons comment le travail de Fernando Ulloa interroge les violences qui parcourent les institutions de soin ainsi que la notion de collectif.
Résultats
Son effort constant pour articuler psychanalyse et politique résonne avec les violences que traverse le soin psychique actuel en France, questionne notre rapport aux dogmes théoriques et propose de concevoir l’éthique analytique comme celle d’un « être psychanalyste » dans l’instant, et non comme identité.
Discussion
En replaçant l’enjeu social au cœur du travail clinique et en intriquant les dimensions thérapeutiques et didactiques, l’œuvre de Fernando Ulloa est fortement imprégnée de celle de Pichon Rivière, dont il fut l’un des principaux élèves, et de ses « groupes opératifs ». En effet, son travail de psychanalyste auprès de ce qu’il nomme les « numérosités sociales » vise à contribuer à l’émergence d’une pensée critique collective. Son engagement pour la justice sociale et sa lutte pour les Droits de l’Homme le mènent à théoriser la notion de « culture de mortification », une certaine tonalité de la souffrance institutionnelle contemporaine. Il montre comment le collectif et la « tendresse » sont deux voies de sortie de cette mortification.
Conclusion
L’héritage clinique et politique de Fernando Ulloa est de nous aider à interroger notre engagement dans la clinique et à penser ce qui soigne l’institution et ceux qui la pratiquent.
Introduction
The article proposes to explore the work as well as the clinical and political career of Fernando Ulloa, an essential reference for institutional analysis in Argentina. It will also address links with the movement for institutional psychotherapy in France.
Method
Through a study of his works and his lectures in the academic, psychoanalytical, and political sphere, we show how Fernando Ulloa's work interrogates the violence that runs through healthcare institutions as well as the notion of “collective elaboration.”
Results
By putting the social issue at the heart of clinical work and by interweaving the therapeutic and didactic dimensions, the work of Fernando Ulloa is strongly inspired by that of Pichon Rivière, of whom he was one of the main students, and of the latter's “group operatives”. Indeed, his work as a psychoanalyst with what he calls “social numerosity” aims to contribute to the emergence of collective critical thought. His commitment to social justice and his fight for human rig
{"title":"Sortir de la « mortification » institutionnelle par le collectif ? Héritage clinique et politique de Fernando Ulloa","authors":"Lucia Bley (Psychologue clinicienne, Docteure en Psychanalyse et Psychopathologie)","doi":"10.1016/j.evopsy.2023.08.003","DOIUrl":"10.1016/j.evopsy.2023.08.003","url":null,"abstract":"<div><h3>Objectifs</h3><p>L’article propose de découvrir l’œuvre et le parcours clinique et politique de Fernando Ulloa, référence incontournable de l’analyse institutionnelle en Argentine, et ses échos avec le mouvement de la psychothérapie institutionnelle en France.</p></div><div><h3>Méthode</h3><p>Par une étude de ses œuvres et de ses interventions dans la sphère universitaire, psychanalytique et politique, nous montrons comment le travail de Fernando Ulloa interroge les violences qui parcourent les institutions de soin ainsi que la notion de collectif.</p></div><div><h3>Résultats</h3><p>Son effort constant pour articuler psychanalyse et politique résonne avec les violences que traverse le soin psychique actuel en France, questionne notre rapport aux dogmes théoriques et propose de concevoir l’éthique analytique comme celle d’un « être psychanalyste » dans l’instant, et non comme identité.</p></div><div><h3>Discussion</h3><p>En replaçant l’enjeu social au cœur du travail clinique et en intriquant les dimensions thérapeutiques et didactiques, l’œuvre de Fernando Ulloa est fortement imprégnée de celle de Pichon Rivière, dont il fut l’un des principaux élèves, et de ses « groupes opératifs ». En effet, son travail de psychanalyste auprès de ce qu’il nomme les « numérosités sociales » vise à contribuer à l’émergence d’une pensée critique collective. Son engagement pour la justice sociale et sa lutte pour les Droits de l’Homme le mènent à théoriser la notion de « culture de mortification », une certaine tonalité de la souffrance institutionnelle contemporaine. Il montre comment le collectif et la « tendresse » sont deux voies de sortie de cette mortification.</p></div><div><h3>Conclusion</h3><p>L’héritage clinique et politique de Fernando Ulloa est de nous aider à interroger notre engagement dans la clinique et à penser ce qui soigne l’institution et ceux qui la pratiquent.</p></div><div><h3>Introduction</h3><p>The article proposes to explore the work as well as the clinical and political career of Fernando Ulloa, an essential reference for institutional analysis in Argentina. It will also address links with the movement for institutional psychotherapy in France.</p></div><div><h3>Method</h3><p>Through a study of his works and his lectures in the academic, psychoanalytical, and political sphere, we show how Fernando Ulloa's work interrogates the violence that runs through healthcare institutions as well as the notion of “collective elaboration.”</p></div><div><h3>Results</h3><p>By putting the social issue at the heart of clinical work and by interweaving the therapeutic and didactic dimensions, the work of Fernando Ulloa is strongly inspired by that of Pichon Rivière, of whom he was one of the main students, and of the latter's “group operatives”. Indeed, his work as a psychoanalyst with what he calls “social numerosity” aims to contribute to the emergence of collective critical thought. His commitment to social justice and his fight for human rig","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135347049","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 : 2023-09-15DOI: 10.1016/j.evopsy.2023.08.002
Frédérique Debout-Cosme (Psychologue clinicienne, Maîtresse de Conférences en psychopathologie et psychodynamique du travail)
Objectif
L’article vise à soutenir une conception métapsychologique permettant de critiquer le modèle déficitaire de la psychose en psychiatrie. Cette critique visant l’héritage de la pensée kraepelinienne et passant par la discussion des apports d’E. Bleuler et H. Ey s’articule autour de la distinction entre les notions de « déficit » et de « défaut ».
Méthode
À partir d’un cas issu de sa clinique au sein d’une unité d’accueil familial thérapeutique pour adultes psychotiques, l’auteure revient à la théorie des psychoses dissociatives à partir du « travailler » et du « travail vivant » de ceux qui prennent soin de ces malades.
Résultats
En mobilisant la théorie laplanchienne de la genèse de la pensée et la topique du clivage de Christophe Dejours, l’auteure soutient l’idée que ce qui caractérise la psychose dissociative n’est pas le déficit mais l’inhibition.
Discussion
Cette inhibition touche les fonctions affectives et perceptives du corps. Elle représente une modalité défensive ne découlant pas d’un traumatisme mais d’un défaut de construction du corps érotique entraînant une économie pulsionnelle singulière appelée disruptive.
Conclusion
Ce défaut de construction n’est pas irréversible mais le traitement thérapeutique de ces patients nécessite–condition sine qua non–la mobilisation du corps érotique des soignants pour la mise au travail de soi sur soi du patient.
Objective
The article proposes a metapsychological conception allowing us to criticize the deficit model of psychosis in psychiatry. This criticism of the Kraepelinian heritage, through the discussion of the contributions of E. Bleuler and H. Ey, revolves around the distinction between the notions of “deficit” and “default.”
Method
From a case extracted from her clinical experience in a therapeutic foster care unit for psychotic adults, the author returns to the theory of dissociative psychosis from the “work” and “living work” of those who care for these patients.
Results
By mobilizing the Laplanchian theory of the genesis of thought and Christophe Dejours's topography of splitting, the author maintains that what characterizes dissociative psychosis is not deficit but inhibition.
Discussion
This inhibition affects the emotional and perceptual functions of the body. It represents a defensive modality not resulting from a trauma but from a defect in the construction of the erotic body leading to a singular instinctual economy, labeled disruptive.
Conclusion
This construction defect is not irreversible, but the therapeutic treatment of these patients requires–a sine qua non condition–the mobilization of the erotic body of the caregivers, in order for the patient to begin their own self-work.
本文旨在支持一种元心理学概念，使我们能够对精神病学中的缺陷模式进行批判。这种批判的重点是克拉佩利尼思想的遗产，包括对 E. Bleuler 和 H. Ey 的贡献的讨论，其基础是 "缺陷 "和 "缺失 "概念之间的区别。方法作者根据她在治疗成年精神病患者的家庭单位中的临床经验，以护理这些患者的 "工作 "和 "生活工作 "为基础，重新回到分离型精神病的理论中来。结果作者运用拉普兰奇（Laplanch）的思想起源理论和克里斯托弗-德约尔（Christophe Dejours）的 "克利瓦奇理论"（topique du clivage），支持这样一种观点，即分离性精神病的特点不是缺失，而是抑制。本文提出了一种元心理学概念，使我们能够对精神病学中的缺失模式进行批判。本文通过讨论 E. Bleuler 和 H. Kraepelin 的贡献，对克拉佩利尼传统进行了批判。方法作者从她在治疗性成人精神病寄养病房的临床经验中提取的一个病例出发，从照顾这些病人的人的 "工作 "和 "生活工作 "中回到分离性精神病的理论。结果通过运用拉普兰奇的思维起源理论和克里斯托弗-德约的分裂地形学，作者认为解离性精神病的特征不是缺失，而是抑制。这种抑制影响到身体的情感和知觉功能，它代表了一种防御模式，并非创伤所致，而是情欲身体构造的缺陷导致了一种被称为破坏性的单一本能经济。
{"title":"Psychopathologie des psychoses dissociatives et Topique du clivage","authors":"Frédérique Debout-Cosme (Psychologue clinicienne, Maîtresse de Conférences en psychopathologie et psychodynamique du travail)","doi":"10.1016/j.evopsy.2023.08.002","DOIUrl":"10.1016/j.evopsy.2023.08.002","url":null,"abstract":"<div><h3>Objectif</h3><p>L’article vise à soutenir une conception métapsychologique permettant de critiquer le modèle déficitaire de la psychose en psychiatrie. Cette critique visant l’héritage de la pensée kraepelinienne et passant par la discussion des apports d’E. Bleuler et H. Ey s’articule autour de la distinction entre les notions de « déficit » et de « défaut ».</p></div><div><h3>Méthode</h3><p>À partir d’un cas issu de sa clinique au sein d’une unité d’accueil familial thérapeutique pour adultes psychotiques, l’auteure revient à la théorie des psychoses dissociatives à partir du « travailler » et du « travail vivant » de ceux qui prennent soin de ces malades.</p></div><div><h3>Résultats</h3><p>En mobilisant la théorie laplanchienne de la genèse de la pensée et la topique du clivage de Christophe Dejours, l’auteure soutient l’idée que ce qui caractérise la psychose dissociative n’est pas le déficit mais l’inhibition.</p></div><div><h3>Discussion</h3><p>Cette inhibition touche les fonctions affectives et perceptives du corps. Elle représente une modalité défensive ne découlant pas d’un traumatisme mais d’un défaut de construction du corps érotique entraînant une économie pulsionnelle singulière appelée disruptive.</p></div><div><h3>Conclusion</h3><p>Ce défaut de construction n’est pas irréversible mais le traitement thérapeutique de ces patients nécessite–condition <em>sine qua non</em>–la mobilisation du corps érotique des soignants pour la mise au travail de soi sur soi du patient.</p></div><div><h3>Objective</h3><p>The article proposes a metapsychological conception allowing us to criticize the deficit model of psychosis in psychiatry. This criticism of the Kraepelinian heritage, through the discussion of the contributions of E. Bleuler and H. Ey, revolves around the distinction between the notions of “deficit” and “default.”</p></div><div><h3>Method</h3><p>From a case extracted from her clinical experience in a therapeutic foster care unit for psychotic adults, the author returns to the theory of dissociative psychosis from the “work” and “living work” of those who care for these patients.</p></div><div><h3>Results</h3><p>By mobilizing the Laplanchian theory of the genesis of thought and Christophe Dejours's topography of splitting, the author maintains that what characterizes dissociative psychosis is not deficit but inhibition.</p></div><div><h3>Discussion</h3><p>This inhibition affects the emotional and perceptual functions of the body. It represents a defensive modality not resulting from a trauma but from a defect in the construction of the erotic body leading to a singular instinctual economy, labeled disruptive.</p></div><div><h3>Conclusion</h3><p>This construction defect is not irreversible, but the therapeutic treatment of these patients requires–a sine qua non condition–the mobilization of the erotic body of the caregivers, in order for the patient to begin their own self-work.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135346856","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 : 2023-09-09DOI: 10.1016/j.evopsy.2023.07.008
Myriam Chérel (Maître de conférence en psychopathologie clinique)
Objectives
The aim of this work is to examine the subjective relationship of autistic subjects to artistic creation, particularly graphic creation. More specifically, it examines the conditions under which graphic creativity can be an autistic subject's preferred means of directing the excess impulses that invade him or her into an out-of-body object, and thereby opening up the possibility of creating a multidimensional space for him- or herself.
Method
Critical analysis of the main theories in the scientific literature on the graphic abilities of autistic subjects. Confrontation of the hypotheses of a cognitive deficit and those of a psychodynamic current. We propose our theoretical development based on a case study. Psychodynamic study of the functions of art and, more generally, of creativity and inventiveness in autistic subjects.
Results
Painting allowed Iris Grace to build her relationship to the world, to her body, to others, and to speech, that is to say, to build a real subjective dynamic. Iris Grace's graphic creativity testifies to one autistic subject's preference for directing an invasive instinctual excess onto paper, into an out-of-body object, thereby allowing her to create a multidimensional space where libido, body, and link to the other were unfolded and complexified.
Discussion
The use of drawings, and their infinite details, allows us to see that artistic creation raises the question of writing. We develop the link with the use of computerized devices and their 3D software: certain autistic subjects prefer this mode of writing because the computer allows them to isolate, in details, the dimensions of the language. Each form, each place, each color, each detail, all these “Ones” lead us to consider that the work of autistic subjects is more about making a consistent whole out of these “Ones”. What clinical work with autistic people teaches us is how effective it is to bet on the strengths of each individual, even if they are first and foremost fixation, obsession, or focus. In this way, they can have some chance of being invested as an out-of-body object, enabling the creation of a multidimensional space. This is not to suggest that painting and/or drawing can be a therapy for every autistic person, or a particularly suitable form of art mediation.
Conclusion
Supporting the creativity of each autistic person in this way helps them to deal with excess jouissance, and to locate it on an edge, thus facilitating the regulation of libido and drives, thanks to the creation of a link and an openness to the world and to learning. In institutional care, it's a question of welcoming the autistic subject as he or she presents him- or herself, welcoming the real the subject has to deal with, and ensuring that his or her creation and inventiveness, whatever it may be, is increasingly cobbled together as a Borromean knot; in s
{"title":"La perspective créatrice de l’autisme : le cas extraordinaire de l’autiste peintre Iris Grace","authors":"Myriam Chérel (Maître de conférence en psychopathologie clinique)","doi":"10.1016/j.evopsy.2023.07.008","DOIUrl":"10.1016/j.evopsy.2023.07.008","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of this work is to examine the subjective relationship of autistic subjects to artistic creation, particularly graphic creation. More specifically, it examines the conditions under which graphic creativity can be an autistic subject's preferred means of directing the excess impulses that invade him or her into an out-of-body object, and thereby opening up the possibility of creating a multidimensional space for him- or herself.</p></div><div><h3>Method</h3><p>Critical analysis of the main theories in the scientific literature on the graphic abilities of autistic subjects. Confrontation of the hypotheses of a cognitive deficit and those of a psychodynamic current. We propose our theoretical development based on a case study. Psychodynamic study of the functions of art and, more generally, of creativity and inventiveness in autistic subjects.</p></div><div><h3>Results</h3><p>Painting allowed Iris Grace to build her relationship to the world, to her body, to others, and to speech, that is to say, to build a real subjective dynamic. Iris Grace's graphic creativity testifies to one autistic subject's preference for directing an invasive instinctual excess onto paper, into an out-of-body object, thereby allowing her to create a multidimensional space where libido, body, and link to the other were unfolded and complexified.</p></div><div><h3>Discussion</h3><p>The use of drawings, and their infinite details, allows us to see that artistic creation raises the question of writing. We develop the link with the use of computerized devices and their 3D software: certain autistic subjects prefer this mode of writing because the computer allows them to isolate, in details, the dimensions of the language. Each form, each place, each color, each detail, all these “Ones” lead us to consider that the work of autistic subjects is more about making a consistent whole out of these “Ones”. What clinical work with autistic people teaches us is how effective it is to bet on the strengths of each individual, even if they are first and foremost fixation, obsession, or focus. In this way, they can have some chance of being invested as an out-of-body object, enabling the creation of a multidimensional space. This is not to suggest that painting and/or drawing can be a therapy for every autistic person, or a particularly suitable form of art mediation.</p></div><div><h3>Conclusion</h3><p>Supporting the creativity of each autistic person in this way helps them to deal with excess jouissance, and to locate it on an edge, thus facilitating the regulation of libido and drives, thanks to the creation of a link and an openness to the world and to learning. In institutional care, it's a question of welcoming the autistic subject as he or she presents him- or herself, welcoming the real the subject has to deal with, and ensuring that his or her creation and inventiveness, whatever it may be, is increasingly cobbled together as a Borromean knot; in s","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135248430","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 : 2023-09-01DOI: 10.1016/j.evopsy.2023.04.007
Mickaël Peoc’h (Maître de conférences associé en psychopathologie clinique)
Objective
This article focuses on the “mirror sign” as an element of psychiatric semiology. Considered as a prodrome of schizophrenia during its description between 1927 and 1930, the article aims to shed light on its contemporary relevance, particularly with regard to changes in society concerning the subject's relationship to their image as well as the relationship to identity or self.
Method
After reviewing the history of the discovery and description of this sign, in order to shed light on its origins and on some essential elements, we take up the hypothesis of a link between a failure of the Lacanian “mirror stage” (stade du miroir) and the occurrence of the sign of the mirror. Links between original description, the frequency of body image disorders in psychosis, and the consequence of the mirror stage on symbolic identity are clarified. A few clinical fragments allow us to question the unfolding hypothesis.
Results
The mirror sign appeared at the beginning of the 20th century as a prognosis for schizophrenia. Alienists linked it to homosexuality, then considered pathological. It appears today that the clinical class of the disorders that can be referred to this sign emerges essentially from a disjunction between body image and identity. This sign can be heuristically put into perspective with the Lacanian statement unpacked in “Le stade du miroir comme formateur de la fonction du Je,” and with the hypothesis that the psychotic structure also offers subjects the possibility of non-standard symptomatic responses. The sign of the mirror and the subjective responses that result from it shed light on what it is that some subjects seeking to create, by working on their image, on their body, a new identity, to respond to an initial perceived disjunction between image and identity.
Discussion
If the sign of the mirror inspires a large number of subjective responses aimed at modifying the body to make it conform to a new identity, and thereby carrying viable neo-identity solutions, it is not experienced without some discomfort in most cases. Nothing makes it possible to predict its future, and the therapeutic action is limited to identifying this sign and supporting the possible elaborations of the subjects who aspire to produce a conjunction between image and identity.
Conclusion
One hundred years after its discovery, the mirror sign, is still an extremely relevant element of psychiatric semiology. It does not necessarily constitute a prodrome of schizophrenia, but it indicates a subjective difficulty in associating image with identity. The symptomatic response of the subject does not require the validation of the clinician; it is linked to a subjective malaise, which can be welcomed, whatever the outcome of this sign.
目的本文着重探讨“镜像符号”作为精神符号学的一个组成部分。在1927年至1930年的描述中，这篇文章被认为是精神分裂症的前驱症状，旨在阐明其当代相关性，特别是关于社会的变化，涉及主体与他们的形象以及与身份或自我的关系。方法在回顾了这一标志的发现和描述的历史后，为了阐明它的起源和一些基本要素，我们提出了拉康“镜像阶段”（stade du miroir）的失败与镜像标志的出现之间的联系的假设。阐明了原始描述、精神病中身体形象障碍的频率以及镜像阶段对象征身份的影响之间的联系。一些临床片段使我们能够质疑正在展开的假说。结果镜像征作为精神分裂症的预后标志出现于20世纪初。Alienists将其与同性恋联系起来，然后被认为是病态的。今天看来，可被称为这种体征的临床疾病类别主要来自身体形象和身份之间的脱节。这一迹象可以从Lacanian在“Le stade du miroir comme formateur de la foction du Je”中的陈述中得到启发，并假设精神病结构也为受试者提供了非标准症状反应的可能性。镜子的标志和由此产生的主观反应揭示了一些主体试图通过在自己的形象和身体上创造一种新的身份，以回应最初感知到的形象和身份之间的脱节。讨论如果镜子的标志激发了大量的主观反应，旨在改变身体，使其符合新的身份，从而带来可行的新身份解决方案，那么在大多数情况下，体验镜子时都会感到不适。没有什么能预测它的未来，治疗作用仅限于识别这个迹象，并支持那些渴望在图像和身份之间产生联系的受试者可能的详细阐述。结论在其发现一百年后，镜像符号仍然是精神符号学中一个极其相关的元素。它不一定构成精神分裂症的前驱症状，但它表明将图像与身份联系起来的主观困难。受试者的症状反应不需要临床医生的验证；这与一种主观不适有关，无论这种迹象的结果如何，这种不适都是值得欢迎的。
{"title":"Disjonction entre image et identité : histoire et actualité du signe du miroir","authors":"Mickaël Peoc’h (Maître de conférences associé en psychopathologie clinique)","doi":"10.1016/j.evopsy.2023.04.007","DOIUrl":"https://doi.org/10.1016/j.evopsy.2023.04.007","url":null,"abstract":"<div><h3>Objective</h3><p>This article focuses on the “mirror sign” as an element of psychiatric semiology. Considered as a prodrome of schizophrenia during its description between 1927 and 1930, the article aims to shed light on its contemporary relevance, particularly with regard to changes in society concerning the subject's relationship to their image as well as the relationship to identity or self.</p></div><div><h3>Method</h3><p>After reviewing the history of the discovery and description of this sign, in order to shed light on its origins and on some essential elements, we take up the hypothesis of a link between a failure of the Lacanian “mirror stage” (stade du miroir) and the occurrence of the sign of the mirror. Links between original description, the frequency of body image disorders in psychosis, and the consequence of the mirror stage on symbolic identity are clarified. A few clinical fragments allow us to question the unfolding hypothesis.</p></div><div><h3>Results</h3><p>The mirror sign appeared at the beginning of the 20th century as a prognosis for schizophrenia. Alienists linked it to homosexuality, then considered pathological. It appears today that the clinical class of the disorders that can be referred to this sign emerges essentially from a disjunction between body image and identity. This sign can be heuristically put into perspective with the Lacanian statement unpacked in “<em>Le stade du miroir comme formateur de la fonction du Je</em>,” and with the hypothesis that the psychotic structure also offers subjects the possibility of non-standard symptomatic responses. The sign of the mirror and the subjective responses that result from it shed light on what it is that some subjects seeking to create, by working on their image, on their body, a new identity, to respond to an initial perceived disjunction between image and identity.</p></div><div><h3>Discussion</h3><p>If the sign of the mirror inspires a large number of subjective responses aimed at modifying the body to make it conform to a new identity, and thereby carrying viable neo-identity solutions, it is not experienced without some discomfort in most cases. Nothing makes it possible to predict its future, and the therapeutic action is limited to identifying this sign and supporting the possible elaborations of the subjects who aspire to produce a conjunction between image and identity.</p></div><div><h3>Conclusion</h3><p>One hundred years after its discovery, the mirror sign, is still an extremely relevant element of psychiatric semiology. It does not necessarily constitute a prodrome of schizophrenia, but it indicates a subjective difficulty in associating image with identity. The symptomatic response of the subject does not require the validation of the clinician; it is linked to a subjective malaise, which can be welcomed, whatever the outcome of this sign.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50203055","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 : 2023-09-01DOI: 10.1016/j.evopsy.2023.04.008
Justine Cesari (Psychologue clinicienne, Doctorante en Psychologie Clinique), Alicia Landbeck (Psychologue clinicienne, Chercheuse associée), Houari Maïdi (Psychologue clinicien, psychanalyste, Professeur de Psychologie clinique et psychopathologie), Rose-Angélique Belot (Psychologue clinicienne, Professeure de Psychologie clinique et psychopathologie)
Aims
In this article, we show the consequences of childhood sexual abuse on psychic development and its implication in victimary repetition in adulthood.
Method
The case study presented in this article is from a doctoral research project in psychology about the impact of early relationships on the experience of intimate partner violence in adulthood. This case appears emblematic of the rest of our population. The elements mentioned are anonymized and analyzed from a psychoanalytic perspective.
Results
The results show the conscious and unconscious consequences of childhood sexual abuse on the victims’ psychological development. Indeed, the psychic intrusion following early sexual abuse hinders the construction of the self and prevents the psychic instances from functioning properly. This intrusion also leads to repetition in violent intimate relationships. Oscillating between primary and secondary processes, the person can cut her/himself off from a part of her/his emotional life to avoid psychic and/or somatic disorganization.
Discussion
After experiencing early sexual trauma, even if the psychic apparatus is temporarily able to keep the traumatic elements far from the conscious mind, these elements still act in the unconscious. The work of shame and guilt, which are constitutive elements of moral masochism, lock the subject into a deadly repetition compulsion that can promote the experience of repetitive intimate partner violence (physical, psychological, sexual) in adulthood.
Conclusion
To prevent, detect, and care for women victims of childhood sexual abuse, it is necessary to consider their modalities of psychic functioning, the formation of their Self, and their ability to psychically transform the trauma they suffered.
{"title":"Maltraitances sexuelles infantiles et répétition victimaire dans les relations conjugales à l’âge adulte","authors":"Justine Cesari (Psychologue clinicienne, Doctorante en Psychologie Clinique), Alicia Landbeck (Psychologue clinicienne, Chercheuse associée), Houari Maïdi (Psychologue clinicien, psychanalyste, Professeur de Psychologie clinique et psychopathologie), Rose-Angélique Belot (Psychologue clinicienne, Professeure de Psychologie clinique et psychopathologie)","doi":"10.1016/j.evopsy.2023.04.008","DOIUrl":"https://doi.org/10.1016/j.evopsy.2023.04.008","url":null,"abstract":"<div><h3>Aims</h3><p>In this article, we show the consequences of childhood sexual abuse on psychic development and its implication in victimary repetition in adulthood.</p></div><div><h3>Method</h3><p>The case study presented in this article is from a doctoral research project in psychology about the impact of early relationships on the experience of intimate partner violence in adulthood. This case appears emblematic of the rest of our population. The elements mentioned are anonymized and analyzed from a psychoanalytic perspective.</p></div><div><h3>Results</h3><p>The results show the conscious and unconscious consequences of childhood sexual abuse on the victims’ psychological development. Indeed, the psychic intrusion following early sexual abuse hinders the construction of the self and prevents the psychic instances from functioning properly. This intrusion also leads to repetition in violent intimate relationships. Oscillating between primary and secondary processes, the person can cut her/himself off from a part of her/his emotional life to avoid psychic and/or somatic disorganization.</p></div><div><h3>Discussion</h3><p>After experiencing early sexual trauma, even if the psychic apparatus is temporarily able to keep the traumatic elements far from the conscious mind, these elements still act in the unconscious. The work of shame and guilt, which are constitutive elements of moral masochism, lock the subject into a deadly repetition compulsion that can promote the experience of repetitive intimate partner violence (physical, psychological, sexual) in adulthood.</p></div><div><h3>Conclusion</h3><p>To prevent, detect, and care for women victims of childhood sexual abuse, it is necessary to consider their modalities of psychic functioning, the formation of their Self, and their ability to psychically transform the trauma they suffered.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50203056","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 : 2023-09-01DOI: 10.1016/j.evopsy.2022.10.001
Philippe Givre
Objective
Although the amalgam of male anorexia and psychosis that has long dominated classical psychiatric literature needs to be put into perspective, the relations between male anorexia and “cold” psychosis, mono-symptomatic psychosis, or delusions of passivity nevertheless warrant further exploration in cases of patients who develop the most chronic symptoms.
Method
Rather surprising similarities and echoes will be shown through the cross-analysis of the fantasies of a patient suffering from restrictive mental anorexia since the age of twelve and the autobiographical and literary writings of Franz Kafka that attest to the presence of a unique imaginary world linked to particularly invasive preoccupations with food and eating.
Results
This comparative analytical study of fantasies and fantasmorphoses involved in the issues of anorexia and in Kafka's universe highlights the important role of what Tausk described as “influencing machines,” which originate in the projection of one's own body considered in its entirety as a genital organ. Paradoxically, these influencing machines, by acting primarily as inhibitors of the drives, will mainly contribute to a weakening of the subjects’ virility.
Discussion
To identify the reasons behind this rejection of the pubertary process and genitality, we must consider that there is a defect in the structuring of the Superego, associated with a failure of bisexualization in this same Superego. One of the clinical hypotheses offered is that this failure or dislocation of the agency of the Superego is responsible for the emergence of a megalomaniacal and asexual Ego ideal.
Conclusion
Whereas Kafka was able to draw creative and sublimatory resources from this imaginary world, the defensive modes elicited by anorexic patients who develop the most troubling symptoms will generally not be enough to completely conceal the de-realizing impact of fantasmorphoses or the uncanny feelings caused by the underlying presence of such “influencing machines.”
{"title":"Fantasmorphoses et machines à influencer dans l’univers de l’anorexie masculine","authors":"Philippe Givre","doi":"10.1016/j.evopsy.2022.10.001","DOIUrl":"https://doi.org/10.1016/j.evopsy.2022.10.001","url":null,"abstract":"<div><h3>Objective</h3><p>Although the amalgam of male anorexia and psychosis that has long dominated classical psychiatric literature needs to be put into perspective, the relations between male anorexia and “cold” psychosis, mono-symptomatic psychosis, or delusions of passivity nevertheless warrant further exploration in cases of patients who develop the most chronic symptoms.</p></div><div><h3>Method</h3><p>Rather surprising similarities and echoes will be shown through the cross-analysis of the fantasies of a patient suffering from restrictive mental anorexia since the age of twelve and the autobiographical and literary writings of Franz Kafka that attest to the presence of a unique imaginary world linked to particularly invasive preoccupations with food and eating.</p></div><div><h3>Results</h3><p>This comparative analytical study of fantasies and fantasmorphoses involved in the issues of anorexia and in Kafka's universe highlights the important role of what Tausk described as “influencing machines,” which originate in the projection of one's own body considered in its entirety as a genital organ. Paradoxically, these influencing machines, by acting primarily as inhibitors of the drives, will mainly contribute to a weakening of the subjects’ virility.</p></div><div><h3>Discussion</h3><p>To identify the reasons behind this rejection of the pubertary process and genitality, we must consider that there is a defect in the structuring of the Superego, associated with a failure of bisexualization in this same Superego. One of the clinical hypotheses offered is that this failure or dislocation of the agency of the Superego is responsible for the emergence of a megalomaniacal and asexual Ego ideal.</p></div><div><h3>Conclusion</h3><p>Whereas Kafka was able to draw creative and sublimatory resources from this imaginary world, the defensive modes elicited by anorexic patients who develop the most troubling symptoms will generally not be enough to completely conceal the de-realizing impact of fantasmorphoses or the uncanny feelings caused by the underlying presence of such “influencing machines.”</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50203019","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 : 2023-09-01DOI: 10.1016/j.evopsy.2023.03.004
Yann Craus (psychiatre, praticien hospitalier)
Objective
Following the evolution of public health policies, which are increasingly experienced by workers in this field as a lack of interest from the supervisory authorities, the aim was to clarify the missions of the medical-psychological centers (CMP) for children and adolescents and above all to testify, for the benefit of colleagues and partners, to the creativity of these structures, to which users are flocking.
Method
A study day on the specificities of sector work in child psychiatry was held at the Ste-Anne Hospital in Paris in June 2019.
Results
As a participant in the first round table entitled “From the land to the territory”, I will take up here what I tried to make more visible regarding professional practice in CMPs, based on the implementation of associated knowledge, at a time when public health policies are situated at the territorial level.
Discussion
I set out how and where the child psychiatrist intervenes in the CMP. It depends on both his own knowledge and what is expected.
Conclusion
This epistemological thinking could help the child psychiatrist to communicate directly with the people he serves.
{"title":"Sur le terrain, souterraine porcelaine … savoirs associés dans la pratique en CMP infanto-juvénile","authors":"Yann Craus (psychiatre, praticien hospitalier)","doi":"10.1016/j.evopsy.2023.03.004","DOIUrl":"https://doi.org/10.1016/j.evopsy.2023.03.004","url":null,"abstract":"<div><h3>Objective</h3><p>Following the evolution of public health policies, which are increasingly experienced by workers in this field as a lack of interest from the supervisory authorities, the aim was to clarify the missions of the medical-psychological centers (CMP) for children and adolescents and above all to testify, for the benefit of colleagues and partners, to the creativity of these structures, to which users are flocking.</p></div><div><h3>Method</h3><p>A study day on the specificities of sector work in child psychiatry was held at the Ste-Anne Hospital in Paris in June 2019.</p></div><div><h3>Results</h3><p>As a participant in the first round table entitled “From the land to the territory”, I will take up here what I tried to make more visible regarding professional practice in CMPs, based on the implementation of associated knowledge, at a time when public health policies are situated at the territorial level.</p></div><div><h3>Discussion</h3><p>I set out how and where the child psychiatrist intervenes in the CMP. It depends on both his own knowledge and what is expected.</p></div><div><h3>Conclusion</h3><p>This epistemological thinking could help the child psychiatrist to communicate directly with the people he serves.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50203050","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 : 2023-09-01DOI: 10.1016/j.evopsy.2023.03.013
Héloïse Haliday
Objectives
The clinician who adopts a psychoanalytic approach in a psychiatric context often regards the encounter between two individuals as an interplay of subjectivities, whose mode of being-in-the-world is shaped by their unique historical experiences. Despite some psychoanalytic authors exploring the concept of “contact,” it has often been reduced to its similarity with transference and countertransference, with little attention given to its distinctive qualities. This limits psychoanalysis in its ability to conceptualize an unmediated, preverbal encounter between two individuals. In this article, we argue that the dimension of “contact” cannot be equated with transference, and that it constitutes a vital tool for diagnosing and guiding therapy for various clinical conditions commonly encountered in psychiatry.
Method
This article is based on theoretical considerations. We first worked on the history of the concept of contact, then of Praecox Gefühl in the works of H.C. Rümke, to which we added the findings of current studies on the relevance of Praecox Gefühl in the diagnosis of schizophrenia and the study of the works of the great phenomenological psychiatrists. In so doing, we aimed to show that contact could be a tool of great use for psychiatric diagnosis, insofar that it allows for a typification of the forms of existence of different patients.
Results
H.C. Rümke's investigation of the concept of Praecox Gefühl highlights the unique mode of contact observed in schizophrenia. It is distinct from the feeling of strangeness and involves an intuitive observation of a perceived distance within the clinical relationship. Given that many psychiatric pathologies can cause patients to withdraw from the shared world, we suggest that the notion of Praecox Gefühl, beyond its original designation of the clinician's experience of schizophrenic dissociation and the particularities of the schizophrenic mode of being-in-the-world, may be applicable to other pathologies studied in psychiatric phenomenology. We propose four main forms of contact: the loss of vitality in schizophrenia, the untraceable authenticity of the hysteric, the impossible fluidity in the melancholic, and the failure of anchorage in mania. By approaching contact as a fractal form that reveals the entire mode of the subject's being-in-the-world, this typifying approach goes beyond a purely semiological or etiological reflection and can be diagnostically useful in guiding therapeutic efforts to enhance the subject's capacity to truly engage with others.
Discussion
Our paper focuses on the relationship between contact and what clinicians commonly refer to as an “encounter”. It is important to recognize that contact is not always equivalent to an encounter, and that assuming otherwise risks overlooking the possibility that certain relational modalities could act
{"title":"Revaloriser la dimension du contact en psychiatrie. Du Praecox Gefülh à un outil de typification des formes d’existence humaine","authors":"Héloïse Haliday","doi":"10.1016/j.evopsy.2023.03.013","DOIUrl":"https://doi.org/10.1016/j.evopsy.2023.03.013","url":null,"abstract":"<div><h3>Objectives</h3><p>The clinician who adopts a psychoanalytic approach in a psychiatric context often regards the encounter between two individuals as an interplay of subjectivities, whose mode of being-in-the-world is shaped by their unique historical experiences. Despite some psychoanalytic authors exploring the concept of “contact,” it has often been reduced to its similarity with transference and countertransference, with little attention given to its distinctive qualities. This limits psychoanalysis in its ability to conceptualize an unmediated, preverbal encounter between two individuals. In this article, we argue that the dimension of “contact” cannot be equated with transference, and that it constitutes a vital tool for diagnosing and guiding therapy for various clinical conditions commonly encountered in psychiatry.</p></div><div><h3>Method</h3><p>This article is based on theoretical considerations. We first worked on the history of the concept of contact, then of <em>Praecox Gefühl</em> in the works of H.C. Rümke, to which we added the findings of current studies on the relevance of <em>Praecox Gefühl</em> in the diagnosis of schizophrenia and the study of the works of the great phenomenological psychiatrists. In so doing, we aimed to show that contact could be a tool of great use for psychiatric diagnosis, insofar that it allows for a typification of the forms of existence of different patients.</p></div><div><h3>Results</h3><p>H.C. Rümke's investigation of the concept of <em>Praecox Gefühl</em> highlights the unique mode of contact observed in schizophrenia. It is distinct from the feeling of strangeness and involves an intuitive observation of a perceived distance within the clinical relationship. Given that many psychiatric pathologies can cause patients to withdraw from the shared world, we suggest that the notion of <em>Praecox Gefühl</em>, beyond its original designation of the clinician's experience of schizophrenic dissociation and the particularities of the schizophrenic mode of being-in-the-world, may be applicable to other pathologies studied in psychiatric phenomenology. We propose four main forms of contact: the loss of vitality in schizophrenia, the untraceable authenticity of the hysteric, the impossible fluidity in the melancholic, and the failure of anchorage in mania. By approaching contact as a fractal form that reveals the entire mode of the subject's being-in-the-world, this typifying approach goes beyond a purely semiological or etiological reflection and can be diagnostically useful in guiding therapeutic efforts to enhance the subject's capacity to truly engage with others.</p></div><div><h3>Discussion</h3><p>Our paper focuses on the relationship between contact and what clinicians commonly refer to as an “encounter”. It is important to recognize that contact is not always equivalent to an encounter, and that assuming otherwise risks overlooking the possibility that certain relational modalities could act","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50203021","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号