Evolution Psychiatrique最新文献

{"title":"Les thérapies d’affirmation de genre : activité médicale et normativation du sujet","authors":"","doi":"10.1016/j.evopsy.2023.10.005","DOIUrl":"10.1016/j.evopsy.2023.10.005","url":null,"abstract":"<div><h3>Goals</h3><p>The objective of this article is to question gender-affirming therapies at the theoretical and clinical levels. They are, in fact, presented in the DSM-5-TR as the only possible therapies for gender dysphoria; we demonstrate that this is questionable from the point of view of the interaction between medical activity and clinical practice with the subject, as well as from the point of view of the evolution of psychopathological models of treatment of gender-related issues, particularly with regard to psychoanalytic data (diagnoses, associated processes and therapies).</p></div><div><h3>Method</h3><p>Our method combines an analysis of the literature and two clinical cases. First, we study diagnostic developments from transsexualism to gender dysphoria in the field of psychopathology and psychoanalysis. Next, we present two clinical cases of patients who have considered or initiated a transition. Then, we study the medical activity involved in gender-affirming care, based on Canguilhem's theses.</p></div><div><h3>Results</h3><p>The DSM-5-TR has a reductive and contradictory conception of dysphoria: it implicitly locates the cause and the solution in the social environment, without taking into account the interaction with the patient. Psychoanalytic theories have, on the contrary, maximized the potential of this interaction, thus making it possible to argue the psychotherapeutic interest of gender reassignment (or affirmation), but also to demonstrate its limits, in particular by taking into account the subjective position of the subject in its psychic structure.</p></div><div><h3>Discussion</h3><p>Reassignment presents itself as a normativation of dysphoria by medical treatments. However, normativation must rather be understood as the process by which subjects establish gender norms that are specific to them and which allow them to treat their dysphoria, by making specific use of medical reassignment protocols. Due to the interaction between subject and environment, normativation is not an adaptation to external or social reality, but implies that the latter is also modified by the former.</p></div><div><h3>Conclusion</h3><p>We cannot therefore subscribe to the thesis of the DSM-5-TR according to which dysphoria has only one possible predefined, systematic, and general treatment. The internal clinical dimension of medical activity assumes that the suffering of patients precedes the formalization that can be made of it, and that medical tools are designed and applied secondarily to a diversity of psychopathological configurations. This is also what the cases and the history of the ideas and practices presented demonstrate. The standardization of patients applies to their environment including therapies, which therefore should be modified and diversified.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 3","pages":"Pages 477-496"},"PeriodicalIF":0.6,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139638424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autisme et médiation thérapeutique musicale immersive : l’espace comme composante du timbre","authors":"Frédéric Vinot (Maître de Conférences HDR en Psychologie Clinique) ,&nbsp;Michel Pascal (Professeur en composition de musique électroacoustique) ,&nbsp;Virginie Cayla (Psychologue Clinicienne)","doi":"10.1016/j.evopsy.2023.11.004","DOIUrl":"10.1016/j.evopsy.2023.11.004","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of this article is to highlight the clinical effects of an immersive music device used as a therapeutic mediator with autistic children. As musical immersion is based on the hypothesis that space is a component of timbre, the aim is to bring together in a novel way two major problematic issues in autism: space and voice. To do this, post-Freudian and Lacanian psychoanalytical references are mobilized and discussed.</p></div><div><h3>Method</h3><p>After a technical presentation of the immersive device and an explanation of the spatial and aesthetic characteristics of the works played on it, the authors describe the clinical case of an 11-year-old autistic child and identify the different stages of the relationship. The initially observed effects of containment were quickly limited, and the child almost rejected the system. It was only during a work based on different spatializations of a voice that the child was able to reengage with the device and with the relationship with the caregiver as “a double,” going so far as to invent games that included him. To shed light on the subjectivizing effects of these sessions, the authors first recall the specific relationship that the autistic subject has with the voice as an “a object,” relying in particular on the notion of “delocalization of the voice,” which is active in all devices for distancing the timbre, the latter being understood as one of the names of the Real of the voice. The article goes on to describe in detail the spatial characteristics of the work to which the child was so sensitive in renewing his relationship with the other. After analysis, the work in question turns out to be composed not of a single unified or unifying space, but of several sound spaces, sometimes broadcast simultaneously.</p></div><div><h3>Results</h3><p>The notion of the delocalization of the voice is then confronted with the fact that the work of immersive music can offer much more than a simple point of delocalization of the voice in the same space: it offers the experience of several simultaneous sound spaces, which we call a “delocalization of the delocalization of the voice,” making it possible to relieve the autistic subject of what Lacan called the “real weight of the subject” implied by the voice object.</p></div><div><h3>Discussion</h3><p>The article raises several points for discussion: firstly, immersive musical works should not be considered as recreating a realistic sound environment (of the virtual reality type), but rather as proposing impossible sound spaces. In this respect, there are both aesthetic and ethical issues at stake in the clinical use that can be made of these immersive musical devices. Moreover, the construction of autistic space is not just a matter of the gaze but also of the voice in its impulsive dimension. Finally, the “delocalization of the delocalization” of the voice would enable the autistic subject to experience the atopic part of it, i.e. its","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 2","pages":"Pages 267-282"},"PeriodicalIF":0.6,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grand entretien avec François Laplantine","authors":"François Laplantine (Anthropologue, professeur émérite des universités) ,&nbsp;Anne Brun (Professeur de psychopathologie et de Psychologie clinique à l’université Lumière Lyon 2, Psychanalyste SPP) ,&nbsp;Olivier Douville (Psychanalyste, maître de conférences des universités)","doi":"10.1016/j.evopsy.2023.12.003","DOIUrl":"10.1016/j.evopsy.2023.12.003","url":null,"abstract":"<div><h3>Objective</h3><p>Based on an interview with François Laplantine, anthropologist and professor emeritus at the University Lumière Lyon 2, the aim is to explore the main milestones in his career, from the philosophy of evil to the anthropology of illness and ethnopsychiatry, in particular psychoanalytic ethnopsychiatry, then from work on Brazil and Japan to a focus on the theme of artistic creation.</p></div><div><h3>Method</h3><p>The method consists of an interview with François Laplantine. The questions deal first with his personal background, then with the reasons for the evolution of the themes on which his works are based, and finally with his exploration of various fields of creation: literature, cinema, theatre and contemporary dance.</p></div><div><h3>Results</h3><p>François Laplantine describes his transition from the philosophy of evil, with his first thesis in philosophy under the supervision of Paul Ricœur, to the anthropology of illness, with his encounter with Devereux. He describes his work on the question of métissages, then his transition from psychoanalysis to an initiation into Candomblé in Brazil, a practice of the multiple that he likens to different forms of theatre in France. He then traces the evolution of his writings from his explorations in Brazil and Japan to artistic creation, particularly literature, music, dance, and film. He discusses the work of many artists, as well as different types of staging of disasters, particularly minimalist stagings in Japanese theatre, with nō and butô. The question of language, of the unspeakable and the invisible, appears central to his work in relation to creation. He also discusses his work on the imaginary and the off-screen, as well as on time and space, in relation to the issue of creation.</p></div><div><h3>Discussion</h3><p>François Laplantine defends the idea that one of the missions of contemporary arts is to attempt to express catastrophe; he explores the limits of language and argues that one of the functions of theatre, and even more so of contemporary dance, is to stage the drama of the inadequacy of language. Recourse to artistic creation is a necessity, in the tension between telling and showing.</p></div><div><h3>Conclusion</h3><p>Exploring artistic creation appears to be a royal road for an anthropologist like François Laplantine.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 1","pages":"Pages 106-118"},"PeriodicalIF":0.6,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139633529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analyse du processus créatif en photographie et son implication clinique en photo-thérapie","authors":"Déborah Leroux (doctorante contractuelle, chargée de cours)","doi":"10.1016/j.evopsy.2023.12.002","DOIUrl":"10.1016/j.evopsy.2023.12.002","url":null,"abstract":"<div><h3>Context</h3><p>The author, a photographer and photo-therapist, tries to develop a new therapeutic approach based on the photographic act.</p></div><div><h3>Aims</h3><p>This article aims to examine the psychic processes involved in the dynamics of taking photos and to explore what can be done with the photographic medium in clinical practice.</p></div><div><h3>Method</h3><p>We will listen to the photographic works of the famous Japanese photographer Hiroshi Sugimoto to see what they say about clinical work involving photo-therapy.</p></div><div><h3>Results</h3><p>During his artistic practice, Hiroshi Sugimoto summons up memory traces related to his own history and that of his ancestors and updates them in his photos. He experiences all kinds of bodily sensations and hallucinations. His photos are already within him in the form of inner visions, even before he has expressed them materially. The elaborative transposition of the inner image, which has become pre-conscious, takes place in a very specific material: his antique medium-format camera and his special lighting not only serve to create an atmosphere, but also to take him on a journey through the history of humanity and his own inner history. He comes to identify completely with his camera, which helps to plunge him into a state of fusion with the object being photographed.</p></div><div><h3>Discussion</h3><p>During his creative process, the photographer goes through phases similar to those that the baby goes through during his development, in an attempt to achieve a (re)actualization of the self: alternating phases of integration and non-integration of the self with more or less chaotic regressive phenomena, a primary identification with a quasi-fusional state between the photographer and the camera and between the photographer and the photographed object, the mobilization of bodily sensations and a return to a state of fluidity in the gaze and gesture.</p></div><div><h3>Conclusions</h3><p>In photo-therapy, this re-actualization of the self is sought and the creative process in photography seems to contribute to this to a certain extent. The regressive states accompanied by bodily sensations, that is to say, this state of pathos that runs through the photographing patient, can, in the aftermath, restore movement in the psyche and bring back to life certain aspects that had not been (sufficiently) represented. The inner images of the psyche are expressed in the form of material external photos but this fixation allows the initial inner image to be reworked in a retroactive loop, and thus to reshape the psyche, through the body. The camera, which has the particularity of being both the tool and the surface of inscription, becomes part of the body of the photographer-patient. The transference is thus diffracted between the analyst and the photographic medium. From the subjectivity of the photographing subject and that of the photographed object, a third subjectivity is created, a kind ","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 1","pages":"Pages 87-105"},"PeriodicalIF":0.6,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139456039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Une belle articulation entre neurosciences et psychopathologie transférentielle. À propos de … « Tact-pulsion. La mémoire de forme de notre psychisme » de Régine Prat","authors":"Pierre Delion (Professeur émérite de pédopsychiatrie, praticien hospitalier honoraire, psychanalyste)","doi":"10.1016/j.evopsy.2023.09.006","DOIUrl":"10.1016/j.evopsy.2023.09.006","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 1","pages":"Pages 174-176"},"PeriodicalIF":0.6,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139391662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Le passage à l’acte suicidaire dans sa dimension perverse, analyse d’un cas clinique","authors":"Francesca Melas (Médecin, Assistante en psychiatrie à l’Université Catholique de Louvain) ,&nbsp;Sylvain Dal (Médecin psychiatre)","doi":"10.1016/j.evopsy.2023.11.003","DOIUrl":"10.1016/j.evopsy.2023.11.003","url":null,"abstract":"<div><h3>Objective</h3><p>The notions of psychosis, neurosis, and perversion structured clinical thought during the golden age of psychoanalysis. But, even if psychosis and neurosis are still an integral part of our medical vocabulary, perversion, on the other hand, has become a forgotten or even obsolete concept. However, some mechanisms of interaction between patients and more precisely some suicide attempts seem to be significantly related to it. In this article, we offer the reader a second look at this clinical perversion.</p></div><div><h3>Methodology</h3><p>This article aims to study some perverse mechanisms that are present in clinical work with suicidal patients and to establish a current, historical, and non-exhaustive definition that will answer the following question: “can a suicide attempt be thought of as a perverse act in its address to the therapist?” The theoretical input will be supported by a preliminary clinical illustration about the hospital and ambulatory monitoring of a young patient.</p></div><div><h3>Results</h3><p>When suicidal acting out takes on a special meaning addressed to the therapist and allows the patient to seize power in the therapeutic relationship, we can clearly see the characteristics of perversion.</p></div><div><h3>Discussion</h3><p>A cautious approach should be adopted about this proposition: not all suicidal acts are to be associated without nuance with perversion. Similarly, it is up to the therapist to understand the mechanisms developed by the patient in the therapeutic relationship and to make them the object of shared therapeutic work.</p></div><div><h3>Conclusion</h3><p>This article offers the reader a theoretical and clinical approach to the suicidal act in patients whose psychic structure can be considered perverse. It allows us to: differentiate between addressed and un-addressed suicidal acts, acknowledge the resulting clinical difficulties, and explore avenues about the monitoring of patients after a suicide attempt.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 2","pages":"Pages 249-265"},"PeriodicalIF":0.6,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139018920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Les pratiques de soin énergétique en France : phénoménologie et processus psychiques dans les thérapies alternatives","authors":"Samuel Caussié (Psychologue clinicien, Docteur en psychologie clinique) ,&nbsp;Thomas Rabeyron (Professeur de psychologie clinique et psychopathologie, Psychologue clinicien)","doi":"10.1016/j.evopsy.2023.11.002","DOIUrl":"10.1016/j.evopsy.2023.11.002","url":null,"abstract":"<div><h3>Aims</h3><div>In this paper, we look at energy healing, a relatively under-studied therapeutic approach in France, despite its strong influence on a wide variety of complementary and alternative therapies. This article attempts to clarify the reasons for the success of these approaches by analyzing the psychic processes inherent in them.</div></div><div><h3>Method</h3><div>Twenty-five therapists (energy therapists, magnetic healers, alternative therapists) were recruited to take part in several semi-directive interviews focusing on the phenomenology of energy healing. The corpus of data was analyzed using a psychoanalytical approach in order to highlight the specific features of these practices.</div></div><div><h3>Results</h3><div>Energy healing is a set of therapeutic practices with heterogeneous methods based on the representation of a vital energy. These practices are frequently used in contexts of “ordinary misfortune” that combine persistent somatic symptoms, psychological suffering, and critical stages in life. The practice and effectiveness of energy healing seem to be based on unconscious psychic processes. These processes encourage the emergence of non-ordinary states of consciousness that potentiate processes of psychic transformation. In some aspects, this setting could be compared to a form of mediation in which the therapist uses body and object manipulations to induce psychic effects.</div></div><div><h3>Discussion</h3><div>The apparently “magical” nature of these therapies polarizes the scientific and media debate around the way in which they do or do not comply with the requirements of evidence-based medicine. The model proposed in this article allows us to move away from these issues and take into account the anthropological aspects of alternative therapeutic systems.</div></div><div><h3>Conclusion</h3><div>The approach developed in this article extends and opens up clinical research on exceptional experiences, by showing that the study of alternative therapies, when it is not solely centered on the question of specific proof of efficacy, offers a fruitful perspective for making more explicit the processes of the caregiving relationship.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 4","pages":"Pages 597-610"},"PeriodicalIF":0.6,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139025213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pouvoir ou ne pas pouvoir être jaloux. À propos de … « Les bienfaits de la jalousie » sous la direction de Catherine Chabert et Estelle Louët","authors":"Manuella De Luca (Professeur, Responsable du pôle de psychiatrie et de psychopathologie de l’adolescent et du jeune adulte)","doi":"10.1016/j.evopsy.2023.05.001","DOIUrl":"10.1016/j.evopsy.2023.05.001","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 1","pages":"Pages 167-173"},"PeriodicalIF":0.6,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139024354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pourquoi les convictions morales facilitent le dogmatisme, l’intolérance et la violence","authors":"Professor Jean Decety","doi":"10.1016/j.evopsy.2023.11.001","DOIUrl":"10.1016/j.evopsy.2023.11.001","url":null,"abstract":"<div><h3>Objectives</h3><p>This theoretical essay attempts to explain, from an interdisciplinary naturalistic perspective that integrates the biological and social sciences, why and how beliefs associated with moral values can lead to dogmatism, intolerant opinions and attitudes, and can motivate violent collective actions.</p></div><div><h3>Method</h3><p>The article relies on an integrative analysis of the empirical literature, drawing on 138 articles (78% published in the last eight years) in anthropology, neuroscience, psychology, political science, and sociology to explain <em>why</em> and <em>how</em> moralization strongly increases the strength of beliefs and attitudes – in certainty and importance – which, in turn, motivates social engagement and induces attitudinal extremism regardless of ideological or political affiliation.</p></div><div><h3>Results</h3><p>Moral convictions are perceived as objective, absolute, necessary, universal, and infallible truths with strong links to emotions, the reward circuit, and the value system in the brain that motivates and controls behavior. Moral values are generally shared with other members of one's community and, therefore, linked to social identity. Perceived social consensus is an important input to objectivity. Objectively grounded moral principles generate an expectation of consensus, which can lead to intolerance and hostility regarding anyone who disagrees. Moral convictions motivate participation in collective action and inspire the courage to oppose perceived injustices, real or imagined, despite a personal cost. Cognitive rigidity is often a characteristic of moral convictions. Once an issue is moralized and considered objective, whether in the social, economic, or political domains, it is more likely to be perceived as an absolute belief, held with high confidence, and immune to corrective information. People who are highly confident in their beliefs are more prone to confirmation bias, making them dogmatic with a sense of moral superiority and less willing to seek or consider corrective information regardless of the accuracy of their beliefs. Specific neural signatures and low-level cognitive dispositions are reliably associated with personality orientations prone to political and social dogmatic attitudes.</p></div><div><h3>Discussion</h3><p>Opinions and attitudes, when moralized, can easily make people dogmatic and intolerant. Moral convictions can serve as mandates that facilitate political activism with extreme and often negative views. The conjunction of moral conviction and identity-based ideology is largely responsible for driving the contemporary hostile affective polarization of opinions. The lack of cognitive flexibility explains the failure to update, calibrate, and discard previous beliefs. This metacognitive overconfidence contributes to a dispositional tendency toward dogmatic intolerance. This makes it easier for people who are extreme in their political attitudes, regardle","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 2","pages":"Pages 227-248"},"PeriodicalIF":0.6,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138616764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crise sanitaire et soins psychiques pour les enfants. Une étude psycho-sociologique au CMP","authors":"Yann Craus (pédopsychiatre) ,&nbsp;Carole Blanc (psychologue clinicienne) ,&nbsp;Patricia Luthin (psychologue clinicienne) ,&nbsp;Yann Diener (psychologue clinicien) ,&nbsp;Hélène Gombeaud (orthophoniste) ,&nbsp;Estela Roitman (psychomotricienne) ,&nbsp;Eddy Raynal (psychomotricien) ,&nbsp;Véronique Durousseau (orthophoniste) ,&nbsp;Sandrine Deloche (pédopsychiatre) ,&nbsp;Aude Béliard (maîtresse de conférences en sociologie) ,&nbsp;Jean-Sébastien Eideliman (maître de conférences en sociologie) ,&nbsp;Thibaud Pombet (maître de conférences en sociologie) ,&nbsp;Livia Velpry (maîtresse de conférences en sociologie)","doi":"10.1016/j.evopsy.2023.10.006","DOIUrl":"10.1016/j.evopsy.2023.10.006","url":null,"abstract":"<div><h3>Objectives</h3><p>In this article, we present the results of a research project conducted jointly by professionals from a child and adolescent mental health center (CMP) and sociologists. We explore how the first confinement (in the spring of 2020) affected the situation of the child patients at the CMP and their families, as well as the care practices of the professionals.</p></div><div><h3>Methods</h3><p>The study was implemented in May 2020. Nine mental health professionals (psychologists, child psychiatrists, speech therapists, psychomotor therapists, social worker) were invited either to write a text reflecting on their experience, or to participate in an interview with one of the four sociologists. In both cases, the suggestion was to describe clinical situations, focusing both on social and psychological aspects, and to formulate ideas on the effects of confinement based on these clinical examples, while preserving the anonymity of the patients. Following this phase, the mental health team and the sociologists met several times to collectively discuss the content of these texts and to elaborate a reflection at a more general level that resulted in this article.</p></div><div><h3>Results</h3><p>This research illustrates some effects of the Covid-19 crisis on children and families, notably the reinforcement of social inequalities, as witnessed by mental health care professionals. It also documents the adaptations of care practices (e.g. remote consultations) during this period, as well as the multiple questions that professionals had to address.</p></div><div><h3>Discussion</h3><p>Regarding the situations of the children and their families, the data collected reveal that social inequalities have been exacerbated by the context of the pandemic, but it also underscores how certain factors (type of housing, family configurations, individuals’ relationships with academic and public health norms) may have contributed to differences between families from similar socio-professional categories. Regarding mental health care, it appears that guaranteeing the continuity of the relationship with the child and/or the family was a crucial concern for the professionals. As face-to-face appointments were limited, practices arose that were not seen as options in the usual work environment and habits, such as phone consultations. Professionals questioned the effects and stakes of these remote encounters and were forced to reposition themselves clinically and therapeutically.</p></div><div><h3>Conclusion</h3><p>This research experience encourages us to renew this type of study, because of the richness of the results produced by an analysis associating professionals and sociologists, but also because of its contribution to the mental health team's capacity to reflect critically on its own practices.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 2","pages":"Pages 189-204"},"PeriodicalIF":0.6,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138618973","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}