Evolution Psychiatrique最新文献

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La position hypocondriaque du sujet souffrant d’une pathologie somatique chronique : un éclairage psychanalytique de la relation médecin–patient 慢性躯体病理患者的低condriaque姿势:医患关系的精神分析阐释
IF 0.6 4区 医学
Evolution Psychiatrique Pub Date : 2025-04-03 DOI: 10.1016/j.evopsy.2025.03.002
Eugénia Jeltikova doctorante en psychanalyse (Enseignante agrégée de lettres classiques)
{"title":"La position hypocondriaque du sujet souffrant d’une pathologie somatique chronique : un éclairage psychanalytique de la relation médecin–patient","authors":"Eugénia Jeltikova doctorante en psychanalyse (Enseignante agrégée de lettres classiques)","doi":"10.1016/j.evopsy.2025.03.002","DOIUrl":"10.1016/j.evopsy.2025.03.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Considering the psychological rearrangements that accompany somatic pathology in terms of the hypochondriacal position sheds light on the subjective experience of illness and allows for a reconsideration of the care relationship in somatic medicine from a transferential perspective. This article aims to contribute to the dialogue between psychoanalysis and medicine, particularly through applying a psychoanalytic lens to autoimmune diseases, the increasing prevalence of which is a characteristic feature of contemporary societies.</div></div><div><h3>Method</h3><div>Based on an analysis of Freud's and Ferenczi's observations on hypochondria, the hypothesis of a broad spectrum of plural hypochondrias allows us to define the hypochondriacal position of the chronic somatic patient, by differentiating it from authentically psychopathological hypochondria by the presence of an underlying organic condition. Testimonials from patients suffering from autoimmune diseases provide insights into the dynamics of this hypochondriacal position, enabling the conceptualization of certain issues.</div></div><div><h3>Results</h3><div>The hypochondriacal position of the chronic somatic patient is a consequence of a verified organic impairment, distinguishing it from psychopathological hypochondria. Whether the underlying pathology is organ-specific or systemic, a symptomatology dominated by pain and fatigue leads to a blurring of the contours of the suffering body in the patient's self-image. Unlike psychopathological hypochondria, it is not a specific somatic site that serves as the fixation of libido, but the somatic body as a whole, experienced as a suffering corporeality. The chronicity of the condition solidifies the hypochondriacal position, given the repetition of medical experiences (auscultations, examinations, consultations, hospitalizations) and the self-monitoring advice received from doctors, along with the concern of loved ones, which engages the patient in a chronicized relationship of self-examination of their body.</div></div><div><h3>Discussion</h3><div>The role of others — whether medical professionals or close friends and family members — proves crucial in the establishment and persistence of the hypochondriacal position. Diagnostic wandering fosters the patient's hypochondriacal identification. The failures to articulate the reality of their somatic suffering lead them to adopt medical language, potentially alienating themselves by finding expression only in operational terms. The hypochondriacal position may serve as a retreat and refuge against the object loss and self-bereavement that chronic somatic pathology imposes on the patient.</div></div><div><h3>Conclusion</h3><div>The care relationship in somatic medicine is rarely discussed in terms of transference. The hypothesis of the hypochondriacal position of the chronic somatic patient allows us to approach the transferential investment placed by the patient on thei","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 275-289"},"PeriodicalIF":0.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Le diagnostic de TSA chez les jeunes enfants : une étude clinico-éthique auprès des parents et des praticiens 幼儿ASD的诊断:父母和从业人员的临床伦理研究
IF 0.6 4区 医学
Evolution Psychiatrique Pub Date : 2025-03-25 DOI: 10.1016/j.evopsy.2025.03.001
Delphine Jacobs (Psychiatre infanto-juvénile, chef de clinique, professeur) , Jean Steyaert (Psychiatre infanto-juvénile, chef de clinique, professeur) , Kris Dierickx (Ethicien, professeur ordinaire) , Kristien Hens (Ethicien, professeur de recherche)
{"title":"Le diagnostic de TSA chez les jeunes enfants : une étude clinico-éthique auprès des parents et des praticiens","authors":"Delphine Jacobs (Psychiatre infanto-juvénile, chef de clinique, professeur) , Jean Steyaert (Psychiatre infanto-juvénile, chef de clinique, professeur) , Kris Dierickx (Ethicien, professeur ordinaire) , Kristien Hens (Ethicien, professeur de recherche)","doi":"10.1016/j.evopsy.2025.03.001","DOIUrl":"10.1016/j.evopsy.2025.03.001","url":null,"abstract":"<div><h3>Goal</h3><div>After three quarters of a century of research and clinical experience, autism spectrum disorder (ASD) turns out to be surprisingly heterogeneous in its presentations, causes, and cognitive mechanisms. In light of the varied nature of this diagnosis, it is unclear how the array of (predominantly “basic”) research findings on ASD is translated into information that is meaningful and valuable to parents and clinicians. Few studies are dedicated to detecting the views and experiences of an ASD diagnosis of a child by parents and clinicians, nor to engaging an ethical reflection on their personal perspectives. An ethical reflection on the results of the empirical studies with parents and physicians leads to the formulation of clinical-ethical considerations towards both policy-makers and clinicians concerning the clinical care offered to young children with ASD.</div></div><div><h3>Method</h3><div>We conducted in-depth interviews on how parents and physicians view and experience a young child's ASD diagnosis. Parents were queried longitudinally: before the start of the diagnostic ASD assessment, right after the feedback session at the end of the assessment, and 12 months later. The interviews were analyzed in Nvivo 11 according to the guidelines of Interpretative Phenomenological Analysis.</div></div><div><h3>Results</h3><div>The interviewed parents and physicians addressed ‘psycho-relational’ implications of an ASD diagnosis as much as ‘treatment-oriented’ implications. The psycho-relational ‘exculpatory’ effect was particularly appreciated, which consists in both parents and child being able to exonerate themselves with regard to the child's unusual behavior towards both the parents and other adults. The interviewed parents and physicians often came to view the ASD diagnosis in a pragmatic way, in the light of its usefulness for child, parents, and to a lesser extent, professionals. Twelve months after their child received an ASD diagnosis, the interviewed parents mainly had come to value the ASD diagnosis for two reasons: the access to care it ensured, and the framework it provided allowing them to adapt their interactions with the child because of the ASD diagnosis. The interviewed physicians from their side needed an ASD diagnosis in order to be useful in their clinical practice, particularly in cases where they were able to describe the child toward parents and teachers using phrases such as “he wants to do what is expected from him but is not able to”, and in order to provide appropriate care. Clinicians expressed some doubts about the use of and need for a formal diagnosis. They preferred to establish a descriptive and treatment-oriented profile of the child, a profile of which an ASD diagnosis was sometimes considered to be just one useful part.</div></div><div><h3>Discussion</h3><div>Based on an ethical analysis and reflection, we formulate four clinico-ethical considerations in relations to policy, and four in relatio","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 321-331"},"PeriodicalIF":0.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090356","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}
引用次数: 0
Dispositif « groupe de passage » auprès de patients exilés et migrants : intérêts et limites 为流亡者和移徙者提供“中转”设施:利益和限制
IF 0.6 4区 医学
Evolution Psychiatrique Pub Date : 2025-03-25 DOI: 10.1016/j.evopsy.2025.02.002
Philippe Drweski (Psychologue clinicien, Maître de conférences)
{"title":"Dispositif « groupe de passage » auprès de patients exilés et migrants : intérêts et limites","authors":"Philippe Drweski (Psychologue clinicien, Maître de conférences)","doi":"10.1016/j.evopsy.2025.02.002","DOIUrl":"10.1016/j.evopsy.2025.02.002","url":null,"abstract":"<div><h3>Objectives</h3><div>This article proposes a reflection on the impacts of exile and immigration on therapeutic work with certain patients. I observe that the dynamics of transference, due to often traumatic histories, are marked by a variety of phenomena: projective identification, acting out, and operational thinking. Based on this observation, I propose an adjustment to the framework through the creation of a tool I call a “group in transition.” This initiative integrates several elements, including the sensory dimension and transitional objects that facilitate connections between the present and the past, and between the subject's current location and their country of origin. The objective is to facilitate associative processes that have been disrupted by various life events encountered by these populations through sensory transference.</div></div><div><h3>Method</h3><div>The method employed is participant observation of a group established with immigrant subjects.</div></div><div><h3>Results</h3><div>The results indicate that this type of group facilitates the establishment of a transference dynamic through a series of elements: the multicultural group, sensory mediation, and transitional objects. The multicultural aspect allows for the representation of otherness within the group, facilitating its elaboration. Sensory experiences promote regression, granting access to certain parts of the psyche that are challenging to reach due to trauma. Lastly, the transitional object helps to link temporalities (the past and the present) and spaces (here and elsewhere), which are often split, allowing for entry into the subjects’ histories. Thus, this group acts as a vector for the elaboration of questions of identity. The identity question manifests in several ways: the first corresponds to a nostalgic elaboration signifying a genuine process of disengagement. However, we also observe the presence of narcissistic defenses embodied within the group through splits concerning culture, triggering rejection responses. Lastly, another occurrence corresponds to a form of depressive collapse.</div></div><div><h3>Discussion</h3><div>These results prompt me to question certain elements of the “group in transition,” such as its very brief duration (3 months) and the group dimension itself. It seems that while the group supports the psychic apparatus for some, it can also potentially serve as a source of collective resistances through a number of alliances structured by culture and religion. These defenses appear to obscure the traumatic dimensions, which are markedly absent from the sessions. The question of the group's duration is perhaps worth exploring, as it may hinder certain processes, particularly in relation to the elaboration of loss.</div></div><div><h3>Conclusion</h3><div>The difficulties encountered in the clinical setting lead me to imagine new tools to address the challenges of clinical practice with exiled and migrant populations. The “group","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 219-231"},"PeriodicalIF":0.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090546","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}
引用次数: 0
Du cri sans appel à la restauration du transfert 从呐喊到恢复转移
IF 0.6 4区 医学
Evolution Psychiatrique Pub Date : 2025-03-08 DOI: 10.1016/j.evopsy.2025.02.001
Isabelle Hubinet (Psychothérapeute, psychologue du travail)
{"title":"Du cri sans appel à la restauration du transfert","authors":"Isabelle Hubinet (Psychothérapeute, psychologue du travail)","doi":"10.1016/j.evopsy.2025.02.001","DOIUrl":"10.1016/j.evopsy.2025.02.001","url":null,"abstract":"<div><h3>Goals</h3><div>To explore the scream through its relationship to voice, speech and silence, the link to the Other, and its function in the psychotic subject, the effects in the listener. To place its position in the specific drive circuit and on the silence-speech axis developed by M. Poizat. To present the absence of closure of the invocation drive in a psychotic patient and the possibilities offered by the wet wraps used in packing therapy in the renewal of contact, which is the basis of the transferential relationship.</div></div><div><h3>Method</h3><div>This is the study of a clinical situation in a psychotic patient in a psychiatric institution, whose frequent inconsolable screams and whose tendency to provoke rejection from caregivers led to the use of a therapeutic device of unusual magnitude. The analysis focuses on the patient's manifestations of vocal jouissance produced in different environments and on the effects of packing therapy conducted in a context of institutional psychotherapy.</div></div><div><h3>Results</h3><div>Vocal phenomena in this psychotic patient, such as whispering and aphonia, will appear a few days after the beginning of the packing therapy. I hypothesize that they resemble the patient's frequent unconsolable cries, and I situate them, alongside silence, opposite to speech, thus revealing the structural lack of symbolism. If this patient's unconsolable scream is a life force inscribed in the body, its repetition and its effects align him with something deathly, the risk of automation and rejection by others. The scream, coupled or not with suffocation, would also be a valuable indicator of the anxiety that arises in the passage into a new environment, especially when the latter is made up of a desirous otherness. Thanks to the packing therapy, the therapeutic work invites the patient to speak and leads him to reinvest in the living and institutional collective; and the screams will lessen in intensity. The daily packing program allowed for an increased proximity with caregivers, and with the patient feeling more present, no longer abandoned, and that he is someone. If the restoration of transference is favorable and brings a noticeable improvement quickly, other transferential movements will require therapeutic rearrangement. Important and sensitive points in the course and continuation of the therapy that could not be observed are the analysis of the caregiving team's countertransference and, in counterpoint to work carried out by healthcare professionals, the role of the peers in work with alterity.</div></div><div><h3>Discussion</h3><div>Packing is a therapeutic choice whose benefits are positive for this highly motivated patient, facilitating a reinvestment of speech and a turning away from a deathly horizon to reconnect with life. A system of lesser magnitude in terms of frequency, duration, and personnel would not have allowed such a positive transferential movement, counteracting the psychological a","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 233-246"},"PeriodicalIF":0.6,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090547","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}
引用次数: 0
Psychothérapie et réflexion éthique d’une équipe de soins palliatifs confrontée à la demande de mourir d’une patiente bipolaire 面对双相情感障碍患者的死亡请求,姑息治疗团队的心理治疗和伦理反思
IF 0.6 4区 医学
Evolution Psychiatrique Pub Date : 2025-02-19 DOI: 10.1016/j.evopsy.2025.01.008
Jennifer Mertz (Psychologue clinicienne) , Marie-Frédérique Bacqué (Professeur en psychopathologie)
{"title":"Psychothérapie et réflexion éthique d’une équipe de soins palliatifs confrontée à la demande de mourir d’une patiente bipolaire","authors":"Jennifer Mertz (Psychologue clinicienne) ,&nbsp;Marie-Frédérique Bacqué (Professeur en psychopathologie)","doi":"10.1016/j.evopsy.2025.01.008","DOIUrl":"10.1016/j.evopsy.2025.01.008","url":null,"abstract":"<div><h3>Objective</h3><div>The person's wishes at the end of their life bring a variety of relational and psychological issues into question. French law allows for Deep and Continuous Sedation Maintained Until Death (SPCMD) under certain conditions. The question then arises of the accuracy of a medical decision in its deontological and ethical dimensions.</div></div><div><h3>Method</h3><div>We present the request to die of Ms. M., a patient suffering from bipolar disorder treated for several years and a cancer for which treatments have been stopped. This clinical case study highlights the work of reflection around the question of supporting a person whose refractory existential suffering is associated with mental depression.</div></div><div><h3>Results</h3><div>The request for SPCMD is not admissible within the framework of the Claeys-Leonetti law, as it does not meet the criterion of a short-term lethal prognosis. We offer psychodynamic supportive psychotherapy to the patient. The psychological support undertaken invites us to read the psychological processes that emerge in the meeting space between Ms. M. and a clinical psychologist with a psychoanalytic orientation.</div></div><div><h3>Discussion</h3><div>The therapeutic listening device specific to the function of the clinical psychologist allows for a space of speech where it is possible to return to what had not been said until then, in this final time of a final accomplishment of a speech act that strengthens and soothes family ties and Ms. M.’s relationship with herself.</div></div><div><h3>Conclusion</h3><div>The request to die is thus presented as the unconscious revealer of psychological processes neglected by medical decision-making.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 290-301"},"PeriodicalIF":0.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090551","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}
引用次数: 0
Le transfert entre neurosciences et psychanalyse 从神经科学到精神分析的转变
IF 0.6 4区 医学
Evolution Psychiatrique Pub Date : 2025-02-14 DOI: 10.1016/j.evopsy.2025.01.010
Thomas Rabeyron (Professeur de psychologie clinique)
{"title":"Le transfert entre neurosciences et psychanalyse","authors":"Thomas Rabeyron (Professeur de psychologie clinique)","doi":"10.1016/j.evopsy.2025.01.010","DOIUrl":"10.1016/j.evopsy.2025.01.010","url":null,"abstract":"<div><h3>Aim</h3><div>Transference is a fundamental concept in analytical practices and theories, whose modeling can be refined through insights from other disciplines such as cognitive neurosciences.</div></div><div><h3>Method</h3><div>We show how this concept can be connected to various findings from cognitive neurosciences, offering a fresh perspective on conceptualizing the dynamics of transference.</div></div><div><h3>Results</h3><div>Connections between transference and connectionist theories, distinctions between implicit and explicit memory, certain properties of self-organized networks such as pattern completion, studies in social cognition on experimental transference, and recent work on brain synchronization using hyperscanning techniques are presented and examined in dialogue with psychoanalytic metapsychology.</div></div><div><h3>Discussion</h3><div>Numerous points of convergence emerge between these disciplines, helping to build a model of the mind supported by elements from diverse but complementary methodological fields.</div></div><div><h3>Conclusion</h3><div>The elements presented in this work underscore the relevance of the psychoanalytic conceptual modeling of transference, emphasizing its essential importance in any psychotherapeutic work.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 207-218"},"PeriodicalIF":0.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Entretien avec Louis Sass par Jérôme Englebert. Réalisé à Rutgers University (New Jersey, USA) le 21 mars 2023 Jerome Englebert对Louis Sass的采访。2023年3月21日在罗格斯大学(美国新泽西州)实现
IF 0.6 4区 医学
Evolution Psychiatrique Pub Date : 2025-02-12 DOI: 10.1016/j.evopsy.2025.01.009
Louis Sass (professeur) , Jérôme Englebert (professeur)
{"title":"Entretien avec Louis Sass par Jérôme Englebert. Réalisé à Rutgers University (New Jersey, USA) le 21 mars 2023","authors":"Louis Sass (professeur) ,&nbsp;Jérôme Englebert (professeur)","doi":"10.1016/j.evopsy.2025.01.009","DOIUrl":"10.1016/j.evopsy.2025.01.009","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this paper is to present an interview with Louis Sass, Professor of Clinical Psychology at Rutgers University, USA. His work is recognized worldwide, and he has been a visiting professor at several institutions, notably in Paris in 2008–2009, and in Belgium in Ghent, Brussels, and Liège in 2023–2024 (as part of the Chaire Francqui program). The interview was conducted in French during Jérôme Englebert's academic stay in New York and at Rutgers University.</div></div><div><h3>Method</h3><div>The method consists of an interview with Louis Sass. The questions concern his main influences and the original readings he makes of authors essential to his work. The transdisciplinary dimension of his work is also highlighted and discussed.</div></div><div><h3>Results</h3><div>Louis Sass is one of the leading specialists in the phenomenological understanding of schizophrenia. He has published numerous articles and several books on psychopathology, the most famous of which is <em>Madness and Modernism: Insanity in the Light of Modern Art, Literature, and Thought</em> (Revised edition, Oxford University Press, 2017). This book is an attempt to understand the schizophrenic mind by exploring its parallels with the avant-garde art and thought of 20th century “modernism” and “postmodernism.” <em>Madness and Modernism</em> introduced the concept of hyper-reflexivity, which is today considered, in the field of phenomenological psychopathology, as a crucial element of schizophrenic experience and a characteristic sign of this existential condition. In addition to psychopathology, Professor Sass's contributions are also to be found in the fields of philosophy, psychoanalysis, art, anthropology, and ethnography. He is also interested in the Rorschach test, which he teaches to clinical psychology students at Rutgers University.</div></div><div><h3>Discussion</h3><div>One sentence in this interview neatly sums up Sass's interest in developing original ways of understanding complex phenomena such as psychopathological conditions, but also various forms of literary and artistic expression or, more recently, different ontologies encountered in ethnographic fieldwork: “What interests me is appreciating the sophistication of others who have been seen in an overly simplistic way.”</div></div><div><h3>Conclusion</h3><div>This interview provides an overview of the work of this important author of phenomenological psychopathology.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 332-345"},"PeriodicalIF":0.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spécificités du transfert dans l’autisme. Du cas Dick à la psychanalyse contemporaine avec les autistes 自闭症中移情的特殊性。从迪克到当代自闭症精神分析
IF 0.6 4区 医学
Evolution Psychiatrique Pub Date : 2025-02-06 DOI: 10.1016/j.evopsy.2025.01.005
Myriam Chérel (Maître de conférence en psychopathologie clinique)
{"title":"Spécificités du transfert dans l’autisme. Du cas Dick à la psychanalyse contemporaine avec les autistes","authors":"Myriam Chérel (Maître de conférence en psychopathologie clinique)","doi":"10.1016/j.evopsy.2025.01.005","DOIUrl":"10.1016/j.evopsy.2025.01.005","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this work is to examine the specific features of transference in autism and define the aim of analytic treatments with autistic patients.</div></div><div><h3>Method</h3><div>Based on a literature review of the pioneers of psychoanalysis with autistic children, their conceptions of autism, the richness of their clinical teachings, and the analytic treatments they proposed, we formulate the hypothesis of a specific type of transference in clinical work with autistic children and propose a treatment orientation based on the fact that the analyst centers their intervention on the child's spontaneous solution.</div></div><div><h3>Results</h3><div>We demonstrate that transference in autism is mediated by the autistic double. Through the double, the subject avoids exchange, protects himself/herself from the encounter with the Other, and constructs his/her autistic dynamic. From the clinician's point of view, agreeing to bear the image of a double favors the construction or deployment of a solution specific to the subject, enabling them to inscribe themselves in the world. From then on, the subject can establish his or her construction with the help of a partner. Witnessing and guaranteeing the autistic person's suppletive construction seems to be the major transferential function, while at the same time opposing any outbursts of the drives.</div></div><div><h3>Discussion</h3><div>Our re-reading of the Dick case shows that the particular status of the object for the autistic person is a reference point from which the treatment can be oriented. This case, like other clinical studies, highlights the specific functioning of autistic thought, its subjective dynamics and particular skills, an originality that requires specific treatment directions.</div></div><div><h3>Conclusion</h3><div>Analytical practice with autistic patients, as we see it, is based on the functions of the autistic edge: protection, equipping jouissance, opening up to knowledge. When it's not there from the outset, opposing the outbursts of jouissance seems one of the best ways to provoke its election. Tempering the child's jouissance is also the best way to encourage the unfolding of his or her subjective construction. For analysts who work with autistic people, we recommend allowing oneself to bear the image of a double in order to instill change in the immutable, and a gentle forcing towards a beyond of the double.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 2","pages":"Pages 261-274"},"PeriodicalIF":0.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090549","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}
引用次数: 0
CV2 - editorial board CV2 -编委会
IF 0.6 4区 医学
Evolution Psychiatrique Pub Date : 2025-01-31 DOI: 10.1016/S0014-3855(25)00006-4
{"title":"CV2 - editorial board","authors":"","doi":"10.1016/S0014-3855(25)00006-4","DOIUrl":"10.1016/S0014-3855(25)00006-4","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Page CO2"},"PeriodicalIF":0.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Zoe Chalaux, Multitudes, 2023 Zoe Chalaux, Multitudes, 2023
IF 0.6 4区 医学
Evolution Psychiatrique Pub Date : 2025-01-21 DOI: 10.1016/j.evopsy.2025.01.002
Norbert Godon (Artiste, conférencier)
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