Dispositif « groupe de passage » auprès de patients exilés et migrants : intérêts et limites

Objectives

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.

Method

The method employed is participant observation of a group established with immigrant subjects.

Results

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.

Discussion

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.

Conclusion

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 in transition” represents an attempt to open certain potentialities but also possesses some limitations. The exploration of a form of sensory transference and the use of mediating objects seem promising, as they initiate a transference dynamic that is difficult to mobilize. However, it appears that the use of the group needs further consideration to enable the overcoming of certain resistances.