When faced with adolescent scarifications, care providers waver between powerlessness and guilt, sometimes even to the point of acting out their aggressiveness. As a way of getting beyond control issues, group work helps to transform personal questioning into professional questioning. The therapeutic posture then becomes that of a caregiver who is able to put up with failure and hate, to let himself be deformed with being destroyed (or destroying himself), thus supporting the process of separation in adolescence.
The encounter between family and caregivers in psychiatry often has negative aspects for both sides from the start. There is fear on the part of the caregivers that the emotional surge of ambivalence and double binds could disturb a diagnostic and therapeutic practice classically founded on separation, while the family fears guilt-arousing accusation of ill-will that have long served to distance it from therapeutic construction. But an integrative “multi-partner therapy,” in which each of the actors involved must discover their own resources and investigate the mechanisms of their own psychic coherence, has clear benefits, both for the patient’s social prognosis and the prevention of secondary pathologies induced by the suffering of the patient’s family. Still, it is necessary to eradicate the prejudices of the past, which are resistant and insidiously persist in poisoning the natural relations between the inevitable protagonists of any coherent treatment aimed at integration and de-stigmatization.
Psychiatric epidemiology raises a number of problems : the necessary operationalization of what is a mental disorder ; the conceptualization of what constitutes a risk factor, etc. These problems are not entirely solvable, but are nevertheless not enough to hamper the collection and interpretation of results, some of which are presented in this article.
The polemic that certain web sites give rise to is all the more enthralling in that this tool signals a real rupture in the nature of investments between the new generation and the old. The turnabout in identity transmission positions is one of the avatars generated by the invasion of avatars with the family unit. Freud wrote a few words about the telephone at the time of « Civilization and its discontents ». What would he say about Second Life in our « Crisis in the Culture » ?
Since June 2007, a medical-psychological staff (UCSA-SMPR) has been practicing in the juvenile penitentiary of the Rhône-Alpes region. A psychiatrist and a psychologist propose to review this experience as a way of investigating temporal aspects of treatment and the issues specific to this institutional setting. What are the goals of treatment ? How should we conceive of the care-providers’ position within an incarcerating structure, where treatment is supposed to be an « auxiliary » to a repressive disciplinary system ? How can we enable an elaboration of the subject’s and the institution’s acts ? These reflections are at the heart of a practice wherein professional identity is often mishandled. Adolescence, 2013, 30, 4, 869-879.
Revue semestrielle de psychanalyse, psychopathologie et sciences humaines, indexée AERES au listing PsycINFO publiée avec le concours du Centre National du Livre et de l’Université de Paris Diderot Paris 7