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Dysphorie épistémologique et trans-psychiatrie 认识论障碍和跨精神病学
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-07-31 DOI: 10.1016/j.evopsy.2024.07.004
Bernard Andrieu (Professeur) , Renaud Evrard (Pyschologue, Maître de conférences HDR)
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引用次数: 0
Armature-opératoire et tristesse fluide chez des sujets transgenres : d’une seconde peau à un Moi-peau corsets 变性人的电枢手术和流体悲伤:从第二层皮肤到紧身胸衣的皮肤自我
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-07-23 DOI: 10.1016/j.evopsy.2024.07.003
Romuald Jean-Dit-Pannel (Psychologue clinicien-psychothérapeute, Professeur des universités)

Goals

I develop my hypothesis of a two different corsets, the second skin and the ego-skin corset, which respectively prevent or deploy according to the psychic reappropriations of the subjects, specially transgender subjects.

Method

My practice as a clinical psychologist-psychotherapist and my research with transgender subjects led me to wonder about a metapsychology of the corset. I expose here two clinical cases.

Results

Two cases in particular led me to think about an authentic depressive capacity that I call here sadness-fluid or fluidity of sadness by analogy to gender-fluid, the fluidity of gender.

Discussion

Also, I reflect on the operative armature that can impose itself throughout the transition process, by the diversity of experiences, stories, and resources found in the subject's different environments.

Conclusion

The therapeutic needs of trans subjects in their journeys and their reflections lead us to consider the needs to loosen, to untie certain ties. This uncorsetting favors a reflexive fluidity, so that the subject can evolve in an authentic ego-skin corset where it belongs to itself.

目标我提出了两种不同紧身胸衣的假设,即第二层皮肤紧身胸衣和自我皮肤紧身胸衣,它们分别根据受试者(尤其是变性受试者)的心理再利用情况进行阻止或部署。方法我作为临床心理学家-心理治疗师的实践以及对变性受试者的研究让我对紧身胸衣的元心理学产生了好奇。我在这里揭示了两个临床案例。结果有两个案例特别让我想到了一种真实的抑郁能力,我在这里将其称为 "悲伤的流动性"(sadness-fluid)或 "悲伤的流动性"(fluidity of sadness),与 "性别的流动性"(gender-fluid,即性别的流动性)相类比。讨论此外,我还思考了在整个变性过程中,变性人在不同环境中的经历、故事和资源的多样性可能会给自己带来的影响。结论变性人在其变性过程中的治疗需求以及他们的反思让我们考虑到放松和解开某些束缚的需求。这种解开束缚的方式有利于反思的流动性,这样主体就能在属于自己的真实自我束缚中发展。
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引用次数: 0
Le livret militaire, le dossier étudiant et la carrière médicale de Lacan 拉康的军事记录簿、学生档案和医学生涯
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-07-19 DOI: 10.1016/j.evopsy.2024.05.007
David Monnier (Enseignant-chercheur)
<div><h3>Objectives</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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
在前一篇文章中研究了拉康博士论文的条件之后,我转向揭示他的学术研究和他的医学生涯,把它放在它的背景下。材料与方法:寻找对拉康论题的参考,历史资料的对比,文本分析与评论。我首先重读拉康,以挑选出在本研究背景下可能明智的传记参考文献。然后我进行了文献综述。这还不足以建立一个详细的事实年表。在那之后,我参观了一些图书馆和其他档案站点。我收集了大量资料:拉康未发表的学生档案;未公开的行政服务记录;他出现的征兵登记簿;他的军事记录,一些罕见的,未使用的,或未发表的拉康学生时期的照片;关于他在这一时期的各种住所的各种鲜为人知的元素。我检查了这些不同的文件,并将它们与其他来源和各种信息进行比较,以澄清他的医学职业生涯。结果我发现拉康在精神病学之前有过几次医学实习。从1921年3月到1922年2月,他在特鲁索医院保罗·埃洛波的外科做了一年的实习。1922年3月至10月,他在圣路易医院的爱德华·让塞尔姆皮肤科实习了7个月。从1922年10月到1923年2月,他在特鲁索医院埃德蒙·莱斯奈尔的儿童疾病科实习了五个月。从1923年3月到1924年2月29日,他在内克尔医院保罗·里比埃尔的心脏科实习了一年。1924年6月至1925年2月,他在Laënnec医院的Marie-Paul Claisse的指导下实习了9个月。从1925年3月到1925年10月,他在圣路易斯医院的莱诺曼德科实习了大约七个半月。从1925年10月到1926年2月,他在Salpêtrière医院Georges Guillain的神经内科实习了大约四个半月。从1926年3月到1927年1月,他在Salpêtrière的Octave Crouzon的神经科实习了大约十个半月。这个旅程突出了拉康的一个方面,它没有被忽视,没有被承认,或被低估,相反,它一被说出来,就以清晰的证据出现:拉康作为一个带着孩子的工人的肖像。事实上,从1932年11月到1933年10月,他的第一份工作是在一家儿童神经精神病学诊所。简单回忆一下他后期工作的一些里程碑就足够了,可以看到童年的这个领域是重要的,拉康的贡献是实质性的。虽然拉康确实没有严格意义上的大学医院生涯,因为他在1934年5月之后离开了医院的环境,我们已经确定他还是回到医院工作了一段时间。1940年7月,他被调动为格雷斯谷军事医院神经精神科的辅助医生。至少从1941年7月到1949年,他在圣安妮精神病医院的门诊部担任精神病医院医生。我们借此机会讨论精神分析专业化的概念。最后,每个人现在都可以参考一个有保证的,虽然仍然不完整的拉康在1919年到1949年之间在医疗机构的生活年表。每一个新元素都会带来一些问题。拉康的一生中仍有许多未知之处,无疑值得我们去探索和发掘。
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引用次数: 0
Institutional psychotherapy put to the test by the health crisis. Clinical reflection at the heart of a public psychiatric service 健康危机对机构心理疗法的考验。公共精神科服务核心的临床反思
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-07-17 DOI: 10.1016/j.evopsy.2024.07.002
Matthieu Braun (psychiatrist, head of a university clinic - regional hospital assistant) , Christophe Chaperot (psychiatrist, head of department)

Objective

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

Method

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

Results

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

Discussion

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

Conclusion

In the aftermath of a crisis, the therapeutic club remains a space of conflict and intrigue, at the crossroads of collective and individual health crises.

目的患有复杂精神疾病的患者需要多学科护理,如果病情加重,可能需要住院治疗。机构心理疗法将精神病、生存危机和机构危机作为临床阐述和发挥创造力的机会。与 Covid-19 大流行相关的健康危机促使我们重新思考其有效性及其在当代多元化实践中的地位。这也为我们提供了前所未有的人类学解读机会。在这种情况下,机构心理疗法是否仍然是制造 "创新"、创造或至少揭示危机以克服危机的机器?在大流行病之后,我们建议详细阐述大流行病给我们带来的启示,即在以机构心理治疗为导向的公共精神科中的日常实践。我们将借鉴对临床小故事的重读、对护理人员和患者的访谈,以及大流行期间在科室会议上所做的记录。结果机构心理治疗的主要概念可能有一些局限性,但它们可以被护理人员-患者集体重塑。在危机期间,集体的失败和个人的症状似乎会相互暴露。在这种情况下,集体制定的象征性框架和服务文化可以成为持续护理的有效支持点。它们将参与者的偏见和隐含理论 "置于危机之中",并支持新的叙述和新的理解方式。结论在危机过后,治疗俱乐部仍然是一个充满冲突和阴谋的空间,处于集体和个人健康危机的十字路口。
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引用次数: 0
La situation projective du modelage comme instrument clinique dans une recherche sur un dispositif de médiation sensorielle 在感官调解装置的研究中,将建模作为临床工具的投射情境
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-06-25 DOI: 10.1016/j.evopsy.2024.05.005
Gabriela Patiño-Lakatos (Psychologue clinicienne, post-doctorante (2019–2023) pour le projet de recherche ANR Staccato 2019, membre associé UTRPP, psychologue au CMP, la source) , Cristina Lindenmeyer (Psychanalyste, professeur de psychopathologie, membre titulaire UTRPP) , Sophie Bergheimer (Psychologue clinicienne, chercheure contractuelle (2019–2023) pour le projet de recherche ANR Staccato 2019, ATER (2023–2024))
<div><h3>Objectives</h3><div>This article examines the use of clay modeling as an instrument for clinical analysis of the relation to one's own body and to the object. While modeling is a widely-used medium in therapeutic work, we present here the use of the modeled self-portrait as a projective method in a research situation involving sensorial mediation using touch. The aim is to understand how the subject invests and engages a relation with this object, based on the way s/he invests and represents her/his body and sensations.</div></div><div><h3>Method</h3><div>The modeling situation was proposed individually to 19 participants at the first of six meetings. The choice of the modeled self-portrait in this research project is inspired by a psychoanalytical epistemology that enables us to understand the unconscious psychic dimensions of body image and the relation to the object, as well as the concepts of mediation, the projective situation, and transference. In the absence of a pre-existing reference to a systematized methodology for analyzing the self-portrait with modeling clay, we referred to psychoanalytic work on projective tests to construct a qualitative analysis grid based on the material collected.</div></div><div><h3>Results</h3><div>The modeled self-portrait enabled us to take into consideration, from an economic, dynamic, and topical point of view, on the one hand, the content that emerged in the modeling and in the verbalizations that accompanied it, and, on the other hand, the characteristics of the modeling process itself. The modeling situation gave rise to regressive and projective movements, leading the participants to express key elements of their personal history, their sensory situation, and the areas of the body invested or disinvested, as well as their psychic behaviors in relation to the object in the present of this research encounter. We identified four ways in which participants related to modeling, depending on their subjectivity and their position in the research process. The form given to the modeling, its structure, and the parts represented or not provided us with indications of certain features of the participants’ body image and the way in which they were able to express it in the space-time of this encounter. We hypothesize that through its connections with the subject's body image, the three-dimensional self-portrait expresses the way in which participants invest their bodies, and sometimes body zones linked to the senses, such as touch, through the modeling activity itself, but also other senses through the elements represented or not, verbalized or not, about the created-modeled object.</div></div><div><h3>Discussion</h3><div>We present some considerations on the complex connections between the relationship to modeling, to the object of sensory mediation through touch, and to autobiographical speech in the interview situation, considering the participants’ verbal and non-verbal productions during the process
本文探讨了使用粘土模型作为临床分析与自身身体和对象关系的工具。虽然模型是治疗工作中广泛使用的一种媒介,但我们在此介绍的是在涉及使用触摸进行感官调解的研究情境中使用模型自画像作为投射方法的情况。我们的目的是了解研究对象是如何根据自己对身体和感觉的投入和表现方式,投入并参与到与这一对象的关系中来的。本研究项目选择自画像模型是受精神分析认识论的启发,该认识论使我们能够理解身体形象的无意识心理层面和与对象的关系,以及中介、投射情境和转移等概念。在没有系统化的方法论来分析泥塑自画像的情况下,我们参考了投射测验方面的精神分析工作,根据收集到的材料构建了一个定性分析网格。结果泥塑自画像使我们能够从经济、动态和专题的角度,一方面考虑到泥塑中出现的内容以及伴随泥塑的口头表达,另一方面考虑到泥塑过程本身的特点。建模情境引发了倒退和投射运动,引导参与者表达他们个人历史的关键要素、他们的感官状况、身体投入或不投入的部位,以及他们在这次研究相遇的当下与对象相关的心理行为。我们根据参与者在研究过程中的主观性和立场,确定了他们与建模相关的四种方式。建模的形式、结构以及所代表的部分或不代表的部分为我们提供了参与者身体形象的某些特征,以及他们在这次相遇的时空中表达身体形象的方式。我们假设,三维自画像通过其与被试身体形象的联系,表达了参与者投入自己身体的方式,有时是通过建模活动本身与感官(如触觉)相关联的身体区域,以及通过对所创建的建模对象表示或不表示、口头或不口头的元素表达其他感官的方式。讨论我们考虑到参与者在研究过程中的言语和非言语表达,就访谈情境中与建模、与通过触摸进行感官中介的对象以及与自传性言语之间的复杂关系进行了一些思考。最后,我们介绍了在本研究和本文背景下收集和分析结果的局限性。 结论模型自画像的使用为我们带来了一些元素,使我们能够更好地理解本研究中参与者所表达的与中介对象的不同关系的心理基础。由于自画像呼唤身体形象和与客体关系中的无意识元素,它在主体自身的心理运作中遇到了阻力和防御模式。
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引用次数: 0
Repenser la génétique de la schizophrénie à l’ère de la crise de la reproduction. À propos de… « Schizophrenia and Genetics: The End of An Illusion » de Jay Joseph 反思生育危机时代的精神分裂症遗传学。关于... "精神分裂症与遗传学:幻觉的终结",作者:杰伊-约瑟夫
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-06-19 DOI: 10.1016/j.evopsy.2024.06.001
Sebur Kapu (Doctorant)
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引用次数: 0
Les pavés du dire, ou quand la rue se fait réseau soignant Les pavés du dire,或当街道成为护理网络时
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-06-12 DOI: 10.1016/j.evopsy.2024.05.004
Camille Veit (Psychologue clinicienne, Docteure en psychologie, Maîtresse de conférences en psychopathologie clinique)

Goals

“I am a housed homeless person”. This statement says something about the experience of constructing an address – a term whose polysemy is immediately obvious in the context of therapeutic practices with people who frequent or have frequented the street. Under certain conditions, how can the street become a constellation of care?

Method

The street is considered here from the perspective of institutional psychotherapy, Lacanian psychoanalysis, and phenomenology. I take a retrospective look at a clinical case, providing insights into, on the one hand, the creation of “spaces of habitability” (de Certeau) and, on the other, the “shared caregiving function” (Tosquelles). I discuss the clinical implications of these findings, as well as their impact on support and accommodation services for the unhoused.

Results

The street doesn’t exist: this is a prerequisite for any possible practice with whoever stays, lives, or makes use of the street. Thus, there is no “street” that can be essentialized: it is constantly made and unmade by those who cross it and inhabit it. The uses of the street – the ways in which it is inhabited – are considered on a case-by-case basis. A distinction between circulation, homelessness, and wandering is then sketched out, based on the concept of “pedestrian enunciation” (Michel de Certeau).

Discussion

Dwelling is always an attempt at dealing with dreams, ideals, and the impossible. Inhabitable spaces are created between shelters, homes, displacements, and circulations. From a clinical perspective, taking these singular ways of living into account is a prerequisite for any possible encounter. Sometimes, this encounter has therapeutic or even psychotherapeutic effects.

Conclusion

In light of the above, clinicians should be mindful of adopting a unanimously militant stance, a theoretical withdrawal, charitable kindness, or a desire to rehabilitate at all costs. These slippages are inevitably revealed as such in the interstices of a practice that should be polyphonic.
目标 "我是一个有住房的无家可归者"。这句话道出了构建一个地址的经验--在对经常或曾经经常在街头出现的人进行治疗的过程中,这个术语的多义性是显而易见的。在某些条件下,街道如何才能成为一种关怀的集合体?方法这里从机构心理治疗、拉康精神分析和现象学的角度来探讨街道。我对一个临床病例进行了回顾性研究,一方面对 "可居住性空间"(德-塞尔托)的创造,另一方面对 "共同的护理功能"(托斯克勒斯)进行了深入探讨。我将讨论这些发现的临床意义,以及它们对为无家可归者提供的支持和住宿服务的影响。结果街道并不存在:这是与任何逗留、居住或使用街道的人开展任何可能的实践的先决条件。因此,不存在可以被本质化的 "街道":街道是由那些穿过街道和居住在街道上的人不断创造和不创造的。街道的用途--街道的居住方式--要根据具体情况来考虑。然后,根据 "行人表达"(Michel de Certeau)的概念,勾勒出流通、无家可归和游荡之间的区别。可居住的空间是在庇护所、家园、流离和循环之间创造出来的。从临床角度来看,考虑到这些独特的生活方式是任何可能的相遇的前提。结语 综上所述,临床医生应注意不要采取一贯的激进立场、理论上的退缩、慈善的仁慈或不惜一切代价进行康复的愿望。在本应是多声部的实践中,不可避免地会出现这样那样的偏差。
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引用次数: 0
« La semaine prochaine, je serai sorti ». La psychothérapie à l’épreuve du temps en milieu carcéral "下周,我将出狱"。监狱中久经考验的心理疗法
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-06-06 DOI: 10.1016/j.evopsy.2024.05.003
Elise Pelladeau (Maître de conférences HDR en psychologie clinique et psychopathologie)

Objective

The aim of this article is to describe the way in which the announced release from prison precipitates the work of linking in the final stages of psychotherapeutic work, and to illustrate the transferential modalities involved. More specifically, we examine the fates and functions of what we propose to call a “hallucinatory temporality” in psychotherapy, at the dawn of the announcement of release from prison.

Method

To illustrate our ideas, we will use the case of Joël, who has been detained in custody for armed robbery, and is in a state of legal recidivism. This patient was receiving weekly psychotherapy in prison and had been seen in a care unit in the few months prior to his release.

Results

In this article, we wanted to illustrate the way in which release from prison, as a negative of the shock of imprisonment, can affect the subject's fantasy life, between anticipation and impulse realization.

Discussion

The defenses mobilized by Joël during the interview seemed to us to be particularly relevant in the way in which they pressed on the drive in the service of the rise in tension, thus producing an effect of reversal from the passive pole to the active pole, even in the time of the session. This temporality, over-invested in its risk thresholds between getting out and staying in, seemed to us to draw artificial contours like so many fantasmatic stopping points to force the representational system in favor of a hallucinatory circulation with masturbatory functions.

Conclusion

If, from the perspective of Roussillon's work cited above, we conceive of symbolization as an experience of subjectivation through domination, it is easy here to see how the ramparts of the therapeutic setting can act as a hallucinatory crossroads, at the tempting moment of dreaming, or at least trying to “hallucinate” the way out. The support of this hallucinatory space – from temporal circularity to fantasmatic temporality – seems to us to benefit from the inter-holding put to work and described by Ciavaldini, even in its transferential manifestations in the session. Beyond the session, as “beyond the wall”, would thus put to the test the solidity of the psychic rampart fashioned by a path other than that of domination.
本文旨在描述在心理治疗工作的最后阶段,宣布出狱是如何促成链接工作的,并说明其中涉及的转移模式。更具体地说,我们要研究的是,在宣布出狱之初,心理治疗中的 "幻觉时间性 "的命运和功能。结果在这篇文章中,我们想说明的是,作为对监禁打击的一种否定,刑满释放会在预期和冲动实现之间影响受试者的幻想生活。讨论在我们看来,若埃尔在访谈过程中调动的防御似乎与我们特别相关,因为它们压迫驱动力的方式是为张力的上升服务的,从而产生了一种从被动极到主动极的逆转效果,甚至在访谈的时间里也是如此。在我们看来,这种时间性过度依赖于 "出去 "和 "待在 "之间的风险阈值,似乎是在人为地划定轮廓,就像许多幻想中的停止点一样,迫使表象系统倾向于具有手淫功能的幻觉循环。结论如果我们从鲁西永(Roussillon)上述著作的角度出发,将象征化视为一种通过支配而实现主体化的体验,那么我们就不难看出,在梦境的诱惑时刻,或至少在试图 "幻化 "出路的时刻,治疗环境的斜坡是如何充当幻觉十字路口的。这种幻觉空间的支持--从时间的循环性到幻想的时间性--在我们看来,似乎得益于奇亚瓦蒂尼(Ciavaldini)所描述的相互牵制,甚至在治疗过程中的转移表现也是如此。因此,作为 "墙外 "的 "会话之外",将考验由统治之外的路径所打造的精神堡垒的坚固性。
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引用次数: 0
CV2 - editorial board CV2 - 编辑委员会
IF 0.6 4区 医学 Q2 Arts and Humanities Pub Date : 2024-05-25 DOI: 10.1016/S0014-3855(24)00038-0
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引用次数: 0
Élever la bizarrerie à la dignité du style. Pour une éthique de l’accompagnement des patients autistes 将怪异提升为风格的尊严。为自闭症患者提供支持的伦理道德
IF 0.6 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-05-23 DOI: 10.1016/j.evopsy.2024.04.003
Isabelle Orrado (Psychanalyste, Post-doctorante en psychologie, Université de Brasilia, Brésil) , Jean-Michel Vives (Psychanalyste, Professeur de psychologie clinique et pathologique, Université Côte d’Azur, France)

Objectives

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

Method

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

Results

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

Discussion

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

Conclusion

The style, thus obtained, corresponds to the possibility of a singular enunciative position – inscribing a presence in the world by tempering the weight of the subject –, which, in autism, always requires a certain amount of tinkering in order to arrive at a solution.
本文旨在确定分析框架如何引导自闭症患者创造一个手工解决方案,使他能够进入这个世界。方法拉康学派的理论概念化是基于对一名年轻自闭症男孩治疗过程中收集的临床观察。结果我们认为,与自闭症患者一起从事治疗工作可以为他提供一个潜在的环境——我们将其与潜在的空间区分开来——在这个环境中,他的特殊怪癖可以提升到一种风格的尊严,自闭症儿童将自己塑造这种风格,这将允许他建立某种社会联系。讨论:我们将分析框架提供的治疗空间限定为潜在环境,我们将其定义为临床医生建立的相遇坐标,使儿童能够体验到他或她的本能动作。刺激应被理解为潜在环境的现象学性质,同时包括调谐、召唤地址、处置和气氛,即与他者的可能关系。临床干预将允许孩子不在这个潜在环境中表现自己——这是潜在空间的本质——而是将自己呈现给世界。临床医生的责任是创造出一个他者,他者能够隔离并使被试者的怪异——这可能被认为是一种失败——进入流通,产生一种独特的标志,并将其提升到自闭症儿童将塑造的风格的尊严。由此获得的风格对应于一种单一发音位置的可能性——通过缓和主题的重量来在世界上留下一个存在——在自闭症中,这总是需要一定程度的修补才能找到解决方案。
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Evolution Psychiatrique
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